Objective To analyze the main causes and risk factors of unplanned reoperation after liver transplantation. Methods The clinical data of 242 liver transplant recipients in the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2024 were retrospectively analyzed. According to whether unplanned reoperation was performed during the same hospitalization after surgery, the recipients were divided into the reoperation group (n=36) and the non-reoperation group (n=206). The preoperative, intraoperative and postoperative data of the two groups, as well as donor and graft-related data, were compared to analyze the risk factors of unplanned reoperation after liver transplantation and the survival status of the two groups. Results Among the 242 liver transplant recipients, 36 underwent unplanned reoperations, with a total of 54 procedures including various laparotomies, endoscopic and interventional surgeries, among which there were 20 laparotomies, 18 endoscopic surgeries and 16 interventional surgeries. The most common cause of unplanned reoperation was biliary complications (20 times), followed by vascular complications (17 times). Compared with the non-reoperation group, the reoperation group had longer graft cold ischemia time, higher postoperative fatality rate of recipients, longer length of stay in the intensive care unit and postoperative hospital stay, and higher total hospitalization costs (all P<0.05). The incidence of unplanned reoperation was higher in recipients who underwent split liver transplantation (P<0.05). Multivariate analysis showed that intraoperative blood loss ≥1 000 mL, positive culture of graft perfusate and split liver transplantation were independent risk factors for unplanned reoperation (all P<0.05). The postoperative 7-day, 1-month, 3-month and 6-month survival rates of recipients in the reoperation group and the non-reoperation group were 100% vs. 98.1%, 88.9% vs. 94.2%, 69.4% vs. 90.8% and 66.7% vs. 90.8%, respectively, and the postoperative survival rate of recipients in the reoperation group was lower than that in the non-reoperation group (P<0.05). Conclusions The main causes of unplanned reoperation after liver transplantation are biliary complications, vascular complications, abdominal incision infection and intra-abdominal hemorrhage. Intraoperative massive blood loss, positive culture of graft perfusate and split liver transplantation are the risk factors associated with unplanned reoperation after liver transplantation.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

ObjectiveTo investigate the potential mechanisms underlying the therapeutic effects of Bushen Huoxue Formulation （补肾活血方， BSHXF） in Parkinson's disease （PD） from the perspectives of synaptic vesicle cycling and intestinal barrier function. MethodsForty-eight male SD rats were randomly divided into four groups， control group， model group， Madopar group， and BSHXF group， with 12 rats in each group. Except for the control group， rats were administered rotenone by gavage once daily for 4 consecutive weeks to establish a PD rat model. After successful modeling， rats in the BSHXF group received concentrated BSHXF solution by gavage at a dose of 13.5 g/（kg·d）， while rats in the Madopar group received Madopar tablet suspension at 2 g/（kg·d）. Rats in the control group and the model group were administered distilled water by gavage at 10 ml/（kg·d）. All groups received continuous gavage treatment for 2 weeks. Motor function was evaluated using the open field test （total distance traveled， average speed， and total distance traveled in the central zone）， rotarod test （latency to fall）， and balance beam test （traversal time）. Histopathological changes in colon tissues were observed by HE staining. Western Blotting was used to detect the protein levels of α-synuclein （α-syn）， phosphorylated serine 129 α-synuclein （pSer129-α-syn）， vesicle-associated membrane protein 2 （VAMP2）， and synaptophysin （SYP） in the substantia nigra and colon tissues. The mRNA expression levels of α-syn， VAMP2， and SYP were detected by RT-PCR， and α-syn expression was examined by immunohistochemistry. Immunofluorescence staining was performed to assess the levels of tight junction protein 1 （ZO-1） and occludin in colon tissues， as well as tyrosine hydroxylase （TH） levels in substantia nigra tissues. ResultsCompared with the control group， rats in the model group showed reduced total distance traveled， average speed， and central-zone distance in the open field test， decreased latency to fall in the rotarod test， and prolonged traversal time in the balance beam test. The protein levels of pSer129-α-syn and α-syn， as well as α-syn mRNA expression were increased in the substantia nigra and colon tissues， whereas the protein and mRNA expression levels of VAMP2 and SYP were decreased. The relative integrated optical density of α-syn in the substantia nigra and colon tissues was increased， while the relative fluorescence intensities of ZO-1 and occludin in colon tissues and TH in the substantia nigra were decreased （P＜0.05）. HE staining showed focal necrosis in the mucosal layer of colon tissues， disappearance of some intestinal glands， extensive inflammatory cell infiltration， and proliferation of fibrous connective tissue in the submucosa. Compared with the model group， both the Madopar group and BSHXF group showed varying degrees of improvement in the above indicators （P＜0.05）. Pathological damage in colon tissues was also alleviated， with only mild fibrous tissue proliferation and limited diffuse inflammatory cell infiltration observed in the mucosal layer. Compared with the Madopar group， rats in the BSHXF group exhibited increased average speed， central-zone distance， and latency to fall in the rotarod test. The levels of pSer129-α-syn and α-syn proteins in the substantia nigra were decreased， while VAMP2 protein expression was increased. In colon tissues， SYP protein levels and mRNA expression were elevated. The relative fluorescence intensity of ZO-1 in colon tissues and TH in substantia nigra tissues was also increased （P＜0.05）. ConclusionBSHXF may improve motor dysfunction in PD by regulating synaptic vesicle cycling， restoring intestinal barrier integrity， and improving neuronal synaptic function through modulation of synaptic vesicle-associated protein expression in the substantia nigra and colon tissues.

ObjectiveTo investigate the potential mechanisms underlying the therapeutic effects of Bushen Huoxue Formulation （补肾活血方， BSHXF） in Parkinson's disease （PD） from the perspectives of synaptic vesicle cycling and intestinal barrier function. MethodsForty-eight male SD rats were randomly divided into four groups， control group， model group， Madopar group， and BSHXF group， with 12 rats in each group. Except for the control group， rats were administered rotenone by gavage once daily for 4 consecutive weeks to establish a PD rat model. After successful modeling， rats in the BSHXF group received concentrated BSHXF solution by gavage at a dose of 13.5 g/（kg·d）， while rats in the Madopar group received Madopar tablet suspension at 2 g/（kg·d）. Rats in the control group and the model group were administered distilled water by gavage at 10 ml/（kg·d）. All groups received continuous gavage treatment for 2 weeks. Motor function was evaluated using the open field test （total distance traveled， average speed， and total distance traveled in the central zone）， rotarod test （latency to fall）， and balance beam test （traversal time）. Histopathological changes in colon tissues were observed by HE staining. Western Blotting was used to detect the protein levels of α-synuclein （α-syn）， phosphorylated serine 129 α-synuclein （pSer129-α-syn）， vesicle-associated membrane protein 2 （VAMP2）， and synaptophysin （SYP） in the substantia nigra and colon tissues. The mRNA expression levels of α-syn， VAMP2， and SYP were detected by RT-PCR， and α-syn expression was examined by immunohistochemistry. Immunofluorescence staining was performed to assess the levels of tight junction protein 1 （ZO-1） and occludin in colon tissues， as well as tyrosine hydroxylase （TH） levels in substantia nigra tissues. ResultsCompared with the control group， rats in the model group showed reduced total distance traveled， average speed， and central-zone distance in the open field test， decreased latency to fall in the rotarod test， and prolonged traversal time in the balance beam test. The protein levels of pSer129-α-syn and α-syn， as well as α-syn mRNA expression were increased in the substantia nigra and colon tissues， whereas the protein and mRNA expression levels of VAMP2 and SYP were decreased. The relative integrated optical density of α-syn in the substantia nigra and colon tissues was increased， while the relative fluorescence intensities of ZO-1 and occludin in colon tissues and TH in the substantia nigra were decreased （P＜0.05）. HE staining showed focal necrosis in the mucosal layer of colon tissues， disappearance of some intestinal glands， extensive inflammatory cell infiltration， and proliferation of fibrous connective tissue in the submucosa. Compared with the model group， both the Madopar group and BSHXF group showed varying degrees of improvement in the above indicators （P＜0.05）. Pathological damage in colon tissues was also alleviated， with only mild fibrous tissue proliferation and limited diffuse inflammatory cell infiltration observed in the mucosal layer. Compared with the Madopar group， rats in the BSHXF group exhibited increased average speed， central-zone distance， and latency to fall in the rotarod test. The levels of pSer129-α-syn and α-syn proteins in the substantia nigra were decreased， while VAMP2 protein expression was increased. In colon tissues， SYP protein levels and mRNA expression were elevated. The relative fluorescence intensity of ZO-1 in colon tissues and TH in substantia nigra tissues was also increased （P＜0.05）. ConclusionBSHXF may improve motor dysfunction in PD by regulating synaptic vesicle cycling， restoring intestinal barrier integrity， and improving neuronal synaptic function through modulation of synaptic vesicle-associated protein expression in the substantia nigra and colon tissues.

Objective To investigate the factors influencing global longitudinal strain(GLS)measured by cardiac magnetic resonance(CMR)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Clinical data of 315 hospitalized patients diagnosed with acute STEMI who underwent percutaneous coronary intervention(PCI)at the First Medical Center of Chinese PLA General Hospital from June 2016 to September 2021 were retrospectively collected.After analyzing CMR images of all patients,GLS and other strain parameters were obtained,and then the patients were divided into two groups according to the median GLS.In order to balance gender and age differences,1:1 propensity score matching was performed,and 206 patients were eventually included:GLS>-11.3%group(indicating severe GLS impairment,n=103)and GLS≤-11.3%group(n=103).Baseline characteristics,laboratory indicators,coronary angiographic parameters,electrocardiogram(ECG)features,and CMR parameters were compared between the two groups.Variables showing significant differences were analyzed for their correlation with GLS.Multivariate logistic regression and multiple stepwise linear regression analyses were performed to identify factors associated with GLS impairment.Results Compared with GLS≤-11.3%group,GLS>-11.3%group had significantly higher peak levels of creatine kinase-MB(CK-MB)and troponin T(TnT)(P<0.001).A higher proportion of patients in GLS>-11.3%group had the left anterior descending artery(LAD)as the culprit vessel,while a lower proportion had the right coronary artery(RCA)as the culprit vessel(P<0.001).Additionally,GLS>-11.3%group had longer QRS duration(P<0.001)and a higher incidence of pathological Q waves(P=0.001).Regarding CMR parameters,GLS>-11.3%group exhibited larger global circumferential strain(GCS),infarct size(IS),and left ventricular end-systolic volume(LVESV),as well as lower global radial strain(GRS)and left ventricular ejection fraction(LVEF)(P<0.001).Multivariate logistic regression indicated that peak TnT(OR=1.092,P=0.001),LAD culprit vessel(OR=3.744,P<0.001),and QRS duration(OR=1.026,P<0.001)were significantly associated with severely impaired GLS.Multiple stepwise linear regression analysis showed that the logarithmic value of peak TnT,LAD as the culprit vessel,and the square root of QRS duration were linearly correlated with GLS values(adjusted R2=0.301,P<0.001),and these independent variables explained 30.1%of the variation in GLS.Conclusion Elevated peak TnT,prolonged QRS duration,and LAD as the culprit vessel are significantly associated with severe GLS impairment in STEMI patients,indicating more severe myocardial infarction and worse left ventricular function.

Objective To explore the relationship between NANOS3 and P-bodies in oocytes and the mechanism of their interaction during early oogenesis.Methods The co-localization of NANOS3 and dead box helicase 6(DDX6)in day post postnatal 1(1dpp)mouse oocytes was observed by immunofluorescence,and the interaction between NANOS3 and DDX6 was detected by immunoprecipitation.NANOS3 and DDX6 full-length plasmids were constructed to transfect HEK293T cells,and the mechanism of their interaction was investigated by immunofluorescence and immunoprecipitation.NANOS3 transfected HeLa cells to investigate whether NANOS3 had the ability of liquid-liquid phase separation(LLPS)by live-cell imaging.The proteins recruited by P-bodies in early oogenesis were identified by DDX6-immunoprecipitation-mass spectrometry(DDX6-IP-MS).Results NANOS3 and DDX6 colocalized and interacted with each other in 1dpp mouse oocytes.However,the co-localization of NANOS3 and DDX6 was not observed in HEK293T cells that had been transfected,but co-immunoprecipitation still demonstrated an interaction between these two proteins.Besides,live-cell imaging revealed that NANOS3 exhibited dynamic fluid-like properties within cells,which may promote the formation of P-bodies through LLPS.Finally,DDX6-IP-MS revealed that DDX6 might recruit NANOS3 into P-bodies by binding to the NANOS3 interacting protein Pumilio.Conclusion NANOS3 serves as a specific component of P-bodies in neonatal oocytes and may be involved in the regulation of early oogenesis.

Objective To explore the perioperative therapeutic effects and follow-up manage-ment in 16 patients with left ventricular assist device(LVAD)implantation.Methods A retrospec-tive analysis was conducted in data of 16 patients who underwent LVAD implantation in the depart-ment of cardiovascular surgery.Data of 6-minute walk test(6MWT),European Quality of Life-5 Di-mension-5 Levels(EQ-5D-5L),New York Heart Association(NYHA)classification,echocardio-graphy,chest radiography,cardiothoracic ratio,and occurrence of complications(infection,bleed-ing,thrombosis,right heart failure,neurological issues)were collected via the electronic medical re-cord system before surgery and at 30,60,and 90 days postoperatively.Results All patients sur-vived with the pump at 90 days postoperatively.One patient with preoperative renal insufficiency un-derwent dialysis and received a heart transplant after 8 months.One patient developed a sterile granu-loma at the percutaneous lead site on the abdominal wall,which improved after treatment,no complica-tions occurred in other patients.At 90 days postoperatively,there was no statistically significant differ-ence in the right ventricular area change fraction and tricuspid annular plane systolic excursion com-pared with preoperative values(P＞0.05).The left ventricular ejection fraction,left ventricular end-diastolic diameter,and cardiothoracic ratio showed significant improvement compared with preoperative levels(P＜0.05).At 30 days postoperatively,30％of patients recovered to NYHA class Ⅰ and 70％to class Ⅱ;at 60 days,80％of patients to class Ⅰ and 20％to class Ⅱ;at 90 days,90％to classⅠ and 10％to class Ⅱ.The 6MWT and EQ-5D-5L scores of patients significantly increased within 90 days postoperatively(P＜0.01).Conclusion Through rigorous preoperative assessment by a multidisciplinary LVAD team,refinement of surgical techniques,and comprehensive management during hospitalization,self-management before discharge,daily follow-up after discharge,and fol-low-up management upon returning to the hospital for patients with LVAD implantation,the cardiac function and quality of life of patients are significantly improved at 90 days postoperatively.

Objective To investigate the effects of transcutaneous auricular vagus nerve stimula-tion(taVNS)on preoperative anxiety and sleep quality in patients undergoing laparoscopic myomecto-my.Methods A total of 106 patients scheduled for elective laparoscopic myomectomy were randomly divided into active stimulation group(a-taVNS group,n=53)and sham stimulation group(s-taVNS group,n=53).Trait Anxiety Inventory(TAI)scores,State Anxiety Inventory(SAI)scores,Hos-pital Anxiety and Depression Scale-anxiety(HADS-A)scores,Amsterdam Preoperative Anxiety and Information Scale-anxiety(APAISa)scores,Athens Insomnia Scale(AIS)scores,hemodynamic parameters,and adverse reactions were evaluated before intervention(T0),30 min after interven-tion(T1),and the next morning(T2).The degrees of anxiety improvement(△SAI=SAIT0-SAIT1;△HADS-A=HADS-AT0-HADS-AT1;△APAISa=APAISaT0-APAISaT1)and sleep improvement(△AIS=AIST0-AIST2)were calculated,and their correlations were assessed.Results At T0,there were no significant differences in SAI,HADS-A,and APAISa scores between the two groups(P=0.376,0.682,0.144).At T1,there were significant differences in SAI and HADS-A scores between the two groups(adjusted P＜0.05),while there was no significant difference in APAISa scores(P=0.141).Compared with the s-taVNS group,the a-taVNS group had higher improvement values of △SAI,△HADS-A,and △APAISa(P＜0.001).Compared with T0,the AIS score de-creased and the incidence of sleep disorders decreased at T2 in the a-taVNS group(P＜0.05).Compared with the s-taVNS group,the AIS score and the proportion of patients with sleep disorders decreased at T2 in the a-taVNS group(P＜0.05).There was a positive correlation between the de-gree of anxiety improvement and the degree of sleep improvement in the a-taVNS group(P＜0.05),while there was no significant correlation in the s-taVNS group(P＞0.05).Compared with T0,sys-tolic blood pressure,diastolic blood pressure,and heart rate decreased at T1 in both groups,but there were no significant differences in these parameters between the two groups(P＞0.05).During the study period,no adverse events such as tinnitus,dizziness,headache,nausea,vomiting,or fa-cial flushing occurred in either group.Conclusion The method taVNS can improve preoperative anxiety and reduce the incidence of sleep disorders in patients undergoing laparoscopic myomectomy.

Objective To identify candidate compounds that activate thermogenesis during cold exposure by integrating the Library of Integrated Network-Based Cellular Signatures(LINCS)with RNA expression profiles specific to cold-induced thermogenesis.Methods Gene expression profiles of interscapular brown adipose tissue(BAT)and inguinal white adipose tissue(iWAT)were generated from 8-week-old C57BL/6J mice which were housed at 5 ℃ or room temperature(23 ℃)for 7 days.The gene expression signatures of the cold-induced BAT and iWAT were compared to the LINCS dataset to predict potential candidates for testing in a cold challenge model that was intended to assess thermogenesis activation.The pharmacological potential of the identified compounds was evaluated in a cold-exposed mouse model.The core body temperature and infrared thermal imaging were collected to monitor physiological responses during cold exposure.Additionally,hematoxylin and eosin(HE)staining was used to assess morphological changes of fat cells of BAT,iWAT,and epididymal white adipose tissue(eWAT).Results The transcriptomic signatures related to cold-induced thermogenesis were obtained and the top 20 candidate compounds were identified by comparison with the LINCS dataset.Mice treated with withaferin A(WA)during the cold challenge exhibited elevated rectal temperatures and smaller adipocyte sizes compared to controls.Conclusion Our drug repurposing strategy,which connects transcriptional profiles with LINCS data,identifies potential compounds.WA enhances thermogenesis and metabolic activity in adipose tissue,which helps maintain body temperature,and improves cold tolerance during exposure to low temperatures.

Objective Analysis of the effects of relaxation training combined with exercise intervention in patients with colorectal cancer undergoing chemotherapy,aiming to provide reference for clinical nursing practice.Methods Using a convenience sampling method,80 colorectal cancer patients undergoing chemotherapy in the oncology ward of a tertiary A hospital in Changzhou,Jiangsu Province from November 2022 to November 2023 were selected as study subjects.Patients were divided into an experimental group and a control group using a random number table method,with 40 patients in each group.The experimental group received relaxation training combined with exercise interventionin addition to routine care provided to the control group.The control group received routine care.Differences in 6-minute walking distance,anxiety,depression and quality of life scores before and after six chemotherapy cycles were compared between the 2 groups.Results Finally,70 patients completed the intervention,with 35 patients in each group.After the intervention,there were differences in 6-minute walking distance,anxiety scores,depression scores,and overall health status scores between the 2 groups were all statistically significant(P＜0.001).Conclusion Relaxation training combined with exercise intervention can maintain exercise endurance in colorectal cancer patients undergoing chemotherapy and alleviate anxiety and depression to some extent,helping to improve patients' quality of life.