OBJECTIVE To investigate the mechanism of isochlorogenic acid A against hepatocellular carcinoma based on the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR） signaling pathway and multi-omics technology. METHODS The invasion rate and migration rate of human hepatocellular carcinoma HepG2 cells after 48 h of intervention with 0 （control group）， 0.25 and 0.5 mg/mL isochlorogenic acid A were examined； mRNA expression of DEP domain-containing mTOR-interacting protein （DEPTOR）， the protein expressions of mTOR， PI3K and phosphatase and tensin homologue deleted on chromosome ten （PTEN）， as well as the phosphorylation level of Akt protein were determined in the cells. Metabolomics analysis was performed using liquid chromatography-tandem mass spectrometry， and differential metabolites were screened and subjected to Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis； transcriptomics monitoring was conducted by RNA sequencing， and differentially expressed genes were screened and subjected to gene ontology （GO） and KEGG pathway enrichment analyses. RESULTS Compared with the control group， intervention with 0.25 and 0.5 mg/mL isochlorogenic acid A for 48 h significantly inhibited the invasion rate and migration rate of HepG2 cells， significantly up-regulated the mRNA expression of DEPTOR and the protein expression of PTEN， and significantly down-regulated the protein expression of PI3K and the phosphorylation level of Akt protein （except for 0.25 mg/mL isochlorogenic acid A） （ P ＜0.05）. A total of 304 differential metabolites and 212 differentially expressed genes were screened by multi-omics analysis. KEGG pathway enrichment analysis suggested that isochlorogenic acid A regulated key signaling of HepG2 cell growth mainly by inhibiting the PI3K/Akt signaling pathway， synergizing with metabolic reprogramming such as mTOR signaling pathway， ferroptosis， pentose phosphate pathway and purine/pyrimidine metabo lism. CONCLUSIONS The anti-hepatocellular carcinoma effect of isochlorogenic acid A is associated with the blockade of abnormal activation of the PI3K/Akt/mTOR signaling pathway. In addition， it may also be related to the inhibition of the pentose phosphate pathway and purine/pyrimidine metabolism， as well as the induction of ferroptosis，etc.

Objective: To investigate the precise detection methods for weak partial D type 15 and evaluate their implications for blood transfusion safety, along with the development of corresponding strategies. Methods: A combination of serological methods, including the microplate method, indirect antiglobulin tube method, and microcolumn gel card method, was employed to identify RhD-negative and RhD variant samples. RhD-negative samples were screened for the presence of RHD genes using whole-blood direct PCR amplification. Subsequently, RhD variant samples and RhD-negative samples containing RHD genes underwent full-coding-region sequencing of the RHD gene to confirm their genotypes. The genotyping results were further correlated with the serological test findings for comprehensive analysis. Results: Among 615 549 first-time healthy blood donors, 3 401 samples with an RhD-negative phenotype and 156 samples with RhD variant were identified. Of the 3 401 RhD-negative samples, 1 054 were found to harbor RHD genes. Gene sequencing analysis of the 156 RhD variants and the 1 054 serological negative samples revealed that 89 samples contained the RHD 15 (c. 845G>A) allele. Conclusion: The integration of serological testing methods and genotyping technologies for the precise determination of RhD blood type plays a critical role in ensuring the safety and compatibility of blood transfusions.

Objective To investigate the clinical efficacy and aesthetic outcome of liposuction combined with mammary adenectomy through a periareolar small incision in the management of gynecomastia(GYN).Methods From January 2019 to June 2023,18 patients with GYN were admitted.All of them were treated with small incision through the areola combined with liposuction.The postoperative aesthetic effect,occurrence of complications and patient satisfaction of the patients were evaluated.Results All 18 patients in this study were follwed up for a period of 3 to 18 months.No serious complications such as wound infection or necrosis of the nipple-areola occurred.Pathological examinations were consistent with the diagnosis of GYN.Except for one patient,who exhibited slight skin folds in the surgical area at the 12-month follow-up,the other patients all achieved symmetrical and smooth chest contours with noticeable aesthetic improvement,resulting in a 100％patient satisfaction rate.Conclusion The combined approach of liposuction combined with mammary adenectomy through a periareolar small incision for the treatment of GYN is straightforward,minimally invasive,and yields satisfactory therapeutic and aesthetic outcomes.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Objective To investigate necroptosis-related diagnostic biomarkers of bronchopulmo-nary dysplasia(BPD)and their relationships with the immune microenvironment through the analysis of necroptosis-related genes(NRGs)in BPD.Methods The dataset GSE32472 was downloaded from the Gene Expression Omnibus(GEO)database,and NRGs were obtained from the Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway and Gene Cards databases.Differentially expressed necroptosis-related genes(DE-NRGs)were screened,and their biological functions and pathways were explored through functional enrichment analysis.Machine learning algorithms,inclu-ding least absolute shrinkage and selection operator(LASSO)and support vector machine-recursive feature elimination(SVM-RFE),were applied to screen feature genes.The Cell-type Ⅰdentification By Estimating Relative Subsets of RNA Transcripts(CIBERSORT)algorithm and the Estimation of Stromal and Immune Cells in Malignant Tumor Tissues using Expression Data(ESTIMATE)algo-rithm were used to explore the immune infiltration characteristics of BPD.Spearman correlation anal-ysis between feature genes and immune cells was performed using the"corrplot"package in R lan-guage.Results A total of 19 DE-NRGs were identified.The main biological functions and path-ways of DE-NRGs included the regulation of necroptosis and inflammatory responses.Three feature genes,namely flotillin-2(FLOT2),CASP8 and FADD-like apoptosis regulators(CFLAR),and charged multivesicular body protein 7(CHMP7),were further screened to construct a nomogram.In the validation sets GSE8586 and GSE188944,the area under the curve(AUC)values were all greater than 0.7.CIBERSORT analysis revealed that BPD group presented a higher proportion of naive B cells,neutrophils,eosinophils and resting mast cells compared to control group(P＜0.05).Meanwhile,the proportion of CD8+T cells,CD4+naive T cells,CD4+resting memory T cells,regulatory T cells,resting natural killer(NK)cells,M0 macrophages,M2 macrophages and activated dendritic cells was lower than that in the control group(P＜0.05).ESTIMATE analysis showed that the stromal score in the BPD group was higher than that in the control group,while the immune score was lower,with statistically significant differences(P＜0.05).Correlation analysis between the three feature genes and ESTIMATE scores indicated that FLOT2 and CFLAR were posi-tively correlated with the stromal score and negatively correlated with the immune score,whereas CHMP7 was positively correlated with the immune score and negatively correlated with the stromal score.Conclusion The three necroptosis-related feature genes can serve as diagnostic biomarkers for BPD-related necroptosis,with high diagnostic efficacy.They may play an important roles through immune mechanisms,providing new insights and theoretical references for the early diagnosis and immune intervention of BPD.

Ferroptosis is a form of programmed cell death,which plays a crucial driving role in the onset and progression of diabetic nephropathy(DN).Ferroptosis is closely related to the damage of renal intrinsic cells in patients with diabetes.Chinese materia medica can improve DN by regulating the ferroptosis of renal intrinsic cells,with a good research and application prospect.This article reviewed the key regulatory factors and regulatory pathways of ferroptosis in DN,explained the"imbalance between yin and yang"of ferroptosis in DN based on TCM theories,and combed the research status of targeted inhibition of ferroptosis by active components of Chinese materia medica.The regulation of active components of Chinese materia medica on ferroptosis in DN has the characteristics of multiple targets,multiple links and integrity,which can provide a reference for the mechanism research and drug development of Chinese materia medica in treating DN.

Objective To investigate the clinical efficacy and aesthetic outcome of liposuction combined with mammary adenectomy through a periareolar small incision in the management of gynecomastia(GYN).Methods From January 2019 to June 2023,18 patients with GYN were admitted.All of them were treated with small incision through the areola combined with liposuction.The postoperative aesthetic effect,occurrence of complications and patient satisfaction of the patients were evaluated.Results All 18 patients in this study were follwed up for a period of 3 to 18 months.No serious complications such as wound infection or necrosis of the nipple-areola occurred.Pathological examinations were consistent with the diagnosis of GYN.Except for one patient,who exhibited slight skin folds in the surgical area at the 12-month follow-up,the other patients all achieved symmetrical and smooth chest contours with noticeable aesthetic improvement,resulting in a 100％patient satisfaction rate.Conclusion The combined approach of liposuction combined with mammary adenectomy through a periareolar small incision for the treatment of GYN is straightforward,minimally invasive,and yields satisfactory therapeutic and aesthetic outcomes.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Ferroptosis is a form of programmed cell death,which plays a crucial driving role in the onset and progression of diabetic nephropathy(DN).Ferroptosis is closely related to the damage of renal intrinsic cells in patients with diabetes.Chinese materia medica can improve DN by regulating the ferroptosis of renal intrinsic cells,with a good research and application prospect.This article reviewed the key regulatory factors and regulatory pathways of ferroptosis in DN,explained the"imbalance between yin and yang"of ferroptosis in DN based on TCM theories,and combed the research status of targeted inhibition of ferroptosis by active components of Chinese materia medica.The regulation of active components of Chinese materia medica on ferroptosis in DN has the characteristics of multiple targets,multiple links and integrity,which can provide a reference for the mechanism research and drug development of Chinese materia medica in treating DN.

Objective To investigate the application value of point-of-care lung ultrasound (POC-LUS) scoring in selecting respiratory support treatment modalities for neonatal infectious pneumonia (NIP). Methods A total of 89 NIP patients were selected as the study subjects and divided into control group (no assisted ventilation) with 46 cases, noninvasive group (noninvasive assisted ventilation) with 28 cases, and invasive group (invasive mechanical ventilation) with 15 cases based on the degree of dyspnea and blood gas analysis results. The POC-LUS scores of the three groups were compared, and the correlations of POC-LUS scores with arterial oxygen partial pressure [p_a(O₂)] and arterial carbon dioxide partial pressure [p_a(CO₂)] were analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of POC-LUS scores for the need for noninvasive assisted ventilation or invasive mechanical ventilation in NIP patients. Results The POC-LUS scores of the noninvasive group and the invasive group were (31.7±7.3) and (42.1±8.0), respectively, which were higher than (21.5±7.3) of the control group. Additionally, the score of the invasive group was higher than that of the noninvasive group (P < 0.05). Correlation analysis revealed a significant negative correlation between POC-LUS scores and p_a(O₂) (r=-0.802, P < 0.05), and a significant positive correlation with p_a(CO₂) (r=0.807, P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of POC-LUS scores for predicting the need for noninvasive assisted ventilation and invasive mechanical ventilation were 0.918 (95%CI, 0.862 to 0.973) and 0.938 (95%CI, 0.889 to 0.987), respectively. The sensitivity was 0.767 and 0.933, and the specificity was 0.935 and 0.824, with optimal cutoff values of 29.5 and 31.5, respectively. Conclusion POC-LUS scoring can quantitatively assess the severity of lung lesions in NIP patients and serves as a guiding tool for clinicians in selecting assisted ventilation treatment modalities.