Objective To investigate the risk factors for postoperative recurrence and metastasis in patients with T1 stageⅢ/Ⅳ clear cell renal cell carcinoma(ccRCC), and to analyze the influence of surgical methods on prognosis, so as to provide prognostic evaluation and treatment guidance for clinical practice. Methods A retrospective analysis was conducted on 398 patients diagnosed with T1 stage Ⅲ/Ⅳ ccRCC who underwent either partial nephrectomy(PN)or radical nephrectomy(RN)at Jiangsu Province Hospital during Jan. 2008 and Sep. 2022. The patients were divided into recurrence group(n=49)and non-recurrence group(n=349)according to whether the tumor recurred during the follow-up period. The general, clinical data and prognosis were compared between the two groups. Univariate and multivariate Cox regression analyses were used to explore the factors influencing disease-free survival(DFS)and overall survival(OS)after surgery. Subgroup analysis using Kaplan-Meier curves was performed for T1a and T1b patients. Results During the median follow-up of 67(42, 98)months, the recurrence group was characterized by older age, larger tumor diameter, higher proportion of T1b stage, and more complex tumor anatomy. Univariate and multivariate Cox regression analyses showed that age ≥55 years and R.E.N.A.L. score ≥7 were independent risk factors for poorer DFS and OS(P＜0.05). Subgroup analysis revealed that PN or RN did not significantly affect DFS or OS in T1a patients and OS in T1b patients, while RN significantly improved DFS in T1b patients(P＜0.05). Conclusion Age ≥55 years and R.E.N.A.L. score ≥7 are independent risk factors for poor DFS and OS in highgrade T1 ccRCC patients. For T1b patients, RN may improve DFS.

Objective: To systematically analyze the revisions content and technological development trends of microbiological standards in the Chinese Pharmacopoeia (ChP) 2025 Edition, and explore its novel requirements in risk-based pharmaceutical product lifecycle management.
Methods: A comprehensive review was conducted on 26 microbiological-related standards to summarize the revision directions and scientific implications from perspectives including the revision overview, international harmonization of microbiological standards, risk-based quality management system, and novel tools and methods with Chinese characteristics.
Results: The ChP 2025 edition demonstrates three prominent features in microbiological-related standards: enhanced international harmonization, introduced emerging molecular biological technologies, and established a risk-based microbiological quality control system.
Conclusion: The new edition of the Pharmacopoeia has systematically constructed a microbiological standard system, which significantly improves the scientificity, standardization and applicability of the standards, providing a crucial support for advancing the microbiological quality control in pharmaceutical industries of China.

BACKGROUND:Flap transplantation technique is a commonly used surgical procedure for the treatment of severe tissue defects,but postoperative flap necrosis is easily triggered by ischemia-reperfusion injury.Therefore,it is still an important research topic to improve the survival rate of transplanted flaps. OBJECTIVE:To review the pathogenesis and latest treatment progress of flap ischemia-reperfusion injury. METHODS:CNKI,WanFang Database and PubMed database were searched for relevant literature published from 2014 to 2024.The search terms used were"flap,ischemia-reperfusion injury,inflammatory response,oxidative stress,Ca2+overload,apoptosis,mesenchymal stem cells,platelet-rich plasma,signaling pathways,shock wave,pretreatment"in Chinese and English.After elimination of irrelevant literature,poor quality and obsolete literature,77 documents were finally included for review. RESULTS AND CONCLUSION:Flap ischemia/reperfusion injury may be related to pathological factors such as inflammatory response,oxidative stress response,Ca2+overload,and apoptosis,which can cause apoptosis of vascular endothelial cells,vascular damage and microcirculation disorders in the flap,and eventually lead to flap necrosis.Studies have found that mesenchymal stem cell transplantation,platelet-rich plasma,signaling pathway modulators,shock waves,and pretreatment can alleviate flap ischemia/reperfusion injuries from different aspects and to varying degrees,and reduce the necrosis rate and necrosis area of the grafted flap.Although there are many therapeutic methods for skin flap ischemia/reperfusion injury,a unified and effective therapeutic method has not yet been developed in the clinic,and the advantages and disadvantages of various therapeutic methods have not yet been compared.Most of the studies remain in the stage of animal experiments,rarely involving clinical observations.Therefore,a lot of research is required in the future to gradually move from animal experiments to the clinic in order to better serve the clinic.

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

Background: s/Aims: Sarcomatoid hepatocellular carcinoma (HCC) is a rare histological subtype of HCC characterized by extremely poor prognosis; however, its molecular characterization has not been elucidated. Methods: In this study, we conducted an integrated multiomics study of whole-exome sequencing, RNA-seq, spatial transcriptome, and immunohistochemical analyses of 28 paired sarcomatoid tumor components and conventional HCC components from 10 patients with sarcomatoid HCC, in order to identify frequently altered genes, infer the tumor subclonal architectures, track the genomic evolution, and delineate the transcriptional characteristics of sarcomatoid HCCs. Results: Our results showed that the sarcomatoid HCCs had poor prognosis. The sarcomatoid tumor components and the conventional HCC components were derived from common ancestors, mostly accessing similar mutational processes. Clonal phylogenies demonstrated branched tumor evolution during sarcomatoid HCC development and progression. TP53 mutation commonly occurred at tumor initiation, whereas ARID2 mutation often occurred later. Transcriptome analyses revealed the epithelial–mesenchymal transition (EMT) and hypoxic phenotype in sarcomatoid tumor components, which were confirmed by immunohistochemical staining. Moreover, we identified ARID2 mutations in 70% (7/10) of patients with sarcomatoid HCC but only 1–5% of patients with non-sarcomatoid HCC. Biofunctional investigations revealed that inactivating mutation of ARID2 contributes to HCC growth and metastasis and induces EMT in a hypoxic microenvironment. Conclusions We offer a comprehensive description of the molecular basis for sarcomatoid HCC, and identify genomic alteration (ARID2 mutation) together with the tumor microenvironment (hypoxic microenvironment), that may contribute to the formation of the sarcomatoid tumor component through EMT, leading to sarcomatoid HCC development and progression.

Objective To discuss the effect of probucol combined with tirofiban treatment on serum lipid peroxide levels and vascular endothelial function in patients with angina pectoris after interventional surgery of coronary heart disease(CHD).Methods A total of 120 patients with angina pectoris occurring after interventional surgery from January 2018 to December 2022 at the People's Hospital of Inner Mongolia Autonomous Region of China were enrolled in this study.Using random digital table method,the patients were divided into observation group(n=60)and control group(n=60).The patients of the control group received tirofiban,while the patients of the observation group received tirofiban plus probucol.All the preoperative and postoperative 7-day relevant indicators were recorded.The main observation indicator was the overall effective rate,and the secondary observation indicators included the frequency and duration of angina attacks,Seattle Angina Questionnaire(SAQ)score,cardiac function,myocardial injury markers,serum lipid peroxide levels,endothelial function and adverse reactions.Results The total effective rate in the observation group was 91.67％(55/60),which was higher than 78.33％(47/60)in the control group,the difference was statistically significant(P＜0.05).After treatment,the improvement degree of angina pectoris,SAQ score,LVEF,serum superoxide dismutase(SOD),nitric oxide(NO)in the observation group were higher than those in the control group,while the LVESD,LVEDD,serum creatine kinase isozyme(CK-MB),lactate dehydrogenase(LDH),creatine kinase(CK),malondialdehyde(MDA),endothelin-1(ET-1)in the observation group were lower than those in the control group,the differences in the above indexes were statistically significant(all P＜0.05).Conclusion For patients with angina pectoris occurring after interventional surgery of CHD,probucol combined with tirofiban has exact efficacy,which can promote the recovery of cardiac function,reduce myocardial injury,regulate serum lipid peroxide levels,and improve vascular endothelial function.

Objective: To analyze the association between poor sleep characteristics and the coexistence of negative emotions and overweight/obesity among college students, so as to provide a scientific basis for improving their physical and mental health. Methods: From November to December 2023, a convenience sampling method was used to survey 6 600 college students from nine universities in Jiangxi, Hunan, and Hubei provinces. The Depression Anxiety and Stress Scale-21 (DASS-21), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and physical examinations were employed to assess negative emotions, poor sleep characteristics, and overweight/obesity. Chi square test and Logistic regression were used to analyze the impact of poor sleep characteristics on the coexistence of negative emotions and overweight/obesity. Results: The coexistence rates of different categories of negative emotions (depression, anxiety, stress) and overweight/obesity were 6.1% ( n= 405), 8.0% ( n =529), and 3.3% ( n =217), respectively. Gender, grade level, major, maternal education level, annual family income, physical activity level, only child status, and carbonated beverage consumption were statistically associated with the coexistence rates of different categories of negative emotions and overweight/obesity ( χ 2=4.01-35.18, all P <0.05). Logistic regression analysis showed that after adjusting for gender, grade level, major, only child status, maternal education level, annual family income, physical activity level, and carbonated beverage consumption, poor sleep characteristics were significantly associated with an increased risk of the coexistence of negative emotions and overweight/obesity ( OR =1.41-6.65); moderate and poor sleep quality levels were significantly associated with an increased risk of the coexistence of different categories of negative emotions and overweight/obesity among female students ( OR =1.99-4.71) (all P <0.05). Conclusions Poor sleep characteristics are associated with the coexistence of negative emotions and overweight/obesity among college students. Greater attention should be paid to sleep issues in this population, and sleep education should be actively promoted to reduce the risk of comorbid negative emotions and overweight/obesity.

Objective:To analyze the risk factors of anxiety and depression in prostate cancer patients after castration, and establish a risk prediction model.Methods:A retrospective analysis was conducted on the data of 60 prostate cancer patients treated in Xi′an People′s Hospital from January 2019 to January 2022. The patients were divided into a training group ( n=42) and a validation group ( n=18) at a ratio of 7∶3. The patients received surgical castration and medical castration. One month after castration, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the anxiety symptoms and depression levels of the patients, respectively. Univariate and multivariate logistic regression analyses were used to identify the risk factors for negative emotions in prostate cancer patients after castration, and a risk prediction model was established. Results:In the training group, 19 patients had a SAS score ≥50, and 21 patients had an SDS score ≥50. Based on these scores, the training group was divided into a negative emotion group ( n=19) and an emotional stability group ( n=23). Multivariate logistic regression analysis showed that marital status, castration scheme, and postoperative Visual Analogue Scale (VAS) score were independent influencing factors for negative emotions in prostate cancer patients after castration ( OR=3.589, 3.364, 5.912, all P<0.05). In both the training group and the validation group, the risk scores of patients with negative emotions were significantly higher than those with emotional stability. In the training group, the area under the curve (AUC) of the risk prediction model for predicting negative emotions was 0.747, with a specificity of 71.02% and a sensitivity of 66.11%; in the validation group, the AUC, specificity, and sensitivity were 0.761, 66.59%, and 76.21%, respectively. The Hosmer-Lemeshow test showed that χ 2 was 4.285 6, P value was 0.830, and the c-index was 0.773(0.692-0.854). The calibration curve showed that the predicted curve was basically consistent with the actual curve, indicating that the prediction model had good discriminative ability and accuracy. Decision curve analysis showed that the model had high clinical significance. Conclusions:Marital status, castration scheme, and postoperative VAS score are important factors affecting anxiety and depression in prostate cancer patients after castration, and the regression model can successfully predict the risk of negative emotions.