Abstract:Objective: To investigate whether M2-type macrophage-derived exosomes (M2-Exo) affect the osteogenic differentiation of lipopolysaccharide (LPS)-stimulated human periodontal ligament stem cells (hPDLSCs) and to elucidate the underlying mechanism. Methods: RAW264.7 macrophages and human periodontal ligament stem cells (hPDLSCs) were used in this study. RAW264.7 cells were induced to polarize into M2-type macrophages, and M2-Exo were extracted and identified by flow cytometry, Western blot (WB), transmission electron microscopy, and other characterization methods. A periodontitis model was established in hPDLSCs by LPS stimulation. Subsequently, M2-Exo were co-cultured with hPDLSCs in osteogenic induction medium, in which the medium was supplemented with fresh M2-Exo regularly during the co-culture period. The effects of M2-Exo on osteogenic differentiation and pyroptosis were evaluated by alkaline phosphatase (ALP) staining, alizarin red S (ARS) staining, WB, and related assays. Nigericin (an NLRP3 agonist) was used for the rescue experiment. Results: M2-type macrophages and M2-Exo were successfully generated and characterized. M2-Exo significantly attenuated LPS-induced suppression of osteogenic differentiation in hPDLSCs, as evidenced by enhanced ALP activity, increased mineralized nodule formation, and upregulated expression of osteogenic markers (P < 0.001). Moreover, M2-Exo alleviated LPS-induced cytotoxicity, reduced pro-inflammatory cytokine levels, and inhibited NLRP3 inflammasome-mediated pyroptosis (P < 0.001). Nigericin abolished the anti-pyroptotic and osteogenic-promoting effects of M2-Exo (P < 0.05). Conclusion: M2-Exo appear to facilitate osteogenic differentiation in LPS-stimulated hPDLSCs through suppression of NLRP3 inflammasome-mediated pyroptosis. However, the underlying regulatory mechanism warrants further validation beyond the current associative data.

Abstract:Objective: Based on the method of bibliometrics, this paper systematically sorts out the characteristics, core research strength, influence of highly cited literature, research hotspots and evolution trends of sericin protein, objectively presents the knowledge structure and development context of this field, and provides data support and reference for subsequent research topics, direction innovation and optimal allocation of resources. Methods: The core collection of Web of Science was used as the data source, and the search terms sericin, silk sericin, sericin protein were set. The academic literature related to sericin protein from 2015 to 2025 was retrieved (limited to Article, Review). After duplicate checking and screening by Note Express, Excel, CiteSpace, VOSviewer and other tools were used to conduct statistical and visual analysis from the dimensions of annual publication volume, country distribution, research institutions and keywords. Results: A total of 1,713 eligible literatures were included. The annual number of publications showed a steady growth trend, China was the core publishing country, Huazhong University of Science and Technology, Southwest University and others were the core research institutions. Keyword analysis showed that the research hotspots focused on the material properties, biological activity and application direction of sericin protein. The emergence of keywords indicates that antibacterial, sericin hydrogel and cell viability were the research frontiers after 2023. Conclusion: The research heat in the field of sericin protein continues to rise, and has formed a research pattern led by China and supported by core institutions and teams. The core research focuses on biomedical applications. At present, there were some problems in the research, such as insufficient depth of cross-regional cooperation and weak connection of clinical transformation. In the future, the development of multifunctional composite materials, optimization of standardized extraction process and clinical transformation research should be strengthened to promote the practical and accurate development of the field.

Abstract:Objective: To compare the differences in composition and function of gut microbiota between patients with chronic spontaneous urticaria and healthy individuals, and to explore the correlation between gut microbiota and the pathogenesis of chronic spontaneous urticaria. Methods: A total of 15 CSU patients and 15 healthy controls were enrolled. Fecal samples were collected for total DNA extraction, metagenomic sequencing and subsequent bioinformatic analysis. The differences in species composition, diversity and functional pathways of gut microbiota were compared between the two groups. Results: There was no significant difference in Alpha diversity indices between the two groups (P > 0.05), while a significant difference was observed in Beta diversity (P < 0.05). Species revealed showed that the relative abundance of Bifidobacterium was increased in the CSU group. By contrast, the abundances of Bacteroidetes, Bacteroides and Faecalibacterium prausnitzii were decreased in CSU patients (P < 0.05). A total of 42 differentially expressed functional pathways were identified via functional annotation. Pathways including lipopolysaccharide biosynthesis and one-carbon pool by folate were enriched in the CSU group, whereas starch and sucrose metabolism as well as galactose metabolism were enriched in healthy controls (P < 0.05). Conclusion: Patients with CSU present obvious gut microbiota dysbiosis and aberrant metabolic pathways. Such alterations may be associated with the pathogenesis of CSU.

Abstract:Objective: To explore the efficacy of denosumab (DEN) and zoledronic acid (ZOL) in the treatment of senile osteoporosis (SOP) and the influence on bone mineral density (BMD) and risk of falls. Methods: A total of 168 patients with SOP were selected as research subjects, and were assigned into ZOL group (n=85, routine treatment and ZOL treatment) and DEN group (n=83, routine treatment and DEN treatment) according to different treatment regimens. The clinical efficacy, BMD (lumbar spine and femoral neck), bone metabolism indicators [N-MID osteocalcin (N-MID), calcitonin (CT), carboxy-terminal propeptide of type I procollagen (PICP), β-crosslaps (β-CTX)], bone pain degree [visual analogue scale (VAS)], risk of falls [short physical performance battery (SPPB)] and adverse reactions were compared between the two groups. Results: There were no statistical differences in clinical efficacy and adverse reactions between DEN group and ZOL group (P > 0.05). BMD values of lumbar spine and femoral neck and SPPB score at 12 months after treatment in DEN group were higher than those in ZOL group (P < 0.05), while the bone metabolism indicators and VAS score were lower compared to ZOL group (P < 0.05). Conclusion: Both DEN and ZOL exhibit good efficacy and safety in the treatment of SOP, but DEN has more advantages than ZOL in improving BMD, inhibiting bone turnover, alleviating bone pain and reducing the risk of falls.

Abstract:Objective:To investigate the characteristic features of gastric motility dysfunction in patients with hypothyroidism (HT)andtoquantitativelyexploretheirassociation withthyroidhormonelevels.Methods:Atotalof83 patientswithhypothyroidism (subgroupedbyetiologyintoHashimoto??sthyroiditis,post- 131Itherapy,andpost-thyroidectomy) and58 healthycontrols wereenrolled.Gastricfilling ultrasonography (GFU)wasperformedtoobtain gastric motility parameters,includinggastricaccommodation,contractionfrequency,peakamplitudeofcontraction waves,contraction wave velocity,gastricmotilityindex(GMI),antralcontractionamplitude(ACA),andgastricemptyingratesatmultipletimepoints (GER).Gastrointestinalsymptom scores (GSRS)andthyroidfunctionlaboratoryindicators [serum thyroid-stimulating hormone(TSH),freetriiodothyronine(FT3),andfreethyroxine(FT4)]weresimultaneouslycollected.Spearmancorrelation analysiswasusedtoassesstheassociationsbetween TSH levels,GSRSscores,andgastric motilityparameters.Results: Comparedwithhealthycontrols,thehypothyroidgroupexhibitededucedcontractionfrequency,peakamplitudeofcontraction waves,contractionwavevelocity,GMI,gastricemptyingratesatmultipletimepoints,andACA (P<0.05).Subgroupanalysis showedthatthepost- 131Itherapyandpost-thyroidectomygroupshadreductionsincertainparameters(proximalGERat10min andACAat10 min,P<0.05).SpearmancorrelationanalysisrevealednegativecorrelationsbetweenTSHlevelsandGMI, contractionfrequency,proximalGERat30min,andACAat30min(P<0.05).GSRSscoreswerealsonegativelycorrelated withGMIandACAat30min(P<0.05).Conclusion:Patientswithhypothyroidismexhibitmultidimensionalgastricmotility dysfunction,whichisassociated with decreasedthyroid hormonelevelsand gastrointestinalsymptoms.Gastric motility abnormalitiesvaryaccordingtotheetiologyofhypothyroidism.Multiparametric,non-invasiveGFU providesanoveltoolfor preciseassessment,providing evidenceforindividualized clinicalinterventions,improving quality oflife,andfacilitating mechanisticunderstandingandmanagement.

Abstract:Objective: To explore the clinical outcomes and postoperative recurrence of laparoscopic radical nephroureterectomy (RNU) combined with bladder sleeve resection for the treatment of upper urinary tract urothelial carcinoma (UTUC). Methods: Clinical data of 98 patients with UTUC were retrospectively analyzed. Intravesical recurrence-free survival (IVRFS) was the primary endpoint, and extra-vesical progression-free survival (EV-PFS) was the exploratory endpoint. Survival outcomes and associated factors were analyzed using Kaplan-Meier and Cox models. Results: The median age was 67.0 (61.2, 73.0) years, and grade ≥ III complications occurred in 6.1%. During a median follow-up of 34.0 (22.5, 44.5) months, intravesical recurrence, local recurrence, distant metastasis and cancer-specific death occurred in 42 (42.9%), 25 (25.5%), 22 (22.4%) and 18 (18.4%) patients, respectively. The IVRFS rates for 1, 2, and 3 years were 69.4%, 60.3%, and 52.9%, respectively, while the EV-PFS rates were 78.1%, 62.9%, and 50.3%, respectively. Non-pelvic tumors were associated with worse IVRFS, while stage ≥ pT3 and lymphovascular invasion were associated with worse EV-PFS. Conclusion: Laparoscopic RNU combined with bladder sleeve resection for the treatment of UTUC has reliable perioperative safety. Given the prevalence of postoperative bladder recurrence, it is recommended to conduct a stratified evaluation of bladder recurrence and extra-bladder progression during clinical follow-up.

Abstract:Objective: To explore the value of echocardiography coronary artery Z-value in the evaluation of coronary artery lesion (CAL) in children with Kawasaki disease (KD). Methods: The data of 85 children with KD complicated with CAL (CAL group, including 52 cases of coronary artery dilatation and 33 cases of coronary artery aneurysm) and 77 children with simple KD (non-CAL group) were retrospectively analyzed. All children completed echocardiography within 24 hours after admission. The Z-values of left main coronary artery (LMCA), right coronary artery (RCA) and left anterior descending artery (LAD) were calculated. Results: In CAL group, the duration of fever, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), LMCA-Z value, RCA-Z value and LAD-Z value were higher than those in non-CAL group (P < 0.05). In CAL group, the three Z-values in children with coronary artery aneurysms were all higher than those in children with coronary artery dilatation (P < 0.05). The three Z-values in CAL group were all positively correlated with CRP, ESR and PCT (P < 0.05). Multivariate analysis revealed that the increases of the three Z-values (OR = 2.228, 2.507, 2.737) were all risk factors for CAL in children with KD (P < 0.05). ROC analysis showed that the diagnostic efficacy AUC of the combined diagnosis of the three indicators was 0.903, which was better than the individual evaluation (P < 0.05). Conclusion: The combined evaluation with LMCA-Z value, RCA-Z value and LAD-Z value can effectively improve the diagnostic accuracy of CAL in children with KD.

Abstract:Objective: To explore the relationship between vaginal microecological indicators, 25-hydroxyvitamin D [25-(OH)D], vitamin B12 (VitB12) and cervical intraepithelial neoplasia (CIN). Methods: The clinical data of 108 patients with suspected CIN admitted to the hospital from June 2022 to June 2025 were retrospectively analyzed. According to the results of cervical histopathological examination, the patients were divided into CIN group and non-CIN group. The vaginal microecological indicators [Lactobacillus ratio (LB%), Nugent score, Shannon-Wiener diversity index (H')], serum 25-(OH)D and serum VitB12 were compared between the two groups of patients at admission. The related indicators of disease severity (Ki-67 proliferation index, lesion epithelial thickness ratio) in CIN group were statistically analyzed. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of vaginal microecological indicators and 25-(OH)D and VitB12 levels at admission on CIN. Pearson correlation coefficient was used to analyze the correlation between vaginal microecological indicators, 25-(OH)D and VitB12 levels at admission and disease severity related indicators in CIN group. Results: Patients in CIN group exhibited lower LB%, 25-(OH)D and VitB12 (P < 0.05) and higher Nugent score and H' compared to non-CIN group (P < 0.05). ROC analysis revealed that the AUCs of LB%, Nugent score, H', 25-(OH)D and VitB12 in the diagnosis of CIN were 0.883, 0.907, 0.865, 0.836 and 0.705, respectively (P < 0.05). Pearson analysis found that at admission, LB%, 25-(OH)D and VitB12 in CIN group were negatively correlated with Ki-67 proliferation index and lesion epithelial thickness ratio (P < 0.05), while Nugent score and H' were positively associated with Ki-67 proliferation index and lesion epithelial thickness ratio (P < 0.05). Conclusion: Vaginal microecological imbalance and insufficient serum 25-(OH)D and VitB12 levels are associated with the occurrence and severity of CIN. These indicators may become potential biomarkers for screening and evaluating CIN risk, and provide new ideas for clinical risk assessment.

Abstract:Objective: To explore the clinical characteristics and risk factors of severe hearing impairment in patients with sudden hearing loss (SHL). Methods: According to the types of hearing curves, 148 patients with SHL were divided into flatness group (n=46), low-frequency group (n=42), high-frequency type group (n=26) and total deafness group (n=34). The clinical relevant data and hearing efficacy in all groups were compared. According to the severity of hearing impairment, patients were divided into severe group (n=53) and non-severe group (n=95). The risk factors of severe hearing impairment were analyzed. Results: There were significant differences in vertigo, history of diabetes mellitus and cerebral infarction, sleep disorders and hearing efficacy among the four groups (P < 0.05). Regression analysis showed that age ≥ 60 years, body mass index (BMI) ≥ 24 kg/m2, hypertension and sleep disorders were all risk factors of severe hearing impairment in SHL patients (P < 0.05). Conclusion: There are significant differences in various clinical data among SHL patients with different types of hearing curves. Age ≥ 60 years, BMI ≥ 24 kg/m2, sleep disorders and hypertension are all risk factors of severe hearing impairment.

Abstract:Objective: To explore the relationship between anticoagulant factor Xa activity, serum endothelin-1 (ET-1), solute carrier family 39 member 11 (SLC39A11) and the occurrence of deep vein thrombosis (DVT) in the lower extremities of patients with gynecological malignancies. Methods: A total of 270 patients with gynecological malignant tumors (malignant group) and 230 patients with gynecological benign tumors (benign group) were selected as the research subjects. The anti-Xa factor activity and the levels of serum ET-1 and SLC39A11 were determined and compared. Lasso-Logistic regression was used to analyze the influencing factors of lower extremity deep vein thrombosis (DVT). In addition, the predictive value and clinical significance of anti-Xa factor activity, serum ET-1, and SLC39A11 levels in the occurrence of lower extremity DVT in patients with gynecological malignant tumors were analyzed. Results: Compared with the benign group, the malignant group had lower anti-factor Xa activity and higher levels of serum ET-1 and SLC39A11 (P < 0.05). Lasso-Logistic regression analysis showed that D-dimer, antithrombin Xa activity, serum ET-1, and SLC39A11 were the influencing factors for the occurrence of lower extremity DVT in patients (P < 0.05). The area under the curve (AUC) of anti-Xa factor activity, serum ET-1, SLC39A11 and their combination in predicting lower extremity deep vein thrombosis (DVT) in patients with gynecological malignancies were 0.844, 0.799, 0.771 and 0.931, respectively, all of which had good predictive value within the risk threshold range of 0.06 to 0.83. The combined prediction of anti-factor Xa activity, ET-1, and SLC39A11 for lower extremity DVT in patients with gynecological malignancies had a significantly greater net benefit than that of a single indicator. Conclusion: The anti-Xa factor activity, ET-1, and SLC39A11 are related to the occurrence of DVT in patients with gynecological malignant tumors. The combined detection of the three has a good application prospect in the prediction of postoperative DVT.

Abstract:Objective: To explore the relationship between anticoagulant factor Xa activity, serum endothelin-1 (ET-1), solute carrier family 39 member 11 (SLC39A11) and the occurrence of deep vein thrombosis (DVT) in the lower extremities of patients with gynecological malignancies. Methods: A total of 270 patients with gynecological malignant tumors (malignant group) and 230 patients with gynecological benign tumors (benign group) were selected as the research subjects. The anti-Xa factor activity and the levels of serum ET-1 and SLC39A11 were determined and compared. Lasso-Logistic regression was used to analyze the influencing factors of lower extremity deep vein thrombosis (DVT). In addition, the predictive value and clinical significance of anti-Xa factor activity, serum ET-1, and SLC39A11 levels in the occurrence of lower extremity DVT in patients with gynecological malignant tumors were analyzed. Results: Compared with the benign group, the malignant group had lower anti-factor Xa activity and higher levels of serum ET-1 and SLC39A11 (P < 0.05). Lasso-Logistic regression analysis showed that D-dimer, antithrombin Xa activity, serum ET-1, and SLC39A11 were the influencing factors for the occurrence of lower extremity DVT in patients (P < 0.05). The area under the curve (AUC) of anti-Xa factor activity, serum ET-1, SLC39A11 and their combination in predicting lower extremity deep vein thrombosis (DVT) in patients with gynecological malignancies were 0.844, 0.799, 0.771 and 0.931, respectively, all of which had good predictive value within the risk threshold range of 0.06 to 0.83. The combined prediction of anti-factor Xa activity, ET-1, and SLC39A11 for lower extremity DVT in patients with gynecological malignancies had a significantly greater net benefit than that of a single indicator. Conclusion: The anti-Xa factor activity, ET-1, and SLC39A11 are related to the occurrence of DVT in patients with gynecological malignant tumors. The combined detection of the three has a good application prospect in the prediction of postoperative DVT.

Abstract:Objective: To develop and validate a dynamic nomogram for the early prediction of 90-day in-hospital mortality risk in critically ill ICU patients with diabetic kidney disease (DKD), thereby filling the gap in predictive models for this population. Methods: Data were extracted from the MIMIC-IV database and divided into training and validation sets in a 7∶3 ratio. Feature variables were selected using the Boruta algorithm combined with Least Absolute Shrinkage and Selection Operator (LASSO) regression. The nomogram for 90-day in-hospital mortality risk was visualized using R software, and a dynamic nomogram was generated using the DynNom package. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC) and calibration curves. The clinical utility was validated through decision curve analysis (DCA). Results: A total of 405 critically ill ICU patients with DKD were included, of whom 88 experienced 90-day in-hospital mortality. The results showed that admission age, red cell distribution width (RDW), and delirium were independent predictors of 90-day in-hospital mortality. Multivariable Logistic regression indicated that all three variables were statistically significant, and a forest plot visualized the effect estimates with 95% confidence intervals. The AUC values were 0.825 (95% CI: 0.793~0.857) for the training set and 0.717 (95% CI: 0.592~0.841) for the validation set. The calibration curves demonstrated good prediction concordance, and DCA confirmed the model's significant clinical value. The dynamic nomogram was available online at: https://codepen.io/Thi-Giang-Ho/pen/vEKOQar. Conclusion: The dynamic nomogram constructed based on the MIMIC-IV database integrates three readily available clinical features to predict the probability of 90-day in-hospital mortality in critically ill ICU patients with DKD. Internal validation demonstrated robust predictive performance and good clinical utility of the model.

Abstract:Objective: To explore the predictive value of dual-energy computed tomography (CT) radiomics nomogram for postoperative recurrence risk in patients with STAS-positive lung adenocarcinoma due to intracavitary dissemination. Methods: A total of 150 patients with STAS-positive lung adenocarcinoma were selected as the research subjects and divided into a recurrence group (n = 47) and a non-recurrence group (n = 103) based on different postoperative outcomes within 1 year. Clinical and pathological data were collected. Preoperative dual-energy CT imaging features, including conventional mixed-energy CT values, iodine concentration on iodine maps, spectral curve slope, effective atomic number, and radiomics scores, were extracted. The Least Absolute Shrinkage and Selection Operator (LASSO) regression method was employed for variable selection. Multivariate Logistic regression analysis was performed to identify independent predictors associated with the study outcome. A nomogram was constructed based on the selected independent predictors to develop the predictive model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the model for postoperative recurrence risk in STAS-positive lung adenocarcinoma patients. Results: The tumor size, conventional mixed-energy CT value, iodine concentration on the iodine basis map, slope of the energy spectrum curve, effective atomic number, and radiomics score of the recurrent group were higher than those of the non-recurrent group (P < 0.05). The proportion of patients with high-grade pathological grading who underwent sublobectomy was lower than that of the non-recurrent group (P < 0.05). Multivariate regression analysis demonstrated that tumor size, conventional mixed-energy CT value, iodine concentration, spectral curve slope, and radiomics score were all independent influencing factors for postoperative recurrence within one year (P < 0.05). The area under the ROC curve (AUC) of the nomogram for predicting postoperative recurrence was 0.891 (95% CI: 0.824~0.959). The calibration curve indicated good agreement between the predicted probabilities of the model and the actual observations. Conclusion: The nomogram model based on dual-energy CT radiomics exhibits a favorable predictive value for the 1-year postoperative recurrence risk in patients with STAS-positive lung adenocarcinoma, providing a reference for postoperative risk stratification.

Abstract:Objective: To explore the therapeutic effect of warm needling combined with transcutaneous vagus nerve stimulation (tVNS) on patients with post-stroke shoulder pain. Methods: A total of 126 patients with post-stroke shoulder pain were selected as the research subjects, and they were classified into an observation group (n = 63) and a control group (n = 63) based on treatment methods. The control group underwent conventional acupuncture, whereas the observation group received combined therapy with tVNS and warm needling; both groups were treated for 3 weeks. The upper-extremity function [Fugl-Meyer Assessment–Upper Extremity (FMA-UE) score, Modified Barthel Index (MBI)], upper limb pain and disability index [Visual Analogue Scale (VAS) score, modified Rankin Scale (mRS) score], shoulder passive range of motion (PROM), and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were compared between the two groups before and after treatment. Results: After treatment, the FMA-UE score, MBI score, forward flexion, back extension, abduction, external rotation, and internal rotation of shoulder PROM were increased in the two groups compared with those before treatment (P < 0.05), and the above indexes in the observation group were higher (P < 0.05). After treatment, the VAS score, mRS score, and PSQI score in the two groups were lower compared with those before treatment (P < 0.05), and the observation group exhibited lower scores (P < 0.05). Conclusion: Warm needling combined with tVNS exhibits relatively good efficacy in the treatment of post-stroke shoulder pain. It can help promote upper extremity recovery, increase the self-care ability of daily life, increase the shoulder passive range of motion, relieve pain, and improve sleep quality.

Abstract:Objective: To investigate the effect of preoperative detrusor pressure at maximum urinary flow rate (PdetQmax) on postoperative outcomes after transurethral ultrasound-guided laser-induced prostatectomy (TULIP) for benign prostatic hyperplasia (BPH). Methods: A total of 124 patients with BPH who underwent TULIP were retrospectively included. According to preoperative PdetQmax, patients were divided into group A (PdetQmax ≤ 20 cmH2O, n = 36), group B (20 < PdetQmax ≤ 40 cmH2O, n = 52), and group C (PdetQmax > 40 cmH2O, n = 36). The general information, perioperative indicators, postoperative clinical efficacy at 6 months, preoperative and postoperative functional scores at 3 and 6 months, postoperative urinary function indicators at 3 months, and incidence of postoperative complications were compared among the three groups. Results: There was a statistically significant difference in PdetQmax and BCI among the three groups (P < 0.05). Compared with group A, groups B and C had shorter postoperative catheterization duration, hospital stay, and time to spontaneous voiding (P < 0.05). Six months after surgery, there was a statistically significant difference in the improvement values and rates of International Prostate Symptom Score (IPSS) among the three groups of patients (P < 0.05), and the improvement in QoL was greater in groups B and C than in group A (P < 0.05). Three months after surgery, PV decreased and Qmax increased in all three groups (P < 0.05), but PVR remained relatively high in group A patients after surgery (P < 0.05). The incidence of postoperative acute urinary retention in group A was higher than that in groups B and C (P < 0.05). Conclusion: TULIP can improve symptoms and voiding function in patients with BPH. However, patients with low PdetQmax show relatively insufficient recovery of objective urinary function and a higher risk of acute urinary retention. Preoperative PdetQmax may serve as a useful reference for outcome expectation and perioperative management.

Abstract:Objective: To investigate the effects of roxadustat on the microinflammatory response, nutritional status, and peritoneal solute transport capacity in peritoneal dialysis patients with renal anemia. Methods: A total of 90 peritoneal dialysis patients with renal anemia were enrolled, and they were divided into two groups according to the treatment regimen: the recombinant human erythropoietin (rhEPO) group (treated with rhEPO alone, n = 45) and the combined group (treated with rhEPO combined with roxadustat, n = 45). After 12 weeks of treatment, anemia-related indicators, nutritional status, microinflammatory factors, and peritoneal solute transport function were compared between the two groups. Results: After treatment, the levels of hemoglobin and hematocrit in both groups were increased compared with those before treatment in the same group (P < 0.05), and the combined group was higher than the rhEPO group (P < 0.05). After treatment, the levels of albumin, prealbumin, and transferrin in both groups were higher than those before treatment in the same group (P < 0.05), and the combined group was higher than the rhEPO group (P < 0.05). The serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) in both groups were decreased after treatment (P < 0.05), and the combined group showed lower levels than the rhEPO group (P < 0.05). There were no significant changes in the 4-hour dialysate-to-plasma creatinine ratio (4 h D/Pcr) before and after treatment in either group, and no significant differences were observed between the two groups (P > 0.05). Conclusion: Roxadustat can further correct the anemic state, improve nutritional status, and regulate systemic microinflammation in peritoneal dialysis patients with renal anemia. Meanwhile, it exerts no obvious adverse effect on the rate of peritoneal solute transport, showing favorable overall clinical efficacy and safety.

Abstract:Objective: To investigate the predictive efficiency of pre-treatment neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), and related antibody levels on the disease outcomes of patients with primary biliary cholangitis (PBC) receiving ursodeoxycholic acid (UDCA) treatment. Methods: A total of 120 PBC patients undergoing UDCA were included. All patients were treated with 13–15 mg·kg?1·d?1 of UDCA for 12 months. According to the biochemical response criteria at 12 months, the patients were classified into a good response group (n = 82) and a poor response group (n = 38). NLR, MPV, and positive antibody conditions [anti-mitochondrial antibody (AMA), anti-gp210 antibody, anti-sp100 antibody] were collected and compared between both groups before treatment. Multivariate Logistic regression analysis was utilized to screen independent predictors for disease outcomes, and the predictive efficiency was assessed by receiver operating characteristic (ROC) curve. Results: Among the 120 patients, the UDCA response rate was 68.33% (82/120). Pre-treatment NLR and MPV levels in the poor response group were higher than those in the good response group (P < 0.05), and the positive rates of anti-gp210 and anti-sp100 antibodies were higher (P < 0.05). No statistically significant difference in the AMA positive rate was found between the two groups (P > 0.05). Multivariate regression analysis indicated that elevated NLR and MPV, as well as positive anti-gp210 antibody, were independent risk factors for poor UDCA response (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of combined prediction of disease outcomes in PBC patients treated with UDCA by NLR, MPV, and anti-gp210 antibody was 0.941, with a sensitivity of 92.11% and a specificity of 86.59%. Conclusion: Pre-treatment levels of NLR, MPV, and anti-gp210 antibody have good predictive value on poor 12-month biochemical response to UDCA treatment in PBC patients. Combined detection can enhance the predictive efficiency, aiding in the early identification of high-risk patients and guiding individualized treatment.

Abstract:Objective: To systematically analyze the common causes leading to inaccurate coagulation test results and their respective impact levels on various parameters, providing a basis for laboratory quality control and clinical specimen collection. Methods: A retrospective analysis was performed on the data of 209 re-tested coagulation specimens. All specimens were divided into four groups according to the initial test results: coagulated blood, suspected heparin contamination, insufficient specimen volume, and elevated hematocrit. Seven coagulation indicators including PT, APTT, TT, FIB, FDP, AT-III, and D-D were collected before and after re-examination. The differences in the above indicators between initial and re-test results in each group were compared between groups. Results: Clotted blood specimens were primarily characterized by abnormally elevated FDP and D-D (median: 28.7 μg/mL and 15.5 μg/mL, respectively) and decreased FIB (median: 2.14 g/L). After re-testing, these values decreased (FDP and D-D median was 4.5 μg/mL and 2.2 μg/mL, respectively) or increased (FIB median: 3.31 g/L). Suspected heparin contamination most significantly affected PT, APTT, and TT, which shortened by 9.2 s, 46.4 s, and 19.6 s (median), respectively, after re-testing. Insufficient sample volume primarily caused prolongation of PT and APTT, which decreased by 6.6 s and 10.3 s (median), respectively, after re-testing. Elevated hematocrit can also cause prolongation of PT and APTT. After re-examination, their mean values decreased by 49.9 s and 27.6 s, respectively. Conclusion: Errors in coagulation tests caused by different specimen issues present characteristic changes. Blood clotting mainly affects FDP, D-D, and FIB, while suspected heparin contamination, insufficient specimen volume, and elevated hematocrit predominantly prolong PT and APTT. Therefore, qualified specimen quality is essential for the accuracy of coagulation testing. Meanwhile, establishing a standardized review and intervention process based on cause analysis in the clinical laboratory is critical to improving the quality of coagulation assays.

Abstract:Objective: To investigate the characteristics of functional jump test performance and lower limb muscle strength recovery in patients with patellar dislocation after medial patellofemoral ligament (MPFL) reconstruction, and to analyze the correlation between these parameters and their guiding value for return-to-sport decision-making. Methods: A total of 116 patients with recurrent patellar dislocation who underwent MPFL reconstruction were enrolled as study subjects. The study group was followed up for 12 months postoperatively to compare functional differences between 6 and 12 months after surgery. Functional jumping ability was assessed using the single-leg hop for distance (SLHD), triple hop for distance (THD), crossover hop for distance (CHD), and the 6-meter timed hop (6m-TH) test. Quadriceps and hamstring muscle strength were evaluated using an isokinetic dynamometry system at angular velocities of 60°/s and 180°/s, and the limb symmetry index (LSI) was calculated. The correlation between various functional indicators was analyzed. Results: The LSI values for SLHD, THD, and CHD at 12 months postoperatively were higher than those at 6 months postoperatively (P < 0.05), while the LSI value for 6m-TH was lower at 12 months than at 6 months (P < 0.05). At the 12-month follow-up, the LSI values for quadriceps peak torque at both 60°/s and 180°/s were higher than those at 6 months postoperatively (P < 0.05), and the hamstring LSI values were also higher than those at 6 months (P < 0.05). Using an LSI ≥ 90% on all four hop tests as the criterion for achieving functional symmetry, the rate was 21.55% at 6 months postoperatively and increased to 41.38% at 12 months postoperatively (P < 0.05). At 12 months postoperatively, quadriceps peak torque LSI values (at both 60°/s and 180°/s) showed positive correlations with the LSI values of SLHD, THD, and CHD (P < 0.05). No significant correlations were observed between the affected-side H/Q ratio and the LSI values of SLHD, THD, and CHD (P > 0.05). Conclusion: Functional jumping ability and muscle strength recovery in patients with patellar dislocation after MPFL reconstruction exhibit time-dependent improvement. However, residual deficits in functional jumping performance persist at 12 months postoperatively. Quadriceps strength recovery is closely associated with jumping performance, providing objective evidence for clinical rehabilitation and return-to-sport assessment.

Abstract:Objective: To explore the predictive efficacy of serum miR-23a-3p and miR-124-3p for fetal growth restriction (FGR) in patients with hypertensive disorders of pregnancy (HDP). Methods: A total of 196 patients with HDP were selected as the research subjects. Based on ultrasound imaging interpretation of fetal growth restriction, subjects were categorized into non-FGR (n = 118) and FGR (n = 78) groups. Serum miR-23a-3p and miR-124-3p levels, as well as neonatal birth weight and placental mass, were compared between groups. Pearson correlation analysis was used to evaluate the relationship between serum markers and neonatal birth weight/placental weight. Univariate and multivariate Logistic regression analyses were performed to identify independent factors associated with FGR in HDP patients. Receiver operating characteristic (ROC) curves were constructed to assess the predictive value of serum markers for FGR. Results: Patients in the FGR group exhibited higher serum miR-23a-3p and miR-124-3p expression levels compared to the non-FGR group (P < 0.05), while both neonatal birth weight and placental weight were lower than in the non-FGR group (P < 0.05). Correlation analysis revealed that serum miR-23a-3p expression negatively correlated with both neonatal birth weight and placental weight (r = ?0.560, ?0.527; P < 0.05), and serum miR-124-3p expression levels were negatively correlated with neonatal birth weight and placental weight (r = ?0.357, ?0.310; P < 0.05). Multivariate analysis revealed that elevated miR-23a-3p and miR-124-3p levels, along with decreased folate, vitamin B12, and placental growth factor levels, were independent risk factors for FGR in HDP patients (P < 0.05). ROC curve analysis revealed that the combined AUC for predicting FGR in HDP patients using miR-23a-3p and miR-124-3p was 0.925, higher than that of miR-124-3p alone (P < 0.05). Conclusion: Elevated serum miR-23a-3p and miR-124-3p expression correlates with the occurrence of FGR in patients with HDP. Combined detection of these two markers demonstrates potential as serum diagnostic factors for FGR, offering clinical application value.

Abstract:Pancreatic pseudoaneurysm is a rare complication of chronic pancreatitis, featuring complex clinical conditions and a high mortality rate. Timely diagnosis and early intervention are therefore critical. This article reports the diagnosis and treatment of 1 patient with ruptured pseudoaneurysm secondary to chronic pancreatitis. Preoperative contrast-enhanced CT with three-dimensional reconstruction was performed for accurate diagnosis and condition evaluation. Intraoperative vascular embolization using the “two-point method” achieved reliable hemostasis with satisfactory clinical outcomes. By analyzing the etiology, clinical manifestations, diagnosis, and treatment of this patient, the authors conclude that endovascular interventional embolization is a safe and effective therapeutic modality for pancreatic pseudoaneurysms.

Abstract:Aggressive angiomyxoma (AAM) is a rare soft tissue mesenchymal tumor, which mainly occurs in the pelvic cavity and perineum of women of childbearing age. AAM has the characteristics of strong invasion and easy recurrence. This article reports a case of the preoperative imaging manifestations, surgical findings, pathological diagnosis, and postoperative recurrence in the pelvic cavity. The imaging features, differential diagnosis, treatment, and prognosis of AAM were summarized through literature review.

Abstract:Objective: To explore the application effect of intraoperative position nursing combined with three-period multi-mode insulation nursing in the perioperative period of patients undergoing transurethral prostatectomy (TURP). Methods: A total of 108 patients who underwent TURP were selected and divided into two groups based on the different nursing methods, with 54 cases in each group. The control group received routine perioperative nursing intervention, while the observation group received intraoperative body position nursing combined with three-period multi-mode thermal insulation nursing on the basis of the nursing regimen in the control group. The intervention time was 1 month. The perioperative body temperature changes, postoperative recovery indicators (urinary catheter indwelling time, length of hospital stay), lower urinary tract symptoms [International Prostate Symptom Score (IPSS)], quality of life [Generic Quality of Life Inventory-74 (GQOLI-74)], and occurrence of perioperative adverse events (hypothermia, chills, postoperative bladder spasm) were compared between the two groups. Results: Compared with the control group, the body temperatures at 30 minutes during surgery, at the end of surgery, and at 2 hours after surgery were higher in the observation group (P < 0.05). The urinary catheter indwelling time in the observation group was shorter compared with the control group (P < 0.05), and the length of hospital stay was shorter (P < 0.05). Compared with the control group, the observation group at 1 month after surgery showed a lower IPSS score (P < 0.05) and higher scores on the dimensions of GQOLI-74 (P < 0.05). The overall incidence rate of perioperative adverse events was lower in the observation group compared with that in the control group (P < 0.05). Conclusion: The combined application of intraoperative body position nursing and three-period multi-mode thermal insulation nursing in the perioperative nursing of TURP patients can effectively maintain perioperative body temperature stability, accelerate the rehabilitation process, improve lower urinary tract symptoms and quality of life, and reduce perioperative adverse events.

Abstract:Neuropathic pain arises from damage and dysfunction of the central and peripheral nervous systems, with its primary clinical manifestations including spontaneous pain, hyperalgesia, hyperpathia, and sensory abnormalities. Mongolian medicine warm acupuncture therapy, a Mongolian traditional external treatment method, is one of the Mongolian traditional therapies. It exhibits a clear analgesic effect on neuropathic pain, though its mechanism of action remains in the initial exploration stage. This article reviews recent domestic and international research findings and, at the levels of the peripheral and central nervous systems, explains the main mechanisms by which Mongolian medicine warm acupuncture therapy alleviates neuropathic pain. These mechanisms include regulating peripheral sensitization and immune-inflammatory responses, inhibiting central sensitization, modulating cell signaling pathways, suppressing spinal glial cell activation, and reducing neuronal apoptosis. The article provides theoretical references for the in-depth study and clinical application of the analgesic mechanism of Mongolian medicine warm acupuncture therapy.