OBJECTIVE To investigate the effects and mechanism of the Yishen paidu formula on renal fibrosis in rats with chronic renal failure （CRF） through the reactive oxygen species （ROS）/thioredoxin-interacting protein （TXNIP）/NOD-like receptor thermal protein domain associated protein 3 （NLRP3） pathway. METHODS Rats were randomly divided into control group， model group， Yishen paidu formula low-dose （Yishen paidu formula-L） group， Yishen paidu formula high-dose （Yishen paidu formula- H） group， Yishen paidu formula-H+pcDNA-NC group， and Yishen paidu formula-H+ pcDNA-TXNIP group， with 10 rats in each group. Except for control group， all other rats were fed a diet containing 0.5% adenine to establish a CRF model； the rats were then administered corresponding drugs or normal saline intragastrically or via tail vein， once daily， for 8 consecutive weeks. After the last administration， the levels of serum creatinine （Scr）， blood urea nitrogen （BUN）， ROS， superoxide dismutase （SOD）， malondialdehyde （MDA）， tumor necrosis factor-α （TNF-α）， interleukin （IL）-6， and IL-1β were measured in each group. Pathological changes in renal tissue were observed， and the protein expression levels of Collagen Ⅲ， α-smooth muscle actin （α-SMA）， transforming growth factor-β1 （TGF-β1）， TXNIP and NLRP3 in renal tissue were detected. RESULTS Compared with model group， the renal histopathological damage and fibrosis of rats in Yishen paidu formula-L group and Yishen paidu formula-H group were significantly alleviated. The levels of Scr， BUN， ROS， MDA， TNF- α， IL-6 and IL-1β， and the protein expressions of Collagen Ⅲ， α-SMA， TGF-β1， TXNIP and NLRP3 were significantly decreased， while SOD levels were significantly increased （P＜0.05）. Moreover， the changes were more pronounced in the Yishen paidu formula-H group （P＜0.05）. Compared with Yishen paidu formula-H+pcDNA-NC group， above indexes of rats in Yishen paidu formula-H+pcDNA-TXNIP group were reversed significantly （P＜0.05）. CONCLUSIONS Yishen paidu formula can inhibit renal fibrosis in CRF rats by suppressing the ROS/TXNIP/NLRP3 pathway.

Objective To explore the correlation between lymph node metastasis and clinicopathological features of lung adenocarcinoma with diameter≤3 cm. Methods The clinicopathologic data of the patients with lung adenocarcinoma≤3 cm in diameter were retrospectively analyzed. The relationship between lymph node metastasis and age, gender, smoking history, pathological subtype, tumor diameter, pleural invasion, vascular invasion and other factors was analyzed. The risk factors of lymph node metastasis were analyzed by univariate and multivariate logistic regression. Results Finally 1 718 patients were collected, including 697 males and 1 021 females with an average age of (58.89±9.85) years. The total lymph node metastasis rate was 12.9%, among whom 452 patients of adenocarcinoma in situ and minimally invasive adenocarcinoma did not have lymph node metastasis, and the lymph node metastasis rate of invasive lung adenocarcinoma was 17.5%. Multivariate analysis showed that tumor diameter, micropapillary subtype, solid subtype, micropapillary component, solid component, vascular invasion and pleural invasion were independent risk factors for lymph node metastasis of invasive lung adenocarcinoma with diameter≤3 cm (P<0.05). While age, lepidic subtype and lepidic component were independent protective factors for lymph node metastasis (P<0.05). Conclusion Clinicopathological features can help predict lymph node metastasis of lung adenocarcinoma with diameter≤3 cm.

ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract（PAE） against human-derived lung adenocarcinoma organoids（LUAD-PDOs） and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid（Nor-PDOs） models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8（CCK-8） assay. Experimental groups included the model group（LUAD-PDOs）， normal group， model administration group（LUAD-PDOs+PAE）， and normal administration group（Nor-PDOs+PAE）. Hematoxylin-eosin（HE） staining was used to observe the pathological structures of PDOs， immunohistochemistry（IHC） was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7（CK-7） and Napsin A， TUNEL staining was applied to detect cell apoptosis. RNA sequencing（RNA-Seq） was conducted to identify differentially expressed genes（DEGs）， followed by Gene Ontology（GO）， Kyoto Encyclopedia of Genes and Genomes（KEGG）， and Gene Set Enrichment Analysis（GSEA）， alongside protein-protein interaction（PPI） network analysis to screen core mechanisms. Finally， key targets were validated by integrating external database analysis with immunofluorescence（IF）. ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L^-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures， whereas LUAD-PDOs displayed dense， solid structures. CCK-8 and TUNEL assays revealed that， compared with the model group， PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells， while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention（347 up-regulated and 372 down-regulated）（P<0.05）. GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism， including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway（P<0.05）. PPI network analysis indicated that breast cancer type 1 susceptibility protein（BRCA1） and checkpoint kinase 1（CHEK1） were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention（P<0.05）. Furthermore， survival analysis based on The Cancer Genome Atlas（TCGA） database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD（P<0.05）. ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis， its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway， with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.

OBJECTIVE To explore the effect and potential mechanism of 717 Jiedu decoction in ameliorating local tissue injury induced by Gloydius brevicaudus venom via regulating macrophage phenotype transformation.METHODS Rat blank-serum and drug-containing serum were prepared by intragastric administration of normal saline， tail-vein injection of anti- G. brevicaudus venom serum （0.6 mL per rat）， and intragastric administration of 717 Jiedu decoction at doses of 0.495， 0.99 and 1.98 g/kg （calculated as crude drug）. M0-type macrophages derived from human leukemia monocytic THP-1 cells induced and differentiated by PMA were divided into normal control group， model group， positive control group， and low-， medium- and high-concentration 717 Jiedu decoction drug-containing serum groups. Except for the normal control group， all other groups were treated with 10 μg/mL G. brevicaudus venom working solution and 10% blank or drug-containing serum. After the cultivation period， the cellular ultrastructural changes in each group were observed； the proportions of M1- and M2-type macrophages， as well as the mRNA and protein expression of macrophage phenotype transformation and hypoxia-inducible factor-1α （HIF-1α） were detected.RESULTS Compared with the normal control group， cells in the model group presented ultrastructural injuries including mitochondrial swelling， cristae rupture and cytoplasmic vacuolization. The proportion of M1-type macrophages and the mRNA and protein expression levels of related phenotype transformation markers [inducible nitric oxide synthase， tumor necrosis factor-α， interleukin-6 （IL-6）， IL-1β] and HIF-1α were significantly increased （ P ＜0.05），whereas the proportion of M2-type macrophages and the mRNA and protein expression levels of related phenotype transformation markers （arginase-1， IL-10， mannose receptor C type 1 and chitinase-3-like protein 1） were significantly decreased （ P ＜0.05）. Compared with the model group， cellular ultrastructural injuries were obviously alleviated， and the above-mentioned indexes were significantly reversed in the high-concentration 717 Jiedu decoction drug-containing serum group （ P ＜0.05）.CONCLUSIONS717 Jiedu decoction can exert anti-inflammatory and tissue-repairing effects by regulating the balance of M1-， M2-type macrophages phenotype transformation and repairing cellular ultrastructural damage. Its mechanism may be related to inhibiting the excessive activation of the HIF-1α pathway.

Objective To investigate the influencing factors of pain during ultrasound-guided puncture sclerotherapy in the treatment of ovarian chocolate cyst(OEC).Methods A retrospective cohort study was conducted on 209 OEC patients undergoing ultrasound-guided puncture sclerotherapy in our department from September 2021 to September 2023.Demographic data,medical history and surgical information were collected.According to surgical approach,they were divided into transabdominal surgery group(n=57)and transvaginal surgery group(n=152).Pain scores were assessed at 5 surgical time points:needle insertion,irrigation,displacement,sclerosis,and needle withdrawal.Pain scores were compared between the 2 groups at each surgical moment.According to the pain scores at the moments of needle insertion and replacement,the patients were divided into the no/mild pain group(pain score ≤ 3)and the moderate/severe pain group(pain score ≥4),and the related factors of the incidence of moderate/severe pain were analyzed.Results There was no statistical difference in intraoperative pain between different surgical approaches(transabdominal/transvaginal)in treating OEC under the guidance of ultrasound.At the moment of needle insertion,significantly higher incidence of moderate/severe pain was observed in the patients with a body mass index(BMI)＞23.9 kg/m2 than those with BMI ≤23.9 kg/m2,and those with a history of dysmenorrhea than those without(P＜0.05).At the time point of displacement,BMI and history of dysmenorrhea had no correlation with the incidence of moderate/severe pain.Age,obstetric history,mode of delivery,time of menarche,menstrual volume,history of pelvic surgery,history of combined adenomyosis,size of cysts,duration of surgery,and surgical approach had no notable impacts on intraoperative pain.Conclusion Different surgical approaches for ultrasound-guided puncture sclerotherapy of OEC have no effect on pain levels at various surgical moments.From the aspect of humanistic care,transabdominal puncture should be preferred.During needle insertion and displacement,particular attention should be given to the overweight patients and those with a history of dysmenorrhea,and appropriate pain intervention measures should be formulated.

Objective To compare the safety and efficacy of curettage and their combination with uterine artery embolization(UAE)in the treatment of cesarean scar pregnancy(CSP)patients with a low score(≤4)in the ultrasound quantification scoring system.Methods Based on our inclusion and exclusion criteria of this randomized controlled study,the women with CSP who had an ultrasonic quantitative score≤4 and were treated in our department from May 2020 to August 2023 were enrolled,and then randomly divided into a curettage group(n=48)and a UAE combination group(n=47)in a ratio of 1∶1.General information,intraoperative conditions,and use of rescue measures within 3 months after operation were collected in the 2 groups of patients.All the patients were followed up until October 2024 to observe the pregnancy outcomes and determine the impact on the menstrual volume after the resumption of normal menstruation.Results The patients from the both groups completed the follow-up.Except for the maximum gestational sac diameter,there were no significant differences in other baseline data between the 2 groups,and the curettage group had notably more patients having a gestational sac diameter≤25 mm than the combination group[37(77.1%)vs 27(57.4%),P<0.05].No statistical differences were observed between the 2 groups in the intraoperative bleeding volume and use of rescue measures within 3 months after surgery.The combination group had obviously more patients with reduced menstrual volume after the resumption of normal menstruation than the dilation and curettage group[30(63.8%)vs 13(27.1%),P<0.001].There were no statistically differences in pregnancy outcomes and the number of days to resume menstruation between the 2 groups.Conclusion For CSP patients with a score of≤4 in the ultrasound quantification scoring system,curettage show no significant difference in therapeutic effectiveness,and even have better efficacy and safety when compared with curettage combined with UAE.

Objective To develop a prediction model for placenta previa in early pregnancy by analyzing embryo implantation sites and related clinical factors,in order to provide an objective basis for early risk identification.Methods A retrospective cohort study was conducted on 232 singleton pregnant women delivering in our hospital between September 2020 and March 2024.According to the final pre-delivery ultrasound findings,they were divided into placenta previa group(n=78)and a non-placenta previa group(n=154).Their ultrasound parameters[distance from lower gestational sac margin to cervical os,implantation site(lower/middle-upper uterine segment),and implantation position(anterior/posterior wall)],and clinical data[age,gravidity(categorized as<2 or≥2 pregnancies),parity(<2 or≥2 deliveries),and history of intrauterine procedures were collected through electronic medical records.Univariate analysis was used to screen potential predictors(P<0.1),and multivariate logistic regression analysis was employed to identify the predictors(P<0.05)for placenta previa.Then a nomogram prediction model was constructed,which was internally validated with Bootstrap(1 000 bootstrap resamples)and assessed for discrimination with area under the receiver operating characteristic curve(AUC)and for calibration with Hosmer-Lemeshow goodness-of-fit test.Results The placenta previa group showed significantly advanced age(≥35 years),lower education level(≤high school),multigravidity(≥2 pregnancies),multiparity(≥2 deliveries),more intrauterine procedures,distance of gestational sac-to-cervical os<5.5 mm,and larger proportion of lower uterine segment implantation than the non-placenta previa group(all P<0.1).But there were no statistical differences between the 2 groups in proportion of posterior wall implantation,history of cesarean section or assisted reproductive technology(ART).Multivariate logistic regression analysis confirmed lower uterine segment implantation(OR=40.40,95%CI:14.68～136.19,P<0.001),posterior wall implantation(OR=2.73,95%CI:1.27～6.28,P=0.013),and intrauterine procedures(OR=3.48,95%CI:1.65～7.70,P=0.001)as independent risk factors.The model based on these predictors demonstrated excellent discrimination(AUC value=0.84,95%CI:0.79～0.90)and calibration(Hosmer-Lemeshow test Chi-square=3.455,P=0.750).Conclusion Lower uterine segment/posterior wall implantation and intrauterine procedures are independent risk factors for placenta previa.Our nomogram model based on these factors shows good predictive efficiency,and can provide reference for early recognition of pregnant woman with high-risk placenta previa.

Objective: To understand the current situation and related factors of screening myopia among students in special education schools, so as to provide evidence for promoting the health level of this population. Methods: From November 2021 to December 2023, a total of 281 students from 6 special education schools in 5 districts of Tianjin were selected by cluster random sampling method for computer optometry visual acuity examination for non ciliary paralysis and questionnaire survey. Multiple Logistic regression was performed to analyze the influencing factors of screening myopia among special education students. Results: The screening myopia detection rate among these special education students in Tianjin was 27.0%, and the screening myopia detection rates of students with autism, developmental delays, and intellectual disabilities were 22.4%, 12.5%, and 33.0%, respectively. The degree of myopia increased with age ( χ 2 trend =22.65, P <0.01). Multivariate Logistic regression analysis showed that age(10-13 years old: OR =5.40, 14-17 years old: OR =8.40, 18-23 years old: OR =6.02), accommodation(non resident: OR =0.29), daily mobile phone usage ≥2 hours ( OR =2.37), and daily computer/tablet usage ≥2 hours ( OR =2.70) were the risk factors for screening myopia among special education students ( P <0.05). Conclusions The detection rate and degree of screening myopia increase with age in special education students. Prolonged screen time exposure is a primary risk factor for screening myopia in special education students. Effective myopia prevention and control strategies should be designed according to the characteristics of special education students.

Objective:To explore effect of Yishen Paidu Formula on inflammatory response in chronic renal failure(CRF)rats and role of Calcineurin/nuclear factor of activated T cell(NFAT).Methods:CRF rat model was constructed,and randomly grouped into model group,low,medium and high doses Yishen Paidu Formula groups,with 10 rats in each group,another 10 rats were fed normally as a blank group;general situation of rats was recorded;urine protein quantification kit was applied to detect 24-hour urine protein level of CRF rats in each group;serum creatinine and urea nitrogen levels of CRF rats were detected;ELISA was applied to detect serum IL-1β,IL-6 and TNF-α levels in CRF rats;pathological changes of renal tissue were observed by HE staining;Western blot was applied to detect expressions of fibroblast growth factor 23(FGF23),Klotho protein,Calcineurin,NFAT protein in renal tissue of CRF rats in each group.Results:Compared with blank group,levels of creatinine,urea nitrogen in serum,24 h urine protein in urine,IL-1β,IL-6,TNF-α in serum,and protein levels of FGF23,Calcineurin,NFAT in kidney tissue were obviously increased in model group,level of Klotho protein was obviously decreased(P<0.05).Compared with model group,levels of creatinine,urea nitrogen in serum,24 h urine protein in urine,IL-1β,IL-6,TNF-α in serum,and protein levels of FGF23,Calcineurin,NFAT in kidney tissue were obviously decreased in low,medium and high doses Yishen Paidu Formula groups,level of Klotho protein was obviously increased,which were more significant with dosage increase(P<0.05).Conclusion:Yishen Paidu Formula may alleviate inflammatory response in CRF rats by inhibiting Calcineurin/NFAT signaling pathway.

Objective:To explore the expression regulation of lipid metabolism gene ABHD5 in testes.Methods:Differential gene analysis was performed by integrating databases of TCGA and GTEx to identify the target gene ABHD5.The expression trends of ABHD5 gene in testicular carcinoma tissue were analyzed.Human testis single-cell atlases were obtained from the Human Protein Atlas and Male Health Atlas databases to determine the expression distribution of ABHD5 across different testicular cell types.Additionally,the GTEx database was utilized to visualize the expression pattern of ABHD5 in the testis,thereby enhancing the understanding of its transcriptional profile.The relationship between ABHD5 expression and age was assessed through integrated database analysis.Western blotting and immunofluorescence were performed to detect differential expressions of ABHD5 in testicular tissues of young and aged mice respectively.Results:The TCGA database indicated that the expression of ABHD5 in human testicular carcinoma tissue was significantly lower than that in normal testicular tissue which showed a negative correlation with patient survival.ABHD5 was highly ex-pressed in germ cells of the testis reveaked from Human Protein Atlas and Male Health Atlas databases.The stability of ABHD5 protein was crucial for testicular tissue,and its expression decreased with age.Furthermore,Western blot and immunofluorescence staining demonstrated that ABHD5 expression in the testicular tissue of aged mice was significantly lower than that in young mice.Conclu-sion:ABHD5 plays an important role in testicular tissue,and may be inseparable from testicular tumors and reproductive aging.How-ever,its mechanism of action remains to be further studied.