Objective: To compare the consistency between bioelectrical impedance analysis (BIA) and dual energy X ray absorptiometry (DXA) in measuring body composition among Tibetan children and adolescents and to explore the applicability of BIA in plateau region, so as to provide scientific and convenient body composition measurement support among children and adolescents. Methods: From May to June, 2022, a total of 344 Tibetan children and adolescents aged 6-17 years were selected from Golmud Municipal National Middle School and Changjiangyuan Nationality Primary School in Qinghai Province by cluster sampling method, and their fat mass, fat mass percentage and lean mass were measured by DXA and BIA. The consistency and correlation between the two methods were assessed by using the Wilcoxon rank-sum test, Spearman correlation analysis, intraclass correlation coefficient (ICC), and Bland-Altman analysis. Results: DXA measured fat mass and fat mass percentage were significantly higher than those obtained by BIA (6-12 years old: Z =9.91, 11.28; 13-17 years old: Z =9.02, 10.21), while lean mass and lean mass percentage were significantly lower than BIA results (6-12 years old: Z =-11.60, -11.30; 13-17 years old: Z =-10.77, -10.36) (all P < 0.05 ). The two methods showed strong correlations in fat mass and lean mass (all r >0.80, all ICC >0.90), but exhibited poor agreement in fat mass percentage and lean mass percentage (6-12 years old: Lin s CCC =0.64, 0.41; 13-17 years old: Lin s CCC = 0.79 , 0.35). Bland-Altman analysis showed that the difference between the two methods was negatively correlated with the average value in FM%(6-12 years old: r =-0.75, 13-17 years old: r =-0.79, both P <0.01). Conclusion BIA and DXA show high consistency in measuring body fat mass and lean body mass in Tibetan children and adolescents, although some bias is still present in certain individuals.

Objective:To evaluate the effect of an obstetric artificial intelligence (AI) assistant combined with a family-centered health education model on maternal self-care ability, comfort status, and spousal caregiving ability.Methods:This prospective, single-center, parallel randomized controlled trial used 1∶1 randomization and was conducted as a superiority trial. Postpartum mothers and their spouses admitted to family-style single rooms at the Third Affiliated Hospital of Guangzhou Medical University between October 2024 and April 2025 were enrolled and randomly assigned to control or intervention groups using a random number table. The control group received conventional health education, while the intervention group received conventional health education plus the AI-assisted family-centered model. Interventions were administered at 2 hours, 6 hours, and 24 hours postpartum, and before discharge. Outcomes included maternal self-care ability, comfort status, and spousal caregiving ability, which were assessed at 2 hours postpartum and before discharge. Data were analyzed using independent and paired t-tests and Chi square tests. Results:Of the 88 mother-spouse dyads initially recruited, four were excluded due to mother-infant separation (e.g., neonatal jaundice), leaving 84 dyads (42 per group). After the intervention, the intervention group showed significantly higher maternal self-care ability scores [(192.81±13.80) vs. (181.00±21.41) scores, t=3.00], higher maternal comfort scores [(104.43±7.52) vs. (96.00±14.29) scores, t=3.38], and better spousal caregiving ability [(6.07±3.13) vs. (9.50±5.02) scores, t=－3.76] compared to the control group (all P<0.05). Conclusion:The obstetric AI assistant combined with a family-centered health education model significantly improved maternal self-care ability and comfort status, as well as spousal caregiving ability.

Objective:To evaluate the effect of an obstetric artificial intelligence (AI) assistant combined with a family-centered health education model on maternal self-care ability, comfort status, and spousal caregiving ability.Methods:This prospective, single-center, parallel randomized controlled trial used 1∶1 randomization and was conducted as a superiority trial. Postpartum mothers and their spouses admitted to family-style single rooms at the Third Affiliated Hospital of Guangzhou Medical University between October 2024 and April 2025 were enrolled and randomly assigned to control or intervention groups using a random number table. The control group received conventional health education, while the intervention group received conventional health education plus the AI-assisted family-centered model. Interventions were administered at 2 hours, 6 hours, and 24 hours postpartum, and before discharge. Outcomes included maternal self-care ability, comfort status, and spousal caregiving ability, which were assessed at 2 hours postpartum and before discharge. Data were analyzed using independent and paired t-tests and Chi square tests. Results:Of the 88 mother-spouse dyads initially recruited, four were excluded due to mother-infant separation (e.g., neonatal jaundice), leaving 84 dyads (42 per group). After the intervention, the intervention group showed significantly higher maternal self-care ability scores [(192.81±13.80) vs. (181.00±21.41) scores, t=3.00], higher maternal comfort scores [(104.43±7.52) vs. (96.00±14.29) scores, t=3.38], and better spousal caregiving ability [(6.07±3.13) vs. (9.50±5.02) scores, t=－3.76] compared to the control group (all P<0.05). Conclusion:The obstetric AI assistant combined with a family-centered health education model significantly improved maternal self-care ability and comfort status, as well as spousal caregiving ability.

Objective:To evaluate the effect of individualized positive end-expiratory pressure (PEEP) ventilation strategy guided by driving pressure on intraoperative intracranial pressure in patients with moderate traumatic brain injury (TBI).Methods:Total of 111 patients aged 18-65 years old, with BMI of 17-28 kg/m 2, ASA grade of Ⅲ-Ⅳ, and Glasgow coma score of 9-11 before operation were treated with evacuation of intracranial hematoma in emergency. The patients were randomly divided into 0 cmH 2O PEEP group (Group 0 PEEP), 5 cmH 2O PEEP group (Group 5 PEEP) and individualized PEEP ventilation group (Group P) guided by driving pressure. The volume control ventilation mode is adopted, VT is 6 mL/kg, FiO 2 is 60%, and the inspiratory expiratory ratio is 1:2. Patients in Group 0 PEEP and Group 5 PEEP were given PEEP 0 or 5 cmH 2O for ventilation after tracheal intubation until the end of the operation. Patients in Group P were given individualized PEEP titration ventilation strategy guided by driving pressure after intubation. Blood gas analysis was performed at 5 min (T1) after tracheal intubation, 60 min (T3) after operation, and 5 min (T4) after operation. PaO 2, PaCO 2, and dynamic compliance (Cdyn) were recorded. The optic nerve sheath diameter (ONSD) was measured before anesthesia induction (T0), after PEEP titration in group P (T2, 10 min after ventilation in group 0 PEEP and 5 PEEP) and at T4; Serum neuron specific enolase (NSE) concentration was measured by ELISA before and 1 day and 3 days after operation; The occurrence of nervous system complications (intracranial infection, intracranial hypertension, epilepsy, brain edema, etc.) within 30 days after operation was followed up. Results:Compared with group 0 PEEP and 5 PEEP, Cdyn and PaO 2 in group P increased at T3-4 ( P<0.05), ONSD was not significantly different among the three groups ( P>0.05), NSE in group P decreased significantly at 1 and 3 days after operation, and the incidence of neurological complications in the three groups was not significantly different at 30 days after operation ( P>0.05). Conclusions:Individualized PEEP ventilation strategy guided by driving pressure can help improve lung and brain function in TBI patients.

Conjunctival melanoma (CM) is a rare and fatal malignant eye tumor. In this study, we deciphered a novel anti-CM mechanism of a natural tetracyclic compound named as cucurbitacin B (CuB). We found that CuB remarkably inhibited the proliferation of CM cells including CM-AS16, CRMM1, CRMM2 and CM2005.1, without toxicity to normal cells. CuB can also induce CM cells G2/M cell cycle arrest. RNA-seq screening identified KIF20A, a key downstream effector of FOXM1 pathway, was abolished by CuB treatment. Further target identification by activity-based protein profiling chemoproteomic approach revealed that GRP78 is a potential target of CuB. Several lines of evidence demonstrated that CuB interacted with GRP78 and bound with a K _d value of 0.11 μmol/L. Furthermore, ATPase activity evaluation showed that CuB suppressed GRP78 both in human recombinant GRP78 protein and cellular lysates. Knockdown of the GRP78 gene significantly induced the downregulation of FOXM1 and related pathway proteins including KIF20A, underlying an interesting therapeutic perspective. Finally, CuB significantly inhibited tumor progression in NCG mice without causing obvious side effects in vivo. Taken together, our current work proved that GRP78-FOXM1-KIF20A as a promising pathway for CM therapy, and the traditional medicine CuB as a candidate drug to hinder this pathway.

Objective:To classify the ultrasound features of ovarian tumors by modified gynecology imaging reporting and data system(mGI-RADS), and explore the clinical value of mGI-RADS in differentiating of benign and malignant tumors.Methods:The 242 ultrasound images of the adnexal mass from 221 patients with ovarian tumor who underwent ultrasound scan and proceeded surgeries in the Second Affiliated Hospital of Harbin Medical University from September 2017 and December 2019 were involved in the retrospective analysis and compared with the pathological results. According to the latest ultrasound terminology for adnexal masses proposed by the International Ovarian Tumor Analysis (IOTA), the adnexal masses were classified. The suspeted malignant sings were screened for mGI-RADS. Using GI-RADS and mGI-RADS classification systems, all the adnexal masses were double-blindly classified by two senior doctors and their diagnostic efficiencies were evaluated.Results:Among the suspected malignant signs proposed by IOTA, resistance index (RI)<0.5, central blood flow signal, ascites, irregular cystic wall with uneven thickness separation, mass composition (solid component ≥30% and silent shadow attenuation), and papillary structure≥7 mm, showed retatively higher OR values(14.282, 10.372, 9.653, 8.832, 5.851, 4.506, respectively. Using GI-RADS and mGI-RADS classification systems, the diagnostic consistency by the two senior doctors in differentiating benign and malignant ovarian neoplasms was good(Kappa=0.767, P<0.05). Grade Ⅳ was divided into three subtypes (Ⅳa, Ⅳb, Ⅳc) by the mGI-RADS, and their positive predictive values for malignant ovarian masses were 69.0%, 90.4% and 92.9% respectively. When a cut-off value >mGRⅣ was used to distinguish the benign and malignant adnexal tumors, the AUC was the largest, and its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.4%, 93.1%, 90.4%, 95.2% and 93.2%, respectively. Conclusions:The mGI-RADS has a high clinical value in the differential diagnosis of ovarian tumors.

Objective:To evaluate the myocardial reserve effect in rabbits′ model of myocardial inshemia-reperfusion by layer-specific strain of speckle tracking imaging and low dose dobutamine stress echocardiography(LDDSE).Methods:Forty rabbits were randomly divided into two groups: ischemia-reperfusion group (IR group) and pharmacological postconditioning group (ATP-PostC group). Echocardiography examinations were performed at baseline, 60 min after ligation (before and after dobutamine stress), and 120 min after reperfusion (before and after dobutamine stress). The size of each chamber was measured and the left ventricular ejection fraction(LVEF) was calculated and the heart rate was recorded. The longitudinal strain of endocardium(SLsys-endo), longitudinal strain of myocardium(SLsys-mid), longitudinal strain of epicardium(SLsys-epi) were acquired. Triphenyl tetrazolium chloride(TTC) and Evans blue staining were applied in two rabbits randomly selected from each group at 60 min after ligation, dobutamine stress and 120 min after reperfusion, respectively.Results:①After coronary artery ligation, LVEF decreased in both groups( P<0.05), SLsys-endo, SLsys-mid, and SLsys-epi decreased in two groups( P<0.01). After low dose dobutamine stress, the SLsys-endo, SLsys-mid and SLsys-epi in the two groups increased, which was different from that after lagation( P<0.05). ②After 120 min reperfusion, the longitudinal strain of the myocardium of both groups increased compared with that after lagation( P<0.01, P<0.05), and the increase in ATP-PostC group was significantly higher than that in IR group( P<0.01). There was no significant difference between the IR group and the first LDDSE( P<0.05). After LDDSE again, the SLsys-endo and SLsys-mid in the two groups further increased, which was different from that after reperfusion ( P<0.05). And the SLsys-endo and SLsys-mid were higher in ATP-PostC group than those in IR group ( P<0.05). ③Pathological results showed that there was no significant difference in myocardial infarct size between IR group and ATP-PostC group at 60 min after ligation ( P>0.05). After 120 min reperfusion, the percentage of myocardial infarct size in the IR group was significantly higher than that in the ATP-PostC group ( P<0.05). Conclusions:Layer-specific strain of STI combined with LDDSE can early detect regional myocardial dysfunction and accurately assess myocardial reserve function, and with endocardial longitudinal strain being more sensitive.

Objective To investigate the incidence of abnormalities and adverse reactions of intrauterine device ( IUD) by three‐dimensional transvaginal ultrasound ,and guide the correct selection of IUD . Methods Female volunteers who came to our hospital for health check‐up from July 2016 to February 2018 were selected as subjects to obtain information of the belt loop time and number of loops . T hree‐dimensional transvaginal ultrasound was used to observe and record the IUD types and positions . T he incidence of location abnormalities ,adverse reactions and cervical lesions of differnet types of IUD were retrospectively analyzed . Results T wo thousand one hundred and thirteen eligible subjects were included in the study ,including 423 cases of McuIUD ,506 cases of circular ring ,405 cases of uterine ring ,372 cases of T‐ring and 407 cases of γ ring . T he statistical analysis showed that the incidence of adverse reactions after wearing rings was as high as 34 .07% ,and the adverse reaction rate of different IUD was different . McuIUD had the highest incidence of adverse reactions ,compared with the circular ring ,the uterine ring ,the T‐ring , and the γ ring ( 47 .99% vs 25 .88% ,27 .41% ,37 .10% ,33 .66% ; all P ＜ 0 .05 ) . Different IUD had different incidence of adverse reactions . T he low back pain rate in McuIUD and γ ring were higher than the other 3 IUDs . T he low back pain rate of McuIUD was higher than the circular ring ,the uterine ring and the T‐ring ( 23 .4% vs 15 .71% ,14 .07% ,13 .7 1% ; all P ＜ 0 .01 ) . Different types of IUD had different incidence of location anomalies . T he descending rate of the circular ring was higher than that of the McuIUD and γ ring ( 6 .32% vs 3 .30% ,3 .19% ; all P＜ 0 .05 ) ,and no statistically significant difference compared with the uterine ring and T‐ring ( 6 .32% vs 3 .45% ,4 .30% ; all P ＞0 .05 ) . T he incarceration rate of the mother ring was higher than that of the circular ring ,uterine ring and T‐ring ( 3 .07% vs 0 ,0 .25% ,0 .54% ;all P ＜0 .01) . T he intrauterine rotation rate of uterine ring and γ ring were higher than that of McuIUD , circular ring and T‐ring ( all P ＜0 .01) . Pregnancy ＞1 and ring times ≥2 were related with the occurrence of adverse reactions of IUD ( P ＜ 0 .05 ) . T he incidence of cervical erosion in the T‐ring was the highest compared with the McuIUD ,circular ring ,uterine ring ,and γ ring ( 30 .65% vs 16 .78% ,16 .80% ,18 .02% , 17 .69% ; all P ＜0 .01) . Conclusions The incidence of adverse reactions is higher in women with different types of IUD . T he incidence of different types of abnormal IUD position is different . T he frequency of pregnancy and band ring are related to the occurence of adverse veactions to IUD .

To evaluate the changes of myocardial viability and systolic function in rabbits with different ischemic periods by layer‐specific strain of ultrasound speckled tracking imaging ( ST I) and low dose dobutamine stress echocardiography ( LDDSE ) . Methods T hirty‐six rabbits were randomly divided into 3 groups( n ＝12) : ①myocardial infarction group Ⅰ :coronary artery occlusion for 45 min ; ②myocardial infarction group Ⅱ :coronary artery occlusion for 60 min ; ③ myocardial infarction group Ⅲ :coronary artery occlusion for 90 min . Echocardiography examinations were performed at baseline ,after ligation and low dose dobutamine stress . After the experiment ,rabbits were killed and the hearts were taken to assess viable or nonviable mycardium , triphenyl tetrazolium chloride and Evans blue staining were applied . Results ①After coronary artery ligation ,left ventricular ejection fraction( LVEF) decreased in 3 groups ( all P ＜ 0 .05 ) , the ventricular global endocardial longitudinal strain ( GSLsys‐endo ) , global myocardial longitudinal strain( GSLsys‐mid) ,and global epicardial longitudinal strain( GSLsys‐epi) decreased in 3 groups ( all P ＜ 0 .05 ) ,the longitudinal strain of endocardium ( SLsys‐endo ) ,longitudinal strain of myocardium ( SLsys‐mid) ,longitudinal strain of epicardium ( SLsys‐epi) decreased in viable myocardial ( all P＜0 .05) ; ②While low dose dobutamine stressing ,the GSLsys and SLsys increased in each groups ,and the GSLsys‐endo ,GSLsys‐mid ,GSLsys‐epi and SLsys‐endo of viable segments in each group were increased ( P＜0 .05) ; ③After ligation and low dose dobutamine stress ,the GSLsys in endocardium in three groups were different( P ＜0 .05) ,and the SLsys in endocardium of viable segments in three groups were different ( P＜0 .05) . Conclusions Layer‐specific strain of STI combined with LDDSE can accurately evaluate the changes of myocardial viability and systolic function in different ischemic periods ,and the longitudinal strain of endocardium is more sensitive ;moreover ,with the increase of coronary artery occlusion time ,the infarcted myocardium increases ,myocardial viability and systolic function decrease .

Humans ; Lymphadenitis