Objective To investigate the safety of robotic single-site hysterectomy(RSSH)for benign diseases.Methods We retrospectively analyzed data of patients who underwent RSSH or traditional transumbilical laparoendoscopic single-site hysterectomy(LESSH)for benign indications from May 2024 to May 2025.The study was comprised of 24 patients in the RSSH group and 42 patients in the LESSH group.Perioperative indicators were compared between the two groups.Results All the surgeries were successfully completed in both groups without conversion or intraoperative/postoperative blood transfusion.The RSSH group had a longer operation time than the LESSH group[161.5(131.3,179.5)min vs.97.5(76.5,123.3)min,Z=-5.226,P＜0.001].However,there were no significant differences in intraoperative blood loss,pre-postoperative hemoglobin difference,postoperative pain score,maximum postoperative temperature,time to flatus,indwelling catheter duration,or postoperative hospital stay(P＞0.05).Conclusion RSSH for benign diseases has a safety profile comparable to traditional LESSH.

Objective:To characterize the minimal inhibitory concentration (MIC) of macrolides against clinical Mycoplasma pneumoniae (MP) isolates and to investigate the significance of 23S rRNA mutations. Methods:Cross-sectional study.A total of 288 clinical MP strains preserved in the laboratory from 2016 to 2021 were taken for macrolide resistance gene testing and the evaluation of in vitro susceptibility to Azithromycin and Erythromycin.MIC 50 and MIC 90 values were calculated separately for macrolide-susceptible and -resistant strains. Results:All 288 MP strains underwent the test of in vitro susceptibility to Azithromycin, while 86 of them were additionally tested for Erythromycin.Among these strains, 22 strains were Azithromycin-sensitive, and 266 strains were Azithromycin-resistant.A2063G mutations were detected in 260 (97.7%) strains, while A2064G mutations were detected in 6 (2.3%) strains.Azithromycin-resistant strains had an MIC 50 of 128.000 μg/mL and an MIC 90 of 512.000 μg/mL, with the MIC ranging between 16.000 and 512.000 μg/mL.Seven strains were sensitive and 79 strains were resistant to Erythromycin.Among Erythromycin-resistant strains, A2063G mutations were detected in 73 (92.4%) strains, while A2064G mutations were detected in 6 (7.6%) strains.Erythromycin-resistant strains had an MIC 50 of 256.000 μg/mL and an MIC 90 of 512.000 μg/mL, with the MIC ranging between 64.000 and 1 024.000 μg/mL. Conclusions:A2063G and A2064G mutations in the 23S rRNA gene of MP are associated with high-level in vitro resistance to Azithromycin and Erythromycin, significantly limiting the clinical effectiveness of these antibiotics.Early resistance gene testing is recommended for suspected MP patients, which can help optimize the treatment, improve prognosis, and prevent resistance spread.

OBJECTIVE To evaluate the effects of phthalic acid esters(PAEs)on the expression of heme oxygenase-1(HO-1)in HepG2 cells,and to construct an HO-1-based three-dimensional quantita-tive structure-activity relationship(3D-QSAR)model.METHODS ① HepG2 cells were treated with seven types of PAEs:di-(2-ethylhexyl)phthalate(DEHP),di-n-octyl phthalate(DnOP),dimethyl phthalate(DMP),diethyl phthalate(DEP),dihexyl phthalate(DHXP),dimethylglycol phthalate(DMEP),and dibutyl phthalate(DBP),at final concentrations of 0(DMSO,solvent control),0.062 5,0.125,0.25,0.5 and 1 mmol·L-1(n=6)for 48 h at 37℃.The expression level of HO-1 was measured by Western blotting.② A 3D-QSAR model was constructed using comparative molecular similarity indices analysis(CoMSIA)based on the measured HO-1 levels.The applicability domain(AD)of the model was evaluated using the leverage method.Model fitting quality and predictive ability were evaluated via the KNIME Enalos+node to verify model stability.Additionally,molecular docking was performed to validate the binding interactions between PAEs and HO-1.RESULTS ① Compared with the solvent control group,48 h of exposure to 0.062 5 mmol·L-1 PAEs(DMP,DMEP,DEHP,DnOP and DEP)significantly increased HO-1 protein expressions,while 1 mmol·L-1 PAEs(DMP,DBP,DnOP,DEP and DHXP)significantly suppressed HO-1 expressions.② The 3D-QSAR model showed a non-cross-validated coefficient(R2)of 0.996 and a cross-validated coefficient(Q2)of 0.548.All the seven PAEs in the 3D-QSAR model were within the applicability domain(AD)and passed external validation.Molecular docking results indi-cated that DBP,DnOP,DEHP and DHXP exhibited stronger binding affinities to HO-1.CONCLUSION Forty-eight hours of exposure of HepG2 cells to 1 mmol·L-1 PAEs can significantly suppress HO-1 expres-sions.The 3D-QSAR model established in this study provides a potential tool for predicting the HO-1-related toxic effects of novel PAEs.

Gut microbiota,implicated in obesity,insulin resistance,depression,and cardiovascular risk,can be modulated by probiotics to mitigate cardiovascular disease risk.Vascular calcification(VC),a regulated process involving mineral deposits in vessels and valves,is a significant risk factor.Diet profoundly impacts both gut micro-biota and VC,influencing cardiovascular health via microbial metabolites.While the link between gut microbiota and VC is established,the precise dietary effects on vascular health remain unclear.This article reviews mecha-nisms through which dietary patterns shape gut microbiota and metabolites,influence VC and highlights directions for future research on VC diagnosis and treatment.

Coronary heart disease(CHD)is one of the most prevalent cardiovascular diseases in China,with a continuously growing patient population,presenting numerous challenges for personalized and precise treatment.Artificial intelligence(AI),leveraging its advantages in processing and analyzing medical data,integrates clinical information,imaging examinations,and various omics analyses to provide clinicians with accurate diag-nostic and treatment recommendations.AI plays a crucial role in risk prediction,diagnostic optimization,and the development of personalized treatment strategies.This article explores the applications of AI in the diagnosis and treatment of CHD,analyzing its contributions and challenges in risk prediction,diagnostic optimization,and treatment decision-making,while also envisioning its future developmental in the field of cardiovascular medicine.

OBJECTIVE To study the mechanism of action of herb pair of Angelica sinensis-Poria cocos in intervening in allergic rhinitis. METHODS The core targets of herb pair of A. sinensis-P. cocos in intervening in allergic rhinitis were predicted through network pharmacology. Allergic rhinitis model of rats was established by intraperitoneal injection of aluminum hydroxide and ovalbumin mixture， and the rats were randomly divided into model group， loratadine group （positive control group， 0.9 mg/kg）， and low-， medium-， high-dose groups of herb pair of A. sinensis-P. cocos （3， 6 and 12 g/kg）， with 10 rats in each group. Another 10 healthy rats were used as the normal group. Each group of rats was intragastrically administered the corresponding liquid or normal saline once a day for 30 consecutive days. After the last administration， the behavioral scores of each group of rats were calculated， the levels of immunoglobulin E （IgE）， histamine， interleukin-4 （IL-4） in serum， and the protein expression levels of IL-6， tumor necrosis factor-α （TNF-α）， and prostaglandin-endoperoxide synthase 2 （PTGS2） in nasal mucosa tissue were detected. The pathological morphology changes of nasal mucosa tissue were observed. RESULTS Network pharmacology analysis revealed that IL-6， TNF and PTGS2 might play a key role in the intervention of allergic rhinitis by herb pair of A. sinensis-P. cocos， and the IL-17 and TNF signaling pathways might be the typical inflammatory signaling pathways intervened by herb pair of A. sinensis-P. cocos in allergic rhinitis. The results of animal experiments showed that compared with the model group， the behavioral score， the levels of IgE， histamine and IL-4， and the protein expressions of IL-6， TNF-α and PTGS2 in each administration group were decreased significantly （P＜0.05）， and there was a dose-dependent relationship with the herb pair of A. sinensis-P. cocos （P＜ 0.05）. CONCLUSIONS The herb pair of A. sinensis-P. cocos can effectively alleviate the symptoms of rats with allergic rhinitis， the mechanism of which may be related to the inhibition of the expressions of IL-6， TNF-α and PTGS2.

The nursing experience was summarised over a patient who developed an impending myasthenic crisis following immune checkpoint inhibitors(ICIs)therapy after the surgery for stage-Ⅳ liver cancer.Key nursing points included:close monitoring for early signs of impending myasthenic crisis;set up a multi-disciplinary team to improve respiratory,oropharyngeal and ocular function,control respiratory infection,provide psychological support in order to prevent the patient from developing a manifest myasthenia-gravis crisis(MC);combine with medications to relieve myasthenic symptoms and prevent adverse drug reactions;individualised rehabilitation training to promote recovery of muscular strength.Eventually,the patient did not develop into a MC during hospitalisation(20d)and was well at 3-month after discharge.

Objective To investigate the mechanism of mitochondrial autophagy regulating the expression of NLRP3 inflammasome in prostate tissue in experimental autoimmune prostatitis(EAP)rats and to provide a theoretical basis for the study of new drug development.Methods A numerical table of 40 SD male rats was randomly divided into 8 groups.Namely,normal group(N),model group(M),rapamycin group(RAP),rapamycin+mitochondrial autophagy inhibitor group(RAP+Mdivi-1),autophagy inhibitor group(3MA),mitochondrial autophagy inhibitor group(Mdivi-1),Caspase1 inhibitor group(Caspase1),NLRP3 inhibitor group(NLRP3),5 animals per group.After drug intervention,HE staining,immunofluorescence,colorimetry,and WB method were used to observe the relevant indexes.Results Compared with group N,the structural damage of prostate gland was obvious in group M.Compared with the M group,the prostate gland structure in RAP group,Caspase-1 group and NLRP3 group were improved.However,that in 3-MA group and Mdivi-1 group was not improved,and even destroyed more obvi-ously.Compared with group N,the co-expression of LC3-II and LAMP-1 was enhanced,mitochondrial membrane potential was decreased,ROS release level was significantly increased in prostate tissue of rats in group M.Com-pared with the M group,the above indexes in RAP group and NLRP3 group were significantly improved.However,the above indexes in 3-MA group and Mdivi-1 group became worse.Compared with group N,the protein expressions of DRP1,PINK1 and Parkin in prostate mitochondria of rats in group M were increased,and the protein expres-sions of OPA1 was decreased.Compared with group M,the protein expressions of DRP1,PINK1 and Parkin in RAP group and NLRP3 group were significantly increased,while those in 3-MA group and Mdivi-1 group were sig-nificantly decreased.OPA1 protein expression was significantly decreased in the RAP group.The protein expression of Parkin in Caspase-1 group was decreased,but the protein expression of DRP1,OPA1 and PINK1 had no significant difference.Compared with group N,the protein expressions of LC3II/LC3I,Beclin1,NLRP3,ASC,Cleaced-Caspase1,Cleaced-IL-1β,and IL-18 in prostate tissue of rats in group M were increased,while the protein expres-sions of P62 was decreased.Compared with M group,LC3II/LC3I and Beclin1 protein expressions in RAP group and NLRP3 group were significantly increased,while those in 3-MA group and Mdivi-1 group were significantly decreased.Compared with M group,P62,NLRP3,ASC,Cleaced-Caspase1,Cleaced-IL-1β and IL-18 protein expressions in RAP group and NLRP3 group were significantly decreased,while those in 3-MA group and Mdivi-1 group were significantly increased.Compared with M group,the protein expressions of NLRP3,ASC,Cleaced-Caspase1,Cleaced-IL-1β,and IL-18 in Caspase-1 group were significantly reduced,but the protein expressions of LC3Ⅱ/LC3Ⅰ,Beclin1,and P62 were not statistically significant.Conclusions NLRP3 inflammatosome is involved in the progression of chronic prostatitis in EAP rats.Mitochondrial autophagy mediates the occurrence and development of prostatitis in EAP by regulating the activation of NLRP3 inflammasome in prostate tissue.

Objective To study the spatial correlation characteristics of the number of large medical equipment alloca-tion in China's provinces and cities,with a view to providing a reference basis for the optimization of the allocation of large medical equipment.Methods It analyzed the spatial autocorrelation of China's large medical equipment alloca-tion and its influencing factors by using the Moran's I,grey correlation and other methods.Results The results of the spatial autocorrelation analysis showed that the allocation of large medical equipment in China was positively corre-lated spatially,and the spatial agglomeration was significant(Global Moran's I index value was 0.392,P＜0.05).The grey correlation of GDP,year-end resident population,geographic area,number of tertiary hospitals,number of beds in medical institutions,number of practicing(assistant)physicians,and annual discharges in each province and city were 0.913,0.919,0.745,0.883,0.907,0.929,0.880,respectively.Conclusion China's large-scale medi-cal equipment configuration of spatial autocorrelation properties,distributed in the eastern Beijing-Tianjin-Hebei,Yangtze River Delta region and some provinces and cities in the west of the large-scale medical equipment configura-tion level in the formation of high-value agglomeration and low-value agglomeration area respectively.At the same time,the equipment configuration has the characteristics of high-quality medical resources concentration,oriented to the needs of the masses,taking into account economic and social development,etc.It is recommended to fur-ther optimise the spatial structure of equipment allocation,incorporate the configuration of large-scale medical equip-ment into the consideration of regional health resource planning at all levels,and enhance the linkage of the equip-ment configuration planning between provinces and cities.

As a classical inflammatory response pathway,the nuclear factor-kappa B(NF-κB)signaling pathway plays a critical role in various physiological and pathological processes.Ferroptosis is a new form of non-apoptotic cell death,and recent studies have shown that there is a strong link between the NF-κB signaling pathway and ferroptosis,which affects the development and progression of liver diseases.Therefore,regulation of ferroptosis by targeting the NF-κB signaling pathway has a great potential in the treatment of liver diseases.This article discusses the influence of the NF-κB signaling pathway on the critical links such as lipid metabolism and iron metabolism during ferroptosis,as well as its mechanism of action in the positive and negative regulation of ferroptosis.Meanwhile,this article reviews the research advances in the role of this signaling pathway in liver diseases such as liver injury,nonalcoholic fatty liver disease,alcoholic liver disease,and hepatocellular carcinoma through the regulation of ferroptosis,so as to provide a reference for further understanding of the pathogenesis of liver diseases and the development of new therapeutic strategies.