ObjectiveTo investigate the correlation between different female body mass index （BMI） values and key indicators of in vitro fertilization/intracytoplasmic sperm injection （IVF/ICSI） treatment cycles， as well as their impact on obstetric outcomes. MethodsA retrospective analysis was conducted on data from patients who underwent IVF/ICSI treatment， with 19 834 cycles included after propensity score matching to balance group differences. Based on the Chinese BMI classification standards with extended categories， patients were stratified into five groups： severely underweight （BMI<16）， underweight （16.0≤BMI<18.5）， normal weight （18.5≤BMI<24.0）， overweight （24.0≤BMI<28.0）， and obese （BMI≥28.0）. Baseline characteristics， ovarian stimulation protocols， treatment processes， and assisted reproductive outcomes were compared among the groups. Additionally， 75 delivered patients with complications were followed up to analyze the association between BMI and pregnancy-related complications. ResultsNo statistically significant differences were observed among the five groups in baseline parameters such as age， duration of infertility， or antral follicle count. Regarding ovarian stimulation protocols and processes， a statistically significant difference was found in the number of IVF oocytes retrieved （P<0.001）， with the normal-weight group showing a significantly higher number than both the overweight and obese groups. In terms of assisted reproductive outcomes， no significant differences were observed in biochemical pregnancy rates or birth defect rates. However， cumulative live birth rates differed significantly among the groups （P<0.05）， which was significantly higher in the overweight group than in the normal-weight group. Among the 75 followed-up patients， 25 were diagnosed with gestational hypertension， and 22 with gestational diabetes mellitus， of whom overweight and obese individuals accounted for 60.00% and 45.40% of the respective complications. ConclusionFemale BMI is significantly associated with IVF/ICSI outcomes. Pre-pregnancy body mass evaluation should be emphasized in patients with extremely low body weight. Although the live birth rate of overweight and obese patients was comparable to that of the normal-weight group， weight reduction prior to treatment is strongly recommended to minimize risks of miscarriage， preterm birth， and pregnancy complications.

Objective To observe and analyze the pregnancy outcomes of simplified laparoscopic cervical cerclage(SLCC)during pregnancy.Methods Between May 2020 and February 2024,a total of 6 pregnant patients with cervical incompetence(CIC)unsuitable for transvaginal cervical cerclage(TVC)underwent prophylactic SLCC.Among the 6 patients,the average number of spontaneous abortions during mid-pregnancy period was 1.3(range,1-2),and 3 had a history of failed TVC.The average gestational week at the time of surgery was10.3 weeks(range,7-13 weeks).The surgery used a modified simple suture technique,entering from the back to the front at the isthmic level,inside the uterine artery,without opening the broad ligament,with the knot located in front of the cervix.Results All the patients underwent the surgery smoothly,with an average operation time of 27.7 min(range,23-33 min)and a blood loss of 1-10 ml during the surgery.No serious complications occurred.All the patients underwent cesarean section to terminate pregnancy,with an average gestational week of 37.2 weeks(range,36+3-38 weeks),all resulting in live births.The average birth weight of the newborns was 2951.7 g(range,2540-3320 g).The cerclage was removed during the surgery in 2 cases.Conclusion SLCC can be used in the early to mid-pregnancy period to treat CIC,achieving good pregnancy outcomes.

Objective:To analyze the association between inflammation-related dietary patterns and the risk for cognitive impairment in older adults aged ≥65 years in longevity areas in China by using reduced rank regression (RRR) analysis.Methods:This study used cross-sectional data from the 2021 Healthy Aging and Biomarkers Cohort Study, including the information about study participants' demographic characteristics, lifestyles, daily life activities, and disease histories. Dietary intake was obtained by using a simplified food frequency questionnaire. Cognitive impairment was evaluated based on the Mini-Mental State Examination Scale combined with years of education. Fasting venous blood samples were collected to detect inflammatory markers, especially high-sensitivity C-reactive protein (hs-CRP) and the platelet-to-lymphocyte ratio (PLR). RRR analysis was used to obtain inflammation-related dietary patterns using hs-CRP and PLR as response variables. Multivariate logistic regression model was used to analyze the association between dietary pattern score and the risk for cognitive impairment. Restricted cubic spline was used to explore the dose response relationship, and mediation analysis was used to quantify the mediating effects of hs-CRP and PLR.Results:Two dietary patterns were identified with RRR. The primary pattern was characterized by higher intakes of flour, red meat, and dairy products, and lower intake of fresh vegetables, explaining 6.84% of the variance in food intake and 0.50% of the variance in inflammatory markers. Compared with the T1 group, the T3 group had significantly higher risk for cognitive impairment ( OR=1.242, 95% CI: 1.034-1.491). Each one standard deviation increase in the dietary pattern score was associated with an 8.7% increase in the risk for cognitive impairment ( OR=1.087, 95% CI: 1.008-1.172), with a significant linear trend (overall-model P<0.001, non-linear P=0.295). Mediation analysis indicated that hs-CRP mediated 6.2% of the association between the dietary pattern and the risk for cognitive impairment. Conclusion:The inflammation- related dietary pattern characterized by higher consumption of flour, red meat, and dairy products and lower consumption of fresh vegetables is associated with an increased risk for cognitive impairment in older adults, and hs-CRP partially mediates this association.

Objective:To observe the safety and short-term efficacy of using an autologous fascia lata sling (AFLS) for tension-free mid-urethral sling (MUS) in the treatment of stress urinary incontinence (SUI).Methods:Between February 2022 and December 2023, 11 patients with SUI underwent AFLS-MUS. Preoperative data were recorded, including basic patient information and completion of urinary distress inventory 6 (UDI-6). During surgery, AFLS was harvested through a small incision using a tendon extractor, and used as a sling for transobturator or retropubic MUS. Perioperative indicators were recorded, including surgical approach, operation time, intraoperative blood loss, postoperative hospital stay, duration of catheterization, perioperative complications (Clavien-Dindo classification), and surgical costs. Follow-ups included outpatient physical examination at 2 months postoperatively, and telephone follow-up at 6 months, 1 year, and annually thereafter. Follow-up content included the presence or absence of urinary leakage symptoms, UDI-6, satisfaction, patient global impression of improvement (PGI-I), and complications.Results:The age of the 11 patients was (54.8±10.9) years (range: 41-72 years), with body mass index of (23.9±1.8) kg/m2 (range: 21.4-27.3 kg/m2). All patients experienced urinary leakage after coughing, sneezing and physical activity, with positive SUI provocation tests. The preoperative UDI-6 was 50.0±21.6 (range: 16.7-79.2), the result of 1-hour pad test was (18.9±12.0) g (range: 2.5-71.2 g). Four cases underwent MUS only, with operation time of (98.0±13.3) minutes (range: 86-117 minutes), and intraoperative blood loss of (17.5±5.0) ml (range: 10-20 ml); 7 cases also underwent pelvic floor repair simultaneously. The postoperative hospital stay was (3.5±2.0) days (range: 2-9 days). The duration of catheterization was (4.5±3.8) days (range: 2-11 days), with postoperative urinary retention in three cases, one of which underwent sling release surgery due to severe postoperative voiding difficulty 1 week after MUS, with no other complications of Clavien-Dindo grade 2 or above. The cost of AFLS harvest plus MUS was (2 762±293) yuan. At the 2-month outpatient follow-up, all patients were free of urinary leakage symptoms, with UDI-6 of 2.3±1.9 (range: 0-8.3); satisfaction was "very satisfied" in 10 cases and "fairly satisfied" in 1 case, with PGI-I all being "much better", and pelvic examinations were normal. Telephone follow-up showed one case lost to follow-up, and the remaining 10 cases had follow-up time of (18.6±4.9) months (range: 7-26 months), all without urinary leakage, with UDI-6 of 2.7±2.6, satisfaction rated as "very satisfied", and PGI-I all "much better".Conclusion:This modified AFLS-MUS for the treatment of SUI shows good short-term efficacy and high safety in harvest site, with the need for more data accumulation and long-term follow-up.

Objective To screen and identify specific monoclonal antibodies targeting the surface envelope protein E8L of the monkeypox intracellular mature virus based on mRNA immunization and single-cell sequencing.Methods E8L-mRNA was synthesized in vitro and encapsulated into lipid nanoparticles(LNPs)for immunization to induce immune responses.The antibody level in blood serum was detected to find out when the mice had produced sufficient antibodies.B cells in the spleen of the mice were isolated by flow cytometry sorting,followed by library construction and sequencing.Based on the analysis of light and heavy chain sequences of the antibodies from the sequencing data,E8L candidate monoclonal antibodies were screened according to the abundance ranking and expressed.The affinity of these monoclonal antibodies was detected by enzyme-linked immunosorbent assay(ELISA).Candidate antibodies with high affinity for E8L were applied to immunochromatographic assays to detect the monkeypox virus(MPXV)E8L protein.Results Mice were immunized by lipid nanoparticles encapsulating E8L-mRNA.Approximately 1.5 million B cells were selected by flow cytometry.After single-cell sequencing,17 candidate monoclonal antibodies for E8L were identified and expressed.Two high affinity monoclonal antibodies were obtained for monkeypox virus E8L protein by ELISA.These two antibodies were used as the basis for immunochromatographic assays to detect E8L protein,with a sensitivity of 0.5 ng/mL.Conclusion Two monoclonal antibodies with high affinity for the MPXV E8L protein are obtained,which can be potentially used for detecting monkeypox virus.

Objective:To develop and validate a clinical prediction model for assessing the risk of postoperative pulmonary complications (PPCs) in elderly patients undergoing surgery with general anesthesia.Methods:This prospective observational study enrolled patients aged ≥65 years who underwent general anesthesia with mechanical ventilation duration >3 hours across six tertiary hospitals between December 2022 and August 2023. Based on follow-up outcomes (until discharge or postoperative day 7), patients were categorized into a non-PPCs group and a PPCs group. Detailed records included baseline patient characteristics, preoperative comorbidities, surgical information (type, duration), and bedside lung ultrasound scores (LUS) assessed within 24 hours postoperatively using a standardized 12-zone protocol. Predictor selection was performed using LASSO regression. Significant predictors identified were incorporated into a multivariate logistic regression analysis to build the prediction model, visualized as a nomogram. Internal validation was conducted via bootstrap resampling (1 000 repetitions). Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) for discrimination, calibration curves for calibration accuracy, and decision curve analysis (DCA) for clinical utility.Results:A total of 130 eligible elderly surgical patients were included. PPCs occurred in 17 patients (incidence rate: 13.1%). Multivariate analysis identified LUS ( OR=1.248, 95% CI: 1.099-1.417, P=0.001) and elective surgery type ( OR=0.206, 95% CI: 0.043-0.988, P=0.048) as independent predictors of PPCs. The nomogram model demonstrated an AUC of 0.867 (95% CI: 0.775-0.959) upon initial testing. Internal validation confirmed good discrimination (AUC=0.863, 95% CI: 0.778-0.972). Calibration curves indicated excellent agreement between predicted probabilities and observed outcomes. Decision curve analysis demonstrated significant clinical net benefit across a wide range of threshold probabilities (0.03-0.89). Conclusions:The clinical prediction model, developed using early postoperative LUS scores and surgical type, effectively predicts the risk of postoperative pulmonary complications in elderly patients following surgery under general anesthesia. The model exhibits strong discrimination, calibration, and clinical utility, providing clinicians with a reliable tool for individualized risk assessment to support clinical decision-making and potentially reduce PPC incidence.

Objective:To investigate the correlation between the expression of hepatoma-derived growth factor (HDGF) and the prognosis of patients with oral cancer.Methods:Clinical data of 96 patients with oral cancer admitted to Nanjing Tongren Hospital, School of Medicine, Southeast University from March 2019 to January 2023 were retrospectively analyzed, and biopsy cancer tissue specimens and adjacent tissues >3 cm from the tumor margin of oral cancer patients were collected. The expression of HDGF in cancer tissues and adjacent tissues was compared, and the influence of HDGF expression on prognosis of patients was analyzed. The patients were followed up for 36 months to compare the survival rate of patients with HDGF-negative and HDGF-positive oral cancer during follow-up.Results:The positive expression rate of HDGF in oral cancer tissues [75.00%(72/96)] was higher than that in adjacent tissues [11.46%(11/96)] ( P<0.05). There was no significant difference in the positive expression rate of HDGF in oral cancer patients with different sex, age, body mass index (BMI), smoking and drinking conditions ( P>0.05). The positive expression rate of HDGF in oral cancer tissues of patients with tumor length ≥3 cm, clinical stage Ⅲ-Ⅳ, lymph node metastasis, low differentiation, and vascular invasion was higher than that of patients with tumor length <3 cm, clinical stageⅠ-Ⅱ, no lymph node metastasis, medium/high differentiation, and no vascular invasion (all P<0.05). Cox regression analysis showed that tumor length, periodontitis or pulpitis, smoking, clinical stage, lymph node metastasis, histological type and positive expression of HDGF were independent influencing factors for overall survival of patients with oral cancer (all P<0.05). By the end of follow-up, the overall survival rate of patients with positive expression of HDGF was 70.77%(46/65), and that of patients with negative expression of HDGF was 95.45%(21/22). The survival rate of patients with negative expression of HDGF was higher than that of patients with positive expression ( P<0.05). Conclusions:The expression of HDGF in oral cancer tissues is abnormally high, which is closely related to clinicopathological features and prognosis.

Objective To compare the effect of transcranial direct current stimulation(tDCS)combined with seated Taijiquan Yun-shou in different sequences on brain functional activation in healthy youths.Methods From September to December,2024,14 healthy young medical interns or probationers were recruited from the Fifth Hospital of Xiamen.They randomly completed three interventions in a crossover design:Yunshou training followed immediately by tDCS(Y-S group),tDCS intervention followed immediately by Yunshou training(S-Y group),and simultaneous implementation of tDCS intervention and Yunshou training(Sim group).Yunshou was practiced in a seated position.For tDCS,the anode was placed over the left primary motor cortex(M1),and the cathode over the right M1.Changes in oxyhemoglobin(HbO2)concentration in the regions of interest were mea-sured using functional near-infrared spectroscopy.Results Three cases dropped down.The brain regions with significant differences before and after intervention included:CH3,CH7 and CH23 of right prefrontal cortex(PFC)in Y-S group;CH12 of left PFC in S-Y group;and CH9,CH10 and CH25 of the left PFC,CH13 and CH14 of the left sensorimotor cortex(SMC),CH15 of the right pre-motor and supplementary motor cortex(PMC),and CH16 of the right SMC in Sim group(P<0.05).After inter-vention,HbO2 concentration was the highest in the bilateral PFC,bilateral PMC and left SMC in the Y-S group(P<0.05);and it was almost the same between Sim group and S-Y group(P>0.05),except that of the right PFC decreased in Sim group.Conclusion The sequential combination of brain-limb integrated regulation is a key factor influencing the immediate cor-tical activation pattern.

Mucopolysaccharidosis type ⅣA（MPS ⅣA）is an autosomal recessive lysosomal storage disorder caused by deficiency of the N-acetylgalactosamine-6-sulfatase（GALNS）enzyme. This enzymatic defect leads to pathological accumulation of keratan sulfate（KS）and chondroitin-6-sulfate（C6S）within lysosomes，resulting in multisystem organ dysfunction characterized predominantly by progressive skeletal dysplasia. The clinical manifestations of MPS ⅣA demonstrate remarkable heterogeneity，ranging from mild forms to life-threatening severe phenotypes. The current mainstay therapeutic approaches consist of enzyme replacement therapy（ERT）and hematopoietic stem cell transplantation（HSCT）. However，these treatment modalities demonstrate limited efficacy in ameliorating skeletal abnormalities. Recent preclinical studies have shown promising results with novel therapeutic approaches including gene therapy and substrate reduction therapy for improving skeletal lesions. This review systematically summarizes current treatment options and research advances in MPS ⅣA to provide evidence-based guidance for clinical practice and future investigations.

ObjectiveTo investigate the protective effects and mechanisms of Zhenzhu Tiaozhi capsules on the kidneys in the mouse model of diabetic kidney disease. MethodsThirty male C57BL/6J mice were selected as experimental objects. The model of diabetic kidney disease was induced by intraperitoneal injection of streptozotocin （STZ） at 40 mg·kg^-1 for 5 days combined with a high-fat diet （HFD）. Fasting blood glucose （FBG） ≥ 11.1 mmol·L^-1， increased urine volume， and continuous appearance of proteinuria indicated successful modeling. Mice were grouped as follows： Blank， model， low- and high-dose （0.98 and 1.96 g·kg^-1， respectively） Zhenzhu Tiaozhi capsules， and losartan potassium （30 mg·kg^-1）， with six mice in each group. After 12 weeks of continuous gavage， urine and kidney specimens were collected， and the 24-h urinary protein and the urinary albumin-to-creatinine ratio （UACR） in mice were measured. Hematoxylin-eosin （HE） staining， periodic acid-Schiff （PAS） staining， and Masson staining were performed for observation of histopathological changes in kidneys. Immunofluorescence assay was employed to detect the positive expression of the podocyte marker protein nephrin. Oil red O staining was used to detect renal lipid deposition. Enzyme linked immunosorbent assay was employed to measure the levels of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in the renal tissue. Western blot was employed to determine the expression levels of sterol regulatory element-binding protein cleavage-activating protein （SCAP）， sterol regulatory element-binding protein-1c （SREBP-1c）， and NOD-like receptor protein 3 （NLRP3） in the renal tissue. ResultsCompared with the blank group， the model group showed increases in 24-h urinary protein and UACR （P<0.05）， glomeruli exhibiting capsule adhesion， collagen fiber deposition， mesangial proliferation， and inflammatory cell infiltration， elevated levels of IL-1β， IL-6， and TNF-α （P<0.05）， reduced positive expression of nephrin （P<0.05）， increased lipid deposition （P<0.05）， and up-regulated expression of SCAP， SREBP-1c， and NLRP3 （P<0.05） in the renal tissue. Compared with the model group， the treatment with losartan potassium or high-dose Zhenzhu Tiaozhi capsules for 12 weeks decreased 24-h urinary protein and UACR （P<0.05）， and the treatment with low-dose Zhenzhu Tiaozhi capsules for 12 weeks reduced the 24-h urinary protein （P<0.05）. Pathological staining results revealed that kidney damage in mice from all treatment groups was alleviated， with reduced inflammatory infiltration， collagen fiber deposition， and mesangial proliferation， and increased positive expression of nephrin in the renal tissue （P<0.05）. In addition， all the treatment groups showed reduced lipid droplets （P<0.05）， lowered levels of IL-1β， IL-6， and TNF-α （P<0.05）， and down-regulated expression of SCAP， SREBP-1c， and NLRP3 （P<0.05） in the renal tissue. ConclusionZhenzhu Tiaozhi capsules can ameliorate kidney damage in the mouse model of diabetic kidney disease by inhibiting the activation of the SCAP-SREBP-1c/NLRP3 signaling pathway， which reduces renal lipid deposition and inflammation.