Objective:To investigate the feasibility and value of nomogram based on base line clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) characteristics for pretreatment predicting the depth of myometrial invasion and tumor grade of endometrioid endometrial carcinoma (EEC).Methods:Preoperative baseline clinical characteristics and DCE-MRI characteristics of 194 EEC patients were prospectively collected at Obstetrics and Gynecology Hospital, Fudan University from October 2020 to January 2022 and used as a training set. Univariate analysis was conducted to compare baseline clinical characteristics and DCE-MRI quantitative parameters [including tumor volume, and mean, median, and standard deviation of volume transfer constant (K trans), rate constant (K ep), extravascular extracellular volume fraction (V e), and initial area under the enhancement curve (iAUC)] between patients with deep myometrial invasion (DMI) and those with superficial myometrial invasion (SMI), as well as between high-grade and low-grade EEC. Multivariate logistics regression analysis was used to identify independent predictors for the construction of nomogram. An independent external testing set comprising 127 EEC patients was retrospectively collected from Zhongshan Hospital, Fudan University and Zhongshan Hospital, Fudan University (Xiamen Branch). The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were used for evaluating the model′s predictive performance and clinical net benefit, respectively. Results:(1) The depth of myometrial invasion: univariate analysis showed that in the training set, the EEC patients with DMI differed significantly from those with SMI in clinical characteristics including higher proportion of postmenopausal state and overweight [body mass index (BMI)≥25 kg/m2], and abnormal levels of serum cancer antigen (CA) 125, CA 199, and human epididymis protein 4 (HE4), and in DCE-MRI quantitative parameters including tumor volume, and median, mean, and standard deviation of K trans, median of V e, as well as median, mean, and standard deviation of iAUC (all P<0.05). Multivariate analysis showed that the patient′s menstrual status, BMI, CA 199, tumor volume, and mean of iAUC were independent predictors of the depth of myometrial invasion, and constructed the nomogram (recorded as Nomogram_1), achieving an AUC of 0.861 (95% CI: 0.803-0.919) in the training set. In the independent external testing set, the AUC was 0.876 (95% CI: 0.815-0.938), with corresponding sensitivity of 82.0%, specificity of 80.7%, accuracy of 81.1%, positive predictive value (PPV) of 65.3%, and negative predictive value (NPV) of 91.0% for predicting DMI. (2) The EEC grade: univariate analysis showed that in the training set, high-grade EEC patients differed significantly from low-grade EEC in clinical characteristics including patient′s age, the proportion of postmenopausal state and overweight, and abnormal levels of serum CA 125, and in DCE-MRI quantitative parameters including tumor volume, median, mean, and standard deviation of K trans, median and mean of V e, as well as median, mean, and standard deviation of iAUC (all P<0.05). Multivariate analysis showed that the patient′s menstrual status, BMI, tumor volume, and median of V e emerged as independent predictors of EEC grade, and constructed the nomogram (recorded as Nomogram_2), achieving an AUC of 0.845 (95% CI: 0.786-0.893) in the training set. While in the external testing set, the AUC was 0.819 (95% CI: 0.744-0.894), with corresponding sensitivity of 72.4%, specificity of 72.4%, accuracy of 72.4%, PPV of 43.8%, and NPV of 89.9% for predicting high-grade EEC. (3) The DCA curves demonstrated that both Nomogram_1 and Nomogram_2 yielded obvious positive clinical net benefits across a wide range of threshold probabilities. Conclusion:The nomogram based on pretreatment clinical and DCE-MRI characteristics has the potential to noninvasive predict the depth of myometrial invasion and grade of EEC, providing valuable reference information for clinical management decision-making.

Objective:To observe the clinical efficacy of subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy and its influence on defecation-related symptoms.Methods:Seventy eligible patients with poststroke constipation were assigned to an observation group or a control group using the random number table method,with 35 patients in each group.The observation group received subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy,whereas the control group received lactulose oral solution.After treatment,the total effective rate and safety were compared between the two groups,and changes in the patient assessment of constipation symptom(PAC-SYM),stool form,and constipation symptom scores were observed.Results:The total effective rate was 87.9%in the observation group and 69.7%in the control group,and the difference was statistically significant(P<0.05).No obvious adverse reactions occurred in either group.After treatment,PAC-SYM and constipation symptom scores in both groups were lower than before treatment(P<0.05),with the observation group scoring lower than the control group(P<0.05).After treatment,the Bristol stool form scale(BSFS)score in both groups increased(P<0.05)and approached the score of normal stool form;the difference in the BSFS score between the two groups was not statistically significant(P>0.05).Conclusion:Compared to oral lactulose,subcutaneous insertion with row needling at the scalp Foot Motor Sensory Area combined with point application therapy can better improve poststroke constipation symptoms,shorten both the interval between bowel movements and the duration of each bowel movement,and reduce rectal and abdominal discomfort,with fewer adverse reactions and good safety.

Major depressive disorder in adolescents is a serious psychiatric condition characterized by profound impairment in psychosocial functioning. Its primary symptoms include low mood, irritability, and anhedonia. Although pharmacological treatments and psychotherapy are currently recommended as first-line treatments, their effectiveness is limited, and pharmacological treatments may carry the risk of increased suicidal ideation. Therefore, exploring new, effective, and safe treatment options is an urgent priority. In recent years, intermittent theta burst stimulation (iTBS), a novel form of transcranial magnetic stimulation, has shown promising results in treating treatment-resistant depression in adults, drawing growing interest in its potential use in adolescents. iTBS modulates neural activity through magnetic stimulation of the cerebral cortex and has been shown to alleviate depressive symptoms, particularly when targeting the left dorsolateral prefrontal cortex (DLPFC). Given the high neuroplasticity of the adolescent brain during this critical developmental stage, adolescents may exhibit heightened sensitivity to iTBS, resulting in more enduring neuroregulatory effects. Research highlights the importance of precise targeting and individualized adjustment of stimulation intensity for optimal therapeutic outcomes. Additionally, accelerated iTBS (aiTBS) protocols have demonstrated faster clinical effects in treating acute or severe depression in adolescents, improving treatment adherence and partially mitigating suicidal tendencies. This review summarizes recent progress in the application of iTBS in adolescent depression, with a focus on its mechanisms, treatment parameters, and related research. The goal is to provide theoretical support and practical guidance for the clinical application of iTBS in adolescent depression care.

Vacuum compression molding (VCM) is a novel technology supporting the research and development of pharmaceutical solid dispersions. It is widely applied due to its precision and convenience in sample preparation. This technology integrates the principles of heating, melting, cooling, and vacuum compression to transform solid powders into shaped solids directly. By selecting different molds, temperatures, and pressures, researchers can prepare samples with diverse characteristics. This paper presents an overview of the equipment composition and working principles of VCM technology, demonstrating its distinct advantages in the formulation screening process of amorphous solid dispersions through comparative analysis with hot melt extrusion using case studies, and introduces its applications in the development of drug delivery systems and rheological characterization analysis, with a perspective on the future development of its functions.

Objective:To investigate the feasibility and value of nomogram based on base line clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) characteristics for pretreatment predicting the depth of myometrial invasion and tumor grade of endometrioid endometrial carcinoma (EEC).Methods:Preoperative baseline clinical characteristics and DCE-MRI characteristics of 194 EEC patients were prospectively collected at Obstetrics and Gynecology Hospital, Fudan University from October 2020 to January 2022 and used as a training set. Univariate analysis was conducted to compare baseline clinical characteristics and DCE-MRI quantitative parameters [including tumor volume, and mean, median, and standard deviation of volume transfer constant (K trans), rate constant (K ep), extravascular extracellular volume fraction (V e), and initial area under the enhancement curve (iAUC)] between patients with deep myometrial invasion (DMI) and those with superficial myometrial invasion (SMI), as well as between high-grade and low-grade EEC. Multivariate logistics regression analysis was used to identify independent predictors for the construction of nomogram. An independent external testing set comprising 127 EEC patients was retrospectively collected from Zhongshan Hospital, Fudan University and Zhongshan Hospital, Fudan University (Xiamen Branch). The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were used for evaluating the model′s predictive performance and clinical net benefit, respectively. Results:(1) The depth of myometrial invasion: univariate analysis showed that in the training set, the EEC patients with DMI differed significantly from those with SMI in clinical characteristics including higher proportion of postmenopausal state and overweight [body mass index (BMI)≥25 kg/m2], and abnormal levels of serum cancer antigen (CA) 125, CA 199, and human epididymis protein 4 (HE4), and in DCE-MRI quantitative parameters including tumor volume, and median, mean, and standard deviation of K trans, median of V e, as well as median, mean, and standard deviation of iAUC (all P<0.05). Multivariate analysis showed that the patient′s menstrual status, BMI, CA 199, tumor volume, and mean of iAUC were independent predictors of the depth of myometrial invasion, and constructed the nomogram (recorded as Nomogram_1), achieving an AUC of 0.861 (95% CI: 0.803-0.919) in the training set. In the independent external testing set, the AUC was 0.876 (95% CI: 0.815-0.938), with corresponding sensitivity of 82.0%, specificity of 80.7%, accuracy of 81.1%, positive predictive value (PPV) of 65.3%, and negative predictive value (NPV) of 91.0% for predicting DMI. (2) The EEC grade: univariate analysis showed that in the training set, high-grade EEC patients differed significantly from low-grade EEC in clinical characteristics including patient′s age, the proportion of postmenopausal state and overweight, and abnormal levels of serum CA 125, and in DCE-MRI quantitative parameters including tumor volume, median, mean, and standard deviation of K trans, median and mean of V e, as well as median, mean, and standard deviation of iAUC (all P<0.05). Multivariate analysis showed that the patient′s menstrual status, BMI, tumor volume, and median of V e emerged as independent predictors of EEC grade, and constructed the nomogram (recorded as Nomogram_2), achieving an AUC of 0.845 (95% CI: 0.786-0.893) in the training set. While in the external testing set, the AUC was 0.819 (95% CI: 0.744-0.894), with corresponding sensitivity of 72.4%, specificity of 72.4%, accuracy of 72.4%, PPV of 43.8%, and NPV of 89.9% for predicting high-grade EEC. (3) The DCA curves demonstrated that both Nomogram_1 and Nomogram_2 yielded obvious positive clinical net benefits across a wide range of threshold probabilities. Conclusion:The nomogram based on pretreatment clinical and DCE-MRI characteristics has the potential to noninvasive predict the depth of myometrial invasion and grade of EEC, providing valuable reference information for clinical management decision-making.

Objective:To observe the clinical efficacy of subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy and its influence on defecation-related symptoms.Methods:Seventy eligible patients with poststroke constipation were assigned to an observation group or a control group using the random number table method,with 35 patients in each group.The observation group received subcutaneous row needling at the Foot Motor Sensory Area combined with point application therapy,whereas the control group received lactulose oral solution.After treatment,the total effective rate and safety were compared between the two groups,and changes in the patient assessment of constipation symptom(PAC-SYM),stool form,and constipation symptom scores were observed.Results:The total effective rate was 87.9%in the observation group and 69.7%in the control group,and the difference was statistically significant(P<0.05).No obvious adverse reactions occurred in either group.After treatment,PAC-SYM and constipation symptom scores in both groups were lower than before treatment(P<0.05),with the observation group scoring lower than the control group(P<0.05).After treatment,the Bristol stool form scale(BSFS)score in both groups increased(P<0.05)and approached the score of normal stool form;the difference in the BSFS score between the two groups was not statistically significant(P>0.05).Conclusion:Compared to oral lactulose,subcutaneous insertion with row needling at the scalp Foot Motor Sensory Area combined with point application therapy can better improve poststroke constipation symptoms,shorten both the interval between bowel movements and the duration of each bowel movement,and reduce rectal and abdominal discomfort,with fewer adverse reactions and good safety.

Objective:To explore the application value of renin-angiotensin-aldosterone system (RAAS) indexes in the clinical diagnosis of essential hypertension.Methods:Eighty-eight patients with essential hypertension treated in the 962nd Hospital of the PLA Joint Logistics Support Force from April 2023 to May 2024 were enrolled as the observation group, and 80 normotensive healthy subjects undergoing physical examination in the same hospital during the same period were selected as the control group. RAAS-related indexes [angiotensin Ⅱ (ATⅡ), plasma renin activity (PRA), and aldosterone (ALD)] were detected in both groups. The levels of ATⅡ, PRA, ALD, and the ratio of plasma ALD to PRA (ARR) were compared between the two groups and among subgroups with different hypertension severities in the observation group. The diagnostic efficacy of each index for essential hypertension was analyzed by receiver operating characteristic (ROC) curve.Results:The levels of ALD, ATⅡ, and ARR in the observation group were significantly higher than those in the control group, while the PRA level was significantly lower (all P<0.05). Among the three subgroups in the observation group, the levels of ATⅡ, ALD, and ARR showed a significant increasing trend in grade 1, grade 2, and grade 3 hypertension subgroups, while the PRA level showed a significant decreasing trend (all P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of plasma PRA, ATⅡ, ALD, and ARR for the diagnosis of essential hypertension were 0.814, 0.703, 0.687, and 0.879, respectively. The combined detection of the four indexes had an AUC of 0.918, with the highest sensitivity and accuracy. Conclusions:Changes in RAAS indexes are closely related to the occurrence and severity of essential hypertension. PRA and ARR are effective indexes for the diagnosis of essential hypertension. The combined detection of the four indexes can achieve more ideal diagnostic efficacy and improve the diagnostic satisfaction of patients.

Objective:To explore the application value of renin-angiotensin-aldosterone system (RAAS) indexes in the clinical diagnosis of essential hypertension.Methods:Eighty-eight patients with essential hypertension treated in the 962nd Hospital of the PLA Joint Logistics Support Force from April 2023 to May 2024 were enrolled as the observation group, and 80 normotensive healthy subjects undergoing physical examination in the same hospital during the same period were selected as the control group. RAAS-related indexes [angiotensin Ⅱ (ATⅡ), plasma renin activity (PRA), and aldosterone (ALD)] were detected in both groups. The levels of ATⅡ, PRA, ALD, and the ratio of plasma ALD to PRA (ARR) were compared between the two groups and among subgroups with different hypertension severities in the observation group. The diagnostic efficacy of each index for essential hypertension was analyzed by receiver operating characteristic (ROC) curve.Results:The levels of ALD, ATⅡ, and ARR in the observation group were significantly higher than those in the control group, while the PRA level was significantly lower (all P<0.05). Among the three subgroups in the observation group, the levels of ATⅡ, ALD, and ARR showed a significant increasing trend in grade 1, grade 2, and grade 3 hypertension subgroups, while the PRA level showed a significant decreasing trend (all P<0.05). ROC curve analysis showed that the areas under the curve (AUC) of plasma PRA, ATⅡ, ALD, and ARR for the diagnosis of essential hypertension were 0.814, 0.703, 0.687, and 0.879, respectively. The combined detection of the four indexes had an AUC of 0.918, with the highest sensitivity and accuracy. Conclusions:Changes in RAAS indexes are closely related to the occurrence and severity of essential hypertension. PRA and ARR are effective indexes for the diagnosis of essential hypertension. The combined detection of the four indexes can achieve more ideal diagnostic efficacy and improve the diagnostic satisfaction of patients.

Major depressive disorder in adolescents is a serious psychiatric condition characterized by profound impairment in psychosocial functioning. Its primary symptoms include low mood, irritability, and anhedonia. Although pharmacological treatments and psychotherapy are currently recommended as first-line treatments, their effectiveness is limited, and pharmacological treatments may carry the risk of increased suicidal ideation. Therefore, exploring new, effective, and safe treatment options is an urgent priority. In recent years, intermittent theta burst stimulation (iTBS), a novel form of transcranial magnetic stimulation, has shown promising results in treating treatment-resistant depression in adults, drawing growing interest in its potential use in adolescents. iTBS modulates neural activity through magnetic stimulation of the cerebral cortex and has been shown to alleviate depressive symptoms, particularly when targeting the left dorsolateral prefrontal cortex (DLPFC). Given the high neuroplasticity of the adolescent brain during this critical developmental stage, adolescents may exhibit heightened sensitivity to iTBS, resulting in more enduring neuroregulatory effects. Research highlights the importance of precise targeting and individualized adjustment of stimulation intensity for optimal therapeutic outcomes. Additionally, accelerated iTBS (aiTBS) protocols have demonstrated faster clinical effects in treating acute or severe depression in adolescents, improving treatment adherence and partially mitigating suicidal tendencies. This review summarizes recent progress in the application of iTBS in adolescent depression, with a focus on its mechanisms, treatment parameters, and related research. The goal is to provide theoretical support and practical guidance for the clinical application of iTBS in adolescent depression care.

Objective:To analyze the efficacy and safety of integrase inhibitor-based single-tablet regimens bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and lamivudine/dolutegravir (3TC/DTG) in the treatment-na?ve patients with acquired immunodeficiency syndrome (AIDS).Methods:This study was a retrospective cohort study. The clinical data of treatment-na?ve AIDS patients initiating anti-retroviral therapy (ART) with B/F/TAF or 3TC/DTG and on ART for greater than or equal to 24 weeks from October 2020 to July 2023 in Shanghai Public Health Clinical Center, Fudan University were collected. The baseline human immunodeficiency virus (HIV)-1 RNA, CD4 + T lymphocyte counts at baseline and 12 weeks of treatment, and the rates of virological suppression and virological failure at 24 weeks of treatment, and levels of total cholesterol, serum creatinine, uric acid before and after treatment were compared between the B/F/TAF group and 3TC/DTG group. Independent sample t test, corrected t test, Mann-Whitney U test, Wilcoxon signed rank test, chi-square test were used for statistical analysis. Results:Among 189 treatment-na?ve AIDS patients, 141 cases were in B/F/TAF group and 48 cases in 3TC/DTG group. The HIV-1 RNA level at baseline was 1.77(0.78, 4.52)×10 5 copies/mL in the B/F/TAF group and 0.97(0.24, 2.20)×10 5 copies/mL in the 3TC/DTG group. There was a statistically significant difference between the two groups ( U=2 221.00, P=0.006).There were 77.3%(109/141) patients on B/F/TAF achieved complete virological suppression with no virological failure at week 24, and 85.4%(41/48) on 3TC/DTG achieved complete virological suppression with one (2.1%) virological failure at week 24. At 12 weeks of treatment, 92.2%(130/141) of the patients in the B/F/TAF group and 85.4%(41/48) of the patients in the 3TC/DTG group had an increase in CD4 + T lymphocyte count by more than 30% compared with baseline. The proportion of CD4 + T lymphocyte count increased by more than 100/μL from baseline in the B/F/TAF group was 67.4%(95/141), and that in the 3TC/DTG group was 52.1%(25/48). There were no significant differences between the two groups ( χ2=1.91 and 3.61, respectively, P=0.167 and 0.733).The levels of total cholesterol ( W=2 036.00, t=-5.42, respectively), serum creatinine ( W=1 098.00, 234.00, respectively), uric acid ( W=2 188.00, 299.00, respectively) and the proportion of patients with mild to moderate renal insufficiency ( χ2=22.29, 8.22, respectively) in the B/F/TAF group and 3TC/DTG group after 24 weeks of treatment were significantly higher than those before treatment (all P<0.01). Conclusions:Both B/F/TAF and 3TC/DTG are effective in terms of virological suppression and immunological recovery and have good safety profiles in treatment-na?ve patients with AIDS.