Objective To investigate the efficacy of preoperative nebulized indocyanine green (ICG)-assisted thoracoscopic anatomical lesion resection (TALR) in treating pediatric congenital pulmonary airway malformation (CPAM). Methods A retrospective analysis was conducted on clinical data of 45 children with CPAM who underwent thoracoscopic surgery at the Third Affiliated Hospital of Zhengzhou University between June 2023 and March 2025. The patients were divided into an ICG group (preoperative nebulized ICG 0.5 mg/kg+TALR) and a non-ICG group (TALR under white light), with perioperative and postoperative recovery parameters compared between groups. Results A total of 45 children [22 males, 23 females; median age 7.4 (1.1-75.0) months] were enrolled. The ICG group (n=22) and non-ICG group (n=23) both achieved uneventful recoveries. Compared to the non-ICG group, the ICG group demonstrated significantly shorter surgical duration [91.3 (38.0-144.0) min vs. 100.0 (50.0-175.0) min, P=0.032], reduced intraoperative blood loss [3.0 (2.0-10.0) mL vs. 5.0 (1.0-10.0) mL, P=0.049], shorter postoperative drainage duration [2.7 (1.9-3.9) d vs. 3.4 (1.8-19.9) d, P=0.003], and shortened hospital stay [4.6 (2.9-9.8) d vs. 5.0 (3.9-21.5) d, P=0.013]. Residual lesions occurred in 2 patients from the non-ICG group but none in the ICG group. Intragroup comparisons revealed significant improvements in ratio of time to peak tidal expiratory flow to expiratory time, ratio of volume to peak tidal expiratory flow to expiratory volume, and tidal volume per kilogram after surgery in both groups (P<0.05), though intergroup differences showed no statistical significance (P>0.05). Conclusion Preoperative nebulized ICG administration facilitates lesion identification in CPAM, reduces technical difficulty of TALR, enhances therapeutic outcomes, and provides valuable assistance for performing TALR procedures.

Cardiac surgery is associated with high risks, significant trauma, and long recovery periods. With advances in cardiac surgery techniques, the mortality rate and incidence of complications have been steadily decreasing. Patient-reported outcomes have gradually become an important area of research in postoperative recovery of cardiac surgery. The use of patient-reported outcome measures (PROMs) in this field helps to reflect patients' physiological, psychological, and social functioning during recovery, and provides scientific evidence for clinical interventions, which may further improve prognosis and enhance patient recovery experience. This paper reviews the dimensions of PROMs in the field of cardiac surgery recovery, the current status of existing PROMs scales, and the progress of their application, while also identifies the limitations of the existing tools. Finally, it explores future research directions for PROMs in cardiac surgery patients.

ObjectiveTo investigate the incidence， glucolipid metabolism characteristics， and associated factors of postoperative overweight/obesity in children and adolescent with craniopharyngioma. MethodsA retrospective study was conducted using follow-up data from 44 patients （aged 0-18 years） diagnosed with craniopharyngioma who underwent surgical treatment and received follow-up care at Sun Yat-sen Memorial Hospital， Sun Yat-sen University， between January 2006 and February 2024. The incidence and glucolipid metabolism characteristics of overweight/obesity were summarized， and potential influencing factors were analyzed. ResultsA total of 44 patients were enrolled. The mean age at surgery was （8.57 ± 4.25） years， and the mean age at last follow-up was （16.02 ± 5.36 ）years. The mean follow-up duration was （7.45 ± 4.64） years （range， 8 months to 17.5 years）. The preoperative incidence of overweight/obesity was 40.91% （predominantly overweight， 27.27%）， which increased to 68.18% postoperatively （predominantly obesity， 50.00%）. Postoperatively， all patients （44/44， 100%） underwent fasting plasma glucose （FPG） testing， among whom 2 （4.55%） had impaired fasting glucose （IFG）. Fasting insulin （FINS） was measured in 20 patients， and insulin resistance was identified in 11 （55.00%）. Oral glucose tolerance testing （OGTT） with insulin release assessment was performed in 12 patients， and all （100%） exhibited abnormal insulin secretion， including 5 （41.67%） with hyperinsulinemia and 3 （25.00%） diagnosed with diabetes mellitus （DM）. All patients （44/44， 100%） underwent lipid profile assessment. The incidence of dyslipidemia was 81.82% （36/44）， including elevated non-high-density lipoprotein cholesterol （29/44， 65.91%）， hypertriglyceridemia （29/44， 65.91%）， low high-density lipoprotein cholesterol （22/44， 50.00%）， and mixed hyperlipidemia （13/44， 29.55%）. Logistic regression analysis indicated that preoperative overweight/obesity and postoperative abnormal glucose metabolism were significant factors associated with postoperative overweight/obesity. Compared with normal-weight patients， those with postoperative overweight/obesity had higher FINS levels （14.22 mU/L vs. 3.57 mU/L）， higher insulin resistance index（HOMA-IR） （2.88 vs. 0.52）， and a higher incidence of abnormal glucose metabolism （77.78% vs. 23.08%）. However， no significant difference was observed in the incidence of dyslipidemia （94.44% vs. 73.08%）. ConclusionsChildren and adolescent with craniopharyngioma exhibit a higher incidence of overweight/obesity than healthy peers preoperatively， which becomes more pronounced after surgery. This is accompanied by a high incidence of glucolipid metabolic disorders， placing these patients at increased risk of metabolic syndrome， which warrants clinical attention and regular metabolic assessment. In patients who develop postoperative obesity， particular attention should be given to the risk of glucose metabolism abnormalities， and further monitoring of glucose homeostasis is recommended.

ObjectiveTo investigate the effects of Ditantang on metabolic dysfunction-associated fatty liver disease （MAFLD） in rats by focusing on the regulation of glycogen synthesis mediated by the uridine diphosphate glucose （UDPG）-site-1-protease （S1P）-sterol regulatory element-binding protein （SREBP） axis. MethodsMAFLD was modeled in SD rats by feeding a high-fat diet for 12 weeks. Rats were randomized into a control group， a model group， low-， medium-， and high-dose （2.68， 5.36， and 10.72 g·kg^-1·d^-1， respectively） Ditantang groups， and a positive control （Yishanfu， 0.18 g·kg^-1·d^-1） group. Starting from week 9 of modeling， each treatment group received corresponding drug interventions via gavage. After the experiment， the serum levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were measured. The levels of TG， non-esterified fatty acids （NEFA）， glycogen， glucose-6-phosphate （G6P）， glucose-1-phosphate （G1P）， and UDPG in the liver tissue samples were measured by biochemical assay kits. Liver pathological morphology and lipid/glycogen deposition were observed via hematoxylin-eosin （HE） staining， oil red O staining， and Periodic acid-Schiff （PAS） staining. Immunofluorescence assay was conducted to detect the expression and localization of phosphoglucomutase-1 （Pgm1） and UDP-glucose pyrophosphorylase 2 （Ugp2） in the rat liver. Real-time PCR and Western blot were employed to quantify mRNA and protein levels， respectively， of key glycogen synthesis enzymes （Pgm1 and Ugp2）， key lipogenesis-related transcription factor SREBP and its target genes ［acetyl-CoA carboxylase （ACC）， fatty acid synthetase （FASN）， and stearoyl-CoA desaturase （SCD1）］， as well as S1P. ResultsCompared with the control group， the model group exhibited elevated levels of TC， TG， LDL-C in the serum and TG and NEFA in the liver， decreased serum HDL-C level （P<0.01）， reduced hepatic levels of G1P， G6P， UDPG， and glycogen （P<0.01）， appearance of fat vacuoles of varying sizes and abundant red lipid droplets， with prominent lipid deposition and reduced areas of deep glycogen staining in the liver tissue， upregulated mRNA and protein levels of SREBP1， S1P， ACC， FASN， and SCD1 （P<0.01）， and downregulated mRNA and protein levels of Pgm1 and Ugp2 （P<0.01）. Compared with the model group， all doses of Ditantang reduced the levels of TC and TG in the serum and TG and NEFA in the liver， while elevating the serum HDL-C level. Additionally， medium- and high-dose Ditantang reducted the LDL-C level （P<0.05）. Ditantang at all doses increased the hepatic levels of G1P， G6P， UDPG， and glycogen， alleviated hepatic steatosis and lipid deposition， enhanced glycogen storage， downregulated the mRNA and protein levels of SREBP1， S1P， ACC， FASN， and SCD1 （P<0.05）， while upregulating the expression of Pgm1 and Ugp2 （P<0.01）. Immunofluorescence analysis revealed decreased fluorescence intensity of S1P and enhanced fluorescence intensity of Ugp2 （P<0.01）. ConclusionDitantang can regulate glycogen synthesis through the UDPG-S1P-SREBP axis to prevent and treat MAFLD.

Objective To explore the valve regurgitation status of left heart after the implantation of left ventricular assist device (LVAD) and its effect on prognosis of patients with LVAD implantation. Methods A total of 35 patients with cardiomyopathy who underwent magnetic levitation LVAD implantation at Zhongshan Hospital, Fudan University from February 2021 to July 2024 were retrospectively selected. Clinical data during hospitalization were collected, including preoperative basic data and postoperative valve regurgitation status. Telephone follow-ups were conducted to monitor patients’ survival status and transthoracic echocardiography was used to assess left valve function. Kaplan-Meier survival curves and log-rank test were employed to compare the survival rate of patients with different levels of valve regurgitation. Results The 35 patients had a mean age of (53.9±11.1) years, with 85.7% male, and 3 patients (8.6%) died during hospitalization. Preoperatively, 17 patients (48.6%) had moderate or greater mitral regurgitation, while all 35 patients had less than moderate aortic regurgitation. One month postoperatively, thirty patients were followed up, among which 24 patients (80%) had less than moderate mitral regurgitation, including 11 cases with alleviated regurgitation compared to pre-surgery; 6 patients (20%) had moderate or greater mitral regurgitation, including 4 cases with stable regurgitation and 2 cases with progression of regurgitation compared to pre-surgery; 2 patients (6.7%) had progression of aortic regurgitation to moderate or greater. The follow-up time was 1.2 (1.0, 2.1) years, with 1-year survival rate of 91.4% and 3-year survival rate of 71.1%. Survival analysis showed that the 3-year survival rate of patients with moderate or greater mitral regurgitation one month postoperatively was significantly lower than that of patients with less than moderate regurgitation (66.7% vs 83.3%, P＝0.046). Conclusions After the implantation of magnetic levitation LVAD, most patients showed improvement in mitral regurgitation, while aortic regurgitation remained unchanged. The degree of mitral regurgitation one month postoperatively is associated with prognosis.

BACKGROUND:There is still no consensus on the optimal internal fixation for the treatment of Pauwels Ⅲ femoral neck fracture,and most of the related finite element analyses have been performed using a single simplified loading condition,and the biomechanical properties of commonly used internal fixation devices need to be further investigated. OBJECTIVE:To analyze the biomechanical characteristics of Pauwels Ⅲ femoral neck fractures treated with cannulated compression screw,dynamic hip screw,and femoral neck system by finite element method under different loading conditions of single-leg standing loads and sideways fall loads. METHODS:The DICOM data of healthy adult femur were obtained by CT scanning,imported into Mimics 15.0 software to obtain the rough model of bone tissue.The data exported from Mimics were optimized by Geomagics software,and then three internal fixation models were built and assembled with the femur model according to the parameters of the clinical application of the cannulated compression screw,dynamic hip screw,and femoral neck system by using Pro/E software.Finally,the three internal fixation models were imported into Ansys software for loading and calculation to analyze the stress distribution and displacement of the femur and the internal fixation under different working conditions of single-leg standing loads and sideways fall loads,as well as the stress characteristics of the calcar femorale and Ward's triangle. RESULTS AND CONCLUSION:(1)Under the single-leg standing load and the sideways fall load,the proximal femoral stress of the three internal fixation models was mainly distributed above the fracture end of the femoral neck.The peak stress of the proximal femoral end,fracture end,Ward triangle,and calcar femorale of the three internal fixation models were the smallest in the femoral neck system model and the largest in the cannulated compression screw model.(2)Under the single-leg standing load and the sideways fall load,the peak displacement of the proximal femur of the three internal fixation models was all located at the top of the femoral head,and the peak displacement was the smallest in the femoral neck system model and the largest in the cannulated compression screw model.(3)The peak displacement of the three internal fixation models was all located at the top of the internal fixation device under the single-leg standing and sideways fall loading conditions,and the peak displacement values were the smallest in the femoral neck system internal fixation model and the largest in the cannulated compression screw internal fixation model.(4)The internal fixation stress of the three internal fixation models was mainly distributed in the area near the fracture end of the internal fixation device under the single-leg standing and sideways fall loads,and the peak value of internal fixation stress was the smallest in the femoral neck system model and the largest in the cannulated compression screw model.(5)These results suggest that the mechanical stability of the femoral neck system is the best,but there may be a risk of stress shielding of the fracture end and calcar femorale.The stress of the internal fixation device of the femoral neck system is more dispersed,and the risk of internal fixation break is lower.

The inheritance, innovation, and development of traditional Chinese medicine(TCM) need to be based on Chinese medicinal materials. The TCM seed industry is the source of TCM production, which is related to the stable supply and quality safety of TCM. This paper summarizes the basic situation of the TCM seed industry and introduces relevant policies and regulations to TCM seeds in the seed industry and the TCM field. At present, the Management Measures of TCM Seeds and Seedlings has not yet promulgated, and TCM seeds are classified as non-major crops in the category of crops for management. This paper also describes the current situation of TCM seed and seedling system construction, which is in the development stage, from six aspects, including the construction of TCM seed industry technical support system; the establishment of TCM seed standard; the construction of germplasm resource preservation system; TCM seed testing, variety registration, and variety protection; production and management of TCM seeds; TCM seed supervision. According to the development status of the TCM seed industry, four problems are put forward, including imperfect systems and standards relevant to TCM seeds, insufficient supervision and law enforcement regarding TCM seeds, insufficient policy measures and capital investment to promote the development of the industry, and the industry's falling into a low-level cycle.Accordingly, four suggestions are provided, including improving laws, regulations, and policies, perfecting standards and norms,strengthening supervision and law enforcement, and promoting support system construction, in order to boost the high-quality development of the TCM seed industry.
Seeds/chemistry* ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/standards* ; Plants, Medicinal/chemistry*

Abdominal war trauma is a common and high-risk type of injury in the modern battlefield,with rapid changes in condition and a high mortality rate.There is an urgent need for emerging medical technologies to improve the efficiency and success rate of first aid for military casualties.With the development of artificial intelligence(AI),5G,and other emerging technologies,the concept of intelligent medical treatment is gradually forming and can assist in the diagnosis and treatment of abdominal trauma.This paper reviews the characteristics of abdominal war trauma in modern wars,discusses the application of intelligent medical treatment for abdominal war trauma and its drawbacks to be solved,aiming to provide reference for research related to abdominal war trauma.

Objective To develop an erythrocyte-based delivery system for butyrylcholinesterase(BChE)that is capable of prophylaxis against organophosphorus nerve agents.Methods Recombinant BChE was produced and analyzed for oligomerization via polyacrylamide gel electrophoresis(PAGE)and Western blotting.A modified hypotonic preswelling method was employed to prepare BChE-loaded erythrocytes.The drug loading capacity and encapsulation efficiency were quantified using enzyme-linked immunosorbent assay(ELISA).Catalytic activity was assessed in vitro with an activity detection kit.The system was characterized via scanning electron microscopy(SEM),flow cytometry and a hematology analyzer.Results Recombinant BChE predominantly existed as dimers(85％dimer,15％monomer).The optimized volume ratio of erythrocytes to hypotonic solution was determined as 1:7.Compared with native and empty erythrocytes,BChE-loaded erythrocytes exhibited significantly higher catalytic activity(P＜0.001).The mean corpuscular volume of BChE-loaded erythrocytes increased(P＜0.001),while the mean content of corpuscular hemoglobin and hemoglobin in erythrocytes per 100 mL decreased(P＜0.001).SEM revealed no morphological differences(biconcave disc shape).Hypotonic preswelling moderately increased erythrocyte apoptosis(P＜0.001),but no statistical difference was observed between BChE-loaded and hypotonic-treated erythrocytes(P＞0.05).CD47 expression remained unchanged compared to native erythrocytes(P＞0.05).Conclusion The modified hypotonic preswelling method can generate BChE-loaded erythrocytes that retain the characteristics of native erythrocytes while conferring catalytic activity,offering a novel strategy for clinical intervention against organophosphorus poisoning.

Objective To investigate the effects of insulin-like growth factor binding protein 7(IGFBP7)on the sensitivity of glioma cells to temozolomide(TMZ)and the related mechanism.Methods IGFBP7 mRNA expression levels in TMZ-sensitive(U87 TMZ-S,U251 TMZ-S)and TMZ-resistant(U87 TMZ-R,U251 TMZ-R)glioma cells were analyzed using RNA sequencing data from the gene expression omnibus(GEO)dataset GSE151680.TMZ-resistant U87 and U251 cell lines were established via stepwise dose escalation.IGFBP7 expressions in TMZ-R cells were detected by quantitative real-time PCR(qPCR)and Western blotting.IGFBP7 was stably knock-downed in TMZ-R cells while IGFBP7 was stably overexpressed in TMZ-S cells using lentiviral infection.Cell viability,migration,invasion and TMZ sensitivity were assessed using CCK-8 assay,apoptosis assay,wound healing assay,Transwell invasion assay and colony formation assay respectively.Cellular senescence was detected by β-galactosidase(SA-β-Gal)staining.The expression levels of senescence molecular markers cyclin-dependent kinase inhibitor 1(p21)and tumor protein p53(p53),as well as DNA damage marker γ-H2A histone family member X(γ-H2AX)were determined by Western blotting.The differences in mRNA expressions of IGFBP7 between glioma tissues and normal tissues as well as the correlations with the overall survival of glioma patients were analyzed using the cancer genome atlas(TCGA),Chinese Glioma Genome Atlas(CGGA),genotype-tissue expression(GTEx)database.Results Compared to normal glioma cells,IGFBP7 expressions were significantly elevated in TMZ-R glioma cells.Overexpression of IGFBP7 in TMZ-S glioma cells enhanced cell viability but suppressed apoptosis following TMZ treatment.The expressions of senescence-associated marker(p21,p53)and DNA damage marker(γ-H2AX)were upregulated in these cells.Notably,IGFBP7 expressions were significantly higher in glioma tissues than in normal tissues,and high IGFBP7 expressions were associated with poor prognosis in glioma patients.Conclusion Knockdown of IGFBP7 promotes TMZ-induced cell senescence and DNA damage,thereby enhancing the sensitivity of gliomas cells to TMZ.