Postoperative cognitive dysfunction (POCD) is a clinically significant complication in elderly patients, largely driven by surgery-induced neuroinflammation. The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway, a crucial regulator of innate immunity, has been implicated in neuroinflammatory activation. This study investigated whether electroacupuncture (EA) improves POCD by modulating this pathway in aged rats. Aged male Sprague-Dawley rats were subjected to sevoflurane anesthesia and splenectomy to establish a POCD model. Animals were divided into sham, POCD, POCD+EA, and POCD+EA+cGAS inhibitor groups. The EA groups received stimulation at Baihui (Governor Vessel 20 (GV20)), Neiguan (Pericardium 6 (PC6)), and Zusanli (Stomach 36 (ST36)) acupoints. Cognitive function was evaluated using the Morris water maze, while hippocampal expression of cGAS-STING pathway components and downstream effectors—interferon regulatory factor 3 (IRF3), nuclear factor kappa B (NF-κB), and interleukin-1 beta (IL-1β)—was assessed by Western blot. Cellular localization was determined by immunofluorescence staining. Compared with the Sham group, rats in the POCD group showed significant impairments in spatial memory, accompanied by upregulated protein expression of cGAS, STING, NF-κB, IRF3, and IL-1β in the hippocampus. Upon pathway activation, cGAS and STING proteins were predominantly co-localized with neurons, and their fluorescence intensity in the hippocampus was markedly increased. These behavioral deficits and molecular alterations were partially reversed in both the POCD+EA and POCD+EA+inhibitor groups. Electroacupuncture alleviates POCD in aged rats by inhibiting hippocampal cGAS-STING pathway activation and reducing neuroinflammation, suggesting a promising non-pharmacological strategy for POCD management.

AIM: To investigate factors associated with anterior chamber exudation following phacoemulsification combined with intraocular lens(IOL)implantation.

METHODS: Clinical data from patients with cataract who underwent phacoemulsification combined with IOL implantation at the hospital between June 2021 and June 2025 were retrospectively analyzed. Patients were divided into an exudation group and a non-exudation group according to the presence or absence of postoperative anterior chamber exudation. Demographic characteristics, underlying diseases, preoperative examination findings, surgery-related factors, intraoperative complications, and postoperative conditions were collected and compared between the two groups. Factors associated with anterior chamber exudation after phacoemulsification combined with IOL implantation were analyzed.

RESULTS: A total of 840 cataract patients(840 eyes)who underwent phacoemulsification combined with IOL implantation were enrolled. According to the presence or absence of postoperative anterior chamber exudation, 42 patients(42 eyes)were assigned to the exudation group, including 18 men and 24 women, with a mean age of 72.04±7.84 y; the remaining 798 patients(798 eyes)were assigned to the non-exudation group, including 370 men and 428 women, with a mean age of 65.13±9.25 y. Univariate analysis showed significant between-group differences in age, duration of cataract, diabetes mellitus, postoperative elevation of intraocular pressure, duration of corticosteroid eye-drop use, and lens nuclear grade(all P<0.05). Restricted cubic spline analysis demonstrated significant overall associations of age, duration of cataract, and duration of corticosteroid eye-drop use with the risk of postoperative anterior chamber exudation(all P<0.001). No significant non-linear associations were observed(P_{for non-linearity} >0.05), indicating linear relationships. Multivariable Logistic regression analysis showed that age(OR=1.096, 95%CI: 1.053-1.141), duration of cataract(OR=1.074, 95%CI: 1.042-1.107), diabetes mellitus(OR=2.630, 95%CI: 1.269-5.453), postoperative elevation of intraocular pressure(OR=4.311, 95%CI: 1.851-10.041), duration of corticosteroid eye-drop use(OR=2.082, 95%CI: 1.479-2.930), and lens nuclear grade ≥IV(OR=2.635, 95%CI: 1.309-5.304)were risk factors for postoperative anterior chamber exudation(all P<0.05). A nomogram prediction model was developed based on these factors. The calibration curve showed good agreement between the predicted and observed probabilities. ROC curve analysis showed that the AUC of the model for predicting postoperative anterior chamber exudation was 0.858(95%CI: 0.801-0.916), with a sensitivity of 0.810 and a specificity of 0.803.

CONCLUSION: Anterior chamber exudation following phacoemulsification combined with IOL implantation is influenced by multiple factors. Age, duration of cataract, diabetes mellitus, postoperative elevation of intraocular pressure, longer duration of corticosteroid eye-drop use, and greater lens nuclear hardness are risk factors. The nomogram developed using these factors demonstrates good predictive performance for postoperative anterior chamber exudation and may facilitate the early identification of high-risk patients and the development of individualized intervention strategies.

ObjectiveTo evaluate the effect of sex on phenotypic stability in mouse models of chemotherapy-induced alopecia (CIA) induced by cyclophosphamide (CYP) or paclitaxel (PTX), and to explore potential mechanisms underlying phenotypic heterogeneity in female mice. MethodsTwenty-eight wild-type specific pathogen-free (SPF) C57BL/6J mice (half male and half female) aged 6-8 weeks were selected for synchronous back hair removal. On the 9th day after hair removal (T0), the mice were randomly divided into a wild-type female CYP group, a wild-type male CYP group, a female negative control group and a male negative control group. Mice in the CYP groups were intraperitoneally injected with a single dose of 120 mg/kg CYP, and mice in the negative control groups were intraperitoneally injected with the same volume of normal saline. Subsequently, the phenotypic changes of the CIA model induced by CYP were continuously observed and photographed. Eleven 6-week-old SPF female C57BL/6J mice underwent bilateral ovariectomy (OVX group). Following successful surgery, these mice and five XY (Sry⁻) mice bred from Four Core Genotypes breeding stock were used to establish the chemotherapy-induced alopecia (CIA) model using the same protocol. Serum was collected from mice in the OVX group, wild-type female CYP group, and wild-type male CYP group on T7 after CYP administration for steroid hormone analysis by mass spectrometry to evaluate the effects of gonadal estrogen and sex chromosome background changes on the stability of the CYP-induced female alopecic phenotype. Finally, twenty SPF C57BL/6J mice aged 6-8 weeks (half male and half female) were randomly divided into a PTX low-dose group and a PTX high-dose group. On the 9th day after simultaneous hair removal, PTX was injected intraperitoneally at a single dose of 80 mg/kg or 120 mg/kg, respectively. Mice from the PTX low-dose group and the PTX high-dose group were continuously observed and photographed to compare the intra-group consistency of the phenotypes of female and male mice. Six SPF C57BL/6J mice (half male and half female) aged 6-8 weeks were used to repeat the construction method of the PTX low-dose group, and the hair follicle histological examination was performed at T0, T4, T7, T14 and T21, respectively, to observe the damage caused by PTX to hair follicle regeneration. ResultsThe phenotypes of CYP-induced male CIA mice are stable and reproducible. There are obvious individual differences in the alopecia phenotype in the CYP-induced female CIA model mice, which may be mainly caused by the differences in the relevant estrogens in the estrous cycle. The difference between OVX+CYP group and XY (Sry⁻) +CYP group disappeared, suggesting that ovarian-derived hormones and XY (Sry⁻) sex chromosome background may be involved in the formation of phenotypic heterogeneity of CYP-induced alopecia in female mice. The mice in the high-dose PTX group and the low-dose PTX group showed a relatively consistent alopecia and regrowth process, and there was no significant sex difference. ConclusionCYP-induced CIA is strongly influenced by sex, and ovariectomy or alteration of the sex chromosome background can improve the consistency of CYP-induced alopecic phenotypes in female mice. PTX-induced CIA shows good phenotypic consistency in both female and male mice, indicating broad applicability across sexes. Taken together, the choice of animal sex in CIA model construction, mechanistic studies, and evaluation of anti-alopecia interventions should take into account the type of chemotherapeutic agent, the study objective, and the required degree of phenotypic stability. Sex should therefore be considered an important variable in model standardization and interpretation of experimental findings.

Objective:Cognitive interviews were used to explore the target population's understanding and cognition of the Questionnaire about Gynaecological and Pelvic Pain Symptoms (ENDOPAIN-4D) in the Chinese context. The consistency of language expression and concept between the Chinese version ENDOPAIN-4D and the original scale was verified.Methods:Qualitative research methods were employed. Objective sampling method was used to select the patients with endometriosis/adenomyosis in the gynecological ward of Chinese Academy of Medical Sciences & Peking Union Medical College Hospital from October to December 2023 as the interview subjects. Two rounds of cognitive interviews were conducted, and the interview data were coded and analyzed using the Question Appraisal System. Based on the interview results and the recommendations of the expert group, the scale items were revised to form the Chinese version of ENDOPAIN-4D, and reliability and validity tests were conducted.Results:This study ultimately included 24 patients with endometriosis/adenomyosis, aged 24-47 years. The results of the first round of interviews showed that some interviewees had ambiguous understandings of the 16 items in the questionnaire, most of the item questions were concentrated in the category of "3 clarity, 4 hypotheses", and a small number of questions appeared in the category of "2 guidance, 5 knowledge/memory, 7 options", and were revised. The results of the second round of interviews showed that respondents could correctly understand the scale items. The Cronbach α coefficient of the total scale was 0.874, and the retest reliability was 0.952. The correlation coefficient of the Chinese version of the Global Pain Scale as the reference index of compatibility validity was 0.764 ( P<0.01), and the exploratory factor analysis extracted a total of 4 dimensions, with a cumulative variance contribution rate of 61.169%. The final formal questionnaire included 21 items in 4 dimensions including spontaneous pelvic pain, pain during sexual intercourse, intestinal pain and/or symptoms, and other symptoms. Conclusions:Cognitive interviews were used to identify cognitive biases in the target population during the completion of the scale and to address them appropriately, reducing the differences in the target population's understanding of the ENDOPAIN-4D scale and improving its scientific validity and reliability.

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

Objective To investigate the sequencing results of the SLC26A4 gene in 34 nuclear families and the genetic diagnosis on the offspring in the nuclear families who have been screened for SLC26A4 gene single-allele mutation in the deafness genetic screening,to provide a basis for genetic consulting.Methods A retrospective anal-ysis was performed on the results of SLC26A4 gene testing in 34 nuclear families,in which the offspring with SLC26A4 gene single-allele mutation in deafness genetic screening of each nuclear family.The offspring of 34 nucle-ar families with the second mutation site detected by sequencing,their audiological results were included in the anal-ysis;and if they suffered from hearing loss,the results of temporal bone CT or inner ear MRI were also included in the analysis.Results The sequencing results of 34 nuclear families showed that there were 23 offsprings(67.65％,23/34)with SLC26A4 gene single-allele mutation,and one parent was SLC26A4 gene single-allele mutation.There were 11 offsprings(32.35％,11/34)with second site,among which 7 offsprings(63.64％,7/11)with SLC26A4 gene complex heterozygous mutations,and their parents were SLC26A4 gene single-allele mutations.Among the 7 offsprings with SLC26A4 gene complex heterozygous mutation,3 cases were with hearing loss,all of which were diagnosed as large vestibular aqueduct syndrome,and the other 4 cases were normal.While 4 offsprings(36.36％,4/11)with SLC26A4 gene double heterozygous mutation(cis mutation),and one parent was SLC26A4 gene double heterozygous mutation.The hearing 4 offsprings with SLC26A4 gene double heterozygous mutations were normal.Among the 34 nuclear families,3 pairs of parents were SLC26A4 gene single-allele mutation,and both mutation sites were pathogenic,risk of reproducing children with hereditary hearing loss was 25％.Conclusion The detec-tion sites of deafness gene chip are limited.Using gene sequencing technology to sequence the nuclear family can fur-ther clarify the gene mutation type in offspring and provide guidance for parents to reproduce.

Objective To analyze the association between eye-related behaviors and myopia among preschool chil-dren in Ningxia Hui Autonomous Region,and to develop a predictive nomogram model.Methods Using stratified cluster random sampling,36 062 preschool children from 400 randomly selected kindergartens in Ningxia Hui Autonomous Region were enrolled between October and December 2023.Primary caregivers of participants completed structured question-naires.Data were randomly split into a training set(n=25 243,70％)and a validation set(n=10 819,30％)in a ratio of 7∶3.The training set was used for model construction,and the validation set for external validation.Calibration plots and the Hosmer-Lemeshow(H-L)goodness-of-fit test assessed agreement between predicted and observed risks.Decision curve analysis(DCA)and clinical impact curve analysis(CICA)evaluated clinical utility.Results The myopia preva-lence among preschool children in Ningxia Hui Autonomous Region was 3.8％.A nomogram model based on binary Logistic regression showed area under the curve(AUC)values of 0.88(95％CI:0.87-0.89)for the training set and 0.89(95％CI:0.87-0.90)for the validation set,indicating strong discriminative ability.Calibration curves and H-L tests revealed good model fit(training set:x2=4.92,P=0.766;validation set:x2=5.52,P=0.961),with all P＞0.05.DCA and CICA confirmed clinical utility.The nomogram identified parental myopia,academic pressure,frequency of eye fatigue,daily screen time,and regular vision checks as the top five predictors of myopia.Conclusion The nomogram demonstrates promising potential for predicting myopia risk in preschool children in Ningxia Hui Autonomous Region,serving as a robust tool for clinical and educational myopia risk assessment.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective:To investigate the clinical pathological features, immunophenotypes, diagnosis, and differential diagnosis of non-small cell lung carcinoma (NSCLC) with trophoblastic differentiation in males, and to improve the understanding of this rare disease.Methods:The clinical and pathological features of 16 NSCLC with trophoblastic differentiation in males diagnosed in Shanghai Pulmonary Hospital from January 2017 to December 2023 were retrospectively analyzed. Relevant literature was reviewed.Results:All 16 patients were male, with an onset median age of 66.5 (56.8, 68.8) years. They had no known personal history of cancer. Among the 8 resected NSCLC with trophoblastic differentiation, 3 showed concurrent lung adenocarcinoma, and 1 showed concurrent lung squamous cell carcinoma. Among the 10 patients who underwent serum β human chorionic gonadotropin (β-HCG) testing after the surgery or biopsy, 7 had significantly increased β-HCG. On gross examination, the tumors were hemorrhagic and necrotic, resembling a hematoma, with a medium texture, clear boundaries and no capsules. At low magnification, tumor cells were arranged in a nested or solid pattern. Those cells often showed massive bleeding, necrosis, and vascular infiltration. They were composed of two types of cells, namely cytotrophoblast and syncytiotrophoblast cells. At high magnification, the tumor cells showed large nuclei and hyperchromatia. They also had rich purple blue to bichromatic cytoplasm, eosinophilic nucleoli, and sometimes bizarre nuclei. The syncytiotrophoblast cells expressed β-HCG, CKpan, GATA3, CD10, and SALL4. Fourteen patients were followed up for 1-37 months. Two of them died, while three showed distant metastasis.Conclusions:NSCLC with trophoblastic differentiation in males is a rare and highly malignant tumor, poorly understood with difficulty in diagnosis. It requires comprehensive histological analysis in combination with clinical and imaging studies. Properly diagnosing this disease relies on recognition of its histopathological characteristics, including large areas of bleeding and necrosis, large and peculiar syncytial trophoblast cells, and varying degrees of β-HCG expression. It seems that β-HCG expression is very valuable for diagnosing this rare tumor.

Dental implantology has developed rapidly for over half a century,since pure titanium(99.7％)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95％.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.