ObjectiveTo investigate the feasibility， safety， and efficacy of surgery-assisted transjugular intrahepatic portosystemic shunt （SA-TIPS） in the treatment of portal hypertension comorbid with complex portal vein thrombosis， including cavernous transformation of the portal vein （CTPV）. MethodsAn analysis was performed for the data of 36 patients with portal hypertension and complex portal vein thrombosis who underwent SA-TIPS in Beijing Shijitan Hospital， Capital Medical University， from November 2023 to January 2025， including general status， technical data of the surgical process （surgical success rate， puncture times， time of operation， the number of stents used， and the length of shunt）， perioperative complications， and surgical recovery. The change in portal pressure gradient （PPG） after shunt was compared， and the rate of reaching the standard for PPG reduction was calculated， as well as stent patency rate within 1 week after surgery. The paired samples t-test was used for comparison of continuous data between two groups. ResultsAmong the 36 patients， 34 （94.4%） underwent SA-TIPS successfully. The incidence rate of perioperative complications was 16.7% （6/36）， including 3 cases of thoraco-abdominal hemorrhage， 2 cases of intraoperative arrhythmia， and 1 case of incision infection. There was a significant reduction in PPG after SA-TIPS （t=19.85， P<0.01）， and the patients achieving a ≥50% reduction in PPG accounted for 76.5% （26/34）. Imaging reexamination within 1 week showed a shunt patency rate of 100%. ConclusionSA-TIPS has a high technical success rate， a favorable safety profile， and good efficacy in the treatment of portal hypertension comorbid with complex portal vein thrombosis （including CTPV）， and therefore， it holds promise for clinical application.

In recent years， the incidence of depression among adolescents has increased significantly， becoming a serious global public health problem. There is a close relationship between adolescent depression and lipid metabolism abnormalities. However， the mechanisms underlying this association have not been fully elucidated. This article provides a review of the mechanisms and interventions linking adolescent depression and lipid metabolism abnormalities， aiming to offer new ideas for interventions in adolescent depression. Using computerized searches of the China National Knowledge Infrastructure （CNKI）， Wanfang Data， PubMed， and Web of Science， studies on the mechanisms and interventions related to adolescent depression and lipid metabolism were collected， with the search period extending up to October 10， 2025. Two researchers independently conducted literature screening and extracted basic information from the included studies. A total of 12 original studies were included. The results indicate that adolescent depression is associated with certain lipid metabolites. Neurobiological factors， immune inflammation， oxidative stress， and gut microbiota imbalance play important roles in this association. In addition， lipid metabolites such as omega-3 polyunsaturated fatty acids （ω-3 PUFAs） have a significant ameliorating effect on adolescent depression. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGSP013）； Shenzhen Science and Technology Program （number， 20210617155253001）］

Objective To explore the effect of transcutaneous auricular vagus nerve stimulation(taVNS)combined with dual-task training(DTT)on upper limb function recovery in patients with ischemic stroke.Methods From January to October,2024,60 ischemic stroke patients with upper limb dysfunction admitted to Zhejiang Rehabilitation Medical Center were selected and randomly divided into control group(n=30)and observation group(n=30).Both groups received conventional rehabilitation training.The control group underwent sham-taVNS combined with DTT,while the observation group received active taVNS combined with DTT,for four weeks.Before and after treatment,they were assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Action Research Arm Test(ARAT),modified Barthel Index(MBI)and motor-evoked potential(MEP)tests.Results The FMA-UE scores,ARAT scores,MBI scores,MEP amplitude and MEP latency improved in both groups af-ter treatment(|t|>3.670,P<0.01),and were superior in the observation group than in the control group(|t|>3.081,P<0.01).Conclusion The combination of taVNS and DTT can significantly improve upper limb function,enhance activities of daily living,and promote neurological recovery in patients with ischemic stroke.

Objective:To explore the application value of multi-slice spiral CT (MSCT) perfusion imaging and magnetic resonance high-resolution vessel wall imaging (HR-VWI) in the evaluation of atherosclerotic ischemic stroke (IS).Methods:A total of 131 patients with atherosclerotic IS (study group) and 62 patients with non-atherosclerotic IS (control group) diagnosed and treated in Handan Central Hospital from May 2022 to May 2024 were retrospectively selected as the study objects. MSCT perfusion imaging and HR-VWI were completed before treatment. MSCT perfusion imaging indexes and HR-VWI indexes were compared between the two groups, and HR-VWI indexes and MSCT perfusion imaging indexes were compared among the study groups with different disease degrees. Receiver operating characteristics (ROC) curve was used to analyze the diagnostic value of HR-VWI indexes and MSCT perfusion imaging indexes in atherosclerotic IS.Results:The stenosis degree, out wall area at maximal lumen narrowing (OWA MLN), plaque loading rate and remodeling index in the study group were higher than those in the control group: (69.22 ± 12.57)% vs. (60.81 ± 10.38)%, (7.62 ± 1.03) mm 2 vs. (6.53 ± 1.18) mm 2, (42.51 ± 8.22)% vs. (36.53 ± 7.29)%, 1.32 ± 0.41 vs. 1.01 ± 0.29; while the lumen area at maximal lumen narrowing (LA MLN) in the study group was lower than that in the control group: (0.84 ± 0.28) mm 2 vs.(1.17 ± 0.41) mm 2, there were statistical differences ( P<0.05). The cerebral blood flow (CBF) and cerebral blood volume (CBV) in the study group were lower than those in the control group: 20.25 ± 2.83) ml/100 min vs. (23.66 ± 2.52) ml/100 min, (1.82 ± 0.53) ml/100g vs. (2.31 ± 0.63) ml/100 g; and the peak time (TTP) and mean transit time (MTT) in the study group were higher than those in the control group: (23.55 ± 4.86) s vs.(19.73 ± 3.73) s, (7.13 ± 1.22) s vs. (6.17 ± 1.06) s, there were statistical differences ( P<0.05). In the study group, with the aggravation of disease severity, the stenosis degree, OWA MLN, plaque load rate and remodeling index were gradually increased, while LA MLN was gradually decreased, there were statistical differences ( P<0.05). ROC curve analysis results showed that the area under the curve value of HR-VWI index combined evaluation and MSCT perfusion imaging index combined evaluation in the diagnosis of atherosclerotic IS was 0.921 and 0.828, respectively. Conclusions:HR-VWI and MSCT perfusion imaging can be used in the assessment of patient's condition of atherosclerotic IS. HR-VWI may be better in evaluating the condition of atherosclerotic IS.

Objective Exploring the behavioral changes induced by quinpirole in obsessive-compulsive disorder(OCD)mouse,investigating the activation of neurons in different brain regions,and identifying differentially expressed genes(DEGs)and enriched biological pathways through transcriptome sequencing technology to elucidate the pathogenesis of OCD.Methods Randomly assign 32 male C57BL/6J mice,aged two months,to an OCD group and a control group(n=16).Administering quinpirole(0.75 mg/kg)via subcutaneous injection to the OCD group mice every other day for a total of 19 injections,while the control group mice received an equivalent volume of saline solution.Following the completion of the model construction,open field testing,elevated plus maze testing,and marble burying tests were conducted.After the completion of behavioral studies,tissue samples were collected.Neuronal damage was assessed using Nissl staining,while the expression of c-Fos and Iba1 proteins was examined through immunofluorescence staining.Transcriptome sequencing technology was utilized to screen for differentially expressed genes and to enrich relevant signaling pathways.The expression of inflammatory cytokines,including TNF-α,NF-κB p65,phosphorylated NF-κB p65(p-NF-κB p65),and IL-6,was detected using Western Blot analysis.Results Mouse induced with OCD by quinpirole exhibit anxiety-like behaviors and compulsive-like behaviors.Neurons in the hippocampal and hypothalamic regions exhibit signs of damage.The expression of c-Fos and Iba1 proteins is increased in the cortex,striatum,hypothalamus,and other brain regions.Western Blot result indicate a significant increase in the expression of pro-inflammatory cytokines such as TNF-α,p-NF-κB p65,and IL-6.Conclusions In OCD mouse,neurons in multiple brain regions are abnormally activated,microglia exhibit dysfunction,and neuroinflammation induced by the activation of the NF-κB signaling pathway accompanies the development of OCD.

[Abtract]Nursing safety management is crucial to patient health outcomes,and real-time monitoring and early warning systems play a vital role in enhancing nursing safety and reducing medical incidents.Wearable flexible devices enable non-invasive,continuous monitoring of various physiological parameters and provide timely alerts.These devices not only improve the efficiency and quality of nursing safety management but also offer patients more convenient,accurate,and personalized care services.This article provides a comprehensive review of the application of wearable flexible devices in nursing safety management,examining their application scenarios,advantages,and challenges,and offering insights to facilitate the further integration of this technology into nursing safety practices.

Renal cell carcinoma in a transplanted kidney is rare, and partial nephrectomy in transplanted kidney is even more uncommon. A patient with papillary transplanted renal cell carcinoma who underwent partial nephrectomy was reported. The patient was admitted to the hospital due to the discovery of transplanted kidney mass, and the enhanced examination of CTU found a lesion in the upper pole of the transplanted kidney in the right iliac fossa, which may be renal cancer, with a diameter of about 2 cm. After open partial nephrectomy of the transplanted kidney, the postoperative pathology showed that the tumor was papillary renal cell carcinoma. The antirejection drugs were used after surgery. During the follow-up period of 16 months, there was no recurrence of transplanted kidney tumor.

Objective:To explore the clinical characteristics and prognostic factors of primary bladder adenocarcinoma（ACB）.Methods:The clinical data of 33 patients with primary ACB who underwent surgical treatment in the Department of Urology of Peking University Third Hospital from July 2003 to January 2024 were retrospectively analyzed. There were 5 females and 28 males，with an average age of（61.3 ± 11.5）years. Twelve patients had comorbidities（6 hypertension，2 coronary heart disease，5 diabetes mellitus，and 3 cerebrovascular diseases）and 12 had a smoking history. The mean body mass index（BMI）was（24.8 ± 3.2）kg/m 2. The maximum tumor diameter measured by enhanced computed tomography（CT）was（29.7 ± 12.7）mm. The preoperative neutrophil-to-lymphocyte ratio（NLR）was 3.4 ± 3.2，and the systemic immune-inflammation index（SII）was（582 ± 496）× 10 9/L.Patients were divided into two groups according to the surgical approach：the radical cystectomy group（ n = 23）and the bladder-sparing group（ n = 10）. For the radical cystectomy group，there were 19 males and 4 females，with a mean age of（59.9 ± 12.6）years. Five patients had comorbidities（3 hypertension，1 coronary heart disease，1 diabetes mellitus，and 2 cerebrovascular diseases）. Eight patients had a smoking history，with a mean BMI of（25.2 ± 3.5）kg/m 2. The maximum tumor diameter was（33.6 ± 10.9）mm，the preoperative NLR was 3.5 ± 3.5，and the SII was（618 ± 558）× 10 9/L. For the bladder-sparing group，there were 9 males and 1 female，with a mean age of（64.5 ± 8.2）years. Seven patients had comorbidities（3 hypertension，1 coronary heart disease，4 diabetes mellitus，and 1 cerebrovascular diseases）. Four patients had a smoking history，with a mean BMI of（23.5 ± 2.3）kg/m 2. The maximum tumor diameter was（20.7 ± 12.5）mm，the preoperative NLR was 3.1 ± 2.2，and the SII was（501 ± 323）× 10 9/L. Statistically significant differences were observed between the two groups in terms of comorbidities（ P = 0.008）and maximum tumor diameter（ P = 0.006），while no significant differences were found in other data（ P > 0.05）. The Kaplan-Meier survival curve was drawn，and Cox regression was used to analyze the prognostic factors of progression-free survival（PFS）and overall survival（OS）of patients. Results:Among the 33 patients，low-grade adenocarcinoma and high-grade adenocarcinoma accounted for 60.6% and 39.4% respectively according to the postoperative pathology，and 3 patients had positive surgical margins. There were 22 cases of muscle-invasive bladder adenocarcinoma，5 cases of lymph node metastasis，and 1 case of distant metastasis. The patients in tumor stages Ⅰ—Ⅳ were 9 cases（27.3%），8 cases（24.2%），7 cases（21.2%），and 9 cases（27.3%）respectively. Nine patients received postoperative adjuvant therapy，including 6 with adjuvant chemotherapy，2 with adjuvant chemotherapy combined with radiotherapy，and 1 with adjuvant immunotherapy. In the radical cystectomy group（ n = 23），there were 13 cases of low-grade and 10 cases of high-grade pathological grading，2 cases with positive margins，19 cases of muscle-invasive bladder adenocarcinoma，5 cases of lymph node metastasis，1 case of distant metastasis，and 5 patients received adjuvant therapy（4 cases of adjuvant chemotherapy，and 1 case of adjuvant immunotherapy）. In the bladder-sparing group（ n = 10），there were 7 cases of low-grade，3 cases of high-grade pathological grading，1 case with positive margins，3 cases of muscle-invasive bladder adenocarcinoma，zero lymph node or distant metastasis，and 4 patients received adjuvant therapy（2 cases of adjuvant chemotherapy，and 2 cases of combined adjuvant chemotherapy and radiotherapy）. A statistically significant difference was found in the proportion of muscle-invasive bladder adenocarcinoma between the two groups（ P = 0.006），while no significant differences were observed in other data（ P > 0.05）.The median follow-up duration of the patients was 28.0 months，the median PFS was 86.0 months，and the median OS was 90.0 months. The 2-year PFS and OS were 65.4% and 73.1% respectively. The 5-year PFS and OS were 54.2% and 56.5% respectively. The Kaplan-Meier survival analysis showed that there were no significant differences in PFS（ P = 0.777）and OS（ P = 0.585）between the radical cystectomy group and the bladder-preserving group. Female（ P = 0.011），BMI < 25 kg/m2（ P = 0.038），and positive surgical margins（ P < 0.01）were associated with poorer PFS. Aged ≥ 70 years（ P = 0.003），lymph node metastasis（ P = 0.041），and positive surgical margins（ P = 0.025）were associated with poorer OS，and patients in the adjuvant therapy group had better OS（ P = 0.005）. Multivariate Cox regression analysis indicated that positive surgical margins（HR 10.2， P = 0.012）were an independent impact factor for PFS，and positive surgical margins（HR 39.8， P = 0.001）and adjuvant therapy（HR 0.12， P = 0.021）were independent impact factors for OS. Conclusions:Positive surgical margins and adjuvant therapy are independent impact factors for the prognosis of patients with primary ACB.

Objective Exploring the behavioral changes induced by quinpirole in obsessive-compulsive disorder(OCD)mouse,investigating the activation of neurons in different brain regions,and identifying differentially expressed genes(DEGs)and enriched biological pathways through transcriptome sequencing technology to elucidate the pathogenesis of OCD.Methods Randomly assign 32 male C57BL/6J mice,aged two months,to an OCD group and a control group(n=16).Administering quinpirole(0.75 mg/kg)via subcutaneous injection to the OCD group mice every other day for a total of 19 injections,while the control group mice received an equivalent volume of saline solution.Following the completion of the model construction,open field testing,elevated plus maze testing,and marble burying tests were conducted.After the completion of behavioral studies,tissue samples were collected.Neuronal damage was assessed using Nissl staining,while the expression of c-Fos and Iba1 proteins was examined through immunofluorescence staining.Transcriptome sequencing technology was utilized to screen for differentially expressed genes and to enrich relevant signaling pathways.The expression of inflammatory cytokines,including TNF-α,NF-κB p65,phosphorylated NF-κB p65(p-NF-κB p65),and IL-6,was detected using Western Blot analysis.Results Mouse induced with OCD by quinpirole exhibit anxiety-like behaviors and compulsive-like behaviors.Neurons in the hippocampal and hypothalamic regions exhibit signs of damage.The expression of c-Fos and Iba1 proteins is increased in the cortex,striatum,hypothalamus,and other brain regions.Western Blot result indicate a significant increase in the expression of pro-inflammatory cytokines such as TNF-α,p-NF-κB p65,and IL-6.Conclusions In OCD mouse,neurons in multiple brain regions are abnormally activated,microglia exhibit dysfunction,and neuroinflammation induced by the activation of the NF-κB signaling pathway accompanies the development of OCD.

Renal cell carcinoma in a transplanted kidney is rare, and partial nephrectomy in transplanted kidney is even more uncommon. A patient with papillary transplanted renal cell carcinoma who underwent partial nephrectomy was reported. The patient was admitted to the hospital due to the discovery of transplanted kidney mass, and the enhanced examination of CTU found a lesion in the upper pole of the transplanted kidney in the right iliac fossa, which may be renal cancer, with a diameter of about 2 cm. After open partial nephrectomy of the transplanted kidney, the postoperative pathology showed that the tumor was papillary renal cell carcinoma. The antirejection drugs were used after surgery. During the follow-up period of 16 months, there was no recurrence of transplanted kidney tumor.