Abstract:Objective To analyze and compare the predictive performance of six machine learning models,namely logistic regression(LR),linear discriminant analysis(LDA),decision tree(DT),random forest(RF),CatBoost,and LightGBM,in predicting the risk of retinopathy in patients with type 2 diabetes.Methods Based on the early warning dataset of diabetic complications from the National Population Health Data Center,retinopathy risk prediction models for type 2 diabetic patients were constructed based on different algorithms.After data cleaning,the training dataset and test dataset were divided according to 7∶3,and the prediction performance(accuracy,recall,precision,F1-Score,and AUC)of the six models was compared using the ten-fold cross-validation method.Results In the test dataset,six models were used to predict the risk of retinopathy in patients with type 2 diabetes,and LightGBM exhibited the highest accuracy(0.773 8),recall(0.825 1),precision(0.762 0),F1-Score(0.792 3),and AUC(0.843 4).CatBoost followed with accuracy(0.744 1),recall(0.787 8),precision(0.729 1),F1-Score(0.757 3),and AUC(0.828 0).Conclusion For predicting the risk of retinopathy in patients with type 2 diabetes,LightGBM performs the best among the six models.Additionally,ensemble learning classifiers(LightGBM,CatBoost,and RF)outperform weak learning classifiers(DT,LR,and LDA)in terms of predictive performance,offering a convenient and reliable reference for clinical auxiliary diagnosis and risk prediction of retinal complications in patients with type 2 diabetes.

Abstract:Objective To investigate the dynamic regulation of DNA damage-inducible transcript 4(DDIT4)in the adaptation of hepatocellular carcinoma(HCC)cells to hypoxic microenvironments and its impact on malignant behavior.Methods A hypoxic model of HCC cells was established using CoCl2 to simulate hypoxic conditions,and the expression of DDIT4 was detected.A stable DDIT4 knockdown cell line was constructed using lentivirus-mediated RNA interference.Cell proliferation and autophagy were assessed using CCK-8 and Western blotting.Transcriptomic and metabolomic sequencing were employed to analyze changes in metabolic pathways.The phosphorylation level of key mTORC1 site(Ser2448)was detected to elucidate the molecular regulatory mechanisms.Results Hypoxic treatment induced dynamic changes in DDIT4 expression in HepG2 cells,with a peak at 24 h followed by a significant decline at 48 h(P＜0.01).DDIT4 knockdown significantly enhanced cell proliferation(P＜0.01)and inhibited autophagic flux(P＜0.05).Integrated transcriptomic and metabolomic analyses further revealed that DDIT4 deficiency led to abnormalities in glycolysis and purine metabolism,along with imbalances in redox homeostasis.Mechanistically,DDIT4 deficiency significantly increased the phosphorylation activity of mTORC1(Ser2448)(P＜0.05).Conclusion Through dynamical regulation of mTORC1 pathway,DDIT4 coordinates hypoxic adaptation of HCC and relieves stress damage through upregulation in the early phase,while its later depletion triggers excessive mTORC1 activation,driving metabolic reprogramming and malignant proliferation.Analyzing the dynamic regulation of DDIT4 in different stages of hypoxia may provide novel therapeutic strategies to overcome clinical challenges in HCC,including chemoresistance and postoperative recurrence.

Abstract:Robot-assisted laparoscopic technology has gradually developed since the end of the 20th century,with high-quality 3D surgical field imaging and sub-millimeter operational accuracy,promoting the innovation of precision and minimally invasive urological surgery.In radical prostatectomy,robot technology significantly improves postoperative urinary control and sexual function recovery through improved surgical techniques such as Retzius space preservation,Hood technique,and posterior approach,and has a lower positive margin and biochemical recurrence rate than open and laparoscopic surgery.Robot-assisted partial nephrectomy achieves the goal of"Trifecta" by shortening the warm ischemia time and reducing renal function damage,and its perioperative outcomes are superior to those of open and laparoscopic procedures.For radical nephrectomy combined with removal of inferior vena cava tumor thrombus,robot technology can reduce intraoperative bleeding and complications,but it requires multidisciplinary collaboration and optimization of preoperative neoadjuvant therapy.Robot-assisted radical cystectomy has shown outstanding performance in bleeding control and minimally invasive procedures,but complete internal urinary diversion still needs to be promoted.In addition,robot technology has demonstrated safety and minimally invasive advantages in areas such as adrenal tumor resection,ureteral reconstruction,and kidney transplantation,especially showing great potential in complex cases.Although robot technology has limitations such as lack of tactile feedback and high cost,the rapid development of domestic systems and the remote application of 5G provide new opportunities for its popularization.In the future,with the integration of AI technology,robotic surgery will further break through in the two aspects of"precision"and"remote",promoting the development of minimally invasive urology.

Abstract:Objective To explore the differences in postoperative renal function among robot-assisted,laparoscopic,and open partial nephrectomy(PN)for T1b renal tumors.Methods A retrospective analysis was conducted on clinical data from 246 patients with T1b renal tumors who underwent PN at Xijing Hospital,Air Force Medical University from March 2009 to April 2023.The patients were divided into three groups:open partial nephrectomy(OPN)group(n=98),laparoscopic partial nephrectomy(LPN)group(n=102),and robot-assisted partial nephrectomy(RAPN)group(n=46).The estimated glomerular filtration rate(eGFR)and eGFR decline were compared among the three groups at 3 months,6 months,1 year,2 years,3 years,4 years,and 5 years postoperatively.Results The median follow-up duration was 12(6,48)months.Preoperative eGFR was higher in the LPN group compared to the OPN group(P=0.002)and higher in the RAPN group compared to the OPN group(P＜0.001),with no significant difference between LPN group and RAPN group(P=0.211).During follow-up,statistically significant differences in eGFR were observed among the groups at 3 months and 6 months postoperatively(P＜0.05),but no significant differences were found at 1-5 years postoperatively(P＞0.05).Pairwise comparisons at 3 months postoperatively showed higher eGFR in the LPN group(P=0.002)and RAPN group(P＜0.001)compared to the OPN group,with no significant difference between LPN group and RAPN group(P=0.108).At 6 months postoperatively,eGFR remained higher in the LPN group(P=0.010)and RAPN group(P=0.033)compared to the OPN group,with no significant difference between LPN group and RAPN group(P=0.940).For eGFR decline,significant differences were observed among the groups at 3 months postoperatively(P=0.044),but no significant differences were found at 6 months and 1-5 years postoperatively(P＞0.05).Pairwise comparisons at 3 months postoperatively showed greater eGFR decline in the OPN group compared to the LPN group(P=0.016),but no significant differences were observed between OPN group and RAPN group(P=0.102)or between LPN group and RAPN group(P=0.609).Conclusion The OPN group has worse baseline eGFR and greater eGFR decline at 3 months postoperatively,suggesting that minimally invasive techniques offer better early renal function preservation compared to traditional OPN.The long-term eGFR at 1-5 years postoperatively is similar among the three surgical procedures.Taking into account the preoperative baseline differences,it suggests that OPN may have a stronger protective effect on long-term renal function after surgery for T1b renal tumors.

Abstract:In 1975,human parvovirus B19(B19V),which is only pathogenic to humans,was first discovered,but research has found that it existed for thousands of years.Due to the time limit of literature,B19V outbreak was recorded only in a unit or country.As for the harm of B19V to humans,it is generally believed that it is mostly mild,and typical manifestations and characteristic diseases are often introduced.However,their atypical manifestations,disability and mortality are not well understood.Since the beginning of 2024,sudden outbreaks of B19V infection have been reported in the United States and more than ten countries in Europe.The affected populations are mainly children and pregnant women,with child deaths and fetal loss posing significant risks.For atypical cases,diagnosis is often delayed due to difficulty in identifying B19V infection.This article briefly introduces the characteristics of B19V,the complexity and atypia of its manifestations,diagnostic criteria,the key problems of both outbreak period and long-term response strategies,providing suggestions for China to deal with the outbreak and final resolution of B19V infection.

Abstract:The characteristics of new aircraft,new combat requirements,and special flight environments pose higher demands on the physical and mental qualities of pilots,bringing new challenges to aviation medical support.Domestic teams have focused on the actual combat needs of aviation units,conducted research on key technologies for aviation medical support,created new simulation training technologies of vestibular function and vestibular illusion,developed high-altitude micro pressure training cabins and underwater escape training equipment,formulated comprehensive prevention and treatment plans for neck and waist injuries,and promoted solutions to key issues that restrict the operational efficiency of pilots.This paper summarizes the technological breakthroughs and theoretical innovations in the field of aviation medical support in China in recent years,as well as the positive role played by the application of these achievements in improving the operational efficiency of pilots,which has certain guiding significance for promoting the disciplinary development of aviation medicine.

Abstract:Objective To investigate the role of microRNA-210,a bioactive substance of exosomes(exos)derived from bone marrow mesenchymal stem cells(BMSCs),in mice after myocardial infarction(MI)to evaluate its potential clinical value in MI.Methods BMSCs-exos were extracted,identified and analyzed by electron microscopy and Western blotting.All mice were randomly divided into four groups:Sham group(only thoracotomy without ligation),MI group(thoracotomy and left anterior descending artery ligation),MI+BMSCs-exos group(left anterior descending artery ligation followed by injection of BMSCs-exos),MI+BMSCs-exos+microRNA-210 inhibitor group(left anterior descending artery ligation followed by injection of BMSCs-exos transfected with microRNA-210 inhibitor).After the mouse model of MI was established by left anterior descending coronary artery ligation,exos or exos transfected with microRNA-210 inhibitor were infused intramuscularly around the infarcted myocardium immediately.MicroRNA-210 was extracted from myocardial tissues of each group and its expression was detected by PCR.The cardiac function was tested by echocardiography.The MI area was measured after Evans blue staining of the heart.The apoptosis of cardiomyocytes in each group was detected by TUNEL.The expression of apoptosis-related proteins in cardiomyocytes was detected by Western blotting.Results Compared with Sham group,left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)in MI group were significantly decreased,the MI area was significantly increased,the apoptosis level of cardiomyocytes was significantly increased,the apoptosis-related protein Bcl-2 expression was significantly decreased,and Bax expression was significantly increased(P＜0.05).Compared with MI group,LVEF and LVFS in MI+BMSCs-exos group were significantly increased,MI area was significantly decreased,myocardial apoptosis level was significantly decreased,apoptosis-related protein Bcl-2 expression was significantly increased,and Bax expression was significantly decreased(P＜0.05).Compared with MI+BMSCs-exos group,LVEF and LVFS in MI+BMSCs-exos+microRNA-210 inhibitor group were significantly decreased,MI area was significantly increased,myocardial apoptosis level was significantly increased,apoptosis-related protein Bcl-2 expression was significantly decreased,and Bax expression was significantly increased(P＜0.05).Conclusion BMSCs-exos inhibit apoptosis via microRNA-210,thereby improving the cardiac function of mice after MI and reducing MI area of mice,and playing a certain protective role in MI.

Abstract:Objective To compare and analyze the safety and effectiveness of carotid endarterectomy(CEA)and carotid artery stenting(CAS)in the treatment of carotid artery stenosis,and explore the differences in clinical efficacy between the two surgical methods.Methods A prospective analysis was conducted on the clinical data of 161 patients with carotid artery stenosis who received CEA or CAS treatment from September 2018 to September 2021.Results After 1 year of follow-up,both groups of patients underwent B-ultrasound at 6 months and 1 year of follow-up.The plaque detection rate and restenosis rate in CEA group were significantly lower than those in CAS group(P＜0.01).The improvement of postoperative National Institutes of Health Stroke Scale(NIHSS)and Mini-Mental State Examination(MMSE)in CEA group was better than that in CAS group(P＜0.01).For patients with mild infarction before surgery,the improvement of modified Rankin Scale(mRS)in CEA group was better than that in CAS group(P＜0.01),and the difference was statistically significant.Conclusion The plaque detection rate of B-ultrasound follow-up at 6 months and 1 year after surgery in CEA group is significantly lower than that in CAS group,and the restenosis rate in CEA group is lower than that in CAS group.After treatment,both groups are able to improve the neurological and cognitive function of patients.The CEA group shows better improvement in postoperative NIHSS and MMSE.For patients with preoperative infarction,CEA shows more significant improvement in mRS.

Abstract:Objective To investigate whether carotid artery shunting can reduce cerebral ischemia-reperfusion injury(IRI)after carotid endarterectomy(CEA).Methods This study was an observational case-control study.Patients who underwent CEA in the Department of Neurosurgery from January 2019 to December 2022 were collected in the Stroke Construction Center database of Tangdu Hospital,Air Force Medical University.A total of 340 patients were divided into two groups.The shunting group included 142 patients who underwent carotid artery shunting,while the control group included 198 patients who did not undergo carotid artery shunting.The indications for carotid artery shunting were severe bilateral internal carotid artery(ICA)stenosis(＞70％),severe ICA stenosis(＞70％)with contralateral ICA occlusion,and ICA subocclusion.The incidence of in-hospital and early postoperative stroke,postoperative IRI,and neurological system were compared between the two groups.Results Cranial nerve injury occurred significantly more frequently in patients in the shunt group compared with the control group(6.3％vs 2.8％).The incidence of postoperative IRI after CEA in the shunt group was significantly lower than that in the control group(P=0.02).During the postoperative follow-up,there were no significant differences in stroke,mortality,and vascular restenosis between the two groups.Conclusion Our findings suggest that carotid artery shunting significantly reduces the incidence of cerebral IRI after CEA in high-risk patients compared with the control group.

Abstract:Objective To investigate the relationship between pancreatic stiffness and pancreatic islet function in patients with type 2 diabetes mellitus(T2DM)by using virtual touch tissue quantification(VTQ)technique.Methods A total of 120 hospitalized T2DM patients(89 males and 31 females),with a mean age of(52.38±12.81)years and diabetes duration of(7.82±6.28)years,were collected in Department of Endocrinology,Tangdu Hospital,Air Force Medical University from June 2020 to January 2021.All subjects underwent anthropometric measurements and fasting blood glucose,fasting C-peptide,glycosylated hemoglobin and other biochemical indicators.VTQ technique was used to measure the pancreatic stiffness.Patients were divided into groups according to the tertiles of pancreatic stiffness,and the C-peptide levels of different pancreatic stiffness groups were compared by one-way ANOVA.Pearson correlation analysis and multiple stepwise linear regression analysis were used for statistical correlation analysis.Results The C-peptide levels decreased gradually with the increase of pancreatic stiffness(F=8.241,P＜0.05).Pearson correlation analysis showed that pancreatic stiffness was positively correlated with diabetes duration(r=0.339,P＜0.01),and negatively correlated with C-peptide levels(r=-0.308,P＜0.01).Multiple linear regression analysis showed that pancreatic stiffness and diabetes duration were independent influencing factors of C-peptide levels(standardized regression coefficients β=-0.228,-0.051,P＜0.05).Conclusion Increased pancreatic stiffness is associated with decreased C-peptide levels.VTQ technique can be used to evaluate pancreatic stiffness,and pancreatic stiffness can be used as an indicator to measure pancreatic islet beta cell function in clinical practice.

Abstract:Objective To explore the effects of perceived stress on emotional eating among military academy cadets and the chain mediating effects of anxiety and sleep quality,providing a basis for the training of healthy eating behaviors and psychological interventions among military academy cadets.Methods Using the Perceived Stress Scale,Adult Eating Behavior Scale,Self-Rating Anxiety Scale,and Pittsburgh Sleep Quality Index,a questionnaire survey was conducted among undergraduate students at a military academy in Xi'an,and a total of 777 valid questionnaires were collected.SPSS software was employed to conduct correlation analysis,regression analysis,and chain mediating effect analysis to test the mediating effects of anxiety and sleep quality between perceived stress and emotional eating.Results There were significant positive correlations between perceived stress and anxiety(r=0.612,P＜0.01),sleep quality(r=0.492,P＜0.05),and emotional eating(r=0.327,P＜0.05).Anxiety and sleep quality had partial mediating effects between perceived stress and emotional eating,and there was also a chain mediating effect between them,with the mediating effect accounting for 49.32％of the total effect.Conclusion The perceived stress of military academy cadets can indirectly affect emotional eating behaviors through anxiety and sleep quality.It is recommended to help cadets cope with stress and reduce emotional eating behaviors through psychological counseling and improving the sleep environment.

Abstract:Objective To investigate the efficacy of extraperitoneal laparoscopic radical prostatectomy(ELRP)in treating prostate cancer(PCa)and analyze the predictive value of neutrophil-to-lymphocyte ratio(NLR),prostate-specific antigen density(PSAD),and alkaline phosphatase(ALP)for patient prognosis.Methods A total of 196 PCa patients admitted to the Department of Urology in Zhoushan Hospital from November 2019 to November 2023 were selected as the object of study.According to different approaches,they were divided into transperitoneal laparoscopic radical prostatectomy(TLRP)group(n=94)and ELRP group(n=102).The end-point of follow-up was patient death or until November 30,2024.According to patient prognosis,they were divided into good prognosis group(n=143)and poor prognosis group(n=53).The perioperative indicators and postoperative in-hospital complications were compared between TLRP group and ELRP group.Poor prognosis of PCa patients was included as positive and good prognosis as negative,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of various indexes for poor prognosis of PCa patients.Results Compared with TLRP group,the operation time and postoperative recovery time of ELRP group were shorter,and the intraoperative blood loss was lower(P＜0.05).During the postoperative hospital stay,the complication rates in ELRP group and TLRP group were 1.96％and 9.57％,respectively,and the incidence in ELRP group was lower(P＜0.05).Among 196 PCa patients,53 had a poor prognosis,with an incidence of 27.04％.Multivariate logistic regression analysis showed that positive surgical margin(OR=1.790,95％CI=1.138-2.814),increased Gleason score(OR=1.870,95％CI=1.126-3.107),increased whole blood NLR(OR=1.833,95％CI=1.040-3.230),increased PSAD(OR=2.059,95％CI=1.299-3.263),and increased serum ALP level(OR=2.418,95％CI=1.419-4.121)were risk factors for poor prognosis in PCa patients(P＜0.05).The ROC curve was drawn to analyze the predictive value of NLR,PSAD,and ALP alone and in combination for poor prognosis of PCa patients.The areas under the curve were 0.830,0.674,0.818,and 0.931,and the combined detection was the highest(Z=2.626,5.541,and 2.585,P＜0.05),with sensitivity of 90.57％and specificity of 87.41％.Conclusion Compared with TLRP,ELRP can improve perioperative indicators and reduce the risk of complications in PCa.Positive surgical margin,increased Gleason score,increased whole blood NLR,increased PSAD,and increased serum ALP level are risk factors for poor prognosis in PCa patients.The combined detection of NLR,PSAD,and ALP has high predictive value for patient prognosis.

Abstract:Objective To explore the psychological status and influencing factors of 1 242 epilepsy patients in rural areas of Shaanxi Province.Methods A cross-sectional study was conducted on patients with convulsive epilepsy who were enrolled in the Shaanxi Province Rural Epilepsy Prevention and Management Project from February 2012 to September 2020.The sociodemographic data and seizure symptomatology information of epilepsy patients were collected through questionnaire survey,and the epilepsy-related psychological burden score was assessed.K-means clustering algorithm in the field of machine learning was used to divide the epilepsy patients into low psychological burden and high psychological burden groups based on the scores of epilepsy-related psychological burden.Multivariate logistic regression analysis was used to analyze the influencing factors of epilepsy-related psychological burden.Results A total of 1 242 patients participated in this study,and 1 109(89.3％)patients showed varying degrees of epilepsy-related psychological burden,with the most common concern being epilepsy recurrence,accounting for 77.4％.There were 454(36.6％)patients in the high psychological burden group,with the most concerning issue being accidental injury,accounting for 96.9％.Multivariate logistic regression analysis showed that unmarried/divorced status,seizure frequency≥24 times/year before treatment,annual family income＜36 000 yuan,and uncontrolled seizures in the past year were risk factors for higher psychological burden in epilepsy patients in rural areas(P＜0.05).Conclusion Nearly 90％of the patients show varying degrees of epilepsy-related psychological burden.Marital status,annual family income,and the condition of seizures are significantly correlated with epilepsy-related psychological burden in rural patients.It is necessary to strengthen epilepsy knowledge education and provide social support and psychological intervention for rural patients to improve their quality of life.

Abstract:Objective To mine and analyze the adverse drug event signals of pembrolizumab,so as to provide reference for safe medication in clinic.Methods Adverse event reports from Q4 2014 to Q4 2022 were extracted from the Food and Drug Administration Adverse Event Reporting System database,and data mining was conducted using reporting odds ratio method and Medicines and Healthcare Products Regulatory Agency method.Results A total of 853 adverse event signals were obtained in the reports of pembrolizumab as the primary suspect drug after screening,and the signals with the highest intensity were immune-mediated hypothyroidism,immune-mediated kidney disease,and immune-mediated gastritis.The top 50 adverse events for signal strength involved a total of 17 systems,including diseases of the hepatobiliary system,endocrine system,and immune system.Conclusion The study finds a variety of adverse event signals not reported by the drug label,such as immune-mediated cystitis,adrenocorticotropic hormone deficiency,and tumour hyperprogression,which can provide references for clinical safe drug use.

Abstract:Objective To analyze the correlation of paravertebral muscle parameters,including muscle cross-sectional area(CSA)and fat infiltration rate(FIR),with gender,left and right sides,body mass index(BMI),age,Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)in patients with chronic low back pain(CLBP).Methods A total of 109 CLBP patients with complete data were collected from Xijing Hospital,Air Force Medical University from April 2023 to December 2023.FIR was calculated by using ImageJ software to measure the fat infiltration area of L2-3,L3-4,L4-5,and L5-S1 multifidus muscle,erector spinae muscle and psoas major muscle,as well as muscle CSA.Gender,BMI,age,VAS,ODI and other information of the patients were obtained from the cases.Non-parametric Mann-Whitney U test was used to analyze the measured paravertebral muscle of each segment and gender,as well as FIR on both sides of the muscle.Spearman correlation analysis was used to measure the correlation between paravertebral muscle and BMI,age,VAS and ODI.Results ①There was no difference between left and right side of paravertebral muscle FIR in CLBP patients(P＞0.05),but there was a difference between genders(P＜0.05).②There was no significant correlation between paravertebral muscle FIR and BMI in CLBP patients,while multifidus muscle FIR and erector spinae muscle FIR were correlated with age,VAS and ODI.③There was no significant correlation between paravertebral muscle CSA and BMI,age,VAS and ODI in CLBP patients.Conclusion This study excludes some irrelevant factors of paravertebral muscle fat infiltration,explores the group more prone to low back pain,and analyzes the relationship between paravertebral muscle FIR and the degree of low back pain and life impact,providing a new idea for evaluating the degree of low back pain of patients and evaluating the therapeutic effect.

Abstract:Objective To explore the potential targets and molecular mechanisms of genistein in the treatment of periodontitis based on network pharmacology,molecular docking technology and bioinformatics analysis.Methods A variety of databases were used to predict the targets of genistein and periodontitis,and GO functional analysis and KEGG enrichment analysis were conducted.The protein-protein interaction network of genistein-periodontitis was plotted using STRING database,and the top 10 key targets were obtained using Cytoscape software.The key targets of genistein in the treatment of periodontitis were analyzed by molecular docking technology.The key cell types on which genistein might act were analyzed using a periodontal single-cell sequencing dataset.Results A total of 731 periodontitis-related disease targets and 89 genistein targets were obtained from the database,and 27 key targets were screened.GO and KEGG pathway enrichment analysis showed that genistein might play a therapeutic role by regulating signaling pathways such as estrogen and serine-type endopeptidase.The results of molecular docking analysis showed that genistein had good binding potential with multiple targets.Conclusion This study explores the potential targets and mechanisms of genistein in the treatment of periodontitis,providing a reference for promoting drug research and development and application.

Abstract:Objective To investigate the effects of lncRNA RUSC1-AS1 on the growth and epithelial-mesenchymal transition of human hepatocellular carcinoma cell SK-HEP-1 xenograft in nude mice,and to explore its mechanism.Methods RUSC1-AS1 shRNA and negative control recombinant plasmids were constructed.The model of human hepatocellular carcinoma cell SK-HEP-1 xenograft was established in nude mice.The nude mice were divided into three groups:Control group,shRNA group and shRNA-NC group.Mice in shRNA group and shRNA-NC group were injected with plasmid through tail vein.The body mass of mice was observed and the tumor volume was recorded during plasmid injection.The tumor tissues were collected and photographed after the last injection.HE staining was used to observe the pathological status of tumor tissues in each group.The mRNA and protein expression levels of E-cadherin(E-cad),N-cadherin(N-cad)and Vimentin in tumor tissues of each group were detected by qRT-PCR and Western blotting.The expression of RUSC1-AS1 and miR-125b-5p in tumor tissues of each group was detected by qRT-PCR.Results Compared with Control group or shRNA-NC group,body mass and mRNA and protein expression levels of E-cad in tumor tissues of shRNA group were significantly increased(P＜0.05).Tumor volume and mRNA and protein expression levels of N-cad and Vimentin in tumor tissues were significantly decreased(P＜0.05).The expression of miR-125b-5p in tumor tissues of nude mice in shRNA group was significantly increased(P＜0.05).Conclusion Interference with the expression of RUSC1-AS1 can significantly inhibit the growth and epithelial-mesenchymal transition of human hepatocellular carcinoma cell SK-HEP-1 xenograft in nude mice,and its mechanism may be related to upregulating the expression of miR-125b-5p.

Abstract:Objective To investigate the effects of intermittent theta-burst stimulation(iTBS)on depression-like behaviors and hippocampal amino acid metabolism in a mouse model with chronic restraint stress(CRS).Methods Twenty-four male C57BL/6J mice aged 6-8 weeks were randomly divided into control group(Sham group),depression group(CRS group),and iTBS treatment group(CRS+iTBS group),with eight mice in each group.Following a week of adaptive feeding,mice in the CRS group and CRS+iTBS group underwent CRS modeling for 14 d.After modeling,the CRS+iTBS group received iTBS intervention for 5 d,while the Sham group and the CRS group underwent sham iTBS intervention for 5 d.Behavioral tests(sucrose preference test,novelty-suppressed feeding test,and tail suspension test)were conducted 24 h after iTBS intervention to evaluate depression-like behaviors.Subsequently,after 24 h of behavioral tests,the animals were sacrificed and hippocampal tissues from all groups were analyzed using untargeted metabolomics via ultra-high-performance liquid chromatography/quadrupole time-of-flight tandem mass spectrometry(UHPLC-QTOF/MS)to assess alterations in amino acid metabolism.Results ①The results of sucrose preference test,novelty-suppressed feeding test,and tail suspension test among the three groups of mice were statistically significant(all P＜0.01).In the sucrose preference test,the CRS group exhibited a significantly lower sucrose preference rate compared to the Sham group and the CRS+iTBS group(both P＜0.01).In the novelty-suppressed feeding test,the feeding latency of mice in the CRS group was significantly higher than that in Sham group and CRS+iTBS group(both P＜0.01).In the tail suspension test,mice in the CRS group displayed a markedly longer immobility time compared to those in Sham group and CRS+iTBS group(both P＜0.01).②The results of UHPLC-QTOF/MS untargeted metabolomics analysis showed that a total of 119 amino acid metabolites were detected in the hippocampus of mice.Compared with the Sham group,there were 23 significantly down-regulated amino acid metabolites and 11 significantly up-regulated amino acid metabolites in the CRS group(both P＜0.05).Compared with the CRS group,a total of 19 significantly down-regulated amino acid metabolites and 1 significantly up-regulated amino acid metabolite were detected in the hippocampus of CRS+iTBS group after iTBS stimulation(P＜0.05).Conclusion iTBS can significantly improve depression-like behaviors in mice with CRS,and its regulatory effect on hippocampal amino acid metabolites may be one of its antidepressant mechanisms.

Abstract:Objective To explore the efficacy and safety of endoscopic nipple-sparing mastectomy(E-NSM)with immediate reconstruction for breast cancer.Methods This study retrospectively investigated 257 patients who underwent nipple-sparing mastectomy at the Department of Thyroid,Breast and Vascular Surgery,Xijing Hospital,Air Force Medical University from January 1,2019 to December 31,2022.Among them,142 patients received conventional open surgery,while 115 patients received endoscopic-assisted surgery.The clinical data of these patients were retrospectively analyzed,including pathological characteristics,surgical procedures,operative time,prosthesis size,flap necrosis,and postoperative infection rates.The BREAST-Q 2.0 questionnaire was used to assess patient satisfaction and quality of life.Results No statistically significant difference was observed in operative time between the conventional nipple-sparing mastectomy group(C-NSM group)and E-NSM group[130(110,170)minvs 135(110,175)min,P=0.232 9].However,the C-NSM group had significantly larger implant compared to the E-NSM group[(236.78±47.36)mL vs(218.52±50.52)mL,P=0.003 8].The median follow-up duration was significantly longer in the C-NSM group than that in the E-NSM group[48(32,58)months vs 32(26,40)months,P＜0.000 1].During postoperative follow-up,although the C-NSM group exhibited a higher number of implant loss compared to the E-NSM group[9 cases(6.34％)vs 2 cases(1.74％)],the difference between the two groups was not statistically significant(P＞0.05).In terms of short-term postoperative complications,including hemorrhage,flap ischemia,nipple-areola complex ischemia,and infection,the C-NSM group demonstrated a significantly higher complication rate compared to the E-NSM group,with statistically significant difference(P＜0.05).At the final follow-up,the E-NSM group demonstrated superior BREAST-Q 2.0 scores in breast satisfaction,psychosocial well-being,and chest pain compared to the C-NSM group,with statistically significant difference(P＜0.05).During the long-term postoperative follow-up period,3 patients in the C-NSM group and 2 patients in the E-NSM group experienced local recurrence,and only one case of distant metastasis was observed in the C-NSM group.In terms of endoscopic operations,the operative time was analyzed,and it was found that the learning curve gradually shortened with the accumulation of surgical experience and case numbers over time.Conclusion E-NSM causes less damage compared with traditional open surgery,and the operative time is not prolonged,with fewer postoperative complications,superior aesthetic outcomes,and short learning curve,demonstrating promising clinical application potential.

Abstract:Objective To compare the differences of heart rate and heart rate variability(HRV)between the parachutists at rest and in the wind tunnel,and to explore the changes of psychological stress and cardiovascular autonomic regulation in the parachutists during parachute descent.Methods Eight young male parachutists were chosen and the process of parachute descent was simulated by wind tunnel experiment.Before the experiment,the parachute cold-weather survival suit and physiological parameter recording detector were worn,and the ECG signal was continuously recorded in the ground resting state.The experiment was carried out in the wind tunnel for at least 10 min,and the ECG signal was continuously dynamically recorded until the end of the experiment.Two states of ECG steady signals were selected for 5 min each.Paired t-test was used to analyze the differences of heart rate,blood oxygen saturation(SpO2)and HRV under these two states,as well as the changes of body temperature of parachutists at the beginning of the experiment and 15 min after the experiment.Results Compared with the ground resting state,the heart rate during blowing in the wind tunnel was significantly increased(P＜0.01),SpO2 was significantly decreased(P＜0.01),and the body temperature was significantly increased 15 min after the experiment(P＜0.01).The time domain related indexes of HRV,including RR interval,average RR,median RR,standard deviation of NN intervals,coefficient of variation of R-R intervals,standard deviation of differences between adjacent NN intervals,root mean square of successive differences and percentage of RR intervals that differ by 50 ms were all significantly decreased(P＜0.01,P＜0.05).The frequency domain related indexes of very low frequency power and low frequency power(LF)were significantly decreased(P＜0.05),while high frequency power(HF)showed no significant change(P=0.060 9),and LF/HF was significantly increased(P＜0.05).Conclusion The stress level,heart rate and HRV of the parachutists increase during parachute descent.Parachute descent has an impact on stress regulation of the cardiovascular autonomic nervous system,and autonomic nervous function develops towards the dominance of sympathetic nervous system.