High-grade endometrial stromal sarcoma(HGESS)is a rare but highly aggressive malignant tumor that poses a significant threat to women's reproductive health.It is associated with a poor clinical prognosis due to its high malignancy.HGESS exhibits diverse pathological morphologies,lacks specific immunohistochemical markers,and demonstrates various genetic alterations.These factors contribute to the challenges in achieving a definitive diagnosis,making accurate identification and diagnosis of this lesion particularly difficult.This article reviews the clinicopathologi-cal features,molecular characteristics,and key points for differential diagnosis of HGESS,aiming to enhance under-standing and awareness of this disease among clinicians and pathologists.

High-grade endometrial stromal sarcoma(HGESS)is a rare but highly aggressive malignant tumor that poses a significant threat to women's reproductive health.It is associated with a poor clinical prognosis due to its high malignancy.HGESS exhibits diverse pathological morphologies,lacks specific immunohistochemical markers,and demonstrates various genetic alterations.These factors contribute to the challenges in achieving a definitive diagnosis,making accurate identification and diagnosis of this lesion particularly difficult.This article reviews the clinicopathologi-cal features,molecular characteristics,and key points for differential diagnosis of HGESS,aiming to enhance under-standing and awareness of this disease among clinicians and pathologists.

Objective:To explore the prenatal ultrasound diagnostic features and prognosis of congenital megalourethra (CM).Methods:A retrospective analysis was conducted on the clinical data and prenatal ultrasound features of two fetuses with CM diagnosed and treated at the Affiliated Hospital of Jining Medical College from July to December 2023. Literature related to the prenatal diagnosis of fetal CM was searched using the Chinese keywords "megalourethra" and "congenital megalourethra" in CNKI, Wanfang, Yiigle, and VIP Chinese Journal Database; and the same keywords in English were used for the retrieval in PubMed, Embase, and Web of Science databases, with the search period from January 1, 1955, to December 31, 2023. Descriptive methods were used to analyze and summarize the prenatal ultrasound features, outcomes, and prognosis of all included cases.Results:(1) Cases from our hospital: Case 1, at 19 weeks of gestation, an ultrasound revealed the symptoms of penile urethral dilation and urinary tract obstruction, with the distal urethral opening visible. Case 2, at 17 weeks of gestation, an ultrasound showed the entire urethra of the fetus was dilated, particularly the penile urethra, with the urethral opening visible at the front end, and bilateral mild pyelectasis. Both cases were considered as fetal CM. The first case decided to terminate the pregnancy after examination at a higher-level hospital; the second case was re-examined two weeks later, showing linear separation of the penile urethra and significant relief in bilateral pyelectasis. Subsequent ultrasound examinations showed no significant changes, and a male infant was delivered by cesarean section at 37 weeks of gestation, with normal urination. (2) Literature review: A total of 54 fetal CM cases were retrieved, plus two cases from our hospital, making a total of 56 cases. Among the 56 cases, 49 cases (88%) were detected in the second trimester; penile urethral dilation was observed in all cases, with 54 cases (96%) being complicated by urinary system abnormalities, and 30 cases (54%) having other system abnormalities; 24 cases (43%) had oligohydramnios or no amniotic fluid. Eighteen cases (32%) resulted in the termination of pregnancy, one case (2%) involved intrauterine fetal death, and 37 cases (66%) resulted in live births, among which, six neonatal deaths occurred (all with oligohydramnios, three with renal dysplasia, two with increased renal parenchymal echogenicity, and one with impaired renal function). Among the 31 surviving cases, six experienced spontaneous resolution of fetal megalourethra in utero, with a favorable prognosis. Of the 20 cases with increased renal parenchymal echogenicity or renal dysplasia, nine (45%) resulted in termination of pregnancy, five (25%) in neonatal death, and among the six (30%) surviving infants, four underwent renal function tests, all showing renal impairment. Among the four cases detected in early pregnancy, two resulted in termination of pregnancy, one in neonatal death, and one infant developed end-stage renal disease.Conclusions:Fetal CM ultrasound images are characterized by dilatation of the penile urethra. Early detection, increased renal echogenicity or renal dysplasia, and oligohydramnios may be associated with adverse outcomes such as neonatal death or renal impairment.

Objective To investigate the neuroprotective effects and mechanisms of the alcoholic extract of the Yi drug(Rubia yunnanensis)on the Alzheimer's disease(AD)model of Caenorhabditis elegans(C.elegans).Methods Based on a transgenic C.elegans model of AD,the efficacy and mechanism of alcoholic extracts of Rubia yunnanensis against β-amyloid(Aβ)-induced toxic effects were explored.C.elegans were synchronized and divided into a control group and low and high dose groups of the alcoholic extract of Rubia yunnanensis to study the effects of the alcoholic extract of Rubia yunnanensis on C.elegans paralysis,lifespan,lipofuscin levels,behavior,growth and development,heat stress and oxidative stress,ROS levels,and Aβ aggregation,as well as the key transcription factors in the insulin/insulin-like growth factor 1 signaling pathway were investigated by GFP reporter gene worm assay and RNAi assay DAF-16 expression.Results Compared with the Control group,the intervention of the alcoholic extracts of Rubia yunnanensis could effectively improve the paralyzed phenotype of C.elegans(P<0.001),prolong the lifespan of C.elegans and reduce the level of lipofuscin in C.elegans significantly(P<0.001),improve the mobility of C.elegans significantly(P<0.001),and improve its resistance to oxidative stress and heat stress damage significantly(P<0.001),and reduce the level of ROS in C.elegans significantly(P<0.001),and reduce the deposition of Aβ protein in the head of C.elegans significantly(P<0.01),and had no effect on the growth and development of C.elegans(P>0.05),and also promoted the nuclear translocation of DAF-16 in the reporter gene C.elegans TJ356,and the effect of the alcoholic extracts of Rubia yunnanensis in delaying the degree of paralysis of C.elegans was lost after silencing the expression of C.elegans DAF-16 by RNAi,whereas the L4440 empty vector control group in the administration of Rubia yunnanensis alcohol extract significantly reduced the level of C.elegans paralysis(P<0.001).Conclusion The alcoholic extract of Rubia yunnanensis can significantly ameliorate the paralyzed phenotype in the C.elegans model of Alzheimer's disease with certain antioxidant,anti-aging and anti-Aβ protein activities,and the mechanism may be related to the activation of DAF-16,a downstream transcription factor of the insulin signaling pathway.

Objective:To analyze the association between remnant cholesterol (RC) and the risk of atherosclerotic cardiovascular disease (ASCVD) in community population in Shanghai.Methods:Using baseline and follow-up data from the Shanghai Suburban Adult Cohort and Biobank, individuals with ASCVD (including coronary heart disease, stroke, myocardial infarction, and peripheral artery disease) at baseline were excluded. A Cox proportional hazards regression model was employed to analyze the relationship between RC and ASCVD risk and the association under different LDL-C levels.Results:A total of 57 281 participants were included, with a median follow-up of 5.61 person-years. During the follow-up, 1 436 ASCVD events (2.51%) were recorded. After adjusting for potential confounders, individuals with moderate ( HR=1.18, 95% CI: 1.03-1.36) or high RC levels ( HR=1.32, 95% CI: 1.15-1.51) had an increased risk of ASCVD. The association was stronger in participants younger than 60 years-old (interaction P=0.048). Participants with RC ≥0.97 mmol/L and LDL-C <3.40 mmol/L demonstrated a 19% ( HR=1.19, 95% CI: 1.06-1.35) increased risk of ASCVD. When RC ≥0.97 mmol/L and LDL-C ≥3.40 mmol/L, ASCVD risk increased by 42% ( HR=1.42, 95% CI: 1.21-1.67). Conclusions:Elevated RC increases ASCVD risk, regardless of LDL-C levels. RC can serve as a valuable predictor and intervention target for ASCVD.

Objective To investigate the neuroprotective effects and mechanisms of the alcoholic extract of the Yi drug(Rubia yunnanensis)on the Alzheimer's disease(AD)model of Caenorhabditis elegans(C.elegans).Methods Based on a transgenic C.elegans model of AD,the efficacy and mechanism of alcoholic extracts of Rubia yunnanensis against β-amyloid(Aβ)-induced toxic effects were explored.C.elegans were synchronized and divided into a control group and low and high dose groups of the alcoholic extract of Rubia yunnanensis to study the effects of the alcoholic extract of Rubia yunnanensis on C.elegans paralysis,lifespan,lipofuscin levels,behavior,growth and development,heat stress and oxidative stress,ROS levels,and Aβ aggregation,as well as the key transcription factors in the insulin/insulin-like growth factor 1 signaling pathway were investigated by GFP reporter gene worm assay and RNAi assay DAF-16 expression.Results Compared with the Control group,the intervention of the alcoholic extracts of Rubia yunnanensis could effectively improve the paralyzed phenotype of C.elegans(P<0.001),prolong the lifespan of C.elegans and reduce the level of lipofuscin in C.elegans significantly(P<0.001),improve the mobility of C.elegans significantly(P<0.001),and improve its resistance to oxidative stress and heat stress damage significantly(P<0.001),and reduce the level of ROS in C.elegans significantly(P<0.001),and reduce the deposition of Aβ protein in the head of C.elegans significantly(P<0.01),and had no effect on the growth and development of C.elegans(P>0.05),and also promoted the nuclear translocation of DAF-16 in the reporter gene C.elegans TJ356,and the effect of the alcoholic extracts of Rubia yunnanensis in delaying the degree of paralysis of C.elegans was lost after silencing the expression of C.elegans DAF-16 by RNAi,whereas the L4440 empty vector control group in the administration of Rubia yunnanensis alcohol extract significantly reduced the level of C.elegans paralysis(P<0.001).Conclusion The alcoholic extract of Rubia yunnanensis can significantly ameliorate the paralyzed phenotype in the C.elegans model of Alzheimer's disease with certain antioxidant,anti-aging and anti-Aβ protein activities,and the mechanism may be related to the activation of DAF-16,a downstream transcription factor of the insulin signaling pathway.

Objective: To establish a method for determining the molecular weight and molecular weight distribution of Poly(Lactide-co-Glycolide Acid) (PLGA) using Size Exclusion Chromatography-Refractive Index-Multiangle Laser Light Scattering (SEC-RI-MALLS) and Size Exclusion Chromatography-Refractive Index (SEC-RID), and to compare the results obtained from these two methods.
Methods: For SEC-RI-MALLS, tetrahydrofuran was used as the mobile phase, Shodex GPC KF-803L was employed as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, and an injection volume of 100 μL. For SEC-RID, tetrahydrofuran was also used as the mobile phase, Agilent PLgel 5 μm MIXD-D was used as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, differential detector temperature at 35 ℃, and an injection volume of 20 μL. The molecular weight and molecular weight distribution were calculated using Agilent’s GPC software. The newly established methods were validated methodologically, and the molecular weight and molecular weight distribution of 13 batches of samples were determined.
Results: The precision, accuracy, stability, and repeatability tests for SEC-RI-MALLS showed RSD values of 1.35%, 1.58%, 1.53%, and 1.26%, respectively. The SEC-RID method exhibited good linearity (r=0.999 9), with RSD values for precision, accuracy, stability, and repeatability tests (n=6) of 2.05%, 1.62%, 1.30%, and 2.97%, respectively. The results obtained from SEC-RI-MALLS were lower than those from SEC-RID, and the molecular weight distribution coefficient was smaller, but the results from the paired T-test performed with the value measured by SEC-RID method and the value measured by SEC-RI-MALLS method multiplied a conversion coefficient of 1.5 showed no significant difference between the two methods.
Conclusion: Both methods are stable and reliable, and can be used for the determination of PLGA molecular weight and molecular weight distribution based on the specific situations.

ObjectiveTo develop a reliable and valid health self-management competence assessment questionnaire for primary and secondary school students in Shanghai, so as to provide an effective tool to evaluate and improve their health management competencies. MethodsBased on the theory and process of scale development, an initial item pool was formed. After two rounds of Delphi consultation with 22 experts in related fields, assessment indicators suitable for evaluating the health self-management ability of Shanghai primary and secondary school students were determined. A total of 666 students were selected using stratified cluster sampling method to carry out the survey. The questionnaire content was refined and items were screened for reliability and validity analyses. ResultsAfter the two rounds of Delphi expert consultation, the original three-dimensional structure (individual management behaviors, personal health cognition and self-management environment) was revised into four dimensions: self-health cognition, self-health skills, self-will quality and self-action level. The initial 50 items were reduced, merged, or newly created, yielding a final 30-item questionnaire. Expert response rates for the two rounds of Delphi consultation were 86.36% and 90.91%, respectively, with an expert authority coefficient of 0.91. The KMO value was 0.936 and Bartlett’s sphericity test yielded a P value of <0.001, indicating that the questionnaire demonstrated good construct validity. The results of internal consistency testing showed that the overall Cronbach’s α coefficient was 0.932, and the split-half reliability coefficient was 0.920. The Cronbach’s α coefficient of each dimension ranged from 0.716 to 0.884, and the split-half reliability coefficient ranged from 0.733 to 0.900. Finally, an evaluation scale with 30 items across 4 dimensions was constructed. ConclusionThe health self-management competence evaluation scale for primary and secondary school students in Shanghai demonstrates good homogeneity and high reliability. It can be used as a tool for evaluating the health self-management competency of primary and secondary school students in Shanghai and provide theoretical support for targeted health interventions.

Ovarian immature teratoma is a relatively rare malignant ovarian tumor that predominantly occurs in children, adolescents, and young adults. In clinical diagnosis and treatment, tumor marker detection and imaging examinations serve as crucial bases for differentiating mature and immature terotomas. A comprehensive preoperative evaluation followed by the selection of an appropriate surgical approach and extent is key to improving prognosis. Some studies have indicated that for stage Ⅰ ovarian immature teratoma, avoiding adjuvant chemotherapy under close follow-up does not increase the risk of recurrence or affect long-term survival of patients; however, for advanced-stage ovarian immature teratoma, standardized postoperative chemotherapy is still recommended. Some patients may experience benign-malignant transformation of malignant germ cell components after surgery, such as growing teratoma syndrome or squamous cell carcinoma transformation. Due to the rarity of ovarian immature teratoma, current understanding of its pathogenesis and clinical management remains limited. This paper provides a review focusing on key clinical issues related to ovarian immature teratoma and proposes corresponding diagnostic and therapeutic recommendations, aiming to offer references for promoting multidisciplinary collaboration and individualized treatment.

OBJECTIVES: To investigate the role of SF3B3 in gastric cancer (GC) progression and prognosis and its possible mechanisms. METHODS: SF3B3 expression levels in pan-cancer and GC were analyzed using TIMER2.0, GEPIA, and UALCAN databases and validated using immunohistochemistry in GC tissues. Survival curves of GC patients were established using Kaplan-Meier Plotter and the data of a patient cohort our hospital. The independent risk factors for 5-year postoperative survival were identified using Cox regression, and their predictive values were evaluated using ROC analysis. SF3B3-associated biological processes were predicted by bioinformatics enrichment analyses. In GC HGC-27 cells, the effects of lentivirus-mediated SF3B3 knockdown and overexpression on cell proliferation and migration were investigated, and the changes in the key glycolytic proteins and extracellular acidification rate (ECAR) were detected. The influence of SF3B3 expression level on tumorigenesis and glycolytic protein expression in vivo were evaluated in a nude mouse xenograft model. RESULTS: High expression of SF3B3 in GC was associated with poor patient prognosis (P<0.05). The factors affecting 5-year survival outcomes following gastric oncological resection included high SF3B3 expression, a CEA level ≥5μg/L, a CA19-9 level ≥37 kU/L, tumor stage T3-4, and lymph node metastasis stage N2-3 (P<0.05). Bioinformatics analysis showed significant enrichment of SF3B3 in glycolysis. In HGC-27 cells, SF3B3 knockdown significantly inhibited while SF3B3 overexpression enhanced cell proliferation, migration, and invasion. SF3B3 knockdown obviously decreased the expressions of HK2, PKM2 and LDHA proteins and ECAR in HGC-27 cells, whereas SF3B3 overexpression produced the opposite effect. In nude mouse xenograft models, SF3B3 knockdown significantly reduced tumor mass and downregulated expression of HK2, PKM2 and LDHA proteins, and SF3B3 overexpression induced the opposite changes. CONCLUSIONS SF3B3 overexpression is associated with poor prognosis of GC patients and promotes GC cell proliferation, migration and invasion possibly by enhancing glycolysis.
Stomach Neoplasms/diagnosis* ; Humans ; Cell Proliferation ; Prognosis ; Animals ; Mice, Nude ; Cell Line, Tumor ; Mice ; Cell Movement ; Male ; Female