Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.

Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.

[Objective]To investigate the difference of ultrasound characteristics between pure mucinous carcinoma(PMC)and fibroadenoma(FA)of the breast.[Methods]Ultrasound data of 50 continuous patients with breast PMC from January 2012 to January 2021 and 100 continuous patients with breast FA from June 2018 to January 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively reviewed.The ultrasound characteristics of the two groups were evaluated according to the 2013 BI-RADS Ultrasound Atlas,and the differences in age,maximum diameter and ultrasound characteristics between the two groups were compared.[Results]The median age of PMC patients was 47 years and that of FA patients was 33 years.The age of PMC patients was higher than that of the FA group,and the differ-ence between the two groups of patients was statistically significant(P<0.001).The median maximum diameter of PMC pa-tients was 2.4 cm,which was greater than that of the FA group(1.8 cm),and the difference was statistically significant(P=0.001).Of the PMC,70%(35/50)were irregular,82%(41/50)were parallel to the skin,92%(46/50)had no circum-scribed margin,72%(36/50)were hypoechoic,and 68%(34/50)had enhanced posterior echo.Of the FA,69%(69/100)were oval or round,98%(98/100)were parallel to the skin,54%(54/100)had circumscribed margin,98%(98/100)were hypoechoic,and 75%(75/100)had no posterior features.The differences in the above ultrasound characteris-tics between the PMC and FA groups were statistically significant(P<0.001,P=0.001,P<0.001,P<0.001,P<0.001).There was no significant difference between calcifications and blood flow.[Conclusions]Compared with the FA group,pa-tients with PMC are older and the diameter of the lesions are larger.On ultrasound,the morphology and margin of most breast PMC still show the growth characteristics of invasive cancer.Meanwhile,the posterior echo of PMC is enhanced,which is a unique manifestation.

Exosomes, a kind of extracellular vesicles, are a research hotspot in the field of regeneration and repair in the circumstance of endometrial injury recently. Exosomes can be released by a variety of cells, and can regulate the function of receptor cells through miRNA and other bioactive substances, thus effectively promoting tissue regeneration and repair. Intrauterine adhesions (IUA) is a common endometrial injury disease resulting from uterine trauma, infection, genetic factors and other causes of damage to the endometrial basal layer. It often causes clinical problems such as abnormal menstruation, infertility and repeated abortion due to partial or total occlusion of the uterine cavity, leading to female reproductive difficulties, and the existing remedies can not achieve satisfactory repair effect concerning endometrial injuries. Therefore, recent studies have been exploring the role of exosomes in promoting endometrial repair and fertility recovery in IUA, proving the effectiveness of exosomes in repairing endometrial damage, and exploring the mechanism. Through inhibiting apoptosis, downregulating the level of epithelial-mesenchymal transition and fibrosis, facilitating cell proliferation, promoting angiogenesis, and regulating immune responses, exosomes can increase the thickness of damaged endometrium and the number of glands, and enhance endometrial receptivity and fertility, thus expected to be a new treatment for IUA in the future. Herein, we will review the research progress in the treatment of IUA with exosomes.

Exosomes, a kind of extracellular vesicles, are a research hotspot in the field of regeneration and repair in the circumstance of endometrial injury recently. Exosomes can be released by a variety of cells, and can regulate the function of receptor cells through miRNA and other bioactive substances, thus effectively promoting tissue regeneration and repair. Intrauterine adhesions (IUA) is a common endometrial injury disease resulting from uterine trauma, infection, genetic factors and other causes of damage to the endometrial basal layer. It often causes clinical problems such as abnormal menstruation, infertility and repeated abortion due to partial or total occlusion of the uterine cavity, leading to female reproductive difficulties, and the existing remedies can not achieve satisfactory repair effect concerning endometrial injuries. Therefore, recent studies have been exploring the role of exosomes in promoting endometrial repair and fertility recovery in IUA, proving the effectiveness of exosomes in repairing endometrial damage, and exploring the mechanism. Through inhibiting apoptosis, downregulating the level of epithelial-mesenchymal transition and fibrosis, facilitating cell proliferation, promoting angiogenesis, and regulating immune responses, exosomes can increase the thickness of damaged endometrium and the number of glands, and enhance endometrial receptivity and fertility, thus expected to be a new treatment for IUA in the future. Herein, we will review the research progress in the treatment of IUA with exosomes.

Objective:Using high-throughput transcriptome sequencing technology to study the differentially expressed genes (DEGs) and related regulatory signaling pathways involved in H1N1 influenza virus infection in primary human retinal pigment epithelial (RPE) cells.Methods:Primary human RPE cells were infected with H1N1 influenza virus for 2 h or 12 h, respectively. Taking H1N1 uninfected cells as a control group, total RNA was extracted, a library was constructed, and transcriptome sequencing was performed. DEGs were screened by DESeq2 software, and DEGs were analyzed by gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway.Results:Compared with the control group, a total of 1830 DEGs were identified in the 2 h H1N1 influenza virus infection group, and 2847 DEGs were identified in the 12 h infection group; 1213 DEGs were identified in the H1N1 influenza virus infection kinetics process (2 h: 12 h). The GO functional annotation analysis of DEGs in the H1N1 influenza virus infection group for 12 h showed that DEGs widely exist in a variety of cellular components and participate in various biological processes such as cellular processes, biological regulation, and metabolic processes. KEGG pathway enrichment analysis showed that DEGs were mainly enriched in the PI3K-Akt signaling pathway, MAPK signaling pathway, cancer MicroRNAs, and cytokine-cytokine receptor interactions in the 2 h H1N1 influenza virus infection group; in the 12 h H1N1 influenza virus infection group, DEGs were mainly enriched in PI3K-Akt signaling pathway, cancer MicroRNAs, AGE-RAGE signaling pathway and immune-inflammatory pathways; during the kinetics of H1N1 influenza virus infection (2 h: 12 h), DEGs were mainly enriched in cytokine-cytokine receptor interaction, TGF-β signaling pathway.Conclusions:Infection with H1N1 influenza virus leads to significant changes in the transcriptome of RPE cells. These data provide scientific reference for elucidating the molecular mechanism of eye infection by respiratory viruses such as influenza virus.

ObjectiveTo investigate the virologic response to direct-acting antiviral (DAA) therapy and the changes in liver stiffness measurement (LSM), fibrosis-4 (FIB-4), and aspartate aminotransferase-to-platelet ratio index (APRI) after treatment in chronic hepatitis C (CHC) patients with different alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at baseline in a real-world setting. MethodsCHC patients who attended the outpatient service of Department of Infectious Diseases, Peking University First Hospital, from December 2017 to May 2020 were enrolled, and virologic response rate was calculated. The Wilcoxon rank-sum test was used to compare LSM, FIB-4, and APRI between groups at baseline and at 12 weeks after treatment, and the chi-square test was used for comparison of categorical data between groups. ResultsA total of 48 CHC patients were enrolled, among whom 33.3% had abnormal ALT or AST at baseline. Among these patients, the virologic response rate was 85.4% at week 4 of treatment and 100% at the end of treatment and at 12, 24, and 48 weeks after treatment, and there were significant changes from baseline to 12 weeks after treatment in LSM ［6.1 (51-12.4) kPa vs 8.6 (5.7-16.9) kPa, Z=-1.676, P=0.043］ and APRI ［0.24(0.19-0.48) vs 0.42(0.23-1.17), Z=-2.050, P=0027］. From baseline to 12 weeks after treatment, the patients with abnormal ALT or AST at baseline had significant changes in LSM ［89(5.6-13.1) kPa vs 14.4(8.0-28.2) kPa, Z=-1.679, P=0.047］ and APRI ［0.44(0.25-0.50) vs 1.29(0.99-2.09), Z=-3.427, P=0.001］. ConclusionCHC patients achieve a high sustained virologic response rate after DAA therapy, and the patients with abnormal ALT or AST at baseline tend to have more significant improvements in LSM and APRI than those without such abnormality.

[Objective] The objective of this study was to evaluate the diagnostic accuracy of the 2013 edition of Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon in diagnosing breast categories 3-5 lesions.[Methods] Using our breast ultrasound database from June 2014 to June 2016,we identified 4428 BI-RADS category 3 to 5 lesions with a known pathological diagnosis in 4 428 adult women.The positive predictive value (PPV) of each BI-RADS category was calculated based on the pathological diagnoses and compared with the reference range provided by the American College of Radiology (ACR).[Results] 4 428 lesions from 4428 patients were included in this study.The PPV of each BI-RADS category waswithin the reference range provided by the ACR in 2013.1198 (27.1％) pathological malignant/borderline results were found in the 4 428 lesions,the other 3 230 (72.9％)lesions were diagnosed with benign results.Among the malignant/borderline lesions,the rate of lymph node metastasis gradually increased as the BI-RADS categories were upgraded.Malignant lesions with a diagnosis ofinvasive ductal carcinoma or invasive lobular carcinoma showed an increasing distribution trend from category 3 to 5.[Conclusion] The 2013 editionof BI-RADS ultrasound lexiconhas good diagnostic accuracy and efficiencyin clinical practice.

Objective To study action mechanism of Shuanghuang Xiaocuo Pills for treatment of rabbit ear acne models. Methods Totally 48 male Japanese white rabbits were divided into blank group, model group, positive medicine group, and Shuanghuang Xiaocuo Pills low, medium, and high dose groups through random number table method. Except for blank group, other groups established rabbit ear acne models. After the models were established, these groups received gavage with relevant medicine, once a day, for 14 days. Then all the rabbit models were under blood sampling. Radioimmunoassay was used to detect contents of IL-8 and TNF-α in serum. Results Compared with blank group, the contents of IL-8 and TNF-αincreased significantly in the model group (P<0.01). Compared with model group, except for Shuanghuang Xiaocuo Pills low dose group, the contents of IL-8 and TNF-αdecreased significantly in other treatment groups (P<0.01). Conclusion Shuanghuang Xiaozuo Pills can treat acne by reducing the contents of IL-8 and TNF-αin serum.

Recognizing acetyl-lysine of histone is a key process of epigenetic regulation that is mediated by a protein module called bromodomain(BRD). The bromodomain inhibitors of the bromodomains and extra-terminal(BET)family have shown great potential in anti-inflammatory and antiproliferative effects. Through a review of diseases and structures about BET bromodomain, different kinds of inhibitors were analyzed and their structure-activity relationships were summarized. Herenin, the recent advances reported are reviewed for discovering more excellent small molecule inhibitors.