Objective:To compare the clinical outcomes of immediate breast reconstruction using latissimus dorsi flap with implant versus mesh with implant based on BREAST-Q evaluation.Methods:From the clinical database of the First Affiliated Hospital of Nanjing Medical University, the patients who underwent immediate breast reconstruction after total mastectomy from January 2020 to December 2023 were selected as the research subjects. All breast reconstruction surgeries were performed by the same surgeon. Patients were divided into two groups according to surgical methods: the latissimus dorsi muscle flap combined with implant immediate breast reconstruction group (LD group) and the mesh combined with implant immediate breast reconstruction group (mesh group). Patients were followed up in outpatient clinics or by telephone one year after surgery. The BREAST-Q was used to evaluate the surgical outcomes of both groups from four dimensions: psychosocial well-being, sexual well-being, chest-physical well-being, and breast satisfaction. The score range for each dimension was 0-100, with higher scores indicating greater patient satisfaction with quality of life and surgical outcomes. Statistical analysis was performed using SPSS 22.0 software. Normally distributed measurement data were expressed as Mean ± SD, and comparisons between the two groups were performed using independent sample t-test. Count data were expressed as number of cases and percentages, and comparisons between groups were performed using chi-square test or Fisher’s exact test. P<0.05 was considered statistically significant. Results:A total of 123 patients were included, with 59 patients in the LD group and 64 patients in the mesh group. In the LD group, the mean age was (37.7±7.0) years, body mass index (BMI) was (22.6±2.6) kg/m 2, and clinical tumor staging showed 2, 22, 30, and 5 cases for stages 0, Ⅰ, Ⅱ, and Ⅲ, respectively. In the mesh group, the mean age was (39.1±7.0) years, BMI was (22.6±2.8) kg/m 2, and clinical tumor staging showed 1, 25, 38, and 0 cases for stages 0, Ⅰ, Ⅱ, and Ⅲ, respectively. There were no statistically significant differences between the two groups in baseline characteristics including age, BMI, and clinical tumor staging (all P>0.05). One year after surgery, the BREAST-Q result showed no statistically significant differences between the LD group and mesh group in psychosocial well-being [(83.0±19.8) points vs. (80.8±19.3) points] and sexual well-being [(62.1±30.4) points vs. (65.8±25.6) points] (all P>0.05). However, the LD group had lower chest-physical well-being scores than the mesh group [(40.6±9.7) points vs. (45.1±9.6) points, P<0.05], while breast satisfaction scores were higher in the LD group than in the mesh group [(68.0±17.8) points vs. (59.8±12.6) points, P<0.01]. Conclusion:Immediate breast reconstruction by both latissimus dorsi flap with implant and mesh with implant can improve patients’ psychosocial and sexual well-being by enhancing breast appearance. However, LD technique provides better breast satisfaction, while the mesh technique offers advantages in physical well-being of the chest wall and upper body. Surgeons should select the most appropriate breast reconstruction technique based on patients’ anatomical conditions, treatment history, and individual needs to optimize postoperative quality of life and satisfaction.

Objective:To explore effect of curculigoside on neuronal pyroptosis in rats with acute cerebral infarction(CI)by regulating cyclic guanosine-adenosine synthase(cGAS)-interferon gene stimulating factor(STING)signaling pathway.Methods:Fifteen rats were randomly selected as sham operation group,and remaining rats were constructed CI models by modified Longa suture method,CI rats successfully modeled were randomly divided into CI group,curculigoside group(5 mg/kg),SR-717 group(3 mg/kg cGAS-STING signaling pathway activator SR-717)and curculigoside+SR-717 group(5 mg/kg curculigoside+3 mg/kg SR-717),with 15 rats in each group,injected once a day for 7 consecutive days,sham operation group and CI group were given equal amounts of nor-mal saline.Neural function was evaluated by Zea-Longa score;inflammatory factors levels were detected by ELISA;TTC staining was used to evaluate volume of CI;TUNEL staining was used to detect neuronal apoptosis;immunofluorescence staining was used to detect GSDMD-N expression;Western blot was used to detect expression of pyroptosis and cGAS-STING pathway proteins.Results:Com-pared with sham operation group,Zea-Longa score,CI volume,IL-1β and IL-18 levels,apoptosis rate,number of GSDMD-N positive cells,NLRP3,cleaved-Caspase-1/Caspase-1,GSDMD-N,cGAS and STING protein expressions in CI group were significantly increased(P<0.05);compared with CI group,Zea-Longa score,CI volume,IL-1β and IL-18 levels,apoptosis rate,number of GSDMD-N positive cells,NLRP3,cleaved-Caspase-1/Caspase-1,GSDMD-N,cGAS and STING protein expressions in curculigoside group were significantly decreased(P<0.05),while the above indexes in SR-717 group had opposite trend(P<0.05);SR-717 reversed improvement effect of curculigoside on neuronal pyroptosis in CI rats.Conclusion:Curculigoside may improve neuronal pyroptosis in CI rats by down-regulating cGAS-STING signaling pathway.

An 82-year-old female patient with atrial fibrillation and heart failure was treated with dabigatran etexilate 110 mg twice daily for 6 years. Two months ago, the patient′s lower limb edema was aggravated and urine output was reduced. Considering the worsening of the patient′s heart failure, torasemide tablets and spironolactone tablets were given, but her symptoms were not improved. Two days ago, the patient had scattered petechiae on the whole skin, tarry stools, and reduced urine (200 ml daily). Laboratory tests showed hemoglobin (Hb) 63 g/l, prothrombin time (PT) 39.5 s, activated partial thromboplastin time (APTT) 117.2 s, thrombin time (TT) >300 s, and international normalized ratio (INR) 3.64; the fibrinogen (Fib) could not be measured. Coagulation dysfunction and gastrointestinal bleeding caused by dabigatran etexilate were considered. Dabigatran etexilate was discontinued, and intravenous infusion of idarucizumab injection (2.5 g) was given twice. Then gastrointestinal bleeding in the patient disappeared and laboratory tests showed PT 12.7 s, APTT 42.4 s, TT 18.8 s, INR 1.18, and Fib 2.67 g/L. After 8 days, the patient′s cardiac function was improved, the skin ecchymosis subsided, and laboratory tests showed Hb 84 g/L, PT 14 s, APTT 37.8 s, TT 41.2 s, INR 1.3, Fib 2.26 g/L, and negative fecal occult blood test.

Objective:To explore effect of curculigoside on neuronal pyroptosis in rats with acute cerebral infarction(CI)by regulating cyclic guanosine-adenosine synthase(cGAS)-interferon gene stimulating factor(STING)signaling pathway.Methods:Fifteen rats were randomly selected as sham operation group,and remaining rats were constructed CI models by modified Longa suture method,CI rats successfully modeled were randomly divided into CI group,curculigoside group(5 mg/kg),SR-717 group(3 mg/kg cGAS-STING signaling pathway activator SR-717)and curculigoside+SR-717 group(5 mg/kg curculigoside+3 mg/kg SR-717),with 15 rats in each group,injected once a day for 7 consecutive days,sham operation group and CI group were given equal amounts of nor-mal saline.Neural function was evaluated by Zea-Longa score;inflammatory factors levels were detected by ELISA;TTC staining was used to evaluate volume of CI;TUNEL staining was used to detect neuronal apoptosis;immunofluorescence staining was used to detect GSDMD-N expression;Western blot was used to detect expression of pyroptosis and cGAS-STING pathway proteins.Results:Com-pared with sham operation group,Zea-Longa score,CI volume,IL-1β and IL-18 levels,apoptosis rate,number of GSDMD-N positive cells,NLRP3,cleaved-Caspase-1/Caspase-1,GSDMD-N,cGAS and STING protein expressions in CI group were significantly increased(P<0.05);compared with CI group,Zea-Longa score,CI volume,IL-1β and IL-18 levels,apoptosis rate,number of GSDMD-N positive cells,NLRP3,cleaved-Caspase-1/Caspase-1,GSDMD-N,cGAS and STING protein expressions in curculigoside group were significantly decreased(P<0.05),while the above indexes in SR-717 group had opposite trend(P<0.05);SR-717 reversed improvement effect of curculigoside on neuronal pyroptosis in CI rats.Conclusion:Curculigoside may improve neuronal pyroptosis in CI rats by down-regulating cGAS-STING signaling pathway.

Quantum dot-based single-virus tracking has become a practical method to explore the molecular mechanism of virus entry into cells,because it can realize virion imaging in living cells.Mink enteritis virus(MEV)is a single-stranded DNA virus with strong environmental resistance,which has caused huge economic losses for the global mink farming industry.Although epidemio-logic and clinical aspects of MEVs have been studied,the mechanisms by which it infect target cells remain unclear.In this study,we implemented quantum dot labeling of mink enteritis virus u-sing the biotin-streptomycin affinity system and monitored the viral infection process in host cells.We found that MEV first attaches to the cell membrane and enters the cell by endocytosis.Live cell images showed quantum dot(QD)-MEV movement along microtubules,and viral infection was also inhibited by treatment with the microtubule inhibitor nocodazole,whereas the addition of the microfilament inhibitor CytoD had no effect on infection,suggesting that MEV transport is de-pendent on microtubules rather than microfilaments.Another imaging results showed that MEV co-localized with Rab5 and Rab7 in host cells,suggesting that the endosomal system is required for MEV internalization.Biochemical analyses showed that viral infection was significantly inhibited after pretreatment of host cells with the endosomal acidification inhibitors NH4 Cl and chloro-quine,suggesting that MEV invasion requires an acidic environment in the endosomes.Our results indicated that MEV enters early and late endosomes after entering the cell membrane,and that in-tracellular translocation is microtubule-dependent,which may in turn uncover a novel target for antiviral treatment.

Objective:To develop a popular science educational product aimed at enhancing home-based self-management among peritoneal dialysis (PD) patients.Methods:A preliminary framework for popular science content on home-based self-management for PD patients was constructed based on an evidence summary. Through refinement of the evidence and expert panel discussions, the final educational content was determined and used to produce a popular science video. From June 18 to June 30, 2024, the video was disseminated through both online and offline channels. A questionnaire survey was used to assess the quality of the popular science educational product.Results:The final content framework consisted of four key areas: volume management, nutrition management, exercise management, and management of common problems. A popular science video with a total duration of 5 minutes and 52 seconds was developed. A total of 158 PD patients rated the quality of the popular science educational product with an average score of (83.03±2.01) .Conclusions:The development method of the popular science educational product is scientifically sound, and the content is suitable for dissemination. It provides a practical reference for improving health literacy and self-management ability among home-based PD patients.

The N-methyl-D-aspartate receptor (NMDA-R) subunit GluN2B is abundantly expressed in brain regions critical for synaptic plasticity and cognitive processes. This study investigated the structure-activity relationships (SAR) of NMDA-R ligands using GluN2B as a molecular target. Thirty potential NMDA-R antagonists were categorized into two structural classes: 1-(1-phenylcyclohexyl) amines (series A) and α-amino-2-phenylcyclohexanone derivatives (series B). In series A compounds, the phenyl ring and R1 substituents were positioned at the carbon center of the cyclohexyl ring, with R2 substituents at the para- or meta-positions of the phenyl ring. SAR analysis revealed optimal binding affinity when R1 was carbonyl (C=O) and R2 was 4-methoxy (4-OMe). Series B compounds featured a cyclohexanone scaffold with NH-R1 at the α-position and a phenyl ring bearing R2 substituents at ortho-, meta-, or para-positions. Maximum binding affinity was achieved with R1 as hydrogen (H) and R2 as hydroxyl (OH). Compounds were assessed for GluN2B-mediated ERK activation to evaluate potential metabotropic signaling properties. Approximately 50% of the compounds demonstrated ERK activation through a non-ionotropic signaling cascade involving Src, phosphatidylinositol 3-kinase, and protein kinase C. This study elucidated key structural determinants for NMDA-R binding and characterized a novel metabotropic signaling pathway. Notably, our findings suggest that compounds acting as antagonists at the ionotropic site may simultaneously function as agonists through non-ionotropic mechanisms.

The N-methyl-D-aspartate receptor (NMDA-R) subunit GluN2B is abundantly expressed in brain regions critical for synaptic plasticity and cognitive processes. This study investigated the structure-activity relationships (SAR) of NMDA-R ligands using GluN2B as a molecular target. Thirty potential NMDA-R antagonists were categorized into two structural classes: 1-(1-phenylcyclohexyl) amines (series A) and α-amino-2-phenylcyclohexanone derivatives (series B). In series A compounds, the phenyl ring and R1 substituents were positioned at the carbon center of the cyclohexyl ring, with R2 substituents at the para- or meta-positions of the phenyl ring. SAR analysis revealed optimal binding affinity when R1 was carbonyl (C=O) and R2 was 4-methoxy (4-OMe). Series B compounds featured a cyclohexanone scaffold with NH-R1 at the α-position and a phenyl ring bearing R2 substituents at ortho-, meta-, or para-positions. Maximum binding affinity was achieved with R1 as hydrogen (H) and R2 as hydroxyl (OH). Compounds were assessed for GluN2B-mediated ERK activation to evaluate potential metabotropic signaling properties. Approximately 50% of the compounds demonstrated ERK activation through a non-ionotropic signaling cascade involving Src, phosphatidylinositol 3-kinase, and protein kinase C. This study elucidated key structural determinants for NMDA-R binding and characterized a novel metabotropic signaling pathway. Notably, our findings suggest that compounds acting as antagonists at the ionotropic site may simultaneously function as agonists through non-ionotropic mechanisms.

The N-methyl-D-aspartate receptor (NMDA-R) subunit GluN2B is abundantly expressed in brain regions critical for synaptic plasticity and cognitive processes. This study investigated the structure-activity relationships (SAR) of NMDA-R ligands using GluN2B as a molecular target. Thirty potential NMDA-R antagonists were categorized into two structural classes: 1-(1-phenylcyclohexyl) amines (series A) and α-amino-2-phenylcyclohexanone derivatives (series B). In series A compounds, the phenyl ring and R1 substituents were positioned at the carbon center of the cyclohexyl ring, with R2 substituents at the para- or meta-positions of the phenyl ring. SAR analysis revealed optimal binding affinity when R1 was carbonyl (C=O) and R2 was 4-methoxy (4-OMe). Series B compounds featured a cyclohexanone scaffold with NH-R1 at the α-position and a phenyl ring bearing R2 substituents at ortho-, meta-, or para-positions. Maximum binding affinity was achieved with R1 as hydrogen (H) and R2 as hydroxyl (OH). Compounds were assessed for GluN2B-mediated ERK activation to evaluate potential metabotropic signaling properties. Approximately 50% of the compounds demonstrated ERK activation through a non-ionotropic signaling cascade involving Src, phosphatidylinositol 3-kinase, and protein kinase C. This study elucidated key structural determinants for NMDA-R binding and characterized a novel metabotropic signaling pathway. Notably, our findings suggest that compounds acting as antagonists at the ionotropic site may simultaneously function as agonists through non-ionotropic mechanisms.

ObjectiveTo explore the typical syndromes and their characteristic of symptoms and signs with high diagnostic value in patients with metabolic syndrome （MS）. MethodsTraditional Chinese medicine （TCM） diagnostic information was collected from 135 MS patients. Syndrome element differentiation and latent class analysis （LCA） were applied to identify the major TCM syndromes in MS patients. Symptoms were analyzed based on the differentiated syndromes， and a binary logistic regression model was constructed to determine symptoms and signs with high diagnostic value. ResultsA total of 135 MS patients were included， involving 163 symptoms and signs with a total frequency of 1749； twenty-three syndrome elements were extracted， 367 times frequency in total， among which 8 syndrome elements occurred ≥10 times with 323 frequencies （88.01% of the total）. These included location-related elements such as kidney （48 times）， spleen （14 times）， and stomach （14 times）， and nature-related elements such as phlegm （71 times）， yin deficiency （64 times）， dampness （57 times）， heat （42 times）， and qi deficiency （13 times）. Based on LCA， the 135 patients were categorized into two groups distinguished by the syndrome elements of dampness and phlegm， forming the "phlegm-dampness syndrome" as the major syndrome type. Nine high-frequency symptoms and signs associated with the phlegm-dampness syndrome were identified，i.e. obesity （39 times）， greasy coating （38 times）， slippery pulse （33 times）， white coating （31 times）， preference for fatty and heavy foods （30 times）， excessive urination （30 times）， fatigue and lack of strength （29 times）， wiry pulse （25 times）， and dark red tongue （25 times）. A binary logistic regression model was constructed combining these nine symptoms and signs with the LCA classification results， ultimately identifying obesity， greasy coating， fatigue and lack of strength， and white coating as independent factors associated with the phlegm-dampness syndrome in MS patients （P＜0.05）. ConclusionThe major TCM syndrome in MS patients is phlegm-dampness syndrome， and obesity， greasy coating， fatigue and lack of strength， and white coating are the typical symptoms and signs for diagnosing phlegm-dampness syndrome in MS patients.