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:Eucommia ulmoides has a certain osteogenic effect,which can promote the proliferation and differentiation of osteoblasts.However,it is unclear whether Eucommia ulmoides has effects on alveolar bone formation and Wnt/β-Catenin signaling pathway. OBJECTIVE:To investigate the mechanism by which Eucommia ulmoides promotes alveolar bone formation in ovariectomized rats based on the Wnt/β-Catenin signaling pathway. METHODS:Sixty female Sprague-Dawley rats were selected and randomly divided into five groups:blank control group,sham-operation group,model group,low-dose group Eucommia ulmoides group,and high-dose Eucommia ulmoides group,with twelve rats in each group.Osteoporosis animal models were constructed by bilateral oophorectomy in the model group and the low-dose and high-dose Eucommia ulmoides groups.The sham-operation group underwent the same method to remove adipose tissue of equal mass around the bilateral ovaries.Three months after surgery,the low-and high-dose Eucommia ulmoides groups were given 2.1 g/kg/d and 4.2 g/kg/d Eucommia ulmoides by gavage,respectively.The sham-operation group and model group were given the same amount of physiological saline by gavage.After 12 weeks of drug intervention,the changes in alveolar bone mass of rats in each group were observed through Micro-CT;hematoxylin-eosin staining was used to observe the pathological structural changes of alveolar bone in rats;enzyme linked immunosorbent assay was used to detect the expression levels of alkaline phosphatase and osteocalcin in the serum of rats;western blot was used to detect the expression levels of β-Catenin and Frizzled9 receptor proteins in the alveolar bone of rats;and real-time fluorescence quantitative PCR was used to detect the expression of osteocalcin,Runt-related transcription factor 2(Runx2),alkaline phosphatase,β-catenin,and frizzled9 mRNAs in alveolar bone tissues of rats. RESULTS AND CONCLUSION:Compared with the blank control group,bone volume fraction,trabecular number,trabecular thickness,and bone mineral density were reduced in the model group(P＜0.05),and trabecular separation was elevated(P＜0.05).Pathological observation showed that the arrangement of trabeculae was disordered and irregular,the trabeculae were thinned or broken,and the marrow cavity was enlarged in the model group,with a significant reduction in bone volume;the level of alkaline phosphatase in the serum was increased(P＜0.05),and the level of osteocalcin was decreased(P＜0.05);mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were decreased(P＜0.05);protein expression of β-Catenin and Frizzled9 was decreased(P＜0.05).Compared with the model group,the low-and high-dose Eucommia ulmoides groups showed an increase in bone volume fraction,trabecular number,trabecular thickness,and bone mineral density(P＜0.05)and a decrease in trabecular separation(P＜0.05).In the low-and high-dose Eucommia ulmoides groups,bone trabeculae were slightly aligned and thickened,with a significant increase in bone mass.Compared with the model group,the serum level of alkaline phosphatase was reduced(P＜0.05)and the serum level of osteocalcin was elevated(P＜0.05)in the low-and high-dose Eucommia ulmoides groups.Compared with the model group,the mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were increased in the low-and high-dose Eucommia ulmoides groups(P＜0.05).Compared with the model group,the protein expression of Frizzled9 was increased in the low-dose Eucommia ulmoides group(P＜0.05),while the protein expression of β-Catenin and Frizzled9 was increased in the high-dose Eucommia ulmoides group(P＜0.05).Compared with the low-dose Eucommia ulmoides group,the high-dose Eucommia ulmoides group had a more significant improvement in the above indexes.To conclude,Eucommia ulmoides can effectively promote the alveolar bone formation,and its mechanism of action might be related to the activation of the Wnt/β-catenin signaling pathway.

Objective: To investigate the differences in enolase and laminin levels in vaginal epithelial tissues between mice successfully infected withGardnerellaand mice not infected with Gardnerella, providing information for further exploration of the correlation between enolase and laminin levels and the incidence of bacterial vaginosis. Methods: Gardnerella strains isolated, purified, and identified from vaginal secretions of patients with bacterial vaginosis were used to infect the vagina of mice and establish a mouse model of bacterial vaginosis. Successful and failed mice was defined as successful and failed groups, respectively. Differential expression of enolase and laminin in the vaginal epithelial tissue of two groups of mice was detected by Western blot. Modeling success rate was statistically analyzed, and the expression differences of enolase and laminin was compared between two groups. Results: One strain of Gardnerella vaginalis infected 10 SPF grade KM mice, 7 mice met the diagnostic criteria for bacterial vaginosis, and 3 mice failed to model, with a success rate of 70%. Western blot was used to detect protein expression levels, and the levels of laminin and enolase in the successfully modeled mouse vaginal epithelial tissue were significantly higher than those in the failed modeling group, with statistical differences between the two groups(P<0.05). Conclusion Enolase and laminin may be involved in the occurrence of bacterial vaginosis, however, further research is needed to determine the mechanisms through which they trigger the occurrence and development of the disease.

BackgroundNurses' moral courage is a special type of altruistic behavior， which is considered to be a key factor to improve patient safety. Empathy level can positively predict altruistic behavior， and moral sensitivity exerts an obvious mediation role in the positive prediction. At present， there is no relevant research to explore the path role of moral sensitivity in the relationship between empathy and moral courage. ObjectiveTo verify the mediation role of moral sensitivity in the relationship between empathy and moral courage among nursing students， so as to provide references for increasing the moral courage among nursing students. MethodsFrom June 1 to June 30， 2022， a total of 602 nursing students were recruited via convenience sampling from a tertiary grade A hospital in Mianyang， and participants were assessed using Interpersonal Reactivity Index-Chinese （IRI-C）， Moral Sensitivity Questionnaire-Revised Chinese Version （MSQ-R-CV） and Nurses' Moral Courage Scale （NMCS）. Pearson correlation analysis was used to assess the correlation among above scales. The Process macro plug-in for SPSS was used to test the mediation effect of moral sensitivity on the relationship between empathy and moral courage. ResultsA total of 602 valid questionnaires were collected， with an effective recovery rate of 96.78%. IRI-C score of nursing students was positively correlated with MSQ-R-CV score and NMCS score （r=0.269， 0.146， P<0.01）. MSQ-R-CV score was positively correlated with NMCS score （r=0.722， P<0.01）. The mediation effect model was established with IRI-C score as independent variable， MSQ-R-CV score as intermediary variable， and NMCS score as dependent variable. Analysis showed that the direct effect of empathy on moral courage among nursing students was not significant （direct effect value of -0.052， 95% CI： -0.178~0.008）， while analysis yielded a significant indirect effect of empathy on moral courage via moral sensitivity （indirect effect value of 0.189， 95% CI： 0.209~0.407）. ConclusionThe moral sensitivity of nursing students plays a significant mediation role in the relationship between empathy and moral courage. ［Funded by 2022 Higher Education Teaching Research and Reform Project of Southwest Medical University （number， JG2022239）］

Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region. Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors. Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation. Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.

Objective This study used resting-state functional magnetic resonance imaging(rs-fMRI)to investigate the changes of local brain regional homogeneity in patients with depression and childhood maltreatment,and we calculated the relationship between altered ReHo values and the severity of childhood maltreatment.Methods 25 patients with depression and childhood maltreatment,25 patients with depression without childhood maltreatment,and 25 age,gender,and education-matched healthy controls were prospectively enrolled.All subjects underwent resting-state functional magnetic resonance imaging and ReHo analysis.One-way analysis of variance was used to compare the group differences,along with multiple comparison correction.Pearson correlation analysis was used to explore the relationship between region ReHo values with clinical scales.Results Compared with the group of depression without childhood maltreatment,the abnormal brain regions of depression with childhood maltreatment are mainly located in the dorsolateral prefrontal cortex,cerebellum,parietal gyrus,and precentral gyrus.The ReHo values of depression with childhood maltreatment in the left cerebellum and the left dorsolateral prefrontal cortex are correlated with the severity of childhood maltreatment.Conclusions Depression with childhood mal-treatment is associated with changes in local spontaneous brain activity,which are correlated with the severity of childhood maltreatment.The brain changes in the dorsolateral prefrontal cortex and cerebellum may explain the neurobiological mechanisms of depression with childhood maltreatment.

Gallbladder benign lesion is a common clinical disease. Some benign gallbladder disease may progress to malignant tumors, but its pathogenesis and malignant transformation tendency have not been fully elucidated. The treatment of benign gallbladder lesions is still controversial: some scholars advocate cholecystectomy to prevent malignant changes; others believe that some benign gallbladder lesions can be followed up closely. Laparoscopic cholecystectomy is the main method for the treatment of benign gallbladder diseases. But aggressive surgery to treat benign gallbladder diseases can possibly cause damage to patients. This article reviews the clinical manifestations, imaging manifestations and progress in diagnosis and treatment of benign gallbladder lesions.