Objective: To evaluate the clinical efficacy and safety of injectable platelet-rich fibrin (i-PRF) in the treatment of mild to moderate female pattern hair loss (FPHL), and to analyze the related clinical factors affecting the therapeutic efficacy of i-PRF. Methods: This was a secondary analysis of a prospective, randomized controlled trial. A total of 29 FPHL patients with Sinclair grade Ⅱ-Ⅲ, who attended the outpatient clinics of Beijing Friendship Hospital, Capital Medical University and Peking University Third Hospital from March 2024 to April 2025, were enrolled. All patients received i-PRF treatment once every 4 weeks for a total of 4 sessions, with follow-up up to 24 weeks. Standardized clinical photographs were taken at baseline, week 12 and week 24. Trichoscopic examination was performed to measure the non-vellus target area hair count (TAHC) and hair diameter (HD) in the target area, and all adverse events were recorded. The Mann-Whitney U test was used to compare the intergroup differences in efficacy for categorical influencing factors; Spearman rank correlation analysis was employed to assess the correlation between continuous influencing factors and efficacy; and multiple linear regression (enter method) was performed to identify independent influencing factors of efficacy. Results: A total of 27 patients completed the trial. At week 12, TAHC significantly increased from 112 (105, 120) hairs/cm at baseline to 128 (110, 150) hairs/cm , with a median increase of 12 (5, 28) hairs/cm and a median growth rate of 10.5 (4.2, 24.5)% (P=0.045); hair diameter significantly increased from 42.5 (39.8, 45.2) μm to 52.0 (47.0, 58.0) μm, with a median increase of 7.5 (3.0, 12.5) μm and a median growth rate of 18.0 (7.5, 29.0)% (P<0.001). At week 24, TAHC further significantly increased to 141 (125, 158) hairs/cm (P<0.001), with a median growth rate of 24.8 (18.5, 32.0)%; hair diameter continued to improve to 55.0 (50.0, 61.0) μm (P=0.008), with a median growth rate of 21.5 (16.0, 27.0)%. The overall incidence of adverse events was 10.34% (3/29), mainly presenting as mild scalp pruritus and transient headache, without severe adverse effects. Multiple linear regression analysis revealed that baseline TAHC was an independent influencing factor for i-PRF efficacy (P<0.05), while age, BMI, disease duration, Sinclair grade, family history of AGA, and baseline HD showed no significant independent effect on efficacy in this model (P>0.05). Conclusion: This preliminary study indicates that i-PRF can improve hair density and hair shaft diameter in patients with FPHL with a favorable safety profile. Patients with FPHL and lower baseline TAHC may achieve greater clinical improvement.

Against the backdrop of a continuously rising incidence of breast cancer globally， breast reconstruction surgery represents one of the key measures to improve patients’ quality of life. Ethics of care emphasizes paying attention to patients’ actual needs in doctor-patient interactions and advocates creating a decision-making environment that facilitates the explicit expression of these needs. Focusing on the decision-making process of 16 breast cancer patients who underwent breast reconstruction surgery and stemming from the perspective of ethics of care， this paper explored the realization paths of autonomy for breast cancer patients when confronting medical decisions on breast reconstruction from three aspects， including the situatedness， relationality， and practicality of ethics of care. The study found that under the ethics of care， the organic interaction of contextualized practice， relational negotiation， and subjectivity cultivation jointly constructed a dynamically evolving medical decision-making ecosystem. This ecosystem， with situational response capabilities based on embodied cognition， relational adjustment mechanisms linked by ethical negotiation， and dual-track support networks aimed at subject empowerment， ultimately achieved the in-depth integration of technical practice and humanistic care.

BACKGROUND:Crosslinked sodium hyaluronate gel has good mechanical property,biocompatibility,and biodegradability,and can be used as an isolated protective material in tumor radiation therapy to protect endangered organs from damage caused by excess radiation dose. OBJECTIVE:To investigate the safety and efficacy of crosslinked sodium hyaluronate gel in reducing the dose of radiation to dangerous organs during brachytherapy. METHODS:A total of 16 specific pathogen-free Kunming mice of the same age and similar body weight were selected as experimental subjects and divided into experimental group and control group by the random number table method,with 8 mice in each group.125I seeds were implanted subcutaneously in the back of mice in the experimental group,and then crosslinked sodium hyaluronate gel was injected around the radioactive particles.Only 125I seeds were implanted subcutaneously in the back of mice in the control group.After injection,the distance between the radioactive particles and the epidermis was measured by spiral CT scan,and the surface radiation dose was measured by radiation dosimeter.Within 10 weeks after injection,the growth state,survival rate,skin radiation damage,and gel retention of mice were observed. RESULTS AND CONCLUSION:(1)Spiral CT scan showed that the implanted gel was relatively concentrated and created an effective distance between the radioactive seeds and the epidermis.The body surface radiation dose of the experimental group was significantly lower than that of the control group(P<0.01).(2)During the experimental observation period,mice in both groups survived;mice in the control group showed obvious irritability and other unstable behavior in the late experimental period,and some mice in the experimental group showed similar behavior.The daily food intake of mice in the two groups had no significant change,and the body mass showed the same increasing trend.After implantation of radioactive seeds,the two groups of mice showed different degrees of radioactive skin injury.From day 23 after injection to the end of the experiment,the skin radiation injury score of the experimental group was lower than that of the control group(P<0.01).At week 10 after implantation,6 mice in the experimental group had no obvious gel residue under their skin,and 2 mice had a very small amount of scattered gel-like samples under their skin.(3)Therefore,the crosslinked sodium hyaluronate injection technique can increase the space between the radioactive target area of 125I seeds and the organ at risk outside the target through physical space occupying,which can effectively reduce the dose of the organ at risk,and play a role in the isolation and protection of the organ at risk.

Objective·To investigate the expression level of O-GlcNAc transferase(OGT)in non-small cell lung cancer(NSCLC)and its impact on lung cancer proliferation,as well as to explore the underlying mechanisms.Methods·The expression of OGT in NSCLC tumors and adjacent normal tissues was detected by immunohistochemistry(IHC).The dataset(GSE31210)from the GEO database was analyzed to assess the correlation between OGT expression and NSCLC patient prognosis.siRNA transfection was performed to knock down OGT expression in H460 and H1299 cells,followed by total RNA extraction and transcriptome sequencing.Pathway enrichment analysis was conducted on differentially downregulated genes in the knockdown group compared with the control group,and Western blotting was used to validate the enrichment results.The effects of OGT knockdown on cell proliferation and colony formation in H460 and H1299 cells were evaluated using the cell counting kit-8(CCK-8)assay and colony formation assay,respectively.The impact of overexpressing downstream genes was also examined.Stable OGT-knockdown cell lines were generated using shRNA and subcutaneously inoculated into nude mice to monitor tumor growth.Results·IHC revealed that OGT expression was significantly upregulated in NSCLC tumor tissues compared to adjacent normal tissues.Patients with high OGT expression exhibited shorter survival times and poorer prognoses than those with low expression.Transcriptome sequencing demonstrated that genes downregulated after OGT knockdown were primarily enriched in the mitogen-activated protein kinase(MAPK)signaling pathway.Western blotting showed that total extracellular regulated protein kinase 1/2(ERK1/2)levels remained unchanged in H460 and H1299 cells after OGT knockdown,while phosphorylated ERK1/2(p-ERK1/2)and its downstream proto-oncogene JUNB protein were markedly reduced.Suppression of OGT expression attenuated the proliferation rate and colony formation capacity of H460 and H1299 cells,whereas JUNB overexpression rescued the proliferation defects induced by OGT knockdown.Notably,H460 cells with stable OGT knockdown formed significantly smaller tumors in nude mice.Conclusion·OGT is highly expressed in NSCLC and correlates with poor prognosis.Knockdown of OGT inhibits NSCLC cell proliferation and clonogenicity in vitro,and tumor growth in vivo.Mechanistically,OGT appears to promote NSCLC progression by activating the ERK/JUNB signaling axis.

Objective To analyze changes in intestinal microbiota composition and metabolites in mice with nitrous oxide poisoning using 16S rDNA sequencing and metabolomics,and to examine correlations between gut microbes and metabolites in order to explore the mechanisms of nitrous oxide poisoning.Methods C57BL/6 mice were randomly divided into a control group and a nitrous oxide poisoning group(n=6).The poisoning group was exposed to 90,000 ppm nitrous oxide twice daily for 1 h over 28 days,while the control group was exposed to air.Fecal samples were collected 24 h after the last exposure.16S rDNA sequencing was used to analyze structural differences in microbial communities and identify significantly different taxa.Metabolomics analysis was performed to detect changes in fecal metabolites and identify differential metabolites.Correlation analysis was conducted between differential microbiota and metabolites.Results 16S rDNA sequencing showed that the poisoning group had increased microbial abundance compared with controls,while species diversity remained unchanged.Significant differences were observed in gut microbiota structure between groups.Metabolomics identified 112 differential metabolites related to nitrous oxide poisoning,mainly involving the cAMP signaling pathway and sphingolipid metabolism.Spearman correlation analysis revealed a strong association between differential microbiota and differential metabolites.Conclusion Nitrous oxide poisoning alters the structure and metabolic profiles of intestinal microbiota.Changes in microbial abundance affect multiple metabolic pathways,which may be related to damage to the nervous and hematological systems.These findings provide a basis for further research on the mechanisms of nitrous oxide poisoning and for clinical treatment.

The nervous system, as the core hub of physiological regulation in the human body, plays a key role in the tumor microenvironment through the neuro-immune-tumor axis. Studies have shown that tumor-infiltrating nerve fibers regulate immune cell functions by releasing neurotransmitters, while immune cells can feedback and modulate neuronal activity, forming a dynamic bidirectional interaction network. The emerging field of cancer neuroimmunology focuses on the complex dialogue mechanisms between the nervous and immune systems in the tumor microenvironment. In-depth analysis of the neuro-immune interaction network not only provides new perspectives for understanding tumor immune escape, but also lays the theoretical foundation for developing novel combination therapies targeting the neuro-immune axis, potentially providing breakthrough strategies to overcome resistance to current immunotherapies.

Objective:To explore the impact of adverse childhood experiences on psychosomatic symptoms and job burnout in the nursing population.Methods:Utilizing a multistage stratified cluster random sampling meth-od,1 661 nurses were selected.Through a 1∶2 propensity score matching approach,demographic and work-related characteristics were balanced between the positive and negative groups of adverse childhood experiences.Finally,880 cases were successfully matched(positive group:300 cases,negative group:580 cases).Linear regression was employed to explore the relationship between nurses'adverse childhood experiences and psychosomatic symptoms(anxiety,depression,physical symptoms),as well as job burnout.The average treatment effect among the treated(ATT)was calculated.Results:Linear regression results revealed a significant positive association between adverse childhood experiences and scores for anxiety symptoms,depression symptoms,physical symptoms,and job burnout(B=1.68,2.67,2.89,5.90;ATT=1.64,2.58,2.82,5.96,Ps＜0.001).However,there was no statistically signif-icant association with scores for a sense of inadequacy in individual achievements(P＞0.05).Conclusion:Nurses who have experienced childhood adverse experiences may exhibit more severe psychosomatic symptoms and job burnout compared to those who have not experienced such adversities during childhood.

Objective:To analyze the application effect of hyperbaric oxygen chamber management system based on five-dimensional quality management model included safety,reliability,effectiveness,availability and economy of equipment in management for the equipment of hyperbaric oxygen chamber management. Methods:The hyperbaric oxygen chamber management system was built on the basis of five-dimensional quality management model,and an assessment indicator system was constructed to perform quality control evaluation with five-dimensional maturities included preparation mode,thinking mode,communication mode,action mode and review mode. Then,a whole process management was conducted for the equipment of hyperbaric oxygen chamber. A hyperbaric oxygen chamber that was used during 2022 and 2023 in The 940th Hospital of People's Liberation Army Joint Service Support Force was selected,and the conventional management was used to manage the equipment during January and October 2022,and the hyperbaric oxygen chamber management system based on five-dimensional quality management model (model management) was used to manage the equipment during January and October 2023. A total of 400 operation logs of hyperbaric oxygen chamber equipment were selected,which included 200 logs of each mode,and the timeliness score,the satisfaction score of relevant personnel and the effect of equipment management between the two models were compared. Results:The timeliness scores of matching ratio of equipment,reasonable configuration of equipment,standard arrangement of equipment and equipment maintenance of model management were respectively (9.26±1.21) points,(9.12±0.98) points,(9.26±1.36) points and (9.36±2.03) points for hyperbaric oxygen chamber,which were higher than those of conventional management,and the differences were statistically significant (t=16.107,15.481,18.671,6.971,P<0.05). The satisfaction scores of operators,operation and maintenance personnel and engineers of equipment of model management were respectively (93.62±4.63) points,(92.69±4.33) points and (95.33±4.36) points,which were higher than those of conventional management method,and the differences of them between two methods were statistically significant (t=17.711,10.082,10.197,P<0.05). In the 200 logs of adopting model management,the ratio of complete files and good operation of equipment were respectively 95.0％ and 94.0％,which were higher than those of conventional management method. While the ratio of operation without standard and abnormal operation of equipment were respectively 1.0％ and 1.5％,which were lower than those of conventional management methods,and the differences of them were statistically significant (x2=14.709,12.754,11.402,11.308,P<0.05). Conclusion:The application of the hyperbaric oxygen chamber management system based on the five-dimensional quality management model in the management of hyperbaric oxygen chamber equipment can maximum improve the operating efficiency of hyperbaric oxygen chamber equipment,and effectively increase the quality and effect of equipment management,and enhance the operation satisfaction of relevant personnel.

Objective:To study the effects of arsenic exposure on neurological function including voluntary motor ability, anxiety, and short-term memory ability of rats, as well as its impact on the expression levels of synaptic function related genes such as neuropeptide 1 (NLGN1), glutamate receptor 2A (NR2A), and postsynaptic density protein 95 (PSD95).Methods:Forty 3-week-old male specific pathogen free (SPF) grade Wistar rats [weighing (453.97 ± 35.68) g] were selected and divided into four groups using a random number table: 0 (control group) and 2, 10, and 50 mg/L arsenic exposure groups, with 10 rats in each group. They were given deionized water and 2, 10, and 50 mg/L sodium arsenite solutions for 12 weeks, respectively. The open field experiment and Y-maze experiment were used to test the voluntary motor ability, anxiety, and short-term memory ability of rats. Nissl staining was used to observe the pathological damage of the hippocampus in the brain. Real time fluorescence quantitative PCR and Western blot were used to detect the mRNA and protein expression levels of NLGN1, NR2A, and PSD95 in the hippocampus, respectively.Results:The results of the open field experiment revealed that the horizontal movement distances of rats in the 2 and 10 mg/L arsenic exposure groups were reduced compared to the control group, the movement distances in the central area in the 2, 10, and 50 mg/L arsenic exposure groups were reduced compared to the control group, and the residence time in the central area in the 10 and 50 mg/L arsenic exposure groups was reduced compared to the control group ( P < 0.05). The results of Y-maze experiment showed that the retention time of new arms in rats of the 2 and 10 mg/L arsenic exposure groups was shorter than that in the control group ( P < 0.05). The pathological examination results of Nissl staining showed that the control group had abundant Nissl bodies in hippocampal tissues of the cytoplasm with intact neuronal structures, tightly arranged cells, appearing blue purple in color and clear visible nuclei. However, the number of Nissl bodies decreased, intercellular gaps increased, disordered arrangement increased, cytoplasmic staining was lighter, and nuclear shrinkage phenomenon increased in the hippocampal tissues of rats in the 2, 10 and 50 mg/L arsenic exposure groups. The real-time fluorescence quantitative PCR detection results showed that there was a statistically significant difference in the mRNA expression levels of NLGN1, NR2A, and PSD95 in the hippocampal tissues of the four groups ( F = 13.85, 44.94, 4.63, P < 0.05). The results of Western blot analysis showed that the protein expression levels of NLGN1 and NR2A in the hippocampal tissues of rats in the 10 and 50 mg/L arsenic exposure groups were lower than those in the control group (0.65 ± 0.07, 0.69 ± 0.03 vs 1.00 ± 0.04, 0.51 ± 0.11, 0.51 ± 0.13 vs 1.00 ± 0.07, P < 0.05), and the expression level of PSD95 in the hippocampal tissues of rats in the 50 mg/L arsenic exposure group was lower than that in the control group (0.51 ± 0.09 vs 1.00 ± 0.05, P < 0.05). Conclusion:Arsenic may affect synaptic function and cause neurological dysfunction in rats by adjusting the expression levels of NLGN1, NR2A, and PSD95.

Objective To analyze the risk factors of neurogenic bladder dysfunction(NB)in patients with spinal cord injury,and establish a risk prediction model of NB in patients with spinal cord injury by decision tree algorithm.Method Clinical data of 176 patients with spinal cord injury admitted from April 2022 to July 2024 were retrospectively analyzed.Patients with spinal cord injury were divided into disorder group and non-disorder group according to whether they were complicated by NB.Multivariate Logistic regression analysis was used to screen the risk factors of NB.Modeler software was used to construct the decision tree model of spinal cord injury patients with concurrent NB,and the 5-fold cross-validation method was used to internally verify the model,and the prediction efficiency of the model was compared.Results Among 176 patients with spinal cord injury,42 patients had concurrent NB,the incidence of NB was 23.86%.Logistic regression analysis showed that the level of spinal cord injury(T10—L2),degree of spinal cord injury(complete injury),course of disease(≥6 months),bladder compliance(abnormal),urinary system infection(yes)and detrusor sphincter disorder(yes)were all independent risk factors for NB in patients with spinal cord injury(P<0.05).Probability forecasting model P=1/[1+e-(-6.008+0.791*X1+3.117*X2+1.492*X3+1.270*X4+1.516*X5+2.158*X6)],models to predict the overall accuracy is 80.5%;The prediction accuracy of the model is 71.7%through the cross-verification of 5 fold.Decision tree model showed that the degree of spinal cord injury had the greatest effect on the complication of NB in patients with spinal cord injury,and the information gain was 0.46.ROC results showed that the AUC values of NB predicted by the two models were close(0.873 vs.0.852,Z=0.875,P=0.469).Conclusion The level of spinal cord injury,degree of spinal cord injury,course of disease,bladder compliance,urinary system infection,detrusor sphincter disorder can all predict the risk of NB.The decision tree model constructed in this study can effectively predict the risk probability of NB in patients with spinal cord injury,and medical staff can make targeted plans according to the above factors to reduce the risk of NB.