Objective To analyze the effect of releasing the lower pulmonary ligament on right residual lung expansion after right upper lobe resection under different body mass index (BMI) levels. Methods The clinical data of patients who underwent thoracoscopic right upper lobe resection in the First Affiliated Hospital with Nanjing Medical University from 2021 to 2022 were retrospectively analyzed. Patients were divided into a group A (17 kg/m2＜BMI≤23 kg/m2), a group B (23 kg/m2＜BMI≤29 kg/m2) and a group C (BMI＞29 kg/m2) according to BMI. The presence of residual cavity was judged by chest X-ray at 7-10 days after operation, the degree of compensation change of the right main bronchus angle was measured, and the changes in lung volume were determined by CT three-dimensional reconstruction. Results A total of 157 patients who underwent thoracoscopic right upper lobe resection were included, including 71 males and 86 females, with an average age of (59.7±11.2) years. There were 50 patients in the group A, 75 patients in the group B, and 32 patients in the group C. In the group A, compared with those without releasing the lower pulmonary ligament, patients with releasing had a lower incidence of postoperative residual cavity (P=0.016), greater changes in bronchus angle (P<0.001), and smaller changes in lung volume (P<0.001). In the group B and C, there was no significant effect of releasing the lower pulmonary ligament on postoperative residual cavity, bronchus angle, and lung volume changes (P>0.05). Conclusion For patients with thin and long body shape and low BMI, releasing the lower pulmonary ligament is helpful to promote the expansion of the residual lung after right upper lobe resection and reduce the occurrence of postoperative residual cavity in patients.

ObjectiveMigraine is a leading neurological disorder and the fourth most common cause of years lived with disability worldwide, affecting nearly 116 million individuals. Although pharmacological treatments are available, their efficacy is often limited by side effects and variable response rates. Repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers a safe, non-invasive alternative for migraine management. However, the neurophysiological mechanisms, particularly how rTMS modulates local cortical excitability and distributed pain-related circuits, remain poorly understood. Elucidating these mechanisms is essential for optimizing treatment protocols and improving clinical outcomes. MethodsThis study employed concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) to investigate neuroplastic and neurocircuitry mechanisms of DLPFC-rTMS in migraine. Study 1 compared 30 migraineurs and 28 healthy controls to identify abnormalities in TMS-evoked potentials (TEPs) and significant current density (SCD) within sensory-discriminative regions including the primary somatosensory cortex (S1) and posterior insula (pINS), cognitive-affective regions including the anterior insula (aINS) and midcingulate cortex (MCC), and a descending modulatory region, the periaqueductal gray (PAG). Study 2 used a single-blind, crossover, sham-controlled design in 34 healthy participants. Each participant received both active (10 Hz, 80% RMT, 1 500 pulses) and sham DLPFC-rTMS in counterbalanced order. TMS-EEG and cold pain tolerance were assessed before and after each session. ResultsIn Study 1, migraineurs showed a significantly less negative N120 amplitude compared to healthy controls (P=0.027, Cohen’s d=0.60), indicating local intracortical disinhibition. No group differences were observed for N40, P60, or P180 components. At the source level, migraineurs exhibited significantly higher SCD in the S1, pINS, aINS, and MCC (allQ<0.05), but not in the ventroposterior thalamus (vpTHAL), mediodorsal thalamus (mdTHAL), or PAG. In Study 2, active rTMS significantly reduced SCD from pre- to post-stimulation in the S1, aINS, and MCC (all Q<0.05). Sham stimulation also reduced SCD in the S1 (Q<0.05) but not in the aINS or MCC. Although no significant group-level analgesic effect was observed between active and sham conditions (P=0.107), correlation analyses revealed that greater SCD reductions in the S1 and MCC were significantly associated with higher post-rTMS pain tolerance (R=-0.487 and -0.495, both Q<0.01) and larger improvements in pain tolerance(R=-0.487 and -0.451, both Q<0.05). No such correlations were found following sham stimulation, suggesting that the behavioural relevance of neural changes is specific to active rTMS. ConclusionThis study provides novel evidence that migraineurs exhibit both local neuroplastic abnormalities (reduced N120 amplitude) and hyperactivity in key pain-processing regions (S1, pINS, aINS, MCC). A single session of DLPFC-rTMS reduced hyperactivity in the aINS, MCC, and S1. Notably, greater reductions in the S1 and MCC were associated with improved pain tolerance. These findings identify distinct cortical circuitries, particularly within the cognitive-affective pain network, that may serve as potential biomarkers for optimizing rTMS treatment in migraine and other chronic pain conditions. Future studies should validate these results in patient populations experiencing spontaneous migraine attacks and explore multi-session or accelerated rTMS protocols.

Tracheobronchial adenoid cystic carcinoma （TACC） is a low-grade malignant tumor originating from the airway mucosa. Despite its slow progression，it is characterized by high invasiveness，frequent recurrence，and a strong tendency for metastasis. Preclinical studies have shown that vascular-targeted therapy holds significant potential. However，an effective systemic treatment for TACC has not been established yet. This study explored TACC from the perspective of "Feiji" in traditional Chinese medicine （TCM） as the starting point. It deeply investigated the mechanisms of abnormal collaterals and tumor vascular recruitment and further elaborated on the theoretical connection between abnormal collaterals and tumor vascular recruitment. Firstly，collateral hyperactivity led to disordered and erratic pulmonary collaterals. Their abnormal structures were similar to the disorderly and tortuous nature of tumor （pseudo）angiogenesis. This resulted in imbalances in the functions of circulation，perfusion，and reverse injection of the pulmonary collaterals，and then led to unrestrained collateral dysfunction and the accumulation of pathogenic factors. Secondly，the remodeling of the extracellular matrix （ECM） and epithelial-mesenchymal transition （EMT） in TACC were critical processes in vascular co-option （VCO），representing the micro-level manifestation of the displacement of nutrient and defense. During this process，ECM remodeling made TACC cells more likely to hijack normal blood vessels，creating a complex vascular microenvironment conducive to tumor growth. In terms of treatment，this study proposed a TCM strategy of "regulating collaterals to expel pathogenic factors and nourishing collaterals to strengthen the healthy Qi"，and listed potential TCM. These were intended to regulate the Qi and blood in the collaterals，repair the functions of abnormal collaterals，and intervene in the vascular recruitment process of TACC. Future research should focus on improving the TCM clinical syndrome characteristics of TACC. Through modern molecular biology techniques，it is necessary to deeply analyze the micro-level pattern of vascular recruitment in TACC. This would enrich the understanding of the profound connection between abnormal collaterals and tumor vascular recruitment，providing empirical evidence for TCM-targeted therapies for vascular recruitment in TACC.

Objective To analyze the results of ultrasonic examinations of hip joints in preterm infants,clarify the developmental characteristics of hip joints across different gestational ages.Meth-ods A total of 881 preterm infants who attended the Child Healthcare Outpatient Clinic of Nanjing Maternity and Child Health Care Hospital between January 2023 and April 2024 were enrolled.The first ultrasonic examination of the hip joints was performed at a corrected gestational age of 4 to 6 weeks.The Graf classification method was employed to categorize the ultrasonic findings.Differences in hip joint development among preterm infants of varying gestational ages were compared,and rele-vant influencing factors were statistically analyzed.Results A total of 1,762 hip joints were exam-ined,with 30 cases of abnormal hip joints detected,yielding an abnormality detection rate of 3.4％(30/881).Among these,26 hips were classified as type Ⅱa and 8 as type Ⅱb.Statistically signifi-cant differences were observed in the detection of left-sided abnormal hip joints between preterm in-fants of other gestational age groups and late preterm infants(P＜0.05).A statistically significant difference was found in the classification of right-sided hip joints between preterm infants of different genders(P＜0.05),while no significant difference was observed for left-sided hip joints(P＞0.05).Statistically significant differences were noted in the detection rates of bilateral abnormal hip joints among preterm infants with varying birth weights(P＜0.05).Advanced maternal age was found to influence the development of left-sided hip joints inpreterm infants,whereas factors such as assisted reproductive technology,breech presentation,and nulliparity had no significant impacts on abnormal hip joint development in preterm infants.Conclusion Ultrasonic technology demonstrates signifi-cant advantages in screening for developmental dysplasia of the hip(DDH)in preterm infants.Dif-ferent gestational ages exert a notable influence on the development of left-sided hip joints in preterm infants.Female preterm infants exhibit a higher risk of right-sided hip joint abnormalities compared to the left side.Breech presentation,assisted reproductive technology,and nulliparity are not risk factors for DDH in preterm infants.However,higher birth weight in preterm infants and advanced maternal age are associated with abnormal hip joint development.Clinical attention should focus on high-risk factors,and enhanced dynamic ultrasonic monitoring of hip joints in preterm infants is war-ranted to facilitate early intervention and treatment.

Objective To investigate the therapeutic potential and prophylactic value of concomitant administration of nonsteroidal anti-inflammatory drug(NSAID)and antimicrobial agents in mitigating the incidence and severity of trauma-induced sepsis.Methods A retrospective cohort study encompassed the collection of clinical records from trauma patients managed in the department of intensive care unit(ICU)of Daping Hospital,Army Medical University(Third Military Medical University)from June 2008 to June 2024.Based on administered therapeutic protocols,patients were stratified into a control group(receiving antibiotic monotherapy)and a experimental group(undergoing adjunctive therapy with NSAID in conjunction with antimicrobial agents).Intergroup comparisons were performed to elucidate differences in baseline clinical characteristics and laboratory indices pertinent to therapeutic outcomes.Results A total of 268 trauma patients were included,with 72 patients in the control group and 196 patients in the experimental group.The majority of cases involved open trauma(67.5%)and injuries sustained from traffic accidents(44.0%),reflecting the principal mechanisms of injury.The respiratory tract was the most common site of infection(67.5%),with Acinetobacter baumannii(A.baumannii)emerging as the leading causative microorganism(18.0%).Among therapeutic agents,ibuprofen represented the most frequently employed NSAID(59.8%),whereas cephalosporins constituted the predominant class of antimicrobials(30.5%).Following intervention,the lymphocyte percentage(LYM%)was markedly elevated in the experimental group relative to control group[0.14(0.09,0.20)vs.0.12(0.09,0.15),P<0.01].In contrast,the levels of white blood cell count(WBC),neutrophil percentage(NEU%),D-dimer,glucose(Glu),and lactic acid(Lac)were significantly reduced[WBC(×109/L):8.82(6.36,12.96)vs.12.10(7.78,15.54);NEU%:0.76(0.67,0.81)vs.0.78(0.72,0.83);D-dimer(μg/L):2208.0(889.5,3301.5)vs.2943.9(1735.4,4997.6);Glu(mmol/L):6.8(6.2,7.9)vs.7.7(6.6,9.2);Lac(mmol/L):0.9(0.6,1.2)vs.1.1(0.8,1.5),all P<0.05].The experimental group demonstrated a significantly reduced incidence of traumatic sepsis compared with the control group[15.8%(31/196)vs.26.4%(19/72),P<0.05].Conclusion The combination of NSAID and antimicrobial agents exerts its protective effect by attenuating inflammatory and stress responses,reestablishing immune homeostasis,correcting coagulopathy,and enhancing tissue perfusion,thereby significantly decreasing the incidence of traumatic sepsis and contributing to improved prognostic outcomes in injured patients.

Objective:To analyze and compare the clinical efficacy of minimally invasive modified Bristow-Latarjet and Bankart prosthesis in the treatment of recurrent shoulder dislocation.Methods:A total of 58 patients with recurrent shoulder dislocation treated in the Hubei Minzu University Affiliated Minda Hospital from October 2019 to December 2022 were retrospectively selected, and 29 patients underwent minimally invasive modified Bristow-Latarjet (Latarjet group) and 29 patients underwent Bankart prosthesis (Bankart group). The basic conditions of surgery, postoperative shoulder joint activity, and postoperative Rowe Shoulder Function Score (Rowe score) of the two groups were compared. The shoulder function recovery of the patients was evaluated using the American Shoulder and Elbow Association Scoring (ASES) system and the University of California at Los Angeles (UCLA) shoulder joint scoring system, and the incidence of complications between the two groups were compared.Results:The operation time, incision length, intraoperative bleeding volume, recovery working time, and reset loss in the Latarjet group were shorter than those in the Bankart group: (45.56 ± 12.18) min vs. (70.35 ± 18.14) min, (4.04 ± 0.82) cm vs. (6.75 ± 0.95) cm, (61.54 ± 8.88) ml vs. (86.07 ± 7.53) ml, (13.31 ± 3.21) weeks vs.(16.24 ± 3.33) weeks, (0.97 ± 0.19) mm vs.(1.24 ± 0.35)mm, there were statistical differences ( P<0.01). The outreach and forward angles in the Latarjet group were higher than those in the Bankart group: (138.25 ± 10.36)° vs. (98.15 ± 9.64)°, (140.14 ± 10.43)° vs. (93.79 ± 8.84)°, there were statistical differences ( P<0.01). The total effective rate in the Latarjet group was higher than that in the Bankart group: 96.55%(28/29) vs. 75.86%(22/29), there was a statistical difference ( χ2 = 5.22, P = 0.022). The Rowe scores after operation in the Latarjet group were higher than that in the Bankart group: (82.52 ± 15.89) scores vs. (66.78 ± 15.34) scores, there was a statistical difference ( P<0.01). The scores of self-assessment and physician assessment of ASES system and UCLA shoulder scores after operation in the Latarjet group were higher than those in the Bankart group: (36.13 ± 8.45) scores vs. (30.17 ± 8.48) scores, (40.03 ± 9.54) scores vs. (34.25 ± 8.74) scores, (32.08 ± 2.44) scores vs. (27.49 ± 2.56) scores, there were statistical differences ( P<0.05). The complication rate in the Latarjet group was lower than that in the Bankart group: 6.90%(2/29) vs. 31.03%(9/29), there was a statistical difference ( χ2 = 5.50, P = 0.019). Conclusions:The minimally invasive modified Bristow-Latarjet in the treatment of recurrent dislocation of the shoulder joint is superior to Bankart prosthesis in terms of shoulder functional recovery and postoperative rehabilitation.

Objective To explore the factors affecting the coefficient of variation(CV)of glucose in type 2 diabetes mellitus(T2DM)patients based on real-time dynamic glucose monitoring system.Methods A total of 354 patients with T2DM hospitalized in the Department of Endocrinology of Jiangsu Shengze Hospital were enrolled in this study from March 2023 to March 2024 and divided into two groups:the glycemic variability(GV,CV>36%)group(n=118)and the glucose stable(GS,CV≤36%)group(n=236).The clinical data of the two groups were compared,and the influencing factors for CV>36%were analyzed.Results The DM duration and HbA1c were higher(P<0.05),while BMI,visceral fat area,subcutaneous fat area(SFA),FC-P,serum uric acid(SUA),and TG were lower in the GV group than in the GS group(P<0.05).Spearman correlation analysis showed that CV was positively correlated with diabetes duration and HbA1c(P<0.05),and negatively correlated with FC-P,SFA and SUA(P<0.05).Logistic regression analysis showed that DM duration,HbA1c,SFA,FC-P and SUA were the influencing factors for GV.Scatter plot analysis showed that there was a linear trend between CV level and log HbA1c and log SFA in T2DM patients.CV level increased with the increase of log HbA1c,and decreased with the increase of log SFA.ROC curve analysis showed that the area under the curve(AUC)of FC-P was 0.703(95%CI:0.640～0.765,P<0.001)for predicting GV in T2DM patients,and the cut-off value was 1.095 ng/ml.The AUC of SUA was 0.622(95%CI:0.555～0.688,P<0.001)for predicting GV,and the cut-off value was 280.5 μmol/L.Conclusions The DM duration,HbA1c,SFA,FC-P and SUA are important factors for GV,and FC-P and SUA have predictive value for GV.

Objective To investigate the role of trichostatin A(TSA)in regulating CD4+T cell subpopulations during Escherichia coli(E.coli)inflammatory infections.Methods Male mice(8 weeks old,weighing 22～25 g)were randomly divided into 3 groups(n=16):a dimethyl sulfoxide(DMSO)control group,an infection group(DMSO+E.coli),and an intervention group(E.coli+TSA).E.coli was administered via intraperitoneal injection at a concentration of 3×10? CFU/mL to establish an infection model.The E.coli+TSA group was further subdivided into 3 subgroups based on different TSA concentrations(2.5,5.0,10.0 mg/kg).Then the samples were collected at different time points(12,24,48,96 h)after TSA intervention.The efficacy of TSA in treating E.coli-induced inflammatory responses and its relationship with CD4+T cell subsets were evaluated by survival rate observation,body weight monitoring,histopathological staining for small intestine,ELISA detection,transcriptomics sequencing,flow cytometry and RT-qPCR analysis.Results Compared with the E.coli group,5 mg/kg TSA significantly increased survival rate,suppressed body weight loss,improved pathological damage in the small intestinal,reduced serum TNF-α level in 24 h after infection(P<0.000 1),and elevated IL-10 level(P<0.05).Transcriptomic analysis revealed that 5 mg/kg TSA intervention for 24 h modulated the T cell differentiation signaling pathways,including those regulating FoxO,Th17,and Th1/2.Flow cytometry and RT-qPCR results showed that compared to the E.coli group,5 mg/kg TSA down-regulated the expression of the Th17 cell marker RORγt in mice 96 h after infection while significantly up-regulated the expression of the Treg cell marker Foxp3(P<0.05).Conclusion TSA may alleviate bacterial infectious inflammatory diseases by regulating the differentiation of CD4+T cells toward the Treg subset while simultaneously inhibiting their differentiation toward the Th17 subset,thereby suppressing the release of proinflammatory cytokines.

Objective Investigate the expression level of discs large homolog associated protein 5(DLGAP5)in oral squamous cell carcinoma(OSCC)and analyze its effects on cell proliferation,migration,invasion capacity,and the Warburg effect.Methods Bioinformatics analysis was performed to identify the potential therapeutic targets for OSCC.A total of 72 OSCC tissue samples and 40 adjacent non-cancerous tissue samples collected in the First Affiliated Hospital of Shihezi University from 2013 to 2024 were included,and the clinical pathological and prognostic data were collected from patients.Immunohistochemistry assay was applied to detect the protein expression of DLGAP5,and its association with clinical pathological features was analyzed.Kaplan-Meier survival curve was plotted for survival analysis,and Cox regression model was employed to analyze the prognostic factors.The expression of DLGAP5 at mRNA and protein levels was detected in HOK,SCC-9,SCC-15,SCC-25,and CAL-27 cell lines with RT-qPCR and Western blotting,respectively.Four small interfering RNAs(siRNAs)were designed to target the DLGAP5 sequence,and then based on the transfection efficiency,the sequence with optimal silencing effect was selected for subsequent functional studies.After DLGAP5 was silenced in the CAL-27 and SCC-15 cells,Western blotting was applied to detect the expression of hexokinase 2(HK2)and enolase 1(ENO1),CCK-8,scratch healing and Transwell assays were conducted to assess cell proliferation,migration,and invasion capabilities,and glucose,lactate,and ATP detection kits were utilized to determine the glycolytic metabolic levels in OSCC cells.Results Bioinformatics analysis indicates that DLGAP5 is a potential key therapeutic target for OSCC.Experimental validation demonstrated that DLGAP5 was highly expressed in both OSCC tissues and cells(P<0.05).Analysis of clinical pathology and prognostic data revealed that DLGAP5 expression level was significantly correlated with tumor TNM stage,lymph node metastasis,and differentiation grade in OSCC patients,and high DLGAP5 expression was associated with poor prognosis(P<0.05).DLGAP5 silencing resulted in significantly reduced expression of HK2 and ENO1,markedly decreased levels of glycolytic metabolites(P<0.05),and notably declined cell proliferation,migration,and invasion capabilities(P<0.05).Conclusion DLGAP5 is highly expressed in OSCC.Silencing DLGAP5 may inhibit OSCC cell proliferation,migration,and invasion by indirectly regulating the Warburg effect,and the molecule is associated with poor prognosis in the OSCC patients.

As a new generation of time-of-flight mass spectrometry,multiple-reflection time-of-flight mass spectrometry(MR-TOF-MS)has been increasingly applied in the fields such as nuclear physics,chemistry,and biology due to its ultra-high resolution and rapid analysis capabilities.However,the analytical performance of MR-TOF-MS largely depends on the ion bunch state entering the mass analyzer.In this study,a rectangular ion trap(RIT)was developed,designed and processed using printed circuit board technology,as an ion accumulating and focusing device for MR-TOF mass analyzer.Compared to traditional ion traps composed of two sets of planar electrodes,this RIT had higher voltage utilization efficiency,resulting in more efficient ion collection and focusing.The ions were cooled to a sufficiently small bunch for precise mass measurement with MR-TOF-MS mass spectrometry in only 1 ms of cooling time in the RIT,then orthogonally ejected to the MR-TOF mass spectrometer for mass analysis.Experimental results indicated that the working cycle,ion flux,and ion focusing state of the RIT fully met the requirements of the MR-TOF mass analyzer.When coupled with the MR-TOF mass analyzer,the RIT enabled MR-TOF-MS to achieve a mass resolution of 1.5×105.