Objective To analyze the composition characteristics and biological functions of tumor cell subpopulations in glioblastoma(GBM)through multi-transcriptomics sequencing technology,and explore the hypoxia characteristics and spatial localization features of the mesenchymal-like(MES-like)tumor cell subpopulation in GBM and the influence on malignant biological behaviors.Methods Multi-transcriptomics sequencing data,including single-cell RNA sequencing(scRNA-seq)data(18 patients),bulk RNA sequencing(bulk RNA-seq)and spatial transcriptomics(ST)data of GBM,were employed to define cell subpopulations in GBM,and Gene Ontology(GO)and Gene Set Enrichment Analysis(GSEA)were utilized to analyze their functions.The proportions and locations of cell subpopulations in bulk RNA-seq data were evaluated with BayesPrism deconvolution.Immunofluorescence assay was conducted for verification on 12 paraffin samples of GBM from patients who visited the neurosurgical department of our hospital from 2015 to 2023 and met the pathological diagnostic criteria for GBM(10 males and 2 females,at an average age of 53.50 years and a median age of 54.50 years).pySCENIC was applied to predict specific transcription factors of tumor cell subpopulations.Results Tumor cells in GBM were highly heterogeneous,and could be mainly divided into 4 subpopulations:astrocyte-like(AC-like),neural progenitor-like(NPC-like),oligodendrocyte progenitor-like(OPC-like)and MES-like.Differential gene analysis found that the MES-like tumor cells highly expressed vascular endothelial growth factor A(VEGFA),adrenomedullin(ADM),N-myc downstream regulated 1(NDRG1),insulin like growth factor binding protein 5(IGFBP5),and A-kinase anchoring protein 12(AKAP12)(P<0.001).pySCENIC transcription factor prediction found that the high-active transcription factors of the MES-like tumor cells were AT-rich interaction domain 3A(ARID3A),FOS like 2,AP-1 transcription factor subunit(FOSL2),endothelial PAS domain protein 1(EPAS1),CCAAT enhancer binding protein delta(CEBPD),and CCAAT enhancer binding protein beta(CEBPB)(P<0.05).GO and GSEA enrichment analyses found that the MES-like tumor cells were enriched in hypoxia-related pathways,especially the pathway of cell responses to hypoxia levels(NES=2.437,P<0.001).BayesPrism deconvolution showed that the MES-like tumor cells mainly existed in PAN(Pseudopalisading cells around necrosis)and perinecrotic zone.Immunofluorescence assay confirmed CD44+(CD44 antigen)MES-like tumor cells were mainly located in hypoxia areas with highly expression of hypoxia inducible factor 1 subunit alpha(HIF1α)(P<0.01).Multivariate Cox regression analysis indicated that the MES-like tumor cells were significantly correlated with the adverse prognosis of GBM patients(HR=1.71,95%CI:1.38～2.11,P<0.001).Conclusion Tumor cells in GBM are of highly heterogeneity.They could be mainly divided into 4 subpopulations:AC-like,NPC-like,OPC-like and MES-like.MES-like tumor cells,mainly locating in PAN and perinecrotic zone,are characterized by hypoxia,which can promote the malignant progression of GBM.

Diffuse choroidal retinal atrophy (DCA) is a type of myopic macular disease that presents with yellowish-white atrophic changes at the posterior pole of the eyeball. DCA is an important critical feature in the diagnosis of pathological myopia. Early intervention and treatment of this disease are of great significance in delaying the progression of pathological myopia and reducing the impairment of visual function. Ophthalmic imaging data can be used to diagnose the disease, and color fundus photography is the most simple and intuitive. Choroidal thickness is also a key indicator in the diagnosis of DCA, but the diagnostic critical value of choroidal thickness has not been clearly defined. With the development and popularization of artificial intelligence technology, the analysis of lesion imaging data is more objective and accurate. In the future, it is expected to actively establish a standard quantitative evaluation system for DCA by means of artificial intelligence to achieve early detection, early diagnosis and early treatment of pathological myopia.

Objective: To investigate the factors related to urinary incontinence and pelvic organ prolapsedon the 42-day after delivery. Methods: A retrospective analysis was made on the data of 1 713 cases of pregnant women who received regular birth examination and delivered from June 2017 to September 2017 and whose medical records exsited on the 42-day after delivery. In this study, 1 402 patients were in vaginal delivery and 311 patients were in cesarean delivery. The occurrence of urinary incontinence and pelvic organ prolapsed and the general case characteristics of patients were analyzed. Results: The incidence rate of stress urinary incontinence in vaginal delivery group was significantly higher than that in cesarean delivery group: 11.20%(157/1 402) vs. 5.79%(18/311), P=0.004. The incidence rate of urgency urinary incontinence and pelvic organ prolapse in two groups had no significant differences (P > 0.05). The age, prepregnancy body mass index (BMI), the rate of vaginal delivery in urinary incontinence patients were significantly higher than those in without urinary incontinence patients: (32.8 ± 3.6) years vs. (30.4 ± 3.8) years, P=0.006; (25.6 ± 5.1) kg/m² vs. (23.5 ± 4.4) kg/m², P=0.001; 90.04%(217/241) vs. 80.50%(1 185/1 472), P=0.004. The age, pre pregnancy BMI in pelvic organ prolapsed patients were significantly higher than those in without pelvic organ prolapsed patients: (32.3 ± 3.7) years vs. (31.5 ± 4.8) years, P=0.033; (24.4 ± 4.2) kg/m² vs. (23.7 ± 3.4) kg/m², P=0.013. Conclusions Pelvic floor dysfunction is more prone to maternal postpartum who receives side cutting or forceps delivery recently, and these maternal postpartum educations should be strengthened to reduce the incidence of severe pelvic floor dysfunction.