Objective To investigate the sleep status in children with autism spectrum disorder (ASD) and its relationship with executive function and neurodevelopment. Methods The medical records of 346 children with ASD in the hospital from April 2023 to January 2025 were retrospectively collected. The sleep status of children was investigated by Children’ s Sleep Habits Questionnaire (CSHQ). According to the score, the children were divided into good sleep group (CSHQ score<41 points, 189 cases) and sleep disorder group (CSHQ score≥41 points, 157 cases). The general data were compared between groups of children. Chinese version of Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) and developmental behavior assessment scale of children aged 0-6 years (Children&#39;s psychological scale-II) were used to analyze the relationship between sleep status and executive function and neurodevelopment in children with ASD. Results The CSHQ score of 346 children was (39.08±3.24) points, including 157 cases with CSHQ score≥41 points and 189 cases with CSHQ score<41 points. The proportion of severe previous medical history and executive function score in sleep disorder group were significantly higher than those in good sleep group, and the evaluation result of developmental quotient was lower than that in good sleep group (P<0.05). Logistic regression analysis showed that executive ability and neurodevelopment were closely related to sleep status in children with ASD (P<0.05). Spearman correlation analysis showed that sleep status in children with ASD was negatively correlated with executive function (r=-0.456, P<0.05), and was positively correlated with the developmental quotient (r=0.547, P<0.05). Conclusion The incidence rate of sleep disorder is high in children with ASD, and sleep status is closely related to executive function and neurodevelopment. Clinically, it is necessary to pay attention to the sleep problems in children with ASD, and take effective intervention measures to improve the sleep quality of children and promote the training of executive function and neurodevelopment.

Myasthenia gravis is an autoimmune disorder characterized by impaired neuromuscular transmission. Thymectomy is one of the therapeutic options for acetylcholine receptor antibody-positive myasthenia gravis patients. The quality of perioperative care is directly associated with surgical safety and patient outcomes. However, there is currently a lack of specialized nursing consensus or guidelines specifically addressing the care of these patients domestically or internationally. To promote the standardization and normalization of perioperative nursing care for myasthenia gravis patients undergoing thymectomy and to ensure treatment efficacy, a panel of 57 experts from relevant fields was convened. Based on evidence-based medicine and clinical practice experience, discussions were held on various aspects including condition assessment, nutritional support, medication management, and airway care, resulting in a consensus with 18 final recommendations by using the Delphi method through two rounds of expert consultation. This consensus aims to provide a scientific reference for the perioperative nursing care of myasthenia gravis patients undergoing thymectomy.

Objective To develop a predictive model for postoperative pulmonary complications (PPC) following video-assisted thoracic surgery (VATS) in lung cancer patients by integrating cardiopulmonary exercise testing (CPET) parameters and machine learning techniques. Methods A retrospective analysis was conducted on patients with early-stage non-small cell lung cancer who underwent CPET and VATS at Guangdong Provincial People’s Hospital between October 2021 and July 2023. Patients were divided into a PPC group and a non-PPC group. The least absolute shrinkage and selection operator (LASSO) regression was used to select important features associated with PPC. Six machine learning algorithms were utilized to construct prediction models, including logistic regression, support vector machine, k-nearest neighbors, random forest, gradient boosting machine, and extreme gradient boosting. The optimal model was interpreted using SHapley Additive exPlanations (SHAP). Results A total of 325 patients were included, with an average age of 60.36 years, and 55.1% were male. Significant differences were observed between the PPC and non-PPC groups in age, diabetes, coronary heart disease, surgical approach, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FVC% predicted, peak oxygen uptake (peak VO2), anaerobic threshold (AT), and ventilatory equivalent for carbon dioxide slope (VE/VCO2 slope) (P<0.05). In the predictive model constructed by selecting 7 key features using LASSO regression, the random forest model demonstrated the best overall performance across various metrics, with an area under the receiver operating curve of 0.930, an F1 score of 0.836, and a Brier score of 0.133 in the training set. It also exhibited good predictive ability and calibration in the test set. SHAP analysis ranked feature importance as follows: peak VO2, VE/VCO2 slope, age, FEV1, smoking history, diabetes, and surgical approach. Conclusion Integrating CPET parameters, the random forest model can effectively identify high-risk patients for PPC and has the potential for clinical application.

Objective To analyze the clinical characteristics and risk factors of noninfectious fever after endovascular repair of aortic dilatation diseases, and to explore management strategies. Methods A retrospective analysis was conducted on the clinical data of patients who underwent endovascular aortic repair for aortic dilatation diseases from January 2021 to October 2023. Based on inclusion and exclusion criteria, the enrolled patients were divided into a febrile group and an afebrile group according to the presence of postoperative fever. Clinical data, including demographics and surgical details, were compared between the two groups. Multivariate logistic regression analysis was performed on indicators with P≤0.05 in the univariate analysis, and receiver operating characteristic (ROC) curves were generated to analyze the predictive value of risk factors for postoperative noninfectious fever. Results A total of 305 patients were included in the final analysis. Postoperative noninfectious fever occurred in 75.08% (229/305) of the patients, with 98.25% of cases occurring within the first two postoperative days. The febrile group (n=229) had a median age of 65.0 (IQR: 53.0, 73.0) years with 83.4% males, while the afebrile group (n=76) had a median age of 71.0 (IQR: 65.0, 76.7) years with 84.2% males. Univariate analysis showed that the age, prevalence of coronary heart disease, preoperative statin use, and prevalence of aortic aneurysm were significantly lower in the febrile group compared to the afebrile group. Logistic regression analysis indicated that age, surgical site, disease type, preoperative elevated body temperature, and stent type were significantly associated with noninfectious fever, while preoperative statin use was negatively correlated. ROC curve analysis demonstrated that age, surgical site, preoperative elevated body temperature, and stent type had significant predictive value for postoperative noninfectious fever (P<0.01). Conclusion Noninfectious fever is highly prevalent following aortic repair. The relationship between fever and infection should be comprehensively evaluated based on risk factors and changes in the patient&#39;s condition to promote the rational use of antibiotics.

Objective To explore whether there is a causal relationship between intestinal flora and esophageal cancer. Methods Summary statistics of intestinal flora and esophageal cancer were obtained from the Genome-wide Association Studies (GWAS) database. Five methods, including inverse variance weighted (IVW), weighted median estimation, Mendelian randomization (MR)-Egger regression, single mode, and weighted mode, were used for analysis, with IVW as the main analysis method. Sensitivity analysis was used to evaluate the reliability of MR results. Results In the IVW method, Oxalobacteraceae [OR=1.001, 95%CI (1.000, 1.002), P=0.023], Faecalibacterium [OR=1.001, 95%CI (1.000, 1.002), P=0.028], Senegalimassilia [OR=1.002, 95%CI (1.000, 1.003), P=0.006] and Veillonella [OR=1.001, 95%CI (1.000, 1.002), P=0.018] were positively correlated with esophageal cancer, while Burkholderiales [OR=0.999, 95%CI (0.998, 1.000), P=0.002], Eubacterium oxidoreducens [OR=0.998, 95%CI (0.997, 0.999), P=0.038], Romboutsia [OR=0.999, 95%CI (0.998, 1.000), P=0.048] and Turicibacter [OR=0.998, 95%CI (0.997, 0.999), P=0.013] were negatively correlated with esophageal cancer. Sensitivity analysis showed no evidence of heterogeneity, horizontal pleiotropy and reverse causality. Conclusion Oxalobacteraceae, Faecalibacterium, Senegalimassilia and Veillonella increase the risk of esophageal cancer, while Burkholderiales, Eubacterium oxidoreducens, Romboutsia and Turicibacter decrease the risk of esophageal cancer. Further studies are needed to explore how these bacteria affect the progression of esophageal cancer.

[摘 要] 目的：探究错配修复蛋白2（MSH2）在胃癌中表达和其与患者临床特征的关系及其对胃癌细胞恶性生物学行为的作用及机制。方法：收集2020年5月至2022年7月期间在邢台市人民医院收治的40例胃癌患者的癌组织和配对癌旁组织及患者的一般临床资料。常规培养正常人胃黏膜上皮细胞GES-1和胃癌细胞AGS、MKN45和BGC-823，用转染试剂分别将sh-NC、shMSH2-1和shMSH2-2慢病毒载体转染至AGS和MKN45细胞中，实验分为sh-NC、shMSH2-1和shMSH2-2组。CCK-8法、克隆形成实验、EdU染色、Transwell小室实验分别检测各组AGS和MKN45细胞的增殖、迁移和侵袭能力。构建裸鼠MKN45细胞移植瘤模型，观察敲减MSH2对移植瘤生长的影响。WB法检测各组细胞中及移植瘤组织中 MSH2、PI3K/AKT/mTOR通路、上皮间质转化相关蛋白的表达。结果：MSH2在胃癌组织和细胞中呈高表达且与淋巴结转移、T分期进展及组织学分化不良均有关联（均P < 0.001）；在AGS和MKN45细胞中成功地敲减了MSH2的表达（P < 0.001）；敲减 MSH2均能显著抑制AGS和MKN45细胞的活力、EdU染色阳性率、克隆形成能力、迁移及侵袭能力和移植瘤的生长（均P < 0.001）；均能显著抑制AGS和MKN45细胞和MKN45移植瘤组织中MSH2蛋白、PI3K/AKT/mTOR通路相关蛋白、N-cadherin蛋白的表达（均P < 0.001），促进E-cadherin蛋白的表达（P < 0.001）。结论：MSH2在胃癌组织和细胞中呈高表达且与淋巴结转移、T分期进展及组织学分化不良有关联，敲减MSH2表达通过抑制PI3K/AKT/mTOR通路调控AGS和MKN45细胞的恶性生物学行为，MSH2可能是胃癌治疗的潜在靶点。

[摘 要] 目的：探究双特异性磷酸酶26（DUSP26）在肺腺癌（LUAD）A549细胞增殖、迁移和侵袭中的作用及其分子机制。方法：检索肿瘤数据库GEPIA2网站DUSP26表达数据，分析DUSP26在LUAD患者和正常人肺组织中的表达差异。收集2022年10月至2023年10月期间萍乡市人民医院手术切除的12例LUAD组织和癌旁组织标本，通过免疫组织化学（IHC）和WB法检测DUSP26在LUAD组织和癌旁组织之间的表达差异；通过WB法检测DUSP26在4种LUAD细胞（A549、SK-LU-1、Calu-3、H1299）和2种正常支气管上皮细胞（BEAS-2B、HBEC）中的表达差异。利用慢病毒转染细胞的方法构建稳定过表达DUSP26（DUSP26-OE）及阴性对照（DUSP26-OENC）的A549细胞，通过克隆形成、划痕愈合实验、Transwell实验分别检测DUSP26过表达对细胞增殖、迁移及侵袭能力的影响，WB法检测各组细胞中TGF-β1/SMAD2/3通路、EMT相关蛋白的表达水平，细胞免疫荧光法检测细胞中Ki-67、cyclin D1表达水平。加入TGF-β1重组蛋白进行回复实验。构建A549细胞裸鼠荷瘤模型，观察DUSP26过表达对移植瘤体内生长的影响，WB法检测移植瘤组织中TGF-β1/SMAD2/3通路、EMT相关蛋白表达水平，免疫荧光染色法检测移植瘤组织中Ki-67、cyclin D1表达水平。结果：DUSP26在LUAD组织和细胞中均呈低表达（P < 0.05或P < 0.01或P < 0.001或P < 0.000 1）。与DUSP26-OENC组相比，DUSP26-OE组A549细胞的增殖、迁移和侵袭能力均显著降低（P < 0.01或P < 0.001），TGF-β1、p-SMAD2/3、vimentin、N-cadherin、snail、Ki-67、cyclin D1表达均降低（P < 0.01或P < 0.001或P < 0.000 1），E-cadherin表达升高（P < 0.000 1）。加入5 ng/mL TGF-β1重组蛋白后，可部分逆转在体外实验中由DUSP26过表达导致的结果。成功构建裸鼠A549细胞荷瘤模型，DUSP26-OE组裸鼠移植瘤生长速度缓慢，体积和质量均减小（均P < 0.001），移植瘤组织中TGF-β1、p-SMAD2/3、vimentin、N-cadherin、snail、Ki-67、cyclin D1表达均降低（P < 0.01或P < 0.001），E-cadherin表达升高（P < 0.000 1）。结论：DUSP26在LUAD组织和细胞中均呈低表达状态，上调DUSP26的表达水平能够通过抑制TGF-β1/SMAD2/3信号通路抑制A549细胞的增殖、迁移和侵袭。

[摘 要] 目的：探讨扁蒴藤素（PT）通过蛋白激酶B（AKT）/糖原合成酶激酶-3β（GSK-3β）信号通路对人乳腺癌细胞MCF-7多柔比星（DOX）敏感性的影响。方法：体外培养MCF-7细胞并建立DOX耐药细胞MCF-7/DOX。MCF-7细胞设NC组、L-PT组（2 μmol/L PT）、M-PT组（4 μmol/L PT）、H-PT组（8 μmol/L PT）、H-PT + SC79组（8 μmol/L PT + 10 μmol/L的AKT/GSK-3β信号通路抑制剂SC79）、H-PT + LY294002组（8 μmol/L PT + 2.5 μmol/L的AKT/GSK-3β信号通路激活剂LY294002）。MCF-7/DOX细胞设MCF-7/DOX组（未处理）、DOX组（50 nmol/L DOX）、PT + DOX组（8 μmol/L PT和50 nmol/L DOX）、PT + DOX + SC79组（8 μmol/L PT + 50 nmol/L DOX + 10 μmol/L SC79）、PT + DOX + LY294002组（8 μmol/L PT + 50 nmol/L DOX + 2.5 μmol/L LY294002）。采用MTT法、平板克隆实验、划痕愈合实验、Transwell实验及WB法分别检测细胞增殖、集落形成数、迁移、侵袭和AKT/GSK-3β信号通路蛋白表达。建立MCF-7细胞裸鼠移植瘤模型，观察PT对移植瘤生长、移植瘤组织中AKT/GSK--3β 信号通路蛋白表达的影响。结果：与NC组相比，L-PT、M-PT、H-PT组MCF-7细胞增殖率、集落形成数、划痕愈合率、侵袭细胞数及p-AKT、p-GSK-3β蛋白表达均呈PT浓度依赖性降低（均P < 0.05）；与H-PT组对比，H-PT + SC79组MCF-7细胞上述指标变化趋势与上述相反，PT + DOX + LY294002组MCF-7细胞上述指标变化趋势与上述相同（均P < 0.05）。MCF-7/DOX组与DOX组细胞增殖率、集落形成数、划痕愈合率、侵袭细胞数及p-AKT、p-GSK-3β蛋白表达无明显差异（均P > 0.05）；分别与MCF-7/DOX组、DOX组对比，PT + DOX组MCF-7/DOX细胞上述指标均降低（均P < 0.05）；对比PT + DOX组，PT + DOX + SC79组上述指标均升高，PT + DOX + LY294002组上述指标均降低（均P < 0.05）。裸鼠移植瘤实验显示，与对照组和DOX相比，PT + DOX组移植瘤质量、体积、p-AKT、p-GSK-3β蛋白表达均降低（均P < 0.05）。结论：PT抑制乳腺癌细胞增殖、迁移和侵袭，并增强其对DOX的化疗敏感性，其机制与抑制AKT/GSK-3β信号通路有关。

After two decades of development, transcatheter left atrial appendage closure has emerged as a safe and effective intervention for stroke prevention in patients with atrial fibrillation. In 2024, significant advancements were made in the field of left atrial appendage closure in terms of evidence-based medicine, device research and development, and guideline consensus. The annual report on transcatheter left atrial appendage closure systematically reviews global academic progress in 2024, encompassing newly published clinical evidence, recently developed occlusion devices, and updated international guidelines/consensus statements. In the future, the development direction of transcatheter left atrial appendage closure mainly includes expanding surgical indications, optimizing imaging assistance technology, improving closure device design, and exploring individualized strategies for postoperative antithrombotic therapy.

Objective To analyze the relationship between neuroticism and gastroesophageal reflux disease (GERD) using the Mendelian randomization (MR) method. Methods Exposure and outcome data were downloaded from the Integrative Epidemiology Unit (IEU) database in August 2023, including summary statistics from genome-wide association studies (GWAS) for neuroticism (n=374 323) and GERD (n=602 604). MR was conducted using the weighted median method, MR-Egger method, inverse variance weighted method, weighted mode method, and simple mode method. The causal relationship between the two was assessed using odds ratio (OR), and sensitivity analyses were performed to ensure the accuracy of the results. Results Neuroticism was associated with an increased risk of GERD [OR=1.229, 95%CI (1.186, 1.274), P<0.001]. Similarly, GERD was associated with an increased risk of neuroticism [OR=1.786, 95%CI (1.623, 1.965), P<0.001]. Conclusion There is a bidirectional causal relationship between neuroticism and gastroesophageal reflux disease.