The spatio-temporal heterogeneity of breast cell subsets forms the fundamental biological basis for physiological development and pathological progression, including tumorigenesis; however, its complex regulatory mechanisms are not yet fully elucidated. With its high-resolution capabilities, single-cell RNA sequencing (scRNA-seq) technology offers a powerful tool for dissecting this cellular heterogeneity. This technology enables the construction of high-precision breast cell atlases, the accurate identification of distinct cell subsets, and the reconstruction of differentiation trajectories from stem/progenitor cells to functional epithelial cells. By resolving the transcriptional regulatory networks that govern cell fate determination, intercellular communication patterns, and dynamic microenvironmental interactions, scRNA-seq has unveiled the molecular foundations of breast development and provided new perspectives on the pathogenesis of related diseases such as breast cancer and macromastia. Furthermore, scRNA-seq demonstrates significant potential for discovering early molecular markers of disease, deciphering tumor heterogeneity, and elucidating mechanisms of therapeutic resistance. The continued application of scRNA-seq for dissecting breast cell heterogeneity, combined with its integration with multi-modal data such as spatial omics, promises to provide critical evidence and new insights for revealing the molecular mechanisms of breast development-related diseases and for formulating precision therapeutic strategies.
Humans ; Single-Cell Analysis/methods* ; Female ; Breast Neoplasms/pathology* ; Sequence Analysis, RNA/methods* ; Breast/cytology*

Objective To investigate alterations in plasma complement levels and white matter imaging characteristics,along with their relationship in patients with first-episode schizophrenia(SCZ).Methods Thirty-eight patients with first-episode schizophrenia and 42 healthy controls were enrolled.Whole-brain diffusion tensor imaging(DTI)was performed using a Philips 3.0 T MRI scanner.Tract-based spatial statistics(TBSS)combined with the Johns Hopkins University(JHU)white matter labels atlas was used to extract and compare white matter characteristics between the two groups.Plasma levels of complement components(C1q,C3,C4,factor B,factor H,and factor P)were measured using the MILLIPLEX? human complement assay kit via multiplex analysis.Spearman correlation analysis was conducted to examine the association between plasma complement levels and white matter features.Results The radial diffusivity(RD)of the left fornix/stria terminalis was significantly higher in the patient group compared to the control group[(0.62±0.04)×10-3mm2/s vs.(0.60±0.03)×10-3mm2/s,PFDR=0.048)].Factor H[677.71(551.58,846.21)ng/mL vs.582.76(513.93,729.71)ng/mL,P=0.041]and factor P[71.36(57.30,95.99)ng/mL vs.60.08(46.67,80.03)ng/mL,P=0.011]were both significantly elevated compared to the control group.Moreover,RD values in the left fornix/stria terminalis were negatively correlated with plasma C3 levels in the patient group(r=-0.362,P=0.025).Conclusion Patients with first-episode schizophrenia exhibit white matter microstructural abnormalities in left fornix/stria terminalis,which are significantly associated with plasma complement levels.

Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

OBJECTIVE: To observe the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative fatigue syndrome (POFS) in elderly patients undergoing laparoscopic radical gastrectomy. METHODS: A total of 80 elderly patients scheduled for laparoscopic radical gastrectomy were randomized into a TEAS group and a sham TEAS group, 40 cases in each one. In the TEAS group, TEAS intervention was applied at bilateral Hegu (LI4), Neiguan (PC6), Zusanli (ST36) and Sanyinjiao (SP6) from 30 min before anesthesia induction until surgery completion, and at 18:00 on 1st, 2nd and 3rd days after surgery, once a day, 30 min a time. In the sham TEAS group, the same acupoints were selected and connected to the electroacupuncture device at the same time, without electrical stimulation. One day before surgery and 1, 3, 7 days after surgery, the 10-item short form of identity consequence fatigue scale (ICFS-10) score was observed, and the POFS incidence rate of 1, 3, 7 days after surgery was assessed in the two groups. One day before surgery, surgery completion, and 1, 3 days after surgery, the serum levels of superoxide dismutase (SOD), β-endorphin (β-EP) were detected; 1 day before surgery and 1, 3, 7 days after surgery, the serum level of tumor necrosis factor-α (TNF-α) was detected in the two groups. The pain visual analog scale (VAS) score was observed at 24, 48 and 72 h after surgery; the intraoperative dosage of propofol and remifentanil, and the incidence rate of postoperative nausea and vomiting, itching, respiratory depression were recorded in the two groups. RESULTS: In the TEAS group, on 1, 3, 7 days after surgery, except for the scores of item 8-10, the item scores and the total scores of ICFS-10 were lower than those in the sham TEAS group (P<0.001); on 3 and 7 days after surgery, the POFS incidence rates were lower than those in the sham TEAS group (P<0.05). In the TEAS group, on 1 and 3 days after surgery, the serum levels of SOD were higher than those in the sham TEAS group (P<0.05, P<0.01); at surgery completion, and on 1, 3 days after surgery, the serum levels of β-EP were higher than those in the sham TEAS group (P<0.001, P<0.01); on 1, 3, 7 days after surgery, the serum levels of TNF-α were lower than those in the sham TEAS group (P<0.01, P<0.001). In the TEAS group, at 24, 48 and 72 h after surgery, the pain VAS scores were lower than those in the sham TEAS group (P<0.001, P<0.01, P<0.05); the intraoperative dosage of remifentanil was lower than that in the sham TEAS group (P<0.001); the incidence rate of postoperative nausea and vomiting was lower than that in the sham TEAS group (P<0.01). CONCLUSION Perioperative TEAS intervention can effectively reduce the incidence rate of POFS, improve fatigue symptom and mental state in elderly patients undergoing laparoscopic radical gastrectomy, its mechanism may related to enhancing endogenous β-EP release, inhibiting inflammatory response, and reducing central oxidative stress, thereby promoting postoperative recovery.
Humans ; Acupuncture Points ; Male ; Female ; Aged ; Transcutaneous Electric Nerve Stimulation ; Postoperative Complications/therapy* ; Middle Aged ; Fatigue/etiology* ; Gastrectomy/adverse effects* ; beta-Endorphin/blood* ; Tumor Necrosis Factor-alpha/blood*

Objective:To investigate the application value of dermoscopy and reflectance confocal microscopy (RCM) in identifying field cancerization in actinic keratosis (AK) in the elderly.Methods:A retrospective analysis was conducted on clinical, dermoscopic, and RCM features of elderly (> 60 years old) patients, who were confirmedly diagnosed with AK and had complete medical records at Shanghai Skin Disease Hospital from January 2022 to December 2023.Results:A total of 132 elderly patients with AK were included. Dermoscopy showed brownish-gray pseudonetwork pigment patterns, follicular horn plugs, irregular branched vessels, and rosette signs in AK lesions. Histopathological examination in 51 patients revealed that 47 (92.16%) were confirmedly diagnosed with AK. Field cancerization was observed in 106 patients (80.3%), among whom 66 (62.26%) had irregular branched vessels, 88 (83.02%) predominantly exhibited brownish-gray pseudonetwork pigment patterns, and 83 (78.30%) showed scattered brown pigment networks/fingerprint-like patterns. Post-treatment follow-up of 63 patients showed varying degrees of changes in vascular and pigment structures by dermoscopy, with significant reductions in follicular horn plugs and superficial yellow-white scales or keratin masses. RCM examinations in 41 AK patients all showed disordered arrangements of keratinocytes presenting as atypical honeycomb patterns, with atypical cells in the AK lesions; in the field cancerization areas of 20 patients, RCM revealed keratinocytes disorderedly arranged in an irregular honeycomb pattern, with some keratinocytes exhibiting mild atypia. Thirty-four AK patients underwent dynamic RCM monitoring before and after 1, 3 and 6 months of ALA-PDT treatment, which showed gradual regularization of arrangements of keratinocytes and reduction of atypical cells, as well as reappearance of atypical keratinocytes upon recurrence.Conclusions:The incidence of field cancerization was relatively high in elderly AK patients. Dermoscopy and RCM are helpful for the early identification of AK and field cancerization, especially in patients with multiple lesions and with difficulties in multi-site biopsy.

Objective:To evaluate the effect of different psychosocial interventions on fertility concerns in cancer patients using network Meta-analysis.Methods:Randomized controlled trials or quasi-experimental studies on the effects of different psychosocial interventions on fertility concerns in cancer patients were electronically searched in China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Embase, Cochrane Library, CINAHL, Web of Science and PsycINFO. The search period was from database establishment to October 31, 2024. Two researchers independently conducted literature screening and data extraction. Conventional Meta-analysis of the included literature was performed using RevMan 5.4, and network Meta-analysis was performed using Stata 18.0.Results:A total of 10 studies involving 835 cancer patients and seven psychosocial interventions were included. Network Meta-analysis showed that there was a statistically significant difference in the intervention effect of fertility counseling ( MD=18.24, 95% CI: 2.85-33.62, P<0.05) and mental awareness training ( MD=17.97, 95% CI: 3.09-32.85, P<0.05) on fertility concerns in cancer patients as compared to routine nursing. The ranked probability plot showed that fertility counseling and mental awareness training had superior results. Conclusions:Fertility counseling has a superior effect on fertility concerns in cancer patients. Mental awareness training may be effective in improving fertility concerns in cancer patients, and further research is needed to validate the effectiveness of mindfulness-based stress reduction, cognitive behavioral therapy, dyadic coping interventions, and educational interventions in improving fertility concerns in cancer patients.

Objective:To evaluate the effect of low-dose esketamine on intraoperative electroencephalogram (EEG) burst suppression under general anesthesia in elderly patients.Methods:In this prospective randomized controlled trial, 86 elderly patients of either sex, scheduled for elective lumbar fusion surgery at Anhui No. 2 Provincial People′s Hospital from March 15 to June 1, 2024, aged 60-85 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification ⅡorⅢ, were divided into 2 groups ( n=43 each) using a random number table method: esketamine group (group S) and control group (group C). In group S, esketamine at a dose of 0.25 mg/kg was intravenously injected after anesthesia induction, while the equal volume of normal saline was intravenously injected in group C. The occurrence of EEG burst suppression and frequency of the characteristic density spectral array were recorded using the Masimo Sedline cerebral function monitor. The patient state index was recorded before esketamine administration and at 5, 10, 30 and 60 min after administration and at 5 min before the end of the surgery. Delirium was assessed using the Confusion Assessment Method at 1 and 3 days after operation. The total pressing times of patient-controlled analgesia within 48 h after operation, requirement for rescue analgesia and occurrence of adverse reactions (nausea and vomiting, delayed emergence from anesthesia, agitation, headache) were recorded. The consumption of ephedrine, phenylephrine, sufentanil and remifentanil during operation, emergence time, time of tracheal extubation, length of stay in the post-anesthesia care unit, and length of postoperative hospital stay were also recorded. Results:Compared with group C, the incidence of EEG burst suppression and frequency of the characteristic density spectral array were significantly decreased, the patient state index values were increased at each time point after administration and 5 min before the end of surgery, the consumption of ephedrine, phenylephrine, sufentanil and remifentanil during operation was reduced, the effective pressing times of patient-controlled analgesia, rate of rescue analgesia, and incidence of postoperative delirium within 3 days after operation were decreased, and the length of postoperative hospital stay was shortened in group S ( P<0.05). Conclusions:Low-dose esketamine can reduce intraoperative EEG burst suppression and decrease the development of postoperative delirium under general anesthesia in elderly patients.

Objective:To evaluate the effect of low-dose esketamine on intraoperative electroencephalogram (EEG) burst suppression under general anesthesia in elderly patients.Methods:In this prospective randomized controlled trial, 86 elderly patients of either sex, scheduled for elective lumbar fusion surgery at Anhui No. 2 Provincial People′s Hospital from March 15 to June 1, 2024, aged 60-85 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification ⅡorⅢ, were divided into 2 groups ( n=43 each) using a random number table method: esketamine group (group S) and control group (group C). In group S, esketamine at a dose of 0.25 mg/kg was intravenously injected after anesthesia induction, while the equal volume of normal saline was intravenously injected in group C. The occurrence of EEG burst suppression and frequency of the characteristic density spectral array were recorded using the Masimo Sedline cerebral function monitor. The patient state index was recorded before esketamine administration and at 5, 10, 30 and 60 min after administration and at 5 min before the end of the surgery. Delirium was assessed using the Confusion Assessment Method at 1 and 3 days after operation. The total pressing times of patient-controlled analgesia within 48 h after operation, requirement for rescue analgesia and occurrence of adverse reactions (nausea and vomiting, delayed emergence from anesthesia, agitation, headache) were recorded. The consumption of ephedrine, phenylephrine, sufentanil and remifentanil during operation, emergence time, time of tracheal extubation, length of stay in the post-anesthesia care unit, and length of postoperative hospital stay were also recorded. Results:Compared with group C, the incidence of EEG burst suppression and frequency of the characteristic density spectral array were significantly decreased, the patient state index values were increased at each time point after administration and 5 min before the end of surgery, the consumption of ephedrine, phenylephrine, sufentanil and remifentanil during operation was reduced, the effective pressing times of patient-controlled analgesia, rate of rescue analgesia, and incidence of postoperative delirium within 3 days after operation were decreased, and the length of postoperative hospital stay was shortened in group S ( P<0.05). Conclusions:Low-dose esketamine can reduce intraoperative EEG burst suppression and decrease the development of postoperative delirium under general anesthesia in elderly patients.

Objective:To evaluate the effect of different psychosocial interventions on fertility concerns in cancer patients using network Meta-analysis.Methods:Randomized controlled trials or quasi-experimental studies on the effects of different psychosocial interventions on fertility concerns in cancer patients were electronically searched in China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, PubMed, Embase, Cochrane Library, CINAHL, Web of Science and PsycINFO. The search period was from database establishment to October 31, 2024. Two researchers independently conducted literature screening and data extraction. Conventional Meta-analysis of the included literature was performed using RevMan 5.4, and network Meta-analysis was performed using Stata 18.0.Results:A total of 10 studies involving 835 cancer patients and seven psychosocial interventions were included. Network Meta-analysis showed that there was a statistically significant difference in the intervention effect of fertility counseling ( MD=18.24, 95% CI: 2.85-33.62, P<0.05) and mental awareness training ( MD=17.97, 95% CI: 3.09-32.85, P<0.05) on fertility concerns in cancer patients as compared to routine nursing. The ranked probability plot showed that fertility counseling and mental awareness training had superior results. Conclusions:Fertility counseling has a superior effect on fertility concerns in cancer patients. Mental awareness training may be effective in improving fertility concerns in cancer patients, and further research is needed to validate the effectiveness of mindfulness-based stress reduction, cognitive behavioral therapy, dyadic coping interventions, and educational interventions in improving fertility concerns in cancer patients.

Objective To investigate alterations in plasma complement levels and white matter imaging characteristics,along with their relationship in patients with first-episode schizophrenia(SCZ).Methods Thirty-eight patients with first-episode schizophrenia and 42 healthy controls were enrolled.Whole-brain diffusion tensor imaging(DTI)was performed using a Philips 3.0 T MRI scanner.Tract-based spatial statistics(TBSS)combined with the Johns Hopkins University(JHU)white matter labels atlas was used to extract and compare white matter characteristics between the two groups.Plasma levels of complement components(C1q,C3,C4,factor B,factor H,and factor P)were measured using the MILLIPLEX? human complement assay kit via multiplex analysis.Spearman correlation analysis was conducted to examine the association between plasma complement levels and white matter features.Results The radial diffusivity(RD)of the left fornix/stria terminalis was significantly higher in the patient group compared to the control group[(0.62±0.04)×10-3mm2/s vs.(0.60±0.03)×10-3mm2/s,PFDR=0.048)].Factor H[677.71(551.58,846.21)ng/mL vs.582.76(513.93,729.71)ng/mL,P=0.041]and factor P[71.36(57.30,95.99)ng/mL vs.60.08(46.67,80.03)ng/mL,P=0.011]were both significantly elevated compared to the control group.Moreover,RD values in the left fornix/stria terminalis were negatively correlated with plasma C3 levels in the patient group(r=-0.362,P=0.025).Conclusion Patients with first-episode schizophrenia exhibit white matter microstructural abnormalities in left fornix/stria terminalis,which are significantly associated with plasma complement levels.