Objective: To investigate factors influencing perioperative blood transfusion in patients with scarred uterus during pregnancy undergoing cesarean section, construct and validate a transfusion risk prediction model, and provide evidence for preoperative assessment and blood management. Methods: Clinical data of 405 patients undergoing cesarean section for scarred uterus during pregnancy at the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to December 2024 were retrospectively collected. The dataset was randomly divided into a training set (n=284) and a validation set (n=121) at a 7∶3 ratio. Within the training set, Firth-penalized logistic regression was employed for multivariate analysis to identify independent factors influencing perioperative blood transfusion and construct a predictive model. Model performance was evaluated in the validation set. Results: Multivariate Firth regression analysis showed that severe placenta previa (OR=75.566, 95%CI: 8.603-9979.174) and placenta accreta (OR=4.591, 95%CI: 1.120-19.416) were independent risk factors for perioperative blood transfusion, while preoperative red blood cell count (OR=0.189, 95%CI: 0.083-0.405) and fibrinogen levels (OR=0.588, 95%CI: 0.395-0.855) were protective factors. The predictive model constructed based on these four variables demonstrated good discriminatory performance, with areas under the receiver operating characteristic curves of 0.803 (95%CI: 0.740-0.867) and 0.753 (95%CI: 0.644-0.862) in the training and validation sets, respectively. Conclusion: For patients with scarred uterus during pregnancy undergoing cesarean section, severe placenta previa and placenta accreta significantly increase the risk of transfusion, while higher preoperative red blood cell count and fibrinogen levels exert a protective effect. The predictive model established in this study facilitates the identification of patients requiring transfusion, thereby enabling preoperative blood preparation and optimized blood management.

Hepatocellular carcinoma (HCC) imposes a major health and economic burden worldwide, with disproportionate effects in low- and middle-income countries (LMICs). Surveillance in high-risk populations, typically using semiannual ultrasound and alpha-fetoprotein testing, has been shown to be cost-effective by enabling earlier detection and improving survival. Yet, its overall value is reduced by poor adherence and the limited sensitivity of ultrasound, particularly in patients with metabolic-associated steatotic liver disease. Emerging approaches—including abbreviated magnetic resonance imaging, multi-biomarker models (e.g., gender, age, AFP, AFP-L3, and DCP), and liquid biopsy assays such as methylated DNA markers—demonstrate greater diagnostic accuracy and potential economic advantages compared with conventional methods. Integration of artificial intelligence into imaging may further enhance efficiency and reduce downstream costs. Moving toward precision surveillance, guided by individualized risk stratification that incorporates etiology, fibrosis stage, and molecular profiles, can optimize allocation of resources and maximize cost-effectiveness at the population level. Interventions to improve adherence, including mailed outreach and behavioral economic incentives, have shown both clinical benefit and cost savings, underscoring the role of implementation science. Because socioeconomic disparities influence both access and outcomes, economic models must explicitly address equity to achieve sustainable impact. Future research should prioritize prospective trials that evaluate not only clinical performance but also the real-world cost-effectiveness of novel technologies and stratified surveillance strategies. For LMICs, adapting proven models into affordable, context-appropriate programs is essential. By combining prevention, precision risk assessment, innovative technologies, and equitable implementation, HCC surveillance can deliver both clinical and economic value, reducing the global burden of disease.

Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine (TCM) compound in treating pulmonary nodules, providing evidence-based medical evidence for TCM intervention in pulmonary nodules. Methods Computer search of PubMed, CNKI, Wanfang, VIP, and SinoMed was conducted to select randomized controlled trials (RCTs) of TCM compound intervention in pulmonary nodules, with the retrieval time from the inception to November 29, 2023. The Cochrane bias risk assessment tool was used to evaluate the quality of the included studies, and Review Manager 5.4 was used for Meta-analysis. Results A total of 18 RCTs were included, covering 8 provinces across the country, with a total sample size of 1301 patients. The TCM compounds used in the included studies all incorporated the method of dissolving phlegm and dissipating nodules. There was a high risk of bias uncertainty in the included studies. Meta-analysis results suggested that TCM compound could significantly reduce the diameter of pulmonary nodules [MD=−1.41, 95%CI (−1.70, −1.13), P<0.001], decrease the number of nodules [MD=−0.37, 95%CI (−0.73, −0.01), P=0.05], alleviate clinical symptoms [MD=−4.84, 95%CI (−6.04, −3.64), P<0.001], and improve lung function [forced expiratory volume in one second (FEV1), MD=0.55, 95%CI (0.09, 1.01), P=0.02; FEV1/forced vital capacity, MD=6.12, 95%CI (4.47, 7.78), P<0.001]. However, there was no statistically significant difference in the probability of malignancy between the experimental group and the control group [MD=−0.01, 95%CI (−0.01, 0.00), P=0.09]. Conclusion TCM compound can significantly reduce the diameter of pulmonary nodules, decrease the number of nodules, alleviate clinical symptoms, and improve lung function, but future multicenter, large-sample, high-quality RCTs are still needed to further explore and verify this conclusion.

Objective:To investigate the relationship between epicardial adipose tissue (EAT) and frequent premature ventricular contractions (PVC) based on no-contrast chest CT scanning and evaluate the predictive value of EAT for high PVC loading levels.Methods:A case-control study was conducted to collect patients with PVC from January 2021 to June 2023 in the First Affiliated Hospital of Xinjiang Medical University. The study subjects were divided into a PVC high-load group (≥20%) and a PVC low-load group (<20%) based on the level of PVC loading in the 24-hour Holter electrocardiography monitoring. The parameter characteristics of EAT were obtained from no-contrast chest CT images. Multivariate logistic regression model analysis was used to assess the factors associated with high PVC loading levels, and the receiver operating characteristic (ROC) curve was used to assess the predictive value of the model.Results:A total of 166 subjects were included in the study, including 50 in the PVC high-load group and 116 in the PVC low-load group. Compared with the PVC low-load group, EATV was significantly increased in the high-load group ( Z=4.83, P<0.001), and EATA was significantly lower in the high-load group than in the low-load group ( t=-3.95, P<0.001). However, there was no statistically significant difference for the comparison of EATD ( Z=-1.56, P=0.120). Multivariate logistic regression model analysis showed that high EATV and low EATA were factors of high PVC loading levels [EATV: OR=1.01 (95% CI: 1.00-1.02), EATA: OR=1.16 (95% CI: 1.02-1.32)]. The area under the ROC curve for predicting high PVC loading levels by EATV and EATA was 0.79 (95% CI: 0.71-0.86). Conclusion:EATV and EATA are factors of high PVC loading levels and have predictive value for high PVC loading levels.

Objective:Preparation of rapamycin nanoparticles inhibits abdominal aortic aneurysm (AAA)in mice.Methods:Aldehyde-modified pluronic F127 encapsulating rapamycin (RAPA) was used to prepare nanoparticles (AMPF@RAPA nanoparticles), which were then characterized and analyzed.Elastase from porcine pancreas was used to induce AAA in C57BL/6J wild-type mice. Rapamycin was administered via intraperitoneal injection, and AMPF@RAPA nanoparticles were administered via intravenous injection. Hematoxylin and eosin staining and elastica van gieson staining were used for histological evaluation of the AAA in mice.Results:Compared with the model group, RAPA intraperitoneal injection significantly reduced the abdominal aorta expansion ratio, with a relative reduction of 40.3% in the abdominal aorta diameter. The particle size of AMPF@RAPA nanoparticles was approximately 104 nm, with an encapsulation efficiency of (71.3±0.7)% and a drug loading of (18.4±0.2)%. Compared with the model group, AMPF@RAPA nanoparticles intravenous injection significantly reduced the abdominal aorta expansion ratio, with a relative reduction of 51% in the abdominal aorta diameter.Conclusion:The intravenous injection of AMPF@RAPA nanoparticles significantly inhibited the development of AAA in mice, demonstrating superior efficacy compared to the intraperitoneal injection of rapamycin.

The water-sediment interface is an important zone for the migration and transformation of chemical substances,but traditional sampling methods make in situ sampling challenging,thus it is difficult to capture information on environmental processes at the micro-scale.In this study,diffusive gradients in thin films(DGT)probe technique was used as in situ tool to detect 18 kinds of typical per-and polyfluoroalkyl substances(PFAS)in the water-sediment system,elucidating their vertical distribution characteristics and patterns.The results showed that different PFAS exhibited distinct variation patterns with depth in water and sediment.Short-chain PFAS exhibited greater mobility,while the migration of long-chain PFAS was restricted in sediment and pore water due to their strong hydrophobicity and adsorption capacity,resulting in relatively small concentration changes in the sediment column.The PFAS concentrations measured by DGT ranged from 11.2 μg/L to 1305 μg/L.For long-chain PFAS,the concentrations measured by DGT were higher than those obtained from direct measurement of water and pore water,while the opposite results were obtained for short-chain PFAS.The DGT results indicated that although long-chain PFAS exhibited strong adsorption to sediment particles,the adsorbed PFAS were still bioavailable.DGT probe technique,with its advantages of in situ sampling and high spatial resolution,provides deep insights into the complex environmental processes occurring at the microscale in the water-sediment systems.DGT offers important technical support and scientific evidence for assessing the adsorption-desorption behavior,bioavailability,and ecological risks of these emerging pollutants in aquatic environment.

Objective:To investigate the mechanism by which hydrogen alleviates myocardial ischemia/reperfusion injury (IRI) through ultrasound-targeted destruction of hydrogen-loaded phospholipid microbubbles in the ischemic myocardium of rats.Methods:A total of 45 rats were randomly divided into three groups: sham operation group, IRI group (model group), and hydrogen treatment group (experimental group), with 15 rats in each group. A rat model of myocardial IRI was established. Rats in the sham group received 0.2 ml of normal saline via the tail vein, those in the model group received 0.2 ml of phospholipid microbubbles without hydrogen, and those in the treatment group received 0.2 ml of hydrogen-loaded phospholipid microbubbles. After 24 hours, cardiac function was assessed by left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS). Serum levels of cardiac troponin I (cTnI), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA). Expression levels of Janus knase 2(JAK2), signal transducer and activator of transcription 3(STAT3), phosphorylated JAK2(p-JAK2), and phosphorylated STAT3(p-STAT3) proteins in myocardial tissue were detected by Western blot. Myocardial infarct size was evaluated by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and myocardial histopathological changes were observed by hematoxylin-eosin (HE) staining.Results:After 24 hours of reperfusion, LVEF [(54.26±2.92) % vs (45.77±27%)] and LVFS [(24.11±1.68) % vs (19.50±1.19%)] were significantly higher in the treatment group than in the model group (both P<0.001). ELISA results showed that levels of CK-MB [(13.58±2.07) μg/L vs (20.07±1.57) μg/L], LDH [(47.76±8.32) μg/L vs (74.39±10.19) μg/L], cTnI [(7.50±0.26) μg/L vs (9.05±0.34) μg/L], and IL-6 [(121.34±8.97) ng/L vs (156.99±6.46) ng/L] were significantly lower in the treatment group compared with the model group (all P<0.001). TTC staining revealed a smaller infarct size in the treatment group [(48.77±2.68)%] than in the model group [(63.53±3.10)%, P<0.001]. Western blot analysis showed that the expression levels of JAK2 and p-STAT3 proteins were significantly lower in the treatment group than in the model group ( P<0.05). HE staining showed no pathological abnormalities in major organs (heart, liver, spleen, lung, and kidney) following hydrogen microbubble treatment. Conclusions:Ultrasound-targeted destruction of hydrogen microbubbles enables local hydrogen release in the myocardium, which downregulates IL-6 and inhibits activation of the JAK/STAT signaling pathway, thereby attenuating inflammation and reducing ischemia/reperfusion injury.

Objective To investigate the effects of goal-directed fluid therapy(GDFT)combined with ultrasound-guided erector spinae plane block(ESPB)on perioperative stress response and postoperative recovery in patients undergoing robot-assisted pedicle screw fixation surgery.Methods Eighty patients scheduled for elec-tive surgery were randomly divided into two groups:control(general anesthesia+conventional fluid management,n=40)and intervention(general anesthesia+GDFT+ESPB,n=40).Heart rate(HR),mean arterial pressure(MAP),serum cortisol(Cor),norepinephrine(NE),blood glucose(GLU)levels,and resting VAS scores were measured and compared between the two groups preoperatively(T?),at screw placement(T?),at end of surgery(T?),30 minutes after extubation(T?),at 24 hours(T?),and 48 hours(T?)postoperatively.Intraoperative fluid volume,remifentanil consumption,postoperative rescue analgesia frequency,time to first ambulation,length of stay,and complications(agitation,nausea and vomiting,respiratory depression)were recorded.Results There were no differences in baseline(T?)indicators between the two groups(P>0.05).The intervention group exhibited significantly lower levels of HR,MAP,Cor,NE,and GLU at T?,T?,and T? compared with the control group(P<0.05),with Cor,NE,and GLU reduced by>30%at T?(P<0.05).Intraoperative fluid volume and remi-fentanil dosage were significantly reduced(both P<0.05).VAS scores and the number of rescue analgesia requests were lower at T?,T?,and T?(P<0.01).Time to first ambulation time and postoperative hospital stay were shortened(both P<0.01).The incidence of agitation,nausea/vomiting and overall complications was lower in the interven-tion group(P<0.05),whereas respiratory depression rates did not differ(P>0.05).Conclusion GDFT plus ESPB can effectively suppress perioperative stress response in robot-assisted spinal surgery,significantly reduce intraoperative opioid dosage and fluid volume,optimize postoperative analgesia,enhance recovery,and lower complication risk.This combination provides an effective ERAS strategy for improving surgical safety and recovery quality.