Objective To explore the clinical efficacy of robot-assisted coronary artery bypass grafting through a small incision in the left intercostal space in the treatment of multivessel coronary disease. Methods A retrospective analysis was conducted on the clinical data of patients who underwent coronary artery bypass grafting through a small incision in the left intercostal space at Central China Fuwai Hospital of Zhengzhou University from January 1, 2023 to October 15, 2024. Patients were divided into a robotic group and a minimally invasive group based on whether the surgery was assisted by the Da Vinci robot. Results A total of 81 patients were included, with 57 in the minimally invasive group, including 41 males and 16 females, with a median age of 65.0 (57.5, 69.5) years; and 24 in the robotic group, including 17 males and 7 females, with a median age of 61.0 (56.0, 69.0) years. There was no statistically significant difference in baseline data between the two groups (P>0.05). The robotic group had less intraoperative bleeding [300 (200, 438) mL vs. 500 (375, 600) mL, P=0.006], shorter postoperative mechanical ventilation time [15.0 (13.3, 23.5) h vs. 22.0 (15.5, 39.5) h, P=0.037], and lower incidence of postoperative pain [8 (33.3%) vs. 33 (57.9%), P=0.043]. The hospitalization cost in the robotic group was higher than that in the minimally invasive group [130491 (123298, 135691) yuan vs. 123892 (115543, 133449) yuan, P=0.023]. There was no statistical difference in postoperative laboratory indicators between the two groups (P>0.05). There was also no statistical difference in the duration of surgery, postoperative 24 h drainage volume, ICU stay time, postoperative hospital stay or incidences of perioperative compications including pleural effusion, transfusion, new-onset atrial fibrillation, acute kidney injury, non-union of incision, major cardiovascular and cerebrovascular adverse events, and reoperation between the two groups (P>0.05). Conclusion Compared with the minimally invasive group, the robotic group shows satisfactory efficacy and can effectively reduce postoperative pain and intraoperative bleeding, and shorten postoperative mechanical ventilation time.

BackgroundIndividuals with schizophrenia are prone to higher rates of hospital readmission， presenting significant clinical challenges and imposing considerable social burdens within the mental health domain. In recent years， various risk prediction models have been developed to forecast readmission in patients with schizophrenia and support clinical decision-making， but their predictive performance and clinical applicability require comprehensive evaluation. ObjectiveTo systematically evaluate the risk prediction models for readmission in patients with schizophrenia， so as to provide insights for the development of high-performance and highly applicable readmission risk prediction models for patients with schizophrenia. MethodsOn July 5， 2025， a systematic literature search was conducted across multiple electronic databases， including PubMed， Embase， Cochrane Library， Web of Science， CINAHL， CNKI， China Biomedical Literature Database， Wanfang Database， and VIP Database， to identify risk prediction models for readmission in patients with schizophrenia. The search period was from the establishment of the databases to July 1， 2025. Two researchers independently performed literature screening， data extraction， risk of bias assessment， and applicability assessment. ResultsA total of 9 studies were included in this review， encompassing 18 risk prediction models for readmission in patients with schizophrenia. Among them， 4 models reported the area under the receiver operating characteristic （ROC） curve （AUC）， ranging from 0.734 to 0.820， 16 models provided AUC values of 0.642–0.879 for internal validation， and 1 model demonstrated an AUC of 0.841 for external validation. Key predictors included disease duration and the concomitant therapy of antipsychotic medications. The risk of bias was assessed as "high" in all included studies. ConclusionThe development of risk prediction models for readmission in patients with schizophrenia remains in an exploratory stage. Although the model exhibits favorable predictive performance， it is associated with a high risk of bias and insufficient performance evaluation.

Objective:This study aims to investigate the relationship between plague epidemics and environmental factors in Lincang City.Methods:Epidemiological survey data and environmental factors (including altitude, temperature, rainfall, and season) from plague occurrence sites in Lincang City from 1990 to 2020 were collected from Lincang Center for Disease Control and Prevention and the data sharing platform of the data sharing service network of the China Meteorological Administration, and analyzed using multiple correspondence analysis (MCA).Results:From 1990 to 2005, a total of 38 outbreaks of plague among rodents had been reported, 17 of which involved human beings. Since 2006, the plague had entered a dormant period, with no further epidemics reported up to 2020. The plague epidemic in Lincang City exhibited a clear seasonal variation, with the primary epidemic season occurred from autumn to early winter, peaking in September and October. Furthermore, the plague epidemic in Lincang City exhibited a pronounced spatial aggregation, with the primary affected regions including Linxiang County, Gengma Dai and Va Autonomous County, Zhenkang County, and Yun County. MCA showed that the Cronbach' α coefficients of all variables in the first and second dimensions were 0.87 and 0.82, respectively, and the characteristic roots were 3.27 and 2.91, respectively. The cumulative contribution rate of the two dimensions was 84.60%. Plague outbreaks were more likely in winter in areas at altitudes of > 1 400 - 1 650 m with 1 000 - 1 200 mm average annual rainfall and 16.0 - 17.9 ℃ average annual temperature, with increased severity. Regions at altitudes of > 500 - 700 m and > 900 - 1 150 m, with average annual rainfall of < 1 000, 1 201 - 1 400 and > 1 600 mm and average annual temperature of 18.0 - 19.9 ℃, showed a higher susceptibility to plague outbreaks, with notably pronounced incidences.Conclusions:The prevalence of plague epidemics is closely related to the local climatic conditions of natural foci in Lincang City. Therefore, it is imperative to enhance the monitoring of these climatic conditions, particularly meteorological data, to facilitate more effective prevention and control of plague outbreaks.

Objective To screening and validation of key genes for programmed cell death(PCD)in gout through bioinformatics and machine learning and immunoinfiltration analysis.Methods Gout-related datasets were obtained from the Gene Expression Omnibus(GEO)database,comprising the human gout dataset GSE160170 and murine gout dataset GSE190138,which served as the training cohort.Differentiall expression genes(DEGs)were screened with difference factor>2 and P<0.05.The DEGs of two data sets were intersected to obtain the common DEGs(co-DEGs).The co-DEGs were enriched by GO function and KEGG pathway analysis.The combination of co-DEGs and PCD related gene set was used to obtain PCD related DEGs.A PPI network was built in the STRING database.The key module genes were screened in Cytoscape's MCODE,the hub genes were screened in 12 algorithms built into the Cytohubba plugin,including Degree,MCC,DMNC,MCN,EPC,BottleNeck,EcCentricity,closness,Radiality,Betweeness,Stress and Clusteringcoefficoent,the common genes of the two was as candidate genes.The regression model of least absolute shrinkage and selection operator(LASSO)was used to screen key genes in the GSE160170 and GSE190138 data sets respectively,and the intersection of the two was adopted to obtain key genes.The diagnostic value of key genes in gout was evaluated by receiver operating characteristic(ROC)curve.The expression difference of gout related immune cells was investigated by single sample gene set enrichmemt analysis(ssGSEA)immunoinfiltration analysis.Finally,blood samples from 30 gout patients admitted to the Department of Rheumatology,Xi'an Fifth Hospital from February to April 2024 were collected as the experimental group,while blood samples from 30 healthy subjects were collected as the control group.RNA was extracted from the Peripheral blood mononuclear cell(PBMC).Quantitative real time polymerase chain reaction(RT-qPCR)was used to validate the expression of key genes in clinical samples.Results 53 common DEGs of GSE160170 and GSE190138 were obtained,among which 43 genes were up-regulated and 10 were down-regulated.GO and KEGG indicated that most genes were involved in cell death,apoptosis,interlenkin(IL)-17 signaling pathway,tumor necrosis facter(TNF)signaling pathway and nucleotide-binding oligomerization domain-(NOD)-like receptor signaling pathway.12 co-DEGs of programmed cell death and gout were obtained.A total of 7 candidate genes were screened.LASSO regression model screened 5 genes and 4 genes respectively in two datasets,and 3 key genes were abtained by the intersection of the two datasets,which were IL-6,plasminogen activator urokinase receptor(PLAUR)and NOD-like receptor thermal protein domain associated protein3(NLRP3).Validation within the training set revealed that all three genes attained perfect diagnostic performance for gout,with area under the ROC(AUC-ROC)curve values of 1.00.Immunoinfiltration analysis showed that the changes of activated CD4+T cells,activated CD8+T cells and natural killer cells were closely related to the occurrence and development of gout.In the clinical samples,compared with the control group,PLAUR,NLRP3 and IL-6 were highly expressed in gout patients,and the differences were statistically significant(t=18.852,9.633,8.293,all P＜0.05).Conclusion IL-6,PLAUR and NLRP3 provide potential biomarkers and therapeutic targets for the diagnosis and treatment of gout,offering new directions in this field.

Objective To investigate the effect of α/β hydrolase folded protein 5(ABHD5)and cellular immunity markers on the response to tirellizumab targeted therapy in patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 123 patients with advanced NSCLC who received tiralizumab in Kailuan General Hospital from October 2020 to December 2023 were selected.The efficacy of the target lesions was evaluated 4 weeks after treatment,and the patients were divided into response group and non-response group according to the treatment effect.Quantitative real time polymerase chain reaction(RT-qPCR)was used to detect the relative expression of ABHD5 in lesion tissues.The expression level of ABHD5,immune indexes[CD4+T,CD8+T,CD4+T/CD8+T,regulatory T cell(Treg),T helper cell 17(Th17),Treg/Th17]and other clinical indexes were compared between the two groups.Multivariate logistic regression analysis of independent factors influencing response to tirelizumab targeted therapy.The predictive value of ABHD5,CD4+T and CD8+T in non-response to treatment of advanced NSCLC was analyzed by receiver operating characteristic(ROC).ABHD5 expression was correlated with CD4+T and CD8+T cells by Pearson correlation analysis.Results Among the 123 patients enrolled,90 responded to treatment and 33 did not respond.The expression of ABHD5(1.16±0.18)and the levels of CD4+T(31.52%±4.26%)and CD8+T(24.39%±1.87%)cells in the non-response group were lower than those in the response group(1.47±0.21,36.43%±4.08%,29.13%±2.15%),and the levels of Treg(7.24%±0.89%)and Th17(6.23%±1.10%)cells were higher than those in the response group(6.37%±0.91%,5.42%±0.66%),and the differences were statistically significant(t=4.725～11.200,all P<0.05).There were significant differences in tumor size,number of metastases and levels of carcinoembryonic antigen(CEA),albumin(ALB)and total bilirubin(TBIL)between the two groups,and the differences were statistically significant(t=2.969～6.523,all P<0.05).ABHD5 expression and CD4+T,CD8+T cell levels were independent protective factors affecting the response to tirelizumab targeted therapy in advanced NSCLC(Wald χ2=15.803,7.954,8.631,all P<0.05).ABHD5 predicted that the AUC of non-response to treatment of advanced NSCLC was 0.897,which was higher than that of 0.860 and 0.835 predicted by CD4+T and CD8+T cells,and the prediction sensitivity and specificity were 72.73%and 94.45%,respectively.ABHD5 expression was positively correlated with the levels of CD4+T and CD8+T cells(r=0.367,0.355,all P<0.05).Conclusion The response to tirelizumab targeted therapy in advanced NSCLC is significantly correlated with the expression of ABHD5 and the levels of CD4+T and CD8+T cells,and ABHD5 has high predictive value in the treatment of advanced NSCLC.

Objective:This study aims to investigate the relationship between plague epidemics and environmental factors in Lincang City.Methods:Epidemiological survey data and environmental factors (including altitude, temperature, rainfall, and season) from plague occurrence sites in Lincang City from 1990 to 2020 were collected from Lincang Center for Disease Control and Prevention and the data sharing platform of the data sharing service network of the China Meteorological Administration, and analyzed using multiple correspondence analysis (MCA).Results:From 1990 to 2005, a total of 38 outbreaks of plague among rodents had been reported, 17 of which involved human beings. Since 2006, the plague had entered a dormant period, with no further epidemics reported up to 2020. The plague epidemic in Lincang City exhibited a clear seasonal variation, with the primary epidemic season occurred from autumn to early winter, peaking in September and October. Furthermore, the plague epidemic in Lincang City exhibited a pronounced spatial aggregation, with the primary affected regions including Linxiang County, Gengma Dai and Va Autonomous County, Zhenkang County, and Yun County. MCA showed that the Cronbach' α coefficients of all variables in the first and second dimensions were 0.87 and 0.82, respectively, and the characteristic roots were 3.27 and 2.91, respectively. The cumulative contribution rate of the two dimensions was 84.60%. Plague outbreaks were more likely in winter in areas at altitudes of > 1 400 - 1 650 m with 1 000 - 1 200 mm average annual rainfall and 16.0 - 17.9 ℃ average annual temperature, with increased severity. Regions at altitudes of > 500 - 700 m and > 900 - 1 150 m, with average annual rainfall of < 1 000, 1 201 - 1 400 and > 1 600 mm and average annual temperature of 18.0 - 19.9 ℃, showed a higher susceptibility to plague outbreaks, with notably pronounced incidences.Conclusions:The prevalence of plague epidemics is closely related to the local climatic conditions of natural foci in Lincang City. Therefore, it is imperative to enhance the monitoring of these climatic conditions, particularly meteorological data, to facilitate more effective prevention and control of plague outbreaks.

Objective The aim of this study is to systematically analyze the therapeutic mechanisms of Wuzi Yuye Decoction in diabetic oligoasthenozoospermia based on network pharmacology and animal experiments.Methods Active components and therapeutic targets of Wuzi Yuye Decoction were screened by integrating multiple databases,and their inter-section with diabetic oligoasthenozoospermia-related targets was obtained.Common targets were identified using the Venny platform,and protein-protein interaction(PPI)networks were constructed via the STRING database.And key targets were screened through topological analysis with Cytoscape.Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses were performed using the DAVID platform.A mouse model of diabetic oligoasthenozoospermia was established by high-fat diet combined with streptozotocin induction,followed by intervention with Wuzi Yuye Decoction.Body weight,testicular index,and sperm quality were assessed,while histopathological changes were evaluated by HE staining and transmission electron microscopy(TEM).In addition,ELISA,oxidative stress assays and Western blot were used to verify the changes in key pathway-related proteins.Results A total of 36 common targets were identified,including key nodes such as TNF,IL6 and IL1B.Enrichment analysis indicated that these targets were sig-nificantly involved in inflammatory responses,oxidative stress,autophagy-apoptosis regulation and reproduction-related pathways.Animal experiments confirmed that Wuzi Yuye Decoction markedly improved testicular mass and sperm motility in diabetic mice,reduced the levels of AGE,TNF-α,IL-6 and IL-1β in testicular tissues,alleviated oxidative stress damage,and restored autophagic flux and blood-testis barrier function by inhibiting the RAGE/NF-κB/mTOR signaling axis.Conclusion Wuzi Yuye Decoction improves the pathological progression of diabetic oligoasthenozoospermia by synergistically modulating multiple targets,including inflammation inhibition,antioxidant effects,autophagy regulation,and related pathways.

Objective:To explore the relationship between tumor necrosis factor-like weak inducer of apoptosis(TWEAK),kidney injury molecule 1(KIM-1),RBC distribution width/platelet ratio(RPR)and disease activity,renal injury in children with sys-temic lupus erythematosus(SLE).Methods:A total of 42 children with newly diagnosed SLE in Xiangyang Central Hospital were en-rolled as SLE group between February 2020 and February 2022,while another 40 healthy children undergoing physical examination during the same period were enrolled as control group.According to scores of systemic lupus erythematosus disease activity index(SLEDAI),SLE children were divided into low disease activity group(≤9 points)24 cases and high disease activity group(>9 points)18 cases.According to presence or absence of renal injury,SLE children were divided into LN group 31 cases and non-LN group 11 cases.The red blood cell distribution width(RDW)and platelet count(PLT)in all objects were detected.RPR was calculated.The levels of serum TWEAK and KIM-1 were detected by ELISA.Results:The levels of serum TWEAK,KIM-1 and RPR in SLE group were significantly higher than those in control group(P<0.05).The levels of serum TWEAK,KIM-1 and RPR in high disease activity group were significantly higher than those in low disease activity group(P<0.05),which were significantly higher in LN group than non-LN group(P<0.05).Correlation analysis showed that RPR was significantly positively correlated with SLEDAI score(P<0.05),TWEAK and KIM-1 were significantly positively correlated with 24 h urinary protein(P<0.05).AUC of RPR for assessing high disease activity of SLE was 0.744(95%CI:0.657～0.818),significantly greater than that of TWEAK and KIM-1[0.678(95%CI:0.588～0.760),0.598(95%CI:0.505～0.686),P<0.05].AUC values of TWEAK and KIM-1 for predicting LN 0.847(95%CI:0.773～0.905)and 0.773(95%CI:0.690～0.842),significantly greater than that of RPR AUC values[0.645(95%CI:0.555～0.727),P<0.05].Conclusion:The levels of TWEAK,KIM-1 and RPR are changed in children with SLE.RPR has higher diagnostic efficiency for SLE activity,while TWEAK and KIM-1 have higher predictive value for LN.

To construct a recombinant fowl adenovirus 4(FAdV-4)expressing the Cap protein of goose astrovirus genotype 2(GoAstV-2),the expression cassette of Cap gene was inserted into the natural 1 966 bp deletion region of the FAdV-4 genome in the infectious clone p15A-cm-FAdV4-HNJZ.The resulted recombinant plasmid p15A-cm-FAdV4-HNJZ-Cap/GoAstV-2 was linearized with restriction enzyme and transfected into chicken hepatoma cell line(LMH)to rescue the recombinant FAdV-4 expressing the Cap protein of GoAstV-2,rF Ad V4-Cap/GoAstV-2.After 15 passages in LMH cells,the recombinant rFAdV4-Cap/GoAstV-2 was identified by PCR using primers flanking the insertion site of the Cap gene expression cassette and using viral genome DNA extracted from rFAdV4-Cap/GoAstV-2 infected LMH cells as template.LMH cells were in-fected with 15th passage rFAdV4-Cap/GoAstV-2 and indirect immunofluorescence was performed with a polyclonal antibody against Cap protein as the primary antibody.Western blot was carried out with lysates of rFAdV4-Cap/GoAstV-2 infected LMH cells.The in vitro replication dynamic of the 15th passage of the rFAdV4-Cap/GoAstV-2 was also investigated in LMH cells.The results demonstrated that the Cap gene of GoAstV-2 was presented in the genome of the recombinant vi-rus rF AdV4-Cap/Go Ast V-2,and could be expressed stably.The prepared recombinant virus in this study will lay a foundation for developing inactivated bivalent vaccine candidate against co-in-fection of FAdV-4 and GoAstV-2 in goose.

There is significant inter-individual variation of pharmacokinetics and pharmacody-namics in patients receiving tacrolimus(TAC)for an-ti-rejection therapy,which cause the rejection or toxic action.Based on results of therapeutic drug monitoring and pathophysiological index of trans-plant patients,the individualized dosing regimen can be designed and adjusted by using model in-formed precision dosing(MIPD).The patients'clini-cal outcome can be improved.In the consensus,the different methods of MIPD used for patients re-ceived TAC for anti-rejection therapy were intro-duced,which can be used for the designing and ad-justing doing regimen,predicting adverse drug reac-tion,improving medication adherence and econom-ics during therapy.