Purpose: The aim of this study is to determine the impact of solute carrier family 3 member 2 (SLC3A2) on the malignant phenotype of gliomas and its role in regulating ferroptosis sensitivity. Materials and Methods: The malignant phenotype of glioma was assessed by cell proliferation assay, colony formation assay, EdU assay, wound healing, and Transwell experiments. We further validated the impact of reduced SLC3A2 expression on the sensitivity to ferroptosis in glioma cells through Cell Counting Kit-8 assays, flow cytometry, western blotting, and transmission electron microscopy. Western blot was used to explore how SLC3A2 affects glioma sensitivity to ferroptosis through the AKT/NF-E2-related factor 2 (NRF2)/glutathione peroxidase 4 (GPX4) axis. By establishing a subcutaneous xenograft tumor model in BALB/c-nude mice, we investigated the growth of tumors following the knockout of SLC3A2 in glioma cells. Results: Downregulation of SLC3A2 suppressed the malignant phenotype of glioma by blocking the cell cycle and epithelial-mesenchymal transition processes. On the other hand, loss of SLC3A2 not only downregulated SLC7A11 but also prevented the activation of the AKT/NRF2/GPX4 axis. These lead to increased accumulation of reactive oxygen species and lipid peroxides, ultimately enhancing the susceptibility of glioma to ferroptosis. Conclusion Our findings suggest that SLC3A2 is an oncogene in gliomas, promoting their occurrence and development. It plays a critical role in ferroptosis resistance through the AKT/NRF2/GPX4 axis.

Objective To construct a dynamic prediction model for JC polyomavirus (JCV) reactivation after kidney transplantation. Methods A retrospective analysis was conducted on the clinical data of 128 recipients who met the inclusion criteria and received kidney transplantation in Nanfang Hospital, Southern Medical University, from June 2021 to December 2024. Dynamic Cox regression and dynamic restricted mean survival time (RMST) regression based on the landmark method were adopted to establish the dynamic prediction models, and Monte Carlo cross-validation was used to evaluate model performance. Results The dynamic models could predict the incidence and onset time of JCV reactivation within the subsequent 3 months according to covariates at each landmark time point from the 1st to the 6th month after transplantation. Remuzzi score, body mass index and warm ischemia time were independent risk factors for JCV reactivation, while a history of urinary BK polyomavirus reactivation served as a protective factor. The median values of the area under the curve, C-index and Brier score of the dynamic Cox model were 0.873, 0.851 and 0.065 respectively, and the C-index of the dynamic RMST model was 0.829, all of which were superior to those of the static model. Conclusions The landmark-based dynamic models exhibit excellent predictive performance, which may integrate baseline data and post-transplant follow-up information to realize dynamic assessment of the risk and time window of JCV reactivation, thereby providing evidence for optimizing post-operative monitoring and individualized intervention strategies.

Patients with lung cancer experience a heavy symptom burden during the perioperative period, which seriously affects their recovery and quality of life. Traditional symptom management models rely mainly on scheduled ward rounds during hospitalization and outpatient follow-up after discharge. However, they have limitations such as delayed symptom recognition, lack of post-discharge monitoring, and non-quantitative symptom assessment, which often lead to delayed interventions and low patient satisfaction. In recent years, the symptom management model based on electronic patient-reported outcomes (ePRO) has been increasingly valued in clinical practice. Existing high-level evidence from both domestic and international studies indicates that, through proactive monitoring, real-time alerts, and remote interventions, this model enables dynamic and continuous symptom management and helps improve patient recovery and healthcare experience. As a supplement to routine medical care, the ePRO-based symptom management model aims to enhance the quality of care rather than replace existing medical processes. To promote the standardized application of this model in perioperative lung cancer care, this consensus integrates domestic and international evidence. After multiple rounds of voting by more than 50 experts, it formulates 12 consensus statements covering the three core components, symptom monitoring, alerting, and intervention, to provide scientific and practical recommendations for clinical practice.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:This study aims to investigate the expression of uridine diphosphate-glucose[]pyrophos-phorylase 2(UGP2)in breast cancer(BC)tissues and its oncogenic mechanism,assessing its potential value as a diag-nostic and prognostic biomarker for breast cancer.Methods:(1)Online database analysis was conducted to assess UGP2 mRNA and protein expression levels in breast cancer and explore their correlation with clinical characteristics.Im-munohistochemistry(IHC)was used to verify UGP2 expression in human breast cancer tumor tissues and evaluate its relationship with clinicopathological features.(2)Kaplan-Meier survival analysis and COX regression models were used to analyze the impact of UGP2 expression on breast cancer patient prognosis.(3)Bioinformatics methods were em-ployed to investigate the correlation between UGP2 and tumor immune cell infiltration,and to predict the biological func-tions and associated signaling pathways of UGP2 in breast cancer.Results:(1)The mRNA and protein expression levels of UGP2 were upregulated in breast cancer tissues(both P<0.05),and were negatively correlated with ER-positive and PR-positive status(OR<1,P<0.05),while positively correlated with Ki-67 levels and the triple-negative breast cancer(TNBC)subtype(OR>1,P<0.05).(2)Elevated expression levels of UGP2 were associated with poorer survival rates in breast cancer patients(both P<0.05)and were identified as an independent adverse prognostic factor for breast cancer(HR=1.40,P<0.05).(3)Functional analysis results suggested that UGP2 may promote tumor progression by regulating metabolism,hormone signaling,and the immune microenvironment.Additionally,UGP2 expression was negatively cor-related with NK cell activation status and positively correlated with the inhibitory state.Conclusion:UGP2 expression is elevated in breast cancer tissues and is closely associated with poor patient prognosis.It may promote cancer pro-gression through mechanisms such as metabolic reprogramming and immune suppression.UGP2 shows promise as a potential biomarker and therapeutic target in breast cancer,providing a basis for personalized treatment.

Objective To explore the mechanism of electroacupuncture improving myocardial ischemia-reperfusion injury(MIRI),electroacupuncture PC6 Attenuates TRPV1 pathway in spinal cord C5-T6 dorsal root ganglion(DRG)on MIRI rats was observed.Methods After one week of experimental feeding,30 SD rats with normal electrocardiogram were randomly divided into sham-operated group and model group,PC6 group,non-meridian and non-acupuncture group,and PC6+capsaicin(TRPV1 receptor agonist)group,with 6 rats in each group.The MIRI model was prepared by ligation of the left anterior descending(LAD)coronary artery in the other groups.The next day after modeling,electroacupuncture of the"PC6"point in the EA group,electroacupuncture of the caudal"non-meridian non-points"in the the non-meridian non-acupuncture point group,and electroacupuncture of the"PC6"point after intraperitoneal injection of capsaicin in the PC6+capsaicin group,20 min/d for 7 days.ECG was used to record the changes of ST level and LF/HF ratio in rats.Evans blue-TTC double staining and HE staining was used to observe the myocardial infarction area and the changes of myocardial tissue morphology.ELISA was used to detect the levels of serum CK-MB and cTnI.Immunofluorescence staining was used to the phenomenon of sympathetic-sensory coupling with TH-CGRP positive labeling in the DRG of rats.qPCR was to detect the mRNA expression of TRPV1,TH,CGRP,SP,ERK and AKT in rat DRG.Results Compared with the sham-operated group,rats in the model group showed significant higher ST level and LF/HF ratio(both P<0.001),and IA/AAR ratio increased significantly(P<0.0001).Massive inflammatory cell infiltration,serum CK-MB,cTnI levels up-regulated significantly(both P<0.0001).The formation of TH-CGRP-labeled sympathetic budding phenomenon in the DRG and the TRPV1,TH,CGRP in the DRG,SP,ERK,and AKT mRNA expression levels increased significantly(both P<0.01).Compared with the model group,the ECG of the endograft group was significantly improved(both P<0.001).The IA/AAR ratio decreased significantly in PC6 group(P<0.001).The myocardial infarction area reduced significantly(P<0.0001).The levels of serum CK-MB and cTnI down-regulated significantly(both P<0.0001),and the phenomenon of sympathetic sprouting within DRG was not evident,and the DRG of the 6 corresponding mRNA expression decreased significantly(both P<0.01).Compared with the PC6 group,the effect of treatment was not obvious in the non-meridian and non-acupuncture group and PC6+capsaicin group,and the electrocardiogram,IA/AAR ratio,myocardial infarcted area,and serum CK-MB,and cTnI levels did not improve(both P<0.01),and a large number of sympathetic budding phenomena were seen in the DRG.The expression of the mRNA corresponding to the phase of 6 increased significantly(both P<0.01).Conculsion Electroacupuncture PC6 may reduce myocardial injury by inhibiting TRPV1 pathway-mediated sympatheticsprouting in dorsal root ganglia.

Objective:To analyze the problems and constraints in the development of district hospitals in new cities of Shanghai,and to provide suggestions for the development of district hospitals based on rainbow model.Methods:Using the purposive sampling method,26 key informants from 16 units of health administrative departments,municipal hospitals,and regional medical centers in 5 new cities were selected for on-site research and in-depth interviews,and the research data were analyzed using the thematic framework method.Results:Macro-level planning layout and resource allocation,meso-level organizational linkage and cooperation and competition,and micro-level medical service and talent discipline are important factors affecting the development of district hospitals;there is a mismatch between the realistic development path and functional positioning,mismatch between the institutional mechanism and the demand for effective integration of medical resources,insufficient specialty development and introduction of new technologies,lack of and serious loss of medical talents,limited policy support,inconsistent standards and transfer of resources,and limited policy support.Limited efforts,non-uniform standards poor referral,and other development bottlenecks.Conclusions:It is suggested to strengthen system integration,optimize the planning and layout of health resources in the new city,and guide the differentiated development of hospitals at the city and district levels;Strengthen organizational integration,improve the cooperation and benefit distribution mechanism,and accelerate the construction of close-knit medical consortiums;Optimize the integration of services,accelerate the application of new technologies,and strengthen the construction of specialty alliances;Deepen the integration of functions and norms,coordinate human,financial,and material resources,and solidify the basic support.

Objective:To investigate the relationship between sagittal position parameters and screw loosening after unilateral biportal endoscopic (UBE) combined with percutaneous pedicle screw fixation for single-segment lumbar spinal stenosis.Methods:A total of 180 patients with single-level lumbar spinal stenosis who received UBE combined with percutaneous pedicle screw internal fixation in our hospital from June 2020 to June 2023 were enrolled. According to the postoperative follow-up, they were divided into the non-loosening group (112 cases) and the loosening group (68 cases). The demographics, operative parameters and sagittal position [pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA)] before and after operation were compared between the two groups. The indicators with significant differences between the two groups were included in the multivariate logistic regression analysis to analyze the influencing factors of screw loosening. The dose-response relationship between sagittal position parameters and screw loosening was analyzed by restricted cubic spline model.Results:At 6 months and 1 year postoperatively, the fusion rates in the loosening group were 47.1% and 55.9%, respectively, which were significantly lower than the rates (85.7% and 100.0%) in the non-loosening group, respectively ( P<0.05). Postoperatively, the SS in the non-loosening group (36.16°±5.35°) and the loosening group (32.02°±5.54°) and the LL in the loosening group (51.26°±6.35°) were all significantly lower than preoperative values (40.51°±6.11°, 40.49°±6.08°, and 54.08°±6.21°) ( P<0.05). Meanwhile, the PT in the non-loosening group (15.24°±2.69°), TK in the non-loosening group (32.46°±7.29°), PI in the loosening group (56.82°±5.23°), PT in the loosening group (17.01°±3.64°), and TK in the loosening group (34.87°±7.21°) were all significantly higher than preoperative values (13.12°±3.19°, 30.25°±5.17°, 52.84°±5.12°, 13.15°±3.21°, and 30.26°±5.12°) ( P<0.05). Postoperatively, the loosening group had significantly lower SS (32.02°±5.54°), LL (51.26°±6.35°), and SVA (-0.87±1.06 cm) than the non-loosening group (36.16°±5.35°, 53.73°±6.27°, and -0.51±1.04 cm), respectively ( P<0.05). Conversely, the PI (56.82°±5.23°), PT (17.01°±3.64°), and TK (34.87°±7.21°) in the loosening group were significantly higher than those in the non-loosening group (53.48°±5.20°, 15.24°±2.69°, and 32.46°±7.29°), respectively ( P<0.05). Binary logistic regression analysis indicated that PT, SS, LL, and SVA were independent risk factors for screw loosening ( P<0.05). The restricted cubic spline model revealed a nonlinear dose-response relationship between sagittal parameters (PT, SS, LL, and SVA) and screw loosening ( P<0.05). With increasing PT, the odds ratio (OR) for screw loosening increased, whereas increasing SS, LL, and SVA reduced the OR for screw loosening. Conclusion:After UBE combined with percutaneous pedicle screw fixation in single-level lumbar spinal stenosis patients, sagittal position parameters PT were positively correlated with screw loosening, while SS, LL and SVA were negatively correlated with screw loosening.

Objective To investigate the feasibility and safety of transoral transgastric natural orifice transluminal endoscopic surgery(TG-NOTES)cholecystectomy in miniature pigs.Methods A total of 11 miniature pigs were selected as the experimental subjects and underwent TG-NOTES cholecystectomy.These pigs were divided into the Group A and Group B according to the surgical procedures.Among them,7 miniature pigs in the Group A underwent endoscopic cholecystectomy without dissecting the gallbladder triangle,while 4 miniature pigs in the Group B underwent endoscopic cholecystectomy after dissecting the gallbladder triangle.The success rate of surgery,the time of each stage of surgery,the incidence of complications,the success rate of cholecystectomy and the survival rate of miniature pigs in the two groups were counted.One miniature pig in the Group A and 4 miniature pigs in the Group B were selected for survival experiments.After surviving for 1 week,they were killed and dissected to observe the healing of incision and incidence of complications.Results The surgical survival rate of experimental animals was 100%,and the success rate of cholecystectomy was 100%.There was no significant difference in the surgical time,time of cut the stomach into the abdomen,time of gallbladder exploration or time of gallbladder removal of miniature pigs between the two groups(P>0.05).The time of ligating gallbladder artery of miniature pigs in the Group B was longer than that in the Group A,and the time of isdating gallbladder was shorter than that in the Group A,with statistically significant differences(P<0.05).There was no significant difference in the average number of complications of miniature pigs between the two groups(P>0.05).The dissection of animals after survival experiments revealed that the incisions healed well without serious complications.Conclusion This study successfully establishes the surgical model of TG-NOTES cholecystectomy,and confirms the safety and feasibility of TG-NOTES cholecystectomy.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.