Objective To analyze the application effects of artificial intelligence (AI) software and Mimics software in preoperative three-dimensional (3D) reconstruction for thoracoscopic anatomical pulmonary segmentectomy. Methods A retrospective analysis was conducted on patients who underwent thoracoscopic pulmonary segmentectomy at the Second People's Hospital of Huai'an from October 2019 to March 2024. Patients who underwent AI 3D reconstruction were included in the AI group, those who underwent Mimics 3D reconstruction were included in the Mimics group, and those who did not undergo 3D reconstruction were included in the control group. Perioperative related indicators of each group were compared. Results A total of 168 patients were included, including 73 males and 95 females, aged 25-81 (61.61±10.55) years. There were 79 patients in the AI group, 53 patients in the Mimics group, and 36 patients in the control group. There were no statistical differences in gender, age, smoking history, nodule size, number of lymph node dissection groups, postoperative pathological results, or postoperative complications among the three groups (P>0.05). There were statistical differences in operation time (P<0.001), extubation time (P<0.001), drainage volume (P<0.001), bleeding volume (P<0.001), and postoperative hospital stay (P=0.001) among the three groups. There were no statistical differences in operation time, extubation time, bleeding volume, or postoperative hospital stay between the AI group and the Mimics group (P>0.05). There was no statistical difference in drainage volume between the AI group and the control group (P=0.494), while there were statistical differences in operation time, drainage tube retention time, bleeding volume, and postoperative hospital stay (P<0.05). Conclusion For patients requiring thoracoscopic anatomical pulmonary segmentectomy, preoperative 3D reconstruction and preoperative planning based on 3D images can shorten the operation time, postoperative extubation time and hospital stay, and reduce intraoperative bleeding and postoperative drainage volume compared with reading CT images only. The use of AI software for 3D reconstruction is not inferior to Mimics manual 3D reconstruction in terms of surgical guidance and postoperative recovery, which can reduce the workload of clinicians and is worth promoting.

BACKGROUND: Previous studies have reported that early computed tomography (CT) findings significantly contribute to the outcomes of cardiac arrest (CA) patients. This study aims to evaluate the association between chest CT features and prognosis in CA patients treated with extracorporeal cardiopulmonary resuscitation (ECPR). METHODS: A retrospective observational study was conducted on adult CA patients treated with ECPR in a tertiary hospital between March 2015 and June 2023. All the patients underwent a whole-body CT scan within 1 h of ECPR. Data regarding demographic and clinical characteristics were collected from electronic medical records. The presence of gravity-dependent distribution and CT scores based on chest CT scans were determined for each patient. The primary outcome was 28-day survival. Receiver operating characteristic (ROC) curves were used to evaluate the ability of chest CT features (gravity-dependent distribution and CT scores) to predict poor outcomes. The cut-off value of the CT score was determined. Kaplan-Meier curves were used to compare 28-day survival between the low- and high-CT score groups, which were classified using the estimated cut-off value. RESULTS: Among the 100 patients included, 74 were non-survivors. The non-survivor patients showed a higher presence of gravity-dependent distribution and higher CT scores than survivors (P<0.05). Patients with gravity-dependent distribution had significantly higher CT scores than those with non-gravity-dependent distribution (P<0.05). The combination of CT score and gravity-dependent distribution predicted poor outcomes better than considering the features individually, demonstrating moderate performance (AUC: 0.693, 95% CI: 0.568-0.801). According to the survival analysis, the risk of death increased as the CT score rose, with an estimated cut-off value of ≥ 11 (P=0.016). CONCLUSION: Chest CT features were associated with poor outcomes in CA patients following ECPR.

ObjectiveTo observe the inhibitory effect of sinomenine on human glioblastoma and its pharmacokinetic characteristics in glioblastoma. MethodA human glioblastoma U87 cell line stably expressing luciferase was constructed， and a mouse glioma model was established for use in both pharmacodynamic and pharmacokinetic studies. Pharmacodynamics： Model mice were randomly divided into model group and sinomenine low-， medium-， and high-dose groups （50， 100， 150 mg·kg^-1）. Sinomenine was administered intraperitoneally for 14 days. The fluorescence value of brain tumors was observed to analyze its inhibitory effect on glioblastoma proliferation. Brain tumors and the surrounding brain tissue were collected， and the expression levels of vascular endothelial growth factor A （VEGFA）， P-glycoprotein （P-gp）， breast cancer resistance protein （BCRP）， and Occludin were detected by Western blot. Pharmacokinetics： Mice were divided into a normal group （50 mg·kg^-1） and model groups （50， 100， 150 mg·kg^-1）. After a single intraperitoneal injection of sinomenine， extracellular fluid from brain tumors was collected in vivo by microdialysis every 15 min for 6 h. Sinomenine concentrations in the dialysate were detected by HPLC-MS/MS， and pharmacokinetic parameters were calculated to analyze pharmacokinetic characteristics of sinomenine in the brain and glioblastoma. ResultCompared with model group， after 14 days of sinomenine administration， the fluorescence value of brain tumors significantly decreased （P<0.05） in a dose-dependent manner. Sinomenine inhibited the increase in VEGF and the degradation of Occludin in the tissue surrounding the tumor and inhibited the expression of VEGF， P-gp， and BCRP in glioblastoma. After a single administration， sinomenine was detected in brain and tumor tissues within 7.5 min. Compared with normal group， the C_max and AUC in the tumor significantly increased， T_max shortened （from 1.63 h to 0.71 h）， and CLz/F decreased. In the dose range of 50-150 mg·kg^-1， sinomenine exhibited a linear pharmacokinetic process in glioblastoma. ConclusionSinomenine has a significant inhibitory effect on glioblastoma， which can inhibit VEGF elevation and drug transporter efflux， reduce tumor invasion， and maintain the integrity of the blood-brain barrier. Sinomenine can rapidly cross the blood-tumor barrier， reach peak concentration， and exhibit linear pharmacokinetic characteristics in the tumor.

Objective: To investigate the prevalence and associated factors of sexting among college students in Jiangxi Province, so as to provide a reference for sexual education interventions in colleges. Methods: A combined method of random cluster sampling and convenience sampling was used to conduct an anonymous questionnaire survey on 13 042 students from 14 colleges in Jiangxi Province in October 2023. A self designed questionnaire was used to collect data on sexting among students, and Chi square tests and binary Logistic regression analysis were conducted to explore the factors associated with sexting among college students in Jiangxi Province. Results: The reported rate of sexting among college students in Jiangxi Province was 11.5%. Binary Logistic regression analysis showed that female students, non only children, and those who do not view pornographic novels/videos/films had a lower likelihood of engaging in sexting ( OR =0.72, 0.83, 0.23, P <0.05). Students who identified as homosexual, lacked knowledge about AIDS, did not mind premarital sex, and had indifferent attitudes towards multiple sexual partners were more likely to engage in sexting ( OR =1.66, 1.53, 1.25, 2.26, 1.78, P <0.05). Students who smoke, drink, and report a history of high risk sexual behavior were more likely to engage in sexting behavior ( OR=1.38-12.20, P <0.05); night owls showed a negative correlation with sexting behavior ( OR=0.24-0.58, P <0.05). Conclusions A significant proportion of college students in Jiangxi Province engage in sexting. It is recommended that colleges and universities strengthen their sexual education efforts and focus on cultivating internet literacy to promote the physical and mental health development of college students.

【Objective】 To analyze the association between preschool children′s emotional regulation ability and parents′ participation in accompanying picture book reading, in order to provide theoretical reference for improving children′s emotional regulation abilility. 【Methods】 From September to November 2022, preschool children aged 3 - 6 years from Guangfeng County, Yukan County, Wannian County, Yanshan County and Wuyuan County were selected by random cluster stratified sampling method. Mann-Whitney U test or Kruskal-Wallis H test were used to analyze the correlation of different levels of children′s emotional control ability with different demographic characteristics as well as parents′ participation in children′s picture book reading. Multivariate Logistic regression model was used to analyze the correlation between parents′ involvement in picture book reading and children′s emotional control ability. 【Results】 Finally 848 valid questionnaires were collected.The average age of children was (4.33±0.95)years old,with 432 boys and 416 girls. Multivariate Logistic regression analysis showed that the temperament control ability(>P75) of preschool children was positively correlated with mother being the main accompanying caregiver (OR=4.17, 95%CI: 2.13 - 8.17), and negatively correlated with father being the main accompanying caregiver (OR=0.38, 95%CI: 0.21 - 0.70) or both parents being the main accompanying caregivers (OR=0.14, 95%CI: 0.07 - 0.28)(P<0.05). The social confidence (father as the main caregiver OR=3.53, 95%CI:1.62 - 7.66; mother as the main caregiver OR=3.52, 95%CI: 1.66 - 7.45) and anxiety control abilities(father as the main caregiver OR=4.32, 95%CI: 1.85 - 10.09; mother as the main caregiver OR=3.39, 95%CI: 1.49 - 7.73) of preschool children were positively correlated with the type of accompanying caregiver(P<0.05). Additionally, the anxiety control ability (>P75) of preschool children was negatively correlated with father′s accompanying frequency (sometimes OR=0.09, 95%CI: 0.03 - 0.28; often OR=0.19, 95%CI: 0.06 - 0.60) and mother′s accompanying duration (<1h/d OR=0.33, 95%CI: 0.12 - 0.91) (P<0.05). 【Conclusions】 The frequency and duration of accompanying reading by father or mother are correlated with the emotional regulation ability of preschool children. Parents can moderately participate in picture book reading to promote the development of preschool children′s emotional control ability.

Objective:To evaluate the prognostic value of coagulofibrinolytic changes in survivors of adult extracorporeal cardiopulmonary resuscitation (ECPR) in Chinese.Methods:133 cardiac arrest (CA) patients whose blood samples were collected after establishment of extracorporeal membrane oxygenation between January 2018 and April 2023 in Emergency Department of the First Affiliated Hospital of Nangjing Medical University were enrolled in this single-center study. The following were examined: platelet counts (PLT), prothrombin time (PT), activated partial thrombin time (APTT), thrombin time (TT), fibrinogen (Fib), and D-dimer (D-D). The prognostic values of these coagulation-related indicators in predicting poor outcomes (Cerebral Performance Category 3-5) were analyzed.Results:Among the 133 patients involved, 96 (72.2%) had poor outcomes after ECPR treatment. In the poor-outcome group, PLT and Fib were significantly decreased, while PT and APTT were significantly prolonged (all P < 0.05). ECPR survivors had a significantly higher risk of poor neurological outcomes in the high-level group than those in the low-level group for PT ( HR=1.87, 95% CI:1.17-2.99, P=0.009), APTT ( HR=1.95, 95% CI:1.26-3.00, P=0.003), and D-D levels ( HR=5.18, 95% CI:2.06-13.03, P<0.001). The risk of poor neurological outcomes was significantly lower in the high-level group for PLT ( HR=0.55, 95%CI:0.35-0.84, P=0.007). Conclusion:Coagulofibrinolytic changes can be promising tools to assess poor neurological outcomes in adult ECPR survivors.

Ribosomopathies encompass a spectrum of disorders arising from impaired ribosome biogenesis and reduced functionality.Mutation or dysexpression of the genes that disturb any finely regulated steps of ribosome biogenesis can result in different types of ribosomopathies in clinic,collectively known as ribosomopathy genes.Emerging data suggest that ribosomopathy patients exhibit a significantly heightened susceptibility to cancer.Abnormal ribosome biogenesis and dysregulation of some ribo-somopathy genes have also been found to be intimately associated with cancer development.The cor-relation between ribosome biogenesis or ribosomopathy and the development of malignancies has been well established.This work aims to review the recent advances in the research of ribosomopathy genes among human cancers and meanwhile,to excavate the potential role of these genes,which have not or rarely been reported in cancer,in the disease development across cancers.We plan to establish a theoretical framework between the ribosomopathy gene and cancer development,to further facilitate the potential of these genes as diagnostic biomarker as well as pharmaceutical targets for cancer treatment.

ObjectiveTo investigate the protective effect of cytochrome P4502D6 （CYP2D6） and cytochrome P4503A4 （CYP3A4）， key enzymes of drug metabolism in liver， on acute liver injury in water extract of Glycyrrhizae Radix et Rhizoma （WEOGRR）. MethodHealthy male Kunming mice were divided into normal group， model group， WEOGRR low-， medium- and high-dose groups （5， 10， 15 g·kg^-1·d^-1） and positive drug group （diammonium glycyrrhizinate， 75 mg·kg^-1·d^-1）， with 10 in each group. One week after preventive administration， acute liver injury model was induced by single intragastric administration of 270 mg·kg^-1 Tripterygium Glycosides tablets， and samples were collected after 18 h. The pathological changes of liver were observed by hematoxylin-eosin （HE） staining. Serum liver function indexes including alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， γ-glutamyl transpeptadase （γ-GT）， alkaline phosphatase （ALP）， and total bilirubin （TBIL） as well as the levels of oxidative stress indexes including malondialdehyde （MDA） and superoxide dismutase （SOD） in hepatocytes were determined by biochemical method. Real-time polymerase chain reaction （Real-time PCR） and Western blot were performed to detect the mRNA and protein expression levels of CYP2D6 and CYP3A4， respectively. ResultCompared with normal group， model group had significant hepatocyte swelling and inflammatory cell infiltration （P<0.01）， increased AST， ALT， γ-GT， ALP and TBIL （P<0.05）， elevated MDA and decreased SOD （P<0.01） as well as down-regulated mRNA and protein expression levels of CYP2D6 and CYP3A4 （P<0.05）. Compared with the model group， the normal group had intact liver structure without obvious abnormality， and the WEOGRR groups and positive drug group presented alleviated hepatocyte swelling and inflammatory cell infiltration （P<0.01）， reduced AST， ALT， γ-GT， ALP and TBIL （P<0.01）， lowered MDA and increased SOD （P<0.01） as well as up-regulated expression levels of CYP2D6 and CYP3A4 （P<0.01）. ConclusionThe protective effect of WEOGRR on acute liver injury induced by Tripterygium glycosides tablets may be related to reducing the contents of AST， ALT， γ-GT， ALP and TBIL in serum， inhibiting MDA and increasing the activity of SOD in liver cells， and enhancing the activities of CYP2D6 and CYP3A4， thus accelerating the metabolism of toxic substances.

Super-enhancers (SEs) are large clusters of enhancers located near the promoter and are necessary to determine the identity of cancer cells. The alterations of super-enhancers can cause dysregulation of the transcriptional program, which resulted in tumor cells being addicted to certain transcriptional programs. Tumor metastasis is the leading cause of death in cancer. Recently, SEs have been demonstrated to facilitate tumor metastasis by regulating lncRNA generation, tumor microenvironment, epithelial-mesenchymal transition, and cancer stem cells. In this review, the characteristics of SEs, the relationship between SEs and tumor metastasis, and inhibitors against SEs are summarized to provide a reference for the relevant mechanism of SEs regulating tumor metastasis and provide new perspectives for the diagnosis and treatment of patients with cancer metastasis.

BACKGROUND: The ion shift index (ISI) as a prognostic indicator that can show the severity of hypoxic-ischemic injury. We aimed to evaluate the performance of the ISI in predicting unfavorable neurological outcomes at hospital discharge in cardiac arrest (CA) patients following extracorporeal cardiopulmonary resuscitation (ECPR) and to compare its performance to other prognostic predictors. METHODS: This was a retrospective observational study including adult CA patients treated with ECPR between January 2018 and December 2022 in a tertiary hospital. Data regarding clinical characteristics and laboratory parameters were collected from medical records. The ISI was determined based on the first available serum electrolyte levels after ECPR. The primary outcome was unfavorable neurological status at hospital discharge, defined as Cerebral Performance Categories 3-5. Comparisons of the characteristics between the two groups were made using the χ2 test for categorical variables and the t-test or non-parametric Mann-Whitney U-test for continuous variables, as appropriate. Correlation analysis was performed using Spearman’s rank correlation coefficient. A two-tailed P-value <0.05 was considered statistically significant. RESULTS: Among the 122 patients involved, 46 (37.7%) had out-of-hospital CA, and 88 had unfavorable neurological outcomes. The ISI was significantly higher in the unfavorable outcome group than in the favorable outcome group (3.74 [3.15-4.57] vs. 2.69 [2.51-3.07], P<0.001). A higher ISI level was independently related to unfavorable outcome (odds ratio=6.529, 95% confidence interval 2.239-19.044, P=0.001). An ISI level >3.12 predicted unfavorable outcomes with a sensitivity and specificity of 74.6% and 85.2%, respectively (P<0.001). The prognostic performance of ISI (area under the curve [AUC]=0.887) was similar to that of other predictors, such as gray-to-white matter ratio (AUC=0.850, P=0.433) and neuron-specific enolase (AUC=0.925, P=0.394). CONCLUSION: ISI may be used as a prognostic biomarker to predict neurological outcomes in CA patients following ECPR.