Objective To explore the relationships of vitamin D and oxidized low-density lipoprotein(ox-LDL)with infertility in patients with polycystic ovary syndrome(PCOS)based on restricted cubic spline models.Methods A total of 150 PCOS patients were selected as the study subjects and followed up for at least 1 year.They were divided into infertile group and non-infertile group according to whether they were infertile.A Logistic regression model was used to analyze the influencing factors of infertility in PCOS patients.Furthermore,the relationships of 1,25-dihydroxyvitamin D3[1,25-(OH)2D3]and ox-LDL with infertility in PCOS patients,as well as their interactive effects on infertility in PCOS patients were analyzed.A restricted cubic spline model was used to analyze the non-linear relationships between 1,25-(OH)2D3,ox-LDL,and infertility in PCOS patients.Results Among 150 PCOS patients,78 were not pregnant,resulting in an infertility rate of 52.00％(78/150).Multivariate Logistic regression analysis showed that the severity of PCOS,body mass index,age,1,25-(OH)2D3,and ox-LDL were all independent influencing factors for infertility in PCOS patients(P＜0.05).After adjusting for confounding factors,1,25-(OH)2D3 and ox-LDL were still associated with the risk of in-fertility in PCOS patients(P＜0.05).Restricted cubic spline model analysis revealed non-linear rela-tionships between 1,25-(OH)2D3,ox-LDL,and the risk of infertility in PCOS patients(P＜0.05).When the serum 1,25-(OH)2D3 level was＜35.70 nmol/L,it was negatively correlated with the risk of infertility in PCOS patients(P＜0.05).When the serum ox-LDL level was ≥381.00 μg/L,it was positively correlated with the risk of infertility in PCOS patients(P＜0.05).Interactive effect analysis showed that 1,25-(OH)2D3 and ox-LDL had antagonistic effects on infertility in PCOS pa-tients(P＜0.05).Conclusion Decreased serum 1,25-(OH)2D3 levels and increased ox-LDL levels in PCOS patients can significantly increase the risk of infertility.Moreover,there is a non-lin-ear dose-response relationship and an antagonistic interactive effect between them,suggesting that regulating vitamin D and oxidative stress levels may be an important strategy for improving the fertili-ty outcomes of PCOS patients.

Objective To investigate clinical therapeutic value of combined posterior nasal nerve and anterior ethmoidal nerve ablation in patients with nasal septal deviation and moderate to severe persistent allergic rhinitis.Methods A total of 47 patients diagnosed with nasal septal deviation and moderate to severe persistent allergic rhinitis from April to December 2024 were divided into two groups.The control group(n=22)underwent septoplasty and bilateral inferior turbinate out-fracture,with postoperative symptom control managed by budesonide nasal spray.The experimental group(n=25)received the same septoplasty and turbinate surgery,supplemented by bilateral posterior nasal nerve and anterior ethmoidal nerve ablation.Symptom improvement was compared between groups by using the Visual Analogue Scale(VAS)and Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)scores preoperatively and3 months postoperatively.Results The operation time of the control group was(36.3±5.9)min,significantly shorter than that of the experimental group[(59.4±6.6)min,t=12.496,P=0.000].Both groups of patients showed significant improvement in VAS and PQLQ scores for nasal symptoms such as nasal congestion,runny nose,sneezing,and itching at 3 months after surgery compared to preoperative levels(all P=0.000).The mean VAS score of the four symptoms in the control group was(4.6±0.9)points at3 months after surgery,which was significantly lower than that before surgery[(6.3±1.1)points,t=9.796,P=0.000].The mean VAS score of the four symptoms in the experimental group was1.0(0.3-4.3)points at3 months after surgery,which was significantly lower than that before surgery[7.0(4.5-9.0)points,Z=-4.376,P=0.000].The improvement rate of the VAS score in the experimental group was(82.4±14.2)%,significantly higher than that in the control group[(26.9±11.7)%,t=14.510,P=0.000].At3 months after surgery,the RQLQ score of the control group[(2.3±0.8)points]was significantly lower than that before surgery[(3.3±0.8)points,t=10.055,P=0.000].The RQLQ score of the experimental group after surgery was 1.4(0.8-3.5)points,which was significantly lower than the preoperative score[3.6(1.5-6.1)points,Z=-4.373,P=0.000].The improvement rate of RQLQ score in the experimental group was(53.0±14.6)%,significantly higher than that in the control group[(30.2±13.4)%,t=5.555,P=0.000].Conclusion Postnasal nerve and anterior ethmoidal nerve ablation combined with nasal septal deviation correction can significantly improve nasal symptoms and quality of life in patients with nasal septal deviation complicated with moderate to severe allergic rhinitis compared with simple nasal septal deviation correction,but the operation time is prolonged.

Objective To investigate clinical therapeutic value of combined posterior nasal nerve and anterior ethmoidal nerve ablation in patients with nasal septal deviation and moderate to severe persistent allergic rhinitis.Methods A total of 47 patients diagnosed with nasal septal deviation and moderate to severe persistent allergic rhinitis from April to December 2024 were divided into two groups.The control group(n=22)underwent septoplasty and bilateral inferior turbinate out-fracture,with postoperative symptom control managed by budesonide nasal spray.The experimental group(n=25)received the same septoplasty and turbinate surgery,supplemented by bilateral posterior nasal nerve and anterior ethmoidal nerve ablation.Symptom improvement was compared between groups by using the Visual Analogue Scale(VAS)and Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)scores preoperatively and3 months postoperatively.Results The operation time of the control group was(36.3±5.9)min,significantly shorter than that of the experimental group[(59.4±6.6)min,t=12.496,P=0.000].Both groups of patients showed significant improvement in VAS and PQLQ scores for nasal symptoms such as nasal congestion,runny nose,sneezing,and itching at 3 months after surgery compared to preoperative levels(all P=0.000).The mean VAS score of the four symptoms in the control group was(4.6±0.9)points at3 months after surgery,which was significantly lower than that before surgery[(6.3±1.1)points,t=9.796,P=0.000].The mean VAS score of the four symptoms in the experimental group was1.0(0.3-4.3)points at3 months after surgery,which was significantly lower than that before surgery[7.0(4.5-9.0)points,Z=-4.376,P=0.000].The improvement rate of the VAS score in the experimental group was(82.4±14.2)%,significantly higher than that in the control group[(26.9±11.7)%,t=14.510,P=0.000].At3 months after surgery,the RQLQ score of the control group[(2.3±0.8)points]was significantly lower than that before surgery[(3.3±0.8)points,t=10.055,P=0.000].The RQLQ score of the experimental group after surgery was 1.4(0.8-3.5)points,which was significantly lower than the preoperative score[3.6(1.5-6.1)points,Z=-4.373,P=0.000].The improvement rate of RQLQ score in the experimental group was(53.0±14.6)%,significantly higher than that in the control group[(30.2±13.4)%,t=5.555,P=0.000].Conclusion Postnasal nerve and anterior ethmoidal nerve ablation combined with nasal septal deviation correction can significantly improve nasal symptoms and quality of life in patients with nasal septal deviation complicated with moderate to severe allergic rhinitis compared with simple nasal septal deviation correction,but the operation time is prolonged.

Gynecological malignancies pose a serious threat to women's health,and the early diagnosis and precise treatment are crucial for improving patients' prognosis.With the rapid advancement of Artificial Intelligence(AI)technology,it has become a revolutionary tool in the medical field.Through functions such as image recognition,data mining,and pattern recognition,it has opened up new avenues for the diagnosis and management of gynecological malignancies.This review comprehensively summarizes the latest research progress of AI in cervical cancer,ovarian cancer and endometrial cancer,with a special focus on its practical applications in tumor management involving early screening,diagnosis,treatment effect evaluation and prediction of prognosis,so as to provide guidance for the future research direction of AI in gynecological malignancies.

[Objective] To explore the expression of Nectin-4 in invasive bladder urothelial carcinoma (BUC) tissue and its clinical significance, so as to provide reference for clinical diagnosis and treatment of BUC. [Methods] Nectin-4 expression in 60 cases of invasive BUC and 40 cases of chronic inflammation of bladder mucosa was detected with immunohistochemical staining (IHC) and RNAscope.The results of the two methods were analyzed and compared, and the relationship between the two methods and the clinicopathological characteristics of invasive BUC was discussed.The correlation between the protein expression of Nectin-4 in BUC tissues, human epidermal growth factor receptor 2 (Her-2) and programmed death factor ligand 1 (PD-L1) was analyzed. [Results] The positive protein expression rates of Nectin-4 detected by IHC were 78.33%(47/60) and 17.50% (7/40) in the invasive BUC group and inflammatory group, respectively, while the positive mRNA expression rates of Nectin-4 detected by RNAscope were 83.33% (50/60) and 12.50% (5/40), respectively.The Kappa values of Nectin-4 in the invasive BUC group and inflammatory group were 0.732 and 0.610, respectively, with general consistency.The protein expression of Nectin-4 in invasive BUC was correlated with muscular invasion, histological grade, vascular thrombus, lymph node metastasis and clinical stage (P<0.05). The mRNA expression of Nectin-4 in invasive BUC was correlated with max tumor diameter, muscular invasion, histological grade, vascular thrombus, lymph node metastasis and clinical stage (P<0.05). The high expression of Nectin-4 in invasive BUC was positively correlated with the expression of Her-2 (P=0.002), but not with the expression of PD-L1 (P>0.05). [Conclusion] Nectin-4 is highly expressed in invasive BUC, and is usually associated with the pathological parameters of poor prognosis.Detection of Nectin-4 expression will help to guide clinical diagnosis and treatment.

Background and purpose:Human epidermal growth factor receptor 2(HER2)serves as one of the paramount drivers of breast cancer metastasis,with roughly 20%-30%of breast cancer patients exhibiting high expression of HER2.The expression level of HER2 is regulatable at multiple molecular levels and determines the metastatic potential of breast cancer cells;however,the manner in which HER2 expression is modulated at the mRNA level remains ambiguous.Circ-0007766 is a circRNA originated from the coding gene ERBB2 for HER2,and whether circ-0007766 can regulate HER2 expression via the ceRNA mechanism has not been reported.This study aimed to analyze whether circ-0007766 acts as a miR-1972 sponge to promote breast cancer cell migration and invasion via upregulation of HER2 expression.Methods:In this study,a high-throughput circRNA chip was employed to screen for circRNAs that exhibited highly specific expression in HER2-positive breast cancer cells.RNA fluorescence in situ hybridization(FISH)was utilized to detect the subcellular localization of circ-0007766.The BaseScope experiment was conducted to analyze the expression level of circ-0007766 in breast cancer tissues and its clinical diagnostic significance.Breast cancer cell models with overexpression and knockdown of circ-0007766 were constructed by transfecting cloning plasmids and siRNA in vitro.The effect of circ-0007766 on the migration and invasion of breast cancer cells was assessed using transwell migration and invasion experiments,and the migration and invasion abilities of MDA-MB-231 and SK-BR-3 cells were measured.Additionally,it was evaluated whether circ-0007766 could promote the migration and invasion of breast cancer cells through miR-1972.A dual luciferase reporter gene assay was used to verify whether circ-0007766 could regulate HER2 expression by binding to miR-1972.The direct interaction between circ-0007766 and miR-1972 was further verified through the RAP experiment.RIP detection was performed in MDA-MB-231 cells,and the relative 3'UTR of HER2 mRNA was measured by real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR).Western blot was used to detect the protein expressions.Results:Circ-0007766 was conspicuously highly expressed in HER2-positive breast cancer cells and distributed in both the cytoplasm and nucleus of cells,with the preponderance being in the cytoplasm.The expression level of circ-0007766 was strikingly higher in breast cancer tissues than in para-cancerous tissues.The expression of circ-0007766 was significantly elevated in HER2-positive breast cancer samples compared with HER2-negative samples.The overexpression(knockdown)of circ-0007766 in HER2-negative breast cancer cells(in HER2-positive breast cancer cells)was capable of promoting(inhibiting)the migration and invasion of breast cancer cells.Circ-0007766 directly bound to miR-1972,which inhibited breast cancer cell migration and invasion,thereby forming an endogenous competitive RNA(ceRNA)regulatory network and impeding the downregulation of HER2 mRNA and protein expression mediated by miR-1972.Circ-0007766 could potentiate the inhibitory effect of miR-1972 on HER2-mediated breast cancer cell migration and invasion that was negatively regulated by miR-1972.CircRNAs sequestered miRNAs to function as ceRNAs,thereby regulating gene expression at both the transcriptional and translational levels.Finally,we discovered that the expressions of circ-0007766 and HER2 were positively correlated in breast cancer cell and tissue samples,while the expression levels of miR-1972 and HER2 were negatively correlated.Circ-0007766 could specifically target miR-1972 to hinder its regulatory effect on HER2 expression.Conclusion:This study discovers that circ-0007766 facilitates the migration and invasion of breast cancer cells via the miR-1972/HER2 signal axis,offering a novel biomarker and potential therapeutic target for patients with metastatic HER2-positive breast cancer.

OBJECTIVE To investigate the effect of a new variety of Sambucus williamsii Hance Yandan on the healing in rats with fractures.METHODS SD rats were randomly allocated to sham surgery group,model group,Zhonghua dieda pill group(0.54 g/kg),wild S.williamsii group(5.4 g/kg,using raw drug dosage),and high-,medium-,and low-dose groups of Yandan(10.8,5.4,2.7 g/kg,using raw drug dosage),with 12 rats in each group.Except for the sham surgery group,the remaining groups were prepared with a femoral fracture model.Starting from the second day after surgery,each group was intubated with the corresponding drugs and distilled water once daily for 8 consecutive weeks.At 2,4,and 8 weeks after administration,the levels of calcium,phosphorus,alkaline phosphatase(ALP),and osteocalcin(OCN)in rat serum were detected.Micro-CT scanning was used to evaluate the morphology and bone microstructural parameters of the fractured femur[bone mineral density(BMD),bone volume/tissue volume(BV/TV),trabecular number(Tb.N),trabecular separation(Tb.Sp),trabecular thickness(Tb.Th)],and hematoxylin-eosin staining was adopted to observe the morphological changes at the bone fracture site.RESULTS Compared with the model group,the levels of calcium in rat serum were significantly decreased(except at 4 weeks after administration),and the levels of phosphorus,ALP,and OCN were significantly increased(P＜0.05)at 2,4,and 8 weeks after administration in the high-dose group of Yandan;bone callus formation,connection of fracture ends,gradual blurring or disappearance of the fracture line,and opening of the marrow cavity were observed in the bone repair process,and a large amount of granulation tissue,fibroblasts,chondrocytes,new trabeculae,and new bone plates were visible at the fracture site of bone tissue;after 8 weeks of administration,BMD,BV/TV,Tb.N,and Tb.Th were significantly increased,and Tb.Sp was significantly decreased(P＜0.05).Most of the above indicators in the wild S.williamsii Hance group showed no significant changes.CONCLUSIONS Yandan has the effect of promoting fracture healing in rats,and its effect is superior to that of wild S.williamsii.

Objective To observe the effect of pre-hospital and intra-hospital collaborative ther-apeutic model in the treatment of patients with acute cerebral infarction.Methods A total of 67 pa-tients with acute cerebral infarction were selected as the research objects,and they were divided into observation group(n=37)and control group(n=30)according to the therapeutic model.The con-trol group was conducted with the traditional therapeutic model,while the observation group was con-ducted with the pre-hospital and intra-hospital collaborative therapeutic model.The time efficiency of intravenous thrombolysis,early recovery of nerve function and oxidative stress indexes were compared between the two groups.Results There was no significant difference in the time from onset to visit between the two groups(P＞0.05);the time from seeing a doctor to thrombolysis and the time from seeing a doctor to signing the informed consent for intravenous thrombolysis in the observation group were significantly shorter than those in the control group(P＜0.05).On the hospital admission,there was no significant difference in the National Institutes of Health Stroke Scale(NIHSS)score be-tween the two groups(P＞0.05);at the time points of 7 days after admission and 90 days after thrombolysis,the NIHSS scores of patients in the observation group were significantly lower than that in the control group(P＜0.05).There were no significant differences in the levels of serum glutathione peroxidase(GSH-Px)and malonaldehyde(MDA)between the two groups(P＞0.05);the level of serum superoxide dismutase(SOD)in the observation group was significantly higher than that in the control group(P＜0.05).One patient died in the control group,with a mortality rate of 3.33％;no patient died in the observation group.Conclusion Pre-hospital and intra-hospital collaborative therapeutic model can effectively improve the time efficiency of intravenous thrombolysis for patients with acute cerebral infarction,alleviate the neurological damage,and reduce degree of oxidative stress reaction and death risk.

BACKGROUND: Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs (NSAIDs) for treating knee osteoarthritis (OA). We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms (FPC) with loxoprofen sodium cataplasms (LSC) in treating patients with knee OA. METHODS: This is an open-label, non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital. Overall, 250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio. Both medications were administered to patients for 28 days. The primary outcome was the change of pain measured by visual analog scale (VAS) score from baseline to day 28 (range, 0-10 points; higher score indicates worse pain; non-inferiority margin: 1 point; superiority margin: 0 point). There were four secondary outcomes, including the extent of pain relief, the change trends of VAS scores, joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and adverse events. RESULTS: Among 250 randomized patients (One patient without complete baseline record in the flurbiprofen cataplasms was excluded; age, 62.8 ± 10.5 years; 61.4% [153/249] women), 234 (93.6%) finally completed the trial. In the intention-to-treat analysis, the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior, and also superior to that in the LSC group (differences and 95% confidence interval, 0.414 (0.147-0.681); P <0.001 for non-inferiority; P = 0.001 for superiority). Similar results were observed of the VAS scores for the current pain and pain during exercise. WOMAC scores were also lower in the FPC group at week 4 (12.50 [8.00-22.50] vs . 16.00 [11.00-27.00], P = 0.010), mainly driven by the dimension of daily activity difficulty. In addition, the FPC group experienced a significantly lower incidence of adverse events (5.6% [7/124] vs . 33.6% [42/125], P <0.001), including irritation, rash and pain of the skin, and sticky hair uncovering pain. CONCLUSIONS This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief, joint function improvement, and safety profile.
Humans ; Female ; Middle Aged ; Aged ; Osteoarthritis, Knee/drug therapy* ; Flurbiprofen/therapeutic use* ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Pain/drug therapy* ; Treatment Outcome ; Double-Blind Method

Objective To observe the effect of pre-hospital and intra-hospital collaborative ther-apeutic model in the treatment of patients with acute cerebral infarction.Methods A total of 67 pa-tients with acute cerebral infarction were selected as the research objects,and they were divided into observation group(n=37)and control group(n=30)according to the therapeutic model.The con-trol group was conducted with the traditional therapeutic model,while the observation group was con-ducted with the pre-hospital and intra-hospital collaborative therapeutic model.The time efficiency of intravenous thrombolysis,early recovery of nerve function and oxidative stress indexes were compared between the two groups.Results There was no significant difference in the time from onset to visit between the two groups(P＞0.05);the time from seeing a doctor to thrombolysis and the time from seeing a doctor to signing the informed consent for intravenous thrombolysis in the observation group were significantly shorter than those in the control group(P＜0.05).On the hospital admission,there was no significant difference in the National Institutes of Health Stroke Scale(NIHSS)score be-tween the two groups(P＞0.05);at the time points of 7 days after admission and 90 days after thrombolysis,the NIHSS scores of patients in the observation group were significantly lower than that in the control group(P＜0.05).There were no significant differences in the levels of serum glutathione peroxidase(GSH-Px)and malonaldehyde(MDA)between the two groups(P＞0.05);the level of serum superoxide dismutase(SOD)in the observation group was significantly higher than that in the control group(P＜0.05).One patient died in the control group,with a mortality rate of 3.33％;no patient died in the observation group.Conclusion Pre-hospital and intra-hospital collaborative therapeutic model can effectively improve the time efficiency of intravenous thrombolysis for patients with acute cerebral infarction,alleviate the neurological damage,and reduce degree of oxidative stress reaction and death risk.