OBJECTIVE To analyze the efficacy and safety of luspatercept in the treatment of myelodysplastic syndromes （MDS） anemia， and provide reference for clinical medication. METHODS The literature related to luspatercept for MDS anemia in PubMed， Cochrane Library， Embase and Web of Science were searched by computer， and the search time was from the establishment of the database to January 2024. The quality of literature was evaluated after they were screened according to inclusion and exclusion criteria， the single-group rate meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software， and the subgroup analysis was conducted. RESULTS A total of 756 patients in 9 articles were included in this study. The results of meta-analysis showed that the proportion of MDS patients who reached ≥8 weeks of red blood cell transfusion independence （RBC-TI） was 46% after using luspatercept [95%CI （0.28， 0.64）， P＜0.000 01]. The proportion of MDS patients whose hematological improvement in erythrocyte （HI-E） was 59% [95%CI （0.43， 0.74）， P＜0.000 01]. Among them， 5 articles reported that the proportion of MDS patients with grade 3-4 adverse reactions was 14% [95%CI （0.07， 0.22）， P＝0.000 2]， and the poor general condition， infection， blood and lymphatic system disease were the common adverse reactions. Subgroup analysis showed that the source of heterogeneity was the blood transfusion burden in the proportion of MDS patients with RBC-TI≥8 weeks， and the source of heterogeneity was the 0931-8356251。revised international prognostic scoring system （IPSS-R） risk grade， SF3B1 mutation status and blood transfusion burden in the proportion of MDS patients with HI-E. Sensitivity analysis showed that the results of this study were stable. CONCLUSIONS Luspatercept can significantly improve blood transfusion dependence， reduce blood transfusion burden and promote hematology improvement in MDS patients. But attention should be paid to the occurrence of grade 3-4 adverse events； adverse events such as poor general condition， infection， blood and lymphatic system diseases are more common.

Objective To investigate the role of androgen-induced DGAT2-mediated ferroptosis in granu-losa cell dysfunction in patients with polycystic ovary syndrome(PCOS).Methods The human granulosa cell line KGN was exposed to various concentrations of testosterone(1,10,and 100 μmol/L).The effects on DGAT2 expres-sion,markers of ferroptosis(GPX4,ROS,MDA),indicators of lipid metabolism(TG,PUFAs),lipid droplet ac-cumulation,and cell viability were evaluated.Additionally,DGAT2 knockdown using siRNA in combination with Erastin treatment was performed to further elucidate the role of DGAT2 in ferroptosis regulation.Results Testoster-one significantly upregulated DGAT2 expression(P<0.01),increased intracellular TG and PUFA levels(P<0.001),promoted lipid droplet accumulation,elevated ROS and MDA levels(P<0.05,P<0.001),suppressed GPX4 expression(P<0.001),and reduced cell viability(P<0.001).DGAT2 knockdown reversed these effects,thereby alleviating ferroptosis and markedly enhancing cell viability(P<0.001).Conclusions DGAT2 may be in-volved in the process of androgen-mediated granulosa cell ferroptosis in patients with PCOS.

Objective:To evaluate the long-term effectiveness of lingual mucosal graft ureteroplasty (LMGU) for managing long-segment (≥5 cm) ureteral strictures in a multi-institutional cohort of patients.Methods:A multi-center retrospective case series study was conducted on clinical data from 42 patients undergoing LMGU for long-segment ureteral strictures (≥5 cm) across five institutions between February 2017 and June 2024. The cohort comprised 31 males and 11 females, with an age of (43.4±12.0) years (range: 15 to 64 years) and a body mass index of (24.6±2.6) kg/m2 (range: 16.0 to 30.0 kg/m2). Strictures involved the left ureter in 24 cases and right ureter in 18 cases, demonstrating a stricture length of (6.4±1.5) cm (range: 5.0 to 11.5 cm). Surgical interventions included either onlay ureteroplasty or augmented anastomotic ureteroplasty, selected according to intraoperative findings. Intraoperative parameters, postoperative complications, and follow-up outcomes were analyzed.Results:Laparoscopic surgery was performed in 22 cases and robot-assisted surgery in 20 cases. Among the 42 patients, 22 underwent onlay ureteroplasty while 20 received augmented anastomotic ureteroplasty. The graft length was (5.9±1.8) cm (range: 3.0 to 12.0 cm), operative time (191.5±55.6) minutes (range: 105.0 to 350.0 minutes), and intraoperative estimated blood loss (86.7±73.6) ml (range: 10.0 to 400.0 ml). All procedures were successfully completed without conversion to open surgery. The postoperative hospital stay was (7.6±2.0) days (range: 4.0 to 15.0 days), with double-J stent removal at 6 to 8 weeks postoperatively. During a follow-up of (49.1±25.0) months (range: 12.0 to 99.0 months), no stricture recurrence was observed in any patient.Conclusion:LMGU is a safe, feasible, and effective long-term technique for managing long-segment (≥5 cm) ureteral strictures.

OBJECTIVE To evaluate the efficacy and safety of Weiyan Tongluo Granules in treating chronic atrophic gastritis(CAG)and explore its potential mechanisms.METHODS From June 2020 to December 2022,100 CAG patients with spleen defi-ciency and blood stasis syndrome were enrolled and randomly divided into a trial group(n=50)and a control group(n=50)using a random number table.The trial group received Weiyan Tongluo Granules plus a folic acid placebo,while the control group received fo-lic acid tablets plus a traditional Chinese medicine granule placebo.The treatment course for both groups was 24 weeks,with 8 and 10 dropouts in the trial and control groups,respectively.Post-treatment comparisons included OLGA/OLGIM staging reversal rates,low-grade intraepithelial neoplasia regression rate,SSDPRO-CG(Patient-Reported Outcome Scale for Chronic Gastritis in Spleen-Stomach Diseases)scores,TCM syndrome scores,and safety indicators.Serum levels of PG I,PGⅡ,PGR,and G-17 were measured via ELISA before and after treatment.Gastric mucosal p-NF-κB and CDX2 protein expression levels were analyzed by Western blot,while mRNA levels of IL-1β,IL-6,VIL1,and MUC2 were quantified via qPCR.RESULTS After treatment,the trial group showed sig-nificantly higher OLGA and OLGIM stage reversal rates than the control group(P<0.05,P<0.01),though no significant difference was observed in low-grade intraepithelial neoplasia regression.Both groups exhibited significant improvements in physiological domain scores and total SSDPRO-CG scores(P<0.01),with the trial group outperforming the control group in physiological,independence,psychological domains,and total scores(P<0.05,P<0.01).TCM syndrome scores(total and sub-items:gastric distension,pain,poor appetite,bloating)decreased significantly in both groups(P<0.01),while the trial group showed greater reductions in loose stools and dull complexion(P<0.01).After-treatment,the trial group had significantly lower TCM syndrome scores than the control group(P<0.05,P<0.01).Serum PG I,PGⅡ,PGR,G-17,gastric mucosal p-NF-κB,CDX2,and IL-1β,IL-6,VIL1,MUC2 mRNA levels improved significantly in the trial group(P<0.05,P<0.01),while the control group improved only in PGⅡ(P<0.05,P<0.01).The trial group's improvements in these biomarkers surpassed the control group's(P<0.05,P<0.01).No treatment-related adverse events occurred in either group.CONCLUSION Weiyan Tongluo Granules ameliorate gastric mucosal pathology,clinical symptoms,psychological state,and quality of life in CAG patients without significant adverse effects.Its mechanism may involve sup-pressing the NF-κB pathway to reduce IL-1β and IL-6 expression,downregulating CDX2 to inhibit VIL1 and MUC2 transcription,thereby reversing the vicious cycle of inflammation-intestinal metaplasia.

Objective:To analyze incidence trends and age distribution of cutaneous melanoma in Jiangsu province from 2010 to 2019.Methods:In this cross-sectional study, data on the reported incidence of cutaneous melanoma from 2009 to 2019 were obtained from 16 cancer registries in Jiangsu Province, which had complete and continuous records after quality control. The Jointpoint log-linear regression model was used, and the average annual percentage change (AAPC) was calculated to analyze incidence trends of cutaneous melanoma in different genders and areas (urban or rural). Data from the Chinese population census in 2000 were used for calculation of age-standardized incidence rates by Chinese standard population. The Jointpoint regression model was used to evaluate the trends in the average age at onset over time. If there were no inflection points, a t test was used to compare changes in the average age at onset and age-specific proportions among different years. The age-period-cohort model was used to analyze changes of the incidence in birth cohorts in different years. Results:The age-standardized incidence rate of cutaneous melanoma in Jiangsu province was 0.26/100 000 in 2009 and 0.49/100 000 in 2019. Overall, the provincial incidence rates showed an increasing trend (AAPC in age-standardized incidence rates: 6.17%, P < 0.001). In the subgroup analyses, increasing trends were observed in different genders and areas (AAPC in age-standardized incidence rates: 4.24% for males, 8.01% for females, 5.17% for urban areas, 7.62% for rural areas, all P < 0.001). The standardized average age at onset of cutaneous melanoma was 59.95 years in 2009 and 58.84 years in 2019, with no significant trend in average age at onset over time ( P = 0.196). People aged 60 years and above had an AAPC of 1.20% ( P = 0.020) in the actual incidence proportion of cutaneous melanoma in 2019 compared with 2009. The age-period-cohort model showed that the incidence progressively increased with the year of birth in age groups among patients of different genders and in different areas (all P < 0.05) . Conclusions:The overall incidence of cutaneous melanoma was relatively low in Jiangsu province from 2009 to 2019, however, an upward trend was observed. Patients in both rural and urban areas, as well as female and male populations, all exhibited increasing incidence rates. The incidence rates of cutaneous melanoma increased with age.

There are no reports on the application of perirenal fat covering technique in lingual mucosal graft ureteroplasty（LMGU），and its safety and effectiveness need to be observed. This study retrospectively analyzed clinical data of 7 patients who underwent lingual mucosa ureteroplasty with intraoperative perirenal fat covering technique. The median stricture length was 5.5（range 4.0 to 6.0）cm，operative duration was 170（range 120 to 230）min，estimated blood loss was 92（range 15 to 110）ml. No conversions to open surgery occurred. During a median follow-up of 46（range 8 to 86）months，all procedures achieved clinical success. The application of perirenal fat covering technique in LMGU is safe and effective.

Objective: To evaluate the feasibility and effectiveness of dual fluorescence laparoscopy in the localization of ureteral stricture and its blood supply，and to provide a new idea for the treatment of complex ureteral stenosis，thus helping doctors to improve the efficiency of ureteral reconstruction surgery. Methods: Our team developed a dual fluorescence laparoscopic system，which could simultaneously identify the ureter stricture by intra-ureteral injection of methylene blue (MB) and assess the blood supply of the ureteral stumps by intravenous injection of indocyanine green (ICG). Results: The clinical data of 3 patients who underwent lingual mucosa ureteroplasty using dual fluorescence laparoscopy in Zhongnan Hospital of Wuhan University were retrospectively analyzed.All operations were successful，without conversion to open surgery.The operation time was 144，132 and 163 minutes，respectively.The length of harvested lingual mucosa graft was 2.0，2.8 and 3.5 cm，respectively.No intraoperative or postoperative complications occurred.Eight weeks after operation，ureterography showed that the ureter was unobstructed. Conclusion: Dual fluorescence laparoscopy is safe and feasible in the repair of complex ureteral stricture with lingual mucosa graft，which provides a new idea for complex ureteral reconstruction.

Objective To investigate the role of androgen-induced DGAT2-mediated ferroptosis in granu-losa cell dysfunction in patients with polycystic ovary syndrome(PCOS).Methods The human granulosa cell line KGN was exposed to various concentrations of testosterone(1,10,and 100 μmol/L).The effects on DGAT2 expres-sion,markers of ferroptosis(GPX4,ROS,MDA),indicators of lipid metabolism(TG,PUFAs),lipid droplet ac-cumulation,and cell viability were evaluated.Additionally,DGAT2 knockdown using siRNA in combination with Erastin treatment was performed to further elucidate the role of DGAT2 in ferroptosis regulation.Results Testoster-one significantly upregulated DGAT2 expression(P<0.01),increased intracellular TG and PUFA levels(P<0.001),promoted lipid droplet accumulation,elevated ROS and MDA levels(P<0.05,P<0.001),suppressed GPX4 expression(P<0.001),and reduced cell viability(P<0.001).DGAT2 knockdown reversed these effects,thereby alleviating ferroptosis and markedly enhancing cell viability(P<0.001).Conclusions DGAT2 may be in-volved in the process of androgen-mediated granulosa cell ferroptosis in patients with PCOS.

BACKGROUND:Relatively or absolutely active bone resorption function of osteoclasts is one of the causative factors of osteoporosis. Therefore,how to inhibit the formation of osteoclasts and reduce the bone resorption activity is a key element in the prevention and treatment of osteoporosis. Liquiritin,which is derived from licorice,plays a role in the clinical treatment of bone diseases,but there are fewer studies addressing the application of liquiritin in osteoporosis and the mechanism is unknown.OBJECTIVE:To confirm,through both in vivo and in vitro experiments,that liquiritin inhibits osteoclast differentiation and alleviates bone loss.METHODS:Cell counting kit-8 was used to detect whether Liquiritin exerts toxic or proliferative effects on mouse bone marrow-derived macrophages,and tartrate-resistant acid phosphatase staining was performed to observe the effect of liquiritin in inhibiting osteoclast differentiation. The affinity of liquiritin binding to proteins related to osteoclast differentiation was verified by network pharmacology. RT-PCR and western blot assays were performed to detect the inhibitory effects of liquiritin on osteoclast-specific protein and gene expression as well as relevant signaling pathways. Finally,the mitigating effect of liquiritin on bone loss was verified in the C57BL/6J mouse osteoporosis model.RESULTS AND CONCLUSION:Liquiritin,at concentrations of 20 μmol/L and below,could inhibit the formation and differentiation of osteoclasts. Concurrently,it exhibited a high affinity with osteoclast-specific proteins such as nuclear factor of activated T-cells 1,Cathepsin K,c-Fos,and matrix metalloproteinase 9,and reduced the relative expression levels of these genes and proteins. Liquiritin could also effectively lower the phosphorylation expression level of JNK in the MAPK signaling pathway at the 15th,30th,45th,and 60th minutes,and it could salvage the degradation of nuclear factor-κB inhibitor α in the nuclear factor-κB signaling pathway at the 60th minute. In vivo experiments demonstrated that liquiritin could mitigate bone loss caused by osteoclasts and improve parameters related to trabecular bone. To conclude,liquiritin possesses the capacity to inhibit osteoclast differentiation and alleviate bone loss,thereby exerting a protective role against osteoporosis.

Objective:To analyze incidence trends and age distribution of cutaneous melanoma in Jiangsu province from 2010 to 2019.Methods:In this cross-sectional study, data on the reported incidence of cutaneous melanoma from 2009 to 2019 were obtained from 16 cancer registries in Jiangsu Province, which had complete and continuous records after quality control. The Jointpoint log-linear regression model was used, and the average annual percentage change (AAPC) was calculated to analyze incidence trends of cutaneous melanoma in different genders and areas (urban or rural). Data from the Chinese population census in 2000 were used for calculation of age-standardized incidence rates by Chinese standard population. The Jointpoint regression model was used to evaluate the trends in the average age at onset over time. If there were no inflection points, a t test was used to compare changes in the average age at onset and age-specific proportions among different years. The age-period-cohort model was used to analyze changes of the incidence in birth cohorts in different years. Results:The age-standardized incidence rate of cutaneous melanoma in Jiangsu province was 0.26/100 000 in 2009 and 0.49/100 000 in 2019. Overall, the provincial incidence rates showed an increasing trend (AAPC in age-standardized incidence rates: 6.17%, P < 0.001). In the subgroup analyses, increasing trends were observed in different genders and areas (AAPC in age-standardized incidence rates: 4.24% for males, 8.01% for females, 5.17% for urban areas, 7.62% for rural areas, all P < 0.001). The standardized average age at onset of cutaneous melanoma was 59.95 years in 2009 and 58.84 years in 2019, with no significant trend in average age at onset over time ( P = 0.196). People aged 60 years and above had an AAPC of 1.20% ( P = 0.020) in the actual incidence proportion of cutaneous melanoma in 2019 compared with 2009. The age-period-cohort model showed that the incidence progressively increased with the year of birth in age groups among patients of different genders and in different areas (all P < 0.05) . Conclusions:The overall incidence of cutaneous melanoma was relatively low in Jiangsu province from 2009 to 2019, however, an upward trend was observed. Patients in both rural and urban areas, as well as female and male populations, all exhibited increasing incidence rates. The incidence rates of cutaneous melanoma increased with age.