OBJECTIVE To construct a predictive tool for surgical site infections(SSIs)in spinal surgery for Chi-nese population to provide evidence support for reducing SSIs.METHODS A systematic review of Chinese and English database literature was conducted for Meta-analysis to obtain pooled risk values for influencing factors,and a risk prediction scoring tool was constructed based on the logistic regression model.Patients who underwent spinal surgery and completed postoperative follow-up in a tertiary hospital in Beijing from Jan.to Dec.2021 were selected to validate the predictive effect of the tool.RESULTS The predictive model for SSIs in Chinese spinal sur-gery patients was Logit(P)=—3.47+0.63(age 60 years)+0.31 ×(patient with cardiovascular disease)+0.69 ×(rheumatoid arthritis)+1.07 ×(diabetes)+1.06 ×(operation duration＞3 h)+1.17 ×(preopera-tive albumin＜35 g/L)+0.71 ×(history of spinal surgery)+0.67 ×(carrying internal implants)+0.73 ×(blood transfusion).The total score of the predictive tool was 92,with a cutoff score of≥24.50 indicating high-risk individuals.The area under the curve was 0.733,with the sensitivity 58.30％and the specificity 79.60％.CONCLUSION The established predictive model for SSIs in Chinese spine surgery demonstrates good predictive performance and can be used as a reference assessment tool in clinical practice.

Objective Melatonin has been shown to have neuroprotective effects.This study is aimed at observing the effects of copper deposition on cognitive function in a toxic milk(TX)mouse model of Wilson disease(WD),and investigating the effects and mechanisms of action of Gandou Bushen Decoction(GDBSD)on melatonin synthesis and pineal function in the WD model mice.Methods A total of 30 homozygous TX mice were randomly assigned to 3 groups(n=10 in each group),including a WD group,a GDBSD group,and a dimercaptosuccinic acid(DMSA)group.A total of 10 DL mice were included in the normal control(NC)group.The structure and copper content of pineal gland tissues,oxidative stress and apoptosis-related markers,and serum melatonin levels were evaluated using hematoxylin-eosin(HE)staining,enzyme-linked immunosorbent assay(ELISA),flow cytometry,and Western blot.Results Compared with the NC group,the WD group exhibited decreased learning and cognitive abilities(P＜0.05),damaged pineal gland structure,increased copper content,reactive oxygen species(ROS)levels,and mitochondrial damage rate in the pineal gland(P＜0.01),altered levels of melatonin and oxidative stress-related markers(P＜0.05),upregulated expression levels of pro-apoptotic proteins Bax and Caspase-3,and decreased expression of the anti-apoptotic protein Bcl-2(P＜0.01).After treatment with GDBSD and DMSA,the SIRT3/FOXO3α signaling pathway was activated,the copper content in the pineal gland was reduced,and oxidative stress and apoptosis-related damages were improved,leading to an improvement in learning and memory abilities(P＜0.05).Conclusion GDBSD can alleviate cognitive impairments in WD mice caused by pineal gland copper deposition by inhibiting oxidative stress and apoptosis in the pineal gland.The underlying molecular mechanism is associated with the regulation of the SIRT3/FOXO3α signaling pathway.

Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.

OBJECTIVE To construct a predictive tool for surgical site infections(SSIs)in spinal surgery for Chi-nese population to provide evidence support for reducing SSIs.METHODS A systematic review of Chinese and English database literature was conducted for Meta-analysis to obtain pooled risk values for influencing factors,and a risk prediction scoring tool was constructed based on the logistic regression model.Patients who underwent spinal surgery and completed postoperative follow-up in a tertiary hospital in Beijing from Jan.to Dec.2021 were selected to validate the predictive effect of the tool.RESULTS The predictive model for SSIs in Chinese spinal sur-gery patients was Logit(P)=—3.47+0.63(age 60 years)+0.31 ×(patient with cardiovascular disease)+0.69 ×(rheumatoid arthritis)+1.07 ×(diabetes)+1.06 ×(operation duration＞3 h)+1.17 ×(preopera-tive albumin＜35 g/L)+0.71 ×(history of spinal surgery)+0.67 ×(carrying internal implants)+0.73 ×(blood transfusion).The total score of the predictive tool was 92,with a cutoff score of≥24.50 indicating high-risk individuals.The area under the curve was 0.733,with the sensitivity 58.30％and the specificity 79.60％.CONCLUSION The established predictive model for SSIs in Chinese spine surgery demonstrates good predictive performance and can be used as a reference assessment tool in clinical practice.

Objective:To investigate the efficacy and safety of protein A immunoadsorption (PAIA) combined with rituximab (RTX) in highly sensitized patients who underwent haplo-hematopoietic stem cell transplantation (haplo-HSCT) .Methods:The clinical data of 56 highly sensitized patients treated with PAIA and RTX before haplo-HSCT at the First Affiliated Hospital of Soochow University and Soochow Hopes Hematonosis Hospital between March 2021 and June 2023 were retrospectively analyzed. The number of human leukocyte antigen (HLA) antibody types and the mean fluorescence intensity (MFI), humoral immunity, adverse reactions during adsorption, and survival within 100 days before and after adsorption were measured.Results:After receiving the PAIA treatment, the median MFI of patients containing only HLA Ⅰ antibodies decreased from 7 859 (3 209-12 444) to 3 719 (0-8 275) ( P<0.001), and the median MFI of HLA Ⅰ+Ⅱ antibodies decreased from 5 476 (1 977-12 382) to 3 714 (0-11 074) ( P=0.035). The median MFI of patients with positive anti-donor-specific antibodies decreased from 8 779 (2 697-18 659) to 4 524 (0–15 989) ( P<0.001). The number of HLA-A, B, C, DR, and DQ antibodies in all patients decreased after the PAIA treatment, and the differences were statistically significant (A, B, C, DR: P<0.001, DQ: P<0.01). The humoral immune monitoring before and after the PAIA treatment showed a significant decrease in the number of IgG and complement C3 ( P<0.001 and P=0.002, respectively). Forty-four patients underwent HLA antibody monitoring after transplantation, and the overall MFI and number of antibody types decreased. However, five patients developed new antibodies with low MFI, and nine patients continued to have high MFI. The overall survival, disease-free survival, non-recurrent mortality, and cumulative recurrence rates at 100 days post-transplantation were 83.8%, 80.2%, 16.1%, and 4.5%, respectively. Conclusions:The combination of PAIA and RTX has a certain therapeutic effect and good safety in the desensitization treatment of highly sensitive patients before haplo-HSCT.

The incidence of breast cancer is on the rise annually, and chemotherapy is potentially effective in prolonging the lifespan of young breast cancer patients which also irreversibly harm the ovaries. Recently, increasingly more studies have focused on the role of gonadotropin-releasing hormone agonist (GnRH-a) for protecting ovarian function in patients undergoing chemotherapy with disputable findings. This review addresses four perspectives including the impact of chemotherapy on ovarian function, the introduction of GnRH-a and the possible mechanism of protecting ovarian function, the advances of clinical research on the ovarian protection by GnRH-a in chemotherapy for patients with breast cancer and other related issues, with the aim of providing thoughts for clinical diagnosis and associated research.

Overweight and obesity are getting more commonplace worldwide and increasingly developing serious health and social issues. Weight loss intervention is regarded as an effective way to improve the fertility outcomes of overweight or obese women of childbearing age who have a substantial impact on their ability to conceive as well as an elevated risk of various perinatal complications. The effectiveness of weight loss therapies in improving fertility outcomes in overweight or obese infertile women is still being investigated. This article aims to investigate the impact of weight loss therapies on overweight or obese women from multiple perspectives, including the effects of weight loss intervention on fertility, assisted reproductive outcomes, and perinatal outcomes to provide more ideas and references for the clinical practice of weight loss interventions.

Overweight and obesity are getting more commonplace worldwide and increasingly developing serious health and social issues. Weight loss intervention is regarded as an effective way to improve the fertility outcomes of overweight or obese women of childbearing age who have a substantial impact on their ability to conceive as well as an elevated risk of various perinatal complications. The effectiveness of weight loss therapies in improving fertility outcomes in overweight or obese infertile women is still being investigated. This article aims to investigate the impact of weight loss therapies on overweight or obese women from multiple perspectives, including the effects of weight loss intervention on fertility, assisted reproductive outcomes, and perinatal outcomes to provide more ideas and references for the clinical practice of weight loss interventions.

The incidence of breast cancer is on the rise annually, and chemotherapy is potentially effective in prolonging the lifespan of young breast cancer patients which also irreversibly harm the ovaries. Recently, increasingly more studies have focused on the role of gonadotropin-releasing hormone agonist (GnRH-a) for protecting ovarian function in patients undergoing chemotherapy with disputable findings. This review addresses four perspectives including the impact of chemotherapy on ovarian function, the introduction of GnRH-a and the possible mechanism of protecting ovarian function, the advances of clinical research on the ovarian protection by GnRH-a in chemotherapy for patients with breast cancer and other related issues, with the aim of providing thoughts for clinical diagnosis and associated research.

BACKGROUND: The distal femur resection in total knee arthroplasty is commonly made using a fixed angle relative to an intramedullary rod. Does a fixed distal femur resection angle influence radiographic alignment in primary total knee arthroplasty? OBJECTIVE: To research the femoral mechanical-anatomical angle in Chinese and how it affects the femoral component angle and postoperative mechanical alignment for total knee arthroplasty. METHODS: Totally 109 cases (148 knees) underwent primary total knee arthroplasty. One surgeon used a fixed resection angle of 5° (group A; n=56 cases, 76 knees). The second surgeon adjusted the resection angle according to preoperative coronal alignment, using 5° for neutral/mild varus, 6° for more severe varus, 4° for mild valgus and 3° for severe valgus knees (group B; n=53 cases, 72 knees). Preoperative hip-knee-ankle angle, femoral mechanical-anatomical angle, postoperative hip-knee-ankle angle, femoral component angle and tibial component angle were measured from standing hip-knee-ankle angle radiographs. For postoperative hip-knee-ankle angle, 177°-183° were considered as neutral mechanical axis. For femoral and tibial component angles, the target results were 88°-92°.RESULTS AND CONCLUSION: (1) There was no statistically significant difference between groups in postoperative hip-knee-ankle angle (group A: (178.78±3.57)°, group B: (178.23±2.78)°; P=0.302) and good rate of hip-knee-ankle angle (group A: 62%, group B: 65%). (2) The mean femoral mechanical-anatomical angle was (6.70±1.34)°preoperatively. There was no significant difference in the good rate of hip-knee-ankle angle (hip-knee-ankle angle < 7°:69%; hip-knee-ankle angle ≥7°: 55%; P=0.108) postoperatively. There was a statistically significant difference about good rate of femoral component angle between different femoral mechanical-anatomical angle angles (femoral mechanical-anatomical angle < 7°: 76%; femoral mechanical-anatomical angle ≥7°: 39%; P < 0.01). (3) There was a statistically significant correlation between preoperative femoral mechanical-anatomical angle and postoperative hip-knee-ankle angle (r=?0.42, P < 0.01) and postoperative femoral component angle (r=?0.58, P < 0.01). (4) The mean femoral mechanical-anatomical angle was larger than foreign values. When the resection angle less than femoral mechanical-anatomical angle, the femoral component may tend to be varus which could affect the lower extremity mechanical alignment. For the larger femoral mechanical-anatomical angle, we advise to adjust the resection angle according to measured value preoperatively.