Objective To investigate the correlation between WT1,BCR-ABL genes and interleukin-6(IL-6),vascular endothelial growth factor(VEGF),plasma protein C(PC),plasma protein S(PS)in patients with myeloproliferative neoplasms(MPN).Methods A total of 54 MPN patients treated in this hospital from January 2021 to January 2024 were selected as the MPN group,and 54 healthy subjects undergoing physical examination during the same period were selected as the control group.The gene relative expression levels of WT1,BCR-ABL and levels of IL-6,VEGF,PC,and PS were detected and compared between the two groups.The correlations between WT1,BCR-ABL gene relative expression levels and IL-6,VEGF,PC,PS levels were analyzed,and the diagnostic efficacy of WT1 and BCR-ABL genes for MPN was evaluated by receiver operat-ing characteristic(ROC)curve.Results Compared with the control group,the gene relative expression levels of WT1,BCR-ABL and the levels of IL-6 and VEGF in the MPN group were higher,while the levels of PC and PS were lower,with statistically significant differences(P<0.05).Pearson correlation analysis showed that WT1 and BCR-ABL gene relative expression levels were positively correlated with IL-6 and VEGF levels,and negatively correlated with PC and PS levels(P<0.05).The combined use of WT1 and BCR-ABL genes has higher diagnostic efficacy for MPN than single indicators,with an area under the curve(AUC)of 0.833 and a sensitivity of 88.69%.Conclusion The relative expression levels of WT1 and BCR-ABL genes are correlated with IL-6,VEGF,PC,and PS levels in MPN patients.The combination of WT1 and BCR-ABL genes can effec-tively diagnose MPN.

Objective:To establish the normal reference value of the left ventricular remodeling index（RI）in healthy adults，and to evaluate the phenotypes of RI in various left ventricular geometries and its relationship with left ventricular systolic and diastolic functions in asymptomatic hypertensive patients.Methods:A retrospective study design was employed，906 healthy Han Chinese volunteers were selected as the control group from the multicenter study "Echocardiographic Measurements in Normal Chinese Adults"（EMINCA），which was conducted in 2012. The normal reference range of left ventricular RI was established based on the 95% CI（ xˉ ± 1.96 s）. Statistical analyses were conducted to evaluate differences in RI across age groups and between genders. A total of 340 asymptomatic hypertensive patients in the Department of Health Management，Sichuan Provincial People's Hospital from July 2023 to March 2024 were prospectively included as the hypertension group. Conventional echocardiography and two-dimensional speckle tracking imaging were used to assess left ventricular structure and function. Parameters such as left ventricular mass index（LVMI），RI，relative wall thickness（RWT），the ratio of early diastolic mitral inflow velocity to the average early diastolic mitral annular velocity（E/e'），and the ratio of early diastolic to late diastolic mitral inflow velocities（E/A）were calculated. Differences of these parameters between the hypertension group and the healthy control group were compared. The hypertension group was stratified into 3 subgroups based on left ventricular posterior wall thickness at end-diastole（LVPWd）and RI：the non-LV hypertrophy group，the left ventricular hypertrophy with normal RI group，and the left ventricular hypertrophy with low RI group. Relevant parameters were compared among these subgroups，and the statistical significance of the differences was analyzed. Pearson correlation analysis and multiple linear regression analysis were performed to explore the relationships between left ventricular RI and GLS，LVEF，the average mitral annular peak systolic velocity（s'），e'，E/e'，E/A. Results:In the healthy control group，RI showed a declining trend with increasing age in both sexes. Furthermore，the RI was significantly higher in the female group compared to the male group（ P<0.001）. Compared with the healthy control group，LVMI and E/e' increased while RI，e' and s' decreased in the hypertension group（all P < 0.001）. Among the 3 subgroups of the hypertension group，compared with the other two groups，LVMI and Ｅ/e' increased while absolute GLS and s' reduced in the left ventricular hypertrophy with low RI subgroup（all P <0.001）. Pearson correlation analysis revealed that RI was negatively correlated with GLS and E/e'（ r=-0.457，-0.281；all P < 0.001），and positively correlated with LVEF，e'，s' and E/A（ r=0.229，0.394，0.150，0.172；all P < 0.05）. Multivariate linear regression analysis demonstrated that left ventricular RI was independently associated with GLS，LVEF，e'，s'，E/e' and E/A. Conclusions:The normal reference range of left ventricular RI tends to decrease with age and is typically higher in females than in males. In asymptomatic patients with primary hypertension，RI，systolic and diastolic functions of the left ventricular are lower，while LVMI is higher. Among these patients，functional impairment is more pronounced in patients with left ventricular hypertrophy and reduced RI. This indicates that left ventricular RI may offer an imaging basis for further classification and stratification of structural and functional abnormalities in the left ventricle of asymptomatic hypertensive patients.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective:To establish the normal reference value of the left ventricular remodeling index（RI）in healthy adults，and to evaluate the phenotypes of RI in various left ventricular geometries and its relationship with left ventricular systolic and diastolic functions in asymptomatic hypertensive patients.Methods:A retrospective study design was employed，906 healthy Han Chinese volunteers were selected as the control group from the multicenter study "Echocardiographic Measurements in Normal Chinese Adults"（EMINCA），which was conducted in 2012. The normal reference range of left ventricular RI was established based on the 95% CI（ xˉ ± 1.96 s）. Statistical analyses were conducted to evaluate differences in RI across age groups and between genders. A total of 340 asymptomatic hypertensive patients in the Department of Health Management，Sichuan Provincial People's Hospital from July 2023 to March 2024 were prospectively included as the hypertension group. Conventional echocardiography and two-dimensional speckle tracking imaging were used to assess left ventricular structure and function. Parameters such as left ventricular mass index（LVMI），RI，relative wall thickness（RWT），the ratio of early diastolic mitral inflow velocity to the average early diastolic mitral annular velocity（E/e'），and the ratio of early diastolic to late diastolic mitral inflow velocities（E/A）were calculated. Differences of these parameters between the hypertension group and the healthy control group were compared. The hypertension group was stratified into 3 subgroups based on left ventricular posterior wall thickness at end-diastole（LVPWd）and RI：the non-LV hypertrophy group，the left ventricular hypertrophy with normal RI group，and the left ventricular hypertrophy with low RI group. Relevant parameters were compared among these subgroups，and the statistical significance of the differences was analyzed. Pearson correlation analysis and multiple linear regression analysis were performed to explore the relationships between left ventricular RI and GLS，LVEF，the average mitral annular peak systolic velocity（s'），e'，E/e'，E/A. Results:In the healthy control group，RI showed a declining trend with increasing age in both sexes. Furthermore，the RI was significantly higher in the female group compared to the male group（ P<0.001）. Compared with the healthy control group，LVMI and E/e' increased while RI，e' and s' decreased in the hypertension group（all P < 0.001）. Among the 3 subgroups of the hypertension group，compared with the other two groups，LVMI and Ｅ/e' increased while absolute GLS and s' reduced in the left ventricular hypertrophy with low RI subgroup（all P <0.001）. Pearson correlation analysis revealed that RI was negatively correlated with GLS and E/e'（ r=-0.457，-0.281；all P < 0.001），and positively correlated with LVEF，e'，s' and E/A（ r=0.229，0.394，0.150，0.172；all P < 0.05）. Multivariate linear regression analysis demonstrated that left ventricular RI was independently associated with GLS，LVEF，e'，s'，E/e' and E/A. Conclusions:The normal reference range of left ventricular RI tends to decrease with age and is typically higher in females than in males. In asymptomatic patients with primary hypertension，RI，systolic and diastolic functions of the left ventricular are lower，while LVMI is higher. Among these patients，functional impairment is more pronounced in patients with left ventricular hypertrophy and reduced RI. This indicates that left ventricular RI may offer an imaging basis for further classification and stratification of structural and functional abnormalities in the left ventricle of asymptomatic hypertensive patients.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

BACKGROUND:The anterior cruciate ligament has unique nonlinear mechanical properties under a complex physiological loading environment.Elastin is an important contributor to the mechanical properties of the anterior cruciate ligament,but its mechanical response to the anterior cruciate ligament under axial tension is not clear. OBJECTIVE:To quantitatively analyze the effect of elastin on the tensile mechanical response of the anterior cruciate ligament. METHODS:Elastase solution and control buffer were prepared.The porcine anterior cruciate ligament samples were prepared into small-size samples and randomly soaked in 0,0.1,1.0,2.0,5.0,and 10.0 U/mL elastase solution for 6 hours,and other small samples of the same size were soaked in 2 U/mL elastase solution for 0,1,3,6,9,and 12 hours.To determine suitable soaking conditions for elastin-targeted enzymes and verify the digestive effect,histological staining was used to compare the effects of enzyme treatment on tissue structure and composition.The ligament samples were randomly divided into elastase-treated group and PBS group,and immersed in 2 U/mL elastase solution and PBS buffer for 6 hours,respectively.A mechanical tensile test was performed before and after immersion. RESULTS AND CONCLUSION:(1)The biochemical results showed that being treated in 2 U/mL elastase solution for 6 hours could reduce the elastin content by 31.1%,and had no significant effect on other mechanical-related components in the tissue.(2)The histological results showed that elastase was able to penetrate the tissue,and the loose degree of tissue increased after treatment.(3)In the mechanical results before and after treatment,the mechanical properties of the PBS group decreased significantly,only the low-tension elastic modulus increased significantly and the initial length increased significantly in the elastase-treated group.(4)The intergroup comparison results showed that there was no significant difference between the two groups in pre-treatment,but the low-tension elastic modulus,initial slopes,saturated slopes,and initial length of the elastase-treated group after treatment were significantly higher than those in the PBS group.(5)These results suggest that elastin degradation significantly affects the biomechanical properties of the anterior cruciate ligament and further complements our understanding of the structure-function relationship of the anterior cruciate ligament.

Objective:To study the trend of menarche age in Han and Mongolian women born from 1951 to 2005 in Mongolian region.Methods:A cross-sectional cluster sampling survey method was adopted, From 2003 to 2019, a retrospective survey was carried out in three banners/counties in Tongliao region on the female population of Han and Mongols nationalities aged 16 to 46 and conducted under standardized survey procedures and quality control standards. The basic data of menarche age of women born between 1951 and 2005 were obtained. The changes and rules were analyzed by taking 1 year, 5 years and 10 years as nodes.Results:Totally 46 and conducted under standardized survey procedures and quality control standards 928 pepole (24 450 Han and 22 478 Mongolian) were recruited, the survey response rate was 96.09% (46 928/48 836). In one-year-period analysis, the menarche age gradually decreased from 1951 to 2005. The mean menarche age of Han and Mongolian women changed from (16.22±0.52) years and (15.86±1.24) years in 1951 to (12.37±1.15) years and (12.33±0.98) years in 2005, respectively. The mean menarche age of Han and Mongolian women decreased 3.85 years and 3.54 years. The trend of the mean menarche age's change showed a significant negative correlation with the years (all P<0.000 1). In five-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.54±1.45) years and (15.53±1.48) years from 1951 to 1955 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.13 years (3.41 months ahead of schedule every 5 years on average) and 3.06 years (3.34 months ahead of schedule every 5 years on average) in Han and Mongolian women respectively. In ten-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.79±0.95) years and (15.53±1.33) years from 1951 to 1960 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.38 years (6.76 months ahead of schedule every 10 years on average) and 3.06 years (6.12 months ahead of schedule every 10 years on average) in Han and Mongolian women respectively. During the 15 years from 1951 to 1965, 1966 to 1970, 1971 to 1990, and 1991 to 2000, they were concentrated at the ages of 15-16, 14-15, 13-14, and 12-13, respectively. The proportion of women at 11 years, 12 years and 13 years menarche age were 26.79% (457/1 706), 73.27% (1 250/1 706), and 92.85% (1 584/1 706) during 2001—2005 in Han women, while the proportion were 23.25% (653/2 809), 62.01% (1 742/2 809), and 90.14% (2 532/2 809) in Mongolian women. Conclusion:The menarche age decreased in Han and Mongolian women from 1951 to 2005, and the ethnic groups tended to be the same. It is recommended to start adolescent education at the age of 8-9 years and pay attention to the changing pattern of early onset of menarche.

Nonalcoholic fatty liver disease(NAFLD)has developed into the most common chronic liver disease and can lead to liver cancer.Our laboratory previously developed a novel prescription for NAFLD,"Eight Zhes Decoction"(EZD),which has shown good curative effects in clinical practice.However,the pharmaco-dynamic material basis and mechanism have not yet been revealed.A strategy integrating lipidomics,network pharmacology and pharmacokinetics was used to reveal the active components and mecha-nisms of EZD against NAFLD.The histopathological results showed that EZD attenuated the degrees of collagen deposition and steatosis in the livers of nonalcoholic steatofibrosis model mice.Furthermore,glycerophospholipid metabolism,arachidonic acid metabolism,glycerolipid metabolism and linoleic acid metabolism with phospholipase A2 group IVA(PLA2G4A)and cytochrome P450 as the core targets and 12,13-cis-epoxyoctadecenoic acid,12(S)-hydroxyeicosatetraenoic acid,leukotriene B4,prostaglandin E2,phosphatidylcholines(PCs)and triacylglycerols(TGs)as the main lipids were found to be involved in the treatment of NAFLD by EZD.Importantly,naringenin,artemetin,canadine,and bicuculline were iden-tified as the active ingredients of EZD against NAFLD;in particular,naringenin reduces PC consumption by inhibiting the expression of PLA2G4A and thus promotes sufficient synthesis of very-low-density lipoprotein to transport excess TGs in the liver.This research provides valuable data and theoretical support for the application of EZD against NAFLD.

Objectives:This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) .Methods:From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy.Results:The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients.Conclusion:Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

Objective:To study the trend of menarche age in Han and Mongolian women born from 1951 to 2005 in Mongolian region.Methods:A cross-sectional cluster sampling survey method was adopted, From 2003 to 2019, a retrospective survey was carried out in three banners/counties in Tongliao region on the female population of Han and Mongols nationalities aged 16 to 46 and conducted under standardized survey procedures and quality control standards. The basic data of menarche age of women born between 1951 and 2005 were obtained. The changes and rules were analyzed by taking 1 year, 5 years and 10 years as nodes.Results:Totally 46 and conducted under standardized survey procedures and quality control standards 928 pepole (24 450 Han and 22 478 Mongolian) were recruited, the survey response rate was 96.09% (46 928/48 836). In one-year-period analysis, the menarche age gradually decreased from 1951 to 2005. The mean menarche age of Han and Mongolian women changed from (16.22±0.52) years and (15.86±1.24) years in 1951 to (12.37±1.15) years and (12.33±0.98) years in 2005, respectively. The mean menarche age of Han and Mongolian women decreased 3.85 years and 3.54 years. The trend of the mean menarche age's change showed a significant negative correlation with the years (all P<0.000 1). In five-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.54±1.45) years and (15.53±1.48) years from 1951 to 1955 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.13 years (3.41 months ahead of schedule every 5 years on average) and 3.06 years (3.34 months ahead of schedule every 5 years on average) in Han and Mongolian women respectively. In ten-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.79±0.95) years and (15.53±1.33) years from 1951 to 1960 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.38 years (6.76 months ahead of schedule every 10 years on average) and 3.06 years (6.12 months ahead of schedule every 10 years on average) in Han and Mongolian women respectively. During the 15 years from 1951 to 1965, 1966 to 1970, 1971 to 1990, and 1991 to 2000, they were concentrated at the ages of 15-16, 14-15, 13-14, and 12-13, respectively. The proportion of women at 11 years, 12 years and 13 years menarche age were 26.79% (457/1 706), 73.27% (1 250/1 706), and 92.85% (1 584/1 706) during 2001—2005 in Han women, while the proportion were 23.25% (653/2 809), 62.01% (1 742/2 809), and 90.14% (2 532/2 809) in Mongolian women. Conclusion:The menarche age decreased in Han and Mongolian women from 1951 to 2005, and the ethnic groups tended to be the same. It is recommended to start adolescent education at the age of 8-9 years and pay attention to the changing pattern of early onset of menarche.