ObjectiveTo investigate the protective effect of α-ketoglutarate （α-KG） on hepatic lipid deposition in offspring caused by arsenic exposure during pregnancy. Methods8-week-old institute of cancer research （ICR） mice were mated in a ratio of 2∶1 between females and males， and the detection of vaginal plugs confirmed pregnant. A total of 32 pregnant mice were randomly divided into four groups： control group， arsenic group， α-KG group， arsenic+α-KG group. On gestational day 0-16 （GD0-GD16）， the arsenic and arsenic+α-KG groups were exposed to sodium arsenite （NaAsO₂ ，15 mg/L） in drinking water everyday， and the α-KG and arsenic+α-KG groups were gavaged with α-KG （2 g/kg） everyday. On GD16， pregnant mice were euthanized to collect fetal liver， and fetal body weight and crown-rump length were measured. Gene expression differences between the control group and the arsenic group were analyzed by transcriptome. The total triglycerides （TGs） and subtypes in fetal liver were detected by liquid chromatography tandem mass spectrometry （LC-MS/MS）. Oil red O staining was used to observe the histopathological changes in the liver. Quantitative polymerase chain reaction （qPCR） was used to detect the expression level of genes related to lipid synthesis， transport， and degradation， and phosphatidylinositol 3' -kinase/ protein kinase B （PI3K/AKT） in the liver of fetus. ResultsTranscriptomics analysis showed that 2 144 genes were downregulated and 1 675 genes were upregulated in the arsenic exposed fetal liver； body weight and crown-rump length were reduced （P_TuKey<0.05）； the level of hepatic TGs was elevated in arsenic group （P_TuKey<0.05）； oil-red O staining showed a significant increase in lipid droplets in arsenic group （P_TuKey<0.01）； the expression of lipid synthesis-related genes were significantly upregulated （P_TuKey<0.05）； the expression of β-oxidation-related genes and lipid degradation-related genes were downregulated （P_TuKey<0.05）； the expression of PI3K， AKT decreased（P_TuKey<0.05）. Compared with the arsenic group， the body weight and crown-rump length of fetus increased in the arsenic+α-KG group （P_TuKey<0.05）； the level of hepatic TGs decreased in the arsenic+α-KG group （P_TuKey<0.05）； oil red O staining showed lipid droplets significantly decreased （P_TuKey<0.01）； the expression of lipid synthesis-related genes were downregulated （P_TuKey<0.05）， the expression of β-oxidation-related genes and lipid degradation-related genes were upregulated （P_TuKey<0.05）； the expression levels of PI3K and AKT increased （P_TuKey<0.05）. Conclusionα-KG alleviated hepatic lipid deposition in offspring exposed to arsenic during pregnancy through activating PI3K/AKT signaling pathway.

Objective: To address systemic challenges in the blood system, such as supply-demand imbalance, inefficient allocation, and inappropriate clinical use, while bridging gaps in current theories regarding the integration of social mobilization, institutional practice, and policy coordination. It sought to construct a system dynamics model spanning from macro to micro levels to analyze the blood management system holistically. Methods: Key variables were identified by a systematic literature search in both Chinese and English databases. An improved Delphi method was then employed to conduct expert consultations across different fields, leading to the selection and determination of core variable sets for each sub-model. Furthermore, by defining their logical relationships, a system dynamics model was constructed to systematically analyze the operation mechanism of the blood management system. Results: Four core sub-models were developed: 1) A macro "Dynamic Balance" model quantifying regional supply-demand equilibrium and inventory control; 2) a mobilization "Three-Layer Funnel" model analyzing how socio-cultural factors, service channels, and policy incentives influence donation behavior; 3) an institutional "Dual-Cycle Regulation" model revealing hospital blood usage is driven by both disease burden (demand cycle) and management practices (regulation cycle); and 4) an individual "Three-Layer Filter" model standardizing clinical transfusion decisions based on necessity, risk-benefit, and context. These were integrated into a "Multi-Layer Linkage and Feedback" model, elucidating bidirectional interactions among five levels: policy environment, regional supply, blood station mobilization, hospital application, and clinical decision-making. Conclusion: This study constructed a system dynamics model for blood management. By defining key variables and their logical relationships, it systematically analyzes the system′s operational mechanism. The integrated framework connects multiple levels—regional supply, voluntary donation, hospital blood use, and clinical decision-making—revealing their intrinsic linkages. Future efforts should employ systems thinking to synergistically enhance supply-side mobilization, demand-side management, systemic regulation, and decision standardization to build a safe, efficient, and sustainable blood security system.

Objective:To explore the status of psychological resilience in female infertility patients and analyze its influencing factors, providing a basis for developing effective intervention measures in clinical practice.Methods:A convenient sampling method was used to select female infertility patients who visited the Reproductive Medicine Center of the First Affiliated Hospital of the University of South China from March to October 2024 as the research objects. A cross-sectional survey was conducted using the General Data Questionnaire, Connor-Davidson Resilience Scale, Herth Hope Index, the Infertility Stigma Scale, Family Resilience Scale and Perceived Social Support Scale. The random forest algorithm was used to rank the importance of variables, Lasso regression was used to further screen variables, and the selected variables were included in multiple stepwise regression analysis to analyze the influencing factors.Results:Ultimately, 322 female infertility patients aged (30.40 ± 4.50) were included. The psychological resilience score was (64.29 ± 10.05) points, which was above the medium level. The top 6 influential factors in the importance of variables were stigma, family resilience, age, social support, infertility cause and hope level. Multiple stepwise regression analysis showed that age, infertility cause, hope level, stigma, family resilience and social support were the main influencing factors of mental resilience of female infertility patients ( t values were -8.32 to 6.85, all P<0.05). Conclusions:The psychological resilience of female infertility patients is above the medium level, and the psychological resilience of infertile women is affected by many factors such as individual characteristics, family environment and social support. Medical staff should take targeted intervention measures to improve the psychological resilience of female infertility patients.

Objective:Summarize the clinical characteristics, treatment methods, and prognosis of paraneoplastic pemphigus with oral lesions, and identify commonalities and features to provide better references for the clinical diagnosis and treatment of this disease.Methods:A retrospective analysis was conducted on the case data and clinical photos of 9 patients with paraneoplastic pemphigus accompanied by oral lesions treated in the Internal Medicine Ward and Department of Stomatology of Beijing Hospital from September 2017 to December 2023, and the clinical characteristics were summarized and analyzed.Results:All 9 patients had oral mucosal and skin lesions simultaneously, in whom visceral tumors were found upon systemic examinations, including 4 cases of Castleman′s disease, 4 cases of thymoma, and 1 case of lung cancer. All patients had received glucocorticoid therapy before a clear diagnosis, but the effect was not significant. After removing the primary tumor, corticosteroid intravenous or oral therapies were usually continued, supplemented with immunoglobulin and immunosuppressants for treatment, which could achieve significant therapeutic effects. With primary tumor resection, 6 patients continued to receive corticosteroid intravenous or oral treatment for 6 to 12 months, supplemented with immunoglobulin and immunosuppressants. Oral mucosal erosion improved significantly and skin lesions were relieved. Three patients who were unable to remove their primary tumor continued with the previous glucocorticoid treatment regimen and died within one year. However, local treatment of their oral cavity during the treatment process still helped alleviate oral mucosal pain, promote erosion healing, and improve nutritional status.Conclusions:Multiple erosions of the oral mucosa and polymorphic skin damages are common clinical manifestations of paraneoplastic pemphigus. Castleman′s disease and thymoma are common coexisting tumors. Early diagnosis and timely surgical resection of tumors are crucial for treatment and prognosis. The application of glucocorticoids and local oral treatment after resection is effective.

Purpose To investigate the expression of SNRPA in gastric cancer and its effect on the proliferation,migration and invasion of gastric cancer cells.Methods The expression of SNRPA in gastric cancer tissues was ana-lyzed using The Cancer Genome Atlas(TCGA)database.The level of SNRPA was detected by immunohistochemistry(EnVision method),and its relationship with clinicopathological parameters was analyzed.Western blot was used to detect the expression of SNRPA in 15 cases of fresh gastric cancer and paracancerous tissues.The expression of SNRPA in MGC-803 and GES-1 cells was detected by immunofluorescence staining.The effects of SNRPA expression on the proliferation,migration and invasion of gastric cancer cell lines were determined by RNA interference technology and cell function assays,and the expression levels of Cyclin D1 protein and EMT-related proteins(E-cadherin,N-cadher-in)were detected by Western blot.Results The expression level of SNRPA in gastric cancer tissues was significantly higher than that in normal gastric mucosal tissues(P＜0.05),with an area under the curve(AUC)of 0.902 for diag-nostic accuracy.The Kaplan-Meier survival curves showed that the survival time of the group with high expression of SNRPA was shorter.SNRPA expression correlated with tumor size,Ki67,infiltration depth,and p53 status(P＜0.05).Compared with the corresponding control group,SNRPA silencing inhibited the proliferation,migration and in-vasion ability of gastric cancer cells,accompanied by decreased Cyclin D1 and N-cadherin expression and increased E-cadherin expression(P＜0.05).Conclusion SNRPA expression is upregulated in gastric cancer tissues and cell lines,promoting the proliferation,migration,and invasion of gastric cancer cells,and may be a potential molecular marker for gastric cancer.

Purpose To investigate the expression of SNRPA in gastric cancer and its effect on the proliferation,migration and invasion of gastric cancer cells.Methods The expression of SNRPA in gastric cancer tissues was ana-lyzed using The Cancer Genome Atlas(TCGA)database.The level of SNRPA was detected by immunohistochemistry(EnVision method),and its relationship with clinicopathological parameters was analyzed.Western blot was used to detect the expression of SNRPA in 15 cases of fresh gastric cancer and paracancerous tissues.The expression of SNRPA in MGC-803 and GES-1 cells was detected by immunofluorescence staining.The effects of SNRPA expression on the proliferation,migration and invasion of gastric cancer cell lines were determined by RNA interference technology and cell function assays,and the expression levels of Cyclin D1 protein and EMT-related proteins(E-cadherin,N-cadher-in)were detected by Western blot.Results The expression level of SNRPA in gastric cancer tissues was significantly higher than that in normal gastric mucosal tissues(P＜0.05),with an area under the curve(AUC)of 0.902 for diag-nostic accuracy.The Kaplan-Meier survival curves showed that the survival time of the group with high expression of SNRPA was shorter.SNRPA expression correlated with tumor size,Ki67,infiltration depth,and p53 status(P＜0.05).Compared with the corresponding control group,SNRPA silencing inhibited the proliferation,migration and in-vasion ability of gastric cancer cells,accompanied by decreased Cyclin D1 and N-cadherin expression and increased E-cadherin expression(P＜0.05).Conclusion SNRPA expression is upregulated in gastric cancer tissues and cell lines,promoting the proliferation,migration,and invasion of gastric cancer cells,and may be a potential molecular marker for gastric cancer.

Objective To summarize the results of different perioperative anticoagulation protocols for elderly patients with atrial fibrillation(AF)undergoing catheter radiofrequency ablation in our center.Methods A total of 197 elderly AF patients undergoing catheter radiofrequency ablation by a single operator in the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2021 to December 2023 were retrospectively recruited,and the results of relevant exami-nations were collected.Based on the use of different direct oral anticoagulants,they were divided into dabigatran(n=125)and rivaroxaban(n=72)groups.During the procedure,the appropriate dose of unfractionated heparin was administered according to the initial activated clotting time(ACT)with a self-made formula.The time and rate of ACT were recorded,and perioperative ad-verse reactions such as bleeding and thrombosis were observed.Results There were no statistical differences between the two groups in baseline data,including age,gender,BMI,medical history,CHA2DS2-VASc score,HAS-BLED score,and left atrial anteroposterior diameter(P＞0.05).The baseline ACT value was obviously shorter(149.73+23.52 s vs 157.91±24.58 s,P=0.032),the initial heparin dose was significantly higher(0.71±0.12 mg/kg vs 0.65±0.13 mg/kg,P=0.031),and the rate of ACT reaching the target within 15 min was notably lower(60％vs 74％,P＜0.05)in the dabigatran group than the rivaroxaban group.But no significant difference was observed in the rate of ACT reaching the target in 45 min after additional heparin administration according to the formula(86％vs 88％,P＞0.05).The dabigatran group used higher dose of heparin during the procedure than the rivaroxaban group(0.99±0.30 mg/kg vs 0.85±0.31 mg/kg,P=0.009).Peri-cardial effusion was observed in one patient of the rivaroxaban group,and hematoma at the site of femoral vein puncture was seen in one patients of the dabigatran group in 1 d after procedure,which was treated surgically.No other severe complications occurred.Conclusion For elderly pa-tients with AF undergoing catheter ablation therapy,continuous perioperative anticoagulation and individualized application of unfractionated heparin based on initial ACT value can rapidly achieve ACT targets and improve anticoagulation efficacy.

Objective To summarize the results of different perioperative anticoagulation protocols for elderly patients with atrial fibrillation(AF)undergoing catheter radiofrequency ablation in our center.Methods A total of 197 elderly AF patients undergoing catheter radiofrequency ablation by a single operator in the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2021 to December 2023 were retrospectively recruited,and the results of relevant exami-nations were collected.Based on the use of different direct oral anticoagulants,they were divided into dabigatran(n=125)and rivaroxaban(n=72)groups.During the procedure,the appropriate dose of unfractionated heparin was administered according to the initial activated clotting time(ACT)with a self-made formula.The time and rate of ACT were recorded,and perioperative ad-verse reactions such as bleeding and thrombosis were observed.Results There were no statistical differences between the two groups in baseline data,including age,gender,BMI,medical history,CHA2DS2-VASc score,HAS-BLED score,and left atrial anteroposterior diameter(P＞0.05).The baseline ACT value was obviously shorter(149.73+23.52 s vs 157.91±24.58 s,P=0.032),the initial heparin dose was significantly higher(0.71±0.12 mg/kg vs 0.65±0.13 mg/kg,P=0.031),and the rate of ACT reaching the target within 15 min was notably lower(60％vs 74％,P＜0.05)in the dabigatran group than the rivaroxaban group.But no significant difference was observed in the rate of ACT reaching the target in 45 min after additional heparin administration according to the formula(86％vs 88％,P＞0.05).The dabigatran group used higher dose of heparin during the procedure than the rivaroxaban group(0.99±0.30 mg/kg vs 0.85±0.31 mg/kg,P=0.009).Peri-cardial effusion was observed in one patient of the rivaroxaban group,and hematoma at the site of femoral vein puncture was seen in one patients of the dabigatran group in 1 d after procedure,which was treated surgically.No other severe complications occurred.Conclusion For elderly pa-tients with AF undergoing catheter ablation therapy,continuous perioperative anticoagulation and individualized application of unfractionated heparin based on initial ACT value can rapidly achieve ACT targets and improve anticoagulation efficacy.

Objective: To examine the effect of intracellular vesicles (IVs) and extracellular vesicles (EVs) that originated from periodontal ligament stem cells (PDLSCs) on the osteogenic differentiation of PDLSCs within a lipopolysaccharide (LPS)-simulated inflammatory microenvironment, and to provide new insights for the application of IVs in the repair and regeneration of periodontal tissue in periodontitis. Methods: Ethical approval was obtained from the institution. Human-origin PDLSCs were extracted, and the IVs and EVs from PDLSCs at the 3rd-6th passages were gathered and identified using transmission electron microscopy, nano flow cytometry (Nano FCM) analysis, and Western Blot. The 3rd-6th generations of PDLSCs were categorized into the following groups: Control group, LPS group, LPS + 100 μg/mL EVs group (LPS+EVs group), and LPS + 100 μg/mL IVs group (LPS+IVs group). The effects of the IVs and EVs on the anti-inflammatory and osteogenic differentiation of PDLSCs in an inflammatory microenvironment were assessed by using a Cell Counting Kit-8 (CCK-8), enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR), Western Blot, alkaline phosphatase (ALP) staining, and alizarin red staining (ARS). Results: Under transmission electron microscopy, the IVs and EVs derived from PDLSCs displayed a double-layer membrane structure. NanoFCM analysis revealed that the average diameters of the IVs and EVs were 79.6 nm and 82.1 nm, respectively. Western Blot analysis indicated that the surface proteins CD9, CD63, and CD81 of the IVs and EVs were positively expressed, while calnexin was negatively expressed, indicating that IVs and EVs were successfully obtained. Compared with the Control group, the proliferation of PDLSCs in the LPS group was reduced, while the levels of inflammatory cytokine interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the cell supernatant were increased, the mRNA expressions of osteogenic differentiation-related genes, including osteoblast-related genes runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), osteocalcin (OCN) of PDLSCs were reduced, the protein expressions of RUNX2 and osteopontin (OPN) were also decreased (P<0.05); compared with the LPS group, the proliferation of PDLSCs in the LPS+EVs group and LPS+IVs group were significantly increased, while the levels of IL-6, TNF-α were significantly reduced, and the mRNA expressions of RUNX2, ALP, OCN were significantly increased, the protein expressions of RUNX2 and OPN were also significantly increased (P<0.05). Further, in the inflammatory microenvironment, Compared with EVs, IVs more significantly promote the proliferation of PDLSCs, inhibit TNF-α expression, enhance the expression of RUNX2 mRNA, upregulate the expression of RUNX2 and OPN proteins, increase ALP activity, and promote the formation of mineralized nodules (P<0.05). Conclusion IVs and EVs derived from PDLSCs can boost the proliferation of PDLSCs in an inflammatory microenvironment, inhibit the expression of inflammatory factors, and advance the osteogenic differentiation of PDLSCs. The anti-inflammatory and osteogenic effects of IVs are superior to those of EVs.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.