Objective To analyze the effect of releasing the lower pulmonary ligament on right residual lung expansion after right upper lobe resection under different body mass index (BMI) levels. Methods The clinical data of patients who underwent thoracoscopic right upper lobe resection in the First Affiliated Hospital with Nanjing Medical University from 2021 to 2022 were retrospectively analyzed. Patients were divided into a group A (17 kg/m2＜BMI≤23 kg/m2), a group B (23 kg/m2＜BMI≤29 kg/m2) and a group C (BMI＞29 kg/m2) according to BMI. The presence of residual cavity was judged by chest X-ray at 7-10 days after operation, the degree of compensation change of the right main bronchus angle was measured, and the changes in lung volume were determined by CT three-dimensional reconstruction. Results A total of 157 patients who underwent thoracoscopic right upper lobe resection were included, including 71 males and 86 females, with an average age of (59.7±11.2) years. There were 50 patients in the group A, 75 patients in the group B, and 32 patients in the group C. In the group A, compared with those without releasing the lower pulmonary ligament, patients with releasing had a lower incidence of postoperative residual cavity (P=0.016), greater changes in bronchus angle (P<0.001), and smaller changes in lung volume (P<0.001). In the group B and C, there was no significant effect of releasing the lower pulmonary ligament on postoperative residual cavity, bronchus angle, and lung volume changes (P>0.05). Conclusion For patients with thin and long body shape and low BMI, releasing the lower pulmonary ligament is helpful to promote the expansion of the residual lung after right upper lobe resection and reduce the occurrence of postoperative residual cavity in patients.

Objective: To systematically evaluate the performance of machine learning (ML) models in predicting non suicidal self injury (NSSI) behavior among adolescents, providing an evidence based foundation for the development of clinically applicable risk assessment tools. Methods: A comprehensive search was conducted in PubMed, Embase, Web of Science, CNKI, and Wanfang databases for relevant studies from their inception to July 21, 2025. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to evaluate the methodological quality of the included studies. Stata 18 software was used to calculate the area under the receiver operating characteristic curve (AUC) of the models, and publication bias assessment, sensitivity analysis, and Egger s test were performed. Results: The total of 12 studies (42 prediction models) involving 58 070 adolescents were included. There were 15 machine learning algorithms in total, among which Random Forest, Logistic Regression, XGBoost, and Support Vector Machines were the most frequently utilized. The most common predictors were gender (female), family function, depression, emotion regulation, and age. All 12 included studies exhibited a high risk of bias. The pooled AUC was 0.80 (95% CI =0.78-0.82), although heterogeneity was substantial ( I 2=95.8%, P <0.01). Sensitivity analysis confirmed the robustness of these findings (no overlap in 95% CI ), while Egger s test indicated the presence of publication bias ( P <0.05). Conclusions Machine learning demonstrates potential in the risk prediction of adolescent NSSI, but existing models have a high risk of bias. Future research should focus on improving methodological quality and optimizing model reliability through rigorous external validation.

Objective:To investigate the miRNA-mRNA regulatory network in a rat model of Tourette syndrome(TS)using transcriptomic technology and to screen key signaling pathways and potential traditional Chinese medicine(TCM)candidates for intervention.Methods:A TS rat model was established using iminodipropionitrile(IDPN).RNA sequencing was performed to identify differentially expressed miRNAs and mRNAs in the brain tissues of TS rats.Bioinformatics analysis was applied to construct interaction networks,and network pharmacology was further employed to screen potential TCM compounds.Results:After 7 days of IDPN modeling,the model group exhibited motor and stereotypical behavioral changes,with behavioral scores greater than 3 points.Hema toxylin-eosin(HE)staining revealed irregular neuronal nuclear morphology,uneven chromatin distribution,nuclear pyknosis,and increased glial cell density.KEGG enrichment analysis identified key pathways:calcium signaling pathway,neuroactive ligand-receptor interaction,p53 signaling pathway,ECM-receptor interaction,and TGF-β signaling pathway.miR-125a-3p,miR-106-3p,and miR-760-3p were identified as pivotal miRNAs.Potential TCM candidates included Ajuga decumbens,Acanthopanax bark,Codonopsis pilosula,Stephania japonica,Os Draconis,Notopterygium root,Siraitia grosvenorii,Zanthoxylum nitidum root,Morinda officinalis,and Corydalis yanhusuo.Conclusion:The miRNAs miR-106-3p,miR-125a-3p,and miR-760-3p may mediate TS pathogenesis by altering critical signaling networks,including the calcium signaling pathway,neuroactive ligand-receptor interaction,and ECM-receptor interaction pathways,leading to neuroimmune inflammation and dopaminergic system dysregulation.TCM compounds such as Corydalis yanhusuo and Ajuga decumbens may exert therapeutic effects through multi-component synergistic regulation of these miRNAs and downstream pathways.

In recent years,the autologous platelet concentrates have increasingly been used in the field of periodontal tissue regenera-tion.To furnish insights that may aid in their clinical application,this article offers a comprehensive review of the evolution of autolo-gous platelet concentrates,encompassing their properties,mechanisms,and utilization in the periodontal regeneration of both soft and hard tissues.

This article focused on the revision and application of General Rule 0982 Determination of Particle Size and Size Distribution by Light Scattering Method in the Chinese Pharmacopoeia(2025 edition).By referencing domestic and international technical requirements and considering practical applications,the structure and content of this general rule were analyzed,and specific revisions were proposed.Key recommendations included adding sections on method validation and results reporting to the current general rule,incorporating the appendix content into the main text,and revising/supplementing the method name,introduction,instrument requirements,and determination procedures.The revised light scattering method would strengthen China's capacity for pharmaceutical quality control.

Objective To investigate the occurrence of liver function abnormalities in patients with follicular lymphoma(FL)treated with the G-CDOP regimen in the real world.Methods Using the hospital information system,a retrospective collection of clinical data was conducted on inpatients diagnosed with FL and treated with at least four courses of the G-CDOP regimen in the Department of Hematology,the First Affiliated Hospital of Soochow University from September 2021 to August 2023.The analysis focused on the incidence,severity,and types of liver function abnormalities,as well as the timing of these occurrences in relation to medication use and other relevant clinical characteristics.Results The study encompassed a total of 55 patients with FL,out of which 30 patients encountered liver function abnormalities during the G-CDOP regimen treatment,yielding an incidence rate of 54.5%.There were 23 cases(41.8%)of grade 1,3 cases(5.5%)of grade 2,and 4 cases(7.3%)of grade 3 liver function abnormalities.Among them,12 cases(21.8%)were hepatocellular injury type,while the cholestasis type was observed in 4 cases(7.3%),and the mixed type was found in 14 cases(25.5%).Liver function abnormalities appeared in 21 patients(38.2%)during the first cycle of the G-CDOP regimen treatment,5 patients(9.1%)in the second cycle,and 1 patient(1.8%),2 patients(3.6%),and 1 patient(1.8%)in the third,fourth,and fifth cycles.Conclusion The G-CDOP regimen has the potential to impact liver function indicators in FL patients,but most are mild and reversible.However,there are also cases of severe liver injury that need to attract clinical attention.

Objective:To study the effects of fluoride and aluminum exposure alone and in combination on pyroptosis and the NOD-like receptor protein 3 (NLRP3)/cysteinyl aspartate specific proteinase-1 (Caspase-1)/gasdermin D (GSDMD) signaling pathway in NG108-15 cells.Methods:Using a factorial design method, NG108-15 cells cultured in vitro were divided into control group [0 mg/L sodium fluoride (NaF) + 0 mg/L aluminium trichloride (AlCl 3)], fluoride group (40 mg/L NaF + 0 mg/L AlCl 3), aluminum group (0 mg/L NaF + 160 mg/L AlCl 3), and fluoride + aluminum group (40 mg/L NaF + 160 mg/L AlCl 3) according to the concentrations of NaF and AlCl 3. After 24 hours of cultivation, the cells were collected for subsequent experiments. The fluorescence intensity of pyroptosis index GSDMD in each group was detected by immunofluorescence method. The mRNA expression levels of NLRP3, apoptosis associated speck-like protein (ASC), Caspase-1, and GSDMD in each group were detected by real-time fluorescence quantitative PCR (qRT-PCR). The protein expression levels of NLRP3, ASC, Caspase-1, GSDMD, gasdermin D N-terminus (GSDMD-N) and interleukin-1β (IL-1β) in each group were detected by Western blotting. Results:The immunofluorescence results showed that compared with the control group (1.00 ± 0.02), the fluorescence intensity of GSDMD in the fluoride, aluminum, and fluoride + aluminum groups (1.49 ± 0.02, 1.22 ± 0.04, 1.25 ± 0.03) were higher ( P < 0.05). The results of qRT-PCR showed that compared with the control group (1.00 ± 0.02, 1.00 ± 0.01, 1.00 ± 0.08, 1.00 ± 0.06), the mRNA expression levels of NLRP3 (1.21 ± 0.06, 1.60 ± 0.07, 1.42 ± 0.02), ASC (2.61 ± 0.07, 1.53 ± 0.01, 2.12 ± 0.03), Caspase-1 (1.32 ± 0.05, 1.53 ± 0.04, 2.07 ± 0.05), and GSDMD (1.60 ± 0.03, 1.65 ± 0.04, 2.23 ± 0.05) were higher in the fluoride, aluminum, and fluoride + aluminum groups ( P < 0.05). Western blotting results showed that compared with the control group (1.00 ± 0.04, 1.00 ± 0.08, 1.00 ± 0.05, 1.00 ± 0.02, 1.00 ± 0.03, 1.00 ± 0.06), the protein expression levels of NLRP3 (1.55 ± 0.06, 1.40 ± 0.07, 1.24 ± 0.05), ASC (1.66 ± 0.05, 1.48 ± 0.06, 1.32 ± 0.06), Caspase-1 (1.51 ± 0.02, 1.40 ± 0.01, 1.28 ± 0.03), GSDMD (1.24 ± 0.03, 1.31 ± 0.06, 1.18 ± 0.03), GSDMD-N (1.18 ± 0.04, 1.27 ± 0.03, 1.27 ± 0.03), and IL-1β (1.81 ± 0.03, 1.70 ± 0.08, 1.52 ± 0.05) were higher in the fluoride, aluminum, and fluoride + aluminum groups ( P < 0.05). Conclusion:Exposure to fluoride and aluminum alone and in combination can induce pyroptosis in NG108-15 cells, and the mechanism may be related to up-regulation of molecules related to the NLRP3/Caspase-1/GSDMD signaling pathway.

Objective:Cognitive interviews were used to explore the target population's understanding and cognition of the Questionnaire about Gynaecological and Pelvic Pain Symptoms (ENDOPAIN-4D) in the Chinese context. The consistency of language expression and concept between the Chinese version ENDOPAIN-4D and the original scale was verified.Methods:Qualitative research methods were employed. Objective sampling method was used to select the patients with endometriosis/adenomyosis in the gynecological ward of Chinese Academy of Medical Sciences & Peking Union Medical College Hospital from October to December 2023 as the interview subjects. Two rounds of cognitive interviews were conducted, and the interview data were coded and analyzed using the Question Appraisal System. Based on the interview results and the recommendations of the expert group, the scale items were revised to form the Chinese version of ENDOPAIN-4D, and reliability and validity tests were conducted.Results:This study ultimately included 24 patients with endometriosis/adenomyosis, aged 24-47 years. The results of the first round of interviews showed that some interviewees had ambiguous understandings of the 16 items in the questionnaire, most of the item questions were concentrated in the category of "3 clarity, 4 hypotheses", and a small number of questions appeared in the category of "2 guidance, 5 knowledge/memory, 7 options", and were revised. The results of the second round of interviews showed that respondents could correctly understand the scale items. The Cronbach α coefficient of the total scale was 0.874, and the retest reliability was 0.952. The correlation coefficient of the Chinese version of the Global Pain Scale as the reference index of compatibility validity was 0.764 ( P<0.01), and the exploratory factor analysis extracted a total of 4 dimensions, with a cumulative variance contribution rate of 61.169%. The final formal questionnaire included 21 items in 4 dimensions including spontaneous pelvic pain, pain during sexual intercourse, intestinal pain and/or symptoms, and other symptoms. Conclusions:Cognitive interviews were used to identify cognitive biases in the target population during the completion of the scale and to address them appropriately, reducing the differences in the target population's understanding of the ENDOPAIN-4D scale and improving its scientific validity and reliability.

Objective To analyze the impact of the National Centralized Drug Procurement Policy(hereinafter referred to as the"centralized procurement policy")on the utilization of breast cancer treatment drugs in a specialized cancer hospital.Methods The defined daily dose(DDD)method was used to compare the daily drug cost(DDC),drug utilization frequency(DDDs),and affordability of letrozole,anastrozole,and capecitabine before and after the implementation of the centralized pro-curement policy in a tertiary specialized cancer hospital in Guangzhou.Results and Conclusion After the policy implementa-tion,the DDC of all three drugs decreased.The out-of-pocket DDC for the selected drugs remained stable or decreased,while the out-of-pocket DDC for both originator drugs and generic drugs increased,with a more pronounced increase for originator drugs.The proportion of DDDs for the selected drugs increased post-policy.The centralized procurement policy not only reduced the prices of selected drugs but also drove down the prices of generic and originator drugs.It is recommended to further expand the scope of centralized procurement for anticancer drugs and the types of cancers covered,as well as to establish a transitional mech-anism for medical insurance payment standards.

OBJECTIVE T o explore the prevention and control measures for the hospital-acquired pulmonary mu-cormycosis caused by Cunninghamella bertholletiae.METHODS One case of patient with pulmonary mucormyco-sis caused by Cunninghamella bertholletiae who was treated in pediatric intensive care unit(PICU)of a three-A general hospital was enrolled in the study,the process of clinical diagnosis and treatment was summarized.A ret-rospective survey regarding four aspects including people,machine,materials and environment was conducted.The related factors leading to the hospital-acquired infections in the patient were analyzed.RESULTS The child was diagnosed with severe aplastic anemia and underwent hematopoietic stem cell transplantation,the child was treated with various invasive procedures during the treatment period and was infected with pulmona-ry mucormycosis caused by the rare Cunninghamella bertholletiae.The occurrence of the pulmonary mucormyco-sis was associated with the poor management of medical textile,insufficient environmental cleaning and disinfec-tion and nonstandard invasive procedures.CONCLUSIONS The Cunninghamella bertholletiae infection is less com-mon,but the risk of death is high.It is necessary for the medical institutions to complete the prevention and con-trol measures and intensify the health care workers'capabilities in identification of the pathogenic fungus so as to reduce the incidence of pulmonary mucormycosis caused by the pathogen.