Objective To explore the correlation between cardiac remodeling and the occurrence of contrast-associated acute kidney injury(CA-AKI)assessed by echocardiography.Methods A retrospective analysis was conducted on the clinical data of 100 patients with coronary artery disease(CAD)who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from March 2021 to March 2024.The patients were divided into CA-AKI group and non-CA-AKI group according to whether CA-AKI occurred.Baseline data and echocardiographic parameters,inclu-ding left ventricular end-diastolic internal diameter index(LVIDDI),left ventricular end-systolic in-ternal diameter index(LVIDSI),and left ventricular mass index(LVMI),were collected and com-pared between the two groups.Logistic regression analysis was used to screen for independent influen-cing factors of CA-AKI occurrence.Results The level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the CA-AKI group was higher than that in the non-CA-AKI group,and the difference was statistically significant(P＜0.001).Compared with the non-CA-AKI group,the CA-AKI group had higher levels of C-reactive protein and glycosylated hemoglobin(HbA1c),as well as a higher proportion of patients with diabetes and anemia,and the differences were statistically significant(P＜0.05).Echocardiographic data showed that LVMI,LVIDDI,and LVIDSI in the CA-AKI group were all higher than those in the non-CA-AKI group,and the differences were statistically sig-nificant(t=2.057,3.429,2.975;P＜0.05).The left ventricular ejection fraction(LVEF)level in the CA-AKI group was lower than that in the non-CA-AKI group,and the difference was statisti-cally significant(t=3.005,P=0.003).Univariate Logistic regression analysis showed that diabe-tes,anemia,inflammation,NT-proBNP,HbA1c,LVMI,LVIDDI,LVIDSI,LVEF,ventricular hy-pertrophy,and ventricular dilation were significantly associated with the occurrence of CA-AKI(P＜0.05).Multivariate Logistic regression analysis results showed that LVMI(OR=3.81;95％CI,1.04 to 8.50;P=0.045),LVIDDI(OR=4.21;95％CI,2.02 to 6.08;P＜0.001),LVIDSI(OR=1.61;95％CI,1.27 to 2.03;P=0.024),ventricular hypertrophy(OR=3.42;95％CI,1.83 to 4.44;P=0.001),and ventricular dilation(OR=2.93;95％CI,1.43 to 3.74;P=0.033)were independent influencing factors for the occurrence of CA-AKI.Conclusion Cardiac remodeling is significantly correlated with the risk of CA-AKI in CAD patients.Clinicians should take protective measures timely for patients with abnormal cardiac structure to prevent the occurrence of CA-AKI.

Adenomyosis is a common gynecological disease in women of reproductive age, characterized by menorrhagia, dysmenorrhea, and infertility. It significantly impairs patients' quality of life and imposes a substantial healthcare burden. Due to its nonspecific clinical manifestations, traditional imaging diagnosis relies heavily on operator experience, and the heterogeneity in lesion distribution and severity among patients poses challenges to early detection and precise classification. Recent advances in artificial intelligence (AI) have demonstrated significant potential in medical imaging analysis, pathological assessment, and personalized treatment planning. Deep learning-based computer-aided diagnostic techniques can automatically identify adenomyosis features in ultrasound and magnetic resonance imaging, thereby improving diagnostic accuracy and consistency. Moreover, AI has shown emerging utility in predicting treatment responses and tailoring individualized management strategies. This review summarizes current AI applications in the diagnosis and treatment of adenomyosis, emphasizing its value in streamlining diagnostic workflows, enhancing clinical decision-making, and advancing precision medicine.

Alternative splicing (AS) is a crucial process that produces functionally distinct proteins from a single gene, depending on the developmental or physiological state of cells in multicellular organisms. It plays a significant role in cellular proliferation, survival, and differentiation, including embryonic development, spermatogenesis, and a broad spectrum of diseases. However, the precise involvement of AS in embryo implantation is still unclear. In this review, we summarize the potential roles of AS in regulating mesenchymal-epithelial transitions during embryo implantation, specifically in epithelium regeneration and decidualization initiation via the mesenchymal-epithelial transformation process. Overall, this review emphasizes the impact of AS and splicing variants on embryo implantation and offers novel insights into the potential application of alternative splicing in the treatment of female infertility.

Objective:To compare the therapeutic value between laparoscopic ureteroureterostomy (LUU) and ureteral reimplantation (UR) for the treatment of pediatric complete renal and ureteral duplication.Methods:This retrospective case-series study included 65 children with complete data, who were diagnosed with complete renal and ureteral duplication at the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2022.Diagnoses were confirmed through preoperative imaging tests, including renal ultrasound, diuretic renography, computed tomography urography, magnetic resonance urography, and voiding cystourethrography.The patients were categorized into 2 groups based on surgical approach.The LUU group had 35 patients, and the UR group had 30 patients.The surgical duration, intraoperative blood loss, the incidence of stent implantation, postoperative length of hospitalization, the upper renal anterioposterior diameter (APD), the upper ureter diameter (UD), and differential renal function (DRF) of the affected kidney before and after surgery were compared between the 2 groups.For continuous variables such as surgery time and intraoperative blood loss that follow a normal distribution, values are expressed as Mean± SD, with between-group differences analyzed using independent t-tests and within-group differences using paired t-tests.For non-normally distributed continuous variables, data are presented as M( Q1, Q3), with group differences assessed by rank-sum tests.Categorical variables like gender and laterality are compared using Chi-square tests. Results:Intraoperative blood loss was significantly different between the LUU and UR groups [(8.5±4.6) mL vs.(12.6±6.4) mL] ( t=2.465, P=0.020).Postoperative length of hospitalization also differed significantly between the 2 groups [(6.4±2.3) days vs.(10.5±2.8) days] ( t=2.308, P=0.027).However, surgical durations of the groups were similar [(143.0±13.2) min vs.(132.0±12.4) min] ( t=-1.965, P=0.057).No significant difference was observed between the two groups [(35/35) cases vs.(26/30) cases] ( χ2=2.932, P=0.087).Four cases in the UR group suffered long-term complications (including anastomotic stricture in 2 cases, vesicoureteral reflux in 1 case, and recurrent urinary tract infection in 1 case).There was 1 case having the long-term complication (which was anastomotic stricture) in the LUU group.The difference in the incidence of long-term complications was not significant between the 2 groups ( χ2=1.239, P=0.266).Both groups showed significant improvements in upper renal APD, UD, and DRF of the affected kidney after surgery.Changes in upper renal APD ( t=-0.032, P=0.962), DRF ( Z=1.895, P=0.073), and UD ( t=1.832, P=0.079) were not statistically significant. Conclusions:Both LUU and UR are safe and effective in the treatment of complete renal and ureteral duplication in children.Compared with UR, LUU has less intraoperative blood loss and shorter postoperative length of hospitalization.LUU does not involve the bladder and causes less damage to the bladder of children.

Sjögren's syndrome (SS) is an autoimmune disease characterized primarily by oral and periocular dryness. Astragalus-Salvia (AS) and Ophiopogon-Dendrobium (OD) represent two frequently utilized herb pairs in SS treatment. While the combination of AS-OD herb pairs demonstrates clinical efficacy in alleviating SS symptoms, its underlying mechanism remains unclear. This investigation sought to assess the therapeutic effects and elucidate the potential mechanisms of AS-OD in non-obese diabetic (NOD)/Ltj mice with SS. The study utilized NOD/Ltj mice as SS models, administering AS-OD treatment for 10 weeks at doses of 113.1, 226.2, and 339.3 mg·d^-1·20 g^-1. Results demonstrated that AS-OD improved SS symptoms, evidenced by enhanced salivary flow rate, decreased anti-SSA/Ro and anti-SSB/La antibody levels, increased swimming duration, and reduced lactate (LA) and blood urea nitrogen (BUN) levels in NOD/Ltj mice. AS-OD reduced lymphocyte infiltration, enhanced Aquaporin-5 (AQP5) expression in the submandibular gland, decreased inflammatory cytokine levels in the submandibular gland, and reduced the T helper type 17/regulatory T lymphocyte (Th17/Treg) cell ratio in the spleen. Transcriptomic and proteomic analyses indicated AS-OD's involvement in regulating phosphatidylinositol-3-kinase/protein kinase B (PI3K/AKT) and Janus kinase 3/signal transducer and activator of transcription 3 (JAK1/STAT3) pathways, with inhibitory effects validated in both NOD/Ltj mice submandibular gland and A-253 cells. Furthermore, AS-OD enhanced cell viability and reduced A-253 cell apoptosis through the PI3K/AKT pathway. In A-253 cells, AS-OD reduced inflammatory cytokine levels, CXC chemokine ligand 9/10 (CXCL9/10), and T-cell chemotaxis by inhibiting the JAK1/STAT3 pathway. AS-OD mitigates SS by suppressing inflammation and immune responses through the PI3K/AKT and JAK1/STAT3 pathways.
Animals ; STAT3 Transcription Factor/genetics* ; Sjogren's Syndrome/immunology* ; Mice, Inbred NOD ; Proto-Oncogene Proteins c-akt/genetics* ; Phosphatidylinositol 3-Kinases/genetics* ; Mice ; Drugs, Chinese Herbal/administration & dosage* ; Signal Transduction/drug effects* ; Janus Kinase 1/genetics* ; Humans ; Female ; Astragalus Plant/chemistry* ; Male

Objective To investigate the effect of high,middle and low dose dexmedetomidine combined with sufentanil on perioperative analgesia and sleep quality in patients with oral cancer.Methods A total of 158 patients undergoing oral cancer surgery in the hospital from January 2023 to June 2024 were selected and divided into group A[n=53,0.6 μg/(kg h)dexmedetomidine+2 μg/kg sufentanil]and group B[n=53,0.4 μg/(kg h)dexmedetomidine+2 μg/kg sufentanil],Group C[n=52,0.2μg/(kg·h)dexmedetomidine+2 μg/kg sufentanil]by random number table method.Stress response indexes[brain-derived neurotrophic factor(BDNF),cortisol(Cor),interleukin-6(IL-6)],bifrequency index and analgcsia nociccption index(BIS,ANI),pain level,T lym-phocyte subsets CD3+,CD4+,CD8+levels,Richards Campbell Sleep Scale(RCSQ)score and adverse reactions were compared between the two groups.Results Compared with 12 h before surgery,serum levels of BDNF,Cor and IL-6 in 3 groups were decreased 48 h after surgery,group A was lower than group B,group C,group B was lower than group C(P＜0.05).Compared with T0,BIS at T1～T3 were significantly different between the 3 groups(P＜0.05),BIS at T1～T3 were lower than those at T0(P＜0.05),and there was no significant difference in BIS at the same time between the 3 groups(P＞0.05),from T,to T3,ANI was higher than that at T0,and ANI in group A was higher than that in group B and group C(P＜0.05).Compared with the preoperative results,the pain scores of the 3 groups were decreased at 1 h,6 h,24 h and 48 h after operation,and the pain scores of group A were lower than those of group B and C,and the pain scores of group B were lower than those of group C(P＜0.05).After operation,CD3+and CD4+were decreased in all 3 groups,group A was lower than group B and group C,group B was lower than group C(P＜0.05),and CD8+was increased in all 3 groups,group A was higher than group B and group C,group B was higher than group C(P＜0.05).Compared with 1 day before the operation,the sleep quality scores of the three groups on the night after the operation and the second night after the operation were all decreased,group A was lower than group B and group C,and group B was lower than group C(P＜0.05).The incidence of hypotension and sinus bradycardia in group A was higher than that in group B and group C(P＜0.05).There was no significant difference in the incidence of hypotension and sinus bradycardia between group B and group C(P＞0.05).There was no significant difference in the incidence of nausea,vomiting and dizziness among the three groups(P＞0.05).Conclusion The analgesic effect of 0.6 μg/(kg·h)dose dexmedetomidine com-bined with sufentanil can effectively reduce the body's stress response and immune suppression,improve sleep quality,but with a greater incidence of intraoperative hypotension and bradycardia.

Adenomyosis is a common gynecological disease in women of reproductive age, characterized by menorrhagia, dysmenorrhea, and infertility. It significantly impairs patients' quality of life and imposes a substantial healthcare burden. Due to its nonspecific clinical manifestations, traditional imaging diagnosis relies heavily on operator experience, and the heterogeneity in lesion distribution and severity among patients poses challenges to early detection and precise classification. Recent advances in artificial intelligence (AI) have demonstrated significant potential in medical imaging analysis, pathological assessment, and personalized treatment planning. Deep learning-based computer-aided diagnostic techniques can automatically identify adenomyosis features in ultrasound and magnetic resonance imaging, thereby improving diagnostic accuracy and consistency. Moreover, AI has shown emerging utility in predicting treatment responses and tailoring individualized management strategies. This review summarizes current AI applications in the diagnosis and treatment of adenomyosis, emphasizing its value in streamlining diagnostic workflows, enhancing clinical decision-making, and advancing precision medicine.

Alternative splicing (AS) is a crucial process that produces functionally distinct proteins from a single gene, depending on the developmental or physiological state of cells in multicellular organisms. It plays a significant role in cellular proliferation, survival, and differentiation, including embryonic development, spermatogenesis, and a broad spectrum of diseases. However, the precise involvement of AS in embryo implantation is still unclear. In this review, we summarize the potential roles of AS in regulating mesenchymal-epithelial transitions during embryo implantation, specifically in epithelium regeneration and decidualization initiation via the mesenchymal-epithelial transformation process. Overall, this review emphasizes the impact of AS and splicing variants on embryo implantation and offers novel insights into the potential application of alternative splicing in the treatment of female infertility.

[Objective] To explore the risk factors of postoperative fever in primary aldosteronism (PA) patients. [Methods] Clinical data of 116 PA patients undergoing adrenalectomy in Peking University People's Hospital during Jan.2018 and Jul.2021 were retrospectively analyzed.Based on postoperative body temperature, the patients were divided into fever group (body temperature ≥38.0 ℃, n=41) and non-fever group (body temperature <38.0 ℃, n=75). Clinical features were analyzed between the two groups.The fever group was subdivided into low fever group (38.0 ℃≤body temperature <38.5 ℃, n=19) and high fever group (body temperature ≥38.5 ℃, n=22). The clinical data of the subgroups were compared. [Results] The incidence of postoperative fever was 35.3%.Logistic regression analysis showed that lower lowest potassium on records (OR=0.419, 95%CI: 0.196-0.894, P=0.025), lower high-density lipoprotein cholesterol (HDL-C) (OR=0.112, 95%CI: 0.018-0.687, P=0.018), and postoperative adrenal insufficiency (OR=4.158, 95%CI: 1.731-9.989, P=0.001) were independent risk factors for postoperative fever.There was no difference between the high and low fever groups.After surgery, infection occurred in 1 patient, adrenal insufficiency in 40 (34.5%) patients, but long-term follow-up indicated that no patients needed lifelong glucocorticoid replacement. [Conclusion] Fever is a common postoperative complication in PA patients, most likely due to transient adrenal insufficiency.Glucocorticoid supplementation should be administered appropriately and timely based on laboratory tests and clinical manifestations.Evaluation of adrenal function is highly recommended for patients undergoing adrenalectomy.

ObjectiveTo investigate the optimal ratio of goat horn replacing antelope horn in Fufang Lingjiao Jiangya pills and the blood pressure-lowering mechanism of this medicine. MethodsThe blood pressure-lowering efficacy of Fufang Lingjiao Jiangya pills with varying proportions of goat horn replacing antelope horn was evaluated on spontaneous hypertensive rats （SHR）. In this experiment， 50 SHR rats were randomly grouped as follows： model （n=8）， captopril （0.01 g·kg^-1） （n=6）， low-dose blank Fufang Lingjiao Jiangya pills （0.342 g·kg^-1） （n=6）， high-dose blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1） （n=6）， low-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， high-dose antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）， low-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.378 g·kg^-1） （n=6）， and high-dose goat horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1） （n=6）. Additionally， 8 WKY rats were used as the normal group. Drugs were administered by gavage for 4 weeks while an equal volume of distilled water was administered for the normal and model groups. Blood pressure was measured before administration， 3 h post administration， and biweekly thereafter. In the experiment for Fufang Lingjiao Jiangya pills with goat horn replacing antelope horn in different proportions， 48 SHR rats were randomly grouped as follows： model， blank Fufang Lingjiao Jiangya pills （0.684 g·kg^-1）， antelope horn-containing Fufang Lingjiao Jiangya pills （0.756 g·kg^-1）， 2× goat horn-containing Fufang Lingjiao Jiangya pills （0.824 g·kg^-1）， 4× goat horn Fufang Lingjiao Jiangya pills （0.969 g·kg^-1）， and 6× goat horn Fufang Lingjiao Jiangya pills （1.112 g·kg^-1）. The normal group included 8 WKY rats， and the normal group and model group received an equal volume of distilled water. The treatment lasted for 2 weeks， and blood pressure was recorded at various time points （pre-administration， 3 h post administration， and on days 4， 7， 10， and 14 of administration）. Serum levels of angiotensin-converting enzyme （ACE）， angiotensin Ⅱ（Ang Ⅱ）， renin， and interleukin-6 （IL-6） were measured by enzyme-linked immunosorbent assay. Histopathological changes in the heart， kidney， and thoracic aorta were observed by hematoxylin-eosin staining. The protein levels of ACE2， angiotensin Ⅱ type 1 receptor （AT1R）， and angiotensinogen （AGT） in the kidney tissue were determined by Western blot， while the expression of nuclear factor （NF）-κB p65 and Toll-like receptor 4 （TLR4） in the thoracic aorta tissue was assessed by immunohistochemistry. ResultsCompared with the model group， all treatment groups showed lowered blood pressure （P<0.05， P<0.01）， and the 6× goat horn-containing Fufang Lingjiao Jiangya pills group showed consistent blood pressure-lowering effect with the antelope horn-containing Fufang Lingjiao Jiangya pills group. Compared with the normal group， the model group showed elevated serum levels of ACE， Ang Ⅱ， renin， and IL-6， while the elevations were declined in the Fufang Lingjiao Jiangya pills groups （P<0.05， P<0.01）. Pathological changes in the heart， kidney， and thoracic aorta were alleviated in all the treatment groups， with the 6× goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups exhibited the best effect. Western blot and immunohistochemistry results showed that all the treatment groups exhibited down-regulated protein levels of AT1R， AGT， NF-κB p65， and TLR4 and up-regulated protein levels of ACE2 （P<0.05， P<0.01） compared with model group， with the 6×goat horn- and antelope horn-containing Fufang Lingjiao Jiangya pills groups showcasing the best effect. ConclusionReplacing antelope horn with 6×goat horn in Fufang Lingjiao Jiangya pills can achieve consistent blood pressure-lowering effect with the original prescription. The prescription may exert the effect by inhibiting the renin-angiotensin-aldosterone system （RAAS） and TLR4/NF-κB signaling pathways.