Abstract:Objective To observe the changes of electroencephalogram(EEG)and the effect of electrical acupoint stimulation during 24 h simulated weightlessness in head down bed rest.Methods A total of 22 volunteers were randomly divided into electroacupuncture group and control group,with 11 people in each group.The control group rested in bed in a head-low position for 24 h,while the electroacupuncture group rested in bed in a head-low position for 24 h and then stimulated bilateral Neiguan acupoints for 30 min.The changes of power spectral density(PSD)of EEG signals in resting state and mood states were analyzed and compared between the two groups before and after bed rest.Results Compared with that before bed rest,the PSD of θ and α band generally decreased in all brain regions,the PSD of right temporal lobe θ band and the PSD of right central region,right parietal lobe,and left occipital lobe α band significantly reduced(P＜0.05).The score of fatigue,depression,and anger,as well as the total score of negative mood disorder of Profile of Mood States(POMS)significantly increased(P＜0.05),while the score of energy significantly decreased(P＜0.05)after 24 h of head down bed rest.Compared with the control group,the PSD in the right frontal lobe θ band was significantly reduced in the electroacupuncture group(P＜0.05),and the depression score of POMS showed a decreasing trend after bed rest.Conclusion The simulated weightlessness effect of 24 h head down bed rest alters the activities of θ and α band of certain brain regions at rest,and can be more likely to cause negative emotions.Electroacupuncture stimulation regulates the activity of the right frontal lobe θ bands and potentially has a positive regulatory effect on the activity of α bands of various brain regions.To some extent,electroacupuncture stimulation also alleviates the generation of negative emotions caused by head down bed rest.

Abstract:Osteoporosis(OP)is a common systemic bone degenerative disease,and imbalance in bone remodeling is an important pathogenesis of OP and fragility fractures.Epigenetics refers to changes in gene expression and function caused by other regulatory mechanisms without altering the DNA sequence,such as post-translational modification of histones,DNA methylation,noncoding RNA,and chromatin remodeling.Histone demethylation modification is one of the current research hotspots in epigenetic mechanism,and is strictly regulated by histone demethylase.Histone lysine demethylases(KDMs)have been confirmed to be involved in the process of bone remodeling,including homeostasis between osteoblasts and osteoclasts.However,as a member of the newly discovered KDMs family in recent years,including KDM7A,KDM7B and KDM7C,the role of KDM7 in the process of bone reconstruction is rarely reported.This paper mainly reviews the latest research progress of epigenetic regulation,histone demethylation modification and KDM7 in bone reconstruction,so as to provide new ideas for the prevention and intervention of OP.

Abstract:Objective To construct a clinical model for predicting postoperative neurological prognosis in patients with acute Stanford type A aortic dissection(AAAD)through preoperative serum markers and baseline characteristics of AAAD patients.Methods The study included AAAD patients in Xijing Hospital,Air Force Medical University from January 2000 to May 2021.After excluding patients who were not examined after admission and whose relevant data were incomplete,they were divided into two groups according to whether there were neurological complications after surgery(n=113)and no neurological complications(n=1 090).Through univariate and multivariate binary logistic regression analysis,predictors of postoperative neurological complications were screened from the entire data,and a nomogram based on preoperative relevant serum markers and clinical characteristics was constructed.In addition,internal validation,area under the receiver operating characteristic curve(AUC),and calibration curve were performed on the model to evaluate the discrimination ability of the model.Results Multivariate logistic regression analysis showed that BMI,D-dimer,creatinine,and troponin Ⅰ were associated with postoperative neurological complications,respectively.A nomogram was established based on the four variables validated internally by AUC 0.713.The calibration chart showed that the predicted and actual probability of postoperative neurological complications in internal validation could be well matched.Conclusion This nomogram can predict the possibility of postoperative neurological complications in patients with AAAD,and has good resolution and clinical application value.

Abstract:Macrophages,as essential components of the innate immune system,play a pivotal role in the anti-tumor immune response by directly phagocytosing tumor cells or through the secretion of cytokines and antigen presentation,which activates T cells after phagocytic activation.Nonetheless,tumor cells often elude macrophage attacks by overexpressing phagocytic checkpoint molecules such as CD47,PD-L1,or CD24.These molecules act on macrophages,transmitting inhibitory signals that suppress their phagocytic activity and facilitating immune evasion.Blocking the phagocytic checkpoint signals in macrophages to restore their capacity to eliminate tumor cells has emerged as a key strategy to enhance the effectiveness of tumor immunotherapy,as evidenced by clinical trials.This review primarily outlines the identified macrophage phagocytic checkpoint molecules and their blockade application in anti-tumor immune therapy,while also envisioning the future development of macrophage phagocytosis checkpoint blockade in anti-tumor immunotherapy.

Abstract:Objective To explore the effects of different 5-field layout modes of intensity-modulated radiotherapy on the target area of mid-thoracic esophageal cancer and the dose of organs at risk.Methods Seven patients with esophageal cancer were selected from the Department of Oncology,Army Characteristic Medical Center,Army Medical University as the study objects,and four sets of static intensity-modulated plans were designed for each patient,respectively:PA:210°,240°,0°,120°,150°;PB:210°,240°,180°,120°,150°;PC:210°,300°,180°,60°,150°;PD:210°,300°,0°,60°,150°.The dose-volume parameters of the target areas and organs at risk were statistically compared among the four plans.Results The target dose of the four plans could reach 95％coverage requirements,and there was no statistical significance in D5％,D95％and Dmean.The V5 of PD double lungs was the lowest,which decreased by about 0.9％relative to the highest group.The V10 of PA double lungs decreased by about 1.9％relative to PC,and PA and PB were statistically significant(P＜0.05).The V20 of PD double lungs was the lowest,in which PD was equivalent to 0.9％decrease in PA.Dmean in PD double lungs was the lowest,which decreased by 15 cGy relative to the highest PA group.There was no significant difference in V30 and V40 between the four groups.The cardiac Dmean of PA and PC was significantly different(P＜0.05),and PB decreased by 36 cGy relative to PA.The spinal cord Dmax was as follows:PB＜PC＜PD＜PA.PB decreased by 122 cGy relative to PA in spinal cord dose-volume.Comparison of the monitor unit(MU)of the three plans showed that PB had the highest MU(469.28±79.71)and PD had the lowest(430.67±62.63),and there was no statistical significance in the comparison among the four groups.The MU of the PB plan in the group with the highest number of jumps increased by 10％compared to that in the PB plan in the group with the lowest number of jumps.Conclusion The target areas of the four groups can meet the requirements,and there is no statistical significance in the dose-volume of organs at risk,which indicates that four field angles designed in this paper can be selected when the intensity-modulated field distribution of conventional static 5-field for esophageal cancer is used.

Abstract:Objective To explore the effect of electroacupuncture(EA)pretreatment on mitophagy in the penumbra region and long-term neurological function recovery in a mouse model of ischemic stroke.Methods Middle cerebral artery occlusion(MCAO)model was used to simulate cerebral stroke.Forty-eight male C57BL/6J mice were randomly divided into sham surgery group(Sham group),sham surgery+EA group(EA group),model group(MCAO group),and EA pretreatment group(EA+MCAO group),with 12 mice in each group.EA group received intervention at the Baihui acupoint for 5 d,30 min per day.Western blotting was used to detect the effects of EA pretreatment on protein expression of mitophagy markers in mice 24 h after MCAO.Forelimb grip strength test,tape removal test,open field test,and Y-maze test were performed to observe the effect of EA pretreatment on the neurological function of mice 3,7,and 14 d after MCAO.Results EA pretreatment increased the expression of BCL2 interacting protein 3(BNIP3)(P＜0.01),while reducing the expression of translocase of outer mitochondrial membrane 20(P＜0.01)and cytochrome c oxidase subunit Ⅳ(P＜0.01),but had no effect on PTEN-induced putative kinase 1 expression.EA pretreatment improved forelimb grip strength of MCAO mice at 7 and 14 d post-surgery(P＜0.05),shortened the time for tape contact/removal(P＜0.05),but did not significantly affect these parameters at 3 d post-surgery.Furthermore,EA pretreatment significantly improved the symmetry of mice 14 d after surgery(P＜0.01)and increased the time spent on new arms and the number of new arm entries in the Y-maze test in MCAO mice 15 d after surgery(P＜0.05).Conclusion EA pretreatment promotes BNIP3-mediated mitophagy and improves long-term neurological function recovery in MCAO mice.

Abstract:Glioma,as the most common primary malignant tumor of the central nervous system,poses a serious challenge to clinical diagnosis and treatment due to its high invasiveness,high recurrence rate,and low survival rate.The multidisciplinary diagnosis and treatment(MDT)model for glioma integrates core disciplines such as neurosurgery,imaging,pathology,radiotherapy,oncology,and neurology to construct a standardized diagnosis and treatment system based on evidence-based medicine,which has become a key strategy for improving the prognosis of glioma patients.This article systematically elaborates on the organizational structure and operational mechanism of MDT for glioma,deeply analyzes the collaborative role of multiple disciplines in precision diagnosis,personalized treatment,and full process management,and explores the innovative direction of MDT model based on the latest clinical evidence and technological breakthroughs,providing theoretical and practical references for optimizing the diagnosis and treatment strategies of glioma.

Abstract:Objective To evaluate the efficacy of modified Guizhi Fuling Powder in treating preoperative soft tissue swelling in closed calcaneal fractures and to explore its clinical mechanism of action.Methods Seventy patients scheduled for surgical treatment of closed calcaneal fractures were selected and divided into the experimental group and the control group by random number table method,with 35 cases in each group.The control group received conventional preoperative anti-edema and analgesic treatments including elevation of the affected limb,ice application to the affected area,intravenous infusion of mannitol,and lornoxicam for pain relief.The experimental group additionally received oral administration of modified Guizhi Fuling Powder.Following anti-edema treatment,both groups underwent surgical internal fixation with plates via either a lateral L-shaped calcaneal incision or a tarsal sinus incision.Comparisons were made between groups for inflammatory factors(TNF-α,IL-1β,IL-6,and CRP),D-dimer(D-D),ferritin(FER),ankle swelling difference,time to skin crease sign appearance,and postoperative incision-related adverse events before and after 5 d of edema reduction treatment.Results There were no statistically significant differences between the two groups in terms of age,gender,or affected foot(left or right).① Blood test indicators:FER expression differed between the two groups(t=2.231,P=0.029).D-D expression differed between groups based on whether patients received modified Guizhi Fuling Powder(t=-2.960,P=0.005).Intra-group differences in D-D expression were observed before and after treatment with modified Guizhi Fuling Powder(t=-5.153,P＜0.001).Intra-group differences in CRP expression were observed in the control group(t=-2.047,P=0.048),whereas no statistically significant intra-group differences were found in the experimental group(t=0.119,P=0.906).There was no statistically significant difference in CRP expression between the two groups at admission(t=-1.308,P=0.195),but there was a significant inter-group difference in CRP expression before surgery(t=-2.213,P=0.032).There were no statistically significant differences in IL-1β between groups or within the experimental group(experimental group intra-group t=-0.088,P=0.930;inter-group at admission t=-1.785,P=0.081;inter-group preoperatively t=0.685,P=0.496).Intra-group expression differed in the control group(t=2.552,P=0.015).TNF-αlevels showed no significant differences between groups or within groups(control group intra-group t=0.139,P=0.890;experimental group intra-group t=1.271,P=0.212;inter-group at admission t=-0.668,P=0.506;inter-group preoperatively t=-1.743,P=0.087).There were no statistically significant differences in IL-6 levels between groups or within the experimental group(experimental group intra-group Z=-0.098,P=0.922;inter-group at admission Z=-0.670,P=0.503;inter-group preoperatively Z=-1.186,P=0.235).Intra-group expression differed significantly in the control group(Z=-3.251,P=0.001).②Observed indicators:Significant inter-group differences were observed in ankle swelling difference at admission and preoperatively(t=2.930,P=0.005).Inter-group differences were also noted in skin crease reappearance time(t=-3.611,P=0.001).Pearson correlation analysis indicated that FER increased with longer skin crease reappearance time,showing moderate positive correlation(r=0.554,P＜0.001).No flap necrosis or infection was observed in the experimental group postoperatively.Three cases of blistering occurred,with an adverse event rate of 8.57％.The control group reported one case of flap necrosis,one case of infection,and six cases of blistering,yielding an adverse event rate of 22.86％.The experimental group demonstrated lower postoperative incision-related adverse events compared to the control group.Conclusion Modified Guizhi Fuling Powder,due to its diuretic,edema-reducing,and blood-activating effects,helps alleviate preoperative swelling in closed calcaneal fractures and promotes better postoperative wound healing.The clinical research mechanism may be related to iron metabolism and coagulation mechanism.

Abstract:The rapid development and cross-integration of tumor immunology,cell biology,and molecular technology have profoundly changed the strategies and landscape of cancer therapy.With the elucidation of tumor immune evasion mechanisms,a variety of novel immunotherapeutic strategies have emerged.Tumor immunotherapy aims to enhance the immune system's ability to recognize and eliminate tumors by activating anti-tumor immune responses and/or blocking immune escape pathways.It has become the fifth pillar of cancer treatment,following surgery,radiotherapy,chemotherapy,and targeted therapy.This review systematically outlines the theoretical foundations and key strategies of tumor immunotherapy,including immune surveillance and immunoediting hypotheses,mechanisms of immune escape,as well as design principles,approved agents,and research progress of major therapeutic approaches such as immune checkpoint inhibitors,adoptive cell therapy,and cancer vaccines,and looks forward to the future development direction.

Abstract:Objective To investigate the clinical safety and effectiveness of minimally invasive coronary artery bypass grafting(MICS-CABG)via the left intercostal approach in elderly patients(＞70 years old)with complex coronary heart disease and reduced ejection fraction(EF＜40％).Methods The clinical data of 60 patients＞70 years old with a preoperative left ventricular EF＜40％who underwent coronary artery bypass grafting in the Department of Cardiac Surgery,Xijing Hospital,Air Force Medical University from April 2022 to October 2024 were analyzed.These patients were divided into two groups:the median sternotomy group(OP-CABG group)with 30 patients and the MICS-CABG group with 30 patients.Based on matched baseline information,a retrospective analysis was conducted to compare the perioperative data and one-year follow-up results between the two groups.Results There was no significant difference in baseline levels between the MICS-CABG group and the OP-CABG group.The MICS-CABG group had shorter operative duration,less intraoperative blood loss,lower perioperative blood transfusion rate,shorter postoperative ventilator assistance time,less postoperative drainage volume,and lower incidence of postoperative pleural effusion and wound complications(all P＜0.05).One-year follow-up after surgery showed that there was no significant difference in the patency rate of bridge vessels,improvement of EF values,MACCE events,and incidence of chronic wound pain between the two groups of patients.However,the MICS-CABG group had lower incidence of complications of poor wound healing compared to the OP-CABG group(P＜0.05).Conclusion Although MICS-CABG technology is difficult and has a long learning curve,its application in elderly patients with complex coronary heart disease and heart failure with reduced EF values can effectively shorten the operative time,reduce intraoperative bleeding,postoperative drainage,and transfusion rate.Compared with conventional open chest surgery,it is more acceptable for patients.One-year follow-up after surgery shows that the improvement of EF values and patency rate of bridge vessels in the MICS-CABG group are similar to those in the OP-CABG group,and effectively avoid complications of poor wound healing.

Abstract:Objective To understand the current status of physical training and the incidence of training-related injuries among military personnel stationed in high-altitude regions,so as to provide data support for establishing standardized and unified comprehensive prevention and treatment protocols for training-related injuries specific to military personnel stationed in high-altitude environments.Methods By means of questionnaire surveys,face-to-face interviews,and on-site investigations,eight high-altitude military training units were investigated and studied.The research encompassed eight aspects,including basic information,routine physical and military training conditions,current physical health status,allocation of physical training equipment,levels of physical activity and sleep quality,incidence of musculoskeletal injuries,prevalence of pain in the neck,shoulder,waist,and legs,as well as diagnosis and treatment of musculoskeletal injuries.A comparative analysis of the collected data was conducted to draw meaningful insights.Results The survey results revealed a substantial occurrence of military training-related injuries,including 1 056 cases among 414 people.These injuries affected up to 11 different body regions,with a notable prevalence of injuries to the foot and ankle,as well as the knee.Additionally,there was a significant incidence of discomfort reported in the neck and waist areas.Conclusion The incidence of training-related injuries among military personnel stationed in high-altitude regions is notably elevated,so the training programs for military personnel in these areas should be systematically implemented under scientifically-informed guidance.Additionally,there should be an emphasis on health education aimed at preventing training-related injuries.These measures are essential for comprehensively enhancing the combat effectiveness of military forces stationed in high-altitude environments.

Abstract:G protein-coupled estrogen receptor(GPER),also known as G protein-coupled receptor 30,is a novel estrogen receptor.In male individuals,GPER is also widely distributed in multiple tissues,including the cardiovascular system,reproductive system,and nervous system.GPER binds to estrogen and other ligands for rapid signal transduction and transcriptional regulation,and plays an important role in pathological processes such as ventricular remodeling,blood pressure regulation,and atherosclerosis.This article mainly reviews the role of GPER in cardiovascular diseases in male.

Abstract:Leucine,isoleucine,and valine are essential amino acids in the body,collectively known as branched-chain amino acids(BCAA)due to their branched side chain structures.BCAA play a critical role not only in protein synthesis but also as bioactive molecules participating extensively in various intracellular biological processes.Studies have shown that BCAA metabolic disturbances play a crucial role in a variety of cardiometabolic diseases,including obesity,insulin resistance,type 2 diabetes,hypertension,atherosclerosis,and heart failure.This review introduces the metabolic processes of BCAA in detail,with an emphasis on summarizing how BCAA metabolic disturbances lead to the occurrence and development of cardiometabolic diseases,and explores the close relationship between BCAA metabolism and cardiometabolic health based on epidemiological evidence.Furthermore,this review also prospects future research directions,aiming to provide new perspectives for a deeper understanding of the role and mechanism of BCAA in cardiometabolic diseases.

Abstract:Premature ovarian insufficiency(POI)is a condition in which a woman develops premature ovarian function decline,which not only reduces the patient's fertility,but also brings about a series of menopausal clinical symptoms,and adversely affects the woman's reproductive and psychological health.The etiology of more than half of POI patients is unknown,and factors such as autoimmune diseases,genetics,and stress may be causative factors,with autoimmune factors accounting for a higher proportion of POI patients,which deserves our attention.Studies have shown that the production of autoimmune antibodies,imbalance of pro-inflammatory and anti-inflammatory factors,and lymphocyte disorders all play key roles in the pathogenesis of POI,and POI may be associated with certain autoimmune diseases,such as autoimmune Addison's disease and autoimmune polyendocrinopathy syndrome.At present,the immunological intervention and other therapeutic methods for POI are still under active exploration.By summarizing the relevant studies on POI and autoimmunity in recent years,this article hopes to provide reference for the reproductive immune mechanism of POI and develop ideas for clinical treatment.

Abstract:Objective To explore the effects of long-term exposure to high cortisol concentrations on human inflammatory response and microbiota-gut-brain axis by using Cushing's disease(CD)as a model.Methods We prospectively included 16 CD patients who were to be operated from May 2021 to March 2024 in the Chinese PLA General Hospital,and recruited 30 healthy controls(HC)during the same period.We compared the differences in neuropsychological and cognitive function scores,inflammatory factors,and gut microbiota between the two groups.Results Our study results showed that the average course of disease of CD patients was(55.75±39.96)months,and the levels of serum cortisol,adrenocorticotropic hormone,24-hour urinary cortisol excretion,and body mass index were significantly higher than those in HC group(P＜0.05).Neuropsychological and cognitive function scale data showed that the scores of Self-Rating Depression Scale and Self-Rating Anxiety Scale in CD patients were significantly higher than those in HC group,while the scores of Mini-Mental State Examination and Montreal Cognitive Assessment were lower than those in HC group(P＜0.000 1).The differences in gut microbial ecology structure between CD patients and HC group included decreased microbial diversity and significant differences at the species and genus levels.Analysis of blood and immunological indicators showed that the white blood cell count,neutrophil proportion,NLR,and levels of IL-1β and IL-8 in CD patients were higher,while the eosinophils proportion was lower(P＜0.05),and the levels of IL-6 and TNF were not significantly different.Conclusion High cortisol concentrations can increase the risk of obesity,cause anxiety and depression,and reduce cognitive function.In addition,it can also cause inflammatory responses,reduce immune function,and lead to changes in the composition and structure of gut microbiota and decreased diversity.

Abstract:Objective To analyze the mechanism of Xiaochaihu decoction in preventing and treating Mycoplasma pneumoniae pneumonia(MPP)in children by using network pharmacology and molecular docking.Methods The effective active ingredients of Xiaochaihu decoction were retrieved through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,and the prescription-related targets were obtained through UniProt.The related targets of MPP in children were collected from GeneCards,DrugBank and CTD databases.Jvenn software was used to obtain the intersection targets of drugs and diseases,and STRING database was used to obtain the relevant information of the protein-protein interaction(PPI)of the intersection targets.Cytoscape 3.10.2 software was used to draw the"drug-component-target"network diagram and PPI network diagram.GO functional enrichment and KEGG pathway enrichment analyses were performed for intersection targets.AutoDockTools 1.5.7 software was used to predict the binding energy of small molecule ligands and biological macromolecular receptors,and PyMOL software was used to map and display the molecular docking results.Results A total of 159 active ingredients and 286 targets of Xiaochaihu decoction were screened,and a total of 88 intersection targets of drugs and disease targets were found.GO functional enrichment analysis showed that it involved 947 biological processes,and KEGG pathway enrichment analysis showed that it mainly involved 187 signaling pathways.Its related signaling pathways mainly included AKT1,IL6,TNF,JUN,PTGS2,TP53,etc.Molecular docking suggested that the active ingredients of the prescription had good binding power with the core targets.Conclusion Xiaochaihu decoction may act on multiple targets such as AKT1,JUN,and PTGS2 through quercetin,kaempferol,and β-sitosterol to inhibit inflammatory reactions and regulate immune function,thereby preventing MPP in children.

Abstract:Objective To explore the changes of serum lactic acid(LAC)level before and after hyperbaric oxygen(HBO)treatment in high-altitude pulmonary edema(HAPE)and its correlation with prognosis.Methods In this study,165 HAPE patients who received HBO treatment in Wenzhou People's Hospital from June 2020 to June 2023 were selected,and general data,blood routine parameters,blood biochemical tests,liver and kidney function,coagulation function indexes,inflammatory factor levels and other related clinical data of the subjects were statistically analyzed.According to the evaluation criteria of efficacy,patients with curative effect were divided into good prognosis group(n=118),and patients with effective and ineffective efficacy were divided into poor prognosis group(n=47).Logistic regression was used to analyze the relationship between LAC and prognosis of HBO treatment in HAPE patients.Subgroup analysis was performed to analyze the correlation between LAC and the risk of poor prognosis after HBO treatment in HAPE patients.Locally weighted scatterplot smoothing(LOWESS)was used to analyze the two-dimensional curve relationship of continuous variables.The interaction between blood flow in cerebral microcirculation and vascular growth factor was analyzed.The dose-response relationship between blood flow in cerebral microcirculation and poor prognosis was analyzed by restricted cubic splines.Finally,decision curve analysis(DCA)of blood flow in cerebral microcirculation was performed.Results Compared with before HBO treatment,there were statistically significant differences in heart rate,respiratory frequency,arterial oxygen saturation,arterial partial pressure of carbon dioxide,arterial partial pressure of oxygen,albumin(Alb),globulin(Glb),red blood cell count,LAC,lactate dehydrogenase(LDH),blood uric acid,urine uric acid,serum aspartate aminotransferase(AST),α-hydroxybutyrate dehydrogenase(α-HBDH),and creatine kinase(CK)in HAPE patients after treatment(P＜0.05).Among the HAPE patients treated with HBO,the indexes of Alb,Glb,LAC,LDH,AST,α-HBDH and CK in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).Multivariate logistic regression analysis showed that LAC,LDH,Alb,α-HBDH and CK were independent influencing factors of poor prognosis in HAPE patients(P＜0.05).In the Alb,LDH,α-HBDH and CK subgroups,there was a stable correlation between LAC and the risk of poor prognosis after HBO treatment in HAPE patients,and there was no interaction between subgroups(Pinteraction＞0.05).LOWESS analysis showed that Alb,LDH,α-HBDH,CK and LAC all had a certain nonlinear relationship,and LAC was positively correlated with Alb,LDH,α-HBDH and CK(P＜0.05).Restricted cubic spline analysis showed that the continuous change of LAC was correlated with poor prognosis in a nonlinear dose-response manner,and LAC was positively correlated with poor prognosis(P＜0.05).When LAC was greater than the cutoff value of 1.56 mmol/L,the risk of poor prognosis increased significantly with the increase of LAC level.DCA showed that LAC had important clinical value in predicting the prognosis of patients.Conclusion High-level LAC is an independent factor affecting the poor prognosis of HAPE patients,and it is positively correlated with poor prognosis.This index may be helpful to evaluate the prognosis of HAPE patients.

Abstract:The incidence of post-traumatic stress disorder(PTSD)is increasing year by year,but the traumatic events leading to PTSD and their consequences are often ignored by patients.Recent evidence suggests that the formation of fear memories and the occurrence of stress-related diseases are accompanied by morphological and functional remodeling of astrocytes.In this paper,we review the existing studies on the role of astrocytes in the pathogenesis of PTSD.Astrocytes synthesize and secrete neurotrophic,pro-and anti-inflammatory factors and regulate the microenvironment of central nervous system through metabolic pathways,ion homeostasis control,and clearance of neurotransmitters.Stress or trauma can cause damage to these important functions of astrocytes,which leads to the pathophysiological evolution of PTSD.Because of the above important role of astrocytes,they may become an effective potential target for PTSD treatment.

Abstract:Objective To train the sample features by using support vector machine(SVM)algorithm,and to use machine learning for mental health status,so as to realize automatic classification and recognition.Methods Firstly,undersampling method was used to solve the problem of sample imbalance,then normalization method was used to control the scores of all indicators in an interval,and samples were trained by selecting different kernel functions of SVM.Finally,hyperparameters were tuned by grid search to obtain the best parameter combination,and the samples were tested again to obtain the evaluation report of the model.Results The results showed that the accuracy,recall and F1-Score of the algorithm based on Sigmoid and RBF kernel functions were improved after grid search parameter tuning.Conclusion This paper provides an idea for the intelligent assessment of psychological risk,which can be applied to other scenarios with a little modification.

Abstract:Objective To compare the clinical efficacy of vaginal natural orifice transluminal endoscopic surgery(vNOTES)and traditional laparoscopic surgery(LAP)for total hysterectomy in large uteri,and to explore the clinical application value of vNOTES.Methods A retrospective analysis was conducted on patients who underwent total hysterectomy for benign lesions with a uterine mass ≥ 500 g at the Department of Gynecology,Wenzhou People's Hospital from January 2021 to January 2023.Patients were divided into vNOTES group(n=56)and LAP group(n=58).The general data,operative time,intraoperative blood loss,postoperative pain scores,hospital stay,postoperative complications,and related functional recovery were compared between the two groups.Results No significant differences were observed in baseline characteristics between the two groups.The vNOTES group demonstrated significantly shorter operative time[(157.31±31.73)min vs(178.37±47.68)min,P=0.007],reduced time to first postoperative flatus[(22.15±5.84)h vs(30.00±8.75)h,P=0.001],shorter hospital stay[(3.05±0.49)d vs(4.33±1.27)d,P=0.001],and lower postoperative pain scores[(1.33±1.36) vs(3.96±1.18),P=0.001)compared to the LAP group.No significant differences were found in intraoperative blood loss,postoperative complication rates,and functional recovery between the two groups.Conclusion vNOTES significantly shortens operative time and hospital stay while reducing postoperative pain scores in total hysterectomy for large uteri,aligning with the concept of enhanced recovery after surgery.It is a promising technique worthy of clinical promotion.