ObjectiveTo investigate the role of disco interacting protein 2 homolog B （DIP2B） in the proliferation， migration， and invasion processes of gastric cancer cells. MethodsBioinformatic analysis was performed using public datasets， including TCGA， GEPIA and TIMER2.0， to assess DIP2B expression and its clinical prognostic value in gastric cancer. DIP2B expression levels in gastric cancer cell lines were validated by Western blot and RT-qPCR. A DIP2B knockdown cell model was established via siRNA mediated gene silencing， and the knockdown efficiency was confirmed. Cell proliferation was assessed using real-time cellular analysis （RTCA） and colony formation assays. Cell migration and invasion were evaluated by Transwell assays， while flow cytometry was employed to detect changes in apoptosis and cell cycle distribution. ResultsDIP2B was significantly upregulated in gastric cancer cells and correlated with poor prognosis in patients （P<0.05）. The experimental results revealed that DIP2B knockdown markedly suppressed the proliferation， migration， and invasion of gastric cancer cells， while promoting apoptosis and inducing cell cycle arrest （P<0.05）. ConclusionDIP2B is highly expressed in gastric cancer and associated with unfavorable prognosis. Knockdown of DIP2B inhibits the proliferation， migration， and invasion of gastric cancer cells and promotes apoptosis， suggesting that DIP2B may serve as a potential prognostic biomarker and therapeutic target for gastric cancer.

Objective:To investigate the effects of repetitive transcranial magnetic stimulation(rTMS) on the core symptoms, brain functional connectivity and activation in children with attention deficit hyperactivity disorder (ADHD) using functional near-infrared spectroscopy (fNIRS).Methods:From September 2022 to March 2024, a total of 35 children with ADHD were selected as research subjects and they were randomly divided into observation group ( n=17) and control group ( n=18). The control group received conventional rehabilitation therapy, while the observation group received rTMS therapy in addition to the conventional therapy. Both groups were treated every other day, with each course of treatment lasting four weeks, and a total of three courses of treatment were administered consecutively. The clinical symptoms of the children with ADHD were assessed using Swanson, Nolan, and Pelham-Ⅳ(SNAP-Ⅳ) before and after treatment. fNIRS was used to detect the relative concentration changes of oxyhemoglobin (HbO 2) and deoxyhemoglobin (HbR) in the prefrontal cortex under resting-state and Go/Nogo task conditions before and after treatment. Statistical analysis was performed using SPSS 26.0 software. Paired sample t-test were used for within-group comparisons, and independent sample t-test were used for between-group comparisons. Results:(1) After treatment, the scores for inattention, hyperactivity/impulsivity and oppositional defiant behavior in the two groups were significantly lower than before treatment ( t=3.51-18.86, all P<0.05). The scores for inattention, hyperactivity/impulsivity and oppositional defiant behavior in the observation group were significantly lower than those in the control group ( t=2.21, 2.03, 2.39, all P<0.05). (2) After treatment, the functional connectivity strength between all regions of interest in both groups was significantly higher than before treatment ( t=3.53-37.90, all P<0.05). The functional connectivity strength of the left dorsolateral prefrontal cortex (0.25±0.03, 0.21±0.03), right dorsolateral prefrontal cortex (0.12±0.02, 0.09±0.02), left medial prefrontal cortex (0.13±0.02, 0.10±0.01) and right medial prefrontal cortex (0.31±0.04, 0.24±0.06) in the observation group was significantly higher than those in the control group (all P<0.05). (3) In the Go/Nogo task, after treatment, the average HbO 2 concentrations in the left dorsolateral prefrontal cortex, right dorsolateral prefrontal cortex, left medial prefrontal cortex, right medial prefrontal cortex, left temporal lobe, and right temporal lobe in both groups were all higher than before treatment (all P<0.05). After treatment, the average HbO 2 concentrations in the left dorsolateral prefrontal cortex, right dorsolateral prefrontal cortex, left medial prefrontal cortex and right medial prefrontal cortex of the observation group were significantly higher than those of the control group (all P<0.05). Conclusion:rTMS therapy can improve the core symptoms of children with ADHD, which may be related to the strength of brain functional connectivity and activation of ADHD brain function by rTMS.

Objective:To analyze the clinical efficacy of oblique lumbar interbody fusion (OLIF) in the treatment of degenerative scoliosis.Methods:The clinical studies of OLIF in the treatment of degenerative scoliosis published up to May 2024 were searched in China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP, Chinese Medical Journal Full-text Database, PubMed, Embase, Web of Science, and Google Scholar databases. Visual analogue scale (VAS), Oswestry disability index (ODI), Cobb's angle of coronal convexity, pelvic tilt (PT), lumbar lordosis (LL), sagittal vertical axis (SVA) were extracted to compare the changes of the indexes before and after surgery. The methodological index for non-randomised studies (MINORS) was used to evaluate the quality of the included literature. Stata 18.0 statistical software was used for the meta-analysis. When the heterogeneity between groups was small, the fixed-effect model was used for analysis, and when the heterogeneity between groups was large, the random-effect model was used for analysis.Results:A total of 152 patients from 7 articles were included in the meta-analysis, including 3 in Chinese and 4 in English, with MINORS scores ranging from 17 to 22. Meta-analysis showed that OLIF for treating degenerative scoliosis was effective in reducing postoperative VAS score [ SMD=-4.74, 95% CI(-5.26, -4.21), P<0.001], ODI [ SMD=-6.21, 95% CI(-8.02, -4.41), P<0.001], coronal plane scoliosis Cobb angle[ SMD=-2.50, 95% CI(-3.22, -1.78), P<0.001], PT [ SMD=-0.73, 95% CI(-1.14, -0.33), P<0.001], and SVA [ SMD=-1.01, 95% CI(-1.75, -0.28), P=0.007], and significantly improved postoperative LL [ SMD=1.16, 95% CI(0.65, 1.68), P<0.001]. Conclusion:OLIF for treating degenerative scoliosis can effectively relieve pain, improve spinal function, and correct coronal facet scoliosis deformity.

Objective To explore the effect of Xiongcan Yishen Formula on ferroptosis in testicular tissue of male rats with late-onset hypogonadism(LOH).Methods A total of 48 male Sprague-Dawley rats aged 6 months were randomly divided into model group,low-dose and high-dose Xiongcan Yishen Formula groups and propionate testosterone group,with 12 rats in each group.An additional 6 male Sprague-Dawley rats aged 8 weeks were set as the normal group.Except for the normal group,the rats were intraperitoneally injected with Cyclophosphamide at a dose of 20 mg/(kg·d)for 5 consecutive days to establish the LOH model,while the normal group received an equal volume of physiological saline for 5 days.The normal group and model group were given equal volumes of distilled water by gavage,while the low-dose and high-dose Xiongcan Yishen Formula groups were administered concentrated decoction at doses of 10.4 g and 41.6 g/kg/d respectively,and the propionate testosterone group received intramuscular injections of 5.21 mg/kg/d propionate testosterone,all for 28 consecutive days.ELISA was used to detect serum testosterone levels in rats,HE staining and transmission electron microscopy were used to observe the gross morphology of testicular tissue and the ultrastructure of Leydig cells,and RT-qPCR and Western blotting were used to detect the expression of ferroptosis-related genes and proteins in testicular tissue.Results The LOH model rats exhibited pathological changes such as atrophy of seminiferous tubules,structural disorder,and reduced spermatocytes in the lumen,as well as ultrastructural changes in Leydig cells including altered nuclear morphology,increased mitochondrial density,and reduced cristae.After intervention with Xiongcan Yishen Formula and propionate testosterone,the pathological changes in testis and the ultrastructure of Leydig cells were improved.Compared with the normal group,serum testosterone levels in the model group were significantly decreased(P＜0.05),the expression of ROS,ACSL4 mRNA and protein in testicular tissue was significantly increased,while the expression of FTH1,GPX4,and SLC7A11 mRNA and protein was significantly decreased(P＜0.05).Compared with the model group,ser-um testosterone levels in the low-dose and high-dose Xiongcan Yishen Formula groups and the propionate testosterone group were significantly increased(P＜0.05),and the expression of ROS,ACSL4 mRNA and protein was significantly decreased(P＜0.05);the high-dose Xiongcan Yishen Formula group showed significantly increased expression of FTH1,GPX4,and SLC7A11 mRNA and protein(P＜0.05).Conclusion Ferroptosis in testicular tissue is increased in LOH rats,and Xiongcan Yishen For-mula can elevate serum testosterone levels and improve pathological changes and ultrastructure in testicular tissue of LOH rats,possibly related to the inhibition of ferroptosis in testicular tissue of LOH rats.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To analyze the clinical efficacy of oblique lumbar interbody fusion (OLIF) in the treatment of degenerative scoliosis.Methods:The clinical studies of OLIF in the treatment of degenerative scoliosis published up to May 2024 were searched in China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP, Chinese Medical Journal Full-text Database, PubMed, Embase, Web of Science, and Google Scholar databases. Visual analogue scale (VAS), Oswestry disability index (ODI), Cobb's angle of coronal convexity, pelvic tilt (PT), lumbar lordosis (LL), sagittal vertical axis (SVA) were extracted to compare the changes of the indexes before and after surgery. The methodological index for non-randomised studies (MINORS) was used to evaluate the quality of the included literature. Stata 18.0 statistical software was used for the meta-analysis. When the heterogeneity between groups was small, the fixed-effect model was used for analysis, and when the heterogeneity between groups was large, the random-effect model was used for analysis.Results:A total of 152 patients from 7 articles were included in the meta-analysis, including 3 in Chinese and 4 in English, with MINORS scores ranging from 17 to 22. Meta-analysis showed that OLIF for treating degenerative scoliosis was effective in reducing postoperative VAS score [ SMD=-4.74, 95% CI(-5.26, -4.21), P<0.001], ODI [ SMD=-6.21, 95% CI(-8.02, -4.41), P<0.001], coronal plane scoliosis Cobb angle[ SMD=-2.50, 95% CI(-3.22, -1.78), P<0.001], PT [ SMD=-0.73, 95% CI(-1.14, -0.33), P<0.001], and SVA [ SMD=-1.01, 95% CI(-1.75, -0.28), P=0.007], and significantly improved postoperative LL [ SMD=1.16, 95% CI(0.65, 1.68), P<0.001]. Conclusion:OLIF for treating degenerative scoliosis can effectively relieve pain, improve spinal function, and correct coronal facet scoliosis deformity.

Objective To analyze the symptomatic improvement effects of vitamin D in children with autism spectrum disorder(ASD)based on the microbiota-gut-brain axis.Methods Seventy-two children with ASD were randomly divided into an observation group and a control group,with 36 cases in each group.Three cases dropped out in the control group.The observation group received 1200 IU/day of vitamin D supplementation in addition to conventional rehabilitation training,while the control group received only conventional rehabilitation training.The intervention lasted for 12 weeks.Assessments were conducted before and after the intervention using the childhood autism rating scale(CARS),autism behavior checklist(ABC),and repetitive behavior scale-revised(RBS-R).Resting-state functional connectivity of the brain was measured using near-infrared functional imaging,and serum levels of 25(OH)D3,inflammatory cytokines,and gut microbiota were analyzed.The differences in these indicators before and after the intervention were compared between the two groups to evaluate clinical efficacy.Results The between-group differences in pre-and post-intervention changes showed that the observation group had significantly greater improvements than the control group in the following measures:CARS scores(-5.92±1.40 vs.-2.55±1.43),RBS-R scores(-5.99±1.01 vs.-3.10±1.47),resting-state brain functional connectivity(0.19±0.15 vs.0.10±0.18),serum 25(OH)D3 levels[(34.89±8.18)ng/mL vs.(0.68±6.73)ng/mL],serum interleukin-6(IL-6)levels[(-6.60±6.07)pg/mL vs.(-0.74±9.45)pg/mL],IL-1β levels[(-2.56±1.33)pg/mL vs.(-0.04±2.13)pg/mL],and tumor necrosis factor-α(TNF-α)levels[(-4.09±3.85)pg/mL vs.(0.21±4.05)pg/mL](P<0.05).Post-intervention,significant differences in gut microbial β-diversity were observed between the two groups(R2=0.030,P=0.040,Adonis).LEfSe analysis revealed that the observation group exhibited enrichment in Clostridia(LDA=4.747,P=0.003),Clostridiales(LDA=4.747,P=0.003),Clostridiaceae(LDA=3.476,P=0.001),Lachnospiraceae(LDA=4.709,P=0.004),Odoribacteraceae(LDA=3.458,P=0.027),Odoribacter(LDA=3.458,P=0.027),Burkholderiales(LDA=3.339,P=0.038),Firmicutes(LDA=4.764,P=0.003),and Betaproteobacteria(LDA=3.338,P=0.037).Conclusion Vitamin D supplementation can modulate gut microbial diversity in children with ASD,significantly influence the abundance of specific gut microbiota,reduce systemic inflammatory cytokines,enhance brain functional connectivity,and alleviate clinical symptoms of ASD.

Objective:To investigate the demand of rural elderly in Shenyang for integrated medical and elderly care service model,providing references for the improvement and development of rural integrated medical and elderly care services in Shenyang.Methods:Elderly individuals from selected rural areas in Shenyang were randomly sampled as study subjects.A questionnaire survey was conducted to analyze their basic demographics,satisfaction with current elderly care services,and demand levels for integrated medical and elderly care programs.Multiple linear regression analysis was used to identify factors influencing the demand for integrated medical and elderly care services among rural elderly.Results:The satisfaction scores of the rural elderly for medical care,cultural and recreational activities,spiritual comfort,and daily living assistance were 3.86±1.37,3.67±1.36,3.49±1.45,and 3.15±1.58,respectively.Multiple linear regression analysis showed that gender,monthly family income,occupation,insurance situation,living situation,and self-care ability were factors influencing the demand for integrated medical and elderly care services(P＜0.05).Conclusion:The demand for integrated medical and elderly care service model among rural elderly is affected by multiple factors.

Objective:To assess the predictive value of the percentage of Gleason pattern 4 (G4%) in prostate biopsy for adverse pathology and biochemical recurrence.Methods:We retrospectively analyzed consecutive patients who underwent radical prostatectomy in our institution between January 2019 and December 2023, and included those who were diagnosed with ISUP 2-3 cancer at biopsy. A total of 109 patients were included in this study. The average age of patients was (67.40±6.11) years, and the average BMI of patients was (25.36±2.97) kg/m 2. 49 Cases (45.0%) had a PI-RADS score of 5, and the median prostate volume was 32.60 (24.57, 45.63) ml. The median of most recent tPSA before biopsy was 9.76 (6.89, 12.95) ng/ml, the median PSAD was 0.28 (0.17, 0.44) ng/ml 2, and the median f/tPSA was 0.11 (0.08, 0.16). Clinical T 2b or higher stage was found in 84 cases (77.1%). The total biopsy core length was (22.91±5.18) cm, with a median of 24 (20, 24) biopsy cores and a median of 6 (4, 9) positive cores. Gleason score 3+ 4 was found in 52 cases (47.7%), and Gleason score 4+ 3 in 57 cases (52.3%). Cribriform was present in 30 cases (27.5%). G4% was calculated based on the proportion of Gleason grade 4 tumor relative to total tumor, tumor proportion relative to total tissue, and tissue length. Patients were divided into high-G4% (≥2.45%) and low-G4% (<2.45%) groups based on the median G4% value, with 55 and 54 cases, respectively. No significant differences were observed in baseline characteristics between the two groups ( P>0.05). The main risk factor of adverse pathology was analyzed by logistic regression, and receiver operating characteristic (ROC) curve and area under curve (AUC) were performed. Patients were further stratified by the G4% cutoff value from ROC, and Kaplan-Meier survival curves were plotted to compare biochemical recurrence free survival (BCRFS) between groups. The main risk factor affecting BCRFS was analyzed by Cox regression. Adverse pathology was defined as postoperative Gleason score ≥4+ 3 or pathological stage ≥T 3a. Results:Adverse pathology occurred in 44 (80.0%) high-G4% and 16 (29.6%) low-G4% patients ( P<0.01). Multivariate analysis identified G4% as an independent risk factor for adverse pathology ( OR=1.23, 95% CI 1.02-1.50, P=0.033). The highest ROC AUC value was seen for G4% (0.799), significantly outperforming Gleason score (0.799 vs. 0.641, P=0.003), tPSA (0.799 vs. 0.615, P=0.003), PSAD (0.799 vs. 0.679, P=0.038), positive cores (0.799 vs. 0.677, P=0.009), clinical T stage (0.799 vs. 0.607, P=0.001) and cribriform (0.799 vs. 0.639, P=0.001). The G4% cutoff value for predicting biochemical recurrence was 10.97%. The median BCRFS was significantly higher in the low G4% (<10.97%) group than that in the high G4% (≥10.97%) group (55 vs. 28 months, P=0.002). Cumulative recurrence free survival rates at 1 and 3 years were 94.6% vs. 74.1% and 78.0% vs. 47.6%, respectively. Multivariate Cox regression analysis indicates that G4% was an independent risk factor affecting BCRFS ( HR=1.11, 95% CI 1.00-1.23, P=0.041). Conclusions:For patients with ISUP 2-3 nmPCa, a higher G4% in biopsy specimens demonstrates strong predictive ability for adverse pathology and biochemical recurrence, outperforming traditional clinical indicators such as Gleason score and PSA.