Traumatic paraplegia, resulting from spinal cord injury, leads to severe motor dysfunction, with limited efficacy and high risks associated with conventional treatments. Brain-computer interface (BCI) has emerged as a promising technology that decodes neural signals to control external devices or stimulate paralyzed muscles, providing a novel approach for functional restoration in paraplegic patients. This article reviews the clinical applications of BCI in treating both high- and low-level traumatic paraplegia. Challenges related to signal decoding, device stability, biocompatibility, clinical safety, and ethical considerations are also discussed. In the future, the integration of artificial intelligence may further enhance BCI as a “neural bridge” for restoring motor and interactive functions in patients with traumatic paraplegia.

Heparin-binding protein (HBP) is a pro-inflammatory granule protein released by activated neutrophils, known for its role in modulating vascular permeability and its pathological significance in infectious diseases. In recent years, HBP has garnered attention due to its immune-activating effects in contexts such as sepsis, acute lung injury and organ transplantation. It has been proposed as a potential biomarker for early detection of infection and inflammation. While preliminary progress has been made in animal studies, clinical evidence remains limited. Therefore, this article focuses on the mechanism of action of HBP in transplantation-related complications, explores its potential pathways for predicting infection risk, mediating ischemia-reperfusion injury and rejection, and evaluates the feasibility of intervention strategies such as neutralizing antibodies, heparin derivatives and albumin. The pivotal role of HBP in regulating inflammatory responses post-transplant may offer a novel target for postoperative infection monitoring and personalized therapeutic interventions.

OBJECTIVE To form an expert consensus on the clinical application of parenteral direct thrombin inhibitors （DTIs） in patients during the perioperative period. METHODS Led by Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC）， a multidisciplinary working group was established. Through literature review and the Delphi method， clinical questions related to the rational perioperative use of parenteral DTIs were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” framework； systematic searches were conducted in CNKI， Medline， Embase and other databases. Relevant evidence from randomized controlled trials and cohort studies was included and synthesized. Evidence quality was assessed using the Grades of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through multiple rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven recommendations （each with an expert consensus rate exceeding 90%） on the use of parenteral DTIs in perioperative patients were developed. These recommendations specify drug selection， dosing ranges， key monitoring points， and safety management strategies for parenteral DTIs in various scenarios， including the perioperative period of ventricular assist device implantation， the perioperative period of cardiac surgery， perioperative patients with lower-extremity atherosclerotic disease， the perioperative period of percutaneous coronary intervention in patients with acute coronary syndrome， the perioperative period of carotid artery stenting in patients with carotid stenosis， the perioperative period of patients with right heart thrombosis， and patients who develop related thrombosis and dysfunction after a central venous catheter insertion. In addition， warning and management pathways for perioperative bleeding and thrombotic events were proposed. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in perioperative period.

[摘 要] 目的：探究蟾毒灵（Buf）对卵巢癌细胞A2780和SKOV3的毒性作用及其机制，评估其与顺铂（DDP）联合应用的协同毒性。方法：常规培养A2780和SKOV3细胞。用CCK-8法、克隆形成实验检测Buf对A2780和SKOV3细胞增殖的影响及半数抑制浓度（IC50）。用不同浓度的Buf处理细胞，显微镜下观察细胞形态变化，比色法检测乳酸脱氢酶（LDH）释放水平，流式细胞术分析检测Annexin Ⅴ+PI+细胞比例，qPCR和WB法检测细胞焦亡相关分子mRNA及蛋白表达水平，通过小干扰RNA敲减A2780和SKOV3细胞中的GSDMD并进行后续功能实验进行验证。通过SynergyFinder分析Buf与DDP对于杀伤A2780和SKOV3细胞的协同效应，并通过流式细胞术、qPCR、WB进行机制探索，进一步利用流式细胞术检测Buf与DDP联用对DDP耐药A2780和SKOV3细胞的影响。结果：与对照组相比，Buf显著抑制卵巢癌细胞增殖及迁移能力（均P < 0.05），诱导LDH释放和细胞焦亡（均P < 0.05），上调核苷酸结合寡聚化结构样受体热蛋白结构域相关蛋白3（NLRP3）、半胱氨酸天冬氨酸蛋白水解酶1（CASP1）、gasdermin家族成员D（GSDMD）、白细胞介素-1β（IL-1β）及IL-18的mRNA及蛋白的表达（均P < 0.05），Buf与DDP联用具有协同抑制A2780和SKOV3细胞增殖的作用，并可进一步增强DDP耐药的A2780和SKOV3细胞对DDP的敏感性（P < 0.01或P < 0.001）。结论：Buf可通过激活NLRP3/CASP1/GSDMD信号通路诱导A2780和SKOV3细胞焦亡，并增强A2780和SKOV3细胞及DDP耐药A2780和SKOV3细胞对DDP的敏感性。

Background The widespread use of herbicides has led to environmental contamination and has implications for human health. The liver is an important organ for the detoxification of environmental pollutants; however, studies on the association between herbicide exposure and liver function are limited. Objectives To investigate the association between baseline serum herbicide levels and changes in liver enzyme levels and liver enzyme abnormalities over a 5-year period in middle-aged and older adults. Methods This study was based on a nested case-control population of type 2 diabetes established in the Dongfeng-Tongji cohort, with a total of 1388 subjects included in this study and followed up for 5 years. Epidemiological data were collected through questionnaires, and baseline serum concentrations of three herbicides (metolachlor, propham, and acetochlor) were measured by gas chromatography-triple quadrupole mass spectrometry. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were detected at baseline and follow-up visits. The associations between baseline serum herbicide levels and changes in AST and ALT over 5 years were assessed using linear regression models with herbicide levels categorized into quartiles, adjusting for age, sex, education level, smoking status, drinking status, physical activity, body mass index, and new-onset type 2 diabetes occurred during follow-up. The relationship between baseline serum herbicide levels and the risk of liver enzyme abnormalities during follow-up was further analyzed using logistic regression models. Results The positive rates of metolachlor, propham, and acetochlor were all higher than 80%, and their spiked rates of recovery ranged from 73.46% to 106.77%. The mean ± standard deviation of the age of subjects at baseline was (62.7±7.6) years, with 34.1% being male. The median serum levels of metolachlor, propham, and acetochlor at baseline were 0.05, 0.16, and 0.03 ng·mL⁻¹, respectively. There was no significant difference in baseline serum herbicide levels between the normal and abnormal liver enzyme groups at follow-up (P >0.05). The baseline liver enzyme levels and the changes in AST and ALT over 5 years in those who developed abnormal liver enzymes were significantly higher than those in the normal liver enzyme group (P <0.05). The linear regression analysis showed that the changes in AST increased progressively over 5 years in the second, third, and fourth quartiles of propham compared to the lowest quartile group (the second quartile: b=1.49, 95%CI: 0.10, 2.87; the third quartile: b=1.52, 95%CI: 0.14, 2.90; the fourth quartile: b=1.69, 95%CI: 0.31, 3.08; P <0.05). The associations of serum metolachlor and acetochlor with changes in AST were not significant. Additionally, no significant relationships were found between the three serum herbicides and the changes in ALT over 5 years or the risk of liver enzyme abnormalities. Conclusion Serum propham levels in middle-aged and older adults are positively associated with changes in liver enzyme AST, which may have an effect on liver function. More studies are needed to provide scientific evidence for the association between herbicide exposure and liver function.

ObjectiveThis study aims to investigate the molecular mechanism by which Guizhi Fulingwan （GFW） inhibits ferroptosis in endometriosis （EMT） through the regulation of the hypoxia inducible factor-1α/heme oxygenase 1 （HIF-1α/HO-1） signaling pathway. MethodsMachine learning was employed to identify ferroptosis-related biomarkers associated with EMT. Network pharmacology was utilized to identify the active components of GFW and its potential therapeutic targets against EMT， including core targets. Functional enrichment analysis was conducted to explore the biological processes， molecular functions， cellular components， and signaling pathways associated with the potential targets. An EMT rat model was established via autologous transplantation. Thirty female Sprague-Dawley （SD） rats were randomly divided into five groups： sham-operated， model， positive control （dienogest at 0.2 mg·kg^-1）， low-dose GFW （2.5 g·kg^-1）， and high-dose GFW （5 g·kg^-1）. After modeling， the rats received their respective treatment by oral gavage for 28 consecutive days， while the sham and model groups received equal volumes of distilled water. Serum and ectopic endometrial tissues were collected. Hematoxylin and eosin （HE） staining was employed to evaluate morphological alterations in ectopic lesions. Quantitative real-time polymerase chain reaction （Real-time PCR） and Western blot were conducted to assess mRNA and protein expression of HIF-1α， HO-1， glutathione peroxidase 4 （GPX4）， spermidine/spermine N1-acetyltransferase （SAT1）， and prostaglandin-endoperoxide synthase 2 （PTGS2）. Tissue levels of malondialdehyde （MDA）， glutathione （GSH）， and ferrous iron （Fe²⁺） were quantified using commercial assay kits. Serum levels of interleukin-6 （IL-6） and transforming growth factor-β₁ （TGF-β₁） were measured via enzyme-linked immunosorbent assay （ELISA）. ResultsFive ferroptosis-related biomarkers in EMT were identified： ALOX12， CHAC1， SAT1， AST1， and HO-1. Network pharmacology analysis revealed 42 active components of GFW and 192 potential therapeutic target genes related to EMT treatment， with FOS， JUN， HO-1 identified as core targets. Functional enrichment analysis indicated that the potential targets were primarily involved in oxidative stress response and reactive oxygen species metabolism and were enriched in the HIF-1 signaling pathway. Compared to the sham-operated group， the model group exhibited significant increases in both mRNA and protein expression of HIF-1α， HO-1， and PTGS2， as well as elevated tissue levels of Fe²⁺ and MDA. Conversely， GSH levels and the expression of GPX4 and SAT1 were markedly reduced， and serum levels of IL-6 and TGF-β₁ levels were significantly higher （P<0.01）. Compared with the model group， all GFW-treated groups showed significant downregulation of HIF-1α and HO-1， reduced Fe²⁺ levels， and downregulated expression of MDA， PTGS2， IL-6， and TGF-β₁. Meanwhile， GSH， GPX4， and SAT1 expression levels were significantly increased （P<0.05， P<0.01）， effectively ameliorating iron overload and oxidative stress， thereby demonstrating therapeutic efficacy in EMT， with the high-dose GFW demonstrating the most pronounced therapeutic effects. ConclusionGFW exerts therapeutic effects on endometriosis by regulating the HIF-1α/HO-1 signaling pathway to rectify iron metabolism disorders and attenuate free iron-induced oxidative damage. It upregulates the antioxidative defense system to inhibit lipid peroxidation cascades and modulates inflammatory cytokine networks. These effects collectively disrupt the pathological interaction between ferroptosis and chronic inflammation， providing a novel theoretical foundation for the clinical application of GFW in EMT treatment.

Objective: To explore methods about how to treat penile foreign body incarceration，so as to provide reference for clinical treatment of such cases. Methods: The diagnosis and treatment of a patient with penile metal foreign body incarceration from the Department of Pediatric Surgery of Tongji Hospital was analyzed，relevant Chinese and English literature were retrieved，and treatment methods and outcomes were summarized. Results: A 11-year-old boy came to our hospital with a screw nut incarcerated around the penis for over 10 days，the distal penis dark red swelling，local epidermis exfoliation oozing.A wire saw was used to cut and remove the incarcerated object.The patient recovered well，with no secondary damage to the penis，and no dysfunctions like dysuria.The search of the Chinese and English databases obtained a total of 79 penile incarceration-related papers involving 184 cases.Treatment methods included direct removal after bloodletting for detumescence，removal after cutting with various instruments，and penis skin degloving. Conclusion: Since penile incarceration is a rare emergency，early treatment can avoid complications with good prognosis.Methods dealing with penile foreign body incarceration have both pros and cons.Therefore，selection of the appropriate methods needs comprehensive evaluation，or follows the order of simple-to-complex operations.

ObjectiveTo systematically investigate the identification characteristics of medicinal amber， elucidate its microscopic features， crystal structural properties， and elemental composition， and thereby provide a scientific foundation for quality control and authenticity verification. MethodsThirty-nine batches of amber samples were collected and analyzed through integrated techniques including morphological analysis， microscopic identification， powder X-ray diffraction （XRD）， Raman spectroscopy， Fourier-transform infrared （FTIR） spectroscopy， and inductively coupled plasma mass spectrometry （ICP-MS） to evaluate their morphological attributes， phase composition， molecular vibrational modes， and trace element profiles. Among them， the XRD experiment used Cu Kα radiation （λ=1.540 6 Å）， with a scanning angle range of 10° to 70° （2θ） and a step size of 0.02°， the Raman spectroscopy experiment employed a 785 nm laser， with a spectral measurement range of 3 400 to 50 cm^-1， a laser power of 300 mW， a laser intensity of 30%， and a scanning time of 100 to 1 000 ms， the infrared spectroscopy experiment used a carbon-sulfur lamp， with a scanning range of 4 000 to 500 cm^-1， a resolution of 4 cm^-1， and 3 scans， the ICP-MS experiment utilized frequency power of 1.2 kW， a double-pass cyclonic spray chamber， a sample introduction system flow rate of 0.7-1.0 L·min^-1， and an auxiliary gas flow of 0.2 L·min^-1. ResultsUnder orthogonal polarized light microscopy， medicinal amber exhibited an isotropic homogeneous structure， with partial samples containing inorganic impurities such as AsS and SiO₂. FTIR spectra revealed characteristic absorption peaks at 2 932-2 939 cm^-1 （C-H stretching vibrations）， 1 705-1 728 cm^-1 （C=O stretching vibrations）， and 880-887 cm^-1 （C=C deformation vibrations）， confirming the oxidative polymerization of terpenoid resin. Raman spectroscopy further identified distinctive peaks at 2 925 cm^-1， 2 870 cm^-1 （saturated C-H stretching）， and 1 648 cm^-1 （C=C stretching）， consistent with the structural features of oxidized-polymerized resin. ICP-MS analysis demonstrated that S， Al， Si， Fe， Na， and Ca were the predominant trace elements in medicinal amber. ConclusionThis study comprehensively evaluated medicinal amber's morphological attributes， phase composition， molecular vibrational modes， and trace elements through multimodal analytical techniques. The findings establish data support for establishing quality standards for medicinal amber and distinguishing it from synthetic resin imitations.

ObjectiveTo systematically investigate the identification characteristics of medicinal amber， elucidate its microscopic features， crystal structural properties， and elemental composition， and thereby provide a scientific foundation for quality control and authenticity verification. MethodsThirty-nine batches of amber samples were collected and analyzed through integrated techniques including morphological analysis， microscopic identification， powder X-ray diffraction （XRD）， Raman spectroscopy， Fourier-transform infrared （FTIR） spectroscopy， and inductively coupled plasma mass spectrometry （ICP-MS） to evaluate their morphological attributes， phase composition， molecular vibrational modes， and trace element profiles. Among them， the XRD experiment used Cu Kα radiation （λ=1.540 6 Å）， with a scanning angle range of 10° to 70° （2θ） and a step size of 0.02°， the Raman spectroscopy experiment employed a 785 nm laser， with a spectral measurement range of 3 400 to 50 cm^-1， a laser power of 300 mW， a laser intensity of 30%， and a scanning time of 100 to 1 000 ms， the infrared spectroscopy experiment used a carbon-sulfur lamp， with a scanning range of 4 000 to 500 cm^-1， a resolution of 4 cm^-1， and 3 scans， the ICP-MS experiment utilized frequency power of 1.2 kW， a double-pass cyclonic spray chamber， a sample introduction system flow rate of 0.7-1.0 L·min^-1， and an auxiliary gas flow of 0.2 L·min^-1. ResultsUnder orthogonal polarized light microscopy， medicinal amber exhibited an isotropic homogeneous structure， with partial samples containing inorganic impurities such as AsS and SiO₂. FTIR spectra revealed characteristic absorption peaks at 2 932-2 939 cm^-1 （C-H stretching vibrations）， 1 705-1 728 cm^-1 （C=O stretching vibrations）， and 880-887 cm^-1 （C=C deformation vibrations）， confirming the oxidative polymerization of terpenoid resin. Raman spectroscopy further identified distinctive peaks at 2 925 cm^-1， 2 870 cm^-1 （saturated C-H stretching）， and 1 648 cm^-1 （C=C stretching）， consistent with the structural features of oxidized-polymerized resin. ICP-MS analysis demonstrated that S， Al， Si， Fe， Na， and Ca were the predominant trace elements in medicinal amber. ConclusionThis study comprehensively evaluated medicinal amber's morphological attributes， phase composition， molecular vibrational modes， and trace elements through multimodal analytical techniques. The findings establish data support for establishing quality standards for medicinal amber and distinguishing it from synthetic resin imitations.

Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.