Objective To investigate the effect of mulberry anthocyanin on the morphology and func-tion of vascular endothelial cells(VEC)and its possible mechanism at the level of autophagy.Methods VEC were cultured in vitro and divided into 5.5/0 mmol/L control group,11/0.125,22/0.250,33/0.500,44/1.000,55/2.000 mmol/L high glucose/high fat groups.The cell functional levels and autophage levels in each group were detected.The optimal high glucose/high lipid concentration was selected as the VEC function inju-ry model group.10,25,50 μmol/L mulberry anthocyanins were added into the model group for processing and divided into the low,middle and high concentrations of mulberry anthocyanin groups.The effects of mulberry anthocyanin on the morphology,function and autophagy of VEC in high sugar and high fat stress were ob-served.Then the autophagy regulator(rapamycin)was added to study its action mechanism.HE staining was used to observe the number and morphology of cells,the CCK-8 assay was used to detect the viability of VEC,the flow cytometry was used to detect the level of reactive oxygen species(ROS)in VEC,the Western blot was used to detect the expression level of Beclin-1 and p62 proteins in VEC,and the kit method was used to detect the level of nitric oxide(NO)and endothelin-1(ET-1)in VEC.Results Compared with the control group,the number and morphology of cells in the middle and high concentrations of high glucose/high fat groups were changed,the cell viability,p62,NO levels were significantly decreased(P<0.05),while the ROS,ET-1,and Beclin-1 expression levels were increased significantly(P<0.05).Compared with the model group,the number of cells in the mulberry anthocyanin groups was increased,morphology was improved,the cellular viability,p62 and No levels were significantly increased,and ROS,Beclin-1 and ET-1 levels were significantly decreased(P<0.05).Compared with the high concentration mulberry anthocyanin group,the cells number was decreased af-ter adding rapamycin,the morphology changed to be irregular,the NO level was decreased,and the ET level was increased(P<0.05).Compared with the control group,the p-phosphatidylinositol 3-kinase(PI3K)and p-protein kinase B(Akt)relative expression levels in the model group were significantly decreased(P<0.05);compared with the model group,the p-PI3K and p-Akt relative expression levels in the high concentration mulberry anthocyanin group were significantly increased(P<0.05).Conclusion Mulberry anthocyanin could in-hibit autophagy by activating the PI3K/Akt/mammalian target of rapamycin(mTOR)signaling pathway and improve the morphology and function of VEC under high glucose and lipid stress.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To explore the correlation between the proximal angle of carotid atherosclerotic plaques and neovascularization scores,and their clinical application value in predicting recurrent cerebral infarction.Methods A total of 88 patients who underwent carotid plaque ultrasound examination in our hospital were selected.According to CT/MRI results,patients were divided into the non-cerebral infarction group(45 cases)and the cerebral infarction group(43 cases).Conventional ultrasound examination was performed followed by contrast-enhanced ultrasound.Plaque length,thickness and proximal angle were measured,and the neovascularization score of the proximal end was evaluated using contrast-enhanced ultrasound,and the results were compared and analyzed.Results In the cerebral infarction group,plaque thickness,proximal angle,and neovascularization score were significantly higher than those in the non-cerebral infarction group(P＜0.05),while there was no significant difference in plaque length.The proportion of plaques with a proximal neovascularization score of 2 or 3 was higher in the cerebral infarction group than those of the non-cerebral infarction group(79.1%vs.24.4%,P＜0.01).A positive correlation was found between the proximal angle and neovascularization score in all patients(rs=0.374,P＜0.01).There was no significant difference between the area under the ROC curve for neovascularization score in predicting recurrent cerebral infarction and the proximal angle(P＞0.05).The optimal cutoff value of the proximal angle was 18.8,and the sensitivity and the specificity for predicting recurrent cerebral infarction were 93.0%and 62.2%.In the cerebral infarction group,seven patients(16.3%)had recurrent infarction within one year,and these patients had higher proximal neovascularization scores,with angles greater than 18.8°.Conclusion There is a strong correlation between proximal angle of carotid plaques and neovascularization score,which has a positive predictive role in the recurrence of cerebral infarction,providing a reliable auxiliary diagnostic basis for clinical practice.

Objective To explore the correlation between the proximal angle of carotid atherosclerotic plaques and neovascularization scores,and their clinical application value in predicting recurrent cerebral infarction.Methods A total of 88 patients who underwent carotid plaque ultrasound examination in our hospital were selected.According to CT/MRI results,patients were divided into the non-cerebral infarction group(45 cases)and the cerebral infarction group(43 cases).Conventional ultrasound examination was performed followed by contrast-enhanced ultrasound.Plaque length,thickness and proximal angle were measured,and the neovascularization score of the proximal end was evaluated using contrast-enhanced ultrasound,and the results were compared and analyzed.Results In the cerebral infarction group,plaque thickness,proximal angle,and neovascularization score were significantly higher than those in the non-cerebral infarction group(P＜0.05),while there was no significant difference in plaque length.The proportion of plaques with a proximal neovascularization score of 2 or 3 was higher in the cerebral infarction group than those of the non-cerebral infarction group(79.1%vs.24.4%,P＜0.01).A positive correlation was found between the proximal angle and neovascularization score in all patients(rs=0.374,P＜0.01).There was no significant difference between the area under the ROC curve for neovascularization score in predicting recurrent cerebral infarction and the proximal angle(P＞0.05).The optimal cutoff value of the proximal angle was 18.8,and the sensitivity and the specificity for predicting recurrent cerebral infarction were 93.0%and 62.2%.In the cerebral infarction group,seven patients(16.3%)had recurrent infarction within one year,and these patients had higher proximal neovascularization scores,with angles greater than 18.8°.Conclusion There is a strong correlation between proximal angle of carotid plaques and neovascularization score,which has a positive predictive role in the recurrence of cerebral infarction,providing a reliable auxiliary diagnostic basis for clinical practice.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To discuss the application of whole-process high-quality nursing intervention in patients with fatal bleeding.Methods A total of 196 patients with fatal bleeding,who were treated at the Hunan Provincial People's Hospital of China from January 2018 to January 2020,were collected as the control group,and other 200 patients with fatal bleeding,who were treated at the Hunan Provincial People's Hospital of China from February 2020 to February 2022,were collected as the observation group.The patients of control group received traditional nursing intervention,while the patients of observation group received whole-process high-quality nursing intervention,which was established on the basis of MEWS scoring,SBAR handover mode,and medical-nursing group responsibility system management.The incidence of complication,mortality,total length of ICU stay,quality of medical care service(including incidence of adverse nursing events and patient satisfaction with nursing care)were compared between the two groups.Results The incidence of complications,mortality,incidence of adverse events in the observation group were lower than those in the control group(all P＜0.05),and the total length of ICU stay in the observation group was shorter than that in the control group(P＜0.05).The patient satisfaction with nursing care in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(P＜0.05).Conclusion The implementation of whole-process high-quality nursing intervention,which is established on the basis of MEWS scoring,SBAR handover mode,and medical-nursing group responsibility system management,can significantly improve the success rate of treatment for patients with fatal bleeding,reduce the incidence of adverse events,improve the prognosis and the patient satisfaction with nursing work.

Background/Aims: The histological characteristics and natural history of precirrhotic primary biliary cholangitis (PBC) with portal hypertension (PH) are unclear. Our aim was to clarify the prevalence, risk factors, and histological characteristics of precirrhotic PBC patients with PH. Methods: This retrospective study compared the clinical features, histological characteristics, and response to ursodeoxycholic acid (UDCA) between the PH and non-PH groups of precirrhotic PBC patients. Results: Out of 165 precirrhotic PBC patients, 40 (24.2%) also had PH. According to histological stage 1, 2 and 3 disease, 5.3% (1/19), 17.3% (17/98), and 45.8% (22/48) of patients also had PH, respectively. Precirrhotic PBC with PH was significantly positively correlated with bile duct loss, degree of cytokeratin 7 positivity, and degree of fibrosis in the portal area, but significantly negatively correlated with lymphoid follicular aggregation. Compared to the non-PH group, patients in the PH group showed a higher prevalence of obliterative portal venopathy, incomplete septal fibrosis, portal tract abnormalities and non-zonal sinusoidal dilatation (p<0.05). In addition, patients with PH were more likely to present with symptoms of jaundice, ascites, epigastric discomfort, a poorer response to UDCA, and more decompensation events (p<0.05). High alkaline phosphatase levels, low white blood cell counts, high Mayo scores, and high FIB-4 index values were risk factors for precirrhotic PBC with PH. Conclusions Approximately 24.2% of precirrhotic PBC patients have PH, which is histologically related to the injury of bile ducts. High alkaline phosphatase levels, low white blood cell counts, high Mayo scores, and high FIB-4 index values are associated with increased risk of precirrhotic PBC with PH.

【Objective】 To investigate the frequency of P1PK and GLOB blood group in Chinese Lahu population and their genetic status, so as to provide data support for the safety of blood transfusion and give advice and transfusion guidance for pregnant women. 【Methods】 Unrelated individuals of Chinese Lahu population were randomly selected for serological identification of P1PK and P blood group and gene sequencing analysis. The frequency of P1PK and GLOB blood group were analyzed. 【Results】 Six cases of anti-PP 1P^k(formerly known as anti-Tj^a) negative blood type were identified as the rare P1-PK-P- blood type (formerly known as Tj^a- blood type or p blood type, hereinafter referred to as p blood group) from 300 Lahu population, with phenotypic frequency of p blood group in P1PK and GLOB blood group system in Lahu population at 2.0%(6/300). 【Conclusion】 The phenotypic frequency of blood group p in Lahu population was significantly higher than that in Europe (5.8 persons per million) and Hong Kong, China (1 person per million),indicating significant ethnic specificity and regional ethnic differences.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.