ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.

ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.

The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

Objective To explore the impact of polymorphisms in the solute carrier organic anion transporter family member 1B1(SLCO1B1)and apolipoprotein E(APOE)genes on statins selection and prognosis in patients after percutaneous coronary intervention(PCI).Methods This retrospective study enrolled 612 patients with coronary heart disease hospitalized in Tianjin Beichen Hospital from January 2021 to February 2023.Among them,411 patients who underwent PCI were assigned to PCI group,and 201 patients who did not undergo PCI were assigned to non-PCI group.According to treatment methods,PCI group was further divided into two subgroups:observation subgroup(n=305)and control subgroup(n=106).Non-PCI group was also divided into two subgroups:observation subgroup(n=147)and control subgroup(n=54).Patients in all observation subgroups underwent the detection of SLCO1B1 and APOE gene polymorphisms before medication,and an initial individualized treatment plan(including the selection of appropriate statins and dosages)was formulated based on the detection results.Patients in control subgroups were given statins at conventional dosages.Basic data before medication,post-medication lipid compliance rates[lipid intention-to-treat(ITT)compliance rate and lipid per-protocol analysis(PP)compliance rate],time to lipid compliance,liver function indicators before and after medication,and prognosis,as well as SLCO1B1 and APOE genotyping and allele frequency distribution were compared between observation subgroup and control subgroup.Conditional logistic regression was used to analyze the relationship between different genotypes and prognostic susceptibility.Multifactor dimensionality reduction(MDR)was applied to analyze the interaction between SLCO1B1 genotype and APOE genotype.Results All genotypes of SLCO1B1 and APOE genes in observation subgroups conformed to the Hardy-Weinberg genetic equilibrium test(P>0.05).Compared with control subgroups,the observation subgroups had significantly higher lipid PP compliance rates after 6 and 12 months of treatment.After 3 months of treatment,the number of completed cases and compliant cases in observation subgroups was significantly higher,and the time to lipid compliance was significantly shorter than that in control subgroups(P<0.05).Compared with before treatment,there were no significant changes in alanine aminotransferase(ALT)and creatine kinase isoenzyme(CK-MB)levels in either observation subgroups or control subgroups(P>0.05);the levels of total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)were significantly decreased(P<0.001),while high-density lipoprotein cholesterol(HDL-C)level was significantly increased(P<0.01).After 12 months of treatment,the aspartate aminotransferase(AST)level in observation subgroups was significantly lower than that before medication and also lower than that in the corresponding control subgroups(P<0.05).Within PCI group:there were 1 case and 5 cases of myocardial infarction,2 cases and 6 cases of target vessel revascularization,0 cases and 3 cases of stroke,0 cases and 7 cases of recurrent angina pectoris,1 case and 5 cases of readmission in observation subgroup and control subgroup,respectively.There were statistically significant differences between observation subgroup and control subgroup(P<0.05).Within non-PCI group:there were 0 cases and 3 cases of cardiogenic death,2 cases and 6 cases of myocardial infarction,2 cases and 5 cases of target vessel revascularization,0 cases and 4 cases of stroke,0 cases and 8 cases of recurrent angina pectoris,and 2 cases and 4 cases of readmission in observation subgroup and control subgroups,respectively,with statistically significant differences between the two subgroups(P<0.05).In the recessive model,SLCO1B1 and APOE genes were significantly correlated with prognosis in both PCI observation subgroup and non-PCI observation subgroup(P<0.05).MDR analysis of the interaction between SLCO1B1 genotype and APOE genotype in PCI observation subgroup and non-PCI observation subgroup showed that there was a significant interaction between the genotypes,which was closely related to prognosis(P<0.05).Conclusion Individualized statin treatment regimens based on the detection of SLCO1B1 and APOE gene polymorphisms can improve the lipid compliance rate,shorten the time to lipid compliance,and improve the prognosis of patients after PCI.

Objective:To study the characteristics of laryngopharyngeal reflux (LPR) events in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study analyzed OSA patients who were admitted in the Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of the Chinese PLA General Hospital between November 2020 to July 2023[OSA group, 52 males, 6 females, aged 23-69 (41.22±11.42) years], and non-OSA patients admitted during the same period serve as the control group[non-OSA group, 40 males, 1 female, aged 21-68 (45.12±11.30) years]. All participants completed the Reflux Symptom Index (RSI), Reflux Finding Score (RFS) scale, and 24-hour Hypopharyngeal Esophageal Multichannel Intraluminal Impedance-pH (HEMII-pH) monitoring. LPR events were categorized based on their physical composition-liquid, gas, or gas-liquid mixed, according to the change of impedance values; and further classified by pH levels as acidic, weakly acidic, or alkaline. Differences in LPR events physical properties and the time trends of LPR events between the two groups were compared. Group comparisons were performed using t-test or Mann-Whitney U-test. Analyses were conducted using Pearson, Spearman, or Kendall′s tau-b correlation analysis. Categorical data were analyzed using chi-square test. Results:A total of 99 patients were enrolled, including 58 with OSA and 41 without OSA. Of these, 88.89% (88/99) met the diagnostic criteria for laryngopharyngeal reflux disease (LPRD). In LPRD patients, the median proportion of non gas reflux events and the number of alkaline reflux were significantly higher in the OSA with LPRD group than in the non OSA with LPRD group (70.00% vs 36.36%, 0 vs 0, Z-values respectively -3.373, -3.134, P<0.01). Liquid reflux proportion and the number of both liquid and mixed reflux events showed a positive correlation with the apnea-hypopnea index (AHI) ( r-values respectively 0.304, 0.326, 0.268, P<0.05), while the gas reflux constituent ratio was inversely correlated with AHI ( r=-0.358, P<0.01). The frequency and proportion of nocturnal reflux events showed a positive correlation with AHI ( r-values respectively 0.250, 0.211, P<0.05). A significantly higher proportion of OSA with LPRD group experienced both daytime and nighttime reflux compared to non OSA with LPRD group (66.67% vs 38.71%, P<0.05). In LPRD patients, over 50% of all LPR events occurred within 3 hours after each of the three main meals. Conclusions:In OSA with LPRD patients, LPR events are predominantly non gas in nature. OSA with LPRD patients exhibits a higher proportion and frequency of nocturnal reflux events and a greater number of alkaline reflux episodes compared to non OSA with LPRD patients.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.