Objective To explore the clinical application value of dual-source CT (DSCT) in imaging evaluation after anterior cruciate ligament (ACL) injury and reconstruction. Methods A total of 93 patients with ACL injury confirmed in our hospital between December 2023 and December 2024 were enrolled as the research subjects. All patients underwent arthroscopic single-bundle anatomical reconstruction of ACL, as well as DSCT and multi-slice spiral CT (MSCT) examinations at 1 month after surgery. ACL scan parameters, bone tunnel aperture center, and radiation dose parameters (CT dose index volume, dose-length product, effective dose) under DSCT and MSCT were compared. At 3 months after surgery, according to postoperative curative effect by International Knee Documentation Committee (IKDC) scoring method, patients were divided into favorable outcome group (IKDC ≥ 70 points, n = 69) and unfavorable outcome group (IKDC < 70 points, n = 24). The two groups were compared for bone tunnel angles [angle between femoral tunnel and joint line (γ angle), angle between femoral tunnel and femoral shaft (θ angle), angle between tibial tunnel and tibial shaft (α angle), angle between tibial tunnel and joint line (β angle)]. The predictive value of bone tunnel angles under DSCT in poor prognosis of patients after ACL reconstruction was analyzed by receiver operating characteristic curves. Results The intraclass correlation coefficients for image quality of ACL length, ACL angle, long diameter of femoral attachment point, long diameter of tibial attachment point, Fx, Fy, Tx, Ty, γ angle, θ angle, α angle, and β angle were 0.812, 0.835, 0.823, 0.834, 0.836, 0.847, 0.841, 0.834, 0.835, and 0.864, respectively. The long diameters of femoral attachment point and tibial attachment point under DSCT were shorter than those under MSCT (P < 0.05), Tx and Ty were lower than those under MSCT (P < 0.05), CT dose index volume, dose-length product, and effective dose were lower than those under MSCT (P < 0.05). The γ angle and θ angle in the favorable outcome group were lower than those in the unfavorable outcome group (P < 0.05). Receiver operating characteristic curve analysis showed that after ACL reconstruction, the areas under the receiver operating characteristic curves of γ angle, θ angle, and their combination under DSCT for predicting poor prognosis were 0.711, 0.712, and 0.783, respectively, with sensitivities of 76.81%, 79.71%, and 92.75% as well as specificities of 70.83%, 75.00%, and 62.50%, respectively (P < 0.05). Conclusion DSCT can evaluate the poor prognosis of patients after ACL reconstruction through ACL scan parameters, bone tunnel aperture center, γ angle, and θ angle, which also can effectively reduce radiation dose.

Gastric cancer remains a highly prevalent malignancy worldwide, with surgical resection currently constituting the cornerstone of treatment aimed at improving long-term patient survival. Owing to their notable advantages, including reduced surgical trauma and accelerated postoperative recovery, minimally invasive procedures are progressively supplanting conventional open surgery and have become the mainstream approach in gastric cancer management. Concurrently, the rapid advancement of artificial intelligence (AI) technologies has enabled real-time intraoperative monitoring of surgical scenes, thereby furnishing novel technical support for adjunctive decision-making, surgical navigation, and skill assessment during gastrectomy. This article provides a systematic review of the current status of AI applications in minimally invasive gastric cancer surgery, with a particular focus on research progress pertaining to instrument recognition, surgical phase identification, delineation of normal anatomical structures, detection of metastatic foci, and early warning of intraoperative adverse events. Furthermore, we discuss the potential value of AI in enhancing surgical efficiency, ensuring patient safety, and optimizing surgical education. On this basis, we further analyze the principal challenges and inherent risks confronting current AI systems, with the aim of informing future technological innovation and facilitating clinical translation.

Objective To analyze the monitoring results of occupational hazard factors (OHF) in the workplace of key industries in Shaoguan City from 2021 to 2024. Methods A total of 486 enterprises of key industries in Shaoguan City, selected from the "Occupational Diseases Hazardous Items Reporting System" and the "Guangdong Provincial Occupational Health Quality Control Platform" from 2021 to 2024, were used as the research subjects. Data on the declaration of occupational hazard projects, the exposure to OHF and the occupational medical examinations for workers, the usage of protective equipment and the setup of protection facilities in enterprises, and the monitoring results of OHF were analyzed. Results From 2021 to 2024, a total of 486 enterprises of key industries in Shaoguan City were monitored, and the detection rate of OHF exceeding national standard was 57.0%. The exceedance rates in medium/large enterprises and small/micro enterprises were 67.1% and 55.0%, respectively. A total of 51 771 worker-exposures to OHF were recorded, with an exposure rate of 55.8%. Training coverage for enterprise managers, occupational health personnel, and workers were 96.7%, 97.1%, and 98.7%, respectively. Abnormal rates in occupational medical examinations were 3.3%, 0.2%, and 0.8% among workers exposed to noise, dust, and chemical factors, respectively. Provision rates of dust respirators, chemical respirators, hearing protection devices (earplugs and earmuffs) were 93.2%, 85.4% and 86.8%, respectively, with wearing compliance rates of 98.7%, 98.8% and 97.1%. Installation rates of dust control, chemical hazard control, and noise control facilities were 97.2%, 90.3%, and 69.9%, respectively, and all facilities were 100.0% effective. Exceedance rates for OHF and noise increased annually (all P<0.05), whereas those for dust and chemical factors decreased (all P<0.05). The exceedance rates of work position from high to low were dust (18.1%), noise (17.1%) and chemical factors (6.4%). Lead-related position had the highest exceedance rate (31.9%). Industries with higher exceedance rates included metal products manufacturing (27.3%), ferrous metal smelting and rolling (24.1%), and non-metallic mineral products manufacturing (23.7%). Conclusion Workplaces in key industries of Shaoguan City face relatively high risks of occupational hazards. It is essential to focus on noise management, with efforts to strengthen occupational health supervision and guidance for small/micro enterprises as well as industries with severe occupational hazards, promoting the standardization of occupational health management.

Patients with lung cancer experience a heavy symptom burden during the perioperative period, which seriously affects their recovery and quality of life. Traditional symptom management models rely mainly on scheduled ward rounds during hospitalization and outpatient follow-up after discharge. However, they have limitations such as delayed symptom recognition, lack of post-discharge monitoring, and non-quantitative symptom assessment, which often lead to delayed interventions and low patient satisfaction. In recent years, the symptom management model based on electronic patient-reported outcomes (ePRO) has been increasingly valued in clinical practice. Existing high-level evidence from both domestic and international studies indicates that, through proactive monitoring, real-time alerts, and remote interventions, this model enables dynamic and continuous symptom management and helps improve patient recovery and healthcare experience. As a supplement to routine medical care, the ePRO-based symptom management model aims to enhance the quality of care rather than replace existing medical processes. To promote the standardized application of this model in perioperative lung cancer care, this consensus integrates domestic and international evidence. After multiple rounds of voting by more than 50 experts, it formulates 12 consensus statements covering the three core components, symptom monitoring, alerting, and intervention, to provide scientific and practical recommendations for clinical practice.

Objective To investigate the causes and management strategies for lower limb ischemic necrosis following xenogeneic heterotopic heart transplantation from a multigene-edited pig to a rhesus monkey. Methods A xenogeneic heterotopic heart transplantation was performed on December 16, 2023, at the Institute of Experimental Animals of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, using a quintuple-gene-edited pig as the donor and a rhesus monkey as the recipient. On postoperative day (POD) 9, the recipient monkey underwent left lower limb amputation due to ischemic necrosis. Blood samples were collected at various time points after transplantation for analysis of hematologic parameters, liver and renal function, myocardial enzymes, and coagulation profiles. Ultrasound and computed tomography (CT) were used to evaluate anastomotic patency and cardiac structure. Immunological assays, including complement-dependent cytotoxicity (CDC) and IgG/IgM antibody detection, combined with clinical observations, were employed to assess rejection type and therapeutic response. Results The recipient monkey survived for 46 days after transplantation. Echocardiography demonstrated preserved biventricular systolic function in the recipient’s native heart, with left ventricular ejection fraction (LVEF) consistently exceeding 50%. In the donor pig heart, left ventricular endocardial thickening was noted on POD 9, followed by right ventricular endocardial thickening on POD 24, while LVEF remained around 35%. No hyperacute or acute rejection was detected immunologically. CDC positivity ranged between 3.4% and 5.1%, with IgG/IgM antibody binding trends consistent with CDC results. Following amputation, the recipient exhibited elevated inflammatory markers, coagulopathy, and reactive thrombocytosis, which later normalized. Immunohistochemical staining of the necrotic limb revealed arterial and venous thrombosis; however, no T-cell or B-cell infiltration was observed in vascular structures, thrombi, nerves, muscles, fascia, or skin tissues, with CD3 and CD20 staining both negative. Conclusion Limb ischemia after xenogeneic heart transplantation may be associated with lower extremity vascular thrombosis triggered by local trauma in the context of transplantation-induced inflammatory activation and coagulation dysfunction. While no clear lymphocyte-mediated rejection was observed, further studies are needed to explore the potential role of non-lymphocyte-mediated immune mechanisms.

Objective To analyze the occurrence status of low blood pressure (BP) in patients with refractory heart failure (RHF) and its relationship with comorbidities. Methods A retrospective analysis was conducted on the clinical data of 360 patients with RHF who were hospitalized in department of cardiology of Affiliated Nantong Hospital of Shanghai University from May 2021 to May 2025. These patients were divided into the RHF with BP group and the RHF group based on their blood pressure at admission. The general data and comorbidities were compared between both groups. Multivariate logistic regression analysis was used to identify the risk factors for coexisting BP. Results The heart rate (HR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood urea nitrogen, high-sensitivity cardiac troponin T, right atrial diameter, proportion of cardiac function grade IV, use rate of diuretics and prevalence rate of dilated cardiomyopathy (DCM) in the RHF with BP group were higher while the high-density lipoprotein cholesterol (HDL-C), albumin, left ventricular ejection fraction, use rate of lipid-lowering drugs and prevalence rate of coronary heart disease were lower compared to the RHF group, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis suggested that increased HR (OR=1.685, 95%CI: 1.106-2.569), increased NT-proBNP (OR=1.772, 95%CI: 1.138-2.759), decreased HDL-C (OR=0.605, 95%CI: 0.400-0.917) and DCM (OR=1.956, 95%CI: 1.176-3.255) were independent risk factors affecting BP in RHF patients (P<0.05). Conclusion The incidence rate of low blood pressure in elderly RHF patients is about 19.17%. Increased heart rate, increased NT-proBNP, decreased HDL-C and dilated cardiomyopathy are closely linked to the occurrence of low blood pressure, and they can be used as clinically related factors to identify patients at high risk of low blood pressure.

Objective To specifically extract and analyze nascent proteins synthesized by bone marrow mesenchymal stem cells(BMSCs)after transplantation into ischemic hearts using a technique employing mutant methionyl-tRNA synthetase(MetRSL247G)for nascent protein labeling,in order to explore the potential mechanisms of action in BMSCs post-transplantation.Methods Point mutation at position 274 of the MetRS gene in BMSCs was induced via lentiviral infection to enable azidonorleucine(ANL)-mediated labeling of nascent proteins in BMSCs.The labeling efficiency was verified by means of fluorescent non-canonical amino-acid tagging(FUNCAT).Thirty healthy female C57BL/6J mice(8-10 weeks old)were divided into control and experimental groups,with 15 mice in each group.The acute myocardial infarction model was constructed by ligating the left anterior descending coronary artery in experimental group,while control mice underwent only thoracotomy without coronary ligation.After modeling,both groups received intramyocardial injections of MetRSL247G-modified BMSCs(MetRSL247G-BMSCs)at 3 different sites in the peri-infarct ischemic region.Mice were intraperitoneally injected with ANL every 6 hours for 4 times on postoperative days 0,2,and 6(n=5 for each time point)respectively,euthanized 24 h after the last injection,and cardiac tissues were isolated.The newly synthesized and labeled proteins produced by BMSCs after transplantation into the myocardium of experimental and control groups were collected,using an enrichment technique for ANL-tagged proteins and liquid chromatography-tandem mass spectrometry(LC-MS)analysis.Gene ontology(GO)analysis,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,protein-protein interaction(PPI)analysis,and heatmap visualization analysis were performed to identify differentially expressed proteins at the 3 time points and screen key pathways and genes.Results Under fluorescence microscopy,the MetRSL247G lentivirus-infected BMSCs were observed to be labelled with mCherry signals,confirming the successful construction of the MetRSL247G-BMSCs cell line.Green fluorescent signals were detected only in nascent proteins in culture medium containing both MetRSL247G-BMSCs and ANL,validating the sensitivity and specificity of the labeling method.GO analysis revealed that differentially expressed proteins were primarily involved in basic cellular biological processes such as extracellular exosome formation,extracellular matrix organization,and focal adhesion.KEGG and PPI analyses indicated that the differential proteins were mainly involved in complement and coagulation cascade pathway,actin cytoskeleton regulation pathway,and apoptosis pathway.Heatmap analysis showed significantly upregulated expression of anti-apoptosis and cell adhesion-related factors in experimental group on day 1(P＜0.05),upregulated anti-apoptotic factors,pro-apoptotic factors,and cell adhesion-related factors on day 3(P＜0.05),and upregulated anti-apoptotic factors,cell differentiation-related factors,and cell adhesion-related factors on day 7(P＜0.05)compared with control group.Expression of apoptosis-inducing factor 1 was significantly downregulated on days 1 and 7(P＜0.05).On day 3,most differentially expressed proteins,including anti-apoptosis factors(Protein S100-A11,Clusterin,Gelsolin),pro-apoptosis factor(Cathepsin B),cell differentiation-related factor(Transgelin-2),and cell adhesion-related factors(Cofilin-1,Periostin,Fibronectin)were significantly upregulated(P＜0.05).Conclusions The MetRSL247G mutation enables BMSCs to incorporate ANL and synthesize labeled proteins,confirming the feasibility of this nascent protein labeling technique.Nascent proteins of BMSCs in ischemic myocardium primarily contribute to extracellular exosome secretion and extracellular matrix organization.BMSCs may adapt to and respond to ischemic and hypoxic environments by influencing complement and coagulation cascades,activating inflammatory factors,regulating actin cytoskeleton structure,and modulating apoptosis,thereby maintaining the survival of BMSCs.

AIM To establish a UPLC-MS/MS method for the simultaneous content determination of isofraxidin,saikosaponin c,ginsenoside Re,puerarin,rosmarinic acid,praeruptorin A,daidzein,baicalin and 5-O-methylvisammioside in Chaige Changyuan Mixture.METHODS The analysis was performed on a 35 ℃ Titank C18 column(100 mm×2.1 mm,3 μm),with the mobile phase comprising of acetonitrile-0.1％formic acid flowing at 0.3 mL/min in a gradient elution manner,and electron spray ionization source was adopted in positive and negative ion scanning with multiple reaction monitoring mode.RESULTS Nine constituents showed good linear relationships within their own ranges(r≥0.999 0),whose average recoveries were 84.08％-115.40％with the RSDs of 0.21％-4.47％.CONCLUSION This efficient,simple,sensitive and specific method can be used for the quality control of Chaige Changyuan Mixture.

Objective:To investigate the role of the IgG subtypes (IgG1 and IgG2a) in anti-glycoprotein (GP) Ⅰbα antibody-induced platelet clearance.Methods:Venous blood was collected from healthy volunteers, and platelets were separated. The phagocytosis of human platelets by human acute monocytic leukemia cells (THP-1 cells) induced by different anti-GPⅠbα antibodies (AN51, AK2, HIP1, TM60, VM16d, WM23, and SZ2) was detected by flow cytometry. The effects of the AN51 full-length antibody, F (ab') 2, and Fab fragments on platelet phagocytosis by THP-1 cells were detected by flow cytometry. Then, the Fc blocking antibody 2.4G2 and normal rat IgG2a or IgG1 were injected into C57BL/6J mice via the posterior ocular vein, and their effects on platelet reduction induced by R300 were detected by a hematology analyzer. Results:Compared with IgG1, the IgG2a subtype of anti-GPⅠbα antibodies induced the phagocytosis of platelets by THP-1 cells in vitro ( P<0.05). In contrast to the AN51 full-length antibody, neither AN51 F (ab') 2 nor the Fab fragment could induce THP-1 cells to phagocytose platelets ( P<0.05). Compared with the control group, anti-mouse GPⅠbα R300-induced thrombocytopenia in mice was reduced at 2, 4, and 6 h after the injection of Fc blocking antibody 2.4G2 ( P<0.05). Similarly, R300-induced thrombocytopenia in mice was reduced at 2, 4, and 6 h after the injection of rat IgG2a ( P<0.05) . Conclusion:IgG2a plays an important role in anti-GPⅠbα-induced clearance.

OBJECTIVE: The aim of this study is to analyze the clinical features and genetic etiology of a patient with multiple morphological abnormalities of the sperm flagella (MMAF) retrospectively. METHODS: A severely oligospermic patient from the Reproductive Center of the First Affiliated Hospital of Ningbo University was selected as the study subject. Clinical data and examination results were collected. High-throughput sequencing and bioinformatics were used to analyze the genetic etiology. And Sanger sequencing was employed to validate findings in the family. Transmission electron microscopy (TEM) was used to observe the sperm ultrastructure, and immunofluorescence analysis was performed to examine the localization of FSIP2 protein in the sperm. RESULTS: The patient presented with severe oligospermia, and sperm morphology displayed MMAF. TEM revealed fibrous sheath and 9+2 microtubule structural disruptions in the sperm. Sequencing identified compound heterozygous variants in the FSIP2 gene (c.17798C > T, c.5927T > G), inherited from the father and mother, respectively. According to the guidelines of the American College of Medical Genetics and Genomics, the variants were classified as pathogenic. The patient's spouse underwent intracytoplasmic single sperm injection, resulting in one embryo, but no clinical pregnancy occurred after embryo transfer. CONCLUSION This study reported the mutation of FSIP2 gene c.17798C > T, c.5927T > G in a patient with MMAF. These findings expand the mutational spectrum of the FSIP2 gene and provide insights for genetic and assisted reproductive counseling for patients with MMAF.
Humans ; Male ; Sperm Tail/pathology* ; Heterozygote ; Oligospermia/genetics* ; Spermatozoa ; Mutation ; Infertility, Male/genetics* ; Adult ; Pedigree ; Retrospective Studies ; Sperm Injections, Intracytoplasmic