Objective: To evaluate the diagnostic performance of magnetic resonance spectroscopy (MRS) in discriminating fumarate hydratase-deficient (FH-d) uterine leiomyomas (ULs) from FH-preserved ULs. Materials and Methods: This study consisted of three stages, with independent cohorts recruited for each stage: 1) sample-size estimation was retrospectively performed on UL specimens (diameter ≥3 cm; age, 20–40 years) from our database with immunohistochemistry (IHC) for 2-succinocysteine (2-SC) as the reference, without genetic testing, 2) MRS sequence optimization in confirmed FH germline mutation participants with ultrasound-detected ULs (diameter ≥3 cm), without IHC analysis, and 3) prospective diagnostic test accuracy was evaluated in consecutive participants with ultrasound-detected ULs (diameter ≥3 cm;age, 20–40 years), using IHC for 2-SC for determining the FH status and subsequent genetic testing in those with positive 2-SC results to identify whether FH mutations were germline or somatic in origin. The choline and fumarate peaks in MRS were classified as positive, negative, or technical failure (TF). TFs were analyzed separately and excluded from the primary diagnostic accuracy calculations. T1-, T2-, and diffusion-weighted images were interpreted as hyperintense or hypointense. The enhancement rate and apparent diffusion coefficient were also acquired. Diagnostic performance was compared between MRS and various magnetic resonance imaging (MRI) features. Results: The optimal MRS parameters for the fumarate peak were echo time (TE) = 140 ms and an average of 256. Among the 360 prospective participants, 37 were confirmed to have FH-dULs. MRS showed positive fumarate peaks in 35 of 37 FH-dULs.After excluding six TFs, the positive fumarate peak on MRS showed 94.6% (35/37) sensitivity, 99.7% (316/317) specificity, and 99.2% (351/354) accuracy, all of which were significantly superior to those of other MRI features (P ≤ 0.002). Conclusion A positive fumarate peak on MRS may be a useful imaging biomarker for diagnosing FH-dULs.

Objective To compare the performance of 7 Chinese-developed GenAI models (DeepSeek, Wenxin Yiyan, Tongyi, Doubao, Kimi, Hunyuan, and iFLYTEK Spark) in responding to common diseases of the pediatric genitourinary system and to explore their potential applications.Methods A total of 80 questions covering basic disease information, diagnosis, treatment, and prognosis related to “hypospadias, hydronephrosis, and cryptorchidism” were developed as prompts.The models were tested under 3 modes:“quick thinking, ”“deep thinking, ” and “deep thinking + internet access.” The results were evaluated in a blinded review by two pediatric urologists.The responses were graded into 4 levels—A, B, C, and D—based on accuracy, completeness, and relevance.The proportions of responses rated as A and A+B were statistically analyzed and compared across the different models/modes.Results The “deep thinking” mode of DeepSeek demonstrated the best performance, with 88% of responses rated as A and 96% rated as A+B.DeepSeek (deep thinking + internet access), Doubao (quick thinking), Hunyuan (deep thinking), and Doubao (deep thinking + internet access) followed closely, also showing excellent response capabilities.Among the top 5 models/modes, significant differences were observed in the proportion of Alevel responses (P＜0.05), while differences in the proportion of A+B-level responses were not statistically significant (P＞0.05).Conclusion Certain Chinese-developed GenAI models, represented by DeepSeek (deep thinking), demonstrate significant application potential.However, they still cannot consistently provide recommendations rated at the A+B level (recommended grade or higher) with 100% accuracy.In clinical practice, both doctors and patients should view GenAI as an auxiliary tool for education and information acquisition rather than as a final decision-making authority.All information must be reviewed and confirmed by professional physicians.

Objective This study aims to conduct a comprehensive analysis of the domestic and international standards for prefilled syringes to advance the scientific and international alignment of China's PFS standard system.Methods A thorough review of the framework,scope,and quality control key points of the 2015 national pharmaceutical packaging material standards(abbreviated as YBB standards),the ISO 11040 international standard system and the United States Pharmacopeia standard system was conducted.Comparative analysis was employed to reveal the similarities and differences among the three,thereby uncovering the unique characteristics of each.Results The YBB standards emphasize quality control for prefilled syringes,offering clear and operational guidelines that provide companies with precise directives for production and testing.However,the scope of these standards is relatively limited.ISO standards apply to a wide range of products,featuring comprehensive coverage and a degree of flexibility.They emphasize the universality of products and compatibility with other international standards,which facilitates global production and trade.USP includes several chapters related to prefilled syringes but lacks a certain level of specificity and systematic approach.Conclusion By thoroughly studying and drawing upon the quality control philosophies,standard frameworks,and key control points of prefilled syringes from both domestic and international standards,we aim to provide valuable references for the development of a robust prefilled syringe standard system within the Chinese Pharmacopoeia.

Iron is an essential trace element for the human body and is critical for vital cellular processes,such as DNA synthesis,respiration,and oxygen transport.The body maintains iron homeostasis through a coordinated balance of absorption,utilization,storage,and distribution.Both iron deficiency and excess can lead to pathologies,with the latter triggering lipid peroxidation and DNA mutations via the Fenton reaction,potentially causing iron-induced cell death in severe cases.Although iron overload can inflict severe damage on multiple organs,including the brain,liver,spleen,heart,ovaries,and kidneys,the mechanisms that regulate iron homeostasis in response to overload are not fully understood.Various animal models have been developed to help elucidate these mechanisms,each reflecting different aspects of iron overload relevant to human diseases,and selection of the most appropriate animal model is needed for the accurate simulation of the pathological and physiological states associated with human iron overload-related diseases.This review synthesizes recent literature on animal models pertinent to iron overload,to offer insights to support the development and analysis of models for diseases related to iron overload.

Objectives:To evaluate the hemodynamic impact of different bypass grafting methods on the left anterior descending(LAD)artery using computational fluid dynamics,providing a theoretical basis for optimizing coronary artery bypass grafting.Methods:A patient-specific 3D coronary model was constructed using SimVascular software,including an in-situ internal mammary artery graft(model 1)and three free grafts of varying diameters(model 2:2 mm internal mammary artery free graft;model 3 and model 4:3 mm and 4 mm great saphenous vein free grafts).The hemodynamic parameters of the native artery and grafts were compared among the four bypass grafting models.Results:All four bypass grafting models supply sufficient blood flow for the severely stenosed LAD.LAD flow was slightly lower in the model 1.Free internal mammary artery grafts showed higher flow and wall shear stress.4 mm great saphenous vein free grafts presented with maximum flow but lowest shear stress,3 mm great saphenous vein free grafts offered better hemodynamic stability.Conclusions:Computational fluid dynamics analysis indicates that free internal mammary grafts could provide superior hemodynamics,while larger grafts result in lower shear stress,which might affect long-term graft patency.These findings thus provide experimental evidences useful for optimizing LAD bypass strategies.

Objective:To investigate the role of inspiratory muscle training in improving the respiratory function of pa-tients with subacute complete high cervical spinal cord injury(C2-C5).Method:From January 2020 to June 2021,60 patients with subacute complete cervical spinal cord injury(C2-C5)ASIA level A were randomly divided into experimental group(n=30)and control group(n=30).The patients in control group were conducted with routine rehabilitation training,in experimental group,inspiratory muscle training was added on the basis of routine rehabilitation treatment.Before and after training for a total of 6 weeks,maximum inspiratory pressure(Plmax),vital capacity(VC),forced expiratory vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximal ventilatory volume(MVV),and dia-phragm thickness were measured,the cases of pulmonary infection were counted.Result:After the training,the improvement of PImax,VC,FVC,FEV1,MVV and diaphragm thickness in patients in experimental group were significantly better than that in patients in control group(P＜0.05),and the rate of pulmonary infection was lower(P＜0.05).Conclusion:Inspiratory muscle training added on the basis of routine rehabilitation treatment can significantly improve the respiratory function of patients with subacute complete high cervical spinal cord injury.

Iron is an essential trace element for the human body and is critical for vital cellular processes,such as DNA synthesis,respiration,and oxygen transport.The body maintains iron homeostasis through a coordinated balance of absorption,utilization,storage,and distribution.Both iron deficiency and excess can lead to pathologies,with the latter triggering lipid peroxidation and DNA mutations via the Fenton reaction,potentially causing iron-induced cell death in severe cases.Although iron overload can inflict severe damage on multiple organs,including the brain,liver,spleen,heart,ovaries,and kidneys,the mechanisms that regulate iron homeostasis in response to overload are not fully understood.Various animal models have been developed to help elucidate these mechanisms,each reflecting different aspects of iron overload relevant to human diseases,and selection of the most appropriate animal model is needed for the accurate simulation of the pathological and physiological states associated with human iron overload-related diseases.This review synthesizes recent literature on animal models pertinent to iron overload,to offer insights to support the development and analysis of models for diseases related to iron overload.

Objectives:To evaluate the hemodynamic impact of different bypass grafting methods on the left anterior descending(LAD)artery using computational fluid dynamics,providing a theoretical basis for optimizing coronary artery bypass grafting.Methods:A patient-specific 3D coronary model was constructed using SimVascular software,including an in-situ internal mammary artery graft(model 1)and three free grafts of varying diameters(model 2:2 mm internal mammary artery free graft;model 3 and model 4:3 mm and 4 mm great saphenous vein free grafts).The hemodynamic parameters of the native artery and grafts were compared among the four bypass grafting models.Results:All four bypass grafting models supply sufficient blood flow for the severely stenosed LAD.LAD flow was slightly lower in the model 1.Free internal mammary artery grafts showed higher flow and wall shear stress.4 mm great saphenous vein free grafts presented with maximum flow but lowest shear stress,3 mm great saphenous vein free grafts offered better hemodynamic stability.Conclusions:Computational fluid dynamics analysis indicates that free internal mammary grafts could provide superior hemodynamics,while larger grafts result in lower shear stress,which might affect long-term graft patency.These findings thus provide experimental evidences useful for optimizing LAD bypass strategies.

Objective:To explore the core factors of self-management and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) and the internal relationship between these two constructs.Methods:A convenience sampling method was used to enroll 210 COPD patients who visited the Fifth Affiliated Hospital, Sun Yat-sen University from January to December 2022. Data were collected using Self-Management Scale and 36-item Short-Form. A relationship network between self-management and QOL was constructed via network analysis, and centrality indicators and network stability were calculated.Results:A total of 210 questionnaires were distributed, and 205 valid questionnaires were recovered, with an effective recovery rate of 97.6%. Emotional management was identified as the core node in both the overall network and the self-management subnetwork (2.064), while vitality was the core node in the QOL subnetwork (0.730). The relationship between self-management and QOL was mainly manifested through the strong association between emotional management and role-emotion.Conclusions:Emotional management is the core factor in the relationship between self-management and QOL in COPD patients. The overall network of self-management and QOL is influenced by the strong association between emotional management and role-emotion.

Objective To investigate the clinical efficacy of national famous traditional Chinese medicine doctor prof.Wang Tan's application of Yang-assisting Lung Repairing and Paralysis Removing Soup combined with pulmonary rehabilitation on patients with idiopathic pulmonary fibrosis.Method A total of 79 patients with pulmonary arthralgia who met the inclusion criteria and visited the inpatient Department of Pulmonary Disease in the Affiliated Hospital of Changchun University of Traditional Chinese Medicine and Professor Wang Tan's Changjiang Scholar Studio from January 2024 to November 2024 were retrospectively analyzed.There were 30 cases in control group and 49 cases in treatment group.Among them,the control group received routine treatment and was given Zhuyang Bufei Chubi decoction and the observation group was added lung rehabilitation treatment on this basis(walking,dumbbell exercises,climbing stairs,resistance bands,breathing trainers,sandbags,abdominal breathing exercises),the course of treatment was 1 month.Compare the recovery of lung function,six-minute walking test(6MWT),C-reactive protein(CRP),quality of life assessment,and overall therapeutic efficacy of the two groups of patients before and after treatment.Result After treatment,the pulmonary function index,exercise endurance,total therapeutic effect,inflammatory response and quality of life of the two groups were analyzed,and the curative effect of the treatment group was better than that of the control group(P<0.05).Conclusion The treatment of idiopathic pulmonary fibrosis patients with Zhuyang Bufei Chubi decoction combined with pulmonary rehabilitation helps patients with various indexes to improve their lung function,exercise endurance,and quality of life.