Purpose: The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs). Materials and Methods: Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients. Results: A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804. Conclusion USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.

Objective To explore whether virtual reality(VR)combined with computerized cogni-tive training intervention can improve the cognitive function in elderly stroke patients.Methods A total of 202 stroke patients admitted to our department from January 2022 to January 2024 were recruited and randomly divided into control group(101 cases,traditional cognitive training intervention)and study group(101 cases,VR combined with computerized cognitive training in-tervention).Before and after 3 months of intervention,Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE),National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Activities of Daily Living Scale(ADL)were applied,serum levels of dopamine,neuropeptide Y(NPY),5-hydroxytryptamine(5-HT)and norepineph-rine(NE)were detected,and P300 wave of event-related potential was measured.The results were compared before and after intervention,and between the two groups.Results After intervention,the scores of MoCA,MMSE and FMA,the levels of NPY,5-HT,NE,dopamine,and the ampli-tude of P300 wave were obviously higher in both groups when compared with those before inter-vention(P＜0.05).The study group obtained notably higher MoCA score(27.64±0.62 vs 26.83±0.65),MMSE score(27.67±0.61 vs 26.83±0.62),NPY,5-HT,NE,dopamine,FMA score and amplitude of P300 wave after intervention than the control group(P＜0.01).The NIHSS score,ADL score and latency in the two groups after intervention were significantly lower than those before intervention(P＜0.05),and the above indicators in the study group were significantly low-er than the control group(P＜0.01).Conclusion VR combined with computerized cognitive training intervention can effectively improve the cognitive function,neurological function,motor function and daily life function,and enhance the neurotransmitter levels in elderly stroke patients.

Objective To explore the clinical efficacy of low-frequency pulse therapy combined with ingestion-swallowing training in the treatment of patients with post-stroke dysphagia.Methods A retrospective study was conducted on 122 patients with post-stroke dysphagia admitted in our hospital from January 2022 to January 2024.According to different interventions,they were divid-ed into a control group(ingestion-swallowing training on the basis of conventional treatment,60 cases)and a combined treatment group(low-frequency pulse therapy and the treatments in the control group,62 cases).Before and after treatment,VFSS and standard swallowing assessment(SSA)were performed,hyoid bone movement displacement(hyoid bone forward and upward)and vertebrobasilar artery blood flow indicators[pulsatility index(PI),mean blood flow velocity(Vm),systolic blood flow velocity(Vs)]were observed,and serum levels of nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)were detected in all the patients.The chan-ges in quality of life(swallow quality of life questionnaire)and occurrence of complications during treatment were observed in the two groups.Results In both groups after treatment,the VFSS score,quality of life score and swallowing symptom score,hyoid bone forward and upward dis-tances,vertebrobasilar artery Vm and Vs,and serum NGF and BDNF levels were all risen signifi-cantly while the SSA score and vertebrobasilar artery PI were obviously declined when compared with the levels before treatment(P＜0.05).After treatment,the combined treatment group had more remarkably improved VFSS score,quality of life score,swallowing symptom score,hyoid bone forward and upward distances,vertebrobasilar Vm and Vs,and serum NGF and BDNF levels,and more notably declined SSA score and vertebrobasilar PI than the control group(P＜0.05,P＜0.01).No statistical difference was seen in the total incidence of complications between the combined treatment group and control group(4.8％vs 10.0％,P＞0.05).Conclusion Com-bined low-frequency pulse therapy and ingestion-swallowing training can effectively promote the recovery of swallowing function,increase the activity of hyoid bone,promote the vertebrobasilar artery blood flow and neurotrophic conditions,and thus improve the quality of life in patients with post-stroke dysphagia,with less complications.

Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.

Purpose: The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs). Materials and Methods: Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients. Results: A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804. Conclusion USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.

Purpose: The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs). Materials and Methods: Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients. Results: A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804. Conclusion USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.

Objective To provide theoretical basis for the clinical application of the rational compatibility of C. odorata by studying the related domestic and international literature and explore the properties of C. odorata according to the theory of Traditional Chinese Medicine. Methods The medical literature related to C. odorata was retrieved and screened from CNKI, VIP, Wanfang Data, China Biomedical Literature Database and foreign literature databases such as PubMed, Web of Science, Scopus, Embase, and SciFinder. A total of 397 English articles and 50 Chinese articles were included in the study, which were systematically classified according to clinical application, chemical composition, pharmacological effect, toxic and side effects, and were analyzed according to the theory of Traditional Chinese Medicine. Results C. odorata features spicy, astringent tastes, a cool nature, entering heart and liver meridians, and a slightly toxic.Its functions included astringing to stop bleeding, detoxifying and promoting tissue regeneration, as well as intercepting malaria and killing parasites. It was used for conditions such as hematemesis, haemoptysis, traumatic bleeding, sores and abscesses, malaria, and leech bites. Conclusion The exploration of the properties and efficacy of C. odorata could provide reference for its clinical research and application in Traditional Chinese Medicine.

Objective:To investigate the efficacy and safety of intravesical injections of botulinum toxin A (BTX-A) for the treatment of pediatric refractory urinary frequency and incontinence (UFI), and to analyze the factors predicting the therapeutic effect of BTX-A injections.Methods:A retrospective case series study was made on 35 children with UFI [(12.3±4.2) years old], including 13 males (37.1%) and 22 females (62.9%), treated in the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2024.Urotherapy and drug treatments were ineffective in all children, who then received intravesical injections of BTX-A.The urodynamic study (UDS) was performed 1 week before treatment and 3 months after treatment, and the Overactive Bladder Symptom Score (OABSS) and Incontinence Quality of Life (I-QOL) were collected.Perioperative and postoperative adverse events were also recorded.A global response assessment (GRA) score of ≥2 at 3 months postoperatively was defined as effective treatment.According to the postoperative GRA score, the patients were divided into effective and ineffective groups to explore the predictive factors affecting the outcome of BTX-A treatment, such as age, gender, preoperative urodynamic parameters, and the types of urinary incontinence. t-test was used to compare quantitative data such as age, UDS parameters, OABSS, and I-QOL scores.The comparison of count data such as gender and urinary incontinence types was conducted using Fisher′s exact test. Results:The bladder compliance, bladder capacity ratio, OABSS and I-QOL scores of patients significantly improved after BTX-A injection (all P<0.05).The 77.1% (27/35) of the patients were satisfied with BTX-A treatment effects.The main adverse event during the follow-up was a temporary increase in postvoid residual urine after injecting BTX-A (7 cases), which was alleviated by the Creade action or clean intermittent catheterization.There was significant difference in age [(13.00±4.32) years vs.(10.00±2.67) years] and preoperative bladder compliance [(11.21±5.74) mL/cmH 2O vs.(5.13±2.42) mL/cmH 2O] between effective (27 cases) and ineffective groups (8 cases) ( t=2.383, 2.899, all P<0.05).The differences in preoperative bladder capacity ratio, maximum filling detrusor pressure, postvoid residual urine, voiding efficiency, gender, and the types of urinary incontinence were not statistically significant between the two groups (all P>0.05). Conclusions:Intravesical injection of BTX-A is a safe and effective treatment for children with refractory UFI.A young age and poor bladder compliance at treatment are associated with poor prognosis of BTX-A treatment.

Objective:To investigate the effects and underlying mechanisms of the hypoxia-inducible factor-1α (HIF-1α) agonist Roxadustat in alleviating pulmonary ischemia-reperfusion injury (IRI) in mice.Method:This study consisted of both in vivo and in vitro experiments. Thirty-six male C57/BL6 mice (6~8 weeks old) were used. In the animal experiments, 20 mice underwent left pulmonary artery ligation to establish the IRI model and were divided into reperfusion groups of 0, 1, 2, or 4 hours (IR-0/1/2/4 h, n=4 each), with a sham group ( n=4) as control. Temporal and spatial changes in pulmonary HIF-1α expression were analyzed. Another 16 mice were randomized into four groups: sham ( n=4), I/R+vehicle (DMSO, n=4), and I/R+Roxadustat treatment at 25 mg/kg or 50 mg/kg (I/R+ROX-LD, I/R+ROX-HD, n=4 each). Roxadustat or DMSO was administered intraperitoneally once daily for 5 days before surgery. Lung injury, inflammation, and endothelial apoptosis were subsequently assessed. In the cell experiments, human umbilical vein endothelial cell (HUVEC) was subjected to hypoxia-reoxygenation (H/R) to determine the time course of HIF-1α expression. Cells pretreated with Roxadustat (25 μmol) were then exposed to H/R, and HIF-1α expression and apoptosis were analyzed. To verify the role of HIF-1α, siRNA knockdown of HIF-1α mRNA was performed before Roxadustat pretreatment and H/R exposure. Result:In vivo, pulmonary HIF-1α mRNA expression increased progressively after reperfusion, while protein expression peaked early and subsequently declined ( P<0.05). Immunofluorescence staining revealed HIF-1α predominantly localized to pulmonary endothelial cells following I/R. Compared with the I/R+DMSO group, Roxadustat (both doses) upregulated HIF-1α expression in lung tissue. In vitro, HIF-1α mRNA expression increased continuously after H/R, while protein levels first rose and then decreased ( P<0.05). Roxadustat pretreatment upregulated Bcl-2 and downregulated Bax and cleaved caspase-3 compared with the H/R group ( P<0.05). HIF-1α knockdown reversed these effects, resulting in decreased Bcl-2 and increased Bax and cleaved caspase-3 expression relative to the Roxadustat-treated group. Conclusion:The HIF-1α agonist Roxadustat inhibits vascular endothelial apoptosis, alleviates endothelial injury, reduces inflammatory cell infiltration in lung tissue, and lowers inflammatory responses in mice with pulmonary ischemia-reperfusion injury.

OBJECTIVE To analyze the comprehensive intervention measures to raise the etiological submission rate for hospitalized patients before antimicrobial treatment and evaluate the effect.METHODS The hospitalized pa-tients who were treated with therapeutic antibiotics in the Affiliated Hospital of Inner Mongolia Medical University from Jan.2023 to Jun.2023 were assigned as the exploratory analysis phase,the hospitalized patients who were treated with therapeutic antibiotics from Jul.2023 to Dec.2023 were assigned as the first post-intervention phase,and the hospitalized patients who were treated with therapeutic antibiotics from Jan.2024 to Mar.2024 were as-signed as the second post-intervention phase.The related indexes for etiological submission rate before the antimi-crobial treatment were compared before and after the intervention.RESULTS After the comprehensive interven-tion,the etiological submission rate of the entire hospital before the antimicrobial treatment was increased from 28.30％to 42.22％in the first post-intervention phase and 55.86％in the second post-intervention phase.The etio-logical submission rate with respect to diagnosis of hospital-associated infection was increased from 68.34％before the intervention to 85.85％in the first post-intervention phase and 94.58％in the second post-intervention phase.The incidence of hospital-associated infection showed a slight downward trend,dropping from 1.51％to 1.27％in the first post-intervention phase and 1.11％in the second post-intervention phase.The proportion of submission of sterile samples showed a slight upward trend,which was 26.13％before the intervention,29.57％in the first post-intervention phase,28.96％in the second post-intervention phase.There were significant differences in the a-bove indexes(P＜0.05).The etiological submission rate before the combined use of key drugs was increased from 84.71％to 85.95％in the first post-intervention phase and 88.33％in the second post-intervention phase,and there was no significant difference.CONCLUSIONS The etiological submission rate of the hospitalized patients be-fore the antimicrobial treatment is remarkably raised by taking the comprehensive intervention measures,but the etiological submission rate before the combined use of key drugs does not meet the standard,the proportion of submission of the sterile samples is not remarkably raised.It is necessary to continuously complete the intervention measures in the next phase.