ObjectiveTo investigate the intervention effects of Suanzaoren Tang on depression model rats induced by isolation combined with chronic unpredictable mild stress （CUMS）， and to examine its influence on the c-Jun N-terminal kinase （JNK）/proto-oncogene protein （c-Myc）/tumor suppressor protein 53 （p53） signaling pathway， thereby revealing its potential functional mechanism. MethodsA total of 72 male SD rats were randomly divided into six groups using a strict random number table： blank group， model group， fluoxetine group （3.6 mg·kg^-1）， and high-， medium-， and low-dose Suanzaoren Tang groups （10， 5， 2.5 g·kg^-1），with 12 rats in each group. A depression model was established using isolation combined with CUMS. Fluoxetine and different doses of Suanzaoren Tang were administered continuously for 28 days. Behavioral indicators such as sucrose water consumption and open field test scores were recorded. Western blot and immunohistochemistry （IHC） were employed to analyze the expression of key proteins in the JNK/c-Myc/p53 signaling pathway， and the terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay was used to evaluate the number of apoptotic cells in the hippocampus. ResultsCompared with the blank group， the model group exhibited a significantly reduced sucrose preference index （P<0.01）， a lower total score of horizontal and vertical movements in the open field test （P<0.01）， significantly increased expression of JNK， c-Myc， and p53 proteins in the hippocampus （P<0.01）， and a higher number of TUNEL-positive cells in the hippocampus （P<0.01）. Compared with the model group， the sucrose preference index and the total score of horizontal and vertical movements in the open field test significantly increased in the high- and medium-dose Suanzaoren Tang groups and the fluoxetine group （P<0.05， P<0.01）. The expression of JNK， c-Myc， and p53 proteins significantly decreased in all Suanzaoren Tang groups （high， medium， and low doses） and the fluoxetine group （P<0.05， P<0.01）. The number of TUNEL-positive cells in the hippocampus also significantly decreased in these groups （P<0.01）. ConclusionSuanzaoren Tang can regulate the expression of JNK/c-Myc/p53 proteins in the hippocampus of depression model rats， and its antidepressant mechanism may be related to its protective effect on hippocampal neurons.

Objective: To explore the efficacy of focal radiofrequency ablation (RFA) in the treatment of low-to-intermediate risk localized prostate cancer and its impact on postoperative urinary control and sexual function recovery，in order to explore the feasibility of minimally invasive methods for the treatment of localized prostate cancer. Methods: Clinical data of 28 patients with low-to-intermediate risk localized prostate cancer who underwent RFA in Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School during Jun.2017 and Feb.2021 were retrospectively analyzed.The 5-year failure-free survival (FFS) rate，surgery related complications，postoperative urinary control and sexual function were collected.The differences between the survival curves of patients in the low-risk and intermediate-risk subgroups were assessed with log-rank test and Breslow test. Results: All surgeries were successfully completed under local anesthesia.During the median follow-up of 43 (40-49) months，the 5-year FFS rate predicted by Kaplan-Meier method was 78.57%; 25 patients (89.29%) did not experience surgery-related complications; 27 patients (96.43%) were able to control urination; 1 patient developed new-onset sexual dysfunction.There was no significant difference in the survival curves between patients in the low-risk and intermediate-risk groups (P>0.05). Conclusion: RFA for patients with low-to-intermediate risk localized prostate cancer has good clinical efficacy，little impact on urinary control and sexual function recovery，and few postoperative complications，which can be used as one of the treatment options for these patients.

Gestational diabetes mellitus(GDM)is closely associated with short-term and long-term adverse outcomes for both mothers and fetuses.In recent years,with the global prevalence of obesity and type 2 diabetes mellitus(T2DM)constantly rising,there is a significant increase in GDM incidence,with notable regional variations.Current challenges in GDM management include insufficient early screening or diagnosis,limited personalized intervention strategies,and poor adherence to long-term follow-up.Key research priorities for the future include optimizing screening methods for high-risk populations,enhancing targeted lifestyle interventions,and establishing effective follow-up and long-term health management systems.In December 2024,the American Diabetes Association(ADA)released the Standards of Care in Diabetes—2025(hereafter referred to as ADA[2025]),providing updated perspectives on the diagnosis and treatment of diabetes mellitus,as well as an overview of the definition,screening and diagnostic criteria,and management strategies for GDM.Based on ADA(2025)and the circumstances of clinical practice in China,we summarized the latest advancements in GDM research,aiming to improve comprehensive management strategies to prevent,delay,and improve adverse outcomes associated with GDM.

Objective To retrospectively review 19 cases of renal epithelioid angiomyolipoma(REAML)and to ex-plore the clinical characteristics and diagnostic methods in order to optimize diagnosis and clinical treatment.Methods Clinical data of 19 patients with REAML admitted to the hospital from June 2020 to March 2024 were re-viewed for clinical characteristics of the disease,surgical procedure and follow-up outcomes.Results All 19 pa-tients received successful laparoscopic surgery.Among them,16 cases received retroperitoneal laparoscopic partial nephrectomy and 3 cases received retroperitoneal laparoscopic radical nephrectomy.Post-operative pathological diag-noses indicated that all cases were classified as renal epithelioid angiomyolipoma.After 4-45 months of follow-up,no tumor recurrence or metastasis was observed.Conclusions Renal epithelioid angiomyolipoma is a rare clinical disease with potential malignant transformation as recurrence and metastasis.Complete resection of the tumor by sur-gery is an effective treatment.Retroperitoneal laparoscopic partial nephrectomy is the first choice.

Objective To explore the changes in serum epidermal growth factor receptor(EGFR)and cancer anti-gen 125(CA125)levels in pregnant women with adenomyosis(AM)and their relationship with pregnancy outcomes.Methods A total of 108 pregnant women with AM(AM pregnant women group)admitted to Baoding Maternal And Child Health Hospital from June 2021 to August 2023 were collected and divided into a good preg-nancy group(n=43)and a poor pregnancy group(n=65)based on pregnancy outcomes.Meanwhile,AM patients were selected as AM group and 108 pregnant women with normal pregnancy test were selected as control group.ELISA was applied to detect the serum level of EGFR and CA125.Pearson correlation was applied to analyze the correlation between serum EGFR and CA125 in AM pregnant women.Multivariate logistic regression was applied to analyze the factors that affected the outcome of AM pregnancy.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum EGFR and CA125 levels for AM pregnancy outcomes.Results Compared with the control group,serum level of EGFR and CA125 in AM group and AM pregnant women group were significantly increased and serum level of EGFR and CA125 in AM pregnant women group was higher than that in AM group(P＜0.05).As the depth grading of endometrial invasion increased,serum level of EGFR and CA125 increased sequentially;The serum level of EGFR and CA125 was obviously elevated in diffuse type and proliferate phase(P＜0.05).The expression level of EGFR and CA125 in the serum of AM pregnant women with premature rupture of membranes,premature birth,placenta previa,and miscarriage was significantly increased(P＜0.05).According to Pearson correlation analysis,there was a positive correlation between serum EGFR and CA125 in AM pregnant women(r=0.487,P＜0.05).The serum level of EGFR and CA125 in good pregnancy group was lower than that in poor pregnancy group(P＜0.05).The area under the curve(AUC)of serum EGFR,CA125,and their combined prediction for AM pregnancy outcome was 0.880,0.835,and 0.955,re-spectively and the combined prediction of AUC for AM pregnancy outcome was significantly higher than that of se-rum EGFR and CA125 alone prediction(Zcombination-EGFR=2.279,Zcombination-CA125=3.304,both P＜0.05).Conclusions Serum level of EGFR and CA125 in AM pregnant women is elevated,which is closely related to pregnancy outcomes and is potential risk factor for poor pregnancy in AM.The combination of the two is more ef-fective in predicting pregnancy outcomes in AM.

ObjectiveTo investigate the therapeutic effect of Baihe Wuyaotang （BWT） on non-alcoholic fatty liver disease （NAFLD） and elucidate its underlying mechanism. MethodC57BL/6J mice were randomly assigned to six groups： normal control， model， positive drug （pioglitazone hydrochloride 1.95×10^-3 g·kg^-1）， and low-， medium-， and high-dose BWT （1.3，2.5 and 5.1 g·kg^-1）. Following a 12-week high-fat diet （HFD） inducement， the mice underwent six weeks of therapeutic intervention with twice-daily drug administration. Body weight was monitored weekly throughout the treatment period. At the fifth week， glucose tolerance （GTT） and insulin tolerance （ITT） tests were conducted. Subsequently， the mice were euthanized for the collection of liver tissue and serum， and the subcutaneous adipose tissue （iWAT） and epididymal adipose tissue （eWAT） were weighed. Serum levels of total triglycerides （TG） and liver function indicators，such as alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， were determined. Histological examinations， including oil red O staining， hematoxylin-eosin （HE） staining， Masson staining， and transmission electron microscopy， were performed to evaluate hepatic lipid deposition， pathological morphology， and ultrastructural changes， respectively. Meanwhile， Western blot and real-time quantitative polymerase chain reaction （Real-time PCR） were employed to analyze alterations， at both gene and protein levels， the insulin signaling pathway molecules， including insulin receptor substrate 1/2/protein kinase B/forkhead box gene O1 （IRS1/2/Akt/FoxO1）， glycogen synthesis enzymes phosphoenolpyruvate carboxy kinase （Pepck） and glucose-6-phosphatase （G6Pase）， lipid metabolism-related genes stearoyl-coA desaturase-1 （SCD-1） and carnitine palmitoyltransferase-1 （CPT-1）， fibrosis-associated molecules α-smooth muscle actin （α-SMA）， type Ⅰ collagen （CollagenⅠ）， and the fibrosis canonical signaling pathway transforming growth factor-β₁/drosophila mothers against decapentaplegic protein2/3（TGF-β₁/p-Smad/Smad2/3）， inflammatory factors such as interleukin（IL）-6， IL-8， IL-11， and IL-1β， autophagy markers LC3B Ⅱ/Ⅰ and p62/SQSTM1， and the expression of mammalian target of rapamycin （mTOR）. ResultCompared with the model group， BWT reduced the body weight and liver weight of NAFLD mice（P<0.05， P<0.01）， inhibited liver lipid accumulation， and reduced the weight of white fat： it reduced the weight of eWAT and iWAT（P<0.05， P<0.01） as well as the serum TG content（P<0.05， P<0.01）. BWT improved the liver function as reflected by the reduced ALT and AST content（P<0.05， P<0.01）. It improved liver insulin resistance by upregulating IRS2， p-Akt/Akt， p-FoxO1/FoxO1 expressions（P<0.05）. Besides， it improved glucose and lipid metabolism disorders： it reduced fasting blood glucose and postprandial blood glucose（P<0.05， P<0.01）， improved GTT and ITT（P<0.05， P<0.01）， reduced the expression of Pepck， G6Pase， and SCD-1（P<0.01）， and increased the expression of CPT-1（P<0.01）. The expressions of α-SMA， Collagen1， and TGF-β₁ proteins were down-regulated（P<0.05， P<0.01）， while the expression of p-Smad/Smad2/3 was downregulated（P<0.05）， suggesting BWT reduced liver fibrosis. BWT inhibited inflammation-related factors as it reduced the gene expression of IL-6， IL-8， IL-11 and IL-1β（P<0.01） and it enhanced autophagy by upregulating LC3B Ⅱ/Ⅰ expression（P<0.05）while downregulating the expression of p62/SQSTM1 and mTOR（P<0.05）. ConclusionBWT ameliorates NAFLD by multifaceted improvements， including improving IR and glucose and lipid metabolism， anti-inflammation， anti-fibrosis， and enhancing autophagy. In particular， BWT may enhance liver autophagy by inhibiting the mTOR-mediated signaling pathway.

AIM:To investigate the application of virtual reality(VR)technology in ocular trauma teaching for medical students.METHODS: A total of 90 medical students who participated in the Ophthalmology teaching program between November 2022 and April 2024 were recruited as subjects. Using a case-control method, 45 students in the case group attended traditional ocular trauma teaching program combined with VR virtual simulation experiments, and 45 students in the control group solely attended traditional ocular trauma teaching program. After the teaching practice, the two groups were compared in terms of their examination performance of theoretical knowledge and case analysis, learning ability(evaluated by the Self-Directed Learning Rating Scale), and the satisfaction survey on the quality of teaching; the statistical analyses were performed using t-test or Chi-square test.RESULTS: The scores of theoretical knowledge and case analysis examinations of the case group were significantly higher than those of the control group, and the differences were statistically significant(scores of theoretical knowledge examination: 57.27±2.78 vs 53.91±3.20; scores of case analysis examination: 35.71±3.73 vs 32.67±5.52, both P<0.05). The scores of the Self-Directed Learning Rating Scale of the case group were significantly higher than those of the control group(P<0.05), and the satisfaction with teaching quality of the case group was significantly higher than that of the control group(P<0.05).CONCLUSION: VR-enabled teaching of ocular trauma can effectively improve medical students' mastery of theoretical knowledge and practical skills, enhance students' self-directed learning ability and improve teaching satisfaction.

Objective To investigate the effects of dexmedetomidine used to supplement analgesia on sleep quality in elderly patients after abdominal surgery.Methods Ninety-eight elderly patients,56 males and 42 females,aged 65-80 years,BMI 18.5-25.0 kg/m2,ASA physical status Ⅱ or Ⅲ,who un-derwent elective abdominal surgery under general anesthesia were selected and divided into two groups using the random number table method:dexmedetomidine group(group D)and control group(group C),49 pa-tients in each group.The two groups were used the same drugs for induction and maintenance of anesthesia,with different analgesic formulas after surgery.Analgesia formula in group C was sufentanil 2 μg/kg,tropi-setron 4 mg,and normal saline to 100 ml,and in group D was sufentanil 2 μg/kg,dexmedetomidine 5μg/kg,tropisetron 4 mg,and normal saline to 100 ml.In the form of questionnaire survey,consensus sleep diary(CSD)was used to record the patient's sleep latency,number of awakenings and duration of waking after sleep 1 day before surgery and 1 day,3,and 7 days after surgery,and then the actual sleep time and sleep efficiency were calculated.The patient's venous blood was collected at 5:00 to 7:00 in the morning to detect serum melatonin,interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor(TNF-α)concentration.Extubation time,the incidence of cough,agitation,respiratory depression,postoperative bradycardia,nausea and vomiting,lethargy,urinary retention,and other adverse reactions were recorded.Results Compared with group C,the sleep latency was significantly reduced,the actual sleep time and the sleep efficiency were significantly increased 1 day,3,and 7 days after surgery(P＜0.05).Compared with group C,the concentration of postoperative melatonin in group D were significantly increased 1 day,3,and 7 days after surgery(P＜0.05),the concentration of IL-6,IL-1β and TNF-α in group D were significantly reduced 1 and 3 days after surgery(P＜0.05).There was no significant difference in the incidence of ad-verse reactions between the two groups.Conclusion Patient-controlled intravenous analgesia with dexme-detomidine assisted in elderly patients after abdominal surgery can improve sleep efficiency,increase sleep time and postoperative sleep quality,which may be related to the changes of melatonin and inflammatory factors after surgery.

Objective Based on the efficacy of Ranae Oviductus in reinforcing the kidney and replenishing essence,a biological titer assay for Ranae Oviductus was developed using anti-ageing vitality as an indicator,and this was used to evaluate the quality of Ranae Oviductus from different origins and to provide a reference for improving its quality standard.Methods MRC-5 cells were used as the study target and H2O2 was used as the acute senescence model-inducing drug to verify the anti-aging effect of Ranae Oviductus by cell viability and β-galactosidase staining rate.Vc was selected as the reference and CCK-8 method was used as the biological titer assay for Ranae Oviductus.Results In the cell viability assay,compared to the model group,the Ranae Oviductus group was able to up-regulate cell viability,with the best effect at 250.0 μg·mL-1,up-regulating by 20.01％.The percentage of SA-β-gal positive cells was reduced by 17.70％in the cells pretreated with Ranae Oviductus.The results of the biological titer of anti-aging determination showed that the biological titer of anti-aging of Ranae Oviductus from different origins ranged from 218.03 to 1152.04 U·mg-1,with an extreme difference of 934.01 U·mg-1.Conclusion The established biological titer assay for Ranae Oviductus can clearly distinguish the differences in the quality of Ranae Oviductus and provide a certain reference for the quality evaluation and control of Ranae Oviductus.

Thrombocytopenia is one of the common complications with the hematologic system in patients with chronic liver disease, which often causes poor quality of life and high risk of bleeding, thereby affecting their diagnosis, treatment, and prognosis. Platelet transfusion can improve the patient's declining platelet count to a certain extent, but it has problems such as high price and being easy to cause immune rejection. Thrombopoietin (TPO), as an important cytokine that affects platelet production, can bind to TPO receptors and activate megakaryocytes to produce platelets. Lusutrombopag is a newly developed small-molecule TPO receptor agonist that can induce bone marrow progenitor cells to differentiate into megakaryocytes and increase platelet production, posing characteristics of oral convenience, safety and effectiveness; thus, it has been used in many countries and regions for the treatment of patients with chronic liver diseases concurrent with thrombocytopenia. Herein, the pharmacological features and clinical research are reviewed.