Objective:To explore the relationship between the changes of quadriceps femoris and ICU acquired weakness(ICU-AW)in children.Method:A prospective collection of pediatric patients treated in the intensive care unit of Shenzhen children's hospital from October 2022 to March 2023.The thickness and cross-sectional area of rectus femoris and the thickness of vastus intermedius were measured by ultrasound on the 1st,4th and 7th day after ICU.The first day served as the baseline to calculate the atrophy rate for each muscle.On the 7th day,the Medical Re-search committee muscle strength score(MRC score)and critical physical function test score(PFIT-s score)were performed.According to the MRC score＜48,patients were divided into ICU-AW group and non-ICU-AW group to analyze the relationship between ICU-AW and the changes of quadriceps femoris.Result:A total of 21 critically ill children were included,including 11 males and 10 females.The incidence of ICU-AW in children was 41.2％(4 cases were not evaluated because of delirium).Within 7 days after en-tering ICU,the atrophy rate of cross-sectional area of rectus femoris was the highest,reaching-8.00％±15.10％.Both groups showed the greatest rate of change in the vastus intermedius thickness over 7 days,with the ICU-AW group mainly showing an increase in thickness(19.51％±16.51％over 4 days,14.14％±28.13％over 7 days),while the non-ICU-AW group primarily showed atrophy(-16.07％±17.46％over 4 days,-15.55％±30.04％over 7 days).The ICU-AW group had an average increase in rectus femoris thickness of 4.51％±8.38％within 7 days of ICU admission,while the non-ICU-AW group had an average atrophy rate of-8.19％±11.79％.There was no correlation between muscular atrophy rate and PFIT-s score(all P＞0.05),but there was a moderate negative correlation between rectus femoris thickness atrophy rate and femoral intermediate muscle thickness atrophy rate and MRC score within 4 days,respectively(ritual color 0.541 million 0.657 million 0.004),and moderate negative correlation between MRC score and thickness atrophy rate of rectus femoris and vastus medius within 7 days.There was no significant correlation between the atrophy rate of cross-section-al area of rectus femoris and MRC score.Conclusion:Compared with the non-ICU-AW group,the muscle thickness in the ICU-AW group is mainly thickened rather than atrophied,which can be identified by ultrasound on the 4th day after ICU.The specific diagnostic threshold is worthy of further study.

Objective To explore the clinical efficacy of single-port laparoscopy combined with gonado-tropin-releasing hormone agonist(GnRH agonist)in the treatment of deep infiltrating endometriosis and its influence on serum circATRNL1 levels,and analyze its predictive value for patient prognosis.Methods 220 patients with deep infiltrating endometriosis from June 2021 to October 2023 were enrolled as study subjects and divided into an experimental group(n=110)and a control group(n=110)according to different surgical methods.The experimental group received single-port laparoscopy surgery combined with GnRH agonist treatment,while the control group only received single-port laparoscopy surgery.The changes in circATRNL1 expression level before and after treatment between the two groups were compared,the short-term efficacy and long-term prognosis of the two groups were evaluated.Spearman correlation analysis was conducted to explore the relationship between circATRNL1 expression levels after treatment and long-term prognosis.All patients were regrouped based on whether they relapsed during follow-up into a relapse group(n=42)and a non-relapse group(n=178).The circATRNL1 levels before and after treatment were compared between the two groups,and the predictive value of circATRNL1 expression levels after treatment for long-term relapse after treatment in patients with endometriosis was analyzed using a receiver operating characteristic curve(ROC curve).Results After treatment,the serum circATRNL1 levels in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative pain VAS score of the experimental group was significantly lower than that of the control group,and the quality of life was significantly better than that of the control group,the recurrence rate was significantly lower than that of the control group,and the differences were statistically significant(P<0.05).The pregnancy rate of the experimental group was higher than that of the control group,and the postoperative dysmenorrhea rate was lower than that of the control group,but the differences were not statistically significant(P>0.05).Spearman correlation analysis showed that circATRNL1 expression levels after treatment was positively correlated with relapse among long-term prognosis indicators(r=0.290,P<0.05),but had no significant correlation with pregnancy rate(r=0.060,P>0.05).Compared to patients in the non-relapse group,the relapse group had significantly higher serum circATRNL1 expression levels after treatment,the difference was statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for serum circATRNL1 expression levels in predicting long-term postoperative relapse in patients with endometriosis after treatment was 0.746,with a sensitivity of 64.29%and a specificity of 82.02%,indicating good predictive value.Conclusion The treatment regimen combining single-port laparoscopy with GnRH agonist can significantly reduce patients'pain levels,improve their quality of life,and decrease the recurrence rate.Furthermore,this combined therapy also notably decreases serum circATRNL1 levels.The serum circATRNL1 expression levels have good predictive value for the long-term recurrence of deep-infiltrating endometriosis patients post-surgery.

Party affairs cadres in public hospitals play a significant role in promoting high-quality development within hospitals.Their competence and quality directly influence the level of Party construction work in public hospitals and affect the comprehensive development of hospitals.They also serve as an important window for the Party to connect with and serve the peo-ple.Based on competency theory,this study selects Party affairs cadres in public hospitals as the research subjects.Through lit-erature review and interviews,competency elements are summarized,and a competency model for Party affairs cadres in public hospitals is constructed.From four dimensions-innovating selection and training mechanisms,developing career planning and mentorship systems,strengthening performance management and incentive mechanisms,and fostering a learning-oriented organi-zational atmosphere-this study proposes innovative strategies for building a team of Party affairs cadres in public hospitals.

AIM:To investigate the effects of puerarin(PU)on fecal metabolomics in atherosclerosis(AS)model mice.METHODS:Apolipoprotein E gene knockout(ApoE-/-)mice were fed a high-fat,high-cholesterol diet to es-tablish an AS model.The mice were randomly divided into control,model,and PU treatment groups,with five mice in each group.Body weight changes were recorded weekly.After 12 weeks,plasma inflammatory cytokines,lipid profiles,and aortic plaque area were measured,and fecal metabolomic analysis was performed using untargeted metabolomics.RE-SULTS:(1)The high-fat,high-cholesterol diet successfully induced the AS model,with significant increases in body weight(P<0.01),plasma levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-1β(P<0.01),as well as higher levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),and triglycerides(TG),and reduced levels of high-density lipoprotein cholesterol(HDL-C)(P<0.01).The plaque area in both the whole aorta and the aortic sinus was significantly increased(P<0.01).(2)PU treatment significantly reduced body weight(P<0.05)and inflammatory cytokine levels(P<0.01),and improved lipid metabolism disorders.Specifically,TC,TG,and LDL-C lev-els significantly decreased(P<0.05 or P<0.01),while HDL-C levels significantly increased(P<0.01).In addition,the plaque area in both the whole aorta and the aortic sinus was significantly reduced in the PU-treated group(P<0.01).(3)Metabolomic analysis showed that PU regulated the levels of L-valine,L-phenylalanine,and L-histidine,restoring abnor-mal amino acid metabolism pathways.Additionally,PU downregulated abnormal levels of phosphatidylcholine and ce-ramide,promoting lipid metabolism balance.PU also modulated bile acid metabolism and oxidative stress mechanisms,improving purine and pyrimidine metabolism and related energy metabolism pathways.CONCLUSION:PU significantly ameliorates metabolic abnormalities in AS mouse models by regulating lipid metabolism,amino acid metabolism,bile acid metabolism,and gut microbiota-related metabolic pathways.

Objective:To explore the predictive value of prognostic nutritional index (PNI) combined with serum peroxiredoxin 3 (PRX3) level for the prognosis of patients with advanced high-grade serous ovarian cancer (HGSOC) .Methods:A total of 103 patients with advanced HGSOC admitted to Affiliated Hospital of Jining Medical University from Jan. 2020 to Dec. 2022 were retrospectively selected and included in the study. Serum albumin (Alb), PRX3 levels and peripheral blood lymphocyte count (LY) levels were measured. The patients were followed up for 2 years, and they were divided into good prognosis group (70 cases) and poor prognosis group (33 cases). Multivariate stepwise Logistic regression analysis was used to analyze the prognostic factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of PNI combined with PRX3 on prognosis.Results:The age, proportion of postoperative residual lesions, proportion of lymph node metastasis, proportion of stage Ⅲ, and PRX3 level in the poor prognosis group were higher than those in the good prognosis group, and the PNI level was lower than that in the good prognosis group ( P<0.05). Multivariate Logistic regression analysis showed that postoperative residual lesions ( OR=2.731, 95% CI: 1.562-4.774), clinical stage ( OR=3.526, 95% CI: 1.503-8.271), PNI level ( OR=0.148, 95% CI: 1.503-8.271) 0.057-0.387) and PRX3 level ( OR=4.011, 95% CI: 1.972-8.154) were independent influencing factors for the prognosis of patients ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) of PNI, PRX3 and their combination for predicting the prognosis of advanced HGSOC patients were 0.807, 0.781 and 0.874, respectively ( P<0.05). The survival curve of patients with high PNI and PRX3 levels was different from that of patients with low PNI and PRX3 levels ( P<0.05) . Conclusion:PNI and PRX3 are independent prognostic factors for advanced HGSOC patients, and the combination of PNI and PRX3 has a better prognostic value in patients with advanced HGSOC.

Objective To explore the mechanism of Modified Xiaoxianxiong Decoction(MXD)in"treating different diseases with the same method"for type 2 diabetes mellitus(T2DM)and obstructive sleep apnea(OSA)using network pharmacology and molecular docking.Methods Active components and related targets of the seven herbs in MXD(composed of Coptidis Rhizoma,Pinelliae Rhizoma,Trichosanthis Fructus,Bupleuri Radix,Salviae Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra,Astragali Radix)were retrieved and screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Swiss Target Prediction was used for target prediction of active components,followed by gene standardization using the UniProt database.Disease-related targets of T2DM and OSA were obtained from DisGeNET,OMIM,and GeneCards databases.A Venn diagram was used to identify overlapping targets between disease-related targets and active component-related targets,yielding potential therapeutic targets of MXD for both T2DM and OSA.The STRING database and Cytoscape 3.10.2 were employed to construct a protein-protein interaction(PPI)network and a"drug-component-target"network,respectively.Core active components and core targets were identified through network topology analysis.GO functional and KEGG pathway enrichment analyses were performed on potential targets using Metascape.Molecular docking validation was conducted using AutoDock to assess binding affinity between core targets and compounds.Results A total of 157 active components of MXD acted on 1 043 protein targets.After comparison with 1 798 OSA-related targets and 3 466 T2DM-related targets,253 potential therapeutic targets were identified.GO enrichment analysis revealed that these targets were primarily involved in biological processes such as upregulation of phosphorus metabolism,regulation of cell migration,circulatory system processes,and hormone level regulation.KEGG pathway analysis identified key pathways including Rap1,AGE-RAGE,cAMP,and Alzheimer's disease.PPI and"drug-component-target"network topology analysis screened 39 core targets(e.g.,IL-6,TNF,Akt1,IL-1β,EGFR)and core active components(e.g.,salvianolic acid B,tanshinone IIA,baicalin,curcumin).Molecular docking confirmed stable binding between these components and their corresponding target proteins.Conclusion The common pharmacodynamic basis of MXD in"treating different diseases with the same method"for T2DM and OSA includes active components such as salvianolic acid B,baicalin,and curcumin.The shared mechanism may involve key targets(e.g.,IL-6,TNF,Akt1)and modulation of signaling pathways such as Rap1,AGE-RAGE,and cAMP.

Objective To investigate the prognosis of patients with negative sentinel lymph nodes(SLN)after neoadjuvant chemotherapy(NAC)for breast cancer who are exempt from axillary lymph node dissection(ALND)and evaluate its safety in clinical treatment.Methods Clinical data of 2,163 patients initially diagnosed with breast cancer and having negative SLNs after NAC were se-lected from the SEER database from 2018 to 2021.Among them,373 patients underwent only SLN biopsy(SLNB group),and 1,790 patients underwent ALND(ALND group).Propensity score matching(PSM)was used to control for confounding factors,and the Kaplan-Meier method was em-ployed to analyze the overall survival rate.Univariate and multivariate Cox regression analyses were conducted to identify prognostic factors influencing the exemption from ALND in patients with negative SLNs after NAC for breast cancer.Results Before PSM,significant differences were observed be-tween the two groups in terms of clinical tumor stage,molecular subtype,estrogen receptor(ER)sta-tus,progesterone receptor(PR)status,human epidermal growth factor receptor 2(HER-2)status,efficacy of NAC,and breast surgery method(P＜0.05).After PSM,363 patients were included in each group.Univariate Cox regression analysis after PSM revealed that age,clinical tumor stage,and ER status were associated with overall survival(OS)of patients(P＜0.05).There was no sig-nificant difference in OS between patients who underwent SLNB and those who underwent ALND(P＞0.05).Multivariate Cox regression analysis indicated that age and clinical tumor stage were independent factors influencing OS in patients with negative SLNs after NAC.Survival curve analysis after PSM showed no statistically significant difference in overall survival rate between the SLNB and ALND groups(P=0.278).Conclusion Exemption from ALND in patients with negative SLNs af-ter NAC is feasible and does not affect the overall survival rate of patients.

Objective To investigate the potential mechanism of miR-21-5p in alleviating cerebral ischemia-reperfusion injury by targeting STAT3.Methods The HT22 cells were induced by OGD/R to construct a cell model of cerebral ischemia reperfusion injury.The expression of miR-21-5p was detected by RT-qPCR.The CCK-8 assay,TUNEL staining and flow cytometry were respectively used to detect the cell viability and apoptosis.ELISA assay was used to determine the contents of inflammatory factors IL-6,IL-10 and TNF-α in the cell supernatant.Western blot was used to detect the expression levels of p-STAT3/STAT3,Cleaved-Caspase-3,Bax and Bcl-2 proteins.The TargetScan database was used to predict the binding sites of miR-21-5p and STAT3.The dual-luciferase reporter gene assay was used to verify the targeting relationship between miR-21-5p and STAT3.Results The relative expression level of miR-21-5p was down-regulated in HT22 cells which induced by OGD/R(P<0.001).The cell viability(P<0.0001)was decreased and the apoptosis rate(P<0.001)was increased in OGD/R induced-HT22 cells.The contents of pro-inflammatory factors IL-6(P<0.001)and TNF-α(P<0.001)was increased,while the content of anti-inflammatory factor IL-10(P<0.001)decreased.After transfection with miR-21-5p mimic,cell viability was enhanced,apoptosis rate was reduced and neuroinflammation was inhibited.MiR-21-5p could target and bind to STAT3.After miR-21-5p inhibitor transfection,cell viability decreased,apoptosis was promoted,and neuroinflammation occurred;STAT3 inhibitor Stattic could reverse the effect of miR-21-5p inhibitor.Conclusion MiR-21-5p could specifically bind to STAT3 and reduce the neuroinflammation and apoptosis of OGD/R induced-HT22 cells.

Party affairs cadres in public hospitals play a significant role in promoting high-quality development within hospitals.Their competence and quality directly influence the level of Party construction work in public hospitals and affect the comprehensive development of hospitals.They also serve as an important window for the Party to connect with and serve the peo-ple.Based on competency theory,this study selects Party affairs cadres in public hospitals as the research subjects.Through lit-erature review and interviews,competency elements are summarized,and a competency model for Party affairs cadres in public hospitals is constructed.From four dimensions-innovating selection and training mechanisms,developing career planning and mentorship systems,strengthening performance management and incentive mechanisms,and fostering a learning-oriented organi-zational atmosphere-this study proposes innovative strategies for building a team of Party affairs cadres in public hospitals.

AIM:To investigate the effects of puerarin(PU)on fecal metabolomics in atherosclerosis(AS)model mice.METHODS:Apolipoprotein E gene knockout(ApoE-/-)mice were fed a high-fat,high-cholesterol diet to es-tablish an AS model.The mice were randomly divided into control,model,and PU treatment groups,with five mice in each group.Body weight changes were recorded weekly.After 12 weeks,plasma inflammatory cytokines,lipid profiles,and aortic plaque area were measured,and fecal metabolomic analysis was performed using untargeted metabolomics.RE-SULTS:(1)The high-fat,high-cholesterol diet successfully induced the AS model,with significant increases in body weight(P<0.01),plasma levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-1β(P<0.01),as well as higher levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),and triglycerides(TG),and reduced levels of high-density lipoprotein cholesterol(HDL-C)(P<0.01).The plaque area in both the whole aorta and the aortic sinus was significantly increased(P<0.01).(2)PU treatment significantly reduced body weight(P<0.05)and inflammatory cytokine levels(P<0.01),and improved lipid metabolism disorders.Specifically,TC,TG,and LDL-C lev-els significantly decreased(P<0.05 or P<0.01),while HDL-C levels significantly increased(P<0.01).In addition,the plaque area in both the whole aorta and the aortic sinus was significantly reduced in the PU-treated group(P<0.01).(3)Metabolomic analysis showed that PU regulated the levels of L-valine,L-phenylalanine,and L-histidine,restoring abnor-mal amino acid metabolism pathways.Additionally,PU downregulated abnormal levels of phosphatidylcholine and ce-ramide,promoting lipid metabolism balance.PU also modulated bile acid metabolism and oxidative stress mechanisms,improving purine and pyrimidine metabolism and related energy metabolism pathways.CONCLUSION:PU significantly ameliorates metabolic abnormalities in AS mouse models by regulating lipid metabolism,amino acid metabolism,bile acid metabolism,and gut microbiota-related metabolic pathways.