Objective To establish an acute rejection model of cervical heart transplantation in mice and evaluate the survival and dynamic rejection process post-transplantation. Methods Mice were randomly divided into sham operation group (n=10), syngeneic transplantation group (n=21), and allogeneic transplantation group (n=65). Sham operation, syngeneic cervical heart transplantation, and allogeneic cervical heart transplantation were performed respectively. The survival of recipient mice and grafts, histopathological changes of graft tissues, subpopulations of splenic lymphocytes, and expression of inflammatory factors in serum and grafts were observed. Results The survival rate and graft survival rate of the sham operation group and syngeneic transplantation group were 100% at 7 days after surgery. In the allogeneic transplantation group, 5 cases failed and died on the first day after surgery. The survival rate at 7 days after surgery was 86%, and all surviving mice had grafts that stopped beating at 7 days after surgery. The allogeneic transplantation group showed significant rejection at 7 days after surgery, accompanied by tissue damage and CD8⁺ T cell infiltration. The proportion of CD8⁺ T cells in the spleen continued to rise post-operation, while the proportion of CD4⁺ T cells showed a downward trend. The expression of interferon-γ in serum and grafts peaked at 5 days after surgery, while the expression of tumor necrosis factor-α showed no statistical significance. Conclusions Acute rejection following heart transplantation in mice intensifies between 5 to 7 days after surgery, which may be a critical time window for immunological intervention.

Objective To investigate the relationship between primary pulmonary mucinous adenocarcinoma (PPMA) mass type and pneumonia type and their difference in malignant degree, and to analyze the role of clinical manifestations and CT features in the diagnosis of this disease. Methods The clinical data of PPMA patients admitted in the First Affiliated Hospital of Xiamen University from May 2011 to March 2022 were retrospectively analyzed. According to CT features, they were divided into a mass type group and a pneumonia type group. The clinical manifestations, CT features and the degree of malignancy between the two groups were analyzed and compared. Results A total of 57 PPMA patients were enrolled. There were 17 males and 40 females, with an average age of (53.82±10.65) years, and 28 (49%) patients had reversed hato-like sign. There were 42 patients in the mass type group and 15 patients in the pneumonia type group. PPMA often occurs in both lower lungs, with clinical manifestations mainly of coughing and expectorating white mucoid sputum. There were statistical differences between the two groups in the maximum diameter of tumor (P<0.001), boundary condition (P<0.001) and pleural indentation sign (P=0.019). There was no statistical difference between the two groups in Ki-67 index (P>0.05). Conclusion There is no statistical difference in the degree of malignancy between the two types of PPMA. Considering their clinical manifestations and differences in imaging features, it is supported that the pneumonia type is just a progression of the mass type. CT can present various manifestations, among which the reversed hato-like sign is expected to become an important imaging feature. Combined with a high proportion of solid components, pleural indentation sign, and vacuole sign, reversed hato-like sign can play a significant role in the diagnosis of PPMA.

Objective The purpose of this article is to summarize and review the current status of the construction of clinical research evaluation systems in domestic public hospitals,identify existing problems in the evaluation system,and propose development strategies and suggestions.Methods Retrieved relevant articles,dissertations and policies from the past five years(2018-2022),screened the titles,viewed the full texts of 52 selected papers and their references,and summarized them.Results The"five-only"indicators have long been an important indicator for evaluating clinical research in public hospitals,but in today's scientific research environment and policy environment,the"five-only"evaluation system has revealed its utilitarian draw-backs and gradually evolved into a hindrance to scientific research.It is urgent to break through the"five-only"orientation and establish a clinical research evaluation system oriented towards"transforming and applying transformation of scientific research achievements".Conclusion The evaluation system for clinical research should break the previous"five-only"evaluation model based on quantity-oriented scientific research evaluation.We can draw on the framework of the research output,influence,and environment indicators in the UK's REF Excellence Framework model,combine the American APT system and the Chinese STEM indicator dimensions,explore multi-outcome evaluation,integrate developmental indicators,and continuously improve the indica-tor system and application methods in practice to promote the development of clinical research in public hospitals.

Objective To investigate the effect of cysteine-rich acidic secretory protein-like protein 1(SPARCL1)on atherosclerosis(AS)plaque formation.Methods A case-control study design was used,394 patients with con-firmed AS were selected as the case group,and 394 healthy medical examiners matched for age and gender were se-lected as the control group.The expression level of serum SPARCL1 was determined by enzyme-linked immunosor-bent assay;immunohistochemistry was used to assess the expression level and localization of SPARCL1 protein in the AS plaque region,and the expression of SPARCL1 protein was also detected in the neutrophils and monocytes of peripheral blood of AS patients and normal controls;SPARCL1 overexpressing and the recombinant adenoviral vec-tors were constructed to inhibit SPARCL1 overexpression and expression,and the effects of SPARCL1 on cell mi-gration were observed in the cell scratch assay using mouse macrophage cells(J774A.1)as target cells.Results Serum SPARCL1 levels in the AS patient group were lower than those in the healthy group(P<0.05);high SPARCL1 expression was detected in AS plaques and was mainly expressed in the cytoplasm of foamy cells;SPARCL1 expression levels in peripheral blood neutrophils and monocytes were lower than those in normal controls in AS patients(P<0.05);recombinant SPARCL1 overexpression and inhibition of expression of adenovirus was successfully constructed;the cell migration rate was decreased in J774A.1 cells that inhibited SPARCL1 expression and increased in J774A.1 cells that overexpressed SPARCL1(P<0.05).Conclusion SPARCL1 is highly ex-pressed in foam cells at the site of AS lesions,which may result from compensatory recruitment of peripheral blood monocytes and neutrophils,and SPARCL1 may be involved as a protective factors for blood vessels in inhibiting the development of AS plaques.

Objective To explore the cerebral cortex activation in different swallowing periods using functional near-infrared spec-troscopy(fNIRS). Methods From October to December 2023,a total of 18 healthy adults were recruited to perform four tasks of visual stimulation,chewing,tongue tip sliding and repeated swallowing during fNIRS acquisition,to calculate the corti-cal activation β values covering a total of 41 channels in frontal,parietal and occipital lobes. Results During the preoral period,the bilateral pre-motor and supplementary motor cortex(PSMC),bilateral inferior pre-frontal gyrus,right visual association cortex(AVC),and left primary motor cortex(PMC)were significantly acti-vated(P<0.05).During oral preparation,the right pars triangularis(PTG),right frontal polar area(FPA),right dorsolateral prefrontal cortex(DPC),left primary somatosensory cortex(PSC),left PSMC and left PMC were sig-nificantly activated(P<0.05).During the transition between oral and pharyngeal phases,bilateral PSMC and bi-lateral PMC were significantly activated(P<0.05).Bilateral PSC,bilateral PTG,bilateral FPA,bilateral orbito-frontal area,bilateral PSMC,bilateral DPC and bilateral PMC were significantly activated during two consecu-tive periods of oral and pharyngeal phases(P<0.05). Conclusion The swallowing movement requires the coordination of the frontal,parietal and occipital cortex.The main activated brain areas are different in different swallowing stages,and the PSMC and PMC are involved in most swallowing stages.

Objective To observe the effects of Gegen Qinlian Decoction on pancreatic endoplasmic reticulum stress in mice with type 2 diabetes mellitus(T2DM);To explore its mechanism of action in the treatment of T2DM.Methods Totally 75 SPF male db/db mice were randomly divided into model group,metformin group,and Gegen Qinlian Decoction high-,medium-,low-dosage groups,with 15 mice in each group.15 db/m mice were set as the blank group.The administration groups received corresponding medicine for gavage for 12 weeks.Body mass,fasting blood glucose(FBG)and glycated hemoglobin(HbA1c)in mice were detected,HE staining was used to observe the pathological changes of pancreatic tissue,the apoptosis of islet cells was determined by TUNEL staining,Western blot was used to detect pancreatic tissue glucose regulatory protein 78(GRP78),protein kinase R-like endoplasmic reticulum kinase(PERK),p-PERK,activated transcription factor 4(ATF4)and C/EBP homologous protein(CHOP)protein expression,RT-PCR was used to detect pancreatic tissue PERK,ATF4,CHOP mRNA expressions.Results Compared with the blank group,the body mass,FBG and HbA1c contents in the model group significantly increased(P<0.01);the pancreatic tissue structure was incomplete,with blurry boundaries and vacuoles inside,leading to a significant increase in pancreatic islet cells apoptosis(P<0.01);the expressions of GRP78,p-PERK,ATF4,and CHOP proteins in pancreatic tissue significantly increased(P<0.01),and the mRNA expressions of PERK,ATF4 and CHOP significantly increased(P<0.01).Compared with the model group,the body mass,FBG and HbA1c contents of mice in each administration group significantly decreased(P<0.05,P<0.01);pathological changes in pancreatic tissue was reduced,and islet cells apoptosis decreased to varying degrees(P<0.05,P<0.01);the expressions of GRP78,p-PERK,ATF4 and CHOP proteins in pancreatic tissue significantly decreased(P<0.01)in Gegen Qinlian Decoction high-and medium-dosage groups and the metformin group,and the expressions of PERK,ATF4 and CHOP mRNA significantly decreased(P<0.05,P<0.01).Conclusion Gegen Qinlian Decoction may decreased pancreatic islet cells apoptosis,protect pancreatic cell function,and delay the progression of T2DM by inhibiting the endoplasmic reticulum stress PERK/ATF4/CHOP signaling pathway,and down-regulating the expressions of related genes and proteins.

Background Bus drivers are a high-risk group for work-related musculoskeletal disorders (WMSDs). There are a large number of bus drivers in mega-cities. High volumes of passenger traffic and complexity of road conditions may elevate their risk of WMSDs, but there are few studies related to this group. Objective To investigate the prevalence of WMSDs among bus drivers in a mega-city and to analyze potential influencing factors. Methods Based on cross-sectional study design and self-administered questionnaire, the prevalence of WMSDs in past 12 months were estimated by stratified cluster sampling among bus drivers in a mega-city. Pearson χ² and logistic regression models were used to analyze the influencing factors for the body regions with a high prevalence. Results The overall prevalence of WMSDs in past 12 months among bus drivers in a mega-city was 49.5% (551/1113). The prevalence of WMSDs by body regions ranged from 4.0% to 38.5%, and led by neck pain (38.5%), lower back pain (25.5%), and shoulder pain (20.8%). The results of logistic regression showed that the risk factors for neck pain were age (>50 years), smoking, tiredness after work (moderate, severe), long sitting (frequently), awkward postures (sometimes, often, frequently), overtime(occasionally, often), workplace temperature (uncomfortable), and noise (severe) (OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506；P<0.05); the lower back pain risk factors were current work experience (6-10 years, 11-15 years, and 16-20 years), smoking, tiredness after work (moderate, severe), and awkward postures(sometimes, often, frequently)(OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786，P<0.05); and the shoulder pain risk factors were age (46-50 years, and >50 years), smoking, tiredness after work (moderate, severe), vehicle type (hybrid power, diesel oil), awkward postures (often, frequently), overtime (often), and workplace temperature (uncomfortable) (OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426，P<0.05). Identified protective factors for neck and lower back pain were off-duty physical activity (1-2 times per week, and ≥3 times per week) (OR=0.553、0.470、0.586、0.485，P<0.05). Conclusion Nearly half of the bus drivers in the mega-city report symptoms of WMSDs, mainly in the neck, lower back, and shoulders. The prevalence is related to individual and occupational factors, and prevention and intervention measures should be actively taken.

Objective:To explore the relationship between atherosclerotic index of plasma(AIP)and vulnerable plaque of coronary under computed tomography(CT)based on coronary CT angiography(CCTA).Methods:Data were retrospectively collected on 213 patients with coronary heart disease(CHD)who underwent CCTA examination from January 2021 to February 2024 at the Second Affiliated Hospital of Shenyang Medical College,and they were divided into a vulnerable plaque group(123 cases)and a non-vulnerable plaque group(90 cases)according to whether existed vulnerable plaque of coronary artery.General clinical data such as age,gender,history of smoking,history of alcohol consumption,history of diabetes,and serum indicators such as AIP were collected.The differences in AIP and other factors between the two groups were compared.The independent influencing factors of vulnerable plaque of coronary artery were determined by multifactorial logistic regression analysis,and the predictive value of AIP for vulnerable plaque was assessed by drawing a receiver operating characteristic(ROC)curve.Results:AIP of vulnerable plaque group was 0.22±0.31,which was higher than that 0.05±0.27 of the vulnerable plaque group,and the difference of AIP between two groups was significant(t=4.223,P<0.001).Multifactorial logistic analysis showed there was independent correlation between AIP and vulnerable plaque under CT(OR=7.556,95%CI:2.442～23.385,P=0.002).The ROC curve showed that the best cut-off value of AIP was 0.20 in predicting vulnerable plaque under CT,and the value of area under curve(AUC)was 0.665,and the sensitivity was 55.56%and the specificity was 73.98%.Conclusion:AIP is an independent influencing factor for CHD patients who complicate vulnerable plaques,and it has a certain of predictive value for vulnerable plaques.

Background::Hepatic ischemia-reperfusion injury (HIRI) remains a common complication during liver transplantation (LT) in patients. As a key downstream effector of the Hippo pathway, Yes-associated protein (YAP) has been reported to be involved in various physiological and pathological processes. However, it remains elusive whether and how YAP may control autophagy activation during ischemia-reperfusion.Methods::Human liver tissues from patients who had undergone LT were obtained to evaluate the correlation between YAP and autophagy activation. Both an in vitro hepatocyte cell line and in vivo liver-specific YAP knockdown mice were used to establish the hepatic ischemia-reperfusion models to determine the role of YAP in the activation of autophagy and the mechanism of regulation. Results::Autophagy was activated in the post-perfusion liver grafts during LT in patients, and the expression of YAP positively correlated with the autophagic level of hepatocytes. Liver-specific knockdown of YAP inhibited hepatocytes autophagy upon hypoxia-reoxygenation and HIRI ( P <0.05). YAP deficiency aggravated HIRI by promoting the apoptosis of hepatocytes both in the in vitro and in vivo models ( P <0.05). Attenuated HIRI by overexpression of YAP was diminished after the inhibition of autophagy with 3-methyladenine. In addition, inhibiting autophagy activation by YAP knockdown exacerbated mitochondrial damage through increasing reactive oxygen species ( P <0.05). Moreover, the regulation of autophagy by YAP during HIRI was mediated by AP1 (c-Jun) N-terminal kinase (JNK) signaling through binding to the transcriptional enhanced associate domain (TEAD). Conclusions::YAP protects against HIRI by inducing autophagy via JNK signaling that suppresses the apoptosis of hepatocytes. Targeting Hippo (YAP)-JNK-autophagy axis may provide a novel strategy for the prevention and treatment of HIRI.