Chronic diseases of the digestive system are becoming more prevalent in the elderly population.To reduce the occurrence of malignant lesions in the upper gastrointestinal tract, it is important to focus on diagnosing and monitoring esophageal and gastric mucosal lesions in the elderly.The advancement of gastrointestinal endoscopy technology has led to the development of various endoscopic equipments and techniques.One such technology is confocal laser microendoscopy, which allows real-time biopsy and cytology of the mucosal surface.This technology holds significant value in the real-time diagnosis of conditions like gastroesophageal reflux disease(GERD), Barrett's esophagus, esophageal high-level intraepithelial neoplasia, early esophageal squamous carcinoma, atrophic gastritis, and pre-cancerous gastric mucosa in the elderly.Understanding the application of confocal laser microendoscopy in diagnosing esophageal and gastric mucosal lesions in the elderly is crucial for clinicians in making diagnostic and therapeutic decisions.

Objective:To explore the development status, research hotspots, and frontiers of low value care (LVC) de-implementation in foreign countries.Methods:The literature on LVC de-implementation included in the Web of Science core collection from 1995 to 2023 was electronically searched. Excel software was used to organize literature. CiteSpace software was used to visually analyze the authors, institutions, countries, journals, co-citation status, and key terms included in the literature.Results:A total of 576 articles were included. The overall number of articles published from 1995 to 2023 showed an increase, with the highest in 2022 (150 articles). The top 10 research institutions with publication volume and centrality> 0.10 were the Harvard University and the United States Department of Veterans Affairs. Compared with other journals, Archives of Internal Medicine, Anesthesiology and American Review of Respiratory Disease had the highest number of indexed literature. The journals with a co-citation frequency greater than 50 and centrality>0.10 were Archives of Internal Medicine, The American Journal of Medicine, British Medical Journal and Annals of Internal Medicine. In addition to the key terms searched for in this study, the key terms frequently cited greater than 30 times in 576 articles were "impact" "management" "outcome" "health" "quality" "health care", and "guidelines". The clusters in keyword clustering analysis that extend the timeline to the past 5 years were "value based care" and "low value care". The analysis of burst words showed that the forefront was the accurate identification of LVC in clinical practice and the intervention strategies for LVC de-implementation. Conclusions:Through the analysis of key terms and burst terms, it is found that in recent years, research topics in this field focus on the relationship between LVC and medical insurance expenditures, the influencing factors of de-implementation, tools (checklists or manuals) for identifying LVC, clinical intervention pathways, de-implementation of different types of LVC, and evaluation of the effectiveness of de-implementation. In the future, domestic research needs to strengthen international cooperation and exchange, explore and construct a suitable implementation path for LVC in China, accurately formulate LVC lists and intervention strategies, optimize nursing measures, improve the effective utilization of medical resources, and provide effective and high-quality nursing services for patients.

Hepatic cystic echinococcosis (HCE) is a global public health problem. At present, the research of echinococcosis mainly focuses on etiology, epidemiology, immunology, imaging and treatment programs, while ignoring the systematic study of its natural decline and death course. The popularization of modern imaging examination methods enable researchers to obtain the clinical data of HCE in different stages, with different imaging features and pathological states. Based on CT imaging features and clinical practice, the authors discuss the natural decline and death course of HCE, in order to provide new ideas for its diagnosis and treatment.

ObjectiveTo investigate the association between ZJU index and the onset of nonalcoholic fatty liver disease （NAFLD） in the Uygur population and the value of ZJU index in predicting the risk of NAFLD. MethodsThe Uighur community of The 51st Regiment of The Third Division of Xinjiang Kashgar Corps was selected as the investigation site， and the Uygur residents who lived in this area and had an age of >18 years were selected as subjects. Follow-up studies were conducted in 2019， 2020， and 2021， and the investigation of outcomes was completed in June to August of 2021. Finally 10 597 subjects were enrolled for analysis. The Kruskal-Wallis H test was used for comparison of continuous variables between groups， and the chi-square test was used for comparison of categorical variables between groups. The subjects were divided into Q1-Q4 groups according to the level of ZJU index. The Kaplan-Meier curve was used to predict the incidence rate of NAFLD， and the Cox regression model was used to analyze the association between ZJU index and the risk of NAFLD； the area under the ROC curve （AUC） was used to evaluate the value of ZJU index in predicting the risk of NAFLD. ResultsDuring the median follow-up time of 4.92 years， the incidence rate of NAFLD was 9.4% （992/10 597） among the study population. After adjustment for multiple factors， there was a significant increase in the risk of NAFLD with the increase in ZJU index， with a hazard ratio of 2.55 （95% confidence interval ［CI］： 1.60‍ — ‍4.06）， 7.32 （95%CI： 4.78‍ — ‍11.20）， and 21.74 （95%CI： 14.32‍ — ‍33.00）， respectively （all P_trend<0.001）. The ROC curve showed that ZJU index had a higher value in predicting NAFLD （AUC=0.816）， and the male subgroup had a significantly higher predictive accuracy of ZJU index than the female subgroup （AUC： 0.829 vs 0.809）. ConclusionZJU index is a predictive factor for the onset of NAFLD in the Uygur population in rural areas of Xinjiang and has a good value in predicting the risk of NAFLD.

Epigallocatechin gallate(EGCG) is the most abundant component in green tea catechins. It has the functions of anti-oxidation stress, anti-inflammatory response and regulating cell apoptosis. EGCG is effective in preventing and treating tumors, improving metabolic diseases such as obesity and diabetes, treating cardiovascular diseases and neuroprotection. EGCG is the main component of tea polyphenols that plays a biological role. This paper searched and summarized the literatures related to the neuropharmacological effects of EGCG at home and abroad, so as to provide more theoretical basis for the clinical application of EGCG in the prevention and treatment of nerve injury, neurodegenerative diseases, cognitive impairment and so on.

Objective:To construct the postgraduate teaching case database of rotation in department of cardiology, and to explore its application effect.Methods:The postgraduate teaching case base of rotation in department of cardiology was constructed during April 2020 to December 2020. A total of 32 graduate students rotating in Department of Cardiology of Affiliated Hospital of Guilin Medical University from January 2021 to April 2021 were selected and randomly divided into two groups. The routine group adopted the traditional teaching method, and the research group applied the teaching case base on this basis, both for one month. The examination results, the changes of clinical practice ability before and after the teaching, and the satisfaction with the teaching mode were compared between the two groups. SPSS 22.0 was used for t test and chi-square test. Results:The final results of the theoretical examination and practical operation examination of the two groups were higher than those of the entrance examination ( P<0.05), and the results of the theoretical examination and practical operation examination of the research group were higher than those of the routine group ( P<0.05). The scores of clinical practice ability of inquiry, case analysis, diagnosis, treatment and follow-up in the two groups after teaching were higher than those before teaching ( P<0.05), and the scores of clinical practice ability in the research group after teaching were higher than those in the routine group ( P<0.05). The satisfaction scores on improving examination results, enhancing clinical practice ability, deepening professional understanding and enhancing professional confidence of the teaching mode of the research group were higher than those of the routine group ( P<0.05). Conclusion:The construction and application of postgraduate teaching case base of cardiology rotation can improve the examination results, enhance the clinical practice ability, and achieve the satisfaction of postgraduates.

Objective:To analyze the changing trend of articles, authors and citation indexes in Chinese Journal of Behavioral Medicine and Brain Science(CJBMBS), so as to provide basis and guidance for further academic quality and editing and proofreading quality improving, and striving to build high-quality scientific and technological journal.Methods:Chinese Medical Journal Network and Wanfang database were used to obtain the information of articles published from 2009 to 2021.The citation indexes of the CJBMBS and the discipline journals of " neurology and psychiatry" were obtained from the natural science volume of the Citation Report (Core Edition) of Chinese Scientific and Technological Journals from 2002 to 2021.All data were analyzed by Excel 2010.Results:The CJBMBS published 187-314 articles per year from 2015 to 2021, and the annual number of articles decreased year by year.The average number of pages per article was 3.66-6.13 pages/article, showing an increasing trend year by year.Since 2015, the CJBMBS set up 3-7 key topics every year, and published 6.4%-16.2% articles of the annual.From 2009 to 2020, the average citation volume of magazine articles was 12.8-27.9, showing an increasing trend year by year.The average number of authors per article was basically stable at 4-6.From 2001 to 2020, the core impact factor of the CJBMBS was 0.188-1.327, with a wave like change and an overall upward trend.The total frequency of core citations was 155-2 836, with a rapid increase from 2001 to 2009, a stable at 2 500 from 2007 to 2017, and a downward trend after 2014.Compared with average level of the core journals of the discipline " neurology and psychiatry" , the core impact factor and the core total citation frequency of the CJBMBS from 2009 to 2020 were both significantly higher.From 2009 to 2020, the fund paper ratio of CJBMBS was 0.42-0.84, showing an upward trend.Conclusion:The citation indexes of CJBMBS are in the forefront of the discipline in recent years.In the future, we should pay more attention to the academic quality of papers and further expand the influence of the journal.

Ameloblastoma is a relatively common benign tumor that occurs in the dental epithelial tissues, which is characterized with local infiltration and growth, high-risk recurrence and metastasis, etc. At present, radical osteotomy is the main treatment of ameloblastoma, whereas it yields high recurrence rate and causes multiple postoperative complications such as facial and functional deformities, etc. For inoperable patients, non-surgical interventions, such as radiotherapy, chemotherapy and molecule-targeted therapy, are urgently needed to improve prognosis and retain organs. This article summarizes the current status and research progresses on non-surgical treatment of ameloblastoma, aiming to provide evidence for individualized treatment of ameloblastoma.

Objective:Ameloblastoma (AM) is a rare tumor derived from dental epithelial tissues, which is prone to recurrence and infiltration. This study aims to identify the prognostic factors of AM.Methods:207 ameloblastoma patients were screened from the SEER database. A Cox regression model and nomogram were constructed to evaluate the factors on the overall survival. Clinical data of 61 patients admitted to Hunan Cancer Hospital were retrospectively analyzed. The independent factors of recurrence rate were analyzed by the Cox regression model.Results:The results on the SEER database showed that age, tumor size, type of surgery, radiotherapy were important prognostic factors of the overall survival. The nomogram was constructed and the C-index was equaled to 0.821, indicating this model was moderately accurate. The receiver operating characteristic (ROC) curve demonstrated that the area under the ROC curve (AUC) at 1, 3, 5, and 10 years were 0.852, 0.869, 0.856, and 0.879, indicating this model had relatively high sensitivity and specificity. Kaplan- Meier survival analysis suggested that overall survival in the high-risk group was significantly lower than that in the low-risk group ( P<0.001). Based on retrospective analysis, clinical symptoms and type of surgery were the independent factors of the local recurrence rate. Kaplan- Meier survival analysis found the recurrence rate of facial swelling and pain was lower compared to those of other symptoms. Compared with the palliative surgery, radical surgery could decrease the recurrence rate. Conclusions:Age, tumor size, type of surgery, and radiotherapy may be important factors of the overall survival. Type of surgery and clinical symptoms are probably the independent factors of the recurrence rate.

Objective ::To investigate the role of trehalose in hepatic ischemia-reperfusion injury and its underlying mechanisms.Methods:C57BL/6J mice were randomly divided into no-ischemia group, ischemia-reperfusion group, trehalose-treated group and normal saline control group. After ischemia for 90 minutes, reperfusion immediately or 6h, blood and liver tissues were collected, and serum was separated. The liver function parameters of ALT, AST, the inflammatory factors of TNF-α, IL-1β and IL-2, and the pathological changes of liver were detected to study the role of trehalose during hepatic ischemia-reperfusion injury. Hypoxia-reoxygenation cell model was established by AML12 mouse hepatocyte line, and divided into experimental group and control group. The experimental group was divided into low dose group and high dose group according to the concentration of trehalose administrated. And the control group had no use of trehalose. The level of apoptosis was measured to study the effect of trehalose on apoptosis induced by hepatic ischemia-reperfusion injury with flow cytometry. Western blot was utilized for detecting the levels of Caspase-3, Cleaved Caspase-3 and Bcl-2 protein to understand the molecular mechanisms of trehalose in apoptosis during hepatic ischemia-reperfusion injury.Results:In vivo animal experiments showed that liver function and such inflammatory factors as ALT, AST, TNF-α, IL-1β and IL-2 increased in ischemia-reperfusion group after hepatic ischemia-reperfusion ( P<0.05), and liver tissue became necrotic. After a treatment of trehalose, the levels of ALT, AST, TNF-α, IL-1β and IL-2 were lower than those of normalsaline control group and the area of liver tissue necrosis also decreased ( P<0.05). In vitro cell experiments showed that the apoptosis level of hepatocytes in the experimental group decreased compared with the control group.And the level of activated pro-apoptotic protein Cleaved Caspase-3 decreased, the level of anti-apoptotic protein Bcl-2 increased. Conclusions:Trehalose has protective effects on hepatic ischemia-reperfusion injury in vivo and in vitro. The mechanism may be involved in inhibiting inflammation induced by hepatic ischemia-reperfusion injury, suppressing the activation of Caspase-3 and promoting the expression of Bcl-2, thus played a protective role by extenuation of hepatocyteapoptosis.