Objective: This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO). Materials and Methods: A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTRasym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTRasym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman’s correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO. Results: Patients with active TAO showed lower MTR values (P < 0.001) and higher MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively;all P < 0.001). MTR and MTRasym (1 ppm) were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTRasym (1 ppm) in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTRasym (1 ppm) significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001). Conclusion MTR and MTRasym (1 ppm) were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.

To investigate the effect of mesenchymal stromal cells (MSCs) on the fibrosis progression and endometrial regeneration in mouse models of endometrial injury, a mouse endometrial injury model was established by physical scraping combined with lipopolysaccharide (LPS) chemical induction, and the endometrium morphology and collagen deposition were evaluated by HE and Masson staining after unilateral administration of MSCs. RT-qPCR and immunofluorescence were used to detect the expression of epithelial markers Epcam and collagen I (Col1). Primary endometrial epithelial cells were isolated to assess p21 expression. Fibrosis-related genes and signaling pathways were validated using transcriptome sequencing and RT-qPCR. The experimental results showed that MSCs increased endometrial thickness and number of glands (P<0.05), up-regulated the expression of Epcam (P<0.01), while significantly reducing uterine collagen fiber deposition (P<0.05) and the expression of p21 in primary epithelial cells (P<0.0001). Transcriptomic analysis revealed that MSCs attenuated collagen deposition by modulating genes involved in the TGF-β signaling pathway. This study elucidates that MSCs facilitate uterine repair by reversing endometrial fibrosis and promoting epithelial regeneration, and their role is related to the regulation of the TGF-β/SMAD pathway and suppression of aberrant collagen accumulation.

Objective: This study explored whether anxiety and core self-evaluation mediate the relationship between negative life events and depressive symptoms in adolescents of the Yi ethnic minority in China. Methods: In this cross-sectional study, a convenience sample of 627 Yi adolescents 10–19 years old (252 males, 40.2%) from primary, middle and high schools in Liangshan Prefecture in China completed the Adolescent Self-Rating Life Events Checklist (ASLEC) to report on negative life events, the Second Edition of the Beck Depression Inventory (BDI-II) to report on depressive symptoms, the Core Self-Evaluations Scale (CSES) to describe core self-evaluation, and the Screen for Child Anxiety-Related Emotional Disorders (SCARED) to report anxiety symptoms. Results: In Pearson correlation analysis, total score and dimension subscores on the ASLEC correlated positively with total score and dimension subscores on the SCARED survey as well as with total score on the BDI. Total ASLEC score and dimension subscores correlated negatively with total CSES score. Mediation analysis indicated that negative life events affected depressive symptoms directly, as well as indirectly via core self-evaluation (mediating effect was 0.087; 95% confidence interval [CI], 0.063–0.113; p<0.001). The chain-mediated pathway effect was significant (mediating effect was 0.017; 95% CI, 0.011–0.026; p<0.001). Conclusion Yi adolescents in Liangshan Prefecture show certain prevalence of anxiety and depression, and they score relatively low on core self-evaluation. In this ethnic group, negative life events can affect depressive symptoms directly as well as indirectly through chain-mediated effects of anxiety and core self-evaluation.

Objective To investigate the factors influencing hyperdynamic circulation-related indicators in patients with liver cirrhosis and ascites.Methods A retrospective analysis was conducted on the clinical data of 377 patients diagnosed with cirrhosis-associated ascites at the Third People's Hospital of Kunming between October 2022 and October 2024.Patients were categorized into grade 1,grade 2,and grade 3 ascites groups according to ascites severity grading.The general demographic characteristics and clinical parameters of the three groups were compared.Potential positive predictors were initially identified through univariate analyses,including Spearman correlation and non-parametric tests.Binary logistic regression and multiple linear regression models were subsequently employed to investigate the factors influencing high dynamic circulation-related indicators(heart rate[HR],E/A ratio,and left ventricular diastolic function[LVDF])in patients with cirrhosis-related ascites.Results Significant differences in the incidence of HR,the ratio of early to late diastolic filling velocities(E/A),and LVDF were observed among different ascites groups(P<0.05).Age,ascites depth,serum chloride(Cl-),CO2,red cell distribution width coefficient of variation(RDW-CV),and etiology were identified as independent determinants of HR in patients with liver cirrhosis and ascites.Age,white blood cell count(WBC),albumin(ALB),and etiology were independent determinants of E/A in patients with liver cirrhosis and ascites.Age(OR=1.088,95%CI 1.062-1.114,P<0.001)and serum potassium(K+)(OR=1.919,95%CI 1.218-3.025,P=0.005)were independent risk factors for LVDF in patients with cirrhotic ascites,whereas RDW-CV(OR=0.902,95%CI 0.883-0.961,P=0.023)and ALB(OR=0.921,95%CI 0.883-0.961,P<0.001)were identified as protective factors.Conclusions Serum ALB is an independent influencing factor for E/A ratio and LVDF in cirrhotic patients with ascites and hyperdynamic circulation.K+and RDW-CV are also independent predictors of LVDF,whereas Cl-independently influences heart rate.Clinical monitoring and targeted intervention for these parameters should be emphasized.

Objective To evaluate and compare the effects of endoscopic spinal surgery performed via the Kambin's triangle approach and the posterior interlaminar approach on patients diagnosed with lumbar disc herniation(LDH)and concurrent lateral recess stenosis.Methods The clinical data of patients who underwent lumbar pedicle screw fixation at our hospital between January 2017 and December 2023 were retrospectively analyzed.Patient information including sex,age,diagnosis,surgical level,presence and type of postoperative neurological complications was recorded.Based on postoperative CT scans,the zone and grade of screw penetration were assessed,and the distribution of different types of pedicle screw penetration was documented.The association between specific types of pedicle screw penetration and the occurrence of postoperative neurological symptoms was then analyzed.Results The operation time and postoperative hospital stay in the Kambin group were significantly shorter than those in the interlaminar group(P<0.05).On postoperative day 1 and at 1 month postoperatively,the VAS scores in the Kambin group were significantly lower than those in the interlaminar group(P<0.05).No significant differences were observed between the two groups in terms of ODI scores on postoperative day 1 and at 3 months postoperatively,or in the postoperative area of lateral recess stenosis(P>0.05).One case of postoperative infection was reported in the interlaminar group.Conclusions For patients with LDH and lateral recess stenosis,endoscopic spinal surgery via the Kambin's triangle approach is associated with a shorter operative duration.Both the Kambin's triangle approach and the interlaminar approach can effectively improve functional outcomes and decompress the lateral recess.However,the interlaminar approach requires further optimization to minimize the risk of complications.

This study was aimed at comparing the effects of storage conditions on the Brucella survival number in brain heart infu-sion medium,to provide experimental data support for the selection of storage conditions for Brucella strains.We created bacterial sus-pensions of seven strains of Brucella melitensis,Brucella abortus,and Brucella suis(denoted A,B,C,D,E,F,G)by using 30%glycerol brain heart infusion medium,then conducted stability testing.For accelerated stability tests,the bacterial solution was placed in a 37℃chamber for 1,2,3,or 4 weeks continuously,and the Brucella survival number at each time point was measured.For freeze-thaw stability testing,the bacterial solutions were frozen at-80℃,transferred to room temperature for 4 hours,and melted in one freeze-thaw cycle,and the Brucella survival number was measured for 2,4,6,and 8 freeze-thaw times.For long-term stability testing,the bacterial solutions were stored at-80℃,and the Brucella survival number was measured at various time points during the first,third,sixth,and twelfth months of storage.A line graph was plotted to demonstrate the changes in Brucella survival number at each time point in the three stability tests.IBM SPSS Statistics 22 software was used to assess statistically significant differences in Brucella survival number at each time point and the initial Brucella survival number.Accelerated stability tests showed that the Bru-cella survival number of the seven strains significantly decreased,and a statistically significant difference in Brucella survival number was observed after 1 week.In freeze-thaw stability tests,with increasing freeze-thaw times,the Brucella survival number of the seven strains showed a decreasing trend.Strains C and F showed statistically significant differences with respect to the initial Brucella sur-vival number after two times of freeze-thaw;strains A and D showed statistically significant differences with respect to the initial Bru-cella survival number after four times of freeze-thaw;strain G showed statistically significant differences with respect to the initial Bru-cella survival number after six times of freeze-thaw;and strain E showed statistically significant differences with respect to the initial Brucella survival number after eight times of freeze-thaw.The data for strain B showed abnormalities.In long-term stability testing,the Brucella survival number for strains C and F after storage for 1 month showed a statistically significant difference with respect to the initial bacterial solution.No statistically significant difference in Brucella survival number was observed for strains B and E after stor-age for 1,3,6,or 12 months.The data for strains A,D,and G showed abnormalities.The sterile 30%glycerol brain heart infusion medium maintained the Brucella survival number in an-80℃environment,and freezing and thawing multiple times should be avoided.Compared with the traditional freeze-drying method,this method is not only easy to perform but also avoids potential bio-safety hazards,and provides a reliable Brucella culture preservation scheme for researchers in related fields.

Objective To explore the value of ZOOMit intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)technology in assessing renal function in diabetic kidney disease(DKD)and non-diabetic kidney disease(non-DKD).Methods Based on the estimated glomerular filtration rate(eGFR),50 DKD patients and 50 non-DKD patients were enrolled,with each group contained 21 mild cases(mild group)and 29 moderate to severe cases(moderate to severe group).All subjects underwent ZOOMit IVIM-DWI examination and the parameter values of the renal cortex and medulla were measured.The differences of IVIM-DWI parameters in renal cortex and medulla between DKD and non-DKD patients,and the correlation with eGFR,and diagnostic efficacy were compared.Results In the DKD patients,the f value of the medulla,the D value of the cortex,and the D* value of the medulla showed statistically significant differences between mild group and moderate to severe group(t=7.836,3.337,2.515,P<0.05),and all were positively correlated with eGFR(r=0.750,0.375,0.404,P<0.05).In the non-DKD patients,the f value of the medulla and the D* value of the medulla showed statistically significant differences between mild group and moderate to severe group(t=2.619,2.453,P<0.05),and were positively correlated with eGFR(r=0.425,0.360,P<0.05).In both DKD and non-DKD patients,the f value of the medulla showed the best efficacy in distinguishing between mild and moderate to severe DKD,with the area under the curve(AUC)=0.961(DeLong test P<0.05).Conclusion ZOOMit IVIM-DWI technology can be used for renal function in DKD and non-DKD,with the f value of the medulla being more suitable for the assessment of renal function in DKD.

Objective To explore the impact of the number of negative lymph node resections on the overall survival and recurrence rate of patients with ovarian cancer.Methods A retrospective selection was made of 150 ovarian cancer patients admitted to our hospital from October 2021 to October 2023 as the research subjects.According to the standard of the number of negative lymph nodes removed,they were divided into three groups:T1 group(≤17),T2 group(18～27),and T3 group(≥28).Clinical characteristics and surgical indicators were collected,and the recurrence and survival situations were analyzed.Results The clinical characteristic analysis results showed that there were no statistically significant differences among the three groups in terms of age,meno-pausal status,BMI,CCI,family history of tumors,etc.(P>0.05).There were no significant differences in surgi-cal methods,residual lesion size,postoperative complications among the three groups(P>0.05).In terms of operation time,T1 group0.05),but with the increase in the number of lymph node resections(from T1 group to T3 group),the recurrence rate showed a statistically significant downward trend(P<0.05).Cox regression analysis showed that the univariate analysis indicated that for each additional negative lymph node,the risk of death decreased by 4.7%(HR=0.953,P<0.05);the multivariate analysis(after adjusting for confounding factors)showed that the risk decreased by 5.8%(HR=0.942,P<0.05).Restricted cubic spline(RCS)analysis confirmed a significant linear association between the two(P<0.05).With 5 lymph nodes as the reference,the risk ratios for 10,20,and 30 resections were 1.003,0.760,and 0.317,respectively,and the trend showed that the risk of death contin-ued to decrease as the number of lymph nodes increased.Multivariate Cox analysis showed that the risk of death in T3 group was 68%lower than that in T1 group(P<0.05),the risk in FIGO stage Ⅲ was 3.11 times higher(P<0.05),and the risk in high-grade tumors was 2.80 times higher(P<0.05).Conclusions The number of nega-tive lymph nodes removed in patients with ovarian cancer is linearly correlated with prognosis.The more lymph nodes removed,the lower the risk of death for the patients.Adequate lymph node removal should be an important part of the surgical treatment for ovarian cancer.

Objective:To investigate the efficacy of preoperative ultrasound-guided injection of carbon nanoparticle suspension in cervical lymph node dissection for thyroid cancer reoperation.Methods:Ninety-four patients undergoing reoperation for thyroid cancer admitted by the same physician team of the Department of Thyroid and Breast Surgery of the Ninety-sixty Hospital of the People’s Liberation Army (PLA) from Jan. 2019 to Sep. 2024 were retrospectively analyzed. According to the different scope of the initial surgery, they were divided into the re-specification clearance group, the regional lymph node clearance group, and the metastatic lymph node dissection group, and the groups were subdivided into the carbon nanoparticle group and the control group according to whether they were injected with carbon nanoparticle before the surgery or not. The t-test, χ2-test, and non-parametric test were used to compare the age, gender, surgical method, duration of surgery, total number of lymph nodes detected, and positive lymph node detection rate between the nano-charcoal group and the control group in the three groups. Results:There was no statistically significant difference between the three groups in terms of age, gender, surgical methods, or the total number of lymph nodes detected (all P>0.05) , and the difference between the surgical time of the carbon nanoparticle group in the re-regulation clearance group and the control group was not statistically significant ( P>0.05) ; the surgical time of the carbon nanoparticle group was shorter than that of the control group in both the regional lymph node clearance and the metastatic lymph node dissection groups, and the difference was statistically significant (all P<0.05) ; the positive detection rate of lymph nodes in the carbon nanoparticle group was higher than that in the control group among the three groups, and the difference was statistically significant (all P<0.05) . Conclusion:In the operation of cervical lymph node dissection for papillary thyroid cancer, preoperative ultrasound-guided injection of carbon nanoparticle can accurately localize the lymph nodes, increase the positive detection rate of lymph nodes, reduce the difficulty of surgical operation, and shorten the operation time.

Objective:To investigate the application of transoral robotic thyroidectomy (TORT) in overweight patients.Methods:Clinical data of 109 thyroid tumor patients who underwent TORT at 960th Hospital of People’s Liberation Army from May. 2020 to Aug. 2023 were retrospectively collected and analyzed. After excluding 10 patients who underwent prophylactic lateral neck dissection, a total of 99 patients were included in this study. According to the World Health Organization (WHO) guidelines, which define people with BMI:25-29.9 kg/m 2 as overweight, we divided the 99 patients into normal weight group (n=69) and overweight group (n=30) . To make the baseline data consistent between the two groups and ensure comparability, 20 matched pairs were generated using a 1∶1 propensity score matching (PSM) method, considering four clinicopathologic factors: age, gender, diameter of tumor and operation scope. In the normal-weight group, there were 18 females and 2 males, aged (32.82±9.51) years (range: 17-53 years) , and there exhibited 18 females and 2 males in the overweight group, aged (35.14±10.63) years (range: 18-55 years) . Results:All patients successfully underwent the operation without conversions to open surgery. After matching, both groups had 2 cases of thyroid adenoma and 18 cases of papillary thyroid carcinoma ( P=1) , with no statistically significant difference in the surgical scope between the two groups ( P=0.376) . There was no statistically significant difference in the mean tumor diameter between the normal-weight group and the overweight group (5.38±1.79 mm vs. 5.61±3.32 mm, P=0.575) . All malignant tumor cases in both groups were classified as T1 stage, and there was no statistically significant difference in N stage ( P=0.186) . All patients with malignant tumors underwent central lymph node dissection, there was no significant difference in the number of central lymph nodes dissected ( P=0.623) and metastatic lymph nodes ( P=0.109) between the two groups. There were no statistically significant differences in operative duration (217.53±62.83 min vs. 220.67±73.73 min, P=0.808) , median postoperative hospital stay [6 (6,7.75) days vs. 6 (6,7) days, P=0.682], or 24-hour drainage volume (78.52±30.49 mL vs. 68.23±29.11 mL, P=0.180) between the normal-weight group and the overweight group. There was no permanent hypoparathyroidism, postoperative hemorrhage, lymphatic fistula, mental nerve injury, postoperative infection in both groups. In both groups, there occurred one case of transient hypoparathyroidism. As for other complications, 1 case of temporary recurrent laryngeal nerve injury and oral tearing occurred in the overweight group, while the normal-weight group had 1 case of skin scald. Conclusions:Among patients who underwent TORT, the overweight group exhibited comparable surgical outcomes and postoperative complications to those in the normal-weight group. TORT is a safe and feasible surgical option for overweight patients, which provides more surgical options for this patient population.