The development research on marine ecological environment online monitoring equipment system in China.

There is an urgent need for marine ecological environment monitoring in China at present, but the traditional manual periodic sampling and testing has such disadvantages as low monitoring frequency and limited station coverage, which could not meet the requirements of large-scale real-time continuous data for current marine ecological early-warning monitoring. Therefore, constructing the multi-level, multi-system, and multi-space marine ecological environment online monitoring system could effectively develop marine ecological environment early-warning monitoring capacity. In this paper, the concept of "System of Systems" was introduced into the construction of marine ecological environment online monitoring equipment system, and the architecture of "System of Systems" of the monitoring equipment was constructed from two layers, structure layer and function layer. The composition of the two layers, and the difficulties in construction of the two layers were emphatically discussed. The paper also analyzed the methods of developing "System of Systems" of marine ecological environment online monitoring system.

Optimal prenatal genetic diagnostic approach for posterior fossa malformation: karyotyping, copy number variant testing, or whole-exome sequencing?

BACKGROUND: Posterior fossa malformation (PFM) is a relatively uncommon prenatal brain malformation. Genetic diagnostic approaches, including chromosome karyotyping, copy number variant (CNV) testing, and whole-exome sequencing (WES), have been applied in several cases of fetal structural malformations. However, the clinical value of appropriate genetic diagnostic approaches for different types of PFMs has not been confirmed. Therefore, in this study, we aimed to analyze the value of different combined genetic diagnostic approaches for various types of fetal PFMs. METHODS: This retrospective study was conducted at Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital. Fifty-one pregnant women diagnosed with fetal PFMs who underwent genetic testing in our hospital from January 1, 2017 to December 31, 2022 were enrolled; women with an isolated enlarged cisterna magna were excluded. All participants were categorized into two groups according to the presence of other abnormalities: isolated and non-isolated PFMs groups. Different combined approaches, including karyotype analysis, CNV testing, and trio-based WES, were used for genetic analysis. The detection rates of karyotype analysis, CNV testing, and WES were measured in the isolated and non-isolated groups. RESULTS: In isolated PFMs, pathogenic/likely pathogenic (P/LP) CNVs were detected in four cases (36.36%, 4/11), whereas G-banding karyotyping and WES showed negative results. In non-isolated PFMs, a sequential genetic approach showed a detection rate of 47.5% (19/40); karyotyping revealed aneuploidies in five cases (16.67%, 5/30), CNV testing showed P/LP CNVs in five cases (16.13%, 5/31), and WES identified P/LP variants (in genes CEP20, TMEM67, OFD1, PTPN11, ARID1A, and SMARCA4) in nine cases (40.91%, 9/22). WES showed a detection rate of 83.33% (5/6) in fetuses with Joubert syndrome. Only six patients (five with Blake's pouch cyst and one with unilateral cerebellar hemisphere dysplasia) survived. CONCLUSIONS: We recommend CNV testing for fetuses with isolated PFMs. A sequential genetic approach (karyotyping, CNV testing, and WES) may be beneficial in fetuses with non-isolated PFMs. Particularly, we recommend WES as the first-line genetic diagnostic tool for Joubert syndrome.

Genetic influence on vascular smooth muscle cell apoptosis.

Vascular smooth muscle cell (VSMC) proliferation, migration, and apoptosis play important roles in many physiological processes and pathological conditions. To identify genetic influences on VSMC behavior, we measured these traits and undertook genome-wide association studies in primary umbilical artery-derived VSMCs from >2000 individuals. Although there were no genome-wide significant associations for VSMC proliferation or migration, genetic variants at two genomic loci (7p15.3 and 7q32.3) showed highly significant associations with VSMC apoptosis (P = 1.95 × 10-13 and P = 7.47 × 10-9, respectively). The lead variant at the 7p51.3 locus was associated with increased expression of the GSDME and PALS2 genes in VSMCs. Knockdown of GSDME or PALS2 in VSMCs attenuated apoptotic cell death. A protein co-immunoprecipitation assay indicated that GSDME complexed with PALS2. PALS2 knockdown attenuated activated caspase-3 and GSDME fragmentation, whilst GSDME knockdown also reduced activated caspase-3. These findings provide new insights into the genetic regulation of VSMC apoptosis, with potential utility for therapeutic development.

Three cassava A20/AN1 family genes, Metip3 (5, and 7), can bestow on tolerance of plants to multiple abiotic stresses but show functional convergence and divergence.

A20/AN1 zinc-finger domain-containing genes are very promising candidates in improving plant tolerance to abiotic stresses, but considerably less is known about functions and mechanisms for many of them. In this study, Metip3 (5, and 7), cassava (Manihot esculenta) A20/AN1 genes carrying one A20 domain and one AN1 domain, were functionally characterized at different layers. Metip3 (5, and 7) proteins were all located in the nucleus. No interactions were found between these three proteins. Metip3 (5, and 7)-expressing Arabidopsis was more tolerant to multiple abiotic stresses by Na, Cd, Mn, Al, drought, high temperature, and low temperature. Metip3- and Metip5-expressing Arabidopsis was sensitive to Cu stress, while Metip7-expressing Arabidopsis was insensitive. The H2O2 production significantly decreased in all transgenic Arabidopsis, however, O2·- production significantly decreased in Metip3- and Metip5-expressing Arabidopsis but did not significantly changed in Metip7-expressing Arabidopsis under drought. Metip3 (5, and 7) expression-silenced cassava showed the decreased tolerance to drought and NaCl, presented significant decreases in superoxide dismutase and catalase activities and proline content, and displayed a significant increase in malondialdehyde content under drought. Taken together with transcriptome sequencing analysis, it is suggested that Metip5 gene can not only affect signal transduction related to plant hormone, mitogen activated protein kinases, and starch and sucrose metabolism, DRE-binding transcription factors, and antioxidants, conferring the drought tolerance, but also might deliver the signals from DREB2A INTERACTING PROTEIN1, E3 ubiquitin-protein ligases to proteasome, leading to the drought intolerance. The results are informative not only for further study on evolution of A20/AN1 genes but also for development of climate resilient crops.

CCR9+CD4+ T cells are associated with disease activity in patients with rheumatoid arthritis.

An increase in CD4+ T cells in the synovium is closely linked to the pathogenesis of rheumatoid arthritis (RA). We aimed to identify the possible causes of the elevated CD4+ T cell levels and to explore the factors influencing disease activity in RA. Fifty-five RA patients, including 28 with active RA (ARA), 27 with inactive RA, and 22 healthy controls, were recruited for this study. The proportion of CCR9+CD4+ T cells and the expression of chemokine receptor 9 (CCR9) on CD4+ T cells were analyzed by flow cytometry. Enzyme-linked immunosorbent assay and chemiluminescent immunoassay were used to evaluate interleukin (IL)-17A and IL-6 levels, respectively. The proportion of CCR9+CD4+ T cells and the expression of CCR9 on CD4+ T cells increased significantly in peripheral blood (PB) and synovial fluid (SF) in ARA compared to those in inactive RA. Furthermore, SF contained more CCR9+CD4+ T cells, IL-6, and IL-17A than PB in RA patients. Moreover, CD4+ T cells in the PB of patients with RA, especially ARA, expressed more CCR9 and secreted more IL-6 and IL-17A after activation. Here, we also demonstrated that both the percentage of CCR9+ cells in CD4+ T cells and the expression of CCR9 on circulating CD4+ T cells were positively correlated with erythrocyte sedimentation rate, hypersensitive C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated peptide antibody. CCR9+CD4+ T cells are elevated in PB and SF, and are associated with disease activity in patients with RA.

Lin28 affects the proliferation and osteogenic differentiation of human dental pulp stem cells by directly inhibiting let-7b maturation.

OBJECTIVE: Activation of Lin28 gene under certain conditions promotes tissue damage repair. However, it remains unknown whether conditional expression of Lin28 facilitates the recovery of damaged pulp tissue. In the study, we focus on exploring the effects and possible regulatory mechanisms of Lin28 on the proliferation and differentiation of human dental pulp stem cells (hDPSCs). MATERIALS AND METHODS: We adopted techniques such as the ethynyl-2'-deoxyuridine (EdU) incorporation assay, RNA-protein immunoprecipitation (RIP) analysis, and luciferase assays to study the regulation of hDPSCs by Lin28. Furthermore, gain-of-function and loss-of-function analyses were also used in explored factors regulating hDPSCs activation. RESULTS: The results show that Lin28 inhibited osteogenic differentiation by directly targets pre-let-7b. Through bioinformatics sequencing and dual luciferase experiments we learned that let-7b directly targets the IGF2BP2 3'UTR. Silencing of IGF2BP2 showed a similar biological effect as overexpression of let-7b. Overexpression of IGF2BP2 counteracted the differentiation-promoting effects produced by let-7b overexpression. DISCUSSION/CONCLUSIONS: In conclusion, the RNA-binding protein Lin28 regulates osteogenic differentiation of hDPSCs by inhibiting let-7 miRNA maturation. And mature let-7b directly regulated the expression of IGF2BP2 by targeting the 3'UTR region of IGF2BP2 mRNA thus further inhibiting the differentiation of hDPSCs.

Post-stroke fatigue, hope and discharge readiness: A cross-sectional survey.

AIMS AND OBJECTIVES: To explore the relationships among post-stroke fatigue, hope and discharge readiness in stroke patients, and to determine whether hope mediates the relationship between post-stroke fatigue and discharge readiness. BACKGROUND: In stroke patients, inadequate discharge readiness has been found to correlate with higher readmission and mortality rates. Although previous qualitative studies have confirmed the impact of fatigue on discharge readiness, few studies explore the impact of post-stroke fatigue and hope on discharge readiness of stroke patients. Consequently, the current research on this relationship and its underlying mechanisms is still quite limited. DESIGN: Cross-sectional study. METHODS: Data were collected from 340 stroke patients. The research tools included demographic and disease characteristics, Discharge Readiness Assessment Scale for Stroke, Neurological Fatigue Index for Stroke and Herth Hope Index. The STROBE checklist was used to guide the presentation of this study. RESULTS: Discharge readiness was negatively correlated with post-stroke fatigue and positively correlated with hope. Additionally, post-stroke fatigue was negatively correlated with hope. Post-stroke fatigue had a direct negative effect on discharge readiness, and it can also generate indirect effects through hope. Hope was the partial mediator between post-stroke fatigue and discharge readiness, explaining 55.8% of the total effect. CONCLUSION: Discharge readiness of this population can be improved by reducing post-stroke fatigue and increasing hope. Therefore, effective management of post-stroke fatigue and hope will help improve discharge readiness. RELEVANCE TO CLINICAL PRACTICE: It is recommended that nursing staff should monitor the occurrence and development of post-stroke fatigue in stroke patients, dynamically evaluate the patient's level of hope, and pay attention to the important role of positive psychological qualities in the outcome of discharge. If medical staff can formulate corresponding intervention measures based on the influence path of discharge readiness, then the discharge readiness of stroke patients can be improved.

The impact of accommodation function on the difference between noncycloplegic and cycloplegic refraction in adult myopes.

PURPOSE: To investigate the impact of accommodation function on the difference between cycloplegic and noncycloplegic subjective and automatic refraction in adult myopes. METHODS: Myopic patients between 18 and 50 years old evaluated at Peking University Third Hospital who underwent cycloplegic and noncycloplegic automatic and subjective refraction were enrolled. Accommodation function, including negative and positive relative accommodation (PRA/NRA) and accommodation response (binocular cross cylinder, BCC) was examined. RESULTS: Of the 3268 individuals enrolled, the mean age was 27.3 ± 6.9 years, and 34.8% of participants were male. The noncycloplegic spherical equivalent (SE) was 0.23 ± 0.29 D and 0.64 ± 0.61 D more myopic than cycloplegic subjective and automatic refraction. Adjusting for associated factors, participants with at least 0.50 D of more myopia SE refraction by noncycloplegic subjective refraction were more likely to be older (odds ratio [OR], 1.029; 95% confidence interval [CI], 1.013-1.045) and with insufficient (OR, 1.514; 95% CI, 1.093-2.096) and excessive (OR, 2.196; 95% CI, 1.538-3.137) NRA value. The automatic refraction SE difference of at least 1.00 D more myopia was more likely to be found in individuals with older age (OR, 1.036; 95% CI, 1.022-1.050) and accommodative lead (OR, 1.255; 95% CI, 1.004-1.568). CONCLUSION: A quarter of adult myopes had at least 0.50 and 1.00 D of subjective and automatic SE difference with cycloplegia. The accommodation function significantly affects the difference between cycloplegic and noncycloplegic refraction. Investigating the differences in refraction measurement guarantees the proper use of cycloplegia in adults for myopia correction.

Pathogenesis of Diabetes from Theory of Spleen Deficiency Causing Diabetes Based on Intestinal Innate Immunity / 中国实验方剂学杂志

In western medicine， the small intestine anatomically belongs to the digestive system and is also an important immune organ of the body. The innate immune system of the small intestine consists of a tissue barrier， innate immune cells， and innate immune molecules. The dysfunction of any part can cause metabolic disorders and eventually lead to diabetes. In the pathogenesis of diabetes， traditional Chinese medicine （TCM） has the theory of ''spleen deficiency causing diabetes''， which points out that the impaired spleen function results in inadequate transformation， impaired essence spread， and turbidity by essence accumulation， which is the core pathological link of blood glucose metabolism disorder in diabetes. In terms of the relationship between the small intestine and the spleen， the theory of TCM holds that the small intestine is located in the abdomen and the abdomen is dominated by the spleen. The digestion， absorption， and endocrine functions of the small intestine are also similar to the functions of spleen in governing movement and transformation and spreading essence by virtue of spleen Qi. Therefore， the anatomical and physiological functions of the small intestine in western medicine are closely related to the spleen in TCM. At the same time， the spleen is closely related to the innate immune function of the small intestine in TCM. The spleen participates in the generation and distribution of defense Qi， and the process of defense Qi playing the external function is similar to the process of the activation of the innate immune response. The spleen is also an important organ involved in fluid metabolism， which can cooperate with the lung and kidney to timely remove turbid fluid from the body. It can also work with the stomach as the hub of Qi ascending and descending and regulate the physiological activities of "clear Yang" and "turbid Yin"， so as to ensure the homeostasis of the internal environment of the body， which is the basis for maintaining the normal function of the innate immunity of the small intestine. Therefore， taking "spleen deficiency causing diabetes" as a bridge， the theory of TCM and western medicine were combined to explain the relationship between small intestinal innate immunity imbalance and the pathogenesis of diabetes from the perspective of TCM， which is helpful to understand the pathogenesis of diabetes in a deeper level and also provide a new perspective and new way for the prevention and treatment of this disease with TCM.

Formulation and technology of oxymatrine-astragaloside IV coloaded liposomes based on quality by design / 药学学报

To optimize the formulation and technology of oxymatrine-astragaloside IV coloaded liposomes (Om-As-Lip) based on quality by design (QbD) principles, and further to verify the feasibility of its amplification process, Om-As-Lip was prepared by ethanol injection combined with pH gradient method. The critical material attributions of Om-As-Lip were evaluated by dual-risk analysis tools and Plackett-Burman design (PBD). The formulation of Om-As-Lip was further optimized with the Box-Behnken design (BBD). The design space was also established based on the contour plots of BBD. In order to further investigate the amplification process of Om-As-Lip, the critical process parameters of high-pressure homogenization (HPH) were optimized by single-factor test, and the quality of the final product was also evaluated. The results of risk analysis and PBD confirmed that the astragaloside concentration, cholesterol concentration, and phospholipid ratio (HSPC∶SPC) were the ctitical material attributes. The model established by BBD had a good predictability, and the optimized mass ratio of As to phospholipids was 1∶40, cholesterol to phospholipids was 1∶10, HSPC to SPC was 51∶9. The design space of Om-As-Lip was as follows: the ratio of cholesterol to phospholipids was 1∶12-1∶5 and HSPC to SPC was 1∶7-17∶3. The optimized high-pressure homogenization pressure was 600 bar, temperature was 4 ℃, and cycle times was 6 times for HPH-Om-As-Lip. The quality of Om-As-Lip prepared based on the QbD concept can meet the expected CQAs, and the formulation and technology established can provide a reliable experimental basis for its future development and applications.

Trend analysis of chronic kidney disease incidence and mortality in Chinese population based on age-period-cohort model / 公共卫生与预防医学

Objective To investigate the changing trend and epidemiological characteristics of the incidence and mortality of chronic kidney disease (CKD) with age, period and birth cohort in Chinese population. Methods Based on the data of incidence and mortality of CKD in Chinese population aged 20-80 years from 1990 to 2019 in GHDx database, joinpoint regression model was used to analyze the incidence and mortality trend of CKD. An age-period-cohort model was constructed to analyze the effects of age, period, and birth cohort on the trend of CKD incidence and mortality. Results Joinpoint regression analysis showed that the standardized incidence rate of chronic kidney disease in Chinese population increased from 146.37/100 000 in 1990 to 161.52/100 000 in 2019, while the standardized mortality rate decreased from 12.98/100 000 in 1990 to 11.23/100 000 in 2019. The APC model analysis showed that the risk of CKD incidence and death in the Chinese population increased with age, while the risk of CKD incidence increased with the increase of period. The risk of death did not change significantly with the increase of period. The cohort born later had a lower risk of CKD incidence and death compared to the cohort born earlier. Conclusion At present, the age effect and period effect of the incidence and death risk of chronic kidney disease in China are dominant. It is important to take effective measures and intervene in a timely manner, especially to strengthen the protection of older high-risk groups born earlier.

Research progress of vaccination status, efficacy and safety in children with tumor / 中华预防医学杂志

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Performance of 3D-printed polylactic acid-nano-hydroxyapatite/chitosan/doxycycline antibacterial scaffold / 中国组织工程研究

BACKGROUND:Polylactic acid has good biocompatibility and biodegradability,and has become a new orthopedic fixation material.However,the lack of cell recognition signal of this material is not conducive to cell adhesion and osteogenic differentiation,which limits its application in biomaterials. OBJECTIVE:3D-printed polylactic acid-nano-hydroxyapatite(nHA)/chitosan(CS)scaffold to evaluate its drug sustained-release and biological properties. METHODS:The porous polylactic acid scaffold(recorded as PLA scaffold)with interporous pores was printed by fused deposition modeling technique,and the scaffold was soaked in dopamine solution to prepare polylactic acid-dopamine scaffold(recorded as PLA-DA scaffold).Nano-hydroxyapatite was immersed in chitosan solution,and then the PLA-DA scaffold was immersed in it to prepare polylactic acid-nano-hydroxyapatite/chitosan scaffold(recorded as PLA-nHA/CS scaffold).The micro-morphology,porosity,water contact angle,and compressive strength of the three scaffolds were characterized.PLA-nHA/CS scaffold loaded with doxycycline(recorded as PLA-nHA/CS-DOX scaffold)was prepared by freeze-drying method,and its drug release was characterized.PLA,PLA-DA,PLA-nHA/CS,and PLA-nHA/CS-DOX scaffolds were co-cultured with MC3T3-E1 cells,separately,to detect cell proliferation and osteogenic differentiation.Staphylococcus aureus suspensions of different concentrations were co-cultured with four groups of scaffolds.The antibacterial performance of scaffolds was detected by inhibition zone test. RESULTS AND CONCLUSION:(1)Under scanning electron microscopy,the surfaces of PLA and PLA-DA scaffolders were dense and smooth,and nHA particles were observed on PLA-nHA/CS scaffolders.The porosity of PLA,PLA-DA and PLA-nHA/CS scaffolds decreased gradually,and the compressive strength increased gradually.The elastic modulus of PLA-nHA/CS scaffolds met the requirements of cancelous bone.The water contact angle of PLA-DA and PLA-nHA/CS brackets was smaller than that of PLA scaffolds.The PLA-nHA/CS scaffold sustainably released drugs in vitro for 8 days.(2)CCK-8 assay showed that the proliferation of MC3T3-E1 cells was not significantly affected by the four groups of scaffolds.The activity of alkaline phosphatase in PLA-DA group,PLA-nHA/CS group,and PLA-nHA/CS-DOX group was higher than that in PLA group.Alizarin red staining showed that compared with PLA group,the cells in PLA-nHA/CS group and PLA-nHA/CS-DOX group showed higher mineralized water level.(3)Inhibition zone test exhibited that PLA and PLA-DA scaffolds had no antibacterial properties.PLA-nHA/CS scaffolds had certain antibacterial properties.PLA-nHA/CS-DOX scaffolds had super antibacterial properties.(4)The results showed that the PLA-nHA/CS-DOX scaffold had good drug release performance,cell compatibility,osteogenic properties,and antibacterial properties.

Influencing factors and prediction model construction of diffuse chorioretinal atrophy in patients with high myopia / 眼科新进展

Objective To investigate the factors that lead to diffuse chorioretinal atrophy(DCA)in patients with high myopia(HM)and to establish a prediction model.Methods In this retrospective case-control study,a total of 169 HM patients(338 eyes)admitted to the Department of Ophthalmology,Harbin 242 Hospital from October 2018 to October 2022 were selected.All patients underwent comprehensive ophthalmic examination at the time of inclusion.The incidence of DCA was evaluated according to the International Photographic Classification and Grading System for myopic maculopa-thy,and the risk factors of DCA in HM patients were analyzed by multivariate Logistic regression.The predictive model of DCA in HM patients was established by the receiver operating characteristic curve(ROC)based on risk factors,and the calibration degree of the predictive model was tested by Hosmer-Lemeshow(H-L).Results Among the 169 patients,34 patients were divided into the DCA group,and 135 patients were divided into the non-DCA group;there were statistically significant differences in age and gender distribution between the two groups(both P＜0.05).The axial length(AL),pat-tern standard deviation(PSD),positive rate of carbonic anhydrase 2(CAII)antibody in the DCA group were higher than those in the non-DCA group,while the best corrected visual acuity(BCVA),mean defect(MD)of the visual field,spheri-cal equivalent(SE),deep retinal microvessel density(MVD)and serum 25-hydroxyvitamin D[25(OH)D]were lower than those in the non-DCA group(all P＜0.05).Older age,longer AL and positive CAII antibody were the risk factors for DCA in HM patients(all P＜0.05),while greater deep retinal MVD and higher 25(OH)D were the protective factors(both P＜0.05).ROC analysis showed that the area under the curve of the prediction model for DCA in HM patients was 0.864(95％CI:0.802-0.911,P＜0.001),and the sensitivity and specificity were 85.29％and 88.15％,respectively.According to the H-L test,the prediction model for DCA in HM patients was relatively consistent with the actual results(P＞0.05).Con-clusion The occurrence of DCA in HM patients is affected by age,AL,CAII antibody,deep retinal MVD and 25(OH)D level,and a prediction model established based on the above factors can predict the risk of DCA well.

Informatization Management and Practical Exploration of Information Technology Laboratories in Universities and Colleges of Traditional Chinese Medicine / 医学信息学杂志

Purpose/Significance To provide reference for the information technology laboratory management in universities and col-leges of traditional Chinese medicine(TCM).Method/Process The paper focuses on the main problems faced by information technology laboratory management in universities and colleges of TCM,and proposes ideas of informatization path selection based on practices in Hu-bei University of Chinese Medicine.It constructs informatization management system from the following aspects:network foundation of in-formation technology laboratory,terminal protection cloud service,internet of things technology application,laboratory opening,experi-mental teaching resource sharing,etc.Result/Conclusion The informatization management system significantly improves the utilization rate of the laboratory,greatly reduces the personnel cost and time cost.

Interpretation of the 5th edition WHO classification of adrenal cortical tumors / 中华病理学杂志

Non-neoplastic lesions were added in the 5th edition WHO classification of adrenal cortical tumor based on the recent update, including adrenal rests, adrenal cysts, congenital adrenal hyperplasia and adrenocortical nodular disease. A range of tumor concepts were updated or refined based on tumor cell origin, histopathology, oncology and molecular biology. The most significant nomenclature change in the field of adrenal cortical pathology involves the refined classification of adrenal cortical nodular disease, which now includes sporadic nodular adrenocortical disease, bilateral micronodular adrenal cortical disease, and bilateral macronodular adrenal cortical disease. The 5th edition WHO classification endorses the nomenclature of the HISTALDO classification to help the classification of aldosterone producing adrenal cortical lesions, which uses CYP11B2 immunohistochemistry to identify functional sites of aldosterone production. The 5th edition WHO classification does not change the Weiss and Lin-Weiss-Bisceglia histopathologic criteria for diagnosing adrenal cortical carcinomas, and underscores the diagnostic and prognostic impact of angioinvasion in these tumors. Reticulin algorithm and Helsinki scoring system were added to assist the differential diagnosis of adrenal cortical neoplasms in adults. Pediatric adrenal cortical neoplasms are assessed using the Wieneke system. The 5th edition WHO classification places an emphasis on an accurate assessment of tumor proliferation rate using both the mitotic count (mitoses per 10 mm2) and Ki-67 labeling index which play an essential role in the dynamic risk stratification of affected patients. This review highlights advances in knowledge of histological features, ancillary studies, and associated genetic findings that increase the understanding of the adrenal cortex pathologies in the 5th edition WHO classification.

Mediating effects of cognitive function on the relationship between literacy level and depressive symptoms in middle-aged and elderly people in China / 公共卫生与预防医学

Objective　To explore the mediating role of cognitive function in the association between literacy level and depressive symptoms in middle-aged and elderly people in China. Methods　 Using the fourth national follow-up data of the China Health and Elderly Care Tracking Survey 2018, 8 124 middle-aged and elderly people aged 45 years and above were included as the study subjects. The PROCESS 4.0 program was used to test the mediating effect of cognitive function between literacy level and depressive symptoms, and the Bootstrap method was used for the mediator variable validation. Results The detection rate of depressive symptoms among middle-aged and elderly people in China was 38.10%. After controlling for gender, place of residence, marital status, smoking, alcohol consumption, and exercise, literacy level was a negative predictor of depressive symptoms in middle-aged and elderly people (β =－0.480, t =－11.248, P<0.001). Cognitive function accounted for 58.75% of the amount of mediating effect between literacy level and depressive symptoms. Conclusion 　Literacy level and cognitive function are associated with depressive symptoms in middle-aged and elderly people. Literacy level can influence depressive symptoms directly or indirectly through the mediation of cognitive dysfunction.

Effect of culture supernatant of human umbilical cord mesenchymal stem cells on survival,apoptosis and endometrium receptivity of human endometrial stromal cells after treated with mifepristone / 吉林大学学报(医学版)

Objective:To discuss the effect of human umbilical cord mesenchymal stem cells culture supernatant(hUCMSCs-Sup)on the proliferation,apoptosis,and endometrium receptivity of the human endometrial stromal cells(hEndoSCs)treated with mifepristone(Ms),and to clarify the possible mechanism.Methods:The hEndoSCs were cultured in vitro and divided into control group and 40,60,80,and 100 μmol·L-1 Ms groups.The survival rates of the cells in various groups were detected by MTT assay.The hEndoSCs were divided into control group,40 μmol·L-1 Ms group,and 60 μmol·L-1 Ms group.The apoptotic rates of the cells in various groups were detected by flow cytometry;the expression levels of apoptosis-related protein B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)proteins in the cells in various groups were detected by Western blotting method,and the ratio of Bcl-2/Bax was calculated.After treated with hUCMSCs-Sup,the hEndoSCs were divided into control group,Ms group,Ms+hUCMSCs-Sup group,and Ms+hUCMSCs-Sup+3-methyladenine(3-MA)group.The survival rates of the cells in various groups were detected by MTT assay;the apoptotic rates of the cells in various groups were detected by flow cytometry;the expression levels of microtubule-associated protein 1 light chain 3B-Ⅱ(LC3B-Ⅱ)and microtubule-associated protein 1 light chain 3B-I(LC3B-Ⅰ)proteins in the cells in various groups were detected by Western blotting method,and the ratio of LC3B-Ⅱ/LC3B-Ⅰwas calculated;the expression levels of endometrium receptivity marker molecules mRNA in the cells in various groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.Results:Compared with control group,the survival rates of the cells in 40,60,80,and 100 μmol·L-1 Ms groups were significantly decreased(P<0.05)in a time-dependent and dose-dependent manner.Compared with control group,the apoptotic rates of the cells in 40 and 60 μmol·L-1 Ms groups were significantly increased(P<0.05),and the ratios of Bcl-2/Bax were significantly decreased(P<0.05).After treated with hUCMSCs-Sup,compared with control group,the survival rate of the cells and ratio of LC3B-Ⅱ/LC3B-Ⅰ in the cells in Ms group were significantly decreased(P<0.05),the apoptotic rate was significantly increased(P<0.05),and the expression levels of homeobox A10(HOXA10),leukemia inhibitory factor(LIF),and integrin subunit beta 3(ITGB3)mRNA in the cells were significantly decreased(P<0.05);compared with Ms group,the survival rate of the cells and ratio of LC3B-Ⅱ/LC3B-Ⅰin the cells in Ms+hUCMSCs-Sup group were significantly increased(P<0.05),the apoptotic rate was significantly decreased(P<0.05),and the expression levels of HOXA10,LIF,and ITGB3 mRNA in the cells were significantly increased(P<0.05);compared with Ms+hUCMSCs-Sup group,the survival rate of the cells and ratio of LC3B-Ⅱ/LC3B-Ⅰ in the cells in Ms+hUCMSCs-Sup+3-MA group were significantly decreased(P<0.05).Conclusion:hUCMSCs-Sup can increase the survival rate and decrease the apoptotic rate of the hEndoSCs after treated with Ms,and increase the endometrium receptivity,and its mechanism may be associated with the activation of autophagy of the hEndoSCs by hUCMSCs-Sup.

Research progress in clinical management of nonalcoholic fatty liver disease / 重庆医学

Nonalcoholic fatty liver disease(NAFLD),also known as metabolic associated fatty liver disease(MAFLD),is one of the most common chronic liver diseases characterized by the fat accumulation in the liver and hepatocellular damage.Patients with NAFLD can manifest as simple fatty liver or non-alcoholic steatohepatitis(NASH)in the early stage,and can progress to hepatic fibrosis,hepatic cirrhosis,hepatic fail-ure,and hepatic carcinoma in the late stage.NAFLD has become the most common chronic liver disease,af-fecting more than 30%of the population worldwide,posing a threat to human health that cannot be ignored.However,the current research on NAFLD is still incomplete,and there is no ideal medication for the treat-ment of NAFLD.The clinical management of NAFLD lacks unified standards and evidence-based evidence,and the multiple comorbidities bring challenges to the clinical management of NAFLD.This article was aimed to review the research progress in the clinical management of NAFLD,including the diagnosis and non-invasive examination methods,evaluation and commonly used tools,treatments methods,advantages and disadvanta-ges,so as to provide a reference for the clinical management of NAFLD.

Application status and prospect of endoscopic surgery in surgical treatment of breast cancer / 国际外科学杂志

At present, breast cancer ranks first in the incidence of female malignant tumors, and the age of onset tends to be younger. With the development of comprehensive treatment, most patients can survive for a long time or even be cured clinically. How to improve the quality of life to achieve multiple physical, figure and psychological rehabilitation are the focus of clinical research. Traditional surgical methods have many shortcomings, such as large trauma, slow recovery, many complications, poor physical recovery, and great mental blow to patients, it has been unable to meet the overall medical demands. With the promotion of endoscopic technology in clinical application, endoscopic surgery is increasingly widely used in the surgical treatment of breast cancer, and the technical means are more mature. Its advantages such as concealed incision, small incision, low trauma, good cosmetic effect, and fewer complications can make up for the shortcomings of traditional surgical methods, meet the clinical needs of patients, and have huge advantages in the surgical treatment of breast cancer, it is worth for breast surgeons to learn and further promote. This article reviews the application status and prospect of endoscopic technology in surgical treatment of breast cancer.