Purpose: In this study, the neural communication patterns between hypothalamic structures and cortical areas in girls diagnosed with central precocious puberty (CPP) were explored. Endocrine profiles were incorporated to clarify the pathophysiological interactions between cerebral networks and hormonal regulation. The hypothalamus was designated as the key focus area for connectivity analysis. Methods: Fifty-seven girls (37 CPP, 20 non-CPP) were recruited from the Pediatric Development Clinic at the Second Affiliated Hospital of Anhui Medical University. The collected data included demographic information, gonadotropin-releasing hormone stimulation tests, and magnetic resonance imaging scans. Hypothalamic functional connectivity (FC) was analyzed using predefined region of interest coordinates, and correlations between hormone levels and FC values were assessed. Results: Compared to the non-CPP group, the CPP group exhibited elevated baseline follicle-stimulating hormone (FSH), baseline luteinizing hormone (LH), peak FSH, peak LH, and peak LH/FSH ratios. Patients with CPP exhibited enhanced neural synchronization linking the right lateral hypothalamic effector zone to the right superior frontal gyrus (displaying a borderline significant correlation with peak LH concentrations), concurrent with diminished functional coupling of the right lateral hypothalamic efferent to the right fusiform/supramarginal gyri. The left lateral hypothalamic projections demonstrated amplified connectivity with the right cuneus. No FC differences were observed in the medial hypothalamus. Conclusion Abnormal lateral hypothalamus FC patterns were identified in CPP girls and were particularly linked to peak LH levels. The findings offer novel insights into the neuroendocrine mechanisms underlying CPP.

Objective To explore the medication rules of oral Chinese medicine compound prescriptions in national patents for treating cervical spondylosis through data mining,so as to provide new references for the treatment of cervical spondylosis with traditional Chinese medicine.Methods The data related to patents of oral Chinese medicine compound prescriptions for treating cervical spondylosis were retrieved and screened from the China National Intellectual Property Administration public service website,and a database of Chinese medicine compound prescriptions was established.Relevant software was used to statistically analyze the frequency of drug use,nature,flavor,meridian tropism,and association rules,and cluster analysis was performed on the Chinese medicines with high association intensity.Results A total of 394 compound prescriptions and 221 Chinese medicines were included.Among them,31 Chinese medicines such as Chuanxiong,Danggui,Gegen,Gancao and Weilingxian were high-frequency drugs for treating cervical spondylosis.The nature of medicine was mainly warm,cold and neutral,and the flavor was mainly bitter,pungent and sweet.The meridian tropism was mainly liver,spleen and lung meridians.Cluster analysis of high-frequency drugs yielded 4 clustered prescriptions.Conclusion The treatment of cervical spondylosis with Chinese medicines mainly focuses on promoting blood circulation for removing obstruction in collaterals,activating qi and relieving pain,dispelling pathogenic wind and eliminating dampness,and tonifying and replenishing liver and kidney,with the method of promoting blood circulation for removing blood stasis,and relieving pain running through the whole process.

Objective:To investigate the pathways involved in bisphenol S(BPS)and bisphenol F(BPF)induced male reproductive injury by bioinformatics methods and experimental verification.Methods:Bioinformatics analysis was conducted to screen the genes related to male reproductive system diseases associated with BPF and BPS from the Comparative Toxicogenomics Database(CTD).Functional enrichment using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed to predict potential signaling pathways and key genes.Cell counting kit-8(CCK-8)method was used to assess the cell viability in various groups treated with different concentrations of BPS and BPF(1×10-3,1×10-2,1×10-1,1×100,1×101,and 1×102 μmol·L-1).TM3 cells were divided into control group(0.1％DMSO),different doses of BPS groups,and different doses of BPF groups.The cells were treated with 20,40,and 80 μmol·L-1 of BPS and BPF for 72 h,respectively.Real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting method were used to detect the expression levels of key genes mRNA and proteins in various groups.Results:The bioinformatics analysis results revealed that 507 and 447 male systemic disease genes related to BPS and BPF were screened by CTD,respectively.The GO enrichment analysis results showed that the selected genes were primarily enriched in biological processes(BP)such as reproductive system development and reproductive structure development.The KEGG pathway analysis results indicated that these genes were significantly enriched in signaling pathways such as phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT),hypoxia-inducible factor-1(HIF-1),and cellular senescence(P＜0.001).The CCK-8 method results showed that compared with control group,the cell viabilities in 1× 102 μmol·L-1 BPF and BPS groups were significantly decreased(P＜0.05),while the viabilities of TM3 cells in other groups had no significant changes(P＞0.05).After BPS treatment,compared with control group,the expression levels of PI3K,AKT,hypoxia-inducible factor-1α(HIF-1α),and CREB-binding protein(CBP)mRNA in low,medium,and high doses of BPS groups were decreased(P＜0.05),the expression levels of PI3K protein were decreased(P＜0.05),the expression levels of B-cell lymphoma-2-associated X protein(Bax)protein were increased(P＜0.05),and the expression levels of serine protease inhibitor clade B,member 10(SERPINB10)mRNA were increased(P＜0.01);the expression levels of Bax and intraflagellar transport 80 homolog(IFT80)mRNA in the cells in medium and high doses of BPS groups were increased(P＜0.05);the expression levels of B-cell lymphoma-2(Bcl-2)mRNA and protein in low and high doses of BPS groups were decreased(P＜0.05);the expression levels of additional sex combs like 2(ASXL2)mRNA in low and medium doses of BPS groups were decreased(P＜0.01).After BPF treatment,compared with control group,the expression levels of Bcl-2,HIF-1α,and structural maintenance of chromosomes protein 1B(SMC1B)mRNA in low,medium,and high doses of BPF groups were decreased(P＜0.05),and the expression levels of IFT80 mRNA(P＜0.01)and Bax protein(P＜0.01)were increased;the expression levels of PI3K,AKT,and ring finger protein 130(RNF130)mRNA in low and high doses of BPF groups were decreased(P＜0.05);the expression level of CBP mRNA in medium dose of BPF group was decreased(P＜0.05),while the expression level of RNF130 mRNA was increased(P＜0.05);the expression levels of PI3K and Bcl-2 proteins in high dose of BPF group were decreased(P＜0.05).Conclusion:BPF and BPS may cause cell cytotoxicity and impair male reproductive health through PI3K/AKT and HIF-1 signaling pathways.RNF130 and SMC1B may be important targets for their induction of male reproductive toxicity.

Objective:To develop a scale to measure the sense of gain of the elderly, and to evaluate its reliability and validity.Methods:According to the content of the sense of gain, combined with the literature research method and interview method, the scale entry pool was established.After the expert consistency evaluation and the optimal test assembly method (OTA) analysis, the formal version of the scale was formed.The stratified sampling method was used to select 1 043 community-dwelling elders for the survey, and the reliability and validity of the scale were evaluated by methods based on classical test theory.Results:The scale of elderly sense of gain, which was screened by OTA method, included four dimensions: health status, relationship and communication, social security, and ideal expectation, with a total of 17 items. The Cronbach's α value of the formal version of the scale was 0. 850, and the Cronbach's α coefficients of the four dimensions were 0.721, 0.772, 0.779, and 0.930, respectively. The CR values of the combined reliabilities of each dimension were all above 0.7. In terms of AVE values, except for the health status dimension was acceptable, the other three dimensions were all above 0.36. The correlation coefficient between the sense of health acquisition and life satisfaction of the elderly was 0.531 ( P<0.01). Conclusion:The developed scale for measuring the sense of gain of the elderly has good reliability and validity, which can be used as an effective tool for measuring the sense of gain of the elderly.

Objective:To develop a scale to measure the sense of gain of the elderly, and to evaluate its reliability and validity.Methods:According to the content of the sense of gain, combined with the literature research method and interview method, the scale entry pool was established.After the expert consistency evaluation and the optimal test assembly method (OTA) analysis, the formal version of the scale was formed.The stratified sampling method was used to select 1 043 community-dwelling elders for the survey, and the reliability and validity of the scale were evaluated by methods based on classical test theory.Results:The scale of elderly sense of gain, which was screened by OTA method, included four dimensions: health status, relationship and communication, social security, and ideal expectation, with a total of 17 items. The Cronbach's α value of the formal version of the scale was 0. 850, and the Cronbach's α coefficients of the four dimensions were 0.721, 0.772, 0.779, and 0.930, respectively. The CR values of the combined reliabilities of each dimension were all above 0.7. In terms of AVE values, except for the health status dimension was acceptable, the other three dimensions were all above 0.36. The correlation coefficient between the sense of health acquisition and life satisfaction of the elderly was 0.531 ( P<0.01). Conclusion:The developed scale for measuring the sense of gain of the elderly has good reliability and validity, which can be used as an effective tool for measuring the sense of gain of the elderly.

Objective To explore the medication rules of oral Chinese medicine compound prescriptions in national patents for treating cervical spondylosis through data mining,so as to provide new references for the treatment of cervical spondylosis with traditional Chinese medicine.Methods The data related to patents of oral Chinese medicine compound prescriptions for treating cervical spondylosis were retrieved and screened from the China National Intellectual Property Administration public service website,and a database of Chinese medicine compound prescriptions was established.Relevant software was used to statistically analyze the frequency of drug use,nature,flavor,meridian tropism,and association rules,and cluster analysis was performed on the Chinese medicines with high association intensity.Results A total of 394 compound prescriptions and 221 Chinese medicines were included.Among them,31 Chinese medicines such as Chuanxiong,Danggui,Gegen,Gancao and Weilingxian were high-frequency drugs for treating cervical spondylosis.The nature of medicine was mainly warm,cold and neutral,and the flavor was mainly bitter,pungent and sweet.The meridian tropism was mainly liver,spleen and lung meridians.Cluster analysis of high-frequency drugs yielded 4 clustered prescriptions.Conclusion The treatment of cervical spondylosis with Chinese medicines mainly focuses on promoting blood circulation for removing obstruction in collaterals,activating qi and relieving pain,dispelling pathogenic wind and eliminating dampness,and tonifying and replenishing liver and kidney,with the method of promoting blood circulation for removing blood stasis,and relieving pain running through the whole process.

Background and purpose:Limbs soft tissue sarcoma(STS)is a common malignant tumor,and surgical resection is the main treatment method for it.The concept of barrier made us realize the blocking effect of natural barrier on STS,and we aimed to search for tissues that can act as barrier,and to perform complete resection of surgical margins around the tissue barrier.This study aimed to investigate the feasibility,safety and prognosis of barrier resection in the treatment of limbs STS.Methods:From December 2013 to September 2016,data of 72 patients who underwent barrier resection of STS of extremities in department of oncosurgery,Minhang Branch,Fudan University Shanghai Cancer Center were retrospectively analyzed,and the resection margin was sampled.All 72 patients underwent preoperative magnetic resonance imaging(MRI)or computed tomography(CT)design,and the physiological barrier or at least 3 cm distance was found outward from the anatomical location of the tumor.And en bloc excision was performed outside this barrier or at a distance of 3 cm.The influence of postoperative pathological margin,musculoskeletal tumor society(MSTS)score and postoperative complications on the patients were analyzed.The 1-and 3-year locoregional recurrence-free survival(LRFS)rates and sarcoma-specific survival(SSS)rates were evaluated,and the influencing factors were analyzed.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(number:1212117-12&1212117-12-1301).Results:All patients had negative margins.The 1-and 3-year LRFS rates were 98.2%and 93.3%,respectively.The 1-and 3-year SSS rates were 98.4%and 94.2%,respectively.The mean MSTS scores were 28.3 preoperatively and 25.5 postoperatively.Surgical complications were grade 1 to 2 in 20 cases and grade 3 in 1 case,and there were no grade 4 to 5 complications.Conclusion:Based on the combination of clinical,imaging and pathology data,barrier resection,including tumor resection and functional reconstruction,can be applied to the surgical treatment of STS,with good feasibility and safety,reliable margin and satisfactory local control.

Objective To investigate the clinical effect of anterograde percutaneous screw fixation under robot navigation in the treatment of acetabular anterior column fractures.Methods A retrospective analysis was made on 7 cases of anterior acetabular column fractures from April 2021 to January 2023.The traction reduction was conducted by using pelvic"double reverse"traction table,the orthopedic robot-assisted design was carried out to plan the screw entry point and direction,and the antegrade channel cannulated screw was used for internal fixation.Results The operation time was 60-95 min(mean,78 min).The intraoperative blood loss was 5-20 ml(mean,8.6 ml).The number of fluoroscopy was7-11(mean,8.7).The guide needle was unadjusted in 3 cases and adjusted for 1-2 times in 4 cases(once in 2 cases and twice in 2 cases).The actual path deviated from the planned by 0.65-1.50 mm(mean,0.98±0.30 mm).The excellent and good rate of screw position was 100%.X-ray and CT examinations were performed at 48 h after the operation.According to the Matta reduction standard,anatomical reduction was achieved in 6 cases and satisfactory reduction in 1 case.All the 7 cases were followed up for 6-28 months(mean,15 months).At the last follow-up,the Harris score of the hip joint was85-96 points(mean,91.6 points)and the pain of visual analogue scale(VAS)was0.There were no complications such as infection,loosening of internal fixation,or neurological dysfunction.Conclusion Anterograde percutaneous screw fixation under robot navigation in the treatment of acetabular anterior column fractures is safe,effective,and satisfactory.

Objective To explore the learning curve of Bikini incision direct anterior approach total hip arthroplasty(Bikini-THA).Methods Clinical data of 80 cases of Bikini-THA initially completed by an operator skilled in posterolateral approach and direct anterior approach total hip arthroplasty from March 2020 to March 2023 were retrospectively analyzed,and the learning curve was observed by scatter plots of operative time and intraoperative bleeding.They were divided into groups A to D according to the order of surgery,with 20 cases in each group.The operative time,intraoperative bleeding,acetabular abduction angle,anteversion angle,angle between stem and femoral axis,postoperative hip Harris score and complications were compared among the 4 groups.Results After about 40 cases,the decreasing trend of operative time and intraoperative bleeding slowed down and stabilized.The operative time and intraoperative bleeding in the 4 groups were group A＞group B＞groups C and D(P＜0.05),and the differences between the group C and group D were not statistically significant(P＞0.05).The acetabular prosthesis was well-positioned in the 4 groups(abduction angle of 30°-50°,anteversion angle of 5°-25°).The femoral prosthesis center fixation rate(angle between stem and femoral axis ≤3°)was group A＜groups C and D(P=0.003,0.003).The differences in the Harris scores of the hip joints at 2 weeks,1 month,3 months,and 12 months postoperatively of the 4 groups were not statistically significant(P＞0.05),and the efficacy evaluations of the hip joints at 12 months postoperatively were all excellent.There were 5 cases of complications in the group A(2 cases of greater trochanter fracture and 3 cases of lateral femoral cutaneous nerve injury),3 cases of complications in the group B(1 case of greater trochanteric fracture,1 case of lateral femoral cutaneous nerve injury,and 1 case of incision infection),1 case of complications in the group C(lateral femoral cutaneous nerve injury),and no complications in the group D.The follow-up period lasted for 12-26 months,with a mean of(19.4±4.7)months.There were no complications such as dislocation or loosening of the prosthesis.Conclusion The Bikini-THA learning curve was approximately 40 cases.

Objective:To evaluate the safety and efficacy of enhanced recovery after surgery(ERAS) in the perioperative period of congenital choledochal cysts in children.Methods:This is a multicenter prospective randomized controlled study. The clinical data of 273 pediatric congenital choledochal cysts(CCC) patients who underwent surgery at 14 medical centers with complete follow-up data were collected through the medical data analysis platform. Among them, 123 cases in ERAS group were managed perioperatively in strict accordance with ERAS mode, and 150 cases in conventional group were managed according to traditional mode. The length of hospital stay,time to first farting, time to complete feeding, the incidence of complications, cost and readmission rate within 30 days,stress indexes and liver function were compared between the two groups.Results:Compared with the conventional group, median time to start farting (2.0 d vs. 3.0 d, P<0.001), median time to complete feeding (5.0 d vs. 7.0 d, P<0.001), median postoperative hospitalization time (6.0 d vs. 9.0 d, P<0.001),the median total length of stay(13.0 d vs. 15.0 d, P<0.001) were shorter,the median hospitalization cost (37,000 yuan vs.43,000 yuan P<0.001) was lower, and stress indexes recovered quickly. The incidence of postoperative hospital stay and readimission rate within 30 d were not statistically different between the two groups. Conclusion:It is safe and feasible to implement ERAS for children with CCC in the perioperative period, which can reduce stress response, speed up recovery,and save medical costs.