Objective:To investigate the efficacy and safety of R0 surgery combined with PARP inhibitors in the treatment of advanced epithelial ovarian cancer in 52 patients.Methods:A retrospective analysis was performed on 104 patients with International Federation of Gynecology and Obstetrics Ⅲ-Ⅳ epithelial ovarian cancer who received treatment at the Department of Gynecology and Obstetrics, Xinhua Hospital, Huainan Xinhua Medical Group from January 2021 to December 2023. The patients were divided into a control group and an observation group ( n = 52/group). Patients in the control group underwent non-R0 surgery followed by six cycles of chemotherapy with platinum and paclitaxel, along with maintenance therapy using olaparib or niraparib. Patients in the observation group underwent R0 surgery followed by the same chemotherapy and maintenance therapy as those in the control group. Comparisons were made between the two groups regarding general data, perioperative conditions, and postoperative levels of cancer antigen 125, human epididymis protein 4, vascular endothelial growth factor, interleukin-15, gamma interferon, and recurrence rates measured within 1 year after chemotherapy. Results:There was no statistically significant difference in age, underlying diseases, or pathological types according to International Federation of Gynecology and Obstetrics staging between the two groups (all P > 0.05). However, compared with the control group, the observation group had a longer surgical time [(290.17 ± 36.72) minutes vs. (206.58 ± 22.57) minutes, t = 171.20, P < 0.001]. The intraoperative blood loss in the observation group was significantly greater than that in the control group [(800.44 ± 134.22) mL vs. (743.16 ± 87.85) mL, t = 1 094.00, P = 0.003]. The interval between surgery and the start of chemotherapy in the observation group was longer than that in the control group [(13.00 ± 0.94) days vs.(12.04 ± 0.92) days, t = 3.07, P < 0.001]. There was no statistically significant difference in postoperative complications ( P > 0.05). Compared with the control group, the observation group had lower levels of cancer antigen 125 [(14.27 ± 2.16) IU/mL vs. (188.57 ± 30.74) IU/mL, t = 40.794, P < 0.001], human epididymis protein 4 [(25.29 ± 2.49) pmol/L vs. (74.21 ± 0.52) pmol/L, t = 138.68, P < 0.001], vascular endothelial growth factor [(23.70 ± 3.01) ng/mL vs. (51.66 ± 4.67) ng/mL, t = 36.28, P < 0.001], and recurrence rate [17.30% (9/52) vs. 88.46% (46/52), χ2 = 52.83, P < 0.001]. Compared with the control group, the observation group showed higher levels of interleukin-15 [(57.36 ± 9.48) pg/mL vs. (24.24 ± 4.04) pg/mL, t = -23.17, P < 0.001] and gamma interferon [(50.16 ± 4.43) pg/mK vs. (12.99 ± 1.30) pg/mL, t = -763.17, P < 0.001]. Conclusions:R0 surgery is effective and safe. R0 surgery followed by maintenance therapy with PARP inhibitors can significantly improve chemotherapy outcomes and delay tumor recurrence in patients with advanced epithelial ovarian cancer non-R0 surgery combined with chemotherapy plus maintenance therapy with PARP inhibitors.

Objective To investigate the factors that influence ocular surface biology and visual acuity in individuals with diabetic dry eye(DDE)and analyze how these factors contribute to changes in visual quality.Methods Based on the disease duration,fasting blood glucose(FBG),and glycated hemoglobin(HbA1c)levels of patients with type 2 diabe-tes mellitus(T2DM),the DDE patients were divided into different groups.Logistic regression analysis was used to identify influencing factors related to ocular surface biology and visual quality in each group of DDE patients.Tear film stability was evaluated based on the tear film rupture time(BUT),Schirmer I test(SIt),and ocular surface disease index(OSDI).Lip-iview? Surface interferometers were used to measure tear film lipid layer thickness(LLT),meibomian gland loss rate(MGP),meibomian gland opening number(MGYLS),and meibomian gland secretion score(MGYSS).Wavefront aber-rometry was used to measure corneal wavefront aberration values at 4 mm and 6 mm pupil diameters.Ocular response ana-lyzer(ORA)was adopted to analyze corneal hysteresis(CH)and corneal resistance factor(CRF).Moreover,ELISA ex-periment to evaluate the trend of changes in inflammatory factors in tears.Results Logistic regression analysis revealed that T2DM duration,smoking history,FBG,HbA1c,total cholesterol(TC),triglycerides(TG),OSDI score,LLT,BUT,SIt,MGP,MGYLS,MGYSS,total higher-order aberrations,spherical aberration,coma aberration,trefoil aberration,tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insu-lin were all influencing factors for the risk of DDE(all P＜0.05).As the T2DM course prolonged and FBG or HbA1 c levels rose,tear film-related indicators(LLT,BUT,and SIt)and meibomian gland-related indicators(MGYLS and MGYSS)inpa-tients gradually decreased,while OSDI scores and MGP gradually increased(all P＜0.05).As the T2DM course prolonged and FBG or HbA1c levels rose,the total higher-order aberrations,spherical aberration,coma aberration,and trefoil aber-ration in DDE patients under 4 mm and 6 mm pupil diameters gradually increased;Meanwhile,best corrected visual acuity,corneal hysteresis,and corneal resistance factor gradually decreased;The contents of tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insulin in tears all gradually increased,while mucin-5AC gradually decreased(all P＜0.05).Conclusion With the prolongation of T2DM duration and the in-crease of FBG or HbA1c,the ocular surface inflammatory response in DDE patients gradually worsens,corneal biological function decreases,and visual quality deteriorates.Timely systemic and local interventions are of great significance for im-proving dry eye symptoms and visual quality in DDE patients.

Objective To investigate the factors that influence ocular surface biology and visual acuity in individuals with diabetic dry eye(DDE)and analyze how these factors contribute to changes in visual quality.Methods Based on the disease duration,fasting blood glucose(FBG),and glycated hemoglobin(HbA1c)levels of patients with type 2 diabe-tes mellitus(T2DM),the DDE patients were divided into different groups.Logistic regression analysis was used to identify influencing factors related to ocular surface biology and visual quality in each group of DDE patients.Tear film stability was evaluated based on the tear film rupture time(BUT),Schirmer I test(SIt),and ocular surface disease index(OSDI).Lip-iview? Surface interferometers were used to measure tear film lipid layer thickness(LLT),meibomian gland loss rate(MGP),meibomian gland opening number(MGYLS),and meibomian gland secretion score(MGYSS).Wavefront aber-rometry was used to measure corneal wavefront aberration values at 4 mm and 6 mm pupil diameters.Ocular response ana-lyzer(ORA)was adopted to analyze corneal hysteresis(CH)and corneal resistance factor(CRF).Moreover,ELISA ex-periment to evaluate the trend of changes in inflammatory factors in tears.Results Logistic regression analysis revealed that T2DM duration,smoking history,FBG,HbA1c,total cholesterol(TC),triglycerides(TG),OSDI score,LLT,BUT,SIt,MGP,MGYLS,MGYSS,total higher-order aberrations,spherical aberration,coma aberration,trefoil aberration,tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insu-lin were all influencing factors for the risk of DDE(all P＜0.05).As the T2DM course prolonged and FBG or HbA1 c levels rose,tear film-related indicators(LLT,BUT,and SIt)and meibomian gland-related indicators(MGYLS and MGYSS)inpa-tients gradually decreased,while OSDI scores and MGP gradually increased(all P＜0.05).As the T2DM course prolonged and FBG or HbA1c levels rose,the total higher-order aberrations,spherical aberration,coma aberration,and trefoil aber-ration in DDE patients under 4 mm and 6 mm pupil diameters gradually increased;Meanwhile,best corrected visual acuity,corneal hysteresis,and corneal resistance factor gradually decreased;The contents of tumor necrosis factor-α,interleukin-6,matrix metalloproteinase-9,receptor for advanced glycation end products,and insulin in tears all gradually increased,while mucin-5AC gradually decreased(all P＜0.05).Conclusion With the prolongation of T2DM duration and the in-crease of FBG or HbA1c,the ocular surface inflammatory response in DDE patients gradually worsens,corneal biological function decreases,and visual quality deteriorates.Timely systemic and local interventions are of great significance for im-proving dry eye symptoms and visual quality in DDE patients.

Objective:To examine frailty in residents aged over 50 in the Chengdu community, investigate the risk factors linked to frailty, and analyze the impact of exercise habits on frailty.Methods:This retrospective study utilized a stratified whole-sample method to select Chengdu residents aged over 50 from 6 communities.Relevant information was collected through face-to-face interactions using a self-developed frailty questionnaire between May 2022 and May 2023.Exercise habits were defined as engaging in physical activity more than three times a week for at least 30 minutes per session, consistently maintained for a minimum of five years prior to the survey.The frailty index(FI)was established based on the multiple-deficit cumulative model.Respondents were classified into categories of no frailty(FI<0.1), mild frailty(0.1 ≤ FI<0.2), and moderate-severe frailty(FI≥0.2).Univariate and multivariate logistic regression analyses were conducted to investigate the factors influencing frailty and to compare the prevalence and progression of frailty among individuals with and without exercise habits across different age groups.Results:A total of 999 participants, comprising 483(48.3%)males and 516(51.7%)females, were enrolled in the study.The average age of the participants was 65.70±9.61 years.Among them, 346(34.6%)were classified as having mild frailty, while 107(10.7%)had moderate-severe frailty.Univariate analysis revealed that age, gender, marital status, education, smoking, alcohol consumption, and exercise habits were potential factors influencing frailty( P<0.05).Multifactorial logistic regression models indicated that individuals aged 70-79 and 80-85 were predictors of mild and moderate-severe frailty, respectively.Being female was identified as an independent risk factor for both mild frailty( OR: 1.196; 95% CI: 1.262-3.073)and moderate-severe frailty( OR: 2.721; 95% CI: 1.282-5.774).Additionally, not engaging in regular exercise was associated with an increased risk of mild frailty( OR: 1.588; 95% CI: 1.149-2.193)and moderate-severe frailty( OR: 3.186; 95% CI: 1.819-5.583).Statistical analysis revealed significant differences in frailty distribution and frailty index changes between individuals with and without exercise habits over the age of 60( P<0.05). Conclusions:Age and gender were found to be closely associated with frailty, with the impact of exercise habits on frailty becoming more pronounced after the age of 60.Encouraging middle-aged and older individuals to adopt regular exercise routines can play a significant role in promoting healthy aging in China.

Objective:To explore the application of Symptom Checklist-90 (SCL-90) combined with the Eysenck Personality Questionnaire (EPQ) scors in diagnosis of mental disorders.Methods:This was a cross-sectional study. A total of 2 569 psychiatric outpatients aged 18-35 years who visited the Mental Health Center of Tongji Hospital from 2010-2020 were included in the study. Patients were diagnosed according the International Classification of Diseases 10th Edition (ICD-10). The psychiatric diagnoses included depressive disorders, anxiety disorders, sleep disorders, bipolar disorder, schizophrenia, stress-related and adjustment disorders, and obsessive-compulsive disorder. The diagnostic value of SCL-90 and EPQ scores for psychiatric disorders of patients was examined with univariate multivariate logistic regression analysis, and evaluated with ten-fold cross-validation, and receiver operating characteristic (ROC) curves.Results:Among the subjects, 921 were male (35.9%) and 1 648 were female (64.1%), with a mean age of (26.83±4.59) years.The main mental disorders were depressive disorders (42.1%, 1 081/2 569) and anxiety disorders (31.4%, 806/2 569). Stepwise logistic regression analysis showed that the highest diagnostic efficacy was for sleep disorders [area under the curve ( AUC)=0.795], significantly with obsessive-compulsive, depression, and anxiety factors of the SCL-90 (all P<0.05); followed by depressive disorders ( AUC=0.751), significantly with the female gender, depression, anxiety, and hostility factors of the SCL-90, and the introversion-extroversion factor of the EPQ (all P<0.05). There were moderate diagnostic efficacy for bipolar disorder ( AUC=0.712) and stress-related disorders ( AUC=0.703), and relatively poor diagnostic performance for anxiety disorders and obsessive-compulsive disorder ( AUC=0.702, 0.661). Conclusion:The combination of SCL-90 and EPQ demonstrates moderate to high diagnostic efficacy for common psychiatric disorders, indicating that it may be used in clinical mental health assessments.

Radiotherapy can cause varying degrees of damage to surrounding normal tissues while treating tumors. In recent years, single-cell RNA sequencing (scRNA-Seq), an emerging technology in modern biology, has gradually played a significant role in research on radiation-induced injuries. Researchers have delved into a variety of radiation-induced brain injuries, including radiation-induced brain injury (RIBI), cardiovascular injury, lung injury, intestinal injury, skin injury, and hematopoietic injury. Their studies provide novel perspectives for revealing the mechanisms behind radiation-induced injuries, assessing the degree of injury, and exploring potential therapies. This study reviews the advances in the application of scRNA-seq to research on radiation-induced injuries.

Objective·To investigate the role and mechanism of sirtuin 5(SIRT5)in pulmonary microvascular endothelial cell injury in sepsis.Methods·Wild-type(WT)and Sirt5 gene knockout C57BL/6 male mice underwent cecal ligation and puncture(CLP)surgery.Following euthanasia,lung tissues were collected.Pulmonary inflammation was assessed using hematoxylin and eosin(H-E)staining;vascular leakage was evaluated by Evans blue(EB)staining;coagulation function in mice was analyzed via immunofluorescence staining of lung tissues.Immunohistochemical staining was employed to detect vascular cell adhesion molecule-1(VCAM-1)protein expression,thereby assessing endothelial inflammation in CLP-treated mice.By using gene editing technology,SIRT5 was knocked down or overexpressed in human umbilical vein endothelial cells(HUVECs),and the cells were subsequently stimulated with lipopolysaccharide(LPS)to induce endothelial inflammation.Protein expression levels of VCAM-1,tissue factor(TF),and other endothelial injury markers were detected by Western blotting,and inflammatory cytokines such as interleukin-6(IL-6)and IL-1β,were detected by quantitative real-time PCR(qPCR).In addition,transcriptomic sequencing was performed on HUVECs overexpressing SIRT5,and key genes including F2R-like thrombin or trypsin receptor 3(F2RL3),serpin family A member 3(SERPINA3),and transforming growth factor β2/β3(TGF-β2/3)were validated by qPCR.Results·Sirt5 knockout significantly aggravated lung injury in CLP mice,reducing their survival rates(P<0.001).H-E staining showed increased inflammatory infiltration in the lung tissue of the mice,while EB staining indicated increased vascular leakage(P<0.001).Immunofluorescence revealed elevated fibrinogen deposition.In HUVECs with SIRT5 knockdown,the protein levels of VCAM-1 and TF,as well as the mRNA levels of inflammatory factors including IL-6,IL-1β,VCAM-1,and E-selectin,were significantly upregulated(all P<0.001),whereas overexpression of SIRT5 reversed these effects.Transcriptome sequencing analysis indicated that SIRT5 regulated endothelial inflammation and coagulation responses by inhibiting the F2RL3/SERPINA3/TGF-β pathway.Conclusion·SIRT5 negatively regulates the F2RL3/SERPINA3/TGF-β signaling axis,thereby alleviating endothelial inflammation and promoting coagulation responses,suggesting its potential protective role in sepsis-induced lung injury.

Objective:To investigate the effect of ear acupoint bean pressing on gastrointestinal motility and related hormones after laparoscopic surgery in patients with hysteromyoma,and to explore the therapeutic mechanism of ear acupoint bean pressing.Methods:Patients undergoing laparoscopic myomectomy in the Department of Gynecology of The People's Hospital Affiliated to Fujian Univer-sity of Traditional Chinese Medicine from May 2022 to December 2023 were randomly divided into an experimental group and a control group,with 57 patients in each group.The experimental group was treated with postoperative routine nursing and ear acupoint bean pressing(targeting the spleen,stomach,and sympathetic),and the control group was treated with postoperative routine nursing and sham ear acupoint bean pressing(containing no Vaccaria seed,targeting the spleen,stomach,and sympathetic).After the intervention,the time to first postoperative passing of flatus and defecation,clinical efficacy,and changes in gastrointestinal hormone levels were compared between the two groups.Results:The time to first postoperative passing of flatus[20.31(17.52,22.38)h vs.21.51(18.53,28.15)h]and defecation[35.32(31.47,39.17)h vs.38.12(33.44,42.78)h]in the experimental group was lower than that in the control group(P<0.05),and the clinical efficacy was better than that in the control group(P<0.05).There were no significant differ-ences in motilin(MTL),gastrin(GAS),somatostatin(SS),and substance P(SP)levels between the two groups before operation(P>0.05).The MTL and GAS levels were increased and the SS and SP levels were decreased after operation.The MTL[(451.52±54.33)pg/mL vs.(476.24±56.35)pg/mL]and GAS[150.50(133.93,164.52)pg/mL vs.173.44(154.45,184.63)pg/mL]levels at 24 h after operation in the experimental group were lower than those in the control group(P<0.05),and the SS[38.34(33.24,40.23)pg/mL vs.33.36(29.13,38.76)pg/mL]level at 24 h after operation was higher than that in the control group(P<0.05),with no significant change in the SP level(P>0.05).The results of repeated measures analysis of variance and generalized estimation equation showed that there were significant differences in the time effect and interaction effect of MTL(P<0.05),a significant difference in the time effect of SP(P<0.05),and significant differences in the time effect,intergroup effect,and interaction effect of GAS and SS(P<0.05).Conclusion:Ear acupoint bean pressing has significant effect on abdominal distension after laparoscopic surgery in patients with hysteromyoma,ef-fectively regulates the level of gastrointestinal motility related hormones,and promotes the recovery of gastrointestinal function.

OBJECTIVES: To develop a risk prediction model for the transformation of chronic atrophic gastritis to high-grade intraepithelial neoplasia (HGIN) based on traditional Chinese medicine (TCM) syndrome patterns. METHODS: Clinical data of 201 chronic atrophic gastritis patients who visited the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine and Dong'erhuan Branch between January 2022 and March 2023 were retrospectively analyzed, including 32 patients with HGIN (HGIN group) and 169 patients with moderate and severe chronic atrophic gastritis (non-HGIN group). The information of demographic characteristics, dietary habits, lifestyle factors, social and psychosocial factors, family history of tumors, medical history and comorbidities, long-term medication, endoscopic findings, histopathological examination results, as well as TCM syndrome types were collected. Potential HGIN risk factors were screened using LASSO regression, and the significant risk factors for establishing an HGIN risk prediction model were identified using logistic regression analysis. The final model was visually presented using a nomogram, and its diagnostic performance was evaluated through receiver operating characteristic curve analysis. RESULTS: Spleen-stomach Qi deficiency was the most common TCM syndrome in both HGIN and non-HGIN groups. LASSO-logistic regression model analysis showed that heavy alcohol consumption (X1), syndrome of static blood in stomach collaterals (X2), low-grade intraepithelial neoplasia (X3), high-salt diet (X4), and age (X5) were independent risk factors related to the occurrence of HGIN, and the predictive model was ln［P/(1－P)］=2.159X1+2.230X2+1.664X3+2.070X4+0.122X5- 11.096. The model demonstrated good discriminative ability, calibration, and goodness-of-fit, with area under the curve values of 0.940 and 0.891 in the training and validation sets, respectively. CONCLUSIONS The TCM syndrome of static blood in stomach collaterals shows correlation with the transformation from chronic atrophic gastritis to HGIN. The HGIN prediction model based on TCM syndrome patterns developed in the study demonstrates potential value in clinical application.
Humans ; Gastritis, Atrophic/diagnosis* ; Medicine, Chinese Traditional ; Retrospective Studies ; Female ; Male ; Middle Aged ; Stomach Neoplasms/diagnosis* ; Adult ; Risk Factors ; Carcinoma in Situ/diagnosis* ; Aged ; Nomograms ; Chronic Disease ; Logistic Models

Medical equipment, as an important indicator of smart hospital evaluation, plays a vital role in hospital operations. To ensure the safe and efficient operation of medical equipment, a reasonable performance evaluation system is indispensable. This study introduces a platform based on Internet of Things (IoT) technology that connects medical devices and collects data, achieving standardized and structured data processing, and supporting online operational supervision. Through the Delphi method, a performance evaluation system for large medical equipment is constructed, including 4 primary indicators and 22 secondary indicators. DICOM data acquisition devices are used to achieve functions such as efficiency analysis, benefit analysis, usage evaluation, and decision-making support for medical equipment. The study is still in its early stages, and in the future, it is expected to integrate more types of equipment, achieve rational resource allocation, and significantly impact decision-making for the development of public hospitals.
Internet of Things ; Delphi Technique