ObjectiveThis study aimed to establish a monocrotaline （MCT）-induced pulmonary arterial hypertension （PAH） rat model to systematically evaluate the protective effect of Xiao Qinglongtang （XQLT） on right cardiac function in model rats and further elucidate the underlying regulatory mechanism. MethodsSixty male SD rats were randomly assigned to the normal group， model group， XQLT low-， medium-， and high-dose groups （XQLT-L/M/H）， and the beraprost sodium tablet group （BST）. Except for the normal group， rats in all other groups were given a single subcutaneous injection of MCT （60 mg·kg^-1） to induce PAH. Three weeks after injection， rats in the XQLT-L/M/H groups were administered XQLT intragastrically at 3.07， 6.14， 12.28 g·kg^-1·d^-1， respectively. Rats in the BST group received beraprost sodium at 12.6 μg·kg^-1·d^-1， and rats in the model group received an equal volume of saline. All treatments lasted for 3 weeks. Right ventricular systolic pressure （RVSP） was measured by right ventricular catheterization. Cardiac function was assessed by echocardiography. The right ventricle was weighed to calculate the right ventricular hypertrophy index （RVHI）. Hematoxylin-eosin （HE） staining， Masson staining， and transmission electron microscopy were used to observe myocardial morphology. Serum metabolomic changes were analyzed using ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS）. Data-independent acquisition （DIA） proteomics was used to detect differentially expressed （DE） proteins in the right ventricle， and Western blot was used to measure the expression of uncoupling protein 3 （UCP3）， phosphatidylinositol 3-kinase catalytic subunit p110α （PIK3CA）， L1 cell adhesion molecule （L1CAM）， and quinone oxidoreductase （CRYZ）. UPLC-MS/MS was used to analyze the chemical components of XQLT. ResultsCompared with the normal group， the model group showed significantly increased RVSP and RVHI （P<0.05）， along with pathological changes in myocardial morphology. Compared with the model group， all XQLT-treated groups exhibited reductions in RVSP and RVHI as well as significant improvements in cardiac function and myocardial morphology. Among the XQLT groups， XQLT-M showed the most pronounced effects （P<0.05）， comparable to the BST group. Serum metabolomics revealed 105 differential metabolites in the XQLT groups versus the model group ［variable importance in projection （VIP） >1， P<0.05］， including 58 upregulated and 47 downregulated metabolites. KEGG enrichment analysis indicated that XQLT intervention downregulated phenylalanine metabolism （P<0.01） and upregulated unsaturated fatty acid biosynthesis （P<0.05）. Proteomics analysis showed that 982 DE proteins were identified in the MCT groups versus the normal group， including 455 upregulated and 527 downregulated proteins （|fold change （FC）| >1.3， P<0.05）. Compared with the model group， 237 DE proteins were identified in the XQLT groups， including 124 upregulated and 113 downregulated proteins （|FC| >1.3， P<0.05）， with 57 overlapping DE proteins. KEGG enrichment suggested that XQLT mainly modulated pathways related to mineral absorption， ribosomal biogenesis， peroxisomes， glycolysis/gluconeogenesis， spliceosomes， and thyroid hormone signaling. Western blot analysis showed that， compared with the model group， XQLT increased the expression of UCP3， PIK3CA， and L1CAM， while decreasing the expression of CRYZ （P<0.05）. ConclusionXQLT exerts a protective effect on right heart function in MCT-induced PAH rats， and its mechanism is associated with maintaining myocardial homeostasis and alleviating right ventricular remodeling.

OBJECTIVE To explore the transformation of the dispensing and drug pickup process in traditional Chinese medicine pharmacy （TCM Pharmacy） in our hospital based on data-intelligence-driven， aiming to improve pharmacists’ work efficiency and patients’ drug pickup experience. METHODS Value stream mapping and journey mapping were used to systematically identify non-value-added links in pharmacists’ dispensing process and key pain points in patients’ drug pickup under the traditional process. An intelligent dispensing and drug pickup system for the TCM Pharmacy was developed based on the C# and Android television platforms， and a machine-learning model was adopted to predict patients’ drug pickup waiting time. A comprehensive evaluation was performed from three perspectives： system performance， prediction accuracy， and satisfaction of pharmacists and patients. RESULTS The system successfully streamlined non-value-added links such as “waiting for writing on the board” and “searching for drugs”， and realized multimodal dynamic prompts of dispensing status through auditory （number calling） and visual （television terminal） channels. The constructed model for predicting drug pickup waiting time exhibited good fitting degree and generalization ability （mean absolute error＝4.28 min， R 2 ＝0.882）. The comprehensive satisfaction scores of pharmacists and patients in the traditional mode were significantly increased from （70.99±1.74） and （73.58±1.98） to （90.02±1.30） and （88.61±2.08） in the new system， respectively （ P ＜0.01）. CONCLUSIONS The transformation of the intelligent drug dispensing and pickup system for TCM pharmacy based on data-intelligence-driven effectively improves the efficiency of pharmacists’ dispensing work， realizes process transparency and waiting time predictability， and significantly enhances patients’ drug pickup experience.

Spermatogenesis is a highly ordered and spatiotemporally regulated developmental process in the male reproductive system, during which spermatogonial stem cells (SSCs), supported by the seminiferous tubule microenvironment, sequentially undergo mitosis, meiosis, and spermiogenesis to ultimately generate structurally intact spermatozoa. This complex process is accompanied by extensive transcriptional reprogramming, chromatin remodeling, and finely tuned post-transcriptional regulation. Precise control of RNA fate is therefore essential for maintaining the continuity and fidelity of spermatogenesis, and its disruption represents a major molecular basis of male infertility. N⁶-methyladenosine (m⁶A), the most abundant internal RNA modification in eukaryotes, has emerged as a critical regulator of post-transcriptional gene expression. m⁶A methyltransferases (“writers”) catalyze the addition of a methyl group to the N⁶ position of adenosine, m⁶A demethylases (“erasers”) remove the modification, and m⁶A-binding proteins (“readers”) recognize m⁶A-modified transcripts. Through the coordinated actions of these factors, m⁶A regulates transcript fate at multiple levels, including RNA splicing, nuclear export, stability, translation, and decay. Emerging evidence indicates that m⁶A-mediated regulation is essential across multiple stages of spermatogenesis, including SSC self-renewal and differentiation, meiotic progression, maintenance of chromosomal stability, and sperm morphogenesis. Beyond its intrinsic functions in germ cells, m⁶A also contributes to the regulation of the testicular microenvironment. In sertoli cells, m⁶A is involved in maintaining blood-testis barrier integrity, RNA processing, and paracrine signaling, thereby providing structural and metabolic support for germ cell development. In Leydig cells, m⁶A regulates steroidogenesis, particularly testosterone synthesis, and participates in cellular stress responses and metabolic homeostasis. Through these mechanisms, m⁶A indirectly influences spermatogenesis by modulating the functional state of testicular somatic cells, highlighting an integrated regulatory mode that combines cell-intrinsic and microenvironment-mediated effects. Notably, distinct classes of m⁶A regulators exhibit pronounced stage-specific functions and coordinated division of labor, collectively forming a multilayered and dynamic regulatory network. Writers often display dosage- and temporal window-dependent effects; erasers contribute to stage-specific demethylation and functional compensation; while readers function through a “switch-buffer” dual-layer architecture, and RNA-binding proteins (RBPs) participate in substrate selection and post-transcriptional regulation. Importantly, emerging evidence suggests that some m⁶A-related proteins can function through noncanonical mechanisms independent of m⁶A recognition, such as intrinsic RNA-binding activity, helicase function, or ribonucleoprotein complex assembly, thereby expanding the functional landscape of the m⁶A regulatory system. Dysregulation of m⁶A machinery can lead to multiple spermatogenic defects, including impaired SSC self-renewal, meiotic arrest, abnormal chromatin remodeling, and defective sperm formation, ultimately resulting in male infertility. Despite substantial advances, several critical questions remain unresolved, including the distinction between m⁶A-dependent and -independent mechanisms, the spatiotemporal dynamics of m⁶A modifications at single-cell resolution, and the coordination and antagonism among different regulatory factors. In this review, we systematically summarize the dual regulation of spermatogenesis by germ cell-intrinsic mechanisms and the testicular microenvironment, and delineate the molecular mechanisms and stage-specific functions of the dynamic m⁶A regulatory network. We further discuss the current limitations in the field and propose feasible experimental strategies for future investigation. Collectively, this work aims to provide a comprehensive framework for understanding the epitranscriptomic regulation of spermatogenesis and to offer theoretical insights into the pathogenesis and clinical management of male infertility.

Spermatogenesis is a highly ordered and spatiotemporally regulated developmental process in the male reproductive system, during which spermatogonial stem cells (SSCs), supported by the seminiferous tubule microenvironment, sequentially undergo mitosis, meiosis, and spermiogenesis to ultimately generate structurally intact spermatozoa. This complex process is accompanied by extensive transcriptional reprogramming, chromatin remodeling, and finely tuned post-transcriptional regulation. Precise control of RNA fate is therefore essential for maintaining the continuity and fidelity of spermatogenesis, and its disruption represents a major molecular basis of male infertility. N⁶-methyladenosine (m⁶A), the most abundant internal RNA modification in eukaryotes, has emerged as a critical regulator of post-transcriptional gene expression. m⁶A methyltransferases (“writers”) catalyze the addition of a methyl group to the N⁶ position of adenosine, m⁶A demethylases (“erasers”) remove the modification, and m⁶A-binding proteins (“readers”) recognize m⁶A-modified transcripts. Through the coordinated actions of these factors, m⁶A regulates transcript fate at multiple levels, including RNA splicing, nuclear export, stability, translation, and decay. Emerging evidence indicates that m⁶A-mediated regulation is essential across multiple stages of spermatogenesis, including SSC self-renewal and differentiation, meiotic progression, maintenance of chromosomal stability, and sperm morphogenesis. Beyond its intrinsic functions in germ cells, m⁶A also contributes to the regulation of the testicular microenvironment. In sertoli cells, m⁶A is involved in maintaining blood-testis barrier integrity, RNA processing, and paracrine signaling, thereby providing structural and metabolic support for germ cell development. In Leydig cells, m⁶A regulates steroidogenesis, particularly testosterone synthesis, and participates in cellular stress responses and metabolic homeostasis. Through these mechanisms, m⁶A indirectly influences spermatogenesis by modulating the functional state of testicular somatic cells, highlighting an integrated regulatory mode that combines cell-intrinsic and microenvironment-mediated effects. Notably, distinct classes of m⁶A regulators exhibit pronounced stage-specific functions and coordinated division of labor, collectively forming a multilayered and dynamic regulatory network. Writers often display dosage- and temporal window-dependent effects; erasers contribute to stage-specific demethylation and functional compensation; while readers function through a “switch-buffer” dual-layer architecture, and RNA-binding proteins (RBPs) participate in substrate selection and post-transcriptional regulation. Importantly, emerging evidence suggests that some m⁶A-related proteins can function through noncanonical mechanisms independent of m⁶A recognition, such as intrinsic RNA-binding activity, helicase function, or ribonucleoprotein complex assembly, thereby expanding the functional landscape of the m⁶A regulatory system. Dysregulation of m⁶A machinery can lead to multiple spermatogenic defects, including impaired SSC self-renewal, meiotic arrest, abnormal chromatin remodeling, and defective sperm formation, ultimately resulting in male infertility. Despite substantial advances, several critical questions remain unresolved, including the distinction between m⁶A-dependent and -independent mechanisms, the spatiotemporal dynamics of m⁶A modifications at single-cell resolution, and the coordination and antagonism among different regulatory factors. In this review, we systematically summarize the dual regulation of spermatogenesis by germ cell-intrinsic mechanisms and the testicular microenvironment, and delineate the molecular mechanisms and stage-specific functions of the dynamic m⁶A regulatory network. We further discuss the current limitations in the field and propose feasible experimental strategies for future investigation. Collectively, this work aims to provide a comprehensive framework for understanding the epitranscriptomic regulation of spermatogenesis and to offer theoretical insights into the pathogenesis and clinical management of male infertility.

Objective To investigate the expression pattern of IQGAP2 in renal cell carcinoma tissues and cell lines,and to analyze its effects on the proliferation and migration of renal cell carcinoma cells.Methods Firstly,GEO database was used to screen differentially expressed genes between renal cell carcinoma tissues,and GEPIA,TIMER2.0 were used to analyze the expression level of IQGAP2 in renal cell carcinoma tissue.Subse-quently,knockdown(siRNA)and overexpression plasmids of IQGAP2 were constructed and transfected into ACHN and 786-O cell lines to perform a series of functional experiments to evaluate the effect of IQGAP2 on the malignant biological behavior of renal carcinoma cells.qRT-PCR and Western Blot were used to detect the expres-sion of EMT(epithelial-mesenchymal transition)related proteins after knockdown and overexpression of IQGAP2.Results In renal cell carcinoma tissues,the relative expression of IQGAP2 was significantly lower than in adja-cent normal tissues(P<0.001).Transfection of si-IQGAP2 in ACHN and 786-O cells effectively downregulated the mRNA and protein expression levels of IQGAP2(P<0.01),while transfection with an overexpression plasmid significantly upregulated its mRNA and protein expression(P<0.001).Further studies revealed that overexpression of IQGAP2 significantly inhibited the proliferation(P<0.05)and migration(P<0.01)of ACHN and 786-O cells,whereas knockdown of IQGAP2 enhanced their proliferation(P<0.05,P<0.001)and migration(P<0.01).Through qRT-PCR and Western blot analyses of EMT-related proteins,it was found that reduced expression of IQGAP2 promoted the epithelial-mesenchymal transition(EMT)process in renal cancer cells.Conclusions The expression of IQGAP2 is low in renal cell carcinoma tissues and cells,and the decrease of the expression level can promote the EMT process of renal cell carcinoma cells,and then enhance the proliferation and migration of renal cell carcinoma cells.IQGAP2 plays an important tumor suppressor role in renal cell carcinoma.

Objective:To investigate the efficacy of arthroscopic ligament augmentation repair in the treatment of chronic lateral ankle instability.Methods:The clinical data of 65 patients with chronic lateral ankle instability who received treatment at Shangluo Central Hospital from October 2019 to October 2022 were retrospectively analyzed. The clinical data were divided into three groups based on treatment methods: the mini-open group ( n = 15), in which patients underwent arthroscopy-assisted small incision lateral ligament repair; the arthroscopy group ( n = 15), in which patients received total ankle arthroscopic ligament augmentation repair; and the non-surgical group ( n = 35), in which patients were treated conservatively. The American Orthopedic Foot and Ankle Score (AOFAS) value, the Tegner Activity Scale (TAS) score, Visual Analog Scale (VAS) score, the time to achieve full weight-bearing, and the time to return to sports were compared among all groups. Results:After treatment, AOFAS value and the TAS score increased in all three groups compared with pre-treatment levels, while the VAS value decreased in all groups. All differences were statistically significant ( t = 6.53, 7.45, 6.58, 6.50, 7.62, 6.52, 6.80, 7.50, 6.49, all P < 0.01). There were no significant differences in AOFAS value, TAS score, and VAS score among the three groups (all P > 0.05). The time to achieve full weight-bearing in the arthroscopy group was 6.6 (5.5, 9.0) weeks, which was shorter than the 7.4 (6.0, 9.0) weeks in the mini-open group and the 9.4 (7.6, 12.0) weeks in the non-surgical group. These differences were statistically significant ( H = 7.98, P = 0.001). The proportion of patients returning to sports in the arthroscopy group was 80% (12/15), which was higher than the 66% (10/15) in the mini-open group and the 28% (10/35) in the non-surgical group. These differences were statistically significant ( χ2 = 30.78, P = 0.025). The time to return to sports in the arthroscopy group was 12.1 (9.5, 15.0) weeks, which was shorter than the 14.6 (12.0, 18.2) weeks in the mini-open group and the 16.1 (13.2, 19.0) weeks in the non-surgical group. These differences were statistically significant ( H = 8.90, P = 0.001). Conclusions:Ankle arthroscopic ligament augmentation repair for the treatment of chronic lateral ankle instability is safe and shows better clinical efficacy, making it a viable option for clinical practice.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective:To investigate the causal effects of plasma lipidomics on pancreatitis using Mendelian ran-domization(MR)and evaluate the roles of intra-pancreatic fat deposition(IPFD)and gallstone disease in this relation-ship.Methods:A bidirectional MR analysis was conducted,with 179 plasma lipids as exposures and acute pancreati-tis(AP)and chronic pancreatitis(CP)as outcomes.Data were sourced from genome-wide association studies(GWAS),the UK Biobank,and the FinnGen project.Two-step Mendelian randomization(TSMR)and multivariable Mendelian ran-domization(MVMR)analyses were applied to assess the mediating roles of IPFD and gallstone disease in the associa-tion between plasma lipids and pancreatitis.Results:MR analysis identified two sterols negatively associated with AP(P＜0.05)and seven sterols negatively associated with CP(P＜0.05).One phospholipid showed a positive association with CP(P＜0.05).IPFD was positively associated with both AP and CP.Gallstone disease was confirmed as a risk fac-tor for AP.However,TSMR analysis indicated that neither IPFD nor gallstone disease mediated the relationship be-tween plasma lipids and pancreatitis.Conclusion:The causal relationship exists among plasma lipomics and AP/CP,also between IPFD,cholelithiasis and pancreatitis.These findings highlight novel risk factors and potential biomarkers to support early diagnosis and intervention for pancreatitis.

BACKGROUND:In recent years,the application of surgical robots has become a research hotspot in the field of spinal surgery,but there is still a lack of literature visualization analysis of spinal surgical robots in China.OBJECTIVE:To conduct literature visualization analysis on the research hotspots of spinal surgical robots for the treatment of spinal diseases to provide a useful reference for the research and development of spinal surgical robots in China.METHODS:The Web of Science core set database was applied to search for relevant literature on spinal surgical robots for the treatment of spinal diseases,and 900 articles were finally included. Visualization analysis was conducted on number of publications,journals,institutions,countries,keywords,co-cited documents and highly cited documents of the included literature using VOSviewer 1.6.19 software.RESULTS AND CONCLUSION:(1) The literature in the field of spinal surgical robots for the treatment of spinal diseases has been increasing year by year,especially in 2023,when the number of publications reached a peak. United States,China,and Germany are the research hotspots in this field. National Natural Science Foundation of China is the main fund in this field. (2) Beijing Jishuitan Hospital,China and Hospital for Special Surgery in United States have made great publications to the research in this field. (3) World Neurosurgery,Spine,and Operative Neurosurgery are the main publication journals in this field. (4) Keyword analysis showed that the research mainly focused on the accuracy of robot-assisted spinal surgery,minimally invasive surgery,robotic spinal surgery,and navigation technology. (5) The results of the co-citation analysis of the literature exhibit that robot-assisted technology has significant advantages in spinal surgery. Compared with traditional surgery,spinal surgical robots such as ROSA? Spine,ExcelsiusGPS,Mazor X,and TiRobot have the advantages of high-precision navigation,precise pedicle screw placement,and real-time feedback. They reduce X-ray radiation exposure during surgery,diminish the risk of complications for patients,and improve the success rate of surgery,showing their application prospects in the field of spinal surgery. (6) Despite this,the application and accuracy of related technologies still need to accumulate experience for improvement. Robotic surgery technology has shown cost-effectiveness in reducing surgical radiation exposure and enhancing surgical accuracy. However,it is needed to explore its accuracy in pedicle screw placement surgery,the impact of surgical time,and economic benefits. (7) The results of the analysis of highly cited literature from 2021 to 2024 further show that the latest research hotspots in this field are currently focused on the application of virtual reality and augmented reality technologies,the improvement of the accuracy of robot-assisted pedicle screw placement,and the application of navigation robot spinal surgery platforms. For example,innovative technologies such as organic electrochemical neurons provide new integrated solutions for brain-computer interfaces,prosthetics,and intelligent soft robotics. Simultaneously,virtual reality and augmented reality technologies have shown broad application prospects in areas such as spinal deformity correction.

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].