With the sustained growth of economy and significant changes in social demographics, the issue of elderly-related diseases has increasingly drawn attention particularly. Alzheimer's disease (AD),as a representative disease of neurodegenerative diseases has become a major challenge, affecting the health and quality of life among the elderly population severely. In recent years, the incidence, prevalence, and mortality rate of AD increase in China, imposing substantial economic burdens on families, society, and the entire healthcare system. To proactively address this challenge and respond to the national 'Healthy China Action' initiative, leading experts from Renji Hospital, Shanghai Jiao Tong University School of Medicine,and Chinese Center for Disease Control and Prevention Chronic Non-communicable Disease Control Center, Fudan University School of Public Health, Shanghai Mental Health Center, Ruijin Hospital,Shanghai Jiao Tong University School of Medicine, Fujian Medical University, and other authoritative institutions, have jointly authored the 'China Alzheimer Disease Report 2024'. Building upon previous editions of 2021, 2022, and 2023, this report updates epidemiological data on AD in China, thoroughly analyzes the latest economic burdens of the disease, and comprehensively evaluates the current status of AD diagnosis and treatment services, as well as the allocation of public health resources in our country. The release of the 'China Alzheimer Disease Report 2024' not only reflects China's progress and efforts in AD research and prevention, but also underscores the social heightened concern for elderly health issues. It aims to provide scientific and technical guidance and robust data support for the prevention, diagnosis, and treatment of AD, offering a professional basis for the government and relevant departments to formulate targeted health policies and intervention measures. Furthermore, it serves as a platform for promoting academic exchanges and cooperation in this field domestically and internationally. Through the dissemination and application of this report, we anticipate it will not only serve as a reference for professionals but also enhance public awareness of AD, promote active participation across various sectors of society, and jointly advance the development of elderly health care in China, empowering us towards achieving 'healthy aging'.

Hashimoto thyroiditis (HT) is a very common organic autoimmune thyroid disease, and its incidence is increasing year by year. It not only causes hypothyroidism in clinical practice, but also has many connections with a variety of immune diseases, endocrine diseases, rheumatic diseases and thyroid cancer. Although the exact etiology of HT has not been fully clarified, the mainstream treatment is still based on management and alternative treatment of hypothyroidism. However, as the research further deepens, more clinical variants have been gradually discovered, more and more factors have been found to be related to the onset of HT, and new discoveries have been made in treatment methods. This article reviews the research progress on clinical manifestations, pathological features, diagnosis, pathogenesis, relationship with other diseases and treatment of HT.

In 2023, the World Health Organization (WHO) released the first document of “Global report on hypertension—The race against a silent killer”. which covers the global prevalence and management of hypertension, analyzes the mortality and disease burden caused by hypertension, explores the risk factors for hypertension, evaluates the cost-effectiveness of blood pressure treatment, and presents successful examples of hypertension management in many countries, especially the global implementation of the WHO-launched HEARTS project for hypertension control. Hypertension is a significant global public health challenge with severe health implications. Over the past 30 years, the number of people with hypertension (defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, or taking antihypertensive medication) has doubled, rising from 650 million in 1990 to 1.3 billion in 2019. Among the global hypertensive population aged 30-79, approximately 54% have been diagnosed, of which 42% are receiving antihypertensive treatment, and only 21% have controlled blood pressure. In 2019, elevated systolic pressure was responsible for over half of cardiovascular disease deaths globally. Increasing the global hypertension control rate to 50% could prevent 76 million deaths from 2023 to 2050. Population-level risk factors for hypertension include high salt and low potassium intake, alcohol consumption, physical inactivity, and air pollution. WHO advocates for the prevention and control of hypertension through measures such as reducing dietary sodium intake, increasing potassium intake, limiting alcohol consumption, quitting smoking, increasing physical activity, and improving air quality. In terms of treatment, WHO guidelines recommend antihypertensive medication for individuals with systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg. For specific populations, it is also recommended to start antihypertensive treatment when systolic blood pressure is between 130-139 mmHg. The use of single-pill combination therapy is also advised to improve adherence and persistence in treatment. The prevalence and management of hypertension in China are also noteworthy. Hypertension is a major cause of mortality and disease burden in the Chinese population. By learning from global successes in hypertension management, China can enhance its efforts in the prevention, control, and monitoring of hypertension, particularly by promoting the application of the HEARTS technical package to improve hypertension management. This report aims to draw attention to major non-communicable diseases, particularly hypertension, as a public health challenge. Through detailed data analysis and successful case studies, the report underscores the importance of hypertension prevention and control, providing scientific evidence for policy-making across countries. This collective effort aims to achieve the global goal of a 25% relative reduction in uncontrolled hypertension prevalence by 2025 compared to 2010. This article will interpret briefly the reports based on the prevalence and management of hypertension in China.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple system involvements. The number of SLE patients in China is large, and patients suffer more severe condition, with low remission rate ，high recurrence rate ，and high risk of infection.The situation of diagnosis and treatment for SLE is still serious. Relevant research released in 2023 shows that there are about 3.41 million cases of SLE patients in the world,and the number of patients in China amounts to 700 000-1 000 000, ranking the first in the world. The average onset age of SLE patients in China is 30.7 years old, and the incidence ratio of women to men is 12∶1.Organ involvement is more common in China, with 45.02% of renal involvement and 37.2% of haematological involvement, which are significantly higher than those in European patients with SLE (27.9% of renal involvement and 18.2% of haematological involvement). The clinical remission rate of SLE patients in China is 2.47%，while the relief rate reported internationally is 22.9%. Currently, the short-term survival rate of SLE patients in China is basically in line with that in the world (5-year survival rate reach 94%), but the long-term survival rate is still not optimistic, declining sharply, with a 25-30 year survival rate of only 30%. In China, 84.13% of SLE patients receive glucocorticoid（GC）therapy, while 42.6% SLE patients receive GC in the world. Infection is the leading cause of death for SLE patients in China, while in western countries, the main causes of death for SLE patients are cardiovascular disease and tumors With the proposal of new classification standards, the introduction of the concept of up-to-date treatment, as well as the use of new treatment methods, the development of SLE diagnosis and treatment will be greatly promoted, and it is expected to further improve the prognosis of patients in China.

Myelodysplastic syndromes (MDS) are a heterogeneous group of myeloid tumours originating from haematopoietic stem/progenitor cells, with a high prevalence in the elderly. Epidemiological surveys in Europe and the United States have revealed that the incidence of MDS is (4-5)/100 000, which increases with age，and the median age at diagnosis of MDS patients reaches 73-76 years. In Shanghai, China, according to the World Health Organization (WHO) 2008 diagnostic criteria, the average incidence rate was 1.51/100 000, and the median age of onset of MDS was found to be 62 years old in a survey conducted in 3.9 million people from 2004 to 2007, of which about one-third of the patients would be transformed into acute myeloid leukemia (AML), and 53% of the patients would die due to infections, haemorrhages, or comorbidities triggered by cytopenias. Elderly MDS patients have their own characteristics in terms of both treatment choices and disease prognosis due to more comorbidities and weaker health. Clinical characteristics of elderly MDS patients include slightly higher white blood cell count, haemoglobin level and more bone marrow blasts than those of young patients, while neutrophil count and platelet count are significantly higher than those of young patients; the number of mutations in elderly MDS patients is higher, with an average of 1.8 mutations per patient, among which the mutations in ASXL1, TET2, SF3B1, STAG2, SRSF2 and TP53 are more common; while the number of mutations in younger patients averages 1.2 per person, among which U2AF1, ASXL1 and RUNX1 mutations are more common. Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is the only curative treatment for MDS, and myeloablative transplantation is feasible in young patients, but only reduced-intensity conditioning (RIC) allo-HSCT can be performed in elderly patients.The natural course and prognosis of elderly MDS patients varies considerably, and the MDS Composite Prognostic Score, which is composed of the composite age (>70 years old), vulnerability index, and IPSS prognostic subgroups, is able to better predict the tolerance of chemotherapy and adverse treatment effects in MDS patients. This consensus is based on the latest evidence-based data in the study of MDS in the elderly at home and abroad, and has been discussed by the experts of the group, which aims to standardise the diagnosis and the whole management of treatment for elderly MDS patients in China.

In China, antithyroid drugs are the first choice of treatment for hyperthyroidism. However, their side effects may result in agranulocytosis, which has an insidious onset and requires urgent treatment. Up to date，the mechanisms of agranulocytosis caused by antithyroid drugs is still unclear. Herein, the article reviewed the direct toxic activities, the immune effects, and the genetic susceptibility of antithyroid drugs, which may be helpful to provide better clinical treatment options and improve the prognosis of agranulocytosis caused by the drugs.

Hyperthyroidism is most common in Graves disease (GD), and traditional antithyroid medicine are often difficult to achieve satisfactory efficacy, and high recurrence rate and long course of treatment are the most prominent problems. Huangyaozi（Dioscorea bublifera L.）, a traditional Chinese medicine, has the effect of “Xiao Ying” and has been widely used in the treatment of GD in recent years, but long-term use may cause liver and kidney damage. Therefore, more research on the efficacy and safety of Huangyaozi need to be done in the treatment of GD.

Subacute thyroiditis (SAT) is a common thyroid inflammatory disease that is frequently prone to misdiagnosis or underdiagnosis, which impact the quality of life for patients adversely. In this review, we summarize the pathogenesis, clinical manifestations, diagnosis, and treatment of SAT, aiming to improve clinician’s understanding of the disease.

Sjögren's syndrome (SS) is a prevalent systemic autoimmune disease, primarily affecting exocrine glands, characterized by lymphocyte and plasma cell infiltration. Patients typically exhibit dry mouth and eyes, with potential involvement of the digestive tract, lungs, and kidneys. In China, SS prevalence ranges from 0.29% to 0.77%, rising to 3.00%-4.00% among the elderly. In Europe, the prevalence is approximately 0.23%. The pathogenesis of SS involves interactions of multiple cells and cytokines, including salivary gland epithelial cells, T-cells, B-cells, dendritic cells, interferon (IFN), interleukin (IL), tumour necrosis factor (TNF) and inflammasomes. Currently, glandular therapy for SS is primarily localised, while treatment for systemic involvement is mainly borrowed from other autoimmune diseases, with no approved targeted drugs yet. Among the targeted therapeutic agents for SS, rituximab, a B-cell targeted therapy, is the most studied and has shown improved salivary efficacy in SS patients with cryoglobulin vasculitis. BAFF inhibitors, CD40 targeting agents, and mesenchymal stem cells have also demonstrated cartain therapeutic effects. For most systemic involvement, glucocorticoids (GCs) are the first-line treatment, while immunosuppressants and biologics serve as second-line options for GCs-tolerant or resistant patients. Although many potential therapeutic targets have been identified, few drugs have been clinically translated. Currently, there is a need to develop relatively safe and effective treatment regimens with minimal adverse effects through comprehensive patient assessment and multidisciplinary collaboration. Future SS drug research will focus on targeted therapies, adverse effects reduction, and multi-drug combinations.

Ultrasonography plays an important role in early screening of thyroid cancer. This article introduced two cases of thyroid metastatic carcinoma secondary to renal clear cell carcinoma and cervical squamous cell carcinoma respectively, analyzed their clinical diagnosis and treatment process, ultrasound characteristics, and prognosis, as well as reviewed the related literature. As atypical thyroid lesions were detected through the ultrasound spectrum in patients with a history of malignant tumors, it should be alert to the possibility of metastatic cancer. Ultrasound-guided core-needle biopsy combined with immunohistochemical testing can help early diagnosis and timely treatment.

Immune-mediated necrotizing myopathy (IMNM) is a significant, subtype of idiopathic inflammatory myopathy（IIM）, characterized by symmetrical proximal limb muscle weakness and markedly elevated serum creatine kinase levels. Some patients may also exhibit extra-skeletal muscle manifestations, including rashes, interstitial lung disease, and myocardial involvement. Since its international nomenclature in 2003, IMNM has gained increasing recognition among researchers and clinicians, leading to numerous scientific investigations and clinical applications. The incidence and prevalence of IMNM can vary across different geographic regions and ethnic groups. A small sample survey conducted in the United States reported an incidence of 0.83 per 100,000 and a prevalence of 1.85 per 100,000. In northern Spain, among patients positive for anti-HMGCR antibodies, the incidence was found to be 0.6 per 100,000, with a prevalence of 3 per 100,000. However, there is a notable paucity of relevant data regarding IMNM in China. Identified risk factors for IMNM include susceptibility alleles (e.g., HLA-DRB1*11), the use of statins or immune checkpoint inhibitors, and viral infections. Diagnosing IMNM requires a comprehensive evaluation that includes assessing muscle involvement symptoms, identifying myositis-specific autoantibodies, measuring creatine kinase levels, analyzing muscle biopsy pathology, and conducting related examinations. Currently, there is a lack of prospective randomized controlled studies on the treatment of IMNM. In clinical practice, glucocorticoids and traditional immunosuppressants are primarily employed on an empirical basis. For refractory cases, treatment regimens may involve rituximab and intravenous human immunoglobulin. Therapeutic strategies targeting B cells and the mechanisms underlying pathogenic autoantibody production may offer promising avenues for future treatment. This article systematically reviews the clinical characteristics, diagnostic criteria, relevant auxiliary examinations, and treatment strategies for IMNM, aiming to provide a comprehensive reference for clinicians in understanding, diagnosing, and managing this condition.

Gestational hyperthyroidism can significantly increase health risks to both mother and fetal. However, there are few reports on its impact on the neuropsychological development of offspring. This article reviews the literature related to the effect of hyperthyroidism during pregnancy on brain structure, intelligence quotient (IQ) and neuropsychiatric disorders of offsprings. It was found that hyperthyroidism during pregnancy may be associated with reduced brain volume and cortical gray matter volume, lower IQ, and increase the risk of depression in offspring. However, its’ relationship with other mental and emotional well-being disorder of the offspring is unclear.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease for which traditional treatments often show limited efficacy in severe and refractory cases. Recently, chimeric antigen receptor (CAR) T cell therapy has emerged as a novel immunotherapy strategy, demonstrating significant efficacy in preliminary studies for SLE treatment. Biomarkers are crucial for the precise assessment of treatment efficacy and safety. Biomarkers for monitoring the efficacy of CAR T cell therapy include traditional markers and markers related to CAR T therapy. Traditional markers for SLE disease monitoring, such as decreased titers of serum anti-double-stranded DNA, anti-single-stranded DNA, anti-nucleosome autoantibodies, normalization of serum complement levels, and improvement of urine protein/creatinine ratio, indicate that the disease is effectively controlled and can still be used for baseline follow-up and disease monitoring during CAR T cell therapy. B cell markers indicating effective CAR T therapy include a decrease in the number of B cells after infusion, a B cell phenotype dominated by the naive B cell, and a significant decrease in the proportion of memory B cells and plasmablasts. Regarding T cell markers related to CAR T therapy, the high proportion of naive T cell (CD45RA+CD27+) and central memory T cell (CD45RA-CD62L+CD27+) subsets before infusion indicate stronger anti-tumor efficacy; The initial expression of transcription factors associated with early memory differentiation on patients’ CAR T cells, such as T cell factor 7 (TCF7) and lymphoid enhancer‐binding factor 1 (LEF1), suggest that these patients may be sensitive to CAR T therapy. After infusion, high expression of T cell activation markers (CD25, CD69 and CD137), and exhaustion markers (CD57, PD-1, and Tim-3) indicate that T cells are in a state of dysfunction, with limited expansion, cytokine secretion and cell killing capabilities. Safety markers, including effector cytokines secreted by CAR T cells [interleukin(IL)-2 and IFN-γ] and cytokines produced by monocytes and macrophages (IL-1 and IL-8), can be used to monitor the most common toxicities and side-effects of CAR T-cell therapies, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).High levels of serum macrophage inflammatory protein-1α (MIP-1α) are of high value for predicting the risk of severe CRS and ICANS after CAR T-cell therapy. In addition, haematotoxicity markers include baseline platelet count and absolute neutrophil count, and an infection-related prediction model consisting of IL-8, IFN-γ and IL-1β are effective in predicting the risk of severe infection in patients after infusion.The design of the CAR receptor structure, the chemotherapeutic modality used to remove the lymphocytes, as well as the choice of treatments that the patient had received and the autoimmune status, all affect the efficacy and safety. A comprehensive and standardised testing and evaluation system should be included in current and future clinical studies to provide a comparative standard for the use of CAR T-cell therapy in autoimmune diseases such as SLE.

Objective　To collect extracellular vesicles（ EVs） secreted by adipose mesenchymal stem cells（ ADSCs） after ultrasound stimulation， compare with EVs secreted by normal ADSCs， and to explore the effects of EVs secreted after ultrasound stimulation on the biological characteristics of ADSCs， including cell proliferation， migration， and adipogenic differentiation abilities. Methods　Firstly， some ADSCs were treated with low-intensity ultrasound， cell culture supernatant was collected and extracellular vesicles （U-EVs） were extracted by ultrafiltration method. Some ADSCs were cultured normally and their extracellular vesicles（ N-EVs） were also collected. The experiments were performed in the following three groups： PBS （blank control group）， EVs secreted by untreated cells （N-EVs group）， and EVs secreted by ultrasoundtreated cells （U-EVs group）. The CCK-8 assay was used to assess the viability of ADSCs under treatment with EVs at different concentrations. The concentration that most strongly enhanced cell viability was selected. At this concentration， cell migration was detected by scratch test， cell proliferation was detected by EdU method， and adipogenic induction medium was used to induce and compare adipogenic differentiation ability of ADSCs. Results　EVs secreted after ultrasound stimulation met the identification standards， and the optimal concentration for affecting ADSCs was about 150 µg/mL. At this concentration， the cell proliferation rate of the U-EVs group（ 19.2%±1.8%） was significantly higher than that of the N-EVs group（ 11.9%±3.4%）， and the Oil Red O staining area of the U-EVs group was（ 2.78±0.23） times that of the control group， significantly higher than （2.11±0.18） times of the N-EVs group. However， there was no significant difference in cell migration rates between the N-EVs （16.3%±2.0%） and U-EVs （21.5%±2.3%） groups. Conclusion　 EVs secreted by ultrasound-stimulated ADSCs significantly enhance the vitality of ADSCs and improve their abilities in cell proliferation， migration， and adipogenic differentiation.

The Global Burden of Disease Study 2021 (GBD 2021) analyzed 371 diseases and injuries using 100,983 data sources, estimating years lived with disability, years of life lost, disability-adjusted life years, and healthy life expectancy. From 1990 to 2019, the annual rate of change in global all-cause mortality ranged from -0.9% to 2.4%, while deaths increased by 10.8% and 7.5% in 2020 and 2021 respectively due to COVID-19. In 2021, COVID-19 was the second lea-ding cause of death globally, with a mortality rate of 94.0 per 100 000. The mortality rates of other major causes, such as ischemic heart disease and stroke were 108.7 and 87.4 per 100 000, respectively. Global life expectancy rose from 65.5 years in 1990 to 73.3 years in 2019 but dropped to 71.7 years in 2021 due to COVID-19, which reduced life expectancy by 2.2 years, significantly impacting the trend of health improvement. In China, GBD 2021 data shows a significant increase in life expectancy from 1990 to 2021: from 69.9 to 80.7 years for women and from 65.7 to 74.9 years for men. However, non-communicable diseases such as cardiovascular diseases, cancers, and chronic respiratory diseases remain major health threats. In 2021, these diseases had the highest burden among the top ten causes in China, with rising incidence and morta-lity rates. Major health risk factors in China include tobacco, hypertension, and dietary risks. This paper, through the systematic analysis of GBD 2021 data, reveals current trends in disease burden globally and in China, and proposes public health strategy recommendations. China should enhance chronic disease management, improve public health emergency responses, address health inequalities, and promote basic research and international cooperation to improve overall health levels.

The application of minimal-invasive blepharoplasty has been increasing year by year because of its advantages such as invisible surgical scar， stable and natural double eyelid and short recovery period. This review summarized the advances of minimal-invasive blepharoplasty at home and abroad， and introduced the surgical procedure of minimal-invasive blepharoplasty and the advantages， disadvantages and complications， so as to provide reference for the clinical application of minimal-invasive blepharoplasty.

Distant tension-offloading suture is one of the solutions for tension impeded wound healing and scarring after surgery. In this paper， an innovated technique of achieving tension-offloading suturing using hypodermic needle guidance was introduced. Hypodermic needle guided suturing（ HGS） technique makes high quality wound closure simple， with cheap and accessible equipment.

The neural crest is a migratory， multipotent stem cell population during vertebrate embryogenesis， and lineage tracing is the focus of its research. Over the 150 years since its first discovery， understanding of the neural crest has gone through a transition from morphological observations to single-cell level. In this paper， important approaches applied to study the neural crest were reviewed including radioisotope labeling， chimeras， vital dye labeling， in vitro clonal analysis， conditional genetic recombination and single-cell sequencing.

In China, the clinical prevalence of hyperthyroidism is 0.78%, subclinical hyperthyroidism is 0.44%, and Graves' disease hyperthyroidism is 0.53%. Untreated hyperthyroidism and subclinical hyperthyroidism may increase the risk of atrial fibrillation, stroke, and other cardiovascular events, as well as osteoporosis and fractures. In special populations (such as pregnant women and the elderly), both the diagnosis and treatment of hyperthyroidism require special conside-rations. Although China has made some progress in the standardized diagnosis and treatment of hyperthyroidism, challenges remain. Despite established guidelines for diagnosis and differential diagnosis, clinical practice faces obstacles, notably due to limited access to thyroid radionuclide imaging and 131 iodine uptake rate in some hospitals. Additionally, the peak systolic velocity (PSV) in the thyroid obtained by thyroid ultrasound is not widely adopted. While clinical treatment methods align with international standards in China, there is a lack of specific guidelines on the initial dose and dose adjustment during the reduction period of antithyroid drugs (ATD). Currently, most clinicians follow the initial dose regimen re-commended by the guidelines established by the American Thyroid Association. Furthermore, indicators in both domestic and international guidelines for predicting adverse reactions to ATD remain unclear. During the ATD treatment of hyperthyroidism, the incidence of transient neutropenia is 1%-5%, and follow-up of baseline blood routine and liver function is ne-cessary. At present, there is a lack of monitoring frequency regulations and high-quality evidence-based medical support for above indice, and clinical practice has not yet established feasible indicators for predicting ATD adverse reactions. ATD-induced agranulocytosis is related to genetic susceptibility, age, drug type and dosage. HLA-B*27:05, HLA-B*38:02 and HLA-DRB1*08:03 on chromosome 6 in Chinese Han population may be susceptibility genes. Progress has been made in the diagnosis and treatment of thyroid associated ophthalmopathy (TAO) in China, with 36.7% of doctors adopting a multidisciplinary approach. Due to accessibility issues, less than 10% of patients receive biological agents to treat TAO, which is significantly lower than that in Western countries. Given these current status and challenges in China, further measures are necessary to improve the diagnosis and treatment of hyperthyroidism.

For locally advanced rectal cancer (LARC), the standard treatment of neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) leaded to limited tumor regression grade and organ preservation rate, and didn’t decrease the rate of distant metastasis. Radiotherapy can promote the immune response and has good synergistic effect with immunotherapy, which is likely to overcome the treatment difficulty of the microsatellite stable(MSS) colorectal cancer. Recently, multiple clinical trials are ongoing in terms of the combination of nCRT and immunotherapy in LARC. Most of them have achieved promising complete response rates, providing new treatment options for preservation of organ functions in mid-low MSS LARC. Large-scale randomized controlled trials are needed in the future to validate these findings and explore the benefit of organ preservation and long-term survival. In addition, studies are still needed on the optimal combination patterns of radiotherapy and immunotherapy and the precise efficacy evaluation, etc.

　Cell therapy has been developed rapidly in recent years. However， the effect of cell therapy in tissue repairing and regeneration is ineffective. Therefore， a new strategy to enhance the therapeutic effect of cell therapy is urgently demanded. Some studies in recent years have found that the combination of mRNA with cell therapy， that is， transfect mRNA into transplanted cells， can promote the efficiency of tissue repairing and regeneration， which could further promote the repair and regeneration of multiple tissues such as cardiovascular， skin， bone and articulus. In this paper， the advantages of the combination of mRNA with cell therapy， other applications in tissue repairing and regeneration， and the difficulties of clinical transformation were all reviewed， aiming to provide new ideas for the tissue repairing and regeneration and the strategies of the clinical transformation.

Since the International guidelines for groin hernia management were published in 2018, many new evidences have been published. In October 2023, the HerniaSurge Group published Update of the international HerniaSurge guidelines for groin hernia management. It updated eight chapters of the last guidelines, proposed 20 key questions, and 39 new statements and 32 recommendations, of which 16 were strong recommendations. This article combined clinical concerns to sort out and interpret the updated version.

Breast cancer is one of the most common cancers affecting women globally. With the advent of digital pathology slide scanners and the continuous evolution of deep learning algorithms, there has been a significant advancement in the application of artificial intelligence (AI) in the diagnosis and treatment of breast cancer. This article provided an overview of the current research and application status of AI in breast cancer pathological diagnosis, and summarized the challenges encountered as well as future directions in this field.

Fat infiltration plays an important role in the pathological development of muscle related diseases， and is closely related to disease recurrence and poor prognosis. In recent years， the research on the potential mechanism of intramuscular fat infiltration has been highly popular at home and abroad， mainly focusing on the basic and clinical research related to skeletal muscle and myocardial fat infiltration. In this paper， the relevant literature on the pathogenesis of intramuscular fat infiltration in skeletal muscle and myocardium in recent years was reviewed， to provide assistance for the basic and clinical research of intramuscular fat infiltration related diseases.

Attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy shows great potential for biomedical applications, especially in clinical hematology, due to its rapid, accurate, and non-invasive nature. The technique captures molecular vibrational spectra, yielding detailed chemical information of nucleic acids, proteins, and lipids in biological samples critical for disease screening and diagnosis. Extensive research demonstrates the efficacy of ATR-FTIR in diagnosing diseases, such as thalassemia, AIDS, breast cancer, ovarian cancer, and brain tumors. Combining ATR-FTIR with chemometrics enables accurate disease screening and differential diagnosis. ATR-FTIR spectroscopy combined with partial least squares regression model was used to quantitatively analyze thalassaemia screening indices in human peripheral blood samples，such as mean erythrocyte haemoglobin content, mean erythrocyte volume and haemoglobin, and the sensitivity and specificity of screening reached 100.0% and 95.3%, respectively. ATR-FTIR spectroscopy combined with linear discriminant analysis method based on genetic algorithm were used to identify the characteristic peaks at 1,558 cm^-1 (amide Ⅰ band), 1,506 cm^-1 (cyclic group) and 901 cm^-1 (phosphodiester stretching band) in the blood samples of pregnant women, the sensitivity and specificity for diagnoding human immunodeficiency virus (HIV) infection was 89% and and 92%, respectively. In breast cancer, ATR-FTIR coupled with principal component regression （PCR） methods reached sensitivity and specificity of 92.3% and 87.1%, respectively. Furthermore, ATR-FTIR spectroscopy is applicable in other biomedical domains, such as detecting cellular and histological samples and classifying disease severity. Despite its promise, challenges like environmental interference and sample contamination persist. Future advancements and optimizations in ATR-FTIR spectroscopy are anticipated to enhance its role in clinical hematology and extend its applicability to a broader spectrum of diseases.

The underlying electrophysiological mechanisms and clinical treatments of cardiovascular diseases, which are the most common cause of morbidity and mortality worldwide, have gotten a lot of attention and been widely explored in recent decades. Along the way, techniques such as medical imaging, computing modeling, and artificial intelligence (AI) have always played significant roles in above studies. In this article, we illustrated the applications of AI in cardiac electrophysiological research and disease prediction. We summarized general principles of AI and then focused on the roles of AI in cardiac basic and clinical studies incorporating magnetic resonance imaging and computing modeling techniques. The main challenges and perspectives were also analyzed.

Objective　To establish the evaluation index system of nursing quality of plastic and reconstructive surgery specialties based on Donabedian theory. Methods　 Thirty five experts from Three-A hospitals in China in plastic and reconstructive surgery were consulted through email from April to June in 2023. The primary nursing quality evaluation index system of plastic and reconstructive surgery specialties was drawn up through literature research and qualitative interview methods. Two rounds of expert consultation were conducted by Delphi method to establish the nursing quality evaluation index system of plastic and reconstructive surgery specialties. Results　The composition of experts in the two rounds of consultation was consistent， and the Cr of the experts was 0.777 1. In this study， the coefficient of variation of the secondary and tertiary indexes was 0.107-0.129， and the coefficient of variation was below 0.15， indicating that the two round consultations were credible and the coordination of the experts was good. Eventually， experts were consistant with each other in regard to all the indexes， the evaluation indexes of nursing quality in plastic and reconstructive surgery including 3 primary indexes， 10 secondary indexes and 47 tertiary indexes were determined through two round consultations by email. Conclusion　 This study established a relatively scientific， rigorous and comprehensive evaluation index system for the quality of surgical care in plastic and reconstructive surgery， providing a theoretical basis for optimizing the quality of nursing care in plastic and reconstructive surgery and improving the satisfaction of patients and doctors.

Numerous microorganisms inhabit the human intestine, participate in the digestion and absorption of nutrients, and produce a large number of metabolites, participate in regulating functions and protect the host from disease damage. Bile acids are produced by cholesterol metabolism and metabolized by the gut microbiota into secondary bile acids. Bile acids facilitate lipid digestion and absorption and interact with the gut microbiota. The composition and quantity of the gut microbiota also regulate bile acid metabolism. As sepsis occurs, the poor prognosis of the disease is associated with disturbances of the gut microbiota and bile acid metabolism. This paper reviews the metabolic process of bile acids, the interaction between bile acids and the gut microbiota, and the changes of gut microbiota and bile acids during sepsis, to provide new ideas for the prevention and treatment of sepsis.