ObjectiveTo observe the clinical efficacy of tonifying kidney and replenishing essence on asthenozoospermia patients with the syndrome of kidney essence deficiency and the effects of this method on the adenosine 5′-monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin complex 1 （mTORC1） signaling pathway. MethodsSeventy-two eligible asthenozoospermia patients with the syndrome of kidney essence deficiency treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from February 2023 to January 2024 were selected and randomly assigned into an observation group and a control group， with 36 patients in each group. The observation group received oral administration of Guilu Tianjing capsules， while the control group received oral administration of L-carnitine oral solution. The treatment course lasted for 4 weeks in both groups. The observed indicators included sperm progressive motility rate （PR）， total sperm motility （PR+NP）， percentage of normal mitochondrial membrane potential （MMP）， and traditional Chinese medicine （TCM） symptom scores before and after treatment in both groups. A three-month follow-up was instituted to record the conception status of the patients’ spouses. Additionally， eight patients were randomly selected from the eligible patients in the observation group， and four healthy males with normal semen routine examination results were included as the control group for the determination of protein expression. Western blotting was conducted to assess the expression of AMPK， phosphorylated （p）-AMPK， regulatory-associated protein of mTOR （RAPTOR） and p-RAPTOR， and PTEN-induced putative kinase 1 （PINK1） in sperms from the observation group before and after treatment， as well as in the sperms of the control group. ResultsThe pregnancy rate of spouses in the observation group was 9.09% （3/33）， which was higher than that （3.33%， 1/30） in the control group. The total response rate was 84.8% （28/33） in the observation group and 66.7% （20/30） in the control group， with no statistically significant difference. After treatment， both groups were improved considering PR， PR+NP， MMP， and TCM symptom scores （P<0.01）. Moreover， the observation group exhibited more pronounced decreases in TCM symptom scores than the control group （P<0.05）， while the changes in PR， PR+NP， and MMP showed no statistical significance between groups. Compared with the control group， the asthenozoospermia group exhibited upregulations in phosphorylation levels of AMPK and RAPTOR and protein level of PINK （P<0.01）. The administration of Guilu Tianjing Capsules led to downregulations in the phosphorylation levels of AMPK and RAPTOR and protein level of PINK1 （P<0.01）. However， the protein levels of AMPK and RAPTOR demonstrated no significant difference between before and after treatment. During the study period， neither group of patients exhibited any notable adverse reactions. ConclusionGuilu Tianjing capsules can enhance the sperm motility and percentage of normal mitochondrial membrane potential in asthenozoospermia patients with the syndrome of kidney essence deficiency by downregulating the AMPK/mTORC1 signaling pathway， lowering the protein level of PINK1， and inhibiting excessive activation of mitophagy.

ObjectiveTo observe the clinical efficacy of tonifying kidney and replenishing essence on asthenozoospermia patients with the syndrome of kidney essence deficiency and the effects of this method on the adenosine 5′-monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin complex 1 （mTORC1） signaling pathway. MethodsSeventy-two eligible asthenozoospermia patients with the syndrome of kidney essence deficiency treated in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from February 2023 to January 2024 were selected and randomly assigned into an observation group and a control group， with 36 patients in each group. The observation group received oral administration of Guilu Tianjing capsules， while the control group received oral administration of L-carnitine oral solution. The treatment course lasted for 4 weeks in both groups. The observed indicators included sperm progressive motility rate （PR）， total sperm motility （PR+NP）， percentage of normal mitochondrial membrane potential （MMP）， and traditional Chinese medicine （TCM） symptom scores before and after treatment in both groups. A three-month follow-up was instituted to record the conception status of the patients’ spouses. Additionally， eight patients were randomly selected from the eligible patients in the observation group， and four healthy males with normal semen routine examination results were included as the control group for the determination of protein expression. Western blotting was conducted to assess the expression of AMPK， phosphorylated （p）-AMPK， regulatory-associated protein of mTOR （RAPTOR） and p-RAPTOR， and PTEN-induced putative kinase 1 （PINK1） in sperms from the observation group before and after treatment， as well as in the sperms of the control group. ResultsThe pregnancy rate of spouses in the observation group was 9.09% （3/33）， which was higher than that （3.33%， 1/30） in the control group. The total response rate was 84.8% （28/33） in the observation group and 66.7% （20/30） in the control group， with no statistically significant difference. After treatment， both groups were improved considering PR， PR+NP， MMP， and TCM symptom scores （P<0.01）. Moreover， the observation group exhibited more pronounced decreases in TCM symptom scores than the control group （P<0.05）， while the changes in PR， PR+NP， and MMP showed no statistical significance between groups. Compared with the control group， the asthenozoospermia group exhibited upregulations in phosphorylation levels of AMPK and RAPTOR and protein level of PINK （P<0.01）. The administration of Guilu Tianjing Capsules led to downregulations in the phosphorylation levels of AMPK and RAPTOR and protein level of PINK1 （P<0.01）. However， the protein levels of AMPK and RAPTOR demonstrated no significant difference between before and after treatment. During the study period， neither group of patients exhibited any notable adverse reactions. ConclusionGuilu Tianjing capsules can enhance the sperm motility and percentage of normal mitochondrial membrane potential in asthenozoospermia patients with the syndrome of kidney essence deficiency by downregulating the AMPK/mTORC1 signaling pathway， lowering the protein level of PINK1， and inhibiting excessive activation of mitophagy.

The co-development of the technology pointing to the "external nature" and the technology pointing to the "physical nature" promotes the co-evolution of the man and the machine. The emerging body enhancement technique is derived from the "defective existence" of the man, and it changes the "body nature" from the inside of the man. The emerging body enhancement techniques are rapidly spread out driven by the multiple forces. The emerging body enhancement techniques has led to the weakening of the natural body identity and the strengthening of the symbolic body identity, the class solidification and the rise of "cyberpunk", the mixing of the natural person and the technical person. To consciously guide the development and application of emerging human enhancement surgery used human care theory. The physical care is an important reference to judge the good and the evil of the emerging body enhancement technique. The management about the body ethics is the optimal choice about the management of the emerging body enhancement technique. The physical care is the important content of the education of the emerging body enhancement technique.

Artificial intelligence (AI) has shown a tendency to replace human brain intelligence, and its rise has led to significant social changes. AI has pioneered the historical process of human-machine co-evolution. In the embedding of AI into medicine, it can be seen that there are a wide range of medical application scenarios. Intelligent medicine based on AI technology is of great significance, achieving spatial transmutation under spatial connection and value release under data mining. Intelligent medicine occupies a "high-level position" in value evaluation. Intelligent medicine has become a risk complex due to its tendency towards de-subjectivity of doctors, questioning the effectiveness of the intelligent algorithms, increasing difficulty in protecting information security and individual privacy, and indifference to medical humanistic care. To prevent the risks of intelligent medicine, it is necessary to reasonably define the relationship between AI and doctors, effectively prevent the risks of intelligent algorithms, increase the protection efforts of patient data security and personal privacy, thickly cultivate humanistic care in AI, and promote the improvement of the scientific and technological ethical governance system through ethical review.

Objective:To identify the risk factors for functional delayed gastric emptying(FDGE)after retroperitoneal tumor resection.Meth-ods:Sixty-seven patients with postoperative FDGE after retroperitoneal tumor resection from September 2017 to December 2022 admited in Peking University International Hospital were included in the observation group,and 836 normal patients who underwent ret-roperitoneal tumor resection during the same period were included in the control group.Medical histories and clinical treatment data were obtained for each group and compared to identify the risk factors for FDGE after retroperitoneal tumor resection.Results:The overall incid-ence of postoperative FDGE was 7.42%.Factors that were significantly elevated(P<0.05)in the observation group relative to the control group included adverse mental factors(37.31%),preoperative digestive tract obstruction(41.79%),postoperative abdominal cavity complic-ations(79.10%),diabetes(29.86%),average age of(61.85±6.11)years,and blood loss(1 011.94±507.30)mL.Pre-and post-surgery albumin levels[(38.22±3.75)g/L and(30.22±3.36)g/L,respectively]were significantly reduced(P<0.05)in the observation group compared to the control group.Risk factor analyses revealed that advanced age,diabetes,preoperative digestive tract obstruction,intraoperative blood loss,perioperative albumin level,postoperative abdominal cavity complications,and adverse mental factors were correlated with postoperative FDGE.Conclusions:Diverse factors could impact the risk of FDGE after retroperitoneal tumor resection.Patients should be accurately evalu-ated;reasonable and detailed prevention and treatment plans should be developed.

Background::Heterogeneity of tumor cells and the tumor microenvironment (TME) is significantly associated with clinical outcomes and treatment responses in patients with urothelial carcinoma (UC). Comprehensive profiling of the cellular diversity and interactions between malignant cells and TME may clarify the mechanisms underlying UC progression and guide the development of novel therapies. This study aimed to extend our understanding of intra-tumoral heterogeneity and the immunosuppressive TME in UC and provide basic support for the development of novel UC therapies.Methods::Seven patients with UC were included who underwent curative surgery at our hospital between July 2020 and October 2020. We performed single-cell RNA sequencing (scRNA-seq) analysis in seven tumors with six matched adjacent normal tissues and integrated the results with two public scRNA-seq datasets. The functional properties and intercellular interactions between single cells were characterized, and the results were validated using multiplex immunofluorescence staining, flow cytometry, and bulk transcriptomic datasets. All statistical analyses were performed using the R package with two-sided tests. Wilcoxon-rank test, log-rank test, one-way analysis of variance test, and Pearson correlation analysis were used properly.Results::Unsupervised t-distributed stochastic neighbor embedding clustering analysis identified ten main cellular subclusters in urothelial tissues. Of them, seven urothelial subtypes were noted, and malignant urothelial cells were characterized with enhanced cellular proliferation and reduced immunogenicity. CD8 + T cell subclusters exhibited enhanced cellular cytotoxicity activities along with increased exhaustion signature in UC tissues, and the recruitment of CD4 + T regulatory cells was also increased in tumor tissues. Regarding myeloid cells, coordinated reprogramming of infiltrated neutrophils, M2-type polarized macrophages, and LAMP3 + dendritic cells contribute to immunosuppressive TME in UC tissues. Tumor tissues demonstrated enhanced angiogenesis mediated by KDR + endothelial cells and RGS5 +/ACTA2 + pericytes. Through deconvolution analysis, we identified multiple cellular subtypes may influence the programmed death-ligand 1 (PD-L1) immunotherapy response in patients with UC. Conclusion::Our scRNA-seq analysis clarified intra-tumoral heterogeneity and delineated the pro-tumoral and immunosuppressive microenvironment in UC tissues, which may provide novel therapeutic targets.

The emerging body enhancement technique repairs the "defective structure" of the body from the inside of the person, so that the body can get the support of technical strength. The emerging body enhancement technique starts the process of gradual disintegration of natural body, and its technical oppression dispels individual freedom, and forms a deep connection between power and capital in emerging body enhancement technique. In order to promote the synthetic development between the technique progress and the order construction, it is significant to rescue the emerging body enhancement technique from the fighting between the biological conservatism and the super humanism, promote the development of the emerging body enhancement technique from the professional education to the popularity education, regulate the development of the emerging body enhancement technique with the theory framework of the body ethics, and promote the development of the supervision of the emerging body enhancement technique to all directions and the whole process.

The co-development of the technology pointing to the "external nature" and the technology pointing to the "physical nature" promotes the co-evolution of the man and the machine. The emerging body enhancement technique is derived from the "defective existence" of the man, and it changes the "body nature" from the inside of the man. The emerging body enhancement techniques are rapidly spread out driven by the multiple forces. The emerging body enhancement techniques has led to the weakening of the natural body identity and the strengthening of the symbolic body identity, the class solidification and the rise of "cyberpunk", the mixing of the natural person and the technical person. To consciously guide the development and application of emerging human enhancement surgery used human care theory. The physical care is an important reference to judge the good and the evil of the emerging body enhancement technique. The management about the body ethics is the optimal choice about the management of the emerging body enhancement technique. The physical care is the important content of the education of the emerging body enhancement technique.

Objective:To detect the expression and methylation of TIA1 in breast cancer and to study its correlation with multi-slice spiral CT signs.Methods:50 patients with breast cancer were collected from Feb.2019 to Mar. 2020. The expression levels of TIA1 in breast cancer tissues and in peritumoral tissues were estimated by quantitative real-time polymerase chain reaction. Bioinformatics software MethPrimer was used for predicting TIA1 promotor and confirmed the existence of cPG island. Methylation-specific PCR (MSP) was performed to detect TIA1 DNA promoter methylation. All patients were examined by multi-slice CT. CT images were analyzed through observing the tumor size, shape, calcification area, lymph node metastasis and margin. The correlation between CT signs and TIA1 methylation status was further analyzed.Results:The expression levels of TIA1 in breast cancer tissues were lower than in peritumoral tissues (0.50±0.12, 0.95±0.10, P=0.00) , while TIA1 DNA promoter methylation rate was higher than in peritumoral tissues (64%, 42%, χ2=4.86, P<0.05) .There were no significant differences in TIA1 DNA promoter methylation rate among patients with different tumor shape and micro calcifications. TIA1 DNA promoter methylation rate in patients with mass diameter≥2 cm were significantly higher than those in patients with mass diameter<2 cm (78.57%, 45.45%, P<0.05) , and TIA1 DNA promoter methylation rate in patients with lymph node metastasis was higher than those without lymph node metastasis (79.17%, 50%, P<0.05) . TIA1 DNA promoter methylation rate in patients with burr at edge of mass was higher than those without burr at edge of mass (80.77%, 45.83%, P<0.05) . Conclusion:There is a correlation between CT imaging signs and TIA1 DNA promoter methylation rate in patients with breast cancer, which can provide more reference for the judgment of malignant degree and prognosis of patients with breast cancer.

Objective:To investigate the multiple origin of retroperitoneal liposarcoma and its postoperative prognosis.Methods:A total of 49 retroperitoneal liposarcoma patients underwent total (ipsilateral) retroperitoneal lipectomy in our center from May 2017 to December 2019 were recruited. Clinical data and the follow-up information were reviewed and the origin and prognosis were analyzed.Results:A total of 15 patients were pathologically diagnosed as multiple primary cancer (MPC), the incidence rate of retroperitoneal liposarcoma with MPC was 30.6% (15/49), while other 34 cases was non-MPC. The postoperative recurrence rates of patients with high differentiation and de-differentiation retroperitoneal liposarcoma were 31.8% and 44.4%, without significant difference ( P>0.05). The postoperative recurrence rates of MPC and non-MPC were 40.0% and 38.2%, without significant difference ( P>0.05). Five cases died within the follow-up. Conclusion:Retroperitoneal liposarcoma might origin form MPC, and total (ipsilateral) retroperitoneal lipectomy is recommended to reduce the recurrence rate.