Kidney disease constitutes a significant global public health issue， with its associated healthcare burden escalating annually. Lipid metabolism disorders play a crucial role in the onset and progression of various kidney diseases. Given the diversity of lipid species and the complexity of metabolic pathways， traditional research methods often fall short in fully elucidating the intricate roles of lipids in kidney diseases. In this context， lipidomics， the systematic analysis of lipid molecules and their metabolic alterations in biological samples， emerges as a powerful tool with unique research value and clinical potential. This review summarizes the latest findings in lipidomics across various kidney diseases and discusses the challenges encountered in clinical application and future research directions.

Objective To study the role and influence of basic Alkaline ceramidase 1 on mucosal barrier and immune regulation in ulcerative colitis （UC）. Methods Acer1 knockout mice （Acer1 KO） were constructed， and the UC model was induced by continuous drinking water of sodium dextran sulfate （DSS） for 7 days， and the severity of symptoms of UC disease in C57 and Acer1 KO mice was compared. The expression levels of intestinal mucosal barriers （ZO-1， Occludin， Claudin， JAMA） were detected by RT-PCR and immunohistochemistry. Systemic immune response levels （IL-1b、IL-6、IL-23、IL-17、IL-10， and TNF-a） were assessed by ELISA and intestinal inflammatory infiltration levels （TNF-a、IL-1b、IL-6、IL-17、IL-21， etc.） were assessed by RT-PCR. Results There was no significant difference between C57 and Acer1 KO mice in free drinking water. In the DSS induced UC model， compared with C57 mice， the survival rate of Acer1 KO mice decreased， the weight decreased significantly， the mechanical barrier and mucus barrier protein expression levels decreased significantly， the intestinal epithelial barrier was seriously damaged， the inflammatory response was strong， and the cytokine infiltration was obvious， with statistical differences （P < 0.05）. Conclusion Acer1 can inhibit inflammatory infiltration by maintaining the integrity of intestinal mucosal barrier， preventing endotoxin， and delaying the progression of UC.

Objective Aimed at investigating the effect and molecular mechanism of artemisinin on hemodynamics and vascular remodeling in monocrotaline（MCT） -induced pulmonary arterial hypertension （PAH） rats. Methods 30 male SD rats were randomly divided into 3 groups （n = 10）： control group， MCT-induced PAH group （MCT group， 60 mg/kg） and artemisinin intervention group （50 mg/kg）. At 28 days after modeling， the right ventricular systolic pressure （RVSP）， mean pulmonary artery pressure （mPAP）， heart rate and right ventricular hypertrophy index （RVHI） were measured to evaluate the development of PAH. HE staining and α-SMA immunohistochemistry were used to observe the morphology and assess muscularization of pulmonary arterioles， and the percentage of medial wall thickness （WT%），the percentage of vascular wall area （WA%） and the proportion of muscular vessels were calculated to evaluate the degree of pulmonary vascular remodeling. The mRNA and protein levels of HIF-1α and LDHA were detected by real-time PCR and Western blot， respectively. Pyruvate and lactate concentration in lung tissue was measured using pyruvate and lactateassay kit. Results Compared with the control group， the RVSP， mPAP， heart rate and RVHI were significantly increased in MCT-induced PAH rats （all P < 0.05）. Histological analysis showed that the increasedmedial wall thickness of small pulmonary arteries and vascular muscularization were observed in MCT-treated rats compared with control rats. WT%， WA% and muscularization degrees of pulmonary arterioles were higher in MCT-treated rats than those in the control group （all P < 0.05）， suggesting successful construction of PAH model. Compared with the MCT group， the RVSP， mPAP， heart rate and RVHI decreased in the rats treated with artemisinin（all P < 0.05）， accompanied with lower WT% and WA% （P < 0.05）， and muscularization of pulmonary arterioles was improved （P < 0.05）. Further study showed the mRNA and protein levels ofHIF-1α and LDHA in lung tissue of MCT-induced PAH rats were higher than those in the control group， the content of lactate and pyruvate and the ratio of lactate to pyruvate were higher than that in the control group （all P < 0.05）. However， the mRNA and protein levels of HIF-1α and LDHA in lung tissue of rats treated with artemisinin were lower than those in the MCT group， the content of lactate and pyruvate and the ratio of lactate to pyruvate were lower than that in the MCT group （all P<0.05）. Conclusion Artemisinin improves hemodynamic and pulmonary vascular remodeling in PAH rats through inhibiting HIF-1α/LDHA signaling pathway-mediated glycolysis.

Objective To investigate whether PKCβ inhibitor can alleviate RIRI by regulating macrophage phenotype. Methods Rats in the renal ischemia?reperfusion injury （RIRI） model group underwent right nephrectomy followed by a 60?minute clamping of the left renal pedicle. In the experimental group （Inhibitor + RIRI）， PKCβ inhibitors were administered orally one day prior to surgery. All rats were euthanized 24 hours post?surgery for the collection of blood and left kidney samples. Renal function， tissue morphology， and the expression levels of renal tubular injury marker KIM?1， renal papilla injury marker RPA?1， macrophage subtype markers， and inflammatory factors were evaluated. Results PKCβ inhibitors alleviated renal ischemia?reperfusion injury in rats. PAS staining revealed marked tubular damage in kidney sections from the RIRI group， whereas kidney inflammatory cell infiltration and renal tubular injury scores were significantly reduced in the Inhibitor+RIRI group following PKCβ inhibitor treatment （all P < 0.05）. The expression levels of Cr， BUN， KIM?1， and RPA?1 were markedly elevated in the RIRI group compared to the Sham and Inhibitor + RIRI groups （all P < 0.05）. After PKCβ inhibitor intervention， the expression levels of Cr， BUN， KIM?1， and RPA?1 were significantly decreased in the Inhibitor + RIRI group relative to the RIRI group （all P < 0.05）. Protein expression levels of iNOS， IL?2， and CD197 in the kidney tissue of the RIRI group were significantly higher than those in the Sham and Inhibitor + RIRI groups （all P < 0.05）. Compared with the RIRI group， the protein expression levels of iNOS， IL?12， and CD197 were significantly reduced in the Inhibitor + RIRI group following PKC β inhibitor intervention （all P < 0.05）. Additionally， the protein expression levels of Dectin?1， ARG?1， and CD163 were significantly higher in the Inhibitor + RIRI group than in the RIRI and Sham groups after PKCβ inhibitor intervention （all P < 0.05）. Conclusions PKCβ inhibitors can mitigate renal dysfunction， renal tubular injury， and the expression of injury markers in the renal tubules and renal papilla following ischemia?reperfusion. Additionally， PKCβ inhibitors play a role in modulating macrophage subtypes by reducing M1 macrophages and promoting polarization to M2， which leads to a decrease in pro?inflammatory factors and an increase in anti?inflammatory factors， ultimately facilitating kidney repair.

Objective To establish mouse models exposed to different doses of neodymium oxide via tracheal instillation， and to investigate the mechanisms underlying brain tissue damage induced by neodymium oxide exposure in mice. Methods Forty?eight male C57/BL6 mice were randomly assigned to four groups： the control group， the low?dose group， the medium?dose group， and the high?dose group. The low?dose， medium?dose， and high?dose groups received 62.5 mg/mL， 125 mg/mL， and 250 mg/mL neodymium oxide， respectively， via non?exposed tracheal instillation. The control group received an equivalent volume of saline using the same administration method. After 35 days， the mice were euthanized， and brain tissues were collected. RT?PCR was used to assess the mRNA expression changes of Claudin?5 and Occludin. Western blot analysis was performed to evaluate the expression changes of Claudin?5 and Occludin tight junction proteins， as well as the expression changes of MMP?2 and MMP?9 in the brain tissues. Additionally， the expression of the RhoA/ROCK2 signaling pathway and downstream cofilin protein was examined. Changes in oxidative stress markers， including MDA， T?AOC， and NO， were measured using a kit method. Results The mRNA expression of Claudin?5 was significantly reduced in the middle?dose and high?dose groups compared to the control group （P < 0.05）. Similarly， the mRNA expression of Occludin was significantly lower in the low?dose， medium?dose， and high?dose groups compared to the control group （P < 0.05）. Additionally， the protein expression of Claudin?5， MMP?2， and Occludin was significantly decreased in the low?dose， medium?dose， and high?dose groups compared to the control group （P < 0.05）. The protein expression of MMP?9 and RhoA was also significantly lower in the medium?dose and high?dose groups compared to the control group （P < 0.05）. Furthermore， the protein expression of ROCK2 and p?cofilin in the high?dose group was significantly lower than that in the control group （P < 0.05）. The content of MDA and T?AOC was significantly lower in the medium?dose and high?dose groups compared to the control group （P < 0.05）， and the content of NO in the high?dose group was significantly lower than that in the control group （P < 0.05）. Conclusion Exposure to neodymium oxide results in increased permeability of the blood?brain barrier in mice， leading to oxidative stress， inflammatory responses， and activation of the RhoA/ROCK2 signaling pathway.

Objective To investigate the correlation between early clinical outcomes following endoscopic surgery for unilateral lumbar disc herniation and variations in the cross?sectional area of the sciatic nerve. Methods Fifty?two patients （n = 52） with unilateral lumbar disc herniation were recruited from June 2023 to June 2024 at the Pain Department of the First Affiliated Hospital of Nanchang University. The cross?sectional area （CSA） values of bilateral sciatic nerves were measured at the gluteal sciatic tuberosity?great femoral rotor level using ultrasound before and on the 4th day after surgery. The change in nerve cross?sectional area ΔCSA and sciatic nerve swelling rate （SR?SN） were calculated. Patient BMI （Body Mass Index）， visual analog scale （VAS）， Japanese Orthopaedic Association score （JOA）， Oswestry Disability Index （ODI）， and Treatment Improvement Rate （TIR） were collected preoperatively and on postoperative day 4. Changes in sciatic nerve cross?sectional area in unilateral lumbar disc herniation and its relationship to clinical outcomes were analyzed using the scoring scales as controls. Results Compared to the preoperative period， there was a significant decrease in VAS and ODI scores， as well as an increase in JOA score on the 4th postoperative day （P < 0.01）. Furthermore， surgical intervention led to substantial improvement in clinical outcomes for the patients. Prior to surgery， the CSA value of the affected side of the sciatic nerve was greater than that of the healthy side （P < 0.01）. Although CSA value decreased on the affected side after surgery， it remained higher than that of the healthy side （P < 0.01）. Additionally， there was a significant difference between SR?SN values on both sides with higher values observed on the affected side （P < 0.01）. Notably， △CSA on the affected side exhibited a negative correlation with postoperative VAS score， JOA score， and treatment improvement rate （P < 0.05）； The SR?SN on the affected side exhibited a positive correlation with BMI and negative correlations with postoperative VAS score， JOA score， and treatment improvement rate （P < 0.05）. However， no significant correlations were observed between △CSA， SR?SN， and ODI score on the affected side. （P > 0.05）. Conclusions In patients undergoing endoscopic surgery for lumbar disc herniation， a greater change in the cross?sectional area of the affected sciatic nerve before and after the operation is associated with more pronounced improvement in early symptoms. However， further investigation is required to explore the relationship between this change and recovery of both lumbar spine and lower limb function.

Objective To evaluate the clinical effectiveness of single?incision intervertebral foraminotomy in treating double?segment lumbar spinal stenosis accompanied by lumbar disc herniation. Methods A retrospective analysis was conducted on 40 cases of double?segment lumbar spinal stenosis and lumbar disc herniation treated in our orthopedic （spinal surgery） department from March 2016 to May 2018. Among these cases， 11 patients （Group A） were treated with percutaneous discectomy， 13 patients （Group B） underwent percutaneous endoscopic discectomy， and 16 patients （Group C） received double?incision percutaneous surgery. General clinical data for all patients were recorded. Visual Analog Scale （VAS） scores， Japanese Orthopaedic Association （JOA） scores， and clinical outcomes were assessed at five different time points： preoperatively， immediately postoperatively， one week postoperatively， one month postoperatively， and at the final follow?up. Statistical analysis was performed on the collected data. Results The operation time， the number of fluoroscopies performed on the hands， the length of the skin incision， and patient satisfaction were all statistically significant （P < 0.05）. An interaction effect was observed between the operation time and the surgical procedure on both the VAS and JOA scores. Both the operation time and the surgical method had significant main effects on the VAS and JOA scores （P < 0.05）. Significant differences in VAS and JOA scores were found among the three groups immediately post?surgery， one week post?surgery， one month post?operation， and at the end of the study （P < 0.05）. Immediately after surgery， there were statistically significant differences in VAS and JOA scores among the three groups （P < 0.05）. One week post?surgery， there were also statistically significant differences in VAS scores among the three groups （P < 0.05）. Conclusions The single?incision intervertebral foramen technique is an effective approach for simultaneously addressing double?segment lumbar spinal stenosis and lumbar disc herniation through decompression. This method boasts a shorter operative duration， reduced intraoperative radiation exposure， and minimal tissue damage. Patient satisfaction is high， making it a valuable addition to clinical practice.

Objective To investigate the heterogeneity between left? and right?sided colorectal cancer （CRC） in terms of clinical pathological features and gene expression， thereby providing a foundation for personalized treatment. Methods A retrospective analysis was conducted on the clinical data， next?generation sequencing （NGS） results， and treatment plans of 186 CRC patients treated at the forth hospital affiliated of guangxi medical university from July 2020 to August 2023. Patients were categorized into left?sided CRC （n = 134） and right?sided CRC （n = 52） based on tumor location. Clinical and pathological characteristics were analyzed using SPSS 24.0 software， and Kaplan?Meier survival curves were generated to compare overall survival （OS） between groups using the Log?rank test. Additionally， this study compared the clinical and pathological features， NGS?based gene mutation profiles， and prognostic differences between left? and right?sided CRC patients. Results In the clinical and pathological characteristics， no significant differences were observed between left? and right?sided CRC patients regarding gender， distant metastasis， ECOG performance status， TNM stage， or levels of carcinoembryonic antigen （CEA） and carbohydrate antigen 19?9 （CA19?9） （P > 0.05）. However， there were significant differences in age （P < 0.05）. In terms of gene mutation characteristics， the mutation frequencies of NRAS， BRAF， and APC genes did not differ significantly between left? and right?sided CRC patients （P > 0.05）. However， right?sided CRC patients exhibited significantly higher mutation frequencies of PIK3CA and SMAD4 genes， as well as a higher prevalence of microsatellite instability （MSI）， compared to left?sided CRC patients （P < 0.05）. Conversely， left?sided CRC patients had significantly higher TP53 mutation frequencies than right?sided CRC patients （P < 0.05）. In prognostic analysis， after a three?year follow?up， no significant difference in OS was observed between the two groups. Conclusions Significant disparities are observed in the clinical pathological features and gene expression profiles between left? and right?sided CRC. These findings indicate that distinct approaches should be adopted in clinical diagnosis and treatment to facilitate personalized and precise care.

Objective Explored the clinical efficacy and mechanism of improved CO₂ fractional laser on treatment for refractory wounds. Methods A total of 122 patients with refractory wounds who were admitted to the hospital from May 2022 to May 2024 were selected and randomly divided into a conventional group （conventional dressing change treatment + photodynamic therapy + conventional CO₂ fractional laser treatment） and an improved group （conventional dressing change treatment + photodynamic therapy + improved CO₂ fractional laser treatment） by lottery， with 61 cases in each group. The serum C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） levels， the number of wound bacteria before treatment and after 1， 2， and 3 weeks of treatment were compared between the two groups. The wound healing rates after 1， 2， and 3 weeks of treatment were compared between the two groups. The clinical efficacy of the two groups was compared. The levels of wound exudate basic fibroblast growth factor （bFGF） and angiopoietin-1 （Ang-1） before treatment and after 1， 2， and 3 weeks of treatment were compared. The adverse reactions of the two groups were compared. Results Repeated measures analysis of variance showed that there were an interaction effect between groups and over time in the serum CRP and ESR levels， the number of wound bacteria in both groups （P < 0.05）. There were no significant differences in the serum CRP and ESR levels and the number of wound bacteria between the two groups before treatment （P > 0.05）. The serum CRP and ESR levels and the number of wound bacteria in the improved group were lower than those in the conventional group after 1， 2， and 3 weeks of treatment （P < 0.05）. Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the wound healing rates of both groups （P < 0.05）. The wound healing rates in the improved group were higher than those in the conventional group after 1， 2， and 3 weeks of treatment （P < 0.05）. The total clinical effective rate of the improved group was higher than that of the conventional group （P < 0.05）. Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the levels of bFGF and Ang-1 in wound exudates of both groups （P < 0.05）. There was no significant difference in the levels of bFGF and Ang-1 in wound exudates between the two groups before treatment （P > 0.05）. The levels of bFGF and Ang-1 in wound exudates in the improved group were higher than those in the conventional group after 1， 2， and 3 weeks of treatment （P < 0.05）. There were no significant differences in the incidence of pain， pruritus and rash between the two groups （P > 0.05）. Conclusions In the treatment of refractory wounds， the combination of improved CO₂ fractional laser and photodynamic therapy could promote the secretion of wound exudate growth factors， inhibit wound bacterial growth and inflammatory response， accelerate wound healing， and improve clinical efficacy， with high safety. The mechanism of action is related to the promotion of wound exudate growth factor secretion.

Objective To investigate the predictive value of the mini?fluid challenge test in elderly orthopedic patients for post?spinal anesthesia hypotension. Methods Seventy?two elderly patients who underwent elective hip or knee replacement surgery were rigorously screened according to predefined inclusion and exclusion criteria. All patients were scheduled for subarachnoid block anesthesia. Subjects were grouped based on changes in blood pressure within 15 minutes of assuming a supine position following single?shot lumbar anesthesia. According to previously established definitions of hypotension， they were categorized into either the hypotension group （H group） or the normal blood pressure group （N group）. Prior to spinal anesthesia， a mini?fluid challenge test was conducted using noninvasive cardiac output monitoring to measure the change in stroke volume index （ΔSVI）， and baseline circulatory data were recorded. Multivariate logistic regression analysis was employed to identify factors influencing outcomes in elderly patients undergoing orthopedic joint replacement surgery. Receiver operating characteristic （ROC） curves for ΔSVI were constructed， and the area under the curve （AUC） was calculated to evaluate its predictive performance. Results After spinal anesthesia， 29 patients （40.27%） experienced hypotension. Compared with Group N， patients in Group H who experienced hypotension within 15 minutes while in a supine position were significantly older， had a higher proportion of ASA grade III， and a higher prevalence of hypertension （P < 0.05）. The analysis results indicated that ΔSVI was an independent influencing factor for post?lumbar anesthesia hypotension in elderly patients. ΔSVI demonstrated a sensitivity of 82.8% and a specificity of 81.4% in predicting post?spinal anesthesia hypotension （PSAH） at a cut?off value of 0.805 or greater. There was a moderate positive linear correlation between the maximum decrease in systolic blood pressure （SBP） and ΔSVI （r = 0.562， P < 0.01）. Conclusion The mini?fluid challenge test is an effective method for predicting hypotension in elderly orthopedic patients following spinal anesthesia.

Objective To evaluate the efficacy and safety of magnetic resonance?guided modified ligation of the intersphincteric fistula tract in the treatment of deep anorectal abscess. Methods A retrospective study was conducted on 148 patients with deep anorectal abscess treated at our hospital from September 2019 to June 2023， who met the inclusion criteria. Of these， 51 patients in the observation group underwent modified LIFT， while 97 patients in the control group received incision and drainage. Using propensity score matching， 47 patients from each group with balanced baseline characteristics were selected， resulting in a total of 94 patients being included in the analysis. The study compared operation time， hospital stay， pain index， postoperative complications， anal function， and healing rate between the two groups. Results Primary lesions originating in the sphincter space were identified through preoperative magnetic resonance imaging in all 94 patients. The mean operation time for the observation group was （43.75 ± 11.77） minutes， significantly longer than that of the control group at （28.90 ± 8.67） minutes （P < 0.05）. At three months post?surgery， the healing rate in the observation group was 80.9%， which was significantly higher than the 57.4% observed in the control group （P < 0.05）. Among patients with fistulas in the observation group， the healing rate was 73.1%， although this difference was not statistically significant in the univariate analysis of clinical characteristics （P > 0.05）. No significant differences were found between the two groups regarding the length of hospital stay， pain index， postoperative complications， or anal function （all P > 0.05）. Conclusions Modified LIFT guided by MRI can be conditionally applied in the treatment of deep anorectal abscesses. This approach can enhance the initial surgical healing rate without significantly increasing the incidence of postoperative complications， thereby avoiding potential damage to anal function.

Objective To investigate alterations in serum NOV/CCN3 levels among women during mid-to-late pregnancy and elucidate its association with gestational diabetes mellitus （GDM） and pregnancy outcomes. Methods Based on the results of an oral glucose tolerance test （OGTT）， we categorized 252 pregnant women into two groups： the GDM group and the control group. Within the GDM group， participants were further stratified based on pre-pregnancy body mass index levels and pregnancy outcomes. We collected clinical data for all study subjects and compared differences in general information， biochemical indicators， as well as NOV/CCN3 levels between these groups. Results The serum levels of NOV/CCN3 in the GDM group were significantly higher compared to those in the control group （P < 0.001）. Spearman correlation analysis revealed a positive association between serum NOV/CCN3 and pre-pregnancy body weight， pre-pregnancy body mass index， insulin resistance index， and total cholesterol； while a negative correlation was observed with insulin sensitivity index （P < 0.05）. Logistic regression analysis demonstrated that NOV/CCN3 is an independent risk factor for the development of GDM ［OR = 1.097， 95% CI （1.020 ~ 1.179）， P = 0.013］， as well as adverse pregnancy outcomes in GDM patients ［OR = 1.032， 95% CI （1.020 ~ 1.045）， P < 0.001］. ROC analysis indicated AUCs of 0.840 and 0.784 for these associations respectively （P < 0.05）. Conclusions Serum levels of NOV/CCN3 in pregnant women at mid- to late-stage are associated with obesity， insulin resistance， and glucose-lipid metabolism， suggesting a potential role of NOV/CCN3 in glycolipid metabolism during gestational diabetes mellitus （GDM）. These findings provide novel insights for assessing the occurrence of GDM and predicting pregnancy outcomes in mid- to late-stage pregnancies.

Objective To investigate the correlation between serum ferritin （SF） and 25-hydroxyvitamin D ［25-（OH）D］ and cervical vascular plaque and cardiac metabolism index （CMI） in elderly patients with nonalcoholic fatty liver disease （NAFLD）. Methods 128 elderly patients with NAFLD in the hospital were selected as study group， and 80 healthy subjects with physical examination were included in control group. The levels of SF and 25-（OH）D were compared between study group and control group and among patients with different lesion degrees. According to the presence or absence of formation of carotid artery plaque， the patients were classified into plaque group （n = 36） and non-plaque group （n = 92）， and the clinical data， SF， 25-（OH）D and CMI were compared. The multiple factors affecting the cervical vascular plaque formation in elderly patients with NAFLD and the correlation of SF and 25-（OH）D levels with cervical vascular plaque and CMI were analyzed. Results Serum SF in study group was significantly higher than that in control group （P < 0.05） while 25-（OH）D level was significantly lower than that in control group （P < 0.05）. SF level was manifested as fatty liver group < steatohepatitis group < liver cirrhosis group （P < 0.05） while 25-（OH）D level revealed fatty liver group > steatohepatitis group > liver cirrhosis group （P < 0.05）. The BMI， diabetes mellitus， hyperlipidemia， serum ALT， AST， LDL-C， SF， FPG， FINS， HOMA-IR， CMI and NFS in plaque group were significantly higher than those in non-plaque group （P < 0.05） while serum 25-（OH）D level was significantly lower than that in non-plaque group （P < 0.05）. Multivariate Logistic regression analysis showed that increased BMI， serum LDL-C， SF， CMI and NFS were risk factors for carotid artery plaque formation in elderly patients with NAFLD （P < 0.05）， and serum 25-（OH）D level was a protective factor （P < 0.05）. Correlation analysis showed that SF was positively correlated with carotid artery plaque and CMI in NAFLD patients （P < 0.05）， and serum 25-（OH）D level was negatively correlated with carotid artery plaque and CMI （P < 0.05）. Conclusion Serum SF and 25-（OH）D are related to the progression of NAFLD， and may affect the cervical vascular plaque formation and cardiac metabolism. Serum SF and 25-（OH）D can be used as observation indicators for the diagnosis and treatment of vascular lesions in patients with NAFLD.

Objective To investigate the clinical characteristics of hepatitis?associated aplastic anemia （HAAA） in pediatric patients. Methods A retrospective study was conducted on 212 children with aplastic anemia （AA） who were hospitalized at Henan Children's Hospital from September 2014 to February 2023. The patients were categorized into two groups based on etiology： the HAAA group and the non?HAAA group. The study group consisted of 23 patients in the HAAA group， while a control group of 115 children without HAAA was matched in a 1∶5 ratio based on age， sex， and severity of aplastic anemia. The clinical characteristics， treatment regimens， and outcomes of the 23 patients with HAAA were analyzed and compared with those of the control group comprising 115 patients. Results Among the 23 children with HAAA， there were 11 males and 12 females， with a median age of 6 years and 3 months （ranging from 1 year and 4 months to 12 years old）. The onset of aplastic anemia in all HAAA children occurred after the initial presentation of acute hepatitis. Following gradual improvement in liver function， peripheral blood images showed a progressive decline by two or three lines， including platelets. Among these cases， very severe aplastic anemia was observed in 14 patients （60.9%）， severe aplastic anemia in 7 patients （30.4%）， and non?severe aplastic anemia in 2 patients （8.7%）. The median interval between hepatitis onset and diagnosis of aplastic anemia was found to be 56 days （range：10 ~ 157 days）. All 23 pediatric patients with HAAA presented with acute icteric hepatitis， accounting for 100% of the cohort. One patient （4.3%） was genetically diagnosed with X?linked lymphoproliferative disease type 2， while liver biopsy revealed drug?induced hepatitis/chemical liver injury in five patients （21.7%）. Compared to the control group， HAAA patients exhibited significantly lower levels of CD4⁺ cells ［（1.2 ± 0.3） vs. （1.5 ± 0.1）］ and CD4⁺/CD8⁺ ratios ［（-0.2 ± 0.4） vs. （0.1 ± 0.2）］ （P < 0.05）. Three patients received immunosuppressive therapy （IST）， 18 underwent hematopoietic stem cell transplantation （HSCT）， and two non?severe cases were treated with methylprednisolone sodium succinate and compound Zapoan pill； all patients survived. Conclusions Children with HAAA present a critical condition and exhibit a poor prognosis， predominantly manifesting as severe or extremely severe aplastic anemia during the recovery phase of hepatitis. Reduction in CD4⁺ cell count and inversion of CD4⁺/CD8⁺ ratio may serve as early warning indicators for HAAA. Effective improvement in prognosis can be achieved through immunosuppressive therapy and hematopoietic stem cell transplantation.

Objective To evaluate the efficacy and safety of a subanesthetic dose of esketamine in preventing postoperative nausea and vomiting following carboprost administration during cesarean section. Methods One hundred thirty?five full?term singleton parturients， ASAⅠ-Ⅱ， aged 20 - 40 years， scheduled for elective cesarean section， were recruited. They were randomly assigned to three groups （n = 45）： the normal saline group （Group C）， the palonosetron group （Group P）， and the esketamine group （Group E）. All parturients received combined spinal?epidural anesthesia， achieving a sensory level of T_5?7. Following umbilical cord clamping， carboprost tromethamine was injected into the uterine body. Concurrently， Group C received intravenous normal saline， Group P received palonosetron， and Group E received esketamine. The incidence of nausea， vomiting， and chest discomfort was recorded from the time of carboprost administration until the parturients left the operating theater. Additionally， mean arterial pressure （MAP）， heart rate （HR）， oxygen saturation （SpO₂）， and Ramsay sedation scores were measured at six time points： upon entering the room （T₀）， 1 minute before intervention （T₁）， 2 minutes （T₂）， 5 minutes （T₃）， 15 minutes （T₄）， and 30 minutes （T5） post?intervention. Maternal satisfaction was evaluated as the parturients left the operating room. Results Compared with group C， the incidence of nausea， vomiting， and chest discomfort in group E was significantly lower （all P < 0.05）. Additionally， group E showed a significantly lower incidence of nausea and chest discomfort compared to group P （all P < 0.05）. In terms of maternal satisfaction， group E reported significantly higher levels than both group C （P < 0.05） and group P （P < 0.05）. No significant differences were observed in the incidence of nausea， vomiting， chest discomfort， or satisfaction between the other groups （P > 0.05）. Conclusion The administration of subanesthetic doses of esketamine significantly decreases the incidence of adverse effects such as nausea， vomiting， and chest tightness that are commonly associated with carboprost tromethamine use during cesarean sections， thereby enhancing patient satisfaction in the perioperative period.

Objective To analyze the effect of aspirin addition on endometrial conditions and pregnancy outcomes in endometriosis-related patients with thin endometrium. Methods A retrospective analysis was conducted on endometriosis-related patients with thin endometrium （thickness < 7 mm） undergoing frozen-thawed embryo transfer at the Reproductive Medical Centre from January 2019 to May 2023 was conducted. Patients undergoing hormone replacement therapy with aspirin （Observation group， n = 162） were compared with those receiving increased estrogen alone （Control group， n = 152）. Endometrial parameters before embryo transfer and clinical outcomes were compared between the groups. Results Compared to the Control group， the Observation group showed significant improvements in pulsatility index （PI） ［（0.77 ± 0.20） vs. （0.84 ± 0.27），P < 0.05］， resistance index （RI） ［（0.49 ± 0.10） vs. （0.63 ± 0.10），P < 0.01］， and systolic/diastolic （S/D） ratio ［（1.94 ± 0.49） vs. （2.22 ± 0.47），P < 0.01］. Moreover， there was a significant increase in the embryo implantation rate （38.00% vs. 27.24%， P < 0.01）， clinical pregnancy rate （56.17% vs. 42.11%， P < 0.05） and live birth rate （84.62% vs. 68.75%， P < 0.05）. Conclusion In endometriosis-related patients with thin endometrium， the addition of aspirin significantly improved uterine and spiral artery blood flow， thereby enhancing pregnancy outcomes during frozen-thawed embryo transfer.

Objective To investigate the utility of combining breast mass growth orientation quantification with the S-Detect technique for predicting axillary lymph node （ALN） metastasis in breast cancer. Methods Data was collected from 163 breast cancer patients admitted to our hospital between March 2023 and October 2024， who were categorized into metastatic （n = 62） and non-metastatic （n = 101） groups based on ALN pathology results. All patients underwent routine preoperative ultrasound and S-Detect examination. Univariate and multivariate regression analyses were performed to assess the correlation between each observational index and ALN metastasis. Significant indexes were identified through screening， leading to the establishment of a logistic regression prediction model. The predictive value of the model was evaluated using receiver operating characteristic （ROC） curve analysis. Results The univariate analysis revealed statistically significant differences （P < 0.05） in the maximum diameter of the mass， border characteristics， margin features， calcification patterns， orientation angle， and blood flow between the two groups. Multifactorial analysis demonstrated that calcification， border characteristics， orientation angle， margin features， and maximum diameter independently influenced the prediction of axillary lymph node （ALN） status in breast cancer patients （P < 0.05）. Consequently， a logistic regression prediction model was constructed as follows： Y = -7.995 + 2.299 × maximal diameter + 1.171 × border + 2.137 × margin + 1.397 × calcication + 0.034 × orientation angle. The area under curve （AUC） for this combined prediction model was 0.869 which significantly outperformed each independent influencing factor alone （P < 0.05）， indicating good agreement between this joint prediction model and pathological results （Kappa = 0.701， P < 0.05）. Conclusions Quantification of the orientation angle of a breast mass aids in predicting axillary lymph node （ALN） metastasis and enhances the interpretation and application of non-parallel orientations. The combination of quantifying growth orientation based on breast mass with artificial intelligence S-Detect technique demonstrates promising predictive value for ALN metastasis in breast cancer， providing a reference basis for personalized treatment.

Objective We tried to analyze the value of three-dimensional speckle tracking imaging technology combined with left ventricular pressure strain loop for evaluation of left ventricular systolic dysfunction in early coronary heart disease patients. Methods 97 patients with early coronary heart disease admitted to our hospital from February 2022 to February 2024 were selected as the research subjects. According to the degree of left ventricular systolic dysfunction， they were divided into those without left ventricular systolic dysfunction （LVEF value ≥ 50%） and those with left ventricular systolic dysfunction （LVEF value < 50%）. All patients underwent clinical data collection， left ventricular pressure strain loop， and three-dimensional speckle tracking imaging technology examination. Results Body mass index， gender， diabetes mellitus and hyperlipidemia were compared between the two groups （P > 0.05）. Compared with the group without left ventricular systolic dysfunction， the group with left ventricular systolic dysfunction is older， with a higher proportion of Killip grades Ⅲ~Ⅳ and multiple coronary artery lesions （P < 0.05）. Compared with the group without reduced left ventricular systolic function， the absolute levels of GWE， GCW， and GWI in the group with reduced left ventricular systolic function were lower， while the absolute level of GWW was higher （P < 0.05）. Compared with the group without left ventricular systolic dysfunction， the left ventricular systolic dysfunction group had lower levels of area， circumference， radial， and longitudinal strain （P < 0.05）. GWE、GCW、GWI、 Area， circumference， radial， and longitudinal strain levels were negatively correlated with the incidence of left ventricular systolic dysfunction， while GWW was positively correlated with the incidence of left ventricular systolic dysfunction （P < 0.05）. The ROC analysis results showed that the sensitivity and accuracy of left ventricular pressure strain loop and three-dimensional speckle tracking imaging technology in predicting left ventricular systolic dysfunction in early coronary heart disease patients were lower than combined detection （P<0.05）. Conclusions Early coronary heart disease patients with reduced left ventricular systolic function had lower absolute levels of area， circumference， radial， longitudinal strain， GWE， GCW， and GWI， and higher absolute levels of GWW. These indicators are all related to the incidence of left ventricular systolic dysfunction. The combination of three-dimensional speckle tracking imaging technology and left ventricular pressure strain loop had high value in predicting left ventricular systolic dysfunction in early coronary heart disease patients.

Objective To evaluate the value of multimodal brain function monitoring using quantitative electroencephalography （QEEG） and transcranial Doppler （TCD） in predicting hematoma enlargement and prognosis in patients with acute hypertensive intracerebral hemorrhage. Methods A retrospective analysis was conducted on the clinical data of 120 patients with acute hypertensive intracerebral hemorrhage from October 2019 to October 2022. All patients underwent QEEG and TCD examinations within 24 hours of admission， and were divided into hematoma enlargement group （79 cases） and hematoma stabilization group （41 cases） based on whether the hematoma had expanded. By comparing the parameter differences of QEEG and TCD between two groups， explore the correlation between these monitoring indicators and hematoma enlargement and patient prognosis. Results The patients in the hematoma enlargement group had a higher average age and a higher smoking rate. The initial neurological damage in the hematoma enlargement group was more severe. The DAR and DTABR values of the hematoma enlargement group were significantly higher than those of the stable group at different time points after cerebral hemorrhage （P < 0.05）. Correlation analysis shows that DAR， DTABR， and P1 have significant positive correlations with hematoma enlargement， with DAR and DTABR showing particularly strong correlations （r values of 0.774 and 0.738， respectively， P < 0.05）， while P1 has relatively weak correlations （r = 0.213， P < 0.05）. ROC curve analysis shows that DAR， DTABR， and P1 parameters have high sensitivity and specificity in predicting hematoma enlargement， with an AUC value of up to 0.970 for DAR. During the follow-up period， the MRS scores of the stable hematoma group were significantly better than those of the hematoma expansion group at all time points （P < 0.05）. Conclusion QEEG and TCD are helpful in early identification of high-risk patients， enabling more targeted treatment measures and improving clinical outcomes for patients.

Objective To assess the prognostic value of serum lysine hydroxylase 3 （PLOD3） and cytokeratin 19 fragment （CYFRA21-1） in predicting the efficacy of three-dimensional brachytherapy in patients with pulmonary metastases. Methods A total of 102 patients with lung metastases who underwent three-dimensional brachytherapy at our hospital were selected as the lung metastasis group from August 2021 to August 2023. During the same period， a control group consisting of 60 healthy individuals who underwent physical examinations was selected. The lung metastasis group was further divided into an effective group （n = 66） and an ineffective group （n = 36） based on therapeutic outcomes. Enzyme-linked immunosorbent assay was employed to measure the levels of serum PLOD3 and CYFRA21-1. Multiple logistic regression analysis was conducted to identify factors influencing the efficacy of three-dimensional brachytherapy in the lung metastasis group. Receiver operating characteristic （ROC） curves were used to assess the predictive value of serum PLOD3 and CYFRA21-1 for treatment efficacy. Results The levels of serum PLOD3 and CYFRA21-1 in the case group were （34.47 ± 6.17） μg/L， （27.85 ± 5.14） μg/L， respectively， which exhibited significantly higher values compared to those observed in the control group （7.26 ± 2.21）μg/L，（9.31 ± 2.46）μg/L （P < 0.05）. A positive correlation was found between serum PLOD3 and CYFRA21-1 in the Lung metastasis group （r = 0.667， P = 0.000）. Logistic regression analysis revealed that multiple metastatic lesions along with elevated serum levels of PLOD3 and CYFRA21-1 were identified as risk factors for the efficacy of three-dimensional brachytherapy in patients with lung metastases （P < 0.05）. Furthermore， when combined with three-dimensional brachytherapy， the area under the curve （AUC） for serum PLOD3 and CYFRA21-1 was calculated as 0.868， demonstrating a superior performance compared to individual measurements of either serum PLOD3 alone （AUC = 0.815） or CYFRA21-1 alone （P < 0.05）. Conclusions The levels of serum PLOD3 and CYFRA21-1 are elevated in patients with lung metastases， exhibiting a significant correlation with the efficacy of three-dimensional brachytherapy. The combined utilization of these two biomarkers demonstrates a robust predictive value for treatment efficacy in patients suffering from lung metastases.

Objective To investigate the awareness of female patients with pelvic floor dysfunction regarding minimally invasive laser treatment of the reproductive tract and analyze the factors influencing their decision-making intentions， this study aims to provide a foundation for early treatment of pelvic floor dysfunction and further development in reproductive health management. Methods A convenience sampling method was employed to select 164 female patients with pelvic floor dysfunction who sought treatment at the Pelvic Rehabilitation Center of Dongguan Maternal and Child Health Care Hospital between June 2023 and August 2024. The study utilized the Female Sexual Function Index， Incontinence Quality of Life Questionnaire， and Family Support Self-Assessment Scale to conduct a survey. Binary logistic stepwise regression analysis was conducted to investigate the factors influencing patients' inclination towards undergoing genital laser minimally invasive treatment. Results Among the 164 female patients， 143（87.2%） expressed an intention to receive treatment， with 22.6% demonstrating a relatively clear understanding of genital laser minimally invasive treatment. Logistic regression analysis revealed that occupation significantly influenced treatment intention （P < 0.05）. Compared to healthcare professionals， individuals in the teaching profession （OR = 10.81， 95% CI： 1.04 ~ 112.21）， self-employed individuals （OR = 20.34， 95% CI ：3.46 ~ 119 .43）， and those in other professions （OR = 16.26，95 %CI： 4.05 ~ 65.29） were more inclined to express willingness for undergoing treatment. Furthermore， a lower score on the Incontinence Quality of Life scale was found to positively correlate with treatment intention （OR = 0.96，95 %CI： 0.93 ~ 0.99）. Conclusion Although patients express a high intention to undergo minimally invasive genital laser treatment， their overall awareness of the procedure remains insufficient.

Limb spasticity is a common complication after stroke， with clinical manifestations such as increased muscle tone， limb stiffness and pain， which reduces the quality of patients' daily life and increases the economic burden. Currently， scales， surface electromyography and biomechanical methods are mostly used to assess limb spasticity in clinical practice， but clinical scales rely on experience and are highly subjective； surface electromyography is prone to compensations and test errors； and biomechanical methods are more restrictive. Musculoskeletal ultrasound is not only capable of detecting muscle parameters and providing quantitative information such as muscle hardness and elasticity， but also has the unique advantages of high-resolution and real-time imaging， which has been increasingly used in clinical diagnosis and treatment. In this paper， we review the evidence related to musculoskeletal ultrasound and limb spasticity assessment， with the aim of exploring a simple and reasonable quantitative assessment method， which will provide some thoughts for the future clinical assessment of limb spasticity.

Bone morphogenetic proteins are a large subclass of the transforming growth factor β family， and Their signaling pathways are mainly classified into two kinds based on whether they depend on Smad protein to mediate or not. BMP signaling pathways are involved in regulating cell proliferation and differentiation， as well as the formation and development of multiple tissues and organs. Recent studies have shown that BMP signaling pathways mainly promote the differentiation and growth of neurons and astrocytes， and are closely related to the myelination of oligodendrocytes. In addition， BMP signaling pathways also play an important role in the occurrence of central nervous system diseases， such as spinal cord injuries， multiple sclerosis， neural tube defects， and Parkinson's disease. This article reviews the BMP signaling pathways' composition， transduction mechanism and their role in the central nervous system and related diseases， in order to provide more potential ideas for basic research and clinical treatment of central nervous system diseases.

Resistant ovary syndrome （ROS） and premature ovarian insufficiency （POI） fall under the category of hypogonadotropic amenorrhea， sharing similar clinical features that often pose challenges in differentiation. ROS can be easily misdiagnosed as POI， which presents a significant obstacle to subsequent treatment. Therefore， it is crucial for patients with fertility requirements to have a clear understanding of the etiology， clinical features， and diagnostic criteria of ROS and POI in order to establish an early diagnosis and develop an appropriate treatment plan. This article provides a systematic and comprehensive discussion on the research progress regarding the etiology and pathogenesis， clinical features and diagnosis， as well as individualized management of ROS and POI. The aim is to offer reference for clinicians in achieving early clarification of diagnoses， avoiding misdiagnosis or mistreatment， while assisting patients in improving symptoms and realizing their fertility aspirations through personalized management.