ObjectiveTo investigate somatization symptoms in adolescents during frequent earthquakes in Hefei， and to explore their correlation with earthquake experiences. MethodsA cross-sectional survey was used to select 324 adolescents in Hefei as the survey objects. The self-rating scale of somatization symptoms （SSS） and the fatigue intensity scale （FIS） were used to evaluate the somatization symptoms and fatigue degree of middle school students， and multivariate Logistic regression analysis was used to explore the related factors of somatization symptoms and fatigue among middle school students. ResultsA total of 324 adolescents were included， and the overall detection rate of somatization symptoms was 6.5%， and the detection rate of moderate or above fatigue was 20.1%. The results of regression analysis showed that adolescents who were concerned about the earthquake for a longer time （≥1 h） had a higher risk of somatization symptoms （OR=5.430， 95%CI： 1.547-19.058）， and adolescents who received pre-earthquake training had a lower degree of fatigue （OR=0.535， 95%CI： 0.292-0.981） （P<0.05）. ConclusionDuring the frequent earthquakes， adolescents have more somatization symptoms and fatigue. Therefore， it is crucial to enhance health education， reduce the emphasis on event-related reports， and implement earthquake prevention and disaster reduction training to improve the physical and mental health of adolescents.

Dry eye （DE） is a prevalent multifactorial disease of the ocular surface， clinically characterized by tear film homeostasis imbalance accompanied by related ocular surface symptoms. Specifically， the tear film is a thin liquid layer of tears covering the cornea and conjunctiva through blinking， while tear film homeostasis serves as the foundation for maintaining normal ocular surface structure and function. Insufficient tear secretion and excessive tear film evaporation lead to tear hyperosmolarity and the production of inflammatory mediators， disrupting tear film homeostasis and subsequently forming DE. Additionally， cascade reactions are triggered， resulting in a "vicious cycle of DE" that exacerbates the disease severity and prolongs its duration. Therefore， for DE treatment， it is crucial to restore tear film homeostasis and terminate this vicious cycle. Traditional Chinese medicine （TCM）， which differentiates and treats DE based on systemic conditions， often achieves favorable therapeutic outcomes， offering additional treatment options for DE. Studies have demonstrated that TCM can alleviate DE by regulating tear film homeostasis and terminating the vicious cycle. This review systematically summarizes recent basic experimental research in China and abroad on TCM in alleviating DE by regulating tear film homeostasis， aiming to provide a theoretical basis for clinical treatment and an insight for research design.

Objective To investigate the role and potential mechanism of glutathione peroxidase 3 (GPX3) in ischemia-reperfusion injury (IRI) during kidney transplantation. Methods C57BL/6 mice were divided into four groups according to different interventions: sham operation group (Sham group), kidney transplantation group (KT group), kidney transplantation + GPX3 overexpression group (KT+GPX3 group) and kidney transplantation + GPX3 overexpression + reactive oxygen species (ROS) agonist group (KT+GPX3+CADD522 group). Twenty-four hours after model establishment, inferior vena cava blood was collected to detect blood urea nitrogen (BUN) and serum creatinine (Scr). Left renal tissues were harvested for immunofluorescence staining to detect ROS and NADPH oxidase 2 (NOX2). Enzyme-linked immunosorbent assay (ELISA) was performed to measure neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), tumor necrosis factor (TNF) -α and interleukin (IL)-1β. Western blotting was used to detect myeloperoxidase (MPO) and citrullinated histone H3 (CitH3). Results Compared with the Sham group, the expression level of GPX3 was decreased in the KT group; compared with the KT group, GPX3 expression was increased in the KT+GPX3 group; compared with the KT+GPX3 group, GPX3 expression was reduced in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the levels of Scr, BUN, NGAL and KIM-1 were elevated in the KT group; compared with the KT group, the above indicators were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, the levels of Scr, BUN, NGAL and KIM-1 were increased in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the expression levels of NOX2 and ROS were increased in the KT group; compared with the KT group, NOX2 and ROS levels were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, NOX2 and ROS levels were upregulated in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the expression levels of MPO and CitH3 were increased in the KT group; compared with the KT group, MPO and CitH3 levels were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, MPO and CitH3 levels were increased in the KT+GPX3+CADD522 group (all P<0.05). Compared with the Sham group, the expression levels of TNF-α and IL-1β were increased in the KT group; compared with the KT group, TNF-α and IL-1β levels were decreased in the KT+GPX3 group; compared with the KT+GPX3 group, TNF-α and IL-1β levels were increased in the KT+GPX3+CADD522 group (all P<0.05). Conclusions GPX3 may alleviate renal tissue inflammation by inhibiting ROS-mediated neutrophil extracellular trap (NET) formation, thereby attenuating IRI in renal transplantation.

BackgroundThe prevalence， disability rate and mortality rate of cerebral small vessel disease （CSVD） are relatively high among the elderly population， imposing a heavy burden on families and society. Among the various clinical manifestations of CSVD， cognitive impairment is the most common， and it is also the most closely related neuro-psychiatric syndrome to clinical practice in psychiatry. Previous studies on CSVD-related cognitive impairment （CSVD-CI） have mostly focused on the field of imaging， while studies on non-invasive electrophysiological and cerebral hemodynamic assessments are relatively scarce. ObjectiveTo analyze the characteristics of event-related potential （ERP） and functional near-infrared spectroscopy （fNIRS） in patients with CSVD-CI， and to explore their correlations with the severity of white matter lesions， in order to provide references for the objective assessment and early identification of CSVD-CI. MethodsA total of 40 patients with CSVD who met the diagnostic criteria of the Chinese Guideline for Diagnosis and Treatment of Cerebral Small Vessel Disease （2020） and had cognitive impairment， as well as were admitted to the Affiliated Hospital of North Sichuan Medical College from December 2024 to December 2025， were enrolled as the case group. Meanwhile， 40 healthy volunteers matched for gender， age and education level were recruited as the control group. Both groups underwent assessment using the Mini-Mental State Examination （MMSE）， ERP-P300 detection， and fNIRS examination. The ERP-P300 indicators， functional connectivity strength of the whole brain and cognitive-related regions of interest （ROI） in fNIRS of the two groups were compared. The severity of the patients' white matter lesions was classified as follows： the Fazekas grade I group （mild white matter lesions） and the Fazekas grades II to III group （moderate to severe white matter lesions）. Spearman correlation analysis was employed to investigate the correlation between the Fazekas grading of brain white matter lesions and the latency of ERP-P300， as well as the strength of functional connectivity measured by fNIRS. ResultsThe MMSE score of the CSVD-CI group was lower than that of the control group （Z=-6.250， P<0.01）， and ERP-P300 lantency was significantly longer than that of the control group （t=12.291， P<0.01）. The MMSE score of the sub-group with Fazekas grade I was higher than that of the sub-groups with grades II to III （Z=-2.420， P<0.05）， and showed a shorter P300 latency than that of the sub-groups with grades II to III （Z=-4.210， P<0.01）. All the differences were statistically significant. The resting-state whole-brain functional connectivity strength in the CSVD-CI group was lower than that in the control group， and the difference was statistically significant （t=10.243， P<0.05）. Compared with the control group， the differences in the functional connectivity strength within the left premotor cortex （PMC）， right PMC， left frontopolar cortex （FPC）， right FPC， left dorsolateral prefrontal cortex （DLPFC）， right DLPFC， left orbitofrontal cortex （OFC）， and right OFC regions in the CSVD-CI group were all statistically significant （P_{FDR correction}<0.01）. The differences in the functional connectivity strength between multiple prefrontal-related brain regions between the CSVD-CI group and the control group were all statistically significant （P_{FDR correction}<0.01）. The severity of white matter lesions in CSVD-CI patients was positively correlated with the P300 latency （r_s=0.891， P<0.05）， and negatively correlated with the fNIRS functional connectivity strength （r_s=-0.359， P<0.05）. ConclusionPatients with CSVD-CI exhibit prolonged P300 latency， as well as decreased functional connectivity strength in multiple brain regions including the whole brain and the prefrontal lobe during the resting state. Moreover， these indicators are correlated with the severity of white matter lesions.

ObjectiveTo investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on prolonged disorders of consciousness (pDoC) after stroke. MethodsSixty patients with pDoC admitted to Zhejiang Provincial People's Hospital from January to July, 2024 were randomly assigned into control group (n = 30) and observation group (n = 30). Both groups received conventional rehabilitation therapy combined with hyperbaric oxygen therapy, while the observation group received rTMS in addition, for four weeks. Before and after treatment, they were assessed with Coma Recovery Scale-Revised (CRS-R), National Institutes of Health Stroke Scale (NIHSS), and bilateral N20 amplitude and latency of somatosensory-evoked potential (SEP), while consciousness status classification and Judson classification were recorded. ResultsOne case in the control group and two in the observation group dropped out. Significant time main effects and interaction effects were observed in CRS-R score (F = 118.420, P < 0.001; F = 23.980, P < 0.001, respectively) and NIHSS score (F = 103.376, P < 0.001; F = 14.241, P < 0.001, respectively). Significant group main effects, time main effects and interaction effects were observed in N20 amplitude (F > 4.303, P < 0.05) and N20 latency (F > 7.569, P < 0.05). Simple effects analysis showed CRS-R score, N20 amplitude, NIHSS score and N20 latency were better in the observation group than in the control group (P < 0.05) after the intervention, while the consciousness status classification and Judson classification were also better (|Z| > 2.160, P < 0.05). ConclusionrTMS can further promote recovery of consciousness, improve neurological function, and enhance the integrity of central conduction pathways in patients with pDoC after stroke.

ObjectiveTo investigate the mechanism by which Luoshi Neiyi prescription treats endometriosis （EMs） through the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway. MethodsAnimal experiments were conducted with 50 female SD rats， which were randomized into a sham operation group （10 rats） and a modeling group （40 rats）. An autologous endometrial transplantation method was used for the modeling of EMs. The 36 successfully modeled rats were randomly allocated into four groups （n=9 each）： The model group， the low-dose （7.87 g·kg^-1） Luoshi Neiyi prescription group， the high-dose （15.74 g·kg^-1） Luoshi Neiyi prescription group， and the dienogest （0.20 mg·kg^-1） group. The physiological status and ectopic lesion volumes of rats in each group were observed. Hematoxylin-eosin （HE） staining was used to observe the morphology of the eutopic endometrial tissue. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of inflammatory factors including interleukin-1β （IL-1β） and prostaglandin E₂ （PGE₂） in the serum of EMs rats. Immunohistochemistry was used to detect the expression of matrix metalloproteinase-9 （MMP-9） and vascular endothelial growth factor A （VEGFA） in the eutopic endometrial tissue. Western blot was adopted to determine the protein levels of TLR4， myeloid differentiation factor 88 （MyD88）， phosphorylated nuclear factor-κB （p-NF-κB）/NF-κB， MMP-9， and VEGFA in the eutopic endometrial tissue. In the cell experiments， the cell-counting kit-8 （CCK-8） assay was employed to screen the optimal concentration of Luoshi Neiyi prescription-containing serum， and a scratch assay was performed to assess the migration ability of iheESCs cells. Interventions with Luoshi Neiyi prescription-containing serum， resatorvid （TAK-242， a TLR4 inhibitor）， and lipopolysaccharides （LPS， a TLR4 agonist） were conducted， and Western blot was used to detect the expression of proteins related to the TLR4/NF-κB signaling pathway. ResultsThis experiment successfully replicated 36 EMs rat models. Compared with the sham operation group， the model group exhibited visible ectopic lesions on the abdominal wall and an increase in the writhing response score （P<0.01）. Furthermore， HE staining revealed the model group exhibited a thickened eutopic epithelium， stromal cell disarrangement， and evident infiltration of inflammatory cells. In addition， the model group showed elevated serum levels of IL-1β and PGE₂ （P<0.05， P<0.01）， increased positive expression of MMP-9 and VEGFA in the ectopic endometrial tissue （P<0.01）， and up-regulated protein levels of TLR4， MyD88， p-NF-κB/NF-κB， MMP-9， and VEGFA in the ectopic endometrial tissue （P<0.05， P<0.01）. Compared with the model group， all treatment groups exhibited a reduction in the ectopic lesion volume （P<0.01）. Furthermore， the writhing response scores were decreased in the high-dose Luoshi Neiyi prescription group and the dienogest group （P<0.05， P<0.01）. The pathological state of the ectopic endometrial tissue was alleviated to varying degrees in the treatment groups. Low-dose Luoshi Neiyi prescription reduced serum PGE₂ levels， and high-dose Luoshi Neiyi prescription and dienogest decreased serum IL-1β and PGE₂ levels in EMs rats （P<0.05， P<0.01）. The treatment groups showed decreased positive expression of MMP-9 and VEGFA in the ectopic endometrial tissue （P<0.05， P<0.01） and down-regulated protein levels of TLR4， MyD88， p-NF-κB/NF-κB， MMP-9， and VEGFA in the ectopic endometrial tissue （P<0.05， P<0.01）. The cell experiments showed that 5%， 10%， and 20% Luoshi Neiyi prescription-containing sera significantly reduced the viability and inhibited the migration of iheESCs. Compared with the control group， 5%， 10%， and 20% Luoshi Neiyi prescription-containing serum groups and the TAK-242 group showed reduced protein levels of TLR4， MyD88， p-NF-κB/NF-κB， MMP-9， and VEGFA （P<0.01）. Compared with the control group， the LPS group showed increased expression of the above proteins （P<0.01）. Compared with the LPS group， the LPS+5%， 10%， and 20% Luoshi Neiyi prescription-containing serum groups showed reduced expression of the above proteins （P<0.05， P<0.01）. ConclusionLuoshi Neiyi prescription may modulate the TLR4/NF-κB signaling pathway to reduce the inflammatory response and histopathological damage in the eutopic endometrium and suppress the adhesive， invasive， and angiogenic biological processes in the ectopic endometrial tissue， thereby exerting its therapeutic effect on EMs.

Objective To explore the potential functional targets of ischemia-reperfusion injury (IRI) in renal allografts derived from different donor sources. Methods Based on the transcriptome sequencing dataset GSE43974 of kidney transplantation IRI from different donor sources, weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) network analysis were performed to screen Hub genes and characterize their expression profiles. A nomogram model was established to evaluate the diagnostic efficacy of these Hub genes, which was further validated using the dataset GSE30718. Immune infiltration analysis was conducted to clarify the correlations between Hub genes and immune cell infiltration. A mouse kidney transplantation IRI model was adopted to verify the expression levels of Hub genes in vivo. Results A total of five Hub genes were finally identified, namely PPP1CC, GART, BIRC6, PMSD11 and TMEM192. Nomogram analysis confirmed that these Hub genes possessed favorable diagnostic performance for kidney transplantation IRI in kidneys from different donors. Immune infiltration analysis revealed distinct infiltration patterns of various immune cells in IRI kidneys from different donors, and Hub genes were closely correlated with the regulation of multiple immune cell infiltration. A total of 390 differentially expressed genes were screened between renal tissues of mice in the kidney transplantation group and sham operation group. Gene Ontology (GO) enrichment analysis indicated that these differentially expressed genes were mainly enriched in biological processes including oxidative stress, inflammation and pyroptosis. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed significant enrichment in glutathione metabolism, neutrophil extracellular trap formation and other signaling pathways. Transcriptome sequencing verified that the expression levels of the five Hub genes were significantly different between the two groups (all P < 0.05). Conclusions Five Hub genes are identified in kidney transplantation IRI using donor kidneys from different sources. Glutathione metabolism and neutrophil extracellular trap formation may participate in the pathogenesis of kidney transplantation IRI.

Objective:To explore the application value of part-cut jejunal transection in digestive tract reconstruction of totally laparoscopic total gastrectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 112 patients with gastric cancer who underwent totally laparoscopic total gastrectomy in The Second Affiliated Hospital of Anhui Medical University from June 2018 to September 2022 were collected. There were 81 males and 31 females, aged (70±8)years. Among the 112 patients, 60 patients undergoing diges-tive tract reconstruction by Roux-en-Y anastomosis with part-cut jejunum were set as the part-cut group, and 52 patients undergoing digestive tract reconstruction by traditional Roux-en-Y anasto-mosis were set as the traditional group. Observation indicators: (1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraopera-tive and postoperative conditions; (3) follow-up. Comparison of measurement data with normal dis-tribution between groups was conducted using the independent sample t test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Com-parison of ordinal data was conducted using the nonparametic rank sum test. Propensity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.02. Results:(1) Propensity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 112 patients, 90 patients were successfully matched, with 45 cases in each of the part-cut group and the traditional group. After propensity score matching, the elimination of body mass index, clinical TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After propensity score matching, the total operation time and digestive tract reconstruction time of patients in the part-cut group were (217.0±15.1)minutes and (34.7±1.8)minutes, versus (252.6±21.9)minutes and (52.6±7.4)minutes in the traditional group, respectively, showing significant differences in the above indicators between the two groups ( t=?8.97, ?15.66, P<0.05). (3) Follow-up. After propensity score matching, 90 patients were followed up postoperatively for (47±15)months. During the follow-up, no patient in either group received secondary surgery, and there was no death. There were 3 cases and 10 cases of Roux stasis syndrome in the part-cut group and the traditional group, respectively, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusion:Compared with traditional Roux-en-Y anastomosis, the Roux-en-Y anastomosis with part-cut jejunum in totally laparoscopic total gastrectomy can signifi-cantly shorten the time for digestive tract reconstruction and reduce the incidence of postoperative Roux stasis syndrome.

Allogeneic haemopoietic stem cell transplantation (allo-HSCT)-related nephrotic syndrome is a rare complication, recognized as a clinical manifestation of chronic graft versus host disease (GVHD). T cell dysfunction is thought to play a significant role in the pathogenesis of allo-HSCT-related nephrotic syndrome, but the precise mechanism remains unclear. This paper reported a case of X-linked adrenoleukodystrophy (X-ALD) who had good control of the disease after allo-HSCT, but developed proteinuria and progressed to nephrotic syndrome after immunosuppressive therapy was tapered. Kidney biopsy revealed secondary membranous nephropathy, which responded well to treatment with glucocorticoids and tacrolimus. Limited literature exist on allo-HSCT-related nephrotic syndrome in children. This study provides a comprehensive summary of its mechanism, clinical features, pathology, diagnosis,and treatment, offering valuable insights for diagnosing and managing allo-HSCT-related nephrotic syndrome in pediatric patients.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.