AIM:To evaluate the effects of liposo-mal bupivacaine for interscalene brachial plexus block on postoperative analgesia and diaphragmat-ic function in patients undergoing arthroscopic ro-tator cuff repair surgery based on a randomized controlled trial.METHODS:Forty patients who scheduled to undergo arthroscopic rotator cuff re-pair surgery,regardless of gender,aged 18 to 65 years,ASA grade Ⅰ or Ⅱ were selected from October 2023 to February 2024.The patients were random-ly divided into bupivacaine liposome group(group LB)and the levobupivacaine group(group BV),with 20 cases in each group.Patients in both groups re-ceived an ultrasound-guided interscalene brachial plexus block,15 mL mixed liquids(bupivacaine lipo-some 10 mL+0.5％levobupivacaine 10 mL)were in-jected into the level of C5-C6 nerve roots and 5 mL onto the surface of prevertebral fascia in the LB group,and same volume of 0.375％levobupiva-caine were injected at the same sites in the BV group respectively.Standardized general anesthe-sia and standardized postoperative analgesia were followed.The primary outcome measures included 48 h rest/motor numerical rating scale(NRS)scores after surgery and the incidence of hemidiaphrag-matic paralysis(HDP)after block.The secondary outcome measures included rest/motor NRS scores at other time points after surgery,pulse oxygen sat-uration(SpO2)30 min after block,duration of sen-sory and motor block,number of analgesic pump presses,time of first postoperative used of opioid drugs and opioid consumption,use of additional analgesics in the wards,satisfaction with analgesia,and the occurrence of perioperative adverse ef-fects and neurological complications.RESULTS:Compared with group BV,patients in LB group showed lower rest NRS scores at 48 h postopera-tion(P＜0.05)and higher incidence of HDP at 24 h after block(45％vs.5.3％,P＜0.05).However,there was no significant difference in motor NRS scores at 48 h,HDP incidence at 30 min and 6 h after block between the two groups(P＞0.05).Both groups showed a decrease in SpO2 after block com-pared to before block(P＜0.05).Compared with BV group,patients in LB group had a significantly lon-ger duration of sensory and motor block(P＜0.01),fewer effective presses with the analgesic pump(P＜0.01),delay in first opioid use and less opioid con-sumption(P＜0.05),higher level of satisfaction with analgesia(P＜0.01),and a lower rate of use of addi-tional analgesics in the ward(P＜0.05).There was no statistically significant difference in the total in-traoperative remifentanil consumption,incidence of perioperative adverse reactions and neurological complication between the two groups(P＞0.05).CONCLUSION:Compared with using levobupiva-caine alone,the addition of liposomal bupivacaine for interscalene brachial plexus block in arthroscop-ic rotator cuff repair can reduce postoperative NRS scores,decrease postoperative opioid dosage and significantly prolong blockduration,but can easily lead to longer duration of HDP in patients.

Objective:To analyze the effects of parental adverse childhood experiences on their offspring's prosocial behaviors,as well as to examine the moderating role of parental positive childhood experiences.Methods:A total of 3 090 parents of preschool children were selected to participate in this study.The Adverse Childhood Ex-periences International Questionnaire(ACE-IQ)and Benevolent Childhood Experiences Scale(BCEs)were used to examine parental adverse childhood experiences(i.e.,abuse,neglect,and dysfunctional households,etc)and posi-tive childhood experiences(i.e.,internal and external perceived safety,support,and positive personality traits,etc),Children Strength and Difficulties Question(SDQ)were performed to test offspring prosocial behaviors.Results:Parents'ACE-IQ scores were negatively correlated with offspring SDQ scores(r=-0.15)and parents'BCEs scores moderated(β=0.19)the relationship between parental ACE-IQ scores and offspring SDQ scores(β=-0.12).Conclusion:The study suggests that parental adverse childhood experiences are negatively associated with offspring pro-social behavior.Additionally,it indicates that an increase in positive childhood experiences can en-hance the relationships of parents'adverse childhood experiences.

Objective:To analyze the effects of parental adverse childhood experiences on their offspring's prosocial behaviors,as well as to examine the moderating role of parental positive childhood experiences.Methods:A total of 3 090 parents of preschool children were selected to participate in this study.The Adverse Childhood Ex-periences International Questionnaire(ACE-IQ)and Benevolent Childhood Experiences Scale(BCEs)were used to examine parental adverse childhood experiences(i.e.,abuse,neglect,and dysfunctional households,etc)and posi-tive childhood experiences(i.e.,internal and external perceived safety,support,and positive personality traits,etc),Children Strength and Difficulties Question(SDQ)were performed to test offspring prosocial behaviors.Results:Parents'ACE-IQ scores were negatively correlated with offspring SDQ scores(r=-0.15)and parents'BCEs scores moderated(β=0.19)the relationship between parental ACE-IQ scores and offspring SDQ scores(β=-0.12).Conclusion:The study suggests that parental adverse childhood experiences are negatively associated with offspring pro-social behavior.Additionally,it indicates that an increase in positive childhood experiences can en-hance the relationships of parents'adverse childhood experiences.

AIM:To evaluate the effects of liposo-mal bupivacaine for interscalene brachial plexus block on postoperative analgesia and diaphragmat-ic function in patients undergoing arthroscopic ro-tator cuff repair surgery based on a randomized controlled trial.METHODS:Forty patients who scheduled to undergo arthroscopic rotator cuff re-pair surgery,regardless of gender,aged 18 to 65 years,ASA grade Ⅰ or Ⅱ were selected from October 2023 to February 2024.The patients were random-ly divided into bupivacaine liposome group(group LB)and the levobupivacaine group(group BV),with 20 cases in each group.Patients in both groups re-ceived an ultrasound-guided interscalene brachial plexus block,15 mL mixed liquids(bupivacaine lipo-some 10 mL+0.5％levobupivacaine 10 mL)were in-jected into the level of C5-C6 nerve roots and 5 mL onto the surface of prevertebral fascia in the LB group,and same volume of 0.375％levobupiva-caine were injected at the same sites in the BV group respectively.Standardized general anesthe-sia and standardized postoperative analgesia were followed.The primary outcome measures included 48 h rest/motor numerical rating scale(NRS)scores after surgery and the incidence of hemidiaphrag-matic paralysis(HDP)after block.The secondary outcome measures included rest/motor NRS scores at other time points after surgery,pulse oxygen sat-uration(SpO2)30 min after block,duration of sen-sory and motor block,number of analgesic pump presses,time of first postoperative used of opioid drugs and opioid consumption,use of additional analgesics in the wards,satisfaction with analgesia,and the occurrence of perioperative adverse ef-fects and neurological complications.RESULTS:Compared with group BV,patients in LB group showed lower rest NRS scores at 48 h postopera-tion(P＜0.05)and higher incidence of HDP at 24 h after block(45％vs.5.3％,P＜0.05).However,there was no significant difference in motor NRS scores at 48 h,HDP incidence at 30 min and 6 h after block between the two groups(P＞0.05).Both groups showed a decrease in SpO2 after block com-pared to before block(P＜0.05).Compared with BV group,patients in LB group had a significantly lon-ger duration of sensory and motor block(P＜0.01),fewer effective presses with the analgesic pump(P＜0.01),delay in first opioid use and less opioid con-sumption(P＜0.05),higher level of satisfaction with analgesia(P＜0.01),and a lower rate of use of addi-tional analgesics in the ward(P＜0.05).There was no statistically significant difference in the total in-traoperative remifentanil consumption,incidence of perioperative adverse reactions and neurological complication between the two groups(P＞0.05).CONCLUSION:Compared with using levobupiva-caine alone,the addition of liposomal bupivacaine for interscalene brachial plexus block in arthroscop-ic rotator cuff repair can reduce postoperative NRS scores,decrease postoperative opioid dosage and significantly prolong blockduration,but can easily lead to longer duration of HDP in patients.

Objective:To explore the role of eosinophil associated ribonuclease A family member 2 (Ear2) in the pathogenesis of lupus and its possible mechanisms involved in renal damage by conditional knockout of myeloid cells in mice.Methods:An Ear2 myeloid conditional knockout mouse model was constructed using CRISP/Cas9 technology, and PCR was applied to identify mice genotype. The experiment was divided into 3 groups: CKO+R848 group, control+R848 group, and control group. R848 (Resiquimod) was used to treat the knockout mice and homozygous control mice to evaluate the occurrence of lupus-like features. Quantitative real-time PCR was performed to detect the expression of Toll-like receptor 7/8 (TLR7/8) and its related inflammatory factors in the kidneys of mice. Flow cytometry (FCM) was used to detect the proportion of patrolling monocytes in the kidneys, and immunofluorescence was used to analyze the spatial distribution of Ear2 and PMOs in renal tissues. In addition, R848 was used to stimulate myeloid cells of conditional knockout (CKO) and control mice in vitro, with changes in the proportion of PMOs detected by flow cytometry. Variance (ANOVA) was used to compare the differences between groups, t-test was used for two-by-two comparisons, and one-way analysis of ANOVA was used for comparisons between multiple groupscant. Results:PCR of myeloid conditioned knockout Ear2 mice showed a genotype of Lyz2 ki/wtEar2 fl/fl and significant down-regulation of Ear2 mRNA levels in bone marrow cells of the knockout mice [(1.03±0.26) vs. (0.22±0.15), t=6.65, P<0.001]. Compared with the control+R848 group, lupus related phenotype presentations of mice was improved and the survival rate tended to increase in the CKO+R848 group (6/10 vs. 7/8, χ2=1.51, P=0.220). The pathological results examination suggested that renal lesions of mice in the CKO+R848 group were also attenuated. The expression level of TLR7 was reduced in the renal tissues of CKO+R848 mice [(1.02±0.09) vs. (0.53±0.04), t=5.13, P=0.003], accompanied by a decrease in PMOs infiltration [(62.00±3.37)% vs. (52.36±0.68)%, t=2.80, P=0.023], and immunofluorescence results showed that Ear2 and PMOs were co-localized in renal tissues. In vitro, R848 stimulation caused an increase in the proportion of PMOs in the control group [(3.99±0.59)% vs. (33.48±1.38)%, t=-33.84, P<0.0001], yet had no effect on CKO mice [(14.33±1.72)% vs. (16.10±1.44)%, t=-1.37, P=0.220]. Conclusion:Conditional knockdown of Ear2 attenuates the development of lupus in mice, especially renal impairments, which is related to the inhibition of TLR7 pathway and reduction of local infiltration of PMOs.

Sick sinus syndrome(SSS)refers to damage to the sinoatrial node and its surrounding tissues,which leads to excitation and conduction dysfunction of the sinoatrial node,Resultsing in arrhythmia diseases.A better understanding of the pathogenesis of SSS is required to provide a basis for its treatment,including establishing an animal model that can simulate human sinus node dysfunction.In this paper,we review the animal selection,the principles and method of modeling,and the evaluation method and detection indicators of the models,to provide a basis for further studies of the pathogenesis of SSS.

【Objective】 To explore the clinical features, treatment and prognosis of paraganglioma of the urinary bladder (PUB). 【Methods】 The clinical data of 41 PUB patients treated at our hospital during Sep.2012 and Sep.2022 were collected. The clinical features, surgical records, pathological reports and follow-up records were retrospectively analyzed. Patients’ survival was estimated with Kaplan-Meier estimator. The differences among groups were compared with Log-rank test. 【Results】 Among the 41 patients, 20 were male and 21 were female, with a median age of 52 years. All patients were treated with surgery, including transurethral resection of bladder tumor (TURBT) in 16 cases, partial cystectomy (PC) in 23 cases, and radical cystectomy (RC) in 2 cases. All patients were followed up for 4.0 to 125.0 months, with a median of 59.0 months. Local recurrence occurred in 5 patients, and distant metastasis occurred in 5 patients. Survival analysis showed that the 5-year overall survival (OS) rate and 5-year relapse-free survival (RFS) rate were 95.7% and 84.8%, respectively. Further analysis showed statistically significant differences in OS and RFS among groups with different maximum tumor diameters, growth patterns, and Ki-67 expressions (P<0.05). For patients with a maximum tumor diameter ≤2.8 cm, there was no significant difference in OS and RFS among different surgical groups. 【Conclusion】 PUB is rare, and a definitive diagnosis is based on pathology. In addition, the main treatment is surgery and the prognosis is good.

With the rapid development of the Internet,e-health technology-based interventions provide high-quality supportive care to meet the care needs of family caregivers of cancer patients,thereby improving the physical and mental health of family caregivers.This article aims to summarize the concept of e-health technology,its current applications,intervention content,and effects among family caregivers of cancer patients.Additionally,it analyzes the shortcomings in the current stage of research and applications,with the goal of providing insights for promoting the utilization of e-health technology in the context of family caregivers of cancer patients.

Objective: To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD. Methods: The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. Results: A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005]. Conclusions The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.

Objective:To construct a prediction model for the prognosis of breast cancer patients with long non-coding RNA expression characteristics.Methods:To construct a long non-coding RNA(LncRNA) model for predicting the prognosis of breast cancer patients.Methods Analyzing LncRNA expression profiles and clinical characteristics of 1 081 breast cancer patients in the cancer genome atlas (TCGA) database.Performing differential expression analysis and univariate analysis on 112 paired breast cancer and normal breast tissues′ transcriptome sequencing data in the TCGA database, and screened for differentially expressed (DELncRNAs) that significantly correlated with the prognosis of BRCA (To reduce batch effects, sequencing data has been normalized using the DESeq function). One thousand eighty-one breast cancer patients were randomly divided into two groups: training set (541) and validation set (540). Performing Cox proportional hazard regression using DELncRNAs and establishing a multi-LncRNA prognosis model in the training set, followed by proportional hazards assumption test(PH assumption test). Patients were divided into high-risk and low-risk groups based on calculated risk score.Kaplan-Meier method was used for survival analysis, and 540 patients′ data were used for validation.To evaluate the prognostic value of the model in patients with squamous cell carcinoma of the lung and hepatocarcinoma in TCGA database.Gene Set Enrichment Analysis (GSEA) was used to analyze the specific mechanism of lncrna affecting the survival of patients.Results:There were 2815 differentially expressed genes screened by transcriptome sequencing, 91 of which were significantly related to the prognosis of breast cancer patients ( P<0.05). Based on the Cox regression analysis of 91 delncrna expression data from 541 breast cancer patients in training set, a Cox proportional risk regression model was constructed based on 5 LncRNA (training set AUC=0.746, validation set AUC=0.650): AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283, and PH assumption test( P=0.388). K-M survival analysis showed that the survival time of high-risk group was significantly worse than that of low-risk group (median survival time: 7.049 and 12.21 years, HR 0.367, 95% CI0.228-0.597, P<0.001), and the survival time of high-risk group was significantly shorter than that of low-risk group (median survival time: 7.57 and 10.85 years, HR 0.412, 95% CI0.214-0.793, P<0.001). Similar prediction results were also obtained in other cancer species of TCGA: lung squamous cell carcinoma ( HR 0.604, 95% CI0.383-0.951, P=0.007) and liver cell carcinoma ( HR 0.551, 95% CI0.307-0.987, P=0.011). GSEA results suggested that the expression patterns of the above five LncRNA were related to the cell cycle regulation of tumor cells. Conclusion:The prognostic model constructed based on expression profile of AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283 can be used to predict the prognosis of breast cancer patients, which is helpful to further guide clinical treatment.