ObjectiveTo explore the role of neuroimaging features monitored by functional near-infrared spectroscopy （fNIRS） in postoperative delirium （POD） in elderly patients undergoing joint replacement during perioperative period， and to provide a basis for early clinical prediction. MethodsA total of 105 elderly patients who underwent joint replacement under general anesthesia were included. The Mini-Mental State Examination （MMSE） scale was used to evaluate the patient's cognition one day before the operation. Before the start of the surgery， fNIRS was used to monitor the changes of cerebral blood oxygen saturation when the patient performed the task state. The 3-minute delirium diagnostic scale （3D-CAM scale） was used to evaluate the occurrence of POD at 24， 48 and 72 h after operation. Brain network analysis was performed and Logistic regression analysis was used to explore the relationship between fNIRS monitoring data and POD in elderly patients undergoing joint replacement surgery during preoperative task state. The receiver operating characteristic curve （ROC curve） was constructed to evaluate the diagnostic efficacy， and the Hosmer-Lemeshow goodness-of-fit test was used to test the goodness of fit of the model. ResultsAmong 105 patients， 100 cases were effectively analyzed， of which 20 cases （20%） had POD. Brain network analysis showed that the r value of functional connectivity correlation coefficient in POD group （0.069±0.118） was lower than that in non-POD group （0.073±0.084）. The low channel connectivity of right primary somatosensory cortex-right primary motor cortex （RS1-RM1） and left anterior pole-right Broca's triangle （LFP-RBA44） was an important factor affecting the occurrence of POD （P < 0.05）. Based on this result， the area under the ROC curve was 0.797 and 0.784， respectively. The results of Hosmer-Lemeshow goodness-of-fit test showed that the model fitted well （all P>0.5）. ConclusionThe neuroimaging features extracted from the cerebral oxygen saturation data monitored by fNIRS are significantly correlated with the risk of POD in elderly patients undergoing joint replacement during perioperative period. Among them， the low connectivity of preoperative RS1-RM1 and LFP-RBA44 brain network channels is an important influencing factor of POD occurrence. Predicting the occurrence of POD based on fNIRS is conducive to the early intervention and risk reduction of perioperative complications， improving medical quality and promoting precision medical practice.

This article reviewed the progress in military operational medicine in the U.S.Armed Forces in 2024 in terms of improved capabilities of health care in extreme natural environments,protection from noise damage,sleep interventions,intelligence monitoring of operational efficiency and more academic exchanges in this field.These measures are intended to improve the operational performance of soldiers in every possible way.This article is expected to provide useful references for related research.

Objective:To investigate the clinical efficacy of autologous adipose-derived stem cell gel (SVF-gel) grafting in the treatment of depressed acne scars.Methods:A retrospective analysis was conducted on data collected from 28 patients who underwent SVF-gel grafting treatment for depressed acne scars in the Department of Dermatology, Xijing Hospital, Air Force Medical University from October 2018 to May 2021. There were 17 males and 11 females, aged 17 - 38 (26 ± 4.86) years. As for clinical types, 8 patients were diagnosed with boxcar acne scars, 14 with rolling acne scars, and 6 with acne scars with characteristics of the two types. The clinical acne scar weighted scale (ECCA scale) was used to evaluate the appearance improvement after the treatment, and patients′ subjective satisfaction scores and incidence of adverse reactions were recorded.Results:After the SVF-gel grafting, the facial appearance of patients with depressed acne scars significantly improved, and the ECCA scores significantly decreased 6 months after surgery (before surgery: 52.5 ± 15.8 points; 6 months after surgery: 23.8 ± 10.2 points; t = 11.68, P < 0.001). The subjective satisfaction rate of patients was 82.14% (23/28), the incidence rate of adverse reactions was 17.86% (5/28), and 5 patients experienced mild inflammatory reactions after surgery, including 2 with subcutaneous nodules. The secondary grafting rate was 67.86% (19/28) . Conclusion:The SVF-gel grafting was markedly effective for the treatment of depressed acne scars, which is worthy of clinical promotion and application.

Invasive angiomyxoma（AAM） is characterized by unclear boundaries, non enveloped glial growth, high recurrence rate, and belongs to a benign tumor, but it is invasive and grows slowly. A patient with recurrent left vestibular invasive angiomyxoma was admitted to the Otorhinolaryngology ward of Beijing Traditional Chinese Medicine Hospital Affiliated with Capital Medical University. The patient underwent two repeated surgeries and underwent a combined internal and external nasal approach for the removal of the nasal vestibular angiomyxoma. The patient recovered well after the surgery and has not recurred since follow-up.
Humans ; Myxoma/pathology* ; Neoplasm Recurrence, Local ; Nose Neoplasms/pathology*

Glioblastoma (GBM) is a highly aggressive primary brain tumor characterized by poor prognosis. Conventional chemo-radiotherapy demonstrates limited therapeutic efficacy and is often accompanied by significant side effects, largely due to factors such as drug resistance, radiation resistance, the presence of the blood-brain barrier (BBB), and the activation of DNA damage repair mechanisms. There is a pressing need to enhance treatment efficacy, with BRD4 identified as a promising target for increasing GBM sensitivity to therapy. Lacking small molecule inhibitors, BRD4 can be degraded using PROteolysis Targeting Chimera (PROTAC), thereby inhibiting DNA damage repair. To deliver PROTAC, SIAIS171142 (SIS) effectively, we designed a responsive nanocapsule, MPL_(SS)P@SIS, featuring GBM-targeting and GSH-responsive drug release. Modified with 1-methyl-l-tryptophan (MLT), nanocapsules facilitate targeted delivery of SIS, downregulating BRD4 and sensitizing GBM cells to radiotherapy and chemotherapy. After intravenous administration, MPL_(SS)P@SIS selectively accumulates in tumor tissue, enhancing the effects of radiotherapy and temozolomide (TMZ) by increasing DNA damage and oxidative stress. GSH activates the nanocapsules, triggering BRD4 degradation and hindering DNA repair. In mouse models, the nanosensitizer, combined with TMZ and X-ray irradiation, efficiently inhibited the growth of GBM. These findings demonstrate a novel PROTAC-based sensitization strategy targeting BRD4, offering a promising approach for effective GBM therapy.

Fasting plasma glucose(FPG)has been widely used in the diagnosis of diabetes mellitus(DM)for its advantages of rapidity,economy,simplicity and acceptability.Hemoglobin A1c(HbA1c)has the advantages of being simple,stable,accurate and unaffected by related factors,and has been used in the diagnosis of DM since it was standardized.However,the value of FPG and HbA1c in the early diagnosis of diabetes have been controversial.The purpose of this paper is to explore the value of the two in the early diagnosis of diabetes.

Kaempferol(KAE),as a natural flavonoid compound,possesses multiple biological activities including po-tent anti-inflammatory,antioxidant,and immunomodulatory effects,as well as anti-cancer properties.It has demonstrated good therapeutic effects in the intervention and treatment of various ocular diseases such as fungal keratitis,corneal trans-plantation rejection,age-related macular degeneration,and diabetic retinopathy.Furthermore,the development of novel ocular drug delivery systems-such as KAE-loaded bovine serum albumin porous membranes,KAE eye drops based on poly-vinylpyrrolidone nanocomplexes,gelatin nanoparticles encapsulating KAE,and platelet-derived extracellular vesicles loaded with KAE-has improved the bioavailability of KAE,laying a foundation for expanding its applications.However,there is a lack of systematic and comprehensive reviews on the application of KAE in ophthalmic diseases.Therefore,this article summarizes the research progress,efficacy mechanisms,and novel delivery methods of KAE in ophthalmic diseases,ai-ming to provide new diagnostic and therapeutic strategies for the treatment of related ocular conditions.

Objective To investigate the incidence and economic burden of healthcare-associated infection(HAI)in patients after liver transplant.Methods Basic clinical information,infection status,and related medical expenses of liver transplant patients in the department of hepatobiliary surgery in a tertiary first-class hospital from November 2012 to December 2023 were investigated retrospectively.A case-control study design was employed,with post-li-ver transplant patients who developed HAI as the infection group and those without HAI during the same period as the control group.The 1∶1 propensity score matching(PSM)method was adopted(caliper value was set at 0.05,employing sampling without replacement).Length of hospital stay and hospitalization expenses between patients in the infection group and the control group were compared using Wilcoxon rank-sum test,and the economic burden due to HAI was calculated.Results A total of 336 liver transplant patients were included in study,out of which 48 had HAI,with an incidence of 14.29％.44 pairs were successfully matched by PSM.After matching,the median hospitalization expense for patients in the infection group was 334 473.73 Yuan,while that of the control group was 285 824.82 Yuan,with a statistically significant difference(Z=-3.430,P＜0.05).The direct economic burden of HAI in liver transplant patients was 48 648.91 Yuan.After matching,the median length of hospital stay in the in-fection group(37.0 days)was 12.5 days longer than that in the control group(24.5 days),with statistically sig-nificnat difference(Z=-3.630,P＜0.001).Conclusion HAI after liver transplant increases patients' hospitaliza-tion expense and prolongs their hospital stay,thus brings huge economic burdens to the patients.

Human immunodeficiency virus(HIV)is the pathogen of acquired immune deficiency syndrome(AIDS).The vi-rus is a highly contagious and highly pathogenic disease caused by the virus attacking the human immune system,which remains a ma-jor global public health problem.Interferon(IFN)is a key cytokine with antiviral and cell-regulatory properties,involved in functions such as cell proliferation,innate and adaptive immune responses.The JAK/STAT signaling pathway is a signal transduction pathway stimulated by cytokines that is involved in many important biological processes such as cell proliferation,differentiation,apoptosis,and immune regulation.With the further in-depth research on AIDS,it has been revealed that IFN and the JAK/STAT pathway play crucial roles in the activation and replication of HIV-1 in target cells.This paper summarizes the structure,signal transduction,and regulatory mechanisms of IFN and the JAK/STAT pathway,and explores the mechanism of IFN-regulated JAK/STAT signaling path-way in HIV-1.It is expected to provide new treatment strategies for the clinical treatment of AIDS.

Based on the theory of the five-body constituents from Huangdi Neijing (Yellow Emperor's Internal Classic), the approach and methods of acupuncture for facial aging are explored. Acupuncture for facial aging can be guided by the concept of the five-body constituents, targeting the facial "skin, flesh, vessels, tendons, and bones", and utilizing five different types of needles-facial needles, needle knives, filiform needles, retaining needles, and elongated needles and filiform needles-to maximize their respective advantages in treating facial aging. Facial needles are applied to the "skin" by selecting facial acupoints or local ashi points (at wrinkle or pigmentation sites). Needle knives are used for the "flesh" to perform longitudinal dredging and transverse dissection of the facial muscle layers. Filiform needles target the "vessels" with needling at Renying (ST9) to improve facial complexion. Retaining needles act on the "tendons" with needling from Taiyang (EX-HN5) to Xiaguan (ST7), and Jiache (ST6) to Daying (ST5), using clockwise twisting to generate a retaining needle sensation and lifting to achieve an overall facial lifting effect.
Humans ; Acupuncture Therapy/methods* ; Face ; Skin Aging ; Acupuncture Points ; Aging