ObjectiveTo develop and evaluate an O-RADSbased multiparametric model integratingcontrast-enhanced US （CEUS） and the z-score standardized risk of ovarian malignancy algorithm （ROMA z-score） to improve the diagnostic accuracy for differentiating benign， borderline， and malignant ovarian epithelial tumors （OETs）. MethodsThis retrospective study included 129 patients with pathologically confirmed OETs between May 2018 and December 2024. Clinical variables （age， menopausal status， BMI， HE4， CA125） and sonographic features （conventional US and CEUS） were collected. Tumors were classified as benign， borderline， or malignant according to pathological findings. A random forest algorithm was used to contruct the predictive model. Receiver operating characteristic （ROC） curves were generated tocompare the diagnostic performance of O-RADS， O-RADS+CEUS， O-RADS+ROMA z-score， and O-RADS+ CEUS+ROMA z-score. ResultsAmong the 129 patients， 63 had benign tumors， 25 had borderline tumors， and 41 had malignant tumors. Compared with O-RADS alone， the combined O-RADS+CEUS+ROMA z-score model demonstrated superior diagnostic performance， with an AUC of 0.87 （95% CI： 0.79-0.95） vs. 0.64 （95% CI： 0.51-0.76）， P＜0.001， for differentiating benign from borderline tumors， and 0.90 （95% CI： 0.83-0.97） vs. 0.64 （95% CI： 0.50-0.78）， P＜0.001， for differentiating borderline from malignant tumors. The random forest analysis identified HE4， CA125 and CEUS features as the most important predictors，contributing 11.02， 8.82， 18.1 points， respectively， to the total importance score of 51.94. In the test cohort， the model achieved an overall diagnostic accuracy of 72.97%， with an AUC of 0.89（95%CI：0.77-1.00）， sensitivity of 67.06%， and specificity of 85.01%. ConclusionsO-RADS+CEUS+ROMA z-score multiparametric model demonstrated the highest diagnostic performance for in differentiating benign from borderline and borderline from malignant OETs. HE4， CA125 and CEUS features were identified as key predictive risk factors， supporting the role of this model in improving preoperative risk stratification of OETs.

Objective To investigate the effects of microRNA-34a(miR-34a-5p)on the progression of chronic lymphocytic leukemia(CLL)through the Wnt/β-catenin signaling pathway.Methods Human chronic B-cell leukemia MEC-1 cells were selected for experimentation.MEC cells were divided into two groups,group one:the p53 agonist group and the control group;group two:the control group,the miR-34a-5p mimic group and its corresponding negative control,the miR-34a-5p inhibitor group and its corresponding negative control,as well as the miR-34a-5p inhibitor+Wnt inhibitor XAV-939 group.The expression levels of miR-34a-5p in each group were measured using real-time fluorescence quantitative PCR(qPCR).Cell proliferation was assessed by CCK-8 assay,while cell migration ability was evaluated using Transwell migration assay.Dual-luciferase reporter assay was employed to validate the targeting relationships between p53 and miR-34a-5p,as well as between miR-34a-5p and Wnt1.Western blot analysis was used to detect the protein expressions of β-catenin and Cyclin D1,which were key components of the Wnt/β-catenin signaling pathway.Results In MEC-1 cells:① compared with the control group,there was a increased miR-34a-5p expression and inhibited cell proliferation in the p53 agonist group(P＜0.05).Dual-luciferase reporter assay confirmed a negative regulatory correlation between miR-34a-5p and p53.② the miR-34a-5p mimic group showed significantly upregulated miR-34a-5p expression compared to the control group,leading to suppressed cell proliferation,reduced migration capability and decreased protein expressions of β-catenin and Cyclin D1(P＜0.05).Conversely,the miR-34a-5p inhibitor group demonstrated significantly downregulated miR-34a-5p expression,resulting in enhanced cell proliferation,increased migratory capacity and upregulated protein levels of β-catenin and Cyclin D1 compared to those of the control group(P＜0.05).③ A targeting relationship was observed between miR-34a-5p and Wnt1.④ Compared with the miR-34a-5p inhibitor group,the XAV-939 group exhibited significantly upregulated miR-34a-5p expression,markedly decreased numbers of migrated cells and substantially reduced protein expression levels of β-catenin and Cyclin D1(P＜0.05).Conclusion miR-34a plays the role of a tumor suppressor gene in CLL.Overexpression of miR-34a can inhibit the Wnt/β-catenin signaling pathway,reduce the proliferation activity and migration ability of cells,and promote cell apoptosis.

Objective:To adapt and validate the Chinese version of the Supervisory Relationship Questionnaire(SRQ)and evaluate its psychometric properties among supervisees.Methods:Item analysis,exploratory factor anal-ysis(EFA)and confirmatory factor analysis(CFA)were conducted on data from 888 supervisees recruited via on-line platform.Test-retest reliability over a four-week interval was examined in a randomly selected subset of 70 su-pervisees.An additional sample of 367 supervisees completed the Supervisory Relationship Scale(SRS)to evaluate criterion validity.Results:The revised SRQ contained 65 items and 6 factors.Both exploratory factor analysis and confirmatory factor analysis supported six-factor structure(safe base,structure,commitment,reflective education,role model and formative feedback),explaining 66.52％of the variance,with factor loadings of the items ranging from 0.58 to 0.83.The revised SRQ had six factors with good fit indices(x2/df=1.31,GFI=0.81,NFI=0.87,CFI=0.97,TLI=0.90,IFI=0.91,RMSEA=0.03,SRMR=0.05).The scores of the revised SRQ were positively correlated with the scores of SRS(ICC=0.96,P＜0.01).The Cronbach α coefficient of the revised SRQ was 0.97,and the test-retest reliability coefficient(ICC)was 0.74.Conclusion:The SRQ-C demonstrates sound psy-chometric properties,including structural validity,criterion-related validity,internal consistency,and temporal stabil-ity.It is a reliable and valid instrument for assessing supervisory relationships from the supervisee perspective.

Objective:To investigate the current status and influencing factors of decision anxiety in guardians of children with acute appendicitis under Endoscopic retrograde appendicitis therapy (ERAT) background, and to provide reference for the development of targeted intervention programs for decision anxiety.Methods:Convenient sampling method was used to select 254 guardians of children with acute appendicitis treated in the Department of Pediatrics, Second Affiliated Hospital of PLA Air Force Medical University from February 2023 to April 2024. A cross-sectional survey was conducted using the General Data Questionnaire, the State-Trait Anxiety Inventory Form Y-State anxiety subscale and the Preparation for Decision Making Scale. Multiple linear regression was used to analyze the influencing factors in guardians of children with acute appendicitis.Results:Among the guardians of 254 children with acute appendicitis, 156 were males and 98 were females, aged (37.44 ± 3.63) years old. The decision anxiety score of guardians of children with acute appendicitis was (52.49 ± 6.54). The results of multiple linear regression showed that age of children, gender of guardian, education level of guardian, per capita monthly income of family, decision making tendency and decision preparation were the main influencing factors of decision anxiety in guardians of children with acute appendicitis ( t values were -7.07-3.58, all P<0.05), which could explain 64.4% of the total variation. Conclusions:The decision anxiety in guardians of children with acute appendicitis is at a high level. Medical staff should provide targeted decision guidance, improve decision assistance programs and provide more effective decision support for guardians of children with acute appendicitis.

A 57-year-old male patient with lung adenocarcinoma accompanied by brain metastasis received radiotherapy and chemotherapy with poor efficacy. Subsequently, he was given camrelizumab at a dose of 200 mg intravenously once every 21 days, combined with intermittent chemotherapy or targeted drug therapy. After 22 months, the patient developed right eye pain with visual loss. Slit lamp examination showed a transverse oval shallow ulcer with clear boundary, clean surface and a maximum diameter of about 6 mm in the center of the cornea of the right eye, with positive fluorescein staining. Immune-related corneal ulcers due to camrelizumab were considered. Camrelizumab was discontinued, and the patients′ ocular symptoms were gradually improved after systemic and local glucocorticoid and corneal repair drugs were given. Seven months later, due to the patient did not follow the doctor′s advice to replace eye drops, overuse of glucocorticoid occurred, resulting in perforation of the original ulcer. The glucocorticoid-containing eye drops was discontinued, the patient underwent amniotic membrane grafting combined with amniotic membrane patching on the right eye, and the patient's condition was improved.

Objective To investigate the application value of positive lateral pelvic lymph nodes combined with T2 mapping in the pathological grade and clinical stage of rectal cancer.Methods Eighty patients with rectal cancer diagnosed by pathology were selected as the study subjects.Among them,26 cases were well differentiated,21 cases were moderately differentiated,and 33 cases were poorly differentiated.According to the clinical stage,there were 17 cases of T1 stage,16 cases of T2 stage,20 cases of T3 stage and 27 cases of T4 stage.The differences in positive lateral pelvic lymph nodes and T2 value in different pathological grades and clinical stages of rectal cancer were compared.Pearson correlation analysis was used to evaluate the correlation between positive lateral pelvic lymph nodes and T2 value and pathological grade and clinical stage of rectal cancer.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of positive lateral pelvic lymph nodes and T2 value in the pathological grade of rectal cancer.Results There were significant differences in positive lateral pelvic lymph nodes and T2 value in different pathological grades and different clinical stages(P<0.05).The positive lateral pelvic lymph nodes was negatively correlated with T2 value(P<0.05).The T2 value was negatively correlated with pathological grade(P<0.05).The T2 value was also negatively correlated with clinical stage(P<0.05).The area under the curve(AUC)[95%confidence interval(CI)]of positive lateral pelvic lymph nodes combined with T2 value in the diagnosis of pathological grade and clinical stage were 0.800(0.635-0.957)and 0.779(0.583-0.981),respec-tively,demonstrated the highest diagnostic performance when used in combination.Conclusion The positive lateral pelvic lymph nodes combined with T2 mapping is helpful to evaluate the degree of differentiation and clinical stage of rectal cancer patients,which can provide valuable references for clinical treatment decisions and prognosis assessment of patients.

Intraocular ointment is conventionally placed on the eye to prevent infection after cataract surgery. The purpose of this study is to report a case and conduct a systematic review of a rare occurrence of the entry of intraocular ointment after cataract surgery. PubMed, Scopus, Embase, CNKI, WANFANG data, China Science and Technology Journal Database and Chinese Medical Journal Full-text Database were systematically searched from their commencement to 30th October 2023, and 19 literatures were screened out and 31 cases of intraocular ointment after surgery were collected. Among the 31 patients, the age of presentation ranged from 55 to 87 years with a median of 73, males accounted for 45.2% and females accounted for 32.3%. The length of the incision was generally 3.2 mm. Most of the patients detected ointment within 3 days post-operation and presented without complications(45.2%). The most common ocular manifestations were corneal edema, glaucoma and uveitis. Early postoperative follow-up is very important. Presence of anterior chamber ointment is a rare complication after cataract surgery, but it can lead to severe vision loss if not detected and treated on time. When patients complain of foreign body sensation in the in the eye after cataract surgery, ophthalmologists need to take a kin interest and examine the eye for early detection of ointment for appropriate intervention and prevent further complications.

Intraocular ointment is conventionally placed on the eye to prevent infection after cataract surgery. The purpose of this study is to report a case and conduct a systematic review of a rare occurrence of the entry of intraocular ointment after cataract surgery. PubMed, Scopus, Embase, CNKI, WANFANG data, China Science and Technology Journal Database and Chinese Medical Journal Full-text Database were systematically searched from their commencement to 30th October 2023, and 19 literatures were screened out and 31 cases of intraocular ointment after surgery were collected. Among the 31 patients, the age of presentation ranged from 55 to 87 years with a median of 73, males accounted for 45.2% and females accounted for 32.3%. The length of the incision was generally 3.2 mm. Most of the patients detected ointment within 3 days post-operation and presented without complications(45.2%). The most common ocular manifestations were corneal edema, glaucoma and uveitis. Early postoperative follow-up is very important. Presence of anterior chamber ointment is a rare complication after cataract surgery, but it can lead to severe vision loss if not detected and treated on time. When patients complain of foreign body sensation in the in the eye after cataract surgery, ophthalmologists need to take a kin interest and examine the eye for early detection of ointment for appropriate intervention and prevent further complications.

Objective To investigate the effects of high-altitude hypoxic environment on the pharmacokinetic characteristics and brain tissue distribution of phenytoin sodium in epileptic rats.Methods A total of 70 male SPF-grade Wistar rats aged 2 months and weighing(200±20)g were used in the study.An epilepsy model was induced in the rats using the lithium chloride-pilocarpine method.The successfully modeled rats were randomly assigned to a normoxic treatment group and a high-altitude hypoxic treatment group.Phenytoin sodium was administered via intragastric gavage at a dose of 50 mg/kg in both groups.Blood samples were collected from the orbital venous plexus before treatment and 0.5,1,2,3,4,6,8,10,and 24 h post treatment.The animals were euthanized after the final blood collection,and samples of the liver and the whole brain tissue were collected.In the brain tissue distribution experiment,brain tissue samples were collected at 0.5,1,2,and 4 h after drug administration.The concentration of phenytoin sodium in rat plasma and brain tissue was determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS),and the pharmacokinetic parameters were calculated using WinNolin 8.1 software.The expression levels of CYP2C9 in liver tissue and those of P-gp in brain tissue of epileptic rats were determined by Western blot.Results Compared with those in the normoxia group,the peak concentration,peak time,and half-life of phenytoin sodium in the high-altitude hypoxia group were significantly decreased by 46.0%,42.3%,and 55.5%,respectively(all P<0.05);the clearance rate was significantly increased by 162.0%(P<0.05);and the area under the curve of plasma concentration-time curve was decreased by 45.6%(P<0.01).At 0.5,1,and 2 hours after administration,compared with that in the normoxia treatment group,the concentration of phenytoin sodium in the brain tissue of the high-altitude hypoxia treatment group was significantly decreased by 78.1%,63.5%,and 32.5%,respectively(all P<0.05).Western blot results showed that the expression levels of CYP2C9 in the liver tissue and P-gp in the brain tissue of rats in the high-altitude hypoxia group were approximately 1.78 and 1.65 times higher than those in the normoxia group,respectively(both P<0.05).Conclusion The hypoxic environment at high altitudes can promote the metabolism of phenytoin sodium,reduce its absorption efficiency,and change the characteristics its distribution in the brain,which may be related to the up-regulation of the expression of CYP2C9 in the liver and that of P-gp in the brain.

OBJECTIVE To investigate the effects of Ephedra-Cinnamomum couplet medicinals on respiratory function and airway inflammation in rats with asthma of cold-fluid retention in lung syndrome and its mechanism. METHODS Sixty Wistar rats were randomly divided into blank group， model group， dexamethasone group [1 mg/（kg·d）]， and Ephedra-Cinnamomum low-， medium-， high-dose groups [0.234， 0.936， 1.872 g/（kg·d）]， with 10 rats in each group. The model and treatment groups were sensitized by intraperitoneal injection of antigen solution （ovalbumin 100 mg + aluminum hydroxide 100 mg） and challenged with 1% ovalbumin nebulization， along with exposure to a cold environment and ingestion of cold water， to establish the asthma model with cold-fluid retention in lung syndrome. From day 2， rats received corresponding drugs or normal saline intragastrically， once a day， for 21 consecutive days. The general behavioral changes in each group of rats were observed during the experimental process. The lung function parameters [peak expiratory flow （PEF）， airway resistance （Raw）， functional residual capacity （FRC）， expiratory flow at 50% of forced vital capacity （EF50%）] Δ 基金项目 国家自然科学基金青年科学基金项目（No.82004233）； were measured before modeling and after the last medication as well as serum contents of interleukin-6 （IL-6）， IL-13， tumor necrosis factor- α （TNF- α） and interferon-gamma （IFN- γ） after the last medication were determined； the histopathological morphological changes in the lung tissues of rats were also observed； mRNA expressions of IL-6， IL-3， TNF-α， IFN-γ， thymic stromal lymphopoietin （TSLP）， and Toll-like receptor 4 （TLR4）， as well as protein expressions of TSLP and TLR4 were determined in lung tissue. RESULTS Compared with model group， the lung tissue damage of rats was relieved significantly； Raw， FRC， the contents and mRNA expression levels of IL-6， IL-13 and TNF-α， as well as the mRNA and protein expressions of TSLP and TLR4 were significantly decreased （P＜0.05）， while the contents and mRNA expressions of PEF， EF50 % and IFN-γ were significantly increased in the dexamethasone group and Ephedra-Cinnamomum medium- and high-dose groups （P＜0.05）. Moreover， only a few rats in the two groups exhibited typical symptoms of asthma. CONCLUSIONS Ephedra-Cinnamomum couplet medicinals improve respiratory function and ameliorate airway inflammation in asthma rats with cold-fluid retention in lung syndrome， the mechanism of which may be associated with inhibiting TSLP/TLR4 signaling pathway and modulating Th1/Th2 imbalance.