Objective:To explore the predictive value of prognostic nutritional index (PNI) combined with serum peroxiredoxin 3 (PRX3) level for the prognosis of patients with advanced high-grade serous ovarian cancer (HGSOC) .Methods:A total of 103 patients with advanced HGSOC admitted to Affiliated Hospital of Jining Medical University from Jan. 2020 to Dec. 2022 were retrospectively selected and included in the study. Serum albumin (Alb), PRX3 levels and peripheral blood lymphocyte count (LY) levels were measured. The patients were followed up for 2 years, and they were divided into good prognosis group (70 cases) and poor prognosis group (33 cases). Multivariate stepwise Logistic regression analysis was used to analyze the prognostic factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of PNI combined with PRX3 on prognosis.Results:The age, proportion of postoperative residual lesions, proportion of lymph node metastasis, proportion of stage Ⅲ, and PRX3 level in the poor prognosis group were higher than those in the good prognosis group, and the PNI level was lower than that in the good prognosis group ( P<0.05). Multivariate Logistic regression analysis showed that postoperative residual lesions ( OR=2.731, 95% CI: 1.562-4.774), clinical stage ( OR=3.526, 95% CI: 1.503-8.271), PNI level ( OR=0.148, 95% CI: 1.503-8.271) 0.057-0.387) and PRX3 level ( OR=4.011, 95% CI: 1.972-8.154) were independent influencing factors for the prognosis of patients ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) of PNI, PRX3 and their combination for predicting the prognosis of advanced HGSOC patients were 0.807, 0.781 and 0.874, respectively ( P<0.05). The survival curve of patients with high PNI and PRX3 levels was different from that of patients with low PNI and PRX3 levels ( P<0.05) . Conclusion:PNI and PRX3 are independent prognostic factors for advanced HGSOC patients, and the combination of PNI and PRX3 has a better prognostic value in patients with advanced HGSOC.

Objective:To explore the predictive value of prognostic nutritional index (PNI) combined with serum peroxiredoxin 3 (PRX3) level for the prognosis of patients with advanced high-grade serous ovarian cancer (HGSOC) .Methods:A total of 103 patients with advanced HGSOC admitted to Affiliated Hospital of Jining Medical University from Jan. 2020 to Dec. 2022 were retrospectively selected and included in the study. Serum albumin (Alb), PRX3 levels and peripheral blood lymphocyte count (LY) levels were measured. The patients were followed up for 2 years, and they were divided into good prognosis group (70 cases) and poor prognosis group (33 cases). Multivariate stepwise Logistic regression analysis was used to analyze the prognostic factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of PNI combined with PRX3 on prognosis.Results:The age, proportion of postoperative residual lesions, proportion of lymph node metastasis, proportion of stage Ⅲ, and PRX3 level in the poor prognosis group were higher than those in the good prognosis group, and the PNI level was lower than that in the good prognosis group ( P<0.05). Multivariate Logistic regression analysis showed that postoperative residual lesions ( OR=2.731, 95% CI: 1.562-4.774), clinical stage ( OR=3.526, 95% CI: 1.503-8.271), PNI level ( OR=0.148, 95% CI: 1.503-8.271) 0.057-0.387) and PRX3 level ( OR=4.011, 95% CI: 1.972-8.154) were independent influencing factors for the prognosis of patients ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) of PNI, PRX3 and their combination for predicting the prognosis of advanced HGSOC patients were 0.807, 0.781 and 0.874, respectively ( P<0.05). The survival curve of patients with high PNI and PRX3 levels was different from that of patients with low PNI and PRX3 levels ( P<0.05) . Conclusion:PNI and PRX3 are independent prognostic factors for advanced HGSOC patients, and the combination of PNI and PRX3 has a better prognostic value in patients with advanced HGSOC.

Compared to traditional suturing, lung stapling using automatic staplers offers advantages such as smaller trauma, faster wound healing, ease of operation, and lower complication rates, making it widely used in clinical practice. However, there are significant differences in bronchial tissue thickness at different anatomical locations, and the market is flooded with various types of staplers. Currently, there is a lack of recommended stapling schemes for bronchial staplers at different anatomical locations. This article reviews the development and application of automatic staplers and summarizes some types of staplers that are currently used in clinical practice, with the aim of promoting the formation of individualized stapler selection protocols for minimally invasive thoracic surgery based on the Chinese population.

BACKGROUND: Electroacupuncture (EA) treatment is efficacious in patients with respiratory disorders, although the mechanisms of its action in lung-function protection are poorly understood. This study aimed to explore the neuroanatomical mechanisms of EA stimulation at the BL13 acupoint (Feishu, EA-BL13) improvement in asthma. METHODS: Allergic asthma was induced by intranasal 2.0% ovalbumin (OVA) instillation combined with intraperitoneal injection of the 10.0% OVA. The levels of interleukin (IL)-4 and IL-5 were detected by enzyme-linked immunosorbent assay. Hematoxylin and eosin and periodic acid-schiff stain were used to evaluate inflammatory cell infiltration and mucus secretion. Cellular oncogene fos induction in neurons after EA stimulation was detected by immunofluorescent staining. The messenger RNA expression levels of adrenergic receptors were quantified with real-time polymerase chain reaction. RESULTS: EA improved airway inflammation and mucus secretion mainly by activating somatosensory-sympathetic pathways ( P <0.001). Briefly, the intermediolateral (IML) nuclei of the spinal cord received signals from somatic EA stimulation and then delivered the information via the sympathetic trunk to the lung. Excited sympathetic nerve endings in lung tissue released large amounts of catecholamines that specifically activated the β2 adrenergic receptor (β2AR) on T cells ( P <0.01) and further decreased the levels of IL-4 and IL-5 ( P <0.001) through the cyclic adenosine monophosphate/protein kinase A signaling pathway. CONCLUSION This study provided a new explanation and clinical basis for the use of EA-BL13 as a treatment for allergic asthma in both the attack and remission stages and other respiratory disorders related to airway inflammation.
Electroacupuncture/methods* ; Animals ; Asthma/immunology* ; Rats ; Rats, Sprague-Dawley ; Male ; Inflammation/therapy* ; Interleukin-4/metabolism* ; Interleukin-5/metabolism*

ObjectiveTo sum up the clinical features of 5α-reductase type 2 deficiency （5α-RD2） complicated by central precocious puberty （CPP）， and provide experience for clinicians. MethodsA retrospective review was conducted of child patients with 5α-RD2 followed up to puberty at a single tertiary pediatric center， in whom 6 cases developed CRP. Clinical characteristics and treatment history of them were analyzed. A literature review was also performed to investigate possible mechanisms underlying the co-occurrence of 5α-RD2 and CPP. ResultsThe median age at initial presentation was 5.55 years （IQR 3.50-7.20）. Common clinical features included micropenis and hypospadias. Median stretched penile length （SPL） was 2.25 cm （IQR 1.8-2.8）， with an SPL-SDS of -4.5 （IQR -3.1 to -5.8）. Median external masculinization score （EMS） and Prader scores were 8.5 （IQR 5.0-9.0） and 4.5 （IQR 3.0-5.0）， respectively. Pubertal onset occurred at a median age of 8.70 years （IQR 7.80-9.00）. Three patients were overweight or obese. Five had received 2.5% dihydrotestosterone （DHT） gel prior to pubertal onset， with a median cumulative dose of 205.5 mg/kg （IQR 72.0-660.3 mg/kg） with DHT gel therapy. Notably， one patient with normal body mass index （BMI） and no history of androgen or gonadotropin therapy also exhibited early pubertal onset at 8.4 years. ConclusionCPP in children with 5α-RD2 may be associated with prior dihydrotestosterone （DHT） gel therapy and elevated BMI； however， a potential intrinsic link to the underlying disorder cannot be excluded. Further studies are needed to elucidate the pathophysiological mechanisms.

Pain is a distressing experience in sensory,emotional,cognitive,and social dimensions associated with existed or potential tissue damage.Studies have demonstrated the efficacy of acupuncture analgesia,but the underlying mechanisms are not fully understood.Bioelectrical signals,as one of the basic characteristics of life activities,play a key role in the process of acu-puncture analgesia.Through advanced neurophysiological techniques and multimodal imaging,it has been found that acupuncture can trigger specific changes in bioelectric signals,thus producing analgesic effects.With the rapid development of modern medi-cal technology,the study of bioelectrical signals has gradually delved into the cellular and molecular levels,providing more possi-bilities to reveal the analgesic mechanism of acupuncture.This review focuses on the close connection between bioelectrical sig-naling phenomena and acupuncture analgesia mechanism,summarizes the current research status of bioelectrical signaling phe-nomena in acupuncture analgesia mechanism by collating related literature.The future research directions were prospected,ai-ming to provide theoretical basis and new ideas for further understanding and applying acupuncture analgesia.

Pain is a distressing experience in sensory,emotional,cognitive,and social dimensions associated with existed or potential tissue damage.Studies have demonstrated the efficacy of acupuncture analgesia,but the underlying mechanisms are not fully understood.Bioelectrical signals,as one of the basic characteristics of life activities,play a key role in the process of acu-puncture analgesia.Through advanced neurophysiological techniques and multimodal imaging,it has been found that acupuncture can trigger specific changes in bioelectric signals,thus producing analgesic effects.With the rapid development of modern medi-cal technology,the study of bioelectrical signals has gradually delved into the cellular and molecular levels,providing more possi-bilities to reveal the analgesic mechanism of acupuncture.This review focuses on the close connection between bioelectrical sig-naling phenomena and acupuncture analgesia mechanism,summarizes the current research status of bioelectrical signaling phe-nomena in acupuncture analgesia mechanism by collating related literature.The future research directions were prospected,ai-ming to provide theoretical basis and new ideas for further understanding and applying acupuncture analgesia.

ObjectiveTo explore the effect of precocious puberty on glucose metabolism and lipid metabolism in female rats. MethodsSixty two-day-old female rats were randomly divided into 2 groups. When aged 5 days， the precocious puberty group and normal group were given a single subcutaneous injection of danazol and solvent soybean oil respectively. The vaginal opening of rats was monitored from their 21 days of age. After 12 hours of fasting， all successful modeling rats were randomly executed within 3 days after vaginal opening， when aged 7 and 12 weeks. Then we measured the rats’ body weight and length， determined the concentrations of glucose， insulin， blood lipids， estradiol， leptin and adiponectin with enzyme-linked immunosorbent assay and observed the pathological changes of perirenal fat， uterus and ovary. ResultsFor body weight and length， rats in the precocious puberty group were smaller than those in the normal group within 3 days after vaginal opening， but which did not affect their subsequent growth and development， and there was no significant difference between the two groups at 7 and 12 weeks of age. Within 3 days after vaginal opening， insulin levels had significant difference between the two groups （P = 0.001）， the precocious group showed hyperinsulinemia and increased number of perirenal adipocytes. At three execution times， no significant difference was noted in estradiol， leptin and adiponectin levels between the two groups. The same was true in the ratios of ovary or uterus to body weight between the two groups. ConclusionsPrecocious puberty makes earlier onset of pubertal development and allows body maladaptation to the sudden changes of the internal environment. However， the changes due to precocious puberty are temporary and reversible， and they may become normal in adulthood.

Objective:To investigate the protective effect of lycopene on rats with cognitive dysfunction (CD) induced by sevoflurane anesthesia through endoplasmic reticulum stress (ERS).Methods:A rat CD model was established using sevoflurane anesthesia induction. SD rats were randomly divided into a sham operation group, model group, low-, high-dose (5 and 10 mg/kg) lycopene groups, and a lycopene + tunicamycin (10 mg/kg + 100 μg/kg) group, with 12 rats in each group. 5 and 10 mg of lycopene was dissolved in 1 ml of sodium carboxymethylcellulose to form a suspension, and 10 μg of clindamycin was dissolved in 1 and 2 ml of 0.1% dimethyl sulfoxide. Rats in the low-, high-dose lycopene groups were gavaged with 1 ml of lycopene suspension, respectively, and the rats in the lycopene + tunicamycin group were gavaged with 1 ml of lycopene suspension and received 1 ml intraperitoneal injection of clindamycin. The sham operation group and the model group received an equal amount of saline by gavage or intraperitoneal injection, respectively. The low-, high-dose lycopene groups received an equal amount of saline by intraperitoneal injection, both 1 time/d for 6 weeks. The Morris water maze test was used to determine the cognitive function of rats. HE staining was used to observe the morphological changes of rat hippocampal tissue. TUNEL staining was used to observe the apoptosis of neurons in rat hippocampal tissue. The ELISA method was used to detect the levels of brain-derived neurotrophic factor (BDNF) and S100 calcifying protein β (S100β) in hippocampal tissue. Western Blot was used to detect the levels of apoptosis-related proteins in rat hippocampal tissues, including the levels of B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax) with ERS marker glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), and cysteinyl aspartate specific proteinase-12 (Caspase-12).Results:Compared with the model group, the escape latency, neuronal apoptosis rate, S100β level, GRP78, CHOP, Caspase-12, and Bax expression were decreased in the low-, high-dose lycopene groups on days 3, 4, and 5 (all P < 0.05), and the number of crossing platforms, BDNF level, and Bcl-2 expression were increased (all P < 0.05). With the increase of lycopene dose, the escape latency, neuronal apoptosis rate, S100β level, GRP78, CHOP, Caspase-12, and Bax expression were decreased in the high-dose lycopene group compared with the low-dose lycopene group on days 3, 4, and 5 (all P < 0.05), and the number of crossing platforms, BDNF level, and Bcl-2 expression were increased (all P < 0.05). Compared with the high-dose lycopene group, the escape latency, neuronal apoptosis rate, S100β level, GRP78, CHOP, Caspase-12, and Bax expression were increased in the lycopene + tunicamycin group on days 3, 4, and 5 (all P < 0.05), and the number of crossing platforms, BDNF level, and Bcl-2 expression were decreased (all P < 0.05). Hippocampal tissue neuronal loss and the inflammatory infiltration were both reduced in CD rats after lycopene intervention. The ERS activator tunicamycin attenuated the protective effect of lycopene on sevoflurane-induced CD rats. Conclusions:Lycopene may play a protective role against CD in rats anesthetized with sevoflurane by inhibiting ERS.

Objective To summarize the clinical characteristics of children with drug-induced hypersensitivity syndrome(DIHS)complicated with herpesvirus reactivation,and to promote the early and accurate identification,diagnosis,and treatment of DIHS in children.Methods The medication history,clinical manifestations,treatment,and prognosis of 12 children confirmed DIHS complicated with herpesvirus reactivation in Guangzhou Women and Children's Medical Center between January 2018 and March 2023 were retrospectively analyzed.The changes in hematological parameters,inflammatory indexes,and hepatic and renal function within 5 d before the eruption,5 d,and 6-10 d after eruption were compared.Results Of the 12 patients,the male-to-female ratio was 5∶1,with a median age of 27(interquartile range 20.50-34.75)months.Two or more antibiotics were used at least two to six weeks before onset,with a combination of 3 or more antibiotics in 7 children,and a combined or sequential application of 2 antibiotics in 5 children.The antibiotics included cephalosporins(n=12),semisynthetic penicillins(n=5),vancomycin(n=4)and azithromycins(n=7).All 12 patients presented fever,rashes,and multiple organ involvement.The rashes were red maculopapules in the early stage and then gradually developed into massive fusion exceeding 50%of the whole body.Among them,seven children were accompanied by facial edema,and two had purplish-red facial rashes.11 children suffered from exfoliative dermatitis in the later stage.12 children presented obviously enlarged lymph nodes.Liver involvement was the most common(100%,simple increase of transaminase in four children,cholestasis in six children,and hepatic failure in two children),and lung involvement was found in nine children.Laboratory examination showed no significant increase in leukocytes or eosinophils within 5 d before the eruption,but low levels of atypical lymphocytes.After the eruption,leukocytes,eosinophils,and atypical lymphocytes increased progressively.Inflammatory indexes of hypersensitive C-reactive protein(CRP),procalcitonin(PCT)increased dramatically before and after the eruption.All the children received intravenous immunoglobulin(IVIG)and methylprednisolone,two children were given antiviral therapy,and nine children were treated with multiple plasma exchanges.After treatment,nine children were cured,one developed immune reconstitution syndrome,and two died of hepatic failure.Conclusions Antibiotics are common allergenic drugs for DIHS in children.Its clinical manifestations include fever and rashes,accompanied by multiple organ involvement,such as the liver and lung.When leukocytes,eosinophils,and atypical lymphocytes are progressively elevated after the eruption,DIHS should be highly suspected,herpesvirus activation should be monitored,medication history should be traced,and early active immunotherapy and antiviral therapy should be conducted if necessary.