Stem-leaf saponins from Panax notoginseng (SLSP) comprise numerous PPD-type saponins with diverse pharmacological properties; however, their role in Parkinson's disease (PD), characterized by microglia-mediated neuroinflammation, remains unclear. This study evaluated the effects of SLSP on suppressing microglia-driven neuroinflammation in experimental PD models, including the 1-methyl-4-phenylpyridinium (MPTP)-induced mouse model and lipopolysaccharide (LPS)-stimulated BV-2 microglia. Our findings revealed that SLSP mitigated behavioral impairments and excessive microglial activation in models of PD, including MPTP-treated mice. Additionally, SLSP inhibited the upregulation of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX2) and attenuated the phosphorylation of PI3K, protein kinase B (AKT), nuclear factor-κB (NFκB), and inhibitor of NFκB protein α (IκBα) both in vivo and in vitro. Moreover, SLSP suppressed the production of inflammatory markers such as interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) in LPS-stimulated BV-2 cells. Notably, the P2Y2R agonist partially reversed the inhibitory effects of SLSP in LPS-treated BV-2 cells. These results suggest that SLSP inhibit microglia-mediated neuroinflammation in experimental PD models, likely through the P2Y2R/PI3K/AKT/NFκB signaling pathway. These novel findings indicate that SLSP may offer therapeutic potential for PD by attenuating microglia-mediated neuroinflammation.
Animals ; Panax notoginseng/chemistry* ; Saponins/pharmacology* ; Microglia/immunology* ; Mice ; NF-kappa B/immunology* ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/immunology* ; Phosphatidylinositol 3-Kinases/genetics* ; Male ; Parkinson Disease/immunology* ; Mice, Inbred C57BL ; Disease Models, Animal ; Plant Leaves/chemistry* ; Neuroinflammatory Diseases/drug therapy* ; Humans

Objective:To compare the clinical outcomes of immediate breast reconstruction using latissimus dorsi flap with implant versus mesh with implant based on BREAST-Q evaluation.Methods:From the clinical database of the First Affiliated Hospital of Nanjing Medical University, the patients who underwent immediate breast reconstruction after total mastectomy from January 2020 to December 2023 were selected as the research subjects. All breast reconstruction surgeries were performed by the same surgeon. Patients were divided into two groups according to surgical methods: the latissimus dorsi muscle flap combined with implant immediate breast reconstruction group (LD group) and the mesh combined with implant immediate breast reconstruction group (mesh group). Patients were followed up in outpatient clinics or by telephone one year after surgery. The BREAST-Q was used to evaluate the surgical outcomes of both groups from four dimensions: psychosocial well-being, sexual well-being, chest-physical well-being, and breast satisfaction. The score range for each dimension was 0-100, with higher scores indicating greater patient satisfaction with quality of life and surgical outcomes. Statistical analysis was performed using SPSS 22.0 software. Normally distributed measurement data were expressed as Mean ± SD, and comparisons between the two groups were performed using independent sample t-test. Count data were expressed as number of cases and percentages, and comparisons between groups were performed using chi-square test or Fisher’s exact test. P<0.05 was considered statistically significant. Results:A total of 123 patients were included, with 59 patients in the LD group and 64 patients in the mesh group. In the LD group, the mean age was (37.7±7.0) years, body mass index (BMI) was (22.6±2.6) kg/m 2, and clinical tumor staging showed 2, 22, 30, and 5 cases for stages 0, Ⅰ, Ⅱ, and Ⅲ, respectively. In the mesh group, the mean age was (39.1±7.0) years, BMI was (22.6±2.8) kg/m 2, and clinical tumor staging showed 1, 25, 38, and 0 cases for stages 0, Ⅰ, Ⅱ, and Ⅲ, respectively. There were no statistically significant differences between the two groups in baseline characteristics including age, BMI, and clinical tumor staging (all P>0.05). One year after surgery, the BREAST-Q result showed no statistically significant differences between the LD group and mesh group in psychosocial well-being [(83.0±19.8) points vs. (80.8±19.3) points] and sexual well-being [(62.1±30.4) points vs. (65.8±25.6) points] (all P>0.05). However, the LD group had lower chest-physical well-being scores than the mesh group [(40.6±9.7) points vs. (45.1±9.6) points, P<0.05], while breast satisfaction scores were higher in the LD group than in the mesh group [(68.0±17.8) points vs. (59.8±12.6) points, P<0.01]. Conclusion:Immediate breast reconstruction by both latissimus dorsi flap with implant and mesh with implant can improve patients’ psychosocial and sexual well-being by enhancing breast appearance. However, LD technique provides better breast satisfaction, while the mesh technique offers advantages in physical well-being of the chest wall and upper body. Surgeons should select the most appropriate breast reconstruction technique based on patients’ anatomical conditions, treatment history, and individual needs to optimize postoperative quality of life and satisfaction.

Objective:To compare the clinical outcomes of immediate breast reconstruction using latissimus dorsi flap with implant versus mesh with implant based on BREAST-Q evaluation.Methods:From the clinical database of the First Affiliated Hospital of Nanjing Medical University, the patients who underwent immediate breast reconstruction after total mastectomy from January 2020 to December 2023 were selected as the research subjects. All breast reconstruction surgeries were performed by the same surgeon. Patients were divided into two groups according to surgical methods: the latissimus dorsi muscle flap combined with implant immediate breast reconstruction group (LD group) and the mesh combined with implant immediate breast reconstruction group (mesh group). Patients were followed up in outpatient clinics or by telephone one year after surgery. The BREAST-Q was used to evaluate the surgical outcomes of both groups from four dimensions: psychosocial well-being, sexual well-being, chest-physical well-being, and breast satisfaction. The score range for each dimension was 0-100, with higher scores indicating greater patient satisfaction with quality of life and surgical outcomes. Statistical analysis was performed using SPSS 22.0 software. Normally distributed measurement data were expressed as Mean ± SD, and comparisons between the two groups were performed using independent sample t-test. Count data were expressed as number of cases and percentages, and comparisons between groups were performed using chi-square test or Fisher’s exact test. P<0.05 was considered statistically significant. Results:A total of 123 patients were included, with 59 patients in the LD group and 64 patients in the mesh group. In the LD group, the mean age was (37.7±7.0) years, body mass index (BMI) was (22.6±2.6) kg/m 2, and clinical tumor staging showed 2, 22, 30, and 5 cases for stages 0, Ⅰ, Ⅱ, and Ⅲ, respectively. In the mesh group, the mean age was (39.1±7.0) years, BMI was (22.6±2.8) kg/m 2, and clinical tumor staging showed 1, 25, 38, and 0 cases for stages 0, Ⅰ, Ⅱ, and Ⅲ, respectively. There were no statistically significant differences between the two groups in baseline characteristics including age, BMI, and clinical tumor staging (all P>0.05). One year after surgery, the BREAST-Q result showed no statistically significant differences between the LD group and mesh group in psychosocial well-being [(83.0±19.8) points vs. (80.8±19.3) points] and sexual well-being [(62.1±30.4) points vs. (65.8±25.6) points] (all P>0.05). However, the LD group had lower chest-physical well-being scores than the mesh group [(40.6±9.7) points vs. (45.1±9.6) points, P<0.05], while breast satisfaction scores were higher in the LD group than in the mesh group [(68.0±17.8) points vs. (59.8±12.6) points, P<0.01]. Conclusion:Immediate breast reconstruction by both latissimus dorsi flap with implant and mesh with implant can improve patients’ psychosocial and sexual well-being by enhancing breast appearance. However, LD technique provides better breast satisfaction, while the mesh technique offers advantages in physical well-being of the chest wall and upper body. Surgeons should select the most appropriate breast reconstruction technique based on patients’ anatomical conditions, treatment history, and individual needs to optimize postoperative quality of life and satisfaction.

Objective To study the impact of a subject's testing state on residual noise level and ABR wave V amplitude during non-sedated ABR testing using Kalman-weighted averaging(KWA).Methods Twenty-one adults(18～34 years old,42 ears)with normal hearing were enrolled for non-sedated ABR testing under three different states(lying,sitting,and writing)in a quiet room using a new Kalman-weighted averaging ABR system(vivosonic integrity system).The residual noise level and the amplitude of wave V for click ABR(cABR)of each subject were recorded.The traditional ABR test system(interacoustics,IA)was also used to record ABR with the residual noise level and the amplitude of wave V measured at the same time.Results ① There was no significant difference in am-plitude of wave V between traditional ABR and non-sedated ABR in three different testing states(P＞0.05).②The residual noise levels in the lying and sitting states of KWA ABR were lower than those of traditional ABR,but there was no statistically difference(P＜0.05).The residual noise level of the KWA ABR system in writing state was significantly higher than that of the other three conditions(P＜0.05).③ There was no significant difference between the left and right ears in the residual noise level and amplitude of wave V for non-sedated ABR in writing state(P＞0.05).Conclusion Compared with traditional ABR,the non-sedated KWA ABR system in uriting state was significantly higher than that of the other three conolitions.Haw ever,the residual noise level in lying and sit-ting states had no significant difference with conditional ABR,and different states of the subject had impact on the residual noise level in the ABR testing to sone extent.

To provide comprehensive, scientific, and precise big data supports for national pediatric cancer prevention and control, the National Center for Pediatric Cancer Surveillance constructed the Surveillance Platform in 2019. Based on stratified and service-oriented design concepts, and a microservices architecture, the platform constructed five layers: document storage, data storage, service, application, and visualization. The platform supported three data reporting methods: automatic collection, file import, and manual entry. It ensured data quality through both rule-based and process-based quality control measures. Additionally, strict data security measures had been established in areas such as security domains, permission management, and data de-identification to ensure the safety and reliability of the monitoring data. As to November 2024, the platform had covered 1 750 surveillance sites(hospitals) and collected information about 6 million pediatric cancer cases, achieving positive results. This practice had laid a solid foundation for the smooth implementation of national pediatric cancer surveillance work and provided scientific evidences for pediatric cancer prevention and control in China. In the future, the platform′s performance needs to be continuously optimized and upgraded. It should further integrate relevant datasets in this field and actively explore and expand new application scenarios with the help of cutting-edge technologies such as big language models.

The enterprise master patient index is an important tool for identifying the diagnosis and treatment records of the same patient in heterogeneous medical data from multiple sources. From June to December 2021, the National Children′s Cancer Monitoring Center screened and determined the enterprise master patient index index system and its recognition logic by literature analysis and expert consultation. Based on the National Children′s Cancer surveillance Platform (hereinafter referred to as the surveillance platform), a corresponding intelligent recognition algorithm system was developed. After multiple rounds of real data verification and adjustment, a enterprise master patient index suitable for multi-source heterogeneous medical data was constructed. From January 2022 to March 2024, the intelligent recognition algorithm system had completed the recognition of 2.46 million pediatric tumor case report cards, established 0.33 million primary indexes and their unique identification codes for malignant tumor patients, and improved the data management and application efficiency of the surveillance platform. The enterprise master patient index based on surveillance platforms had played an important role in the registration and follow-up of pediatric cancer cases and related medical research, which could provide references for the construction of master indexes on other medical big data platforms in China.

The national pediatric cancer surveillance data known as the pediatric cancer case report card(report card), had the characteristics of wide sources, diverse collection methods and a large amount of information. Based on the characteristics of the surveillance data, the National Center for Pediatric Cancer Surveillance (surveillance center) established quality control program for surveillance data according to the relevant norms and standards from China and other countries. The program defined the variables, requirements and rules for the quality control of surveillance data. The surveillance center designed different quality control processes according to the way of data reporting including manual filling/file import and port docking, and formulated a series of supporting measures to achieve the completeness, accuracy and standardization of surveillance data. By analyzing the report cards of patients discharged from hospital from 2021 to 2023, the surveillance center found that the number of problem report cards decreased from 40.6% (202 185 cards / 497 538 cards) before feedback to 31.1% (157 725 cards / 506 817 cards) after feedback. The data quality control program not only improved the quality of surveillance data, but also provided references for the establishment of the data quality control program of other registration systems of medical field.

Building a nationwide representative sibling information database of pediatric cancer is of great significance for the research of pediatric cancer. In October 2022, based on the national pediatric cancer surveillance platform, the National Center for Pediatric Cancer Surveillance(NCPCS) identified and integrated the information of pediatric cancer cases using the patient master index, and then determined and retrieved the diagnosis and treatment information of pediatric cancer siblings through the sibling pair matching algorithm system, to establish the sibling information database. The information database was stored in the sibling database module of the surveillance platform, which realized the dynamic update, retrieval, download, and analysis of sibling information. The database provided data and technical support for the further childhood cancer research among siblings, as well as provided a reference for the construction of research-oriented databases for other disease surveillance systems. As of March 2024, this database had included 2 980 childhood cancer patients, collecting nearly 30 000 related medical records. In the future, NCPCS should further improve the sensitivity of sibling decision logic and expand the functionality of the sibling information database, so as to better meet the diverse needs of clinical and scientific research.

In-depth understanding of the clinical diagnosis and treatment practices of various health workers is of great significance for optimizing the allocation of health workforce. In 2023, based on the surveillance platform of National Center for Pediatric Cancer Surveillance(NCPCS), the NCPCS effectively integrated human resources data with clinical diagnosis and treatment data. By clarifying the conceptual and logical structures of the database, a clinical health workforce database was constructed using a distributed relational database. This database adhered to the data quality control principles of uniqueness, integrity, logic, and validity, and implemented scientific and effective data security protection strategies throughout the entire data life cycle. In practical applications, statistical analyses could be conducted on this database from two dimensions: health workforce and diagnosis-treatment processes, assisting relevant departments and hospitals in the refined management of health workforce allocation and promoting discipline construction. As of May 2024, the database had incorporated 931 hospitals, with the number of various health workers exceeding 640 000. The clinical health workforce database provided references for health administrative departments and hospitals at all levels to grasp the clinical practices of various health workers, and to achieve a clinical-demand-oriented allocation of health workforce.

To provide comprehensive, scientific, and precise big data supports for national pediatric cancer prevention and control, the National Center for Pediatric Cancer Surveillance constructed the Surveillance Platform in 2019. Based on stratified and service-oriented design concepts, and a microservices architecture, the platform constructed five layers: document storage, data storage, service, application, and visualization. The platform supported three data reporting methods: automatic collection, file import, and manual entry. It ensured data quality through both rule-based and process-based quality control measures. Additionally, strict data security measures had been established in areas such as security domains, permission management, and data de-identification to ensure the safety and reliability of the monitoring data. As to November 2024, the platform had covered 1 750 surveillance sites(hospitals) and collected information about 6 million pediatric cancer cases, achieving positive results. This practice had laid a solid foundation for the smooth implementation of national pediatric cancer surveillance work and provided scientific evidences for pediatric cancer prevention and control in China. In the future, the platform′s performance needs to be continuously optimized and upgraded. It should further integrate relevant datasets in this field and actively explore and expand new application scenarios with the help of cutting-edge technologies such as big language models.