Alzheimer's disease(AD)is the most common neurodegenerative disease in the elderly,and its main pathological manifestations include senile plaques formed by β-amyloid deposition and neuronal fibrillar nodules formed by hyperphosphorylation of tau proteins.Lysosome is an important organelle in eukaryotic cells,containing a variety of hydrolytic enzymes that can break down proteins and other biomolecules.It is closely related to intracellular transport and autophagy,and is important for maintaining cellular homeostasis.This review summarizes the interaction between lysosomal dysfunction and the development and progression of AD and the potential therapeutic mechanisms in treating AD by regulating and restoring the functions of lysosomes.Lysosomal dysfunction can lead to neurodegenerative diseases such as AD.Modulation of lysosomal function is a promising treatment strategy for AD.It is expected that more drugs and therapeutic regimens based on this mechanism can be used in the clinical treatment for AD patients in the future.

Chronic pain causes physical suffering and can have major psychological impacts in patients.Chronic pain can induce depressive disorder,and clinical studies have consistently shown that chronic pain and depression frequently co-occur,suggesting the possibility of shared pathogenic mechanisms underlying these conditions.Acupuncture,as an alternative therapy,has been widely used for analgesia and to treat depression,with demonstrated clinical efficacy.The therapeutic mechanism of acupuncture is related to neural and endocrine regulation.This review considers the mechanism of chronic pain accompanied by depression,in relation to the brain regions and neural circuits affected by acupuncture treatment.This review provides a new approach for the treatment of depression caused by chronic pain.

Objective To investigate the clinical efficacy and aesthetic outcome of liposuction combined with mammary adenectomy through a periareolar small incision in the management of gynecomastia(GYN).Methods From January 2019 to June 2023,18 patients with GYN were admitted.All of them were treated with small incision through the areola combined with liposuction.The postoperative aesthetic effect,occurrence of complications and patient satisfaction of the patients were evaluated.Results All 18 patients in this study were follwed up for a period of 3 to 18 months.No serious complications such as wound infection or necrosis of the nipple-areola occurred.Pathological examinations were consistent with the diagnosis of GYN.Except for one patient,who exhibited slight skin folds in the surgical area at the 12-month follow-up,the other patients all achieved symmetrical and smooth chest contours with noticeable aesthetic improvement,resulting in a 100％patient satisfaction rate.Conclusion The combined approach of liposuction combined with mammary adenectomy through a periareolar small incision for the treatment of GYN is straightforward,minimally invasive,and yields satisfactory therapeutic and aesthetic outcomes.

Objective:To explore the application value of the "Dual-Wing" traction technique in the medial & head lateral laparoscopic left hemicolectomy with radical resection.Methods:The "Dual-Wing " traction technique is based on the theory of mesenteric anatomy. The assistant lifts the proper mesentery of the digestive tract to be resected or the adjacent mesenteric tissue connected to it,thereby elevating the target organ and its mesentery as a whole away from the mesenteric bed. By utilizing the tension transmission between the proper mesenteries of adjacent organs to create counter-tension,the surgeon's operative actions are always maintained along the line of maximum counter-tension.After incising the mesenteric fusion line,this technique assists the surgeon in entering the fusion plane. A descriptive case series study method was adopted to retrospectively analyze the clinical and pathological data of 37 colorectal cancer patients who underwent laparoscopic left hemicolectomy with the "Dual-Wing" traction technique via a medial and cephalad approach, performed by the Department of Gastrointestinal Surgery at Dongjie Campus of the First Hospital of Quanzhou, Fujian Medical University, from May 2023 to November 2023.Results:All patients successfully underwent laparoscopic left hemicolectomy via the medial & head lateral approach using the "Dual-Wing" traction technique.The surgery adhered to the principles of total mesocolic excision and safely mobilized the left colon and its mesentery from the correct anatomical plane. In the entire group of patients,there were 14 males and 23 females; the mean operative time was 94.1±18.3 minutes; the mean intraoperative blood loss was 9.8±5.4 ml; the mean number of lymph nodes dissected was 18.1±3.9; the mean number of positive lymph nodes was 1.4±1.6; the pathological specimen resection margin grading was Grade A in 29 cases, Grade B in 8 cases, and no Grade C cases; the tumor TNM staging was Stage I in 3 cases, Stage IIA in 7 cases, Stage IIB in 6 cases, Stage IIIA in 2 cases, Stage IIIB in 15 cases, and Stage IIIC in 4 cases; the mean time to first flatus postoperatively was 35.7±7.5 hours; the mean length of hospital stay was 9.1±1.7 days. There were no intraoperative injuries to the pancreas or spleen. Postoperative complications occurred in 3 cases. No anastomotic leakage was observed in the entire group, and there were no deaths following the surgery.Conclusion:The application of the "Dual-Wing" traction technique to establish a stable surgical scenario can significantly reduce the demands on the assistant. It is conducive to maintaining mesenteric tension and fully exposing the surgical field. It also allows for the rapid identification and maintenance of the correct anatomical plane. For colorectal cancer patients, the surgery is safe and feasible, with satisfactory short-term therapeutic effects.

Objective:To analyze the electroencephalogram(EEG) average relative power spectrum in patients with unipolar and bipolar depression under the eyes-open and eyes-closed resting states.Methods:A total of 38 patients with unipolar depression (UD group), 48 patients with bipolar depression (BD group), and 43 healthy controls (HC group) were recruited from August 2022 to December 2023.The 64-channel EEG was recorded under eyes-open (EO) and eyes-closed (EC) resting states which alternated twice. The Mann-Whitney U test and Kruskal-Wallis H test were performed by SPSS 25.0 software. Results:There were no significant differences in the average relative power of delta and beta bands among the UD, BD and HC groups in all EO and EC states (all P>0.05). The average relative power of theta band in the three groups showed statistically significant differences in all EO and EC states ( H=7.852-12.583, all P<0.05). Further pairwise comparisons showed that in the first EO and EC stage, the average relative power of theta band of the UD and BD groups were significantly higher than that of the HC group (EO1: 0.18(0.17, 0.21), 0.19(0.16, 0.21), 0.16(0.14, 0.18), EC1: 0.15(0.13, 0.21), 0.15(0.13, 0.20), 0.13(0.10, 0.16); all P<0.05).In the second EO and EC stage, the average relative power of theta band of the BD group was significantly higher than that of the HC group (EO2: 0.18(0.15, 0.22), 0.16(0.14, 0.18), EC2: 0.15(0.13, 0.19), 0.13(0.11, 0.16); both P<0.05).There were statistically significant differences in the average relative power of alpha band among the three groups in the first EO and EC stage, as well as the second EC stage ( H=5.027-10.668, all P<0.05). Further pairwise comparisons showed that in the first EO stage, the average relative power of alpha band in the BD group was significantly higher than that in the UD group (0.20(0.16, 0.25), 0.14(0.11, 0.22), P=0.003), and in the following EC stages, the average relative power of alpha band in the UD group was significantly lower than that in the HC group (EC1: 0.40(0.33, 0.46), 0.51(0.40, 0.58), EC2: 0.41(0.35, 0.50), 0.48(0.43, 0.58); both P<0.05). Conclusion:At the initial stage of the resting state, both unipolar and bipolar depression patients demonstrate abnormal theta band activity under the eyes-open and eyes-closed states, while the alpha band activity under the eyes-open condition differs between the two groups of patients. These findings may provide potentially objective biomarkers to assist the diagnosis of unipolar and bipolar depression patients in clinical settings.

Objective:To analyze the electroencephalogram(EEG) average relative power spectrum in patients with unipolar and bipolar depression under the eyes-open and eyes-closed resting states.Methods:A total of 38 patients with unipolar depression (UD group), 48 patients with bipolar depression (BD group), and 43 healthy controls (HC group) were recruited from August 2022 to December 2023.The 64-channel EEG was recorded under eyes-open (EO) and eyes-closed (EC) resting states which alternated twice. The Mann-Whitney U test and Kruskal-Wallis H test were performed by SPSS 25.0 software. Results:There were no significant differences in the average relative power of delta and beta bands among the UD, BD and HC groups in all EO and EC states (all P>0.05). The average relative power of theta band in the three groups showed statistically significant differences in all EO and EC states ( H=7.852-12.583, all P<0.05). Further pairwise comparisons showed that in the first EO and EC stage, the average relative power of theta band of the UD and BD groups were significantly higher than that of the HC group (EO1: 0.18(0.17, 0.21), 0.19(0.16, 0.21), 0.16(0.14, 0.18), EC1: 0.15(0.13, 0.21), 0.15(0.13, 0.20), 0.13(0.10, 0.16); all P<0.05).In the second EO and EC stage, the average relative power of theta band of the BD group was significantly higher than that of the HC group (EO2: 0.18(0.15, 0.22), 0.16(0.14, 0.18), EC2: 0.15(0.13, 0.19), 0.13(0.11, 0.16); both P<0.05).There were statistically significant differences in the average relative power of alpha band among the three groups in the first EO and EC stage, as well as the second EC stage ( H=5.027-10.668, all P<0.05). Further pairwise comparisons showed that in the first EO stage, the average relative power of alpha band in the BD group was significantly higher than that in the UD group (0.20(0.16, 0.25), 0.14(0.11, 0.22), P=0.003), and in the following EC stages, the average relative power of alpha band in the UD group was significantly lower than that in the HC group (EC1: 0.40(0.33, 0.46), 0.51(0.40, 0.58), EC2: 0.41(0.35, 0.50), 0.48(0.43, 0.58); both P<0.05). Conclusion:At the initial stage of the resting state, both unipolar and bipolar depression patients demonstrate abnormal theta band activity under the eyes-open and eyes-closed states, while the alpha band activity under the eyes-open condition differs between the two groups of patients. These findings may provide potentially objective biomarkers to assist the diagnosis of unipolar and bipolar depression patients in clinical settings.

Objective Human facial morphology is an appearance phenotype with high heritability,high diversity,and complexity.Traditional facial morphological genetic analysis is mostly based on facial landmark measurements,using linear regression for genome-wide association studies,but this method extracts limited facial morphological feature information.This study established an extraction method for multidimensional facial representations and validated the correlation between 473 single-nucleotide polymorphisms(SNPs)previously reported to be significantly associated with facial features and facial representations in the Han Chinese population.Methods After acquiring facial 3D images,3D morphable face models and HR-net network were used to align and quantify the 3D images,obtaining high-density 3D facial point cloud data.After unsupervised clustering of the point cloud,principal component analysis was applied to reduce dimensionality and extract multidimensional morphological phenotypes for each facial region.Based on these multidimensional phenotypes,partial least squares regression(PLSR)and canonical correlation analysis(CCA)were used for genetic association analysis.Results A total of 10 SNPs were validated to be significantly associated with facial morphology in Han Chinese,of which 7 SNPs were validated by the PLSR method,2 SNPs were validated by the CCA method,and 1 SNP was validated by both methods.Conclusion Among the 10 significantly associated SNP sites,9 related facial morphological regions were consistent with previous reports in other populations,indicating that genes affecting complex facial morphology have cross-population effects.

Objective:To explore the impact of the two-way referral model on compliance and prognosis in patients with heart failure.Methods:This bidirectional cohort study enrolled chronic heart failure (CHF) patients treated at Qilu Hospital of Shandong University or designated primary hospitals between March 2018 and March 2022. Patients were categorized into two groups based on referral status: two-way referral group (participating in the referral model with≥1 follow-up visit at primary hospitals) and the core hospital group (receiving treatment and follow-up exclusively at Qilu Hospital). Baseline clinical characteristics were collected and compared between groups. Patients underwent followed-up, with primary endpoints including follow-up rate, drug (β-blockers, angiotension converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blockers (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), sodium-glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonists) utilization rate and target dose achievement rate. Secondary endpoints encompassed changes from baseline in left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and N-terminal pro-brain natriuretic peptide (NT-proBNP), plus cardiovascular mortality and heart failure rehospitalization. Generalized linear mixed models analyzed longitudinal trends in LVEF, LVEDd, and NT-proBNP levels. Kaplan-Meier curves and Cox regression evaluated LVEF recovery rates, supplemented by subgroup analyses. Multivariate logistic regression was used to identify factors influencing target dose achievement rate for β-blockers and ACEI/ARB/ARNI therapies in CHF patients.Results:A total of 357 patients were enrolled, aged 53 (41, 63) years, including 256 males (71.7%). 157 patients were in the two-way referral group and 200 patients in the core hospital-treated group. Compared with the core hospital-treated group, the two-way referral group had lower baseline LVEF (28 (22, 34)% vs. 31 (23, 36)%, P=0.021) and systolic blood pressure (116 (104, 125) mmHg vs. 121 (109, 134) mmHg (1 mmHg=0.133 kPa), P=0.010). The 12-month follow-up rate of the two-way referral group was higher than the core hospital-treated group (73.8% vs. 56.0%, P=0.004). No significant between-group differences were observed in drug utilization rate of β-blockers, ACEI/ARB/ARNI, or sodium-glucose cotransporter 2 inhibitors during follow-up (all P>0.05), while mineralocorticoid receptor antagonists use showed a declining trend in both groups. Although the core hospital-treated group had higher target dose achievement rates for β-blockers (65.4% vs. 49.3%, P=0.042) and ACEI/ARB/ARNI (79.8% vs. 65.8%, P=0.046) than the two-way referral group, multivariate logistic regression indicated that the two-way referral model was not a negative predictor for these outcomes (all P>0.05). Both groups showed improved NT-proBNP, LVEDd, and LVEF from baseline (all P<0.001) with no significant difference in trends between groups (all P>0.05). There was no significant difference in the composite incidence (7.6% vs. 6.5%, P=0.674) and cumulative incidence (log-rank P=0.684) of cardiovascular death and heart failure rehospitalization at 12 months between two groups. Conclusion:The two-way referral model demonstrates advantages in improving medication adherence, drug utilization rates, and targetdoseachievement rates among CHF patients. This model not only promotes cardiac functional recovery but also reduces risks of cardiovascular mortality and heart failure rehospitalization, achieving comparable therapeutic and management outcomes to those observed in core hospital-treated patients.

Objective:To investigate the influencing factors of adverse reactions of reconstructive flaps after postoperative precision radiation therapy for head and neck tumors.Methods:Medical records of 46 patients who underwent radiotherapy after flap reconstruction for head and neck tumors in the Affiliated Hospital of Inner Mongolia Medical University between January 2016 and October 2022 were retrospectively analyzed. The overall survival (OS), local regional control (LRC) and dosimetric parameters after radiotherapy were analyzed. The adverse reactions mainly including radiation dermatitis and flap necrosis at 3 and 6 months after radiotherapy, flap atrophy, flap fibrosis, dysphagia and chewing dysfunction at 12 and 24 months after radiotherapy were recorded. Adverse reactions were graded using the common terminology criteria for adverse events (CTCAE) version 5.0. Quantitative data were analyzed by one-way analysis of variance or rank-sum test. Qualitative data were analyzed by chi-square test or Fisher's exact test. Multivariate analysis of influencing factors of adverse reactions was performed using binary logistic stepwise regression.Results:All 46 patients were aged 57.6 years on average. The median follow-up time was 65 months (12-100 months). After the follow-up, 22 patients died, 6 recurred, and 7 had distant metastases. The 5-year OS rate was 48% and 5-year LRC rate was 69%. The incidence of radiation dermatitis was decreased over time after the end of radiotherapy: 80% (37/46) and 65% (30/46) at 3 months and 6 months after radiotherapy, respectively. The incidence of grade 3 radiation dermatitis was 11% (5/46) and 0 at 3 and 6 months after radiotherapy, respectively. The incidence of grade 2 flap necrosis was 4% (2/46) at 3 months after radiotherapy. At 12 months after radiotherapy, the incidence of flap atrophy and fibrosis was 83% (38/46) and 67% (31/46) , and the incidence of grade 3 flap atrophy and fibrosis was equally 4% (2/46) , respectively. All patients had dysphagia and chewing dysfunction at 12 months after radiotherapy. At 24 months after radiotherapy, 83% (38/46) and 61% (28/46) of patients still had dysphagia and chewing dysfunction. Multivariate regression analysis showed that irradiated flap volume, total radiotherapy dose, pharyngeal constrictor D mean and pharyngeal constrictor V 60 Gy, the interval between surgery and radiotherapy, gender and age were the independent influencing factors of adverse reactions of reconstructive flaps after precision radiation therapy for head and neck tumors. Conclusions:For patients undergoing flap reconstruction for head and neck tumors, under the premise of ensuring tumor control, the dose to normal tissue and flap blood supply area should be strictly limited, the irradiated volume should be reduced, and the interval between surgery and radiotherapy should be shortened (≤6 weeks) to reduce the risk of adverse reactions. Hypo-fractionated radiotherapy plan should be formulated or the total radiotherapy dose should be appropriately adjusted for elderly patients to reduce long-term complications.

Objective:To investigate the correlation between metabolic syndrome (MS), its different components and the risk of cholecystolithiasis and gallbladder polyp in Uygur population in rural areas of southern Xinjiang.Methods:This study was a prospective cohort study. A baseline survey was conducted in August 2016. A typical sampling method was used to select 10 476 Uygur people in rural areas of southern Xinjiang as the research objects. Baseline clinical data were collected, including demographic data such as age, gender, and education level, and laboratory examination indicators such as blood glucose and triglyceride levels. According to the MS diagnostic criteria of the relevant guidelines, 10 476 subjects were divided into the MS group (3 475 cases) and the non-MS group (7 001 cases). The incidence of cholecystolithiasis and gallbladder polyp was followed up in 2019, 2021 and 2023, respectively. Cox regression was used to analyze the correlation between MS, its different components and the risk of cholecystolithiasis and gallbladder polyp. Chi-square test and independent sample t test were used for statistical analysis. Results:The median follow-up time was 6.43 years in 10 476 subjects, and the overall cumulative incidence of cholecystolithiasis and gallbladder polyp was 5.43% (569/10 476). The cumulative incidence of cholecystolithiasis and gallbladder polyp in the MS group was 10.73% (373/ 3 475), which was significantly higher than that in the non-MS group (2.80% (196/7 001)); χ2= 284.62, P<0.001). The results of multivariate Cox regression analysis showed that, 41 to 59 years old ( HR=1.26, 95% confidence interval (95% CI): 1.03 to 1.54, P=0.025), ≥60 years old ( HR=1.88, 95% CI: 1.45 to 2.45, P<0.001), female ( HR=1.34, 95% CI: 1.13 to 1.60, P=0.001), MS ( HR=2.19, 95% CI: 1.59 to 3.01, P<0.001), hypertriglyceridemia ( HR=1.47, 95% CI: 1.18 to 1.83, P=0.001), hypertension ( HR=1.30, 95% CI: 1.04 to 1.62, P=0.023), and hyperglycemia ( HR=1.24, 95% CI: 1.01 to 1.52, P=0.041) were independent risk factors for cholecystolithiasis and gallbladder polyp. After the adjustment of age and gender, MS ( HR=3.39, 95% CI: 2.82 to 4.07, P<0.001), hypertriglyceridemia ( HR=2.37, 95% CI: 2.00 to 2.81, P<0.001), hypertension ( HR=2.00, 95% CI: 1.66 to 2.41, P<0.001), and hyperglycemia ( HR=1.86, 95% CI: 1.55 to 2.23, P<0.001) were still correlated with cholecystolithiasis and gallbladder polyp, and there was the srtongest correlation between MS and cholecystolithiasis and gallbladder polyp. The results of univariate Cox regression analysis showed that along with the increase of accumulated of MS components, the risk of cholecystolithiasis and gallbladder polyp significantly increased (1 to 5 components corresponding HR (95% CI) were 1.92 (1.13 to 3.24), 2.21 (1.32 to 3.69), 6.91 (4.22 to 11.30), 8.56 (5.15 to 14.22), and 10.73 (5.66 to 20.33); P=0.015, =0.002, <0.001, <0.001, and <0.001); after age and gender were adjusted, this trend still existed (1 to 5 components corresponding HR (95% CI) were 1.81(1.07 to 3.06), 1.95(1.16 to 3.27), 5.64(3.42 to 9.32), 6.69(3.97 to 11.25), and 7.76(4.04 to 14.91); P=0.028, =0.012, <0.001, <0.001, and <0.001). Conclusion:MS and its components can increase the risk of cholecystolithiasis and gallbladder polyp, and the risk of cholecystolithiasis and gallbladder polyp significantly increases along with the increase of accumulated of MS components.