Objective:To evaluate the safety and efficacy of radiofrequency ablation（RFA）in the treatment of papillary thyroid microcarcinoma（PTMC）near and remote from the thyroid capsule.Methods:The clinical data，ultrasound images，ablation parameters and postoperative follow-up metrics were prospectively collected from 130 patients with pathologically confirmed PTMC in the Second Affiliated Hospital of Xi'an Jiaotong University who underwent RFA treatment between January 2023 and December 2024. According to whether the nodule margin was ≤ 2 mm from the thyroid capsule，the patients were divided into the subcapsular group（60 cases）and the remote from the capsule group（70 cases）. The clinical data，ablation parameters，complication rate，absorption of ablation lesions，tumor recurrence and metastasis were compared between the two groups.Results:The success rates of RFA in both groups were 100%. There was a statistically significant difference between the two groups at baseline in the location of nodules（ χ2=13.266， P=0.001）. After 12 months of routine follow-up，the incidence of complications was 5.00%（3/60）in the subcapsular group and 1.43%（1/70）in the remote from the capsule group，all complications recovered within 1 month，with no statistically significant difference（ P=0.407）. There were no significant changes in thyroid function［including free triiodothyronine（FT3），free thyroxine（FT4）and thyroid-stimulating hormone（TSH）］before and one month after RFA in the two groups（all P>0.05）. A statistically significant difference in the volume reduction rate（VRR）between the two groups was observed only when maximum diameter ≤ 5?mm at the 1st and 3rd months（all P<0.05）. For the remaining postoperative follow-up periods，there were no statistically significant differences in ablation zone volume or VRR between the two groups（all P>0.05）. At the final follow-up，for lesions with maximum diameter ≤ 5?mm，the tumor disappearance rate was 100% in both the subcapsular and remote from the capsule groups. For lesions with maximum diameter >5 mm，the rates were 78.4%（29/37）and 89.7%（26/29）in the respective groups，with no statistically significant difference between the two groups（ χ2 = 1.489， P =0.222）.There was no local tumor progression，lymph node metastasis or distant metastasis in either group. Conclusions:RFA is a safe and effective treatment for subcapsular PTMC，demonstrating comparable efficacy to that for PTMC located remote from the thyroid capsule.

ObjectiveTo investigate the effect of Danggui Shaoyaosan on ferroptosis in the rat model of non-alcoholic fatty liver disease （NAFLD） and explore the underlying mechanism based on the nuclear factor E₂-related factor 2 （Nrf2）/solute carrier family 7 member 11 （SLC7A11）/glutathione peroxidase 4 （GPX4） signaling pathway. MethodsThe sixty SD rats were randomly grouped as follows： control， model， Yishanfu （0.144 g·kg^-1）， and low-， medium-， and high-dose （2.44， 4.88， and 9.76 g·kg^-1， respectively） Danggui Shaoyaosan. A high-fat diet was used to establish the rat model of NAFLD. After 12 weeks of modeling， rats were treated with corresponding agents for 4 weeks. Then， the body weight and liver weight were measured， and the liver index was calculated. At the same time， serum and liver samples were collected. The levels or activities of total cholesterol （TC）， triglycerides （TG）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and Fe²⁺ in the serum and TC， TG， free fatty acids （FFA）， malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione peroxidase （GPX）， and Fe²⁺ in the liver were measured. Hematoxylin-eosin staining and oil red O staining were employed to observe the pathological changes in the liver. Immunofluorescence was used to assess the reactive oxygen species （ROS） content in the liver. Mitochondrial morphology was observed by transmission electron microscopy. The protein levels of Nrf2， SLC7A11， GPX4， transferrin receptor 1 （TFR1）， and divalent metal transporter 1 （DMT1） in the liver were determined by Western blot. ResultsCompared with the control group， the model group showed increases in the body weight， liver weight， liver index， levels or activities of TC， TG， ALT， AST， and Fe²⁺ in the serum， levels of TC， TG， FFA， MDA， Fe²⁺， and ROS in the liver， and protein levels of TFR1 and DMT1 in the liver （P<0.01）， and decreases in the activities of SOD， GPX and the protein levels of Nrf2， SLC7A11， and GPX4 in the liver （P<0.05， P<0.01）. Meanwhile， the liver tissue in the model group presented steatosis， iron deposition， mitochondrial shrinkage， and blurred or swollen mitochondrial cristae. Compared with the model group， all doses of Danggui Shaoyaosan reduced the body weight， liver weight， liver index， levels or activities of TC， TG， ALT， AST， and Fe²⁺ in the serum， levels of TC， TG， FFA， MDA， Fe²⁺， and ROS in the liver， and protein levels of TFR1 and DMT1 in the liver （P<0.01）， while increasing the activities of SOD and GPX and the protein levels of Nrf2， SLC7A11， and GPX4 in the liver （P<0.01）. Furthermore， Danggui Shaoyaosan alleviated steatosis， iron deposition， and mitochondrial damage in the liver. ConclusionDanggui Shaoyaosan may inhibit lipid peroxidation and ferroptosis by activating the Nrf2/SLC7A11/GPX4 signaling pathway to treat NAFLD.

Objective:To discuss the infection status and clinical outcomes in the patients with bullous pemphigoid(BP),and to analyze the risk factors for infection in hospitalized BP patients,as well as to construct and evaluate the risk prediction model.Methods:A total of 126 patients first diagnosed with BP were selected.According to the occurrence of infection,the patients were divided into infection group(52 cases)and non-infection group(74 cases).The infection status and outcomes of the patients in two groups were recorded;statistical analysis was performed on the general data,laboratory examination results,FRAIL scale scores for frailty screening,NRS2002 scores,and skin lesion severity of the patients in two groups;multivariate Logistic regression model was used to identify the risk factors for infection in the patients;the goodness-of-fit test was used to evaluate the model;receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the model for infection.Results:Among the 126 hospitalized BP patients,52 cases had infection,with an infection rate of 41.27％.The mortality rate of the patients in infection group was higher than that in non-infection group(P＜0.05),and the remission rate of the patients in non-infection group was higher than that in infection group(P＜0.05).The FRAIL scale score for frailty screening,NRS2002 score,serum albumin level,prealbumin level,number of hospitalization,skin lesion severity,and time of hospital stay of the patients in infection group were significantly higher than those in non-infection group(P＜0.05).The multivariate Logistic regression analysis results derived the regression equation:Logistic(P)=-7.63+0.922× skin lesion severity+2.565×FRAIL scale score for frailty screening+1.214×NRS2002 score.The area under the curve of the Logistic regression model was 0.916.Conclusion:The FRAIL scale score for frailty screening,NRS2002 score,and skin lesion severity are the risk factors for infection in the hospitalized BP patients.The constructed infection risk prediction model based on these factors has good predictive value and may provide new ideas for the prevention and control of infection in the hospitalized BP patients.

Objective To explore the potential molecular mechanism of Maitong Jun'an decoction(MTJA)in the treatment of coronary heart disease based on network pharmacology,molecular docking and animal experiments.Methods The main active components and corresponding protein targets of MTJA were screened in Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and SwissTargetPrediction combined with literatures.Genes associated with myocardial infarction and heart failure in coronary heart disease were searched in DisGeNET,Genecards and Online Mendelian Inheritance in Man(OMIM)databases.The intersection of compound targets and disease targets was obtained,and"medicine-composition-target-disease"network was constructed.The overlapping targets were imported into STRING database to construct protein-protein interaction(PPI)network.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were performed on the targets,and molecular docking studies were further conducted on the core targets and active compounds.The rat model of myocardial infarction was established.The morphological and pathological changes of heart tissue were observed by hematoxylin-eosin staining,and the expression of core target protein was detected by Western blotting.Results There were 264 nodes and 1 193 interrelationships in the"medicine-composition-target-disease"network.Quercetin and kaempferol were the key components as ranked by degree value.The proteins with high degree in PPI network were interleukin(IL)-6,IL-1β and protein kinase B 1(Akt1).GO and KEGG analyses showed that the mechanism of MTJA in the treatment of coronary heart disease mainly involved lipids and atherosclerosis,advanced glycation end product(AGE)-receptor for advanced glycation end product(RAGE)signaling pathway in diabetes complications,fluid shear stress and atherosclerosis,IL-17 signaling pathway,etc.The results of molecular docking showed that the important compounds of MTJA had strong binding ability with the core target.The results of animal experiments showed that MTJA could significantly alleviate the myocardial injury in rats with myocardial infarction,and reduce the expression levels of IL-1β and IL-6 proteins in apical tissue of rats with coronary heart disease.Conclusion MTJA may play a role in the treatment of coronary heart disease by reducing the expression levels of IL-1β and IL-6 proteins.

Objective:To evaluate the safety and efficacy of radiofrequency ablation（RFA）in the treatment of papillary thyroid microcarcinoma（PTMC）near and remote from the thyroid capsule.Methods:The clinical data，ultrasound images，ablation parameters and postoperative follow-up metrics were prospectively collected from 130 patients with pathologically confirmed PTMC in the Second Affiliated Hospital of Xi'an Jiaotong University who underwent RFA treatment between January 2023 and December 2024. According to whether the nodule margin was ≤ 2 mm from the thyroid capsule，the patients were divided into the subcapsular group（60 cases）and the remote from the capsule group（70 cases）. The clinical data，ablation parameters，complication rate，absorption of ablation lesions，tumor recurrence and metastasis were compared between the two groups.Results:The success rates of RFA in both groups were 100%. There was a statistically significant difference between the two groups at baseline in the location of nodules（ χ2=13.266， P=0.001）. After 12 months of routine follow-up，the incidence of complications was 5.00%（3/60）in the subcapsular group and 1.43%（1/70）in the remote from the capsule group，all complications recovered within 1 month，with no statistically significant difference（ P=0.407）. There were no significant changes in thyroid function［including free triiodothyronine（FT3），free thyroxine（FT4）and thyroid-stimulating hormone（TSH）］before and one month after RFA in the two groups（all P>0.05）. A statistically significant difference in the volume reduction rate（VRR）between the two groups was observed only when maximum diameter ≤ 5?mm at the 1st and 3rd months（all P<0.05）. For the remaining postoperative follow-up periods，there were no statistically significant differences in ablation zone volume or VRR between the two groups（all P>0.05）. At the final follow-up，for lesions with maximum diameter ≤ 5?mm，the tumor disappearance rate was 100% in both the subcapsular and remote from the capsule groups. For lesions with maximum diameter >5 mm，the rates were 78.4%（29/37）and 89.7%（26/29）in the respective groups，with no statistically significant difference between the two groups（ χ2 = 1.489， P =0.222）.There was no local tumor progression，lymph node metastasis or distant metastasis in either group. Conclusions:RFA is a safe and effective treatment for subcapsular PTMC，demonstrating comparable efficacy to that for PTMC located remote from the thyroid capsule.

Comprehensive improvement in course teaching quality is an important link in deepening the reform of undergraduate education and teaching. Since 2018, West China Medical School, Sichuan University, has implemented the collective lesson preparation system of "two meetings, seven decisions, and three preparation sessions" for undergraduate clinical courses, thereby effectively implementing subject cooperation, organizational guidance, and resource integration among clinical teachers and determining the key elements of the course through "teaching, learning, and exam preparations" before class. In the process of course operation, the concept of quality control based on plan-do-check-act cycle is deeply integrated with the collective lesson preparation system, and active implementation of the whole-process quality control loop of planning (plan), organization and implementation (do), inspection of results (check), and treatment and improvement (action) has effectively improved the teaching quality of undergraduate clinical courses.

Regional odontodysplasia(ROD)is a localized developmental anomaly involving deciduous and perma-nent dentition,with a significant impact on patients.The affected teeth display unique ghost-like radiological characteris-tics,clinically manifesting as delayed tooth eruption,abnormal tooth morphology,and recurrent swelling of gingiva.In this paper,we report a case of a 2-year-old patient with ROD whose chief complaint was facial cellulitis.We analyze the medical history,clinical examination,radiographic findings,and histologic findings,and review the pathological fea-tures,pathogenesis,multidisciplinary diagnosis,and treatment of ROD.This rare case,which offers clinical samples for its further study,can provide a deeper study of ROD.

OBJECTIVE To explore the effects and mechanisms of cycloartenol on myocardial ischemia-reperfusion injury in mice.METHODS In vitro experiments,primary cardiomyocytes were extracted from 1-3 days SD mice.The hypoxia/reoxygenation model was established by incubating cells in a hypoxic culture box for 3 hours followed by reoxygenation in a normal culture box for 3 hours.The primary cardiomyocytes were divided into Control group,H/R group,low-dose(3 μmol·L-1)and high-dose(10 μmol·L-1)cycloartenol groups,and SB203580 group.CCK-8 was used to detect cell viability,the apoptosis rate was detected by flow cytometry,and Western blot was used to detect the expression levels of p38 MAPK and p-p38 MAPK in each group.In an in vi-vo experiment,7-week-old male C57BL/6J mice were randomly divided into a Control group,an I/R group,and three doses of cyclo-artenol(0.2,0.5,1.0 mg·kg-1)groups.The mice were continuously administered for seven days before the surgery.The model was prepared by ligation of the left anterior descending coronary artery(LAD)for 30 minutes,followed by reperfusion for 24 hours to in-duce myocardial ischemia-reperfusion injury.Left ventricular ejection fraction(LVEF),cardiac output(CO),left ventricular fractional shortening(LVFS)of each group of mice were detected by small animal ultrasound.TTC staining was used to detect the changes of is-chemic infarct size in each group.The changes of myocardial tissue in each group were observed by HE staining.The expression levels of p38 MAPK,p-p38 MAPK,IL-6 and TNF-α in myocardial tissue of mice were detected by Western blot.Serum levels of creatine ki-nase isoenzyme(CK-MB),lactate dehydrogenase(LDH),cardiac troponin I(cTnI),interleukin-6(IL-6),and tumor necrosis fac-tor-α(TNF-α)were measured using ELISA kits.RESULTS In vitro experiments demonstrated that compared with the H/R group,both the cycloartenol and SB203580 pretreatment groups showed a significant increase in myocardial cell viability and the apoptosis rate decrease,which can downregulate the protein expression level of p-p38 MAPK and decrease the ratio of p-p38 MAPK/p38 MAPK(P<0.05).In vivo experiments confirmed that compared with the I/R group,cycloartenol pretreatment significantly improved LVEF,LVFS,and CO values(P<0.05),reduce myocardial ischemic infarct size,thereby enhancing myocardial function.The protein ex-pression level of p-p38 MAPK in myocardial tissue was down-regulated,the ratio of p-p38 MAPK/p38 MAPK was decreased,and the expression levels of IL-6 and TNF-α were decreased.Additionally,cycloartenol pretreatment reduced the levels of CK-MB,LDH,cT-nI,IL-6,and TNF-α in mouse serum(P<0.05).CONCLUSION Pre-treatment with cycloartenol can protect mouse cardiac func-tion and alleviate myocardial ischemia-reperfusion injury.Its mechanism of action may be related to the inhibition of p38 MAPK phos-phorylation,reducing inflammatory reactions.

Objective·To investigate the effects of sennoside A(SA)on the formation of atherosclerotic plaque and the expression of 5-hydroxytryptamine(5-HT)and its receptor in mice with diabetes mellitus type 2(T2DM).Methods·Twelve mice with knocked-out apolipoprotein E gene were randomly divided into two groups,namely the model group and the model+SA group,with six mice in each group.Six C57BL/6J mice with the same genetic background were used as the control group.The control group was fed with normal diet,and the model group and the model+SA group were given intraperitoneal injection of streptozotocin(30 mg/kg)daily on the basis of high-fat diet to establish a model of T2DM.The model+SA group was given SA daily by gavage for 8 weeks,and the control group and the model group were given equal volume of distillation-distillation H2O by gavage.The body weight,fasting blood glucose(FBG)and 2-h postprandial blood glucose of mice were compared before and after modeling and treatment.The area of aortic plaque was observed by oil red O staining and hematoxylin-eosin(H-E)staining,and the level of 5-HT in serum and thoracic aorta was measured by ELISA kit.Western blotting was used to detect the expression of 5-hydroxytryptamine receptor 2B(HTR2B)and serotonin transporter(SERT)in thoracic aorta of mice.Results·Compared with the control group,the body weight,FBG and 2-h postprandial blood glucose in the model group increased,and glucose metabolism was disordered.The expression of HTR2B and SERT protein in thoracic aorta increased,while the concentration of 5-HT in thoracic aorta decreased.The serum 5-HT concentration increased(all P<0.05).After treatment with SA,compared with the model group,the body weight of the model+SA group decreased,and FBG and 2-h postprandial blood glucose were significantly improved.The area of aortic plaque and the expression of HTR2B and SERT protein in thoracic aorta significantly decreased,while the concentration of 5-HT increased.The serum 5-HT concentration decreased(all P<0.05).Conclusion·SA can reduce atherosclerotic plaque area in T2DM mice,which may be related to lowering blood glucose and inhibiting the expression of 5-HT and its receptor.

Objective:To investigate the chain mediation effect of psychological flexibility and dyadic coping between perceived social support and family function in parents of pediatric liver transplant recipients.Methods:Totally 320 parents of pediatric liver transplant recipients who were treated at the Department of Pediatric Organ Transplantation, Tianjin First Central Hospital from April to October 2023 were selected by convenience sampling. The participants were surveyed using a general information questionnaire, the Perceived Social Support Scale (PSSS), the Acceptance and Action Questionnaire-Ⅱ (AAQ-Ⅱ), the Dyadic Coping Inventory (DCI), and the Family APGAR Index (APGAR). Pearson correlation analysis was used to examine the relationships between perceived social support, psychological flexibility, dyadic coping, and family function in these parents. Structural equation modeling (SEM) was performed using Amos 26.0 to analyze the chain mediation effect of psychological flexibility and dyadic coping between perceived social support and family function, with the Bootstrap method used for model testing.Results:A total of 320 questionnaires were distributed, with 312 valid responses, yielding a response rate of 97.50% (312/320). The scores for the 312 parents were as follows: PSSS (59.29±15.64), AAQ-Ⅱ (20.35±9.07), DCI (124.64±32.65), and APGAR (6.98±2.74). Family function was positively correlated with perceived social support and dyadic coping ( P<0.01), and perceived social support was positively correlated with dyadic coping ( P<0.01). Psychological flexibility was negatively correlated with family function, perceived social support, and dyadic coping ( P<0.01). SEM results showed that psychological flexibility and dyadic coping had a significant chain mediation effect between perceived social support and family function, with a mediation effect value of 0.059. The chain mediation effect of psychological flexibility and dyadic coping accounted for 13.81% of the total effect (0.059/0.427) . Conclusions:Perceived social support directly affects family function in parents of pediatric liver transplant recipients and also indirectly influences family function through the chain mediation effect of psychological flexibility and dyadic coping.