Breast cancer survivors often suffer from a variety of complications post operation, such as upper limb dysfunction, limb lymphedema, brachial plexus nerve injury, and so on. This article reviewed the pathogenesis and rehabilitation of these complications.

Retrieval of ancient DNA (aDNA) sequences from organism remains provide direct view of their evolutionary history. However, researches on aDNA have suffered from lots of technical problems. Specifically, discredited sequences were generated from damaged aDNA templates, and expensive and time-consuming methods were employed. Here, a method which could recover the endogenous aDNA as well as to reduce the cost and research period is described. This is achieved by improving the ancient DNA extraction method of isopropanol precipitation, and reevaluating the method of PCR after N-glycosylase (UNG) treatment, which could remove the damaged DNA from the aDNA extract. The efficiency of these methods were tested by comparing with traditional methods using ancient specimens of pig teeth aged between 4 300 years before present (BP) and 3 900 BP. The results showed that: firstly, the extraction efficiency of the improved method of isopropanol precipitation and current method with silica-based spin column were all 60%. Furthermore, the research period at least could be reduced by half with the application of the improved methods and the cost to 1/10 of the current method. Secondly, sequences obtained through the method of PCR after UNG treatment were 100% authentic. In contrast, 66%～ 88% sequences were authentic based on the results obtained with the method of multiple PCRs without UNG treatment. And the research cost and period needed by the method with UNG treatment were only half of the later one. These results demonstrate that the improved extraction method of isopropanol precipitation combined with the method of PCR after UNG treatment could increase the success rate of authentic DNA amplified and at least reduce the research cost and period by half. Therefore, this method can be applied in the large-scale detection of ancient specimens.

Objective To elucidate intracellular transcription factor activation of C_7～T_5 dorsal root ganglia in rats recurrently infected with respiratory syncytial virus (RSV). Methods Eighty 1～2 weeks old Sprague-Dawley rats were randomly divided into 2 groups: a control group and a RSV-infection group. The rats in the RSV-infection group were infected with 5 ×10~5 U/mL RSV once a week and the rats in the control group were treated with culture medium without RSV. Airway response was measured after 8 weeks. Lung tissue was submitted for HE staining and in situ hybridization. The C_7～T_5 dorsal root ganglia were obtained for the preliminary screening of the intracellular transcription factors by TranSignal~(TM) protein/DNA combo array. Nuclear protein of C_7～T_5 dorsal root ganglia were extracted and submitted to Western blot. Results Airway response in the RSV-infection group was higher than that in the control group (P＜0.05). HE staining showed inflammatory cell infiltration, and in situ hybridization demonstrated positive RSV RNA in the RSV-infection rat lung which was not present in the control group, thus validating the efficacy of our model. TranSignalTM protein/DNA combo array screening showed that 55 transcription factors increased by at least 2 folds in the C_7～T_5 DRG cells of the RSV-infection group. The transcription factors Smad and interferon regulatory factor (1 or 2) were the 2 most upregulated transcription factors identified by combo array screening (59 and 43 fold increase compared with the control, respectively). Western blot confirmed Smad(1/2/3) and IRF-1 upregulate while IRF-2 remained unchanged. Conclusion Respiratory syncytial virus infection results in airway hyperresponsiveness and transcription factor activation in C7～T5 spinal adorsal root ganglia in rats, which may contribute to airway nerve network dysfunction and airway hyperresponsiveness.

Objective To observe the influence of Huiyang Shengji Ointment and its modified formulae on interleukin-1 (IL-1α) and thromboxane B2 (TXB2) in diabetic rats with chronic skin ulcers, and explore the mechanism for promoting the healing of ulcer.Methods Six out of 160 rats were randomly selected as a blank group, without any further processing. The remaining rats were made diabetic model and randomly divided into five groups after 2 weeks:1 d, 3 d, 5 d, 7 d and 14 d groups. Then, these groups were further divided into normal group (Vaseline ointments), model group (Vaseline ointments), Huiyang Shengji Ointment group (whole formula Ointment), Wenyang Yiqi group (Yiqi group, modified Wenyang Yiqi formula ointments) and Huoxue Shengji group (Huoxue group, modified Huoxue Shengji formula ointments). Normal group and model group were given Vaseline ointments;whole formula group, Yiqi group and Huoxue group were given corresponding ointment. Normal group used the method of skin excision, while other groups used STZ injection-hydrocortisone interference-skin excision-foreign body embedded preparation of composite factors for chronic skin ulcer model. After the appropriate treatment period, the rats were executed and tested for the contents of IL-1α and TXB2 in serum by enzyme-linked immunosorbent assay of five time points.Results In treatment 3 d, the contents of IL-1α in Yiqi group were significantly higher than the blank group, model group, whole formula group and Huoxue group (P<0.05). In treatment 5 d, the contents of IL-1α in whole formula group were significantly higher than the blank group and model group (P<0.05). In treatment 7 d, the contents of IL-1α in each treatment group were significantly higher than blank group and model group (P<0.05), and the whole formula group was higher than the Yiqi group and Huoxue group. In treatment 14 d, the contents of IL-1α in model group and Huoxue group were lower than the blank group (P<0.05). In treatment 3 d, the contents of TXB2 in normal group and the whole formula group were higher than the blank group (P<0.05). In treatment 5 d, the contents of TXB2 in whole formula group were higher than the blank group and the normal group (P<0.05). In treatment 7 d, the contents of TXB2 in Yiqi group were higher than the blank, the model, the whole formula and Huoxue groups (P<0.05). In treatment 14 d, the contents of TXB2 in Huoxue group were higher than the blank and model group (P<0.05), and the contents of TXB2 in the blank group and normal group was lower than those treatment groups (P<0.05).Conclusion Huiyang Shengji Ointment and its modified formulae could promote inflammation, stimulate secretion of inflammatory cytokines, while Yiqi Wenyang ointments played a more active role in promoting inflammation of the early phase of wound surface.

Objective To analyze the clinical characteristics of severe retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI),and to evaluate the management model of ROP screening of ELBWI and the clinical effects and treatment timing of photocoagulation with intravitreous injection of vascular endothelial growth factor inhibitor (Avastin).Methods Forty-five cases of ELBWI (birth weight ＜ 1000 g) survived finally in our neonatal intensive care unit from July 1,2004 to June 30,2011 were reviewed.ROP screening was regularly performed in 4 ～ 6 weeks postpartum with binocular indirect funduscope by ophthalmologists.Newborns with severe ROP were treated with laser photocoagulation in the fundus.Some newborns that developed aggressive posterior ROP(APROP) were treated with combined intravitreous injection of Avastin and photocoagulation.Results Thirteen of 45 cases (28.89％) had not developed to ROP finally.Six cases (13.33％) developed to stage 1 ～ 2 ROP and then spontaneous recovery during the follow-up period.Twenty-six newborns (57.78％) developed to severe aggressive posterior ROP (APROP) and need to be treated with photocoagulation.All 3 APROP infants (6.67％) were received intravitreous Avastin injection prior to photocoagulation.The visual acuity of all 45 patients (100％) in this study was preserved.Conclusion ELBWI have a higher morbidity of severe ROP.Timely screening and intervention are effective to prevent disease progression.Intravitreous Avastin injection prior to photocoagulation may be necessary to preserve the visual acuity of infants with APROP.Respiratory management is the key for post-operation care.

Objective To explore the MSCT characteristics of adhesive abdominal internal hernias and its complication of strangulated intestinal necrosis.Methods The CT data of 21 cases with adhesive abdominal internal hernias proved by operation were analyzed retrospectively.Raw data of CT images were reconstructed with MPR and/or CTA procedure for visualizing the hernia ring, intestinal mesentery and ansa interstinalis.Results Adhesive bands (hernia ring), crowding of distended and fluid-filled bowel loops with an abnormal location was visualized in 19 cases, among which the transitional segment from stenosis to dilation of the intestine was visualized in 17 cases.The crowded and engorged mesenteric vessels, edematous mesentery were visualized in 17 cases,among which mesenteric torsion was visualized in 11 cases.Varying amounts of ascites was visualized in 15 cases.All adhesive abdominal internal hernias in our study were classified according to their image manifestation.Dilated intestinal loop with thickened bowel wall was classified to type Ⅰ (7 cases).Dilated intestinal loop with normal bowel wall was classified to type Ⅱ (9 cases).Normal size of the intestinal loop with thickened bowel wall was classified to type Ⅲ (5 cases).The difference of CT values of the intestinal wall on non-contrast CT,enhancement CT values in arterial and portal phase of contrast-enhanced CT among three types of adhesive abdominal internal hernias showed statistical significance (P<0.05).The CT values and CT enhancement for type Ⅰ and Ⅲ were lower compared to type Ⅱ, while the difference of CT values between type Ⅰ and Ⅲ showed no statistical significance (P>0.05).8 cases of adhesive abdominal internal hernias were accompanied by intestinal necrosis (5 cases for type Ⅰ,3 cases for type Ⅲ).The necrotic intestine loop manifested as markedly thickened and blurred bowel wall with reduced enhancement, while thrombosis embolism of SMV was visualized in 4 cases and thrombosis embolism of SMA in 3 cases,respectively.Massive ascites was visualized in 8 cases.Conclusion The adhesion bands,transitional segment of small intestine,gathered and translocated intestinal loops are the clue to the diagnosis of adhesive abdominal internal hernias.Edema of mesentery, gathered and engorged mesenteric vessels, occlusion of SMV or SMA and the conspicuously thickened bowel wall with reduced enhancement are the image characteristics of intestinal necrosis.

The main characteristics of polycystic ovary syndrome (PCOS) are hyperandrogen, ovulation disorder, insulin resistance and obesity. However, its pathogenesis is not completely understood. Therefore, it is very important to study the metabolic pathways that may be related to PCOS and find its metabolic markers. The application of metabolomics provides a new direction for studying the pathogenesis of PCOS. It is a very valuable and developing technology that can discover new metabolites and explore potential biomarkers for endocrine and metabolic diseases. In addition, metabolomics technology can also improve the diagnosis and treatment of PCOS. This article aims to summarize the recent applications and research progress of metabolomics in PCOS, elaborating on metabolites and metabolic pathways.

Objective:To integrate the experience of terminal care of nurses in Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) .Methods:Qualitative and mixed studies related to the terminal care by neonatal and pediatric nurses were systematically searched on the Cochrane Library, the Australia Joanna Briggs Institute Evidence-based Health Care Center Database, PubMed, EBSCO, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP and the China Biomedical Medicine Database. The search time limit was from the establishment of the database to May 2022. The article quality was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center (2016). Meta-synthesis was performed using the aggregation integration method.Results:A total of 9 articles were included. A total of 32 research results were extracted and summarized into 7 categories, forming 3 integrated results, including the ethical dilemmas and complex care experiences of nurses in NICU and PICU during the implementation of palliative care, the attitudes and coping strategies of neonatal and pediatric nurses in responding to death events, the realistic dilemmas and needs of nurses in NICU and PICU during terminal care.Conclusions:Terminal care in NICU and PICU requires multiple efforts. Hospital managers should pay attention to the emotional burden of nurses during terminal care, and enhance their positive coping ability, and focus on improving the terminal care environment and resources in NICU and PICU to provide high-quality terminal care services for children.

Objective: To explore the association between negative life events and smartphone addiction among middle school students, so as to provide theoretical support and practical guidance for prevention and intervention of smartphone addiction among middle school students. Methods: Using cluster sampling, 8 890 students were selected to survey from 27 junior high schools and 3 senior high schools in a district of Shenzhen in 2022 (baseline) and 2023 (followup). Data were collected through selfresigned questionnaires on basic information, the Smartphone Addiction Scale-Short Version, and the Adolescent Selfrating Life Events Checklist. Mixedeffects models were employed to analyze the association. Results: Compared to 2022, the punishment scores of middle school students in 2023 [1.00 (0.00, 6.00) and 1.00 (0.00, 6.00)] decreased (Z=4.27), while the scores of interpersonal stress, learning stress and adaptation [4.00(0.00, 8.00), 4.00(0.00, 8.00); 4.00(1.00, 8.00), 5.00(2.00, 9.00); 2.00 (0.00, 6.00), 3.00 (0.00, 7.00)] increased (Z=-3.04, -8.36, -6.80) (P<0.01). Mixedeffects models revealed a positive doseresponse relationship between negative life events and smartphone addiction (OR=1.08-1.17, P<0.01). Stepwise regression showed independent positive effects of interpersonal stress (OR=1.05), academic stress (OR=1.03), and adaptation stress (OR=1.11) on smartphone addiction (P<0.01). Subgroup analysis of nonaddicted students in 2022 confirmed persistent associations for academic stress (OR=1.03) and adaptation (OR=1.07) (P<0.01). Conclusion Negative life events exhibit a positive doseresponse relationship with smartphone addiction, particularly interpersonal stress, academic stress, and adaptationrelated events.

Objective: To explore the longitudinal association between only-child status and smartphone addiction among middle school students, so as to provide a basis for establishing family intervention measures for smartphone addiction in middle school students. Methods: In October 2022 and October 2023, a preliminary survey and follow-up were conducted among 8 759 middle and high school students from 30 schools in a district of Shenzhen. A self-designed questionnaire was used to determine whether the students were the only-child, and the Chinese Version of the Smartphone Addiction Scale-Short Version (C-SAS-SV) was utilized to assess the students smartphone addiction status. A multilevel mixed-effects model and subgroup analysis were applied to examine the association between only-child status and smartphone addiction among middle school students. Results: During 2022 to 2023, the prevalence of smartphone addiction in the cohort of middle school students increased from 24.1% to 25.2%. Compared with only-child, non-only child were more likely to be addicted to smartphones (adjusted model: OR =1.2, 95% CI =1.1-1.4) and also scored higher on smartphone addiction (adjusted model: β =0.9, 95% CI =0.2-1.5)( P <0.05). Subgroup analysis further revealed that compared to baseline, non-only child demonstrated an increased prevalence of smartphone addiction (adjusted model: OR = 1.2 , 95% CI =1.0-1.5) and higher addiction scores (adjusted model: β =0.8, 95% CI =0.2-1.5) after one year( P <0.05). Conclusions Non-only child face higher risk of smartphone addiction. Under the current population policy, it is crucial to address smartphone addiction among middle school students who is not only child.