ObjectiveTo investigate the molecular mechanisms related to angiogenesis during the development and progression of diabetic retinopathy （DR）. MethodsAngiogenesis-related genes were obtained from the Gencard website and intersected with differentially expressed genes from DR datasets （GSE60436 and GSE94019）. Functional enrichment and protein-protein interaction （PPI） networks were then used to screen candidate genes and evaluate their diagnostic value. Gene set enrichment analysis （GSEA） was used to explore potential pathways underlying candidate genes， and immune infiltration analysis revealed associations between candidate genes and immune cells. Cellular experiments were conducted to validate the role of fibronectin 1 （FN1） in human retinal microvascular endothelial cells （HRMECs） under high glucose （HG） conditions. ResultsA total of 237 differentially expressed genes related to angiogenesis were identified， enriched in pathways such as phosphoinositide 3-kinase/protein kinase B signaling pathway （PI3K-Akt）， tumor suppressor protein 53 （P53）， tumor necrosis factor （TNF）， and Janus kinase （JAK）/signal transducer and activator of transcription signaling pathway （STAT）. Among them， collagen type I alpha 1 chain （COL1A1）， COL1A2， FN1， TNF， and tumor protein p53 （TP53） were key genes with high diagnostic value. GSEA indicated that these genes were involved in multiple signaling pathways， including P53. CIBERSORTx analysis revealed significant associations with the infiltration of multiple immune cells. HG treatment led to the upregulation of FN1. In HG-induced HRMECs， compared with the si-NC control group， si-FN1 significantly reduced cell proliferation， migration， and tube formation， while P53 protein expression was increased. ConclusionThis study reveals the important role of FN1 in angiogenesis in DR and suggests that it may be a potential diagnostic and therapeutic target.

ObjectiveTo observe the clinical efficacy and safety of Yanghe Xiaonang Decoction （阳和消囊汤， YXD） in the treatment of polycystic ovarian syndrome （PCOS）-related infertility with healthy qi deficiency and phlegm stasis syndrome. MethodsA total of 120 PCOS-related infertility participants with healthy qi deficiency and phlegm stasis syndrome were randomly divided into a treatment group and a control group in a 1∶1 ratio， with 60 cases in each group. The treatment group started taking YXD on the first day of the menstrual cycle， one dose daily， until the day of sexual intercourse when follicles matured and were released. Those without mature follicles or ovulation could take it until the 14th to 28th day. The control group was given oral letrozole at 2.5 mg daily starting on the 5th day of the menstrual cycle for 5 consecutive days. If the basal body temperature curve remained monophasic on the 28th day of the menstrual cycle， and no dominant follicle was detected by color Doppler ultrasound， estrogen plus progesterone or progesterone alone was administered for withdrawal bleeding， followed by a new treatment cycle. The treatment lasted for three consecutive menstrual cycles. Patients were followed up for 3 months upon confirmed pregnancy or after the completion of the 3rd treatment cycle. The clinical pregnancy rate， total effective rate， pregnancy rate， biochemical pregnancy rate， embryonic arrest rate， and ectopic pregnancy rate between the two groups were compared. Transvaginal color Doppler ultrasound was used for monitoring endometrial thickness， cyclic ovulation status， number of follicles between 2-9 mm， and the difference in transverse and longitudinal diameters of dominant follicles. The levels of endocrine hormone indicators including serum testosterone （T）， prolactin （PRL）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， progesterone （P）， estradiol （E₂）， free testosterone （F-T）， androstenedione （ASD）， inhibin B （INH-B）， and anti-Müllerian hormone （AMH）， as well as the total traditional Chinese medicine （TCM） symptom scores before and after treatment were compared between the two groups. ResultsA total of 58 patients in each group were included in the statistical analysis. The clinical pregnancy rate in the treatment group was 39.66% （23/58）， higher than 22.41% （13/58） in the control group （P＜0.05）. The total effective rate in the treatment group was 96.55% （56/58）， higher than 79.31% （46/58） in the control group （P＜0.05）. The biochemical pregnancy rate and embryonic arrest rate in the treatment group were lower than those in the control group （P＜0.05）. The treatment group was superior to the control group in increasing endometrial thickness and reducing the number of 2-9 mm follicles at the 2nd and 3rd cycles， as well as in improving the cyclic ovulation status and the difference in transverse and longitudinal diameters of dominant follicles at the 3rd cycle （P＜0.05）. After treatment， the treatment group exhibited significant reductions in serum T， LH， F-T， ASD， INH-B， and AMH levels （P＜0.05）. The control group also showed significant decreases in LH， F-T， INH-B， and AMH levels （P＜0.05）. The levels of F-T， INH-B， and AMH in the treatment group after treatment were lower than those in the control group （P＜0.05）. The improvement of the total TCM symptom score in the treatment group was superior to that in the control group （P＜0.05）. ConclusionYXD can significantly improve the clinical pregnancy rate， reduce the rates of biochemical pregnancy and embryonic arrest， alleviate clinical symptoms， increase endometrial thickness， enhance dominant follicles， and improve endocrine hormone levels in PCOS-related infertility with healthy qi deficiency and phlegm stasis syndrome， showing good safety.

Objective:To understand the species of mosquitoes and the status of important mosquito-borne viruses in the Ningxia surveyed regions, to identify the dominant mosquito species and virus types, and to analyze their genetic characteristics, providing a scientific basis for predicting and controlling mosquito-borne infectious diseases.Methods:Mosquitoes were collected using light traps in Yinchuan and Wuzhong cities of the Ningxia Hui Autonomous Region, and the collected mosquitoes were classified and identified. Real-time polymerase chain reaction (PCR) was used to detect the Japanese encephalitis virus (JEV), West Nile virus (WNV), Chikungunya virus (CHIKV), Sindbis virus (SINV) carried by mosquitoes. The positive sample was subjected to sequencing the whole genome, and the phylogenetic tree of virus strains was constructed using bioinformatics methods.Results:From June to August 2023, a total of 8 561 mosquitoes of 3 genera and 6 species were collected in Yinchuan and Wuzhong cities, Ningxia, among which Culex pipiens pallens was the dominant species with 3 050 individuals, accounting for 35.63%; Anopheles sinensis with 2 379 individuals, accounting for 27.79%; Culex tritaeniorhynchus with 1 489 individuals, accounting for 17.39%; Caspian Aedes with 1 468 individuals, accounting for 27.79%; Aedes vexans with 152 individuals, accounting for 1.78%; and Culex modestus with 23 individuals, accounting for 0.27%. JEV GIb type was detected in the specimens of Culex tritaeniorhynchus collected in Qingtongxia city. Conclusions:The dominant mosquito species in the surveyed areas of Ningxia are primarily Culex pipiens pallens, and JEV GIb virus was detected in Culex tritaeniorhynchus in Qingtongxia city. This study provides basic data for understanding the current status of mosquitoes and mosquito-borne viruses in the Ningxia region and offers scientific guidance for further public health prevention and control measures.

Objective To observe the value of artificial intelligence ultrasound combined with serum hyaluronic acid synthase 2(HAS2)and trefoil factor-1(TFF1)for early diagnosis of breast cancer.Methods Totally 176 patients with suspected breast cancer were retrospective enrolled and divided into malignant group(n=50)and benign group(n=126)according to pathological results.Artificial intelligence ultrasound and convolutional neural network algorithms were used to automatically label suspicious breast lesions.The lesions were manually graded based on breast imaging reports and data systems,classifying 0-3 grades as benign lesions,4-5 grades as malignant lesions.Clinical data and artificial intelligence ultrasound manifestations were compared between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy of HAS2,TFF1,artificial intelligence ultrasound and their combination for diagnosing breast cancer.Results HAS2,TFF1,as well as the proportions of abnormal glandular thickness,low-echo lesions and abnormal blood flow morphology in malignant group were all higher than those in benign group(all P＜0.001).AUC of serum HAS2,TFF1 and artificial intelligence ultrasound for diagnosing breast cancer was 0.772,0.754 and 0.859,respectively.The combined diagnostic efficacy of the above three(AUC=0.925)was higher than single diagnostic efficacy(all P＜0.05).Conclusion Artificial intelligence ultrasound combined with serum HAS2 and TFF1 had good efficacy for early diagnosis of breast cancer.

Fungi are widely present in the human environment and generally non-pathogenic.However,they may invade tissues and cause disease when host immunity is compromised or conditions conducive to fungal proliferation arise.A case of a 70-year-old woman with acute gastrointestinal perforation and secondary abdominal infection,admitted to the department of intensive care medicine(ICU)of the Affiliated Hospital of Qingdao University on August 17,2021 was enrolled.Following emergency exploratory laparotomy with gastric perforation repair,partial small bowel resection,peritoneal lavage drainage,and jejunal feeding jejunostomy,the patient received imipenem and cilastatin sodium antimicrobial therapy.Despite these interventions,clinical deterioration ensued with septic shock and multiple organ dysfunction syndrome.Prompt initiation of antifungal therapy alongside existing anti-infective treatment,anti-shock management,continuous renal replacement therapy(CRRT),and invasive mechanical ventilation led to rapid clinical improvement.Notably,blood cultures obtained at admission revealed Candida albicans after 5 days in ICU,while pathological examination of gastric pyloric perforation margins(8 days post-admission)demonstrated abundant Candida and small bowel ulcer sections showed extensive Mucor infiltration.This case highlights critical lessons in ICU management:Invasive fungal infection should be strongly suspected when gastrointestinal perforation patients deteriorate despite adequate surgical intervention and empirical antibacterial therapy;Timely fungal diagnostic workup should be initiated,utilizing validated fungal infection risk assessment tools to guide rapid diagnosis;Early empirical antifungal therapy proves crucial for improving outcomes in such critical scenarios.

Objective:To investigate the effects of SS31 peptide on cognitive function and cortical oxidative stress in Alzheimer's disease (AD) model mice.Methods:Eighteen SPF grade male 8-month-old APP/PS1 mice were randomly divided into model group and SS31 group according to the random number table method, with nine mice in each group. Additionally, nine C57BL/6J mice with matched weight were selected as the control group. The mice in SS31 group were intraperitoneally injected with SS31 peptide (3 mg/kg, 0.3 mg/mL), while the mice in model group and control group were intraperitoneally injected with an equal volume of 0.9% NaCl solution.The response ability and daily living ability of mice were evaluated by nest building test (NBT).The learning, memory and exploration abilities of mice were assessed by new object recognition (NOR) and Morris water maze test (MWM). ELISA was used to detect the levels of β -amyloid protein (Aβ) and reactive oxygen species (ROS) in cerebral cortex of mice, and immunofluorescence (IF) was used to detect the number of Aβ plaques.Flow cytometry was used to detect neuronal apoptosis rate, Nissl staining was used to detect neuronal damage, and transmission electron microscopy was used to observe neuronal and mitochondrial morphology. Statistical analysis was conducted by SPSS 25.0 software. One-way ANOVA or repeated measures ANOVA or Kruskal-Wallis H test were used for multi-group comparison. Results:(1) The cognitive evaluation results showed that there were statistically significant differences in NBT latency, 15 hour nest building score, and NOR recognition index among the 3 groups of mice ( F=5.488, 6.750, 10.379, all P<0.05), as well as the platform crossing frequency( H=6.742, P<0.05).The time and group interaction of MWM escape latency in the 3 groups of mice were not significant( F=0.975, P=0.460), but the main effect of time and group were significant( F=14.011, 4.173, both P<0.05).The percentage of platform quadrant dwell time in the model group ((22.91 ± 5.16)%) was lower than that in the control group ((39.96±4.69)%) ( P<0.05), but there was no statistically significant difference compared to the SS31 group ((25.18±3.04)%) ( P>0.05). (2) The ELISA results showed that there were statistically significant differences in the levels of Aβ40, Aβ42 and ROS in cerebral cortex of the 3 groups of mice ( F=12.634, 43.670, 7.143, all P<0.01).All the above indicators of cerebral cortex in the model group were higher than those in control group and SS31 group (all P<0.05). The IF results also confirmed that the numbers of Aβ40 and Aβ42 plaques in cerebral cortex of the model group were higher than those of the control group and SS31 group (all P<0.05). (3) The results of flow cytometry and Nissl staining showed that there were statistically significant differences in the apoptosis rate and injury rate of cortical neurons among the 3 groups of mice ( F=234.086, 43.800, both P<0.05), and the two indicators of cortical neurons in the model group were higher than those in control group and SS31 group (all P<0.05). The transmission electron microscopy results showed that compared with the control group, the structure and morphology of cortical neurons and mitochondria in the model group were abnormal, while the structure and morphology of the SS31 group were close to normal. Conclusion:SS31 peptide can improve cognitive function in AD model mice by inhibiting oxidative stress and neuronal apoptosis in cerebral cortex.

The phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR)signaling pathway plays a crucial role in the regulation of renal fibrosis by participating in inflammatory response,oxidative stress and autophagy.Paeoniflorin exhibits remarkable efficacy in treating myocardial and liver fibrosis.This article provides a comprehensive review on the research progress of paeoniflora in preventing and treating renal fibrosis through modulation of the PI3K/Akt/mTOR signaling pathway,offering novel insights for traditional Chinese medicine-based approaches to prevent and treat renal fibrosis.

Objective To design a positive and negative pressure sequential irrigation suction device and explore its efficacy when applied to unblocking nasoenteric tubes.Methods The device consisted of a positive-pressure irrigation component,a negative-pressure suction component,a three-way adapter and a precise unblocker.The positive-pressure irrigation compo-nent was composed of a positive-pressure irrigation unit,a positive pressure regulator,a pressure sensor,a pressure bag and etc;the negative-pressure suction component was made up of a negative-pressure suction unit,a negative pressure regulator,a negative-pressure gauge,a negative-pressure bottle and etc.The pressure bag was hollow cylinder-shaped,and made of ordinary polyvinyl chloride for its inner layer and acrylonitrile-styrene-butadiene copolymer for its outer layer.Sixty patients with nasoenteric tube blockage were selected and randomly divided into a control group and an observation group,with 30 cases in each group.Irrigation suction was carried out with a 10 mL syringe for the control group and with the device for the observation group,and then unblocking was performed with lukewarm water between 38 and 40 degrees.The two groups were compared in terms of the unblocking efficacy,time required for unblocking and the days and cost of nutritional support.SPSS 22.0 software was used for statistical analysis.Results The observation group gained advantages over the control group in terms of the total effective rate(93.3％vs 73.4％),unblocking efficacy,time required for unblocking((7.63±4.97)min vs(10.73±4.57)min),days of nutritional support((10.07±3.07)d vs(13.03±4.05)d)and cost of nutritional support((3 180±260)yuan vs(4 550±660)yuan).Conclusion The device developed effectively enhances the efficacy for unblocking nasoenteric tubes,shortens the time required and decreases the days and cost of nutritional support,and thus is worthy promoting practi-cally.[Chinese Medical Equipment Journal,2025,46(1):114-117]

Objective To observe the value of artificial intelligence ultrasound combined with serum hyaluronic acid synthase 2(HAS2)and trefoil factor-1(TFF1)for early diagnosis of breast cancer.Methods Totally 176 patients with suspected breast cancer were retrospective enrolled and divided into malignant group(n=50)and benign group(n=126)according to pathological results.Artificial intelligence ultrasound and convolutional neural network algorithms were used to automatically label suspicious breast lesions.The lesions were manually graded based on breast imaging reports and data systems,classifying 0-3 grades as benign lesions,4-5 grades as malignant lesions.Clinical data and artificial intelligence ultrasound manifestations were compared between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy of HAS2,TFF1,artificial intelligence ultrasound and their combination for diagnosing breast cancer.Results HAS2,TFF1,as well as the proportions of abnormal glandular thickness,low-echo lesions and abnormal blood flow morphology in malignant group were all higher than those in benign group(all P＜0.001).AUC of serum HAS2,TFF1 and artificial intelligence ultrasound for diagnosing breast cancer was 0.772,0.754 and 0.859,respectively.The combined diagnostic efficacy of the above three(AUC=0.925)was higher than single diagnostic efficacy(all P＜0.05).Conclusion Artificial intelligence ultrasound combined with serum HAS2 and TFF1 had good efficacy for early diagnosis of breast cancer.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.