Objective To investigate the effect of spontaneous hypertension on the remodeling of cardiac and aortic tissues in rats, with special attention to the changes in the content of collagen fibers, elastic fibers and secreted Frizzled-related protein 2 （sFRP2） in cardiac and aortic tissues. Methods 28-week-old SHR rats （Spontaneously Hypertensive rats） and WKY （Wistar-Kyoto rats） of the same age were selected as experimental animals. Cardiac load was assessed by calculating the cardiac weight index. Collagen fibers and elastic fibers were isolated from the rat thoracic aorta by hot alkali method, and their content was determined by biochemical analysis. In addition, pathological evaluation of tissue sections of the left ventricle and thoracic aorta were performed by H&E staining, Sirius red staining, and lichen red staining. Western blotting was used to determine the expression level of sFRP2 protein in cardiac tissues. Results Compared with WKY rats, the heart weight index of SHR rats increased significantly （P<0.001）, and the results of biochemical analysis and staining of pathological sections showed that the content of collagen fibers in the aorta in the SHR group was higher than that in the WKY group, while the content of elastic fibers was lower, but the difference did not have statistical significance. The content of collagen fibers in the heart of the SHR group was significantly higher than that in the WKY group （P<0.01）. Western blotting showed that there was no significant difference in the expression level of sFRP2 protein in heart tissues between the two groups. Conclusion The remodeling of cardiac and aortic tissues in a rat model of spontaneous hypertension may involve complex molecular mechanisms, not just changes in the content of collagen fibers and elastic fibers. The detailed mechanism of the progression of spontaneous hypertension and target organs damage still need further investigation.

BackgroundSchizophrenia is a complex， chronic and severe mental disorder， and the pathogenesis of which has not been fully elucidated. The abnormalities in lipid metabolism and circulating metabolomes have already been implicated in the pathophysiology of schizophrenia. However， available studies have mainly focused on a few liposomes and circulating metabolites， failing to systematically reveal the mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia. ObjectiveTo uncover mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia， thereby providing biomarkers and potential therapeutic targets for the prevention and treatment of schizophrenia. MethodsData from Genome-Wide Association Studies （GWAS） were analyzed， taking data on 179 liposomes as exposure variables， data on 123 circulating metabolites as intermediate variables， and data on schizophrenia as outcome variable. A two-step， two-sample Mendelian randomization analysis was conducted using the inverse-variance weighted （IVW）， MR- Egger， Weighted median， and Weighted mode methods to study the causal relationship of liposomes with schizophrenia and the mediating role of circulating metabolomes in the relationship. ResultsIVW model identified 8 lipids associated with schizophrenia without reverse causality. There were 5 circulating metabolomes strongly associated with schizophrenia. Acetate played a significant mediating role in the causal relationship between phosphatidylinositol （18：0_18：2） and schizophrenia （P=0.023， 95% CI： 0.036~0.532）， accounting for 28.4% of the causal relationship. ConclusionThis study demonstrates a causal relationship between liposomes and schizophrenia， with phosphatidylinositol being a risk factor in the progression of schizophrenia， and acetate playing a mediating role in this process. ［Fund by National Natural Science Foundation of China General Program （number， 82271546）； Shanxi Merit Funding for Overseas Students Sci-Tech Activities Project （number， 20240041）； Shanxi Province Science and Technology Innovation Leading Talent Team Project （number， 202304051001049）； Shanxi Scientific Research Foundation for the Returned Overseas Chinese Scholars （number， 2022-190）； "Six Measures for Health Care Prosperity" Specialized Research Program （number， Y2024008）］

Objective To explore the digital transformation path of primary medical and health institutions in China,and provide reference for the research and follow-up policy formulation in the field.Methods The experience and practice of Tianjin digital health service consortium were collected by semi-structured interview,and the external and internal data were continuously collected as supplements.Finally,the data were coded and analyzed by programmatic grounded method.Results After coding,39 first-level categories and 13 second-level categories were obtained.Finally,guided by the theoretical analysis framework of organizational change,five core categories were obtained,namely,driving factors,structural change,technological change,person change and task change,so as to establish the digital transformation of primary health care institutions.Conclusion The four dimensions of structure,technology,person and task change influence and complement each other.The digital transformation of regional medical institutions should ensure the coordinated development of multiple dimensions at the organizational level.Finally,suggestions are put forward in three aspects:attaching importance to top-level design driving,applying digital technology to empower business scenarios,and actively promoting practical experience in relevant regions.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective To investigate the effect of acacetin(ACE)on the apoptosis of dental pulp cells induced by lipopolysaccharide(LPS)by regulating the high mobility histone 1(HMGB1)/Toll-like receptor 4(TLR4)signaling pathway.Methods Third generation dental pulp cells were isolated,cloned and purified from pulp of five patients with healthy teeth extracted from orthodontics and impaction.Cell morphology was observed and identification of stromal cell surface antigen1(STRO1)by immunofluorescence,and epidermal antigens CD90,CD105,CD34 and CD45 were identified by flow cytometry.MTT was applied to identify the effect of ACE on the activity of primary dental pulp cells(DPSCs).DPSCs were divided into the control group(0 μmol/L ACE culture),the LPS group(1 ng/L LPS treatment),the L-ACE group(added 20 μmol/L ACE on the basis of LPS group),the H-ACE group(added 40 μmol/L ACE on the basis of LPS group),the pcDNA-NC group(transfected pcDNA-NC plasmid on the basis of H-ACE group)and the HMGB group(transfected pcDNA-HMGB on the basis of H-ACE group).Cell proliferation was detected by CCK-8.Clone formation number was detected by clone formation assay.Western blot experiments were applied to detect the expression of HMGB1/TLR4 pathway,apoptosis and inflammation related proteins.ELISA assay was applied to detect levels of interleukin(IL-)-1β,IL-4 and tumor necrosis factor-α(TNF-α)in cell supernatant.Results DPSCs were successfully isolated and identified based on cell morphology,positive expression of STRO1,positive expression of CD90 and CD105,and negative identification of CD34 and CD45.Compared with the control group,cell proliferation activity,clonal cell count,B-cell lymphoma-2(Bcl-2)and IL-4 levels were decreased in the LPS group,while apoptosis rate,the pathway related proteins HMGB1,TLR4,apoptosis related proteins aspartate-specific cysteine protease(Caspase)-3,Caspase-7,Bcl-2 associated X protein(Bax),and inflammatory factors IL-1β,TNF-α were increased in the LPS group(P＜0.05).Compared with the LPS group,cell proliferation activity,Bcl-2 and IL-4 were increased successively in the L-ACE group and the H-ACE group,and apoptosis rate,pathway-related proteins HMGB1,TLR4,Caspase-3,Caspase-7 and Bax,and inflammatory factors IL-1β,TNF-α were reduced successively(P＜0.05).Overexpression of HMGB reversed the effects of H-ACE on cell proliferation,apoptosis,expression of related proteins and inflammatory factors(P＜0.05).Conclusion ACE inhibits LPS induced apoptosis of dental pulp cells,and it may be achieved by inhibiting the HMGB1/TLR4 signaling pathway.

Background and aims:Liver cirrhosis is a complex disease that may result in increased morbidity and mortality following bariatric surgery(BS).This study aimed to explore the outcome of BS in patients with unexpected cirrhosis,focusing on postoperative complications and the progression of liver disease. Methods:A retrospective study of bariatric patients with cirrhosis from four centers in China between 2016 and 2023 was conducted,with follow-up for one year after BS.The primary outcome was the safety of BS in patients with unexpected cirrhosis,while the secondary outcome was the metabolic efficacy of BS in this group postoperatively. Results:A total of 47 patients met the study criteria,including 46 cases of Child-Pugh class A cirrhosis and 1 case of Child-Pugh B.Pathological examination confirmed nodular cirrhosis in 21 patients(44.68％),pseudolobule formation in 1 patient(2.13％),lipedema degeneration with inflammatory cell infiltration in 3 patients(6.38％),and chronic hepatitis in 1 patient(2.13％).The average percentage of total weight loss was 29.73±6.53％at one year postoperatively.During the 30-day postoperative period,the complication rate was 6.38％,which included portal vein thrombosis,gastrointestinal bleeding,and intra-abdominal infection.Moreover,no cases of liver decompensation or mortality were reported during the follow-up period.The remission rates of comorbidities among 41 patients one year after surgery were as fol-lows:dyslipidemia 100％,type 2 diabetes 82.61％,hypertension 84.62％,and obstructive sleep apnea syndrome 85.71％. Conclusions:BS can be safely performed in patients with unexpected cirrhosis in the compensated stage of liver disease,with low postoperative morbidity and no mortality observed during one-year follow-up.

Purpose To investigate the value of MYB and Notch1 immunohistochemical staining in the differential diagno-sis of classic adenoid cystic carcinoma of the breast(C-AdCC)and solid-basaloid adenoid cystic carcinoma of the breast(SB-AdCC).Methods MYB and Notch1 immunohistochemical staining were performed in 20 cases of C-AdCC,6 cases of SB-AdCC and 65 cases of other breast lesions in the archives of pa-thology department.26 cases of AdCC were detected by FISH,and 6 cases of SB-AdCC were detected by NGS.Results MYB immunohistochemical staining showed that C-AdCC(20/20)was moderately or strongly positive,while SB-AdCC(4/6)was mod-erately or strongly positive.Collagenous spherulosis(5/5)showed focal or diffuse weak positivity;Malignant adenomyoepi-thelioma(3/3)was focally moderately or strongly positive;8 matrix-producing carcinomas and 9 secretory carcinomas and 40 non-specific triple-negative breast cancers were negative.Immu-nohistochemistry of Notch1 showed diffuse moderate positive for SB-AdCC(3/6)and negative for C-AdCC(20/20).3 cases of malignant adenomyoepithelioma,5 cases of collagenous spherulo-sis,8 cases of matrix-producing carcinoma,9 cases of secretory carcinoma and 40 cases of non-specific triple-negative breast cancer were negative.FISH showed MYB gene disruption in C-AdCC(12/19)and NGS showed SB-AdCC(3/6)Notch1 muta-tion.Conclusion Moderately or strongly diffuse expression of MYB and Notch1 by immunohistochemistry can assist in the dif-ferentiation of C-AdCC from SB-AdCC,and it can be further clarified by molecular detection when it is difficult to distinguish malignant adenomyoepithelioma.

The STAR tool was used to evaluate and analyze the science, transparency, and applicability of Chinese pathology guidelines and consensus published in medical journals in 2022. There were a total of 18 pathology guidelines and consensuses published in 2022, including 1 guideline and 17 consensuses. The results showed that the guideline score was 21.83 points, lower than the overall guideline average (43.4 points). Consensus ratings scored an average of 27.87 points, on par with the overall consensus level (28.3 points). Areas that scored above the overall level were "conflict of interest" and "working groups", while areas that scored below the overall level were "proposals", "funding", "evidence", "consensus approaches" and "accessibility". To sum up, the formulation of pathology guidelines and consensuses in 2022 is not standardized, and the evidence retrieval process, evidence evaluation methods and grading criteria for recommendations on clinical issues are not provided in the formulation process; the process and method for reaching consensus are not provided, the plan is lacking, and registration is not carried out. It is therefore suggested that guidelines/consensus makers in the field of pathology should attach importance to evidence-based medical evidence, strictly follow guideline formulation methods and processes, further improve the scientific, applicable and transparent guidelines/consensuses in the field, and better provide support for clinicians and patients.

ObjectiveWe analyzed the prevalence of metabolic syndrome in adult residents of Nanjing and explored its influencing factors in order to provide technical references for the prevention of metabolic syndrome. MethodsBased on the data of the Nanjing adult chronic disease thematic survey from January 2017 to June 2018， the influencing factors of metabolic syndrome were analyzed using multifactorial logistic regression model and decision tree model. ResultsThe weighted prevalence of metabolic syndrome among people aged 18 years and over in Nanjing was 16.14%（95%CI：16.12%‒16.16%）. Prevalence of metabolic syndrome was statistically different（P<0.05）among respondents with different demographic characteristics. Logistic regression model analysis showed that age， gender， education， physical activity level， marriage status， smoking status， drinking status， weight status， diabetes and hypertension family history were the influencing factors for the prevalence of metabolic syndrome（P<0.05）. The results of the decision tree model showed that weight status was the most influential factor for metabolic syndrome， followed by age， gender， diabetes family history and smoking status. ConclusionThe prevalence of metabolic syndrome is high among the adult population in Nanjing， and special attention should be paid to middle-aged and elderly men who are overweight and obese， have a family history of diabetes and smoking.

Enteropathy-associated T cell lymphoma(EATL)is a rare subtype of mature T cell lymphoma,formerly known as EATL type Ⅰ.EATL is closely linked to celiac disease.Risk factors for EATL include a history of celiac disease,human leukocyte antigen-DQ2(HLA-DQ2)gene susceptibility,aberrant intestinal intraepithelial lymphocytes(IELs)accumulation and ulcerative jejunitis.The pathogenesis is related to HLA-DQ2 allele variation,mutational events of Janus kinase(JAK)-signal transducer and activator of transcription(STAT)pathway and nuclear factor kappa-B(NF-κ B),as well as functional changes of microRNA(miRNA).Commonly involved sites in EATL are the small intestine,followed by the stomach and colon.EATL usually presents with dyspepsia,gluten-insensitive malabsorption,intestinal obstruction,hemorrhage and perforation.EATL is an aggressive disease,with a poor prognosis.Misdiagnosis is common during the early stage of the disease.Anthracycline-based combination chemotherapy is the dominant treatment for EATL.Surgical resection is used to alleviate obstruction,hemorrhage,or perforation in some patients.Stem cell transplantation for consolidation after remission of first-line chemotherapy can prolong patients'survival time.Monoclonal antibody brentuximab vedotin targeting CD30,anti-CD52 antibody alemtuzumab,immune checkpoint inhibitors,and drugs used to treat refractory celiac disease(RCD)type Ⅱ and peripheral T cell lymphomas(PTCL)may be effective against EATL.This paper summarizes the epidemiology,genetic and molecular characteristics,clinicopathological characteristics,immunophenotypic characteristics and new advances in the treatment of EATL.