Objective To analyze the application value of 3D Slicer software in endoscopic transsphenoidal surgery for pituitary adenoma resection.Methods A retrospective analysis was made on the clinical data of 36 patients with pituitary adenomas treated with 3D Slicer-assisted endoscopic transsphenoidal surgery(3D Slicer group)in the Department of Neurosurgery,The Second Affiliated Hospital of Xi'an Jiaotong University,from January 2024 to December 2024.Preoperatively,multimodal images were fused and reconstructed using 3D Slicer software to systematically evaluate bony anatomical structures such as sphenoid sinus ostia,intrasphenoidal septa,and sellar floor structures,design the size of pedicled nasoseptal flaps,and clarify the positional relationships between pituitary adenomas and surrounding vital structures including the internal carotid artery,pituitary gland,and optic chiasm,so as to provide real-time guidance for intraoperative procedures.Meanwhile,45 patients with pituitary adenomas treated with neuronavigation-assisted endoscopic transsphenoidal surgery from January 2023 to December 2023 were included as the control group(neuronavigation group).The surgical outcomes and postoperative complications were compared between the two groups.Results Compared with the neuronavigation group,the 3D Slicer group demonstrated higher identification rates of the optic nerve groove and carotid artery impression(94.4％vs.77.8％),shorter operative time[(2.9±0.6)h vs.(3.5±0.9)h],less intraoperative bleeding[(159.7±70.5)mL vs.(237.8±96.0)mL],and a lower incidence of postoperative olfactory dysfunction(8.3％vs.26.7％),with statistically significant differences(P＜0.05).However,there were no statistically significant differences between the two groups in the identification rate of the sphenoid sinus ostium(100.0％vs.97.8％),gross total resection rate(75.0％vs.64.4％),and the incidence of other postoperative complications,including cerebrospinal fluid leakage(0.0％vs.6.7％),intracranial infection(2.8％vs.11.1％),transient diabetes insipidus(30.6％vs.22.2％),and hypopituitarism(38.9％vs.37.8％,P＞0.05).Conclusion 3D Slicer software helps improve the mastery of anatomical basics in endoscopic transsphenoidal approach among junior and primary physicians,enhancing the clinical efficacy and safety of pituitary adenoma resection,and thus is worthy of clinical promotion.

Objective:To investigate the impact of the number of cesarean deliveries on adverse maternal and neonatal outcomes.Methods:A retrospective analysis was conducted on 11 904 singleton pregnant women who underwent cesarean delivery at the Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2019 to December 31st, 2023. The women were grouped according to the number of cesarean deliveries: those undergoing their first cesarean delivery (1CD group, 7 231 cases), those undergoing their second cesarean delivery (2CD group, 3 749 cases), those undergoing their third cesarean delivery (3CD group, 841 cases), and those undergoing their fourth or more cesarean deliveries (4CD group, 83 cases). Differences in clinical characteristics, related surgical procedures, and adverse maternal and neonatal outcomes among the groups were compared. Binary logistic regression analysis was used to assess the impact of the number of cesarean deliveries on related surgical procedures and adverse maternal and neonatal outcomes.Results:(1) During the 5-year period, the total number of women undergoing cesarean delivery in our hospital showed a slight downward trend, while the proportion of women undergoing three or more cesarean deliveries increased. (2) Compared with women undergoing their first cesarean delivery, women in each repeat cesarean delivery group were older, had higher proportions of advanced maternal age and pre-pregnancy body mass index, and had more pregnancies, deliveries, and induced abortions; the incidence of placenta previa, placental implantation, antepartum hemorrhage, gestational hyperglycemia, and failed trial of labor requiring conversion to surgery was higher, while the incidence of premature rupture of membranes was lower; the proportions of ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and postoperative intestinal obstruction were higher, and the amount of postpartum hemorrhage was greater; the gestational age at delivery of neonates was earlier, but the rates of preterm birth at 28-31 +6 and 32-33 +6 weeks of gestation were lower; the differences were statistically significant ( P<0.05) for all comparisons. (3) The number of cesarean deliveries was not an independent risk factor for the dose-dependent occurrence of placenta previa (a OR=0.99, 95% CI: 0.98-1.01; P=0.261). In women without placenta previa, the number of cesarean deliveries was not a risk factor for placental implantation (a OR=1.12, 95% CI: 0.90-1.39; P=0.320). However, in women with placenta previa, the number of cesarean deliveries was a risk factor for placental implantation (a OR=4.01, 95% CI: 3.08-5.22; P<0.001). In the overall population, the number of cesarean deliveries was a risk factor for ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, bladder rupture repair, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and preterm birth (all P<0.05). However, the number of cesarean deliveries was not a risk factor for postoperative intestinal obstruction, admission to the intensive care unit, neonatal asphyxia, admission to the neonatal intensive care unit, or neonatal death (all P<0.05). Conclusions:The number of cesarean deliveries could lead to adverse maternal and neonatal outcomes, but the relationship is not simply dose-dependent. It is speculated that the occurrence of severe adverse maternal and neonatal outcomes is more closely related to maternal complications and comorbidities, as well as whether multidisciplinary comprehensive management was received.

Objective:To investigate the age-specific distribution characteristics of plantar pressure parameters in healthy children aged 3-12 years.Methods:This cross-sectional study retrieved data from the hospital information system in January 2025 for 272 children aged 3-12 years who underwent physical examinations and voluntarily completed plantar pressure analysis at Beijing Children′s Hospital, Capital Medical University, from July 2022 to December 2024. Demographic and clinical data, including anthropometric measurements (height and weight), flatfoot diagnosis and plantar pressure parameters (maximum pressure, time to maximum force, and contact time percentage in bilateral forefoot, midfoot, and hindfoot) were recorded. Participants were categorized into 3 age groups (3-6 years, 7-9 years, and 10-12 years) and were grouped by gender as well. Intergroup comparisons used one-way ANOVA or least-significant difference test or χ2 tests. Spearman′s rank correlation assessed the relationship between flatfoot prevalence and age. Results:Among 272 children (143 boys, 129 girls), age groups comprised 3-6 years (118 children, 64 boys and 54 girls), 7-9 years (96 children, 49 boys and 47 girls), and 10-12 years (58 children, 30 boys and 28 girls). Flatfoot prevalence was higher in boys than in that of girls (41.3% (59/143) vs. 28.7% (37/129), χ2=4.70, P=0.030), and negatively correlated with age ( r=-0.21, P<0.001). There all had statistically differences in the maximum pressure values of the bilateral forefoot and hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). The maximum pressure values of bilateral midfoot in the group of aged 10-12 years were all higher than those of the other two groups (all P<0.001). There had no statistically differences in the time maximum force value of the bilateral forefoot among the 3 age groups (all P>0.05). The time maximum force values of bilateral midfoot in the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). There all had statistically differences in the time maximum force value of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There all had statistically differences in the contact time percentage values of the bilateral forefoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There had no statistically differences in the contact time percentage values of the bilateral midfoot among the 3 age groups (all P>0.05). There all had statistically differences in the contact time percentage values of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). Conclusion:Plantar pressure parameters exhibit distinct age-related patterns, reflecting the development of gait patterns and foot arch formation, which will be useful for monitoring physical growth and sports rehabilitation.

Objective:To investigate the impact of the number of cesarean deliveries on adverse maternal and neonatal outcomes.Methods:A retrospective analysis was conducted on 11 904 singleton pregnant women who underwent cesarean delivery at the Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2019 to December 31st, 2023. The women were grouped according to the number of cesarean deliveries: those undergoing their first cesarean delivery (1CD group, 7 231 cases), those undergoing their second cesarean delivery (2CD group, 3 749 cases), those undergoing their third cesarean delivery (3CD group, 841 cases), and those undergoing their fourth or more cesarean deliveries (4CD group, 83 cases). Differences in clinical characteristics, related surgical procedures, and adverse maternal and neonatal outcomes among the groups were compared. Binary logistic regression analysis was used to assess the impact of the number of cesarean deliveries on related surgical procedures and adverse maternal and neonatal outcomes.Results:(1) During the 5-year period, the total number of women undergoing cesarean delivery in our hospital showed a slight downward trend, while the proportion of women undergoing three or more cesarean deliveries increased. (2) Compared with women undergoing their first cesarean delivery, women in each repeat cesarean delivery group were older, had higher proportions of advanced maternal age and pre-pregnancy body mass index, and had more pregnancies, deliveries, and induced abortions; the incidence of placenta previa, placental implantation, antepartum hemorrhage, gestational hyperglycemia, and failed trial of labor requiring conversion to surgery was higher, while the incidence of premature rupture of membranes was lower; the proportions of ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and postoperative intestinal obstruction were higher, and the amount of postpartum hemorrhage was greater; the gestational age at delivery of neonates was earlier, but the rates of preterm birth at 28-31 +6 and 32-33 +6 weeks of gestation were lower; the differences were statistically significant ( P<0.05) for all comparisons. (3) The number of cesarean deliveries was not an independent risk factor for the dose-dependent occurrence of placenta previa (a OR=0.99, 95% CI: 0.98-1.01; P=0.261). In women without placenta previa, the number of cesarean deliveries was not a risk factor for placental implantation (a OR=1.12, 95% CI: 0.90-1.39; P=0.320). However, in women with placenta previa, the number of cesarean deliveries was a risk factor for placental implantation (a OR=4.01, 95% CI: 3.08-5.22; P<0.001). In the overall population, the number of cesarean deliveries was a risk factor for ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, bladder rupture repair, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and preterm birth (all P<0.05). However, the number of cesarean deliveries was not a risk factor for postoperative intestinal obstruction, admission to the intensive care unit, neonatal asphyxia, admission to the neonatal intensive care unit, or neonatal death (all P<0.05). Conclusions:The number of cesarean deliveries could lead to adverse maternal and neonatal outcomes, but the relationship is not simply dose-dependent. It is speculated that the occurrence of severe adverse maternal and neonatal outcomes is more closely related to maternal complications and comorbidities, as well as whether multidisciplinary comprehensive management was received.

Objective To analyze the application value of 3D Slicer software in endoscopic transsphenoidal surgery for pituitary adenoma resection.Methods A retrospective analysis was made on the clinical data of 36 patients with pituitary adenomas treated with 3D Slicer-assisted endoscopic transsphenoidal surgery(3D Slicer group)in the Department of Neurosurgery,The Second Affiliated Hospital of Xi'an Jiaotong University,from January 2024 to December 2024.Preoperatively,multimodal images were fused and reconstructed using 3D Slicer software to systematically evaluate bony anatomical structures such as sphenoid sinus ostia,intrasphenoidal septa,and sellar floor structures,design the size of pedicled nasoseptal flaps,and clarify the positional relationships between pituitary adenomas and surrounding vital structures including the internal carotid artery,pituitary gland,and optic chiasm,so as to provide real-time guidance for intraoperative procedures.Meanwhile,45 patients with pituitary adenomas treated with neuronavigation-assisted endoscopic transsphenoidal surgery from January 2023 to December 2023 were included as the control group(neuronavigation group).The surgical outcomes and postoperative complications were compared between the two groups.Results Compared with the neuronavigation group,the 3D Slicer group demonstrated higher identification rates of the optic nerve groove and carotid artery impression(94.4％vs.77.8％),shorter operative time[(2.9±0.6)h vs.(3.5±0.9)h],less intraoperative bleeding[(159.7±70.5)mL vs.(237.8±96.0)mL],and a lower incidence of postoperative olfactory dysfunction(8.3％vs.26.7％),with statistically significant differences(P＜0.05).However,there were no statistically significant differences between the two groups in the identification rate of the sphenoid sinus ostium(100.0％vs.97.8％),gross total resection rate(75.0％vs.64.4％),and the incidence of other postoperative complications,including cerebrospinal fluid leakage(0.0％vs.6.7％),intracranial infection(2.8％vs.11.1％),transient diabetes insipidus(30.6％vs.22.2％),and hypopituitarism(38.9％vs.37.8％,P＞0.05).Conclusion 3D Slicer software helps improve the mastery of anatomical basics in endoscopic transsphenoidal approach among junior and primary physicians,enhancing the clinical efficacy and safety of pituitary adenoma resection,and thus is worthy of clinical promotion.

Objective:To investigate the age-specific distribution characteristics of plantar pressure parameters in healthy children aged 3-12 years.Methods:This cross-sectional study retrieved data from the hospital information system in January 2025 for 272 children aged 3-12 years who underwent physical examinations and voluntarily completed plantar pressure analysis at Beijing Children′s Hospital, Capital Medical University, from July 2022 to December 2024. Demographic and clinical data, including anthropometric measurements (height and weight), flatfoot diagnosis and plantar pressure parameters (maximum pressure, time to maximum force, and contact time percentage in bilateral forefoot, midfoot, and hindfoot) were recorded. Participants were categorized into 3 age groups (3-6 years, 7-9 years, and 10-12 years) and were grouped by gender as well. Intergroup comparisons used one-way ANOVA or least-significant difference test or χ2 tests. Spearman′s rank correlation assessed the relationship between flatfoot prevalence and age. Results:Among 272 children (143 boys, 129 girls), age groups comprised 3-6 years (118 children, 64 boys and 54 girls), 7-9 years (96 children, 49 boys and 47 girls), and 10-12 years (58 children, 30 boys and 28 girls). Flatfoot prevalence was higher in boys than in that of girls (41.3% (59/143) vs. 28.7% (37/129), χ2=4.70, P=0.030), and negatively correlated with age ( r=-0.21, P<0.001). There all had statistically differences in the maximum pressure values of the bilateral forefoot and hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). The maximum pressure values of bilateral midfoot in the group of aged 10-12 years were all higher than those of the other two groups (all P<0.001). There had no statistically differences in the time maximum force value of the bilateral forefoot among the 3 age groups (all P>0.05). The time maximum force values of bilateral midfoot in the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). There all had statistically differences in the time maximum force value of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There all had statistically differences in the contact time percentage values of the bilateral forefoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There had no statistically differences in the contact time percentage values of the bilateral midfoot among the 3 age groups (all P>0.05). There all had statistically differences in the contact time percentage values of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). Conclusion:Plantar pressure parameters exhibit distinct age-related patterns, reflecting the development of gait patterns and foot arch formation, which will be useful for monitoring physical growth and sports rehabilitation.

Idiopathic oligoasthenospermia （IO） has been increasingly emphasized in the diagnosis and treatment of male infertility. Oxidative stress damage directly affects sperm quality and spermatogenesis， constituting a major causative factor of IO. Firstly， due to its high content of polyunsaturated fatty acids， the sperm plasma membrane is highly sensitive to reactive oxygen species （ROS）， leading to lipid peroxidation accumulation and even inducing ferroptosis. Secondly， deficient downstream key proteins in the base excision repair pathway render sperm unable to repair extensive DNA oxidative damage under oxidative stress. Simultaneously， under oxidative stress， the apoptotic pathway of sperm is cascade-activated， causing rapid loss of motility. ROS further disrupts the hypothalamic-pituitary-gonadal axis， inhibiting testosterone production and ultimately affecting spermatogenesis. Wuzi Yanzongwan，in line with traditional Chinese medicine theory of treating IO through "nourishing kidney essence and harmonizing Yin and Yang"， clinically demonstrates its ability to improve sperm morphology， count， and motility， thereby enhancing male fertility. The research on the pharmacological constituents of Wuzi Yanzongwan primarily involves establishing a characteristic spectrum of Chinese medicine to achieve quality control and exploring the pharmacology of effective components. Studies have found that its main active ingredients consist of flavonoids and phenylpropanoids. Specifically， compounds such as hyperin， acteoside， kaempferol， and schisandrin A are identified as the primary active substances and quality control components. These compounds exhibit strong antioxidant activity and have been partly applied in research related to reproductive endocrine disorders. Tripterygium glycoside is primarily used for modeling of oxidative stress-induced IO. It leads to the accumulation of various lipid peroxides in testicular tissues and concurrently compromises the body's antioxidant capacity. Mechanistic studies have found that Wuzi Yanzongwan can inhibit elevated ROS levels in IO models and enhance the body's antioxidant capacity， thereby ameliorating inflammation， suppressing cell apoptosis， promoting testosterone production， and ultimately alleviating the decline in sperm quality and spermatogenesis caused by oxidative stress.

BACKGROUND:It is reported that bone marrow mesenchymal stem cell(BMSC)transplantation might be a promising treatment for liver fibrosis.But the mechanism is still unclear.OBJECTIVE:To observe the hepatic stellate cells apoptosis induced by BMSC transplantation,and to study the mechanism of BMSC in treating hepatic fibrosis in vivo.METHODS:CCl_4 subcutaneous injection was performed to induce rat liver fibrosis.After 8 weeks of CCU injection,20 rats which underwent successful model establishment were randomly divided into experimental group and control group,10 in each group.The experimental group received MSC transplantation via tail vein injection,and the control group were given DMEM instead.The rats were killed and the livers were harvested at three time point,the day of MSC transplantation,3 days after transplantation,and 7 days after transplantation.The hydroxyproline content was detected by HE and Masson staining,and the expression changes of α-smooth muscle actin(α-SMA)proteins were determined using immunohistochemistry.The apoptosis of hepatic stellate cells were determined by α-SMA and TUNEL(terminal dUTP nick-end labeling)dual-staining.RESULTS AND CONCLUSION:After 8 weeks of CCU injection,the hydroxyproline content increased and histology indicated progress of liver fibrosis.At 7 days after MSC transplantation,the hydroxyproline in the liver was decreased,and the liver fibrosis was alleviated in the experimental group but aggravated in the control group.Immunohistochemistry indicated that α-SMA positive cells were increased at 8 weeks after CCU injection.At day 7 after transplantation,α-SMA positive cells in the experimental group were significantly less than control group(P ＜ 0.05).At 3 days after transplantation,the hepatic stellate cells apoptosis in the experimental group was significantly aggravated compared with control group(P ＜ 0.05).This suggested that MSC transplant was an effective treatment for liver fibrosis.MSC inducing hepatic stellate cells apoptosis may be one of the mechanisms.

Objective To study the relation between p38 MAPK pathway and multidrug resistance of stomach cancer. Methods The activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR was examined by immunoprecipitation after treating with vincristine for 0,2,15,30,60 minutes. Results Vincristine could activate the activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR. The difference between them was that in cell SGC7901 vincristine activate the p38 MAPK rapidly whereas in cell SGC7901/VCR slowly. Conclusion Vincristine could affect the activity of p38 MAPK in gastric cancer cell SGC7901 and multidrug resistant cell SGC7901/VCR.

AIM: To investigate a new method for identification of traditional Chinese medicine injection by FTIR. METHODS: For the steadiness of spectra, the factors of effecting spectrum's information quality were all investigated scientifically over the experiment procedures and instrumental setting, such as the preparation of samples, resolution ratio, scanning times, repeating scanning times, etc. The traditional Chinese medicine injections were used as the analytical samples such as Radix Isatidis, Rhizoma Chuanxiong, Flos Carthami, Radix Astragali and Herba Houttuyniae. RESULTS: Although all these original spectrums were similar at a certain degree, the FTIR combined with computer aided analysis, such as the cluster analysis and derivative spectrometry comparability calculation could be used to identify these injections. CONCLUSION: The method of identification by FTIR is non destructive testing, cheap, clean, fast, simple and convenient. The result indicates this method is suitable for establishing identification database of traditional Chinese medicine injections.