Objective To preliminary explore the imaging manifestations of digital breast tomosynthesis (DBT) and contrast-enhanced mammography (CEM) in triple-negative breast cancer (TNBC) patients with different levels of human epidermal growth factor receptor 2 (HER2) expression. Methods A retrospective analysis was conducted on TNBC patients who underwent preoperative DBT or CEM examinations at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2019 and Shanghai Second People’s Hospital from January 2022 to May 2025. Clinical data, pathological and immunohistochemical results, and imaging data were collected. Results A total of 69 TNBC patients pathologically confirmed as invasive ductal carcinoma were included, among which 34 underwent DBT and 35 underwent CEM. Among these patients, 34 (49.28%) had HER2-low expression and 35 (50.72%) had HER2-zero expression. DBT results showed that the proportion of spiculation signs in HER2-low group (n＝14) was significantly higher than that in HER2-zero group (n＝20; P＝0.009, P_adj＝0.045). However, there were no significant differences in breast density type, mass shape, or calcification between the two groups. CEM results showed that on low-energy images, the proportion of spiculation signs in the HER2-low group (n＝20) was higher than that in the HER2-zero group (n＝15; P＝0.011, P_adj＝0.077). Results of CEM showed that on reconstructed images, differences in background parenchymal enhancement and mass enhancement patterns between the two groups were not statistically significant; in both groups, heterogeneous enhancement was the most common, followed by homogeneous enhancement, with ring enhancement being the least common. Conclusions TNBC with low HER2 expression and TNBC with zero HER2 expression may have potential differences in the presentation of spiculation signs on DBT. However, the correlation between CEM manifestations and TNBC with different HER2 expression levels requires further research.

Objective:To investigate the effects of Xuebijing injection on gut microbiota and intestinal mechanical barrier in mice with lipopolysaccharide (LPS)-induced sepsis, and analyze the potential mechanism by which Xuebijing injection protects gastrointestinal tract.Methods:Twenty-four healthy and clean grade male C57BL/6N mice were divided into four groups, control group, LPS group, LPS+ 5 μl/g Xuebijing injection group (5 μl/g Xuebijing injection group), and LPS+ 10 μl/g Xuebijing injection group (10 μl/g Xuebijing injection group), with six mice in each group. A mouse model of sepsis was established by intraperitoneal injection of mice with 10 μg/g LPS. At 0 and 12 h after successful modeling, the mice were intraperitoneally injected with 5 or 10 μl/g Xuebijing injection. Blood, ileum, and colon fecal samples were collected 12 h after the second administration. ELISA was used to detect the levels of diamine oxidase (DAO), D-blood lactic acid (D-Lac), TNF-α, and IL-6. HE staining was used to observe the local ileum damage, and Chiu′s score was used to evaluate the degree of intestinal tissue damage. Immunohistochemical staining and Western blot were used to detect the expression of Claudin-1, Occludin, and zona occludins-1(ZO-1) in ileum tissues, followed by semi quantitative analysis. One-way analysis of variance was used for intergroup comparisons, and LSD or Tamhane′s T2 test was used for pairwise comparisons based on the homogeneity of variance. The diversity and species composition of mouse fecal microbiota, and the differences among groups were analyzed using 16S rRNA sequencing.Results:The levels of DAO, D-Lac, TNF-α, and IL-6 in the LPS group were higher than those in the control group (all P<0.000 1). After the intervention with Xuebijing injection, the levels of DAO, D-Lac, TNF-α, and IL-6 decreased (all P<0.05) and showed no significant differences with those in the control group (all P>0.05). Besides, 10 μl/g Xuebijing injection was more effective than 5 μl/g Xuebijing injection in reducing the concentrations (all P<0.05). Chiu′s score was higher in the LPS group than in the control group and the 10 μl/g Xuebijing injection group (both P<0.05). Western blot showed that the expression levels of Occludin, Claudin-1, and ZO-1 in the LPS group were lower than those in the control group (all P<0.01), and Xuebijing injection intervention significantly increased the expression levels of these proteins in a dose-dependent manner as compared with the LPS group (all P<0.000 1). Apart from the expression level of ZO-1, which showed no significant difference between the two Xuebijing injection groups ( P>0.05), the results of immunohistochemical staining were consistent with those of Western blot. The 16S rRNA sequencing results showed that there were differences in the Alpha and Beta diversity indices, and the composition and structure of gut microbiota among the four groups. The structure of gut microbiota in the mice treated with Xuebijing injection was similar to that in the mice of the control group and it was in a dose-dependent manner. Wilcoxon rank sum test showed that there were statistically significant differences in six gut microbiota groups at the phylum level, and 32 gut microbiota groups at the genus level among the mice of four groups (all P<0.05). Conclusions:Xuebijing injection can provide protective effects on the gastrointestinal tract by protecting the structure of gut microbiota and intestinal barrier function, and the protective effect is somewhat correlated with the drug dosage.

Objective:To evaluate the efficacy of intraoperative sliding CT assisted deep brain stimulation of subthalaminal nucleus (STN-DBS) in short-term motor improvement and its influencing factors in patients with Parkinson's disease (PD) under general anesthesia.Methods:The cohort consisted of 48 PD patients accepted STN-DBS in Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from June 2021 to June 2023, including 21 patients accepted STN-DBS under general anesthesia and 27 patients accepted STN-DBS under local anesthesia. STN-DBS was performed in the CT operating room and intraoperative CT was used to confirm the electrode position. Regular program-controlled follow-up for over one year in Out-patient Clinic was applied after discharge. Operation time, complications, stimulus-related adverse events, unified Parkinson's disease rating scale (UPDRS)-Ⅲ score and UPDRS-Ⅲ improvement rate at medicine-off (Med-off) stage/DBS-on stage 1 year after operation, and UPDRS-Ⅲ score and UPDRS-Ⅲ improvement rate at medicine-on (Med-on) stage/DBS-on stage 1 year after operation, and levodopa equivalent daily dose (LEDD) and LEDD reduction were compared between the two groups. Spearman rank correlation analysis or Pearson correlation analysis were used to investigate the correlation between short-term motor improvement ([UPDRS-Ⅲ score at Med-off stage before operation-UPDRS-Ⅲ score at Med-off stage/DBS-on stage 1 year after operation]/UPDRS-Ⅲ score at Med-off stage before operation×100%) and clinical data in PD after STN-DBS under general anesthesia.Results:The operation time of general anesthesia group was (1.9±0.5) h, and that of local anesthesia group was (2.6±0.8) h, with significant difference ( P<0.05). During the 1-year follow-up, no significant difference in incidence of adverse reactions, UPDRS-Ⅲ score improvement rate at Med-on and Med-off stages, LEDD and LEDD reduction was noted between the two groups ( P>0.05). In the general anesthesia group, the short-term motor improvement after STN-DBS was negatively correlated with age or gender ( P>0.05), but positively correlated with maximum improvement rate of preoperative UPDRS-Ⅲ score ( r=0.840, P<0.001). Conclusion:For patients who cannot tolerate local anesthesia, DBS under general anesthesia is also safe and effective.

Objective:To analyze the trends of preterm birth among women of advanced maternal age in Haidian District, Beijing from 2013 to 2022.Methods:A retrospective analysis was conducted on the birth registration data in Haidian District, Beijing, from January 2013 to December 2022, focusing on the records of women aged ≥35 who delivered between 22 and 44 weeks of gestation. The Joinpoint regression model was used to analyze the time trends of preterm birth rates among women of advanced maternal age in the Haidian District. Interrupted time series (ITS) analysis was applied to quantitatively evaluate the transient and long-term effects of China's universal two-child policy on the preterm birth rate among women of advanced maternal age.Results:(1) A total of 70 640 birth registration records from 68 587 women were finally included. The number of women giving birth peaked between 2016 and 2018 (8 158, 9 906, and 8 914 cases, respectively). The proportion of permanent residents in Beijing gradually decreased from 53.7% (2 175/4 049) in 2013 to 42.0% (4 160/9 906) in 2017 and then increased to over 98% between 2019 and 2022 [98.8% (7 828/7 925), 99.1% (6 283/6 340), 99.3% (5 970/6 014), and 99.5% (6 371/6 404), respectively]. (2) Among the 68 587 women, 57 339 (83.6%) were delivered at tertiary hospitals, and 35 496 (51.8%) were delivered by cesarean section. The proportion of multiple births increased slowly from 2.4% (236/9 906) in 2017 to 3.5% (225/6 404) in 2022. From 2013 to 2015, primiparous women accounted for the majority. Subsequently, the proportion of multiparous women increased annually, reaching 71.6% (6 385/8 914) in 2018 before gradually decreasing to 56.2% (3 600/6 404) in 2022. (3) A total of 70 640 live births were delivered. The highest number of deliveries was in 2017, with 10 139 cases. From 2013 to 2022, 36 995 male infants and 33 645 female infants were born, with preterm birth rates of 10.6% (3 914/36 995) and 9.4% (3 123/33 645), respectively. (4) Among the 70 640 infants, there were 124 extremely preterm infants (0.2%), 773 very preterm infants (1.1%), and 6 140 late preterm infants (8.7%), accounting for 1.8%, 11.0%, and 87.3% of all preterm infants (7 037 cases), respectively. (5) The optimal fitting results of Joinpoint regression indicated that the preterm birth rate showed a declining trend from 2013 to 2017 ( APC=－4.4%, 95% CI: -13.0% to -0.2%); with 2017 as the turning point, the preterm birth rate exhibited an upward trend from 2017 to 2022 ( APC=4.5%, 95% CI: 1.6% to 13.0%). (6) The results of ITS analysis revealed that the preterm birth rate instantly decreased by 0.79% ( β2=－0.79, P=0.026) in the month when the universal two-child policy took effect. In comparison, it increased by an average of 0.03% per month ( β3=0.07, P=0.001) after the implementation of the policy. After adjusting for the proportion of multiple births, the preterm birth rate significantly decreased before the policy took effect ( β1=－0.06, P=0.003), but increased by an average of 0.01% per month ( β3=0.07, P<0.001) after the policy took effect. There was no statistical significance in the transient impact of the policy on the preterm birth rate in this district ( β2=0.80, P=0.145). Conclusions:From 2013 to 2022, the preterm birth rates among women of advanced maternal age in Haidian District exhibit a "V"-shaped pattern with the implementation of the two-child policy as the turning point. It is necessary to continue strengthening maternal health care for women of advanced maternal age and ensure the targeted provision of related services to address the issue of increased preterm birth rates following the enforcement of the two-child policy.

Objective:To investigate the effects of Xuebijing injection on gut microbiota and intestinal mechanical barrier in mice with lipopolysaccharide (LPS)-induced sepsis, and analyze the potential mechanism by which Xuebijing injection protects gastrointestinal tract.Methods:Twenty-four healthy and clean grade male C57BL/6N mice were divided into four groups, control group, LPS group, LPS+ 5 μl/g Xuebijing injection group (5 μl/g Xuebijing injection group), and LPS+ 10 μl/g Xuebijing injection group (10 μl/g Xuebijing injection group), with six mice in each group. A mouse model of sepsis was established by intraperitoneal injection of mice with 10 μg/g LPS. At 0 and 12 h after successful modeling, the mice were intraperitoneally injected with 5 or 10 μl/g Xuebijing injection. Blood, ileum, and colon fecal samples were collected 12 h after the second administration. ELISA was used to detect the levels of diamine oxidase (DAO), D-blood lactic acid (D-Lac), TNF-α, and IL-6. HE staining was used to observe the local ileum damage, and Chiu′s score was used to evaluate the degree of intestinal tissue damage. Immunohistochemical staining and Western blot were used to detect the expression of Claudin-1, Occludin, and zona occludins-1(ZO-1) in ileum tissues, followed by semi quantitative analysis. One-way analysis of variance was used for intergroup comparisons, and LSD or Tamhane′s T2 test was used for pairwise comparisons based on the homogeneity of variance. The diversity and species composition of mouse fecal microbiota, and the differences among groups were analyzed using 16S rRNA sequencing.Results:The levels of DAO, D-Lac, TNF-α, and IL-6 in the LPS group were higher than those in the control group (all P<0.000 1). After the intervention with Xuebijing injection, the levels of DAO, D-Lac, TNF-α, and IL-6 decreased (all P<0.05) and showed no significant differences with those in the control group (all P>0.05). Besides, 10 μl/g Xuebijing injection was more effective than 5 μl/g Xuebijing injection in reducing the concentrations (all P<0.05). Chiu′s score was higher in the LPS group than in the control group and the 10 μl/g Xuebijing injection group (both P<0.05). Western blot showed that the expression levels of Occludin, Claudin-1, and ZO-1 in the LPS group were lower than those in the control group (all P<0.01), and Xuebijing injection intervention significantly increased the expression levels of these proteins in a dose-dependent manner as compared with the LPS group (all P<0.000 1). Apart from the expression level of ZO-1, which showed no significant difference between the two Xuebijing injection groups ( P>0.05), the results of immunohistochemical staining were consistent with those of Western blot. The 16S rRNA sequencing results showed that there were differences in the Alpha and Beta diversity indices, and the composition and structure of gut microbiota among the four groups. The structure of gut microbiota in the mice treated with Xuebijing injection was similar to that in the mice of the control group and it was in a dose-dependent manner. Wilcoxon rank sum test showed that there were statistically significant differences in six gut microbiota groups at the phylum level, and 32 gut microbiota groups at the genus level among the mice of four groups (all P<0.05). Conclusions:Xuebijing injection can provide protective effects on the gastrointestinal tract by protecting the structure of gut microbiota and intestinal barrier function, and the protective effect is somewhat correlated with the drug dosage.

Objective:To evaluate the efficacy of intraoperative sliding CT assisted deep brain stimulation of subthalaminal nucleus (STN-DBS) in short-term motor improvement and its influencing factors in patients with Parkinson's disease (PD) under general anesthesia.Methods:The cohort consisted of 48 PD patients accepted STN-DBS in Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from June 2021 to June 2023, including 21 patients accepted STN-DBS under general anesthesia and 27 patients accepted STN-DBS under local anesthesia. STN-DBS was performed in the CT operating room and intraoperative CT was used to confirm the electrode position. Regular program-controlled follow-up for over one year in Out-patient Clinic was applied after discharge. Operation time, complications, stimulus-related adverse events, unified Parkinson's disease rating scale (UPDRS)-Ⅲ score and UPDRS-Ⅲ improvement rate at medicine-off (Med-off) stage/DBS-on stage 1 year after operation, and UPDRS-Ⅲ score and UPDRS-Ⅲ improvement rate at medicine-on (Med-on) stage/DBS-on stage 1 year after operation, and levodopa equivalent daily dose (LEDD) and LEDD reduction were compared between the two groups. Spearman rank correlation analysis or Pearson correlation analysis were used to investigate the correlation between short-term motor improvement ([UPDRS-Ⅲ score at Med-off stage before operation-UPDRS-Ⅲ score at Med-off stage/DBS-on stage 1 year after operation]/UPDRS-Ⅲ score at Med-off stage before operation×100%) and clinical data in PD after STN-DBS under general anesthesia.Results:The operation time of general anesthesia group was (1.9±0.5) h, and that of local anesthesia group was (2.6±0.8) h, with significant difference ( P<0.05). During the 1-year follow-up, no significant difference in incidence of adverse reactions, UPDRS-Ⅲ score improvement rate at Med-on and Med-off stages, LEDD and LEDD reduction was noted between the two groups ( P>0.05). In the general anesthesia group, the short-term motor improvement after STN-DBS was negatively correlated with age or gender ( P>0.05), but positively correlated with maximum improvement rate of preoperative UPDRS-Ⅲ score ( r=0.840, P<0.001). Conclusion:For patients who cannot tolerate local anesthesia, DBS under general anesthesia is also safe and effective.

Objective:To analyze the trends of preterm birth among women of advanced maternal age in Haidian District, Beijing from 2013 to 2022.Methods:A retrospective analysis was conducted on the birth registration data in Haidian District, Beijing, from January 2013 to December 2022, focusing on the records of women aged ≥35 who delivered between 22 and 44 weeks of gestation. The Joinpoint regression model was used to analyze the time trends of preterm birth rates among women of advanced maternal age in the Haidian District. Interrupted time series (ITS) analysis was applied to quantitatively evaluate the transient and long-term effects of China's universal two-child policy on the preterm birth rate among women of advanced maternal age.Results:(1) A total of 70 640 birth registration records from 68 587 women were finally included. The number of women giving birth peaked between 2016 and 2018 (8 158, 9 906, and 8 914 cases, respectively). The proportion of permanent residents in Beijing gradually decreased from 53.7% (2 175/4 049) in 2013 to 42.0% (4 160/9 906) in 2017 and then increased to over 98% between 2019 and 2022 [98.8% (7 828/7 925), 99.1% (6 283/6 340), 99.3% (5 970/6 014), and 99.5% (6 371/6 404), respectively]. (2) Among the 68 587 women, 57 339 (83.6%) were delivered at tertiary hospitals, and 35 496 (51.8%) were delivered by cesarean section. The proportion of multiple births increased slowly from 2.4% (236/9 906) in 2017 to 3.5% (225/6 404) in 2022. From 2013 to 2015, primiparous women accounted for the majority. Subsequently, the proportion of multiparous women increased annually, reaching 71.6% (6 385/8 914) in 2018 before gradually decreasing to 56.2% (3 600/6 404) in 2022. (3) A total of 70 640 live births were delivered. The highest number of deliveries was in 2017, with 10 139 cases. From 2013 to 2022, 36 995 male infants and 33 645 female infants were born, with preterm birth rates of 10.6% (3 914/36 995) and 9.4% (3 123/33 645), respectively. (4) Among the 70 640 infants, there were 124 extremely preterm infants (0.2%), 773 very preterm infants (1.1%), and 6 140 late preterm infants (8.7%), accounting for 1.8%, 11.0%, and 87.3% of all preterm infants (7 037 cases), respectively. (5) The optimal fitting results of Joinpoint regression indicated that the preterm birth rate showed a declining trend from 2013 to 2017 ( APC=－4.4%, 95% CI: -13.0% to -0.2%); with 2017 as the turning point, the preterm birth rate exhibited an upward trend from 2017 to 2022 ( APC=4.5%, 95% CI: 1.6% to 13.0%). (6) The results of ITS analysis revealed that the preterm birth rate instantly decreased by 0.79% ( β2=－0.79, P=0.026) in the month when the universal two-child policy took effect. In comparison, it increased by an average of 0.03% per month ( β3=0.07, P=0.001) after the implementation of the policy. After adjusting for the proportion of multiple births, the preterm birth rate significantly decreased before the policy took effect ( β1=－0.06, P=0.003), but increased by an average of 0.01% per month ( β3=0.07, P<0.001) after the policy took effect. There was no statistical significance in the transient impact of the policy on the preterm birth rate in this district ( β2=0.80, P=0.145). Conclusions:From 2013 to 2022, the preterm birth rates among women of advanced maternal age in Haidian District exhibit a "V"-shaped pattern with the implementation of the two-child policy as the turning point. It is necessary to continue strengthening maternal health care for women of advanced maternal age and ensure the targeted provision of related services to address the issue of increased preterm birth rates following the enforcement of the two-child policy.

Objective:To evaluate the clinical value of intraoperative sliding CT in deep brain stimulation (DBS) for Parkinson's disease (PD).Methods:A total of 117 PD patients accepted DBS in Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from May 2019 to May 2023 were chosen; 46 patients had local anesthesia and 71 had general anesthesia. Bilateral subthalamic nucleus (STN) DBS was performed in 73 patients, bilateral medial globus pallidus (GPi) DBS was performed in 43 patients, and right GPi and left STN DBS was performed in 1 patient. Preoperative/intraoperative sliding CT images and preoperative MRI images were fused to calculate the spatial distance between the preoperative planned target and actual target (adjusting electrode position timely in case of spatial distance greater than 2 mm [electrode displacement]). Differences of spatial distance between preoperative planned target and actual target in patients accepted different types of anesthesia and surgical modalities were compared.Results:All 117 patients were successfully operated and 234 electrodes were implanted. No patients needed a second operation for misalignment of electrodes or poor efficacy. During CT scan, neither anesthesia extubation or mechanical collision nor intracranial hemorrhage complications occurred. Spatial distance between the preoperative planned target and actual target was (1.35±0.50) mm in 117 patients. Displacement was noted in 4 electrodes and immediately adjusted during the operation; and CT re-examination confirmed good electrode position. No statistical significance in spatial distance between the preoperative planned target and actual target was noted between the general anesthesia group and local anesthesia group, and between the STN group and GPi group ( P>0.05). Conclusion:Intraoperative sliding CT is simple, safe and effective, which helps to timely adjust the electrode position during operation, avoids second operation and complications, and improves the safety and efficacy of DBS.

Objective To analyze the clinical outcomes of early invasive fungal disease(IFD)in patients after allogenetic hematopoietic stem cell transplantation(allo-HCST)with metagenomic next-generation sequencing(mNGS).Methods A retrospective analysis was conducted on patients undergoing allo-HCST in our Bone Marrow Transplantation Center between July 2021 and October 2022.These patients experienced one of the following conditions within 100 d after transplantation:① Patients with persistent fever and negative blood culture after empiric antimicrobial therapy for 72 h or longer;② Hyperpyrexia of unknown origin occurred again after effective anti-infection in the past;③ Symptoms in lower respiratory tract associated with lung lesions on CT scan,and empiric anti-infective therapy was ineffective.Peripheral blood or bronchoscopic alveolar lavage fluid were tested with mNGS,and overall survival(OS)and non-relapse mortality(NRM)were analyzed.Results There were 60 patients enrolled in this study.For the peripheral blood samples of 47 cases and bronchoalveolar lavage fluid samples of 13 cases,mNGS found that 19 cases were negative to pathogens,30 cases were non-fungal positive,and 11 case were fungal positive,including 3 cases of aspergillus,5 cases of mucor,2 cases of Candida tropicalis,and 1 case of Trichosporon asahii.Of the 11 patients with fungal positive,8 achieved complete remission after antifungal therapy according to the mNGS results.The 1-year OS and NRM of the 60 patients were 70.0％(95％CI:64.1％～75.9％)and 20.0％(95％CI:11.9％～32.5％),respectively,while those of the fungal infection patients were 54.5％(95％CI:49.5％～69.5％)and 36.4％(95％ CI:15.5％～70.3％),respectively.No significant differences were seen in 1-year OS(P=0.487)and 1-year NRM(P=0.358)among the negative,fungal infection and non-fungal infection patients,neither OS(P=0.238)and NRM(P=0.154)between the fungal infection and the non-fungal infection patients.Conclusion mNGS can rapidly diagnose the early IFD after allo-HSCT,which is helpful for timely and effective treatment and improves the prognosis of patients.

Objective: To explore the effects of 8week highintensity interval training on body shape and adipokines of obese male college students, so as to provide practical reference for weight loss of obese college students. Methods: A total of 30 male college students [age (20.10±0.55)years] with body mass index (BMI) ≥28 kg/m2 were recruited in March 2022 at China University of Petroleum (East China). The 8week highintensity interval training (HIIT) intervention was conducted from 11 April to 10 June 2022, 3 times a week (Monday, Wednesday, Friday), each time for 16:30-17:30. Body composition and adipokine levels were assessed before and after the intervention. All indicators were compared by pairedsamples ttests and single factor repeated measurement analysis of variance before and after intervention, and Pearson correlation analyses were used to test for associations between variables. Results: After 8 weeks of intervention, BMI, waist circumference and body fat of obese male college students decreased from (31.36±4.41)kg/m2, (107.52±9.66)cm and (28.04±5.79)kg to (30.40±4.37)kg/m2, (100.67±8.29)cm and (22.56±5.22)kg, respectively (t=3.84, 8.02, 9.29). Fatfree body mass index increased from (70.19±5.54)kg/m2 to (75.34±5.25)kg/m2 (t=-8.65) (P<0.01). There were statistically significant differences in the levels of Leptin, Adiponectin, and Irisin before intervention, at week 4 and at week 8 (F=26.05, 35.62, 4.95, P<0.05). There was no statistically significant difference in the content of reticulin (F=3.62, P>0.05). Conclusions The 8week of HIIT can effectively improve body shape of obese male college students and affect the effects of adipokines in the body. HIIT can be added to sports exercise to improve the health status of obese college students.