At present, the incidence and mortality rate of severe acute pancreatitis is 15%-20% and about 20%, respectively, which can lead to local and systemic complications of patients and huge medical costs. The occurrence of acute pancreatitis is closely related to inflammatory response. This article reviews the progress of anti-inflammation therapy and immunotherapy of acute pancreatitis, aiming to provide reference for treatment in patients with acute pancreatitis.

Objective: To explore the relationship of family function with sleep and externalizing problem behaviors of preschool children, so as to provide a guidance for externalizing problem prevention and intervention among preschool children. Methods: From October 2023 to January 2024, a convenience sampling method was used to select 5 138 preschool children from kindergartens in 8 districts of Wuhan City, Hubei Province. Parents completed the survey for Family Adaptability and Cohesion Scale, children s sleep habits and Child Behavior Checklist (CBCL). Spearman correlation analysis was used to examine the correlation of family function with scores of sleep quality and externalizing problem behaviors among preschool children. A mediation model analysis and bootstrap test were conducted to further investigate the mediating role of sleep quality between family function and externalizing problem behaviors. Mplus 8.7 software was used for latent profile analysis of family function. Results: The reported rates of poor sleep quality and externalizing problem behaviors among preschool children were 11.8% ( n =607), 20.0% ( n =1 026). The relevant analysis results showed that family function was negatively correlated with sleep quality and externalizing problem behaviors ( r = -0.20, -0.23), and sleep quality was positively correlated with externalizing problem behaviors ( r =0.27) ( P <0.01). The mediation effect test showed that family function negatively predicted externalizing problem behaviors ( β =-0.079) and sleep quality ( β = -0.075), while sleep quality positively predicted externalizing problem behaviors ( β =0.215) ( P <0.01). The latent profile analysis results showed that family function could be classified into 4 categories: high family function group (23.01%), upper middle family function group (44.65%), moderate family function group (26.24%) and low family function group (6.11%). Compared to high family function, the other three categories significantly positively predicted externalizing problem behaviors, and the mediating effects of sleep quality on different categories of family function were statistically significant [upper middle family function: mediation effect value was 0.022 (95% CI =0.004-0.041) and direct effect value was 0.329 (95% CI =0.263-0.396); middle family function: mediation effect value was 0.087 (95% CI =0.063-0.115) and direct effect value was 0.491 (95% CI =0.416-0.565); low family function: mediation effect value was 0.144 (95% CI =0.107-0.185) and direct effect 0.621 (95% CI =0.503-0.740)] ( P < 0.05 ). Conclusion Family function negatively predicts the externalizing problem behaviors of preschool children, and sleep quality plays a partial mediating role.

Objective To analyze the difference of CT features between hyperlipidemic acute pancreatitis (HLAP) and acute biliary pancreatitis (ABP). Methods Retrospective analysis was performed on 66 HLAP patients and 96 ABP patients admitted to East Hospital Affiliated to Tongji University from January 2018 to December 2019. The clinical data and CT features of patients between the two groups were compared. Results There were statistically significant differences in the clinical data and CT grades (A-E) between the HLAP group and the ABP group (P＜0.01). ABP group showed more swelling and effusion in pancreatic body and tail (58.3%), 16.7% of swelling and effusion in whole pancreas, but rare swelling and effusion located in pancreatic head and neck alone (3.1%). The HLAP group showed more swelling and effusion in whole pancreas (48.5%), 39.4% of swelling and effusion in pancreatic head and neck, but rare swelling and effusion located in pancreatic body and tail alone (12.1%). Conclusions CT features of HLAP are significantly different from the ABP, which may be useful for early precise diagnosis and treatment for HLAP.

Ferroptosis is a unique regulated form of cell death that is distinct from apoptosis, necrosis, and other well-characterized regulated cell death types, and plays an important role in the occurrence and development of chronic metabolic diseases, including diabetes, hypertension, hyperlipidemia, and non-alcoholic steatohepatitis. Recently, increasing evidence has supported traditional Chinese medicine (TCM) as a new hot spot for the treatment of chronic metabolic diseases by mediating ferroptosis. Unfortunately, few systematic reviews have described the importance of TCM in treating chronic metabolic diseases through the ferroptosis pathway. In the current review, the mechanism of ferroptosis and the roles of ferroptosis in chronic metabolic diseases are summarized. Additionally, this review illustrates that the regulation of ferroptosis by TCM could be an effective approach for treating chronic metabolic diseases based on experimental evidence and clinical application. In summary, this work will improve the understanding of ferroptosis and the ability of TCM to regulate ferroptosis in chronic metabolic diseases, thereby promoting the development and application of natural TCM.

Objective To assess the clinical utility of single-molecule real-time technology(SMRT)in identifying triplicated α-globin genes and compound variant alleles.Methods A total of 36 samples with tripli-cated α-globin genes were collected.Among them,28 samples were confirmed by PCR flow-through hybridiza-tion and 8 samples were confirmed by Next Generation Sequencing(NGS).These 36 samples included tripli-cated α-globin genes compound variants with cis or trans arrangements unknown,such as αααanti4 2 compoundαcsα(2 cases),αααanti4.2 compound-α3.7(10 cases),and HKαα/--SEA pending confirmation(2 cases),SMRT technology was employed to detect thalassemia gene variants.Additionally,a pedigree with the genotype ofαααanti4.2 compound-α3.7 variant was recruited,including the proband(Ⅱ-1),its father(Ⅰ-1),and mother(Ⅰ-2).PCR flow-through hybridization and SMRT were employed to detect thalassemia gene variants.Results SMRT detected 35 out of 36 samples with triplicated α-globin genes,and 1 sample with quadrupllcated α-globin genes(ααααanti4.2).Among the 2 αααanti4 2 compound αCSα variant samples,both αααanti42 and αCSα were arranged in trans,with a genotype of αααanti4.2/αCSα.Among the 10 αααanti4.2 compound-α3.7 variant samples,9 samples hadαααanti4.2 and-α3.7 in a cis arrangement,with a genotype of HKαα/αα,and 1 sample had αααannti4.2 and-α3.7 in a trans arrangement,with a genotype of αααanti4.2/-α3.7.Compared with PCR flow-through hybridization,SMRT detected one case of a large segment deletion in the β-globin gene and two unknown variants,which led to an increase in the positive detection rate of approximately 10.71％(3/28).The pedigree analysis showed that the proband(Ⅱ-1)inherited αααanti4.2 and-α3.7 variants from his mother(Ⅰ-2),with a genotype of HKαα/αα,con-sistent with the SMRT detection results.Conclusion SMRT can accurately detect triplicated or quadrupllcat-ed α-globin genes,and compound variant alleles.It offers high accuracy,enables one-step identification of cis or trans arrangements,and provides comprehensive coverage of thalassemia gene variations,demonstrating its significant clinical value.

Objective To observe the clinical efficacy of Ruanjian Sanjie Pills in the treatment of patients with hepatitis B-related cirrhosis in compensatory stage differentiated as blood stasis blocking collaterals syndrome.Methods A total of 80 cases of patients with hepatitis B-related cirrhosis in compensatory stage admitted to Bao'an Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January 2023 to April 2024 were randomly divided into the trial group and the control group,40 cases in each group.The control group was treated with oral administration of Entecavir for hepatitis B virus(HBV),and the trial group was treated with Ruanjian Sanjie Pills on the basis of treatment for the control group,the course of treatment covering one year.Before and after treatment,the two groups were observed in the changes of routine blood test indicators of white blood cell count(WBC)and platelet count(PLT),liver function indicators[albumin(ALB),total bilirubin(TBIL),alanine transaminase(ALT)and aspartate transaminase(AST)],prothrombin time(PT),liver stiffness measurement(LSM),and traditional Chinese medicine(TCM)syndrome scores.After treatment,the clinical efficacy and safety were evaluated.Results(1)There were three cases in the control group and four cases in the trial group fell off,and eventually 37 cases in the control group and 36 cases in the trial group were enrolled in the efficacy statistics.(2)After one year of treatment,the total effective rate of the trial group was 91.67%(33/36)and that of the control group was 67.57%(25/37),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the trial group was significantly superior to that of the control group(P<0.05).(3)After treatment,the routine blood test indicators of WBC and PLT in the trial group were increased compared with those before treatment(P<0.05),while the WBC and PLT in the control group did not change significantly(P>0.05).The post-treatment WBC and PLT in the trial group were significantly higher than those of the control group(P<0.05).(4)After treatment,the ALB of patients in the two groups was increased compared with that before treatment(P<0.05),and the PT value of patients in the two groups and the ALT of the trial group were decreased compared with those before treatment(P<0.05),but TBIL and AST of the two groups and ALT of the control group did not differ from those before treatment(P>0.05).The comparison between the two groups showed that the decrease of PT value in the trial group was significantly superior to that of the control group(P>0.05),but no statistically significant differences of ALT,AST,TBIL and ALB were shown between the two groups(P>0.05).(5)After treatment,the LSM of patients in the two groups was decreased compared with that before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).(6)After treatment,the TCM syndrome scores of the two groups of patients were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).(7)There were no significant adverse reactions or adverse events occurring in the two groups during the treatment.Conclusion Ruanjian Sanjie Pills can improve the clinical symptoms of patients with hepatitis B-related cirrhosis in the compensatory stage,improve the coagulation function,reduce the hardness of the liver,and slow down the process of cirrhosis,with satisfactory efficacy and good safety.

Abdominal obesity represents the predominant obesity phenotype in China.Compared to peripheral obesity,individuals with abdominal obesity are more prone to metabolic disorders,cardiovascular diseases,and higher mortality rates.Catgut embedding therapy at acupoints has demonstrated significant clinical efficacy in preventing and treating abdominal obesity.However,standardized clinical guidelines for its application in abdominal obesity management have not yet been established.This review comprehensively summarizes the clinical applications of catgut embedding therapy for simple abdominal obesity and abdominal obesity with various complications,aiming to provide clinical evidence and theoretical guidance for its use in preventing and treating abdominal obesity.

Objective To explore the application effect of key point nursing from the perspective of cluster analysis in preventing complications among patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 97 AMI patients who un-derwent PCI in the cardiology department of our hospital from March 2022 to October 2023 were se-lected and divided into control group with 51 patients(March to December 2022)and observation group with 46 patients(January to October 2023)based on their admission time.The control group received routine nursing,while the observation group received key point nursing from the perspective of cluster analysis.The emergency nursing conditions,occurrence of complications during hospitaliza-tion,major adverse cardiovascular events(MACE),and satisfaction of patients were compared be-tween the two groups.Results The door-to-balloon(D2B)time,results of time to myocardial injury markers,and length of hospital stay were shorter in the observation group than those in the control group(P＜0.05).The incidence rates of reperfusion arrhythmia during surgery,total vascular com-plications after surgery,unplanned extubation,and total MACE within 6 months after surgery were lower in the observation group than those in the control group(P＜0.05).The overall satisfaction rate with nursing in the observation group was 95.65％(44/46),which was higher than 82.35％(42/51)in the control group(P＜0.05).Conclusion Key point nursing from the perspective of cluster analysis can shorten the rescue time and length of hospital stay for patients undergoing PCI,reduce the incidence of vascular complications and MACE during hospitalization,and improve satis-faction of patients.

Objective To investigate the effect of APOE4 in regulating LRP1 and on β-amyloid protein Aβ25-35-induced oxidative stress and inflammatory response in astrocytes.Methods Human astrocytes were transfected with sh-NC,sh-APOE4,pcDNA-NC,and pcDNA-LRP1,and then induced with 10 μM Aβ25-35 for 24 h to establish an AD cell model.The roles of APOE4 and LRP1 in Aβ25-35-induced oxidative stress and inflammatory response were assessed using Western blot,flow cytometry,the detection kits of MDA,SOD,and GSH,as well as enzyme-linked immunosorbent assay(ELISA)kits for TNF-α,IL-6,and IL-1β.The protein-protein interaction between APOE4 and LRP1 was detected through co-immunoprecipitation and western blot experiments.Results Aβ25-35 induction upregulated APOE4 expression(P<0.01),promoted the levels of ROS(P<0.001),MDA(P<0.001),and inflammatory cytokines TNF-α,IL-6,and IL-1β(P<0.001)in astrocytes,while inhibited the expression of SOD,GSH,and LRP1(P<0.001).Knockdown of APOE4 or overexpression of LRP1 suppressed the Aβ25-35-induced increase in ROS,oxidative stress markers,and inflammatory cytokines in cells(P<0.05).APOE4 negatively regulated LRP1 protein expression through protein-protein interactions.The levels of ROS,MDA,and inflammatory cytokines were higher(P<0.05),and the concentrations of SOD and GSH were lower(P<0.001),in cells with simultaneous knockdown of APOE4 and LRP1 compared to those with APOE4 knockdown alone.Conclusion Knockdown of APOE4 attenuates Aβ25-35-induced oxidative stress and inflammatory response in astrocytes by upregulating LRP1.

Objective To investigate the epidemiological characteristics and mutation spectrum of monogenic diseases in Chinese population through a large-scale,multicenter carrier screening.Methods This study was conducted among a total of 33 104 participants(16 610 females)from 12 clinical centers across China.Carrier status for 223 genes was analyzed using high-throughput sequencing and different PCR methods.Results The overall combined carrier frequency was 55.58%for 197 autosomal genes and 1.84%for 26 X-linked genes in these participants.Among the 16 669 families,874 at-risk couples(5.24%)were identified.Specifically,584 couples(3.50%)were at risk for autosomal genes,306(1.84%)for X-linked genes,and 16 for both autosomal and X-linked genes.The most frequently detected autosomal at-risk genes included GJB2(autosomal recessive deafness type 1A,393 couples),HBA1/HBA2(α-thalassemia,36 couples),PAH(phenylketonuria,14 couples),and SMN1(spinal muscular atrophy,14 couples).The most frequently detected X-linked at-risk genes were G6PD(G6PD deficiency,236 couples),DMD(Duchenne muscular dystrophy,23 couples),and FMR1(fragile X syndrome,17 couples).After excluding GJB2 c.109G>A,the detection rate of at-risk couples was 3.91%(651/16 669),which was lowered to 1.72%(287/16 669)after further excluding G6PD.The theoretical incidence rate of severe monogenic birth defects was approximately 4.35‰(72.5/16 669).Screening for a battery of the top 22 most frequent genes in the at-risk couples could detect over 95%of at-risk couples,while screening for the top 54 genes further increased the detection rate to over 99%.Conclusion This study reveals the carrier frequencies of 223 monogenic genetic disorders in the Chinese population and provides evidence for carrier screening strategy development and panel design tailored to the Chinese population.In carrier testing,genetic counseling for specific genes or gene variants can be challenging,and the couples need to be informed of these difficulties before testing and provided with options for not screening these genes or gene variants.