Epilepsy （EP） is a group of chronic neurological disorders characterized by abnormal discharges of brain neurons.Howeve，approximately one-third of patients exhibit obvious drug resistance， and studies have confirmed the critical role of genetic factors. The ALG13 gene encodes a subunit of uridine diphosphate N-acetylglucosamine （UDP-GlcNAc） transferase，and its mutations can lead to congenital disorders of glycosylation （CDGs）. Patients with such mutations frequently present with epileptic seizures，indicating a strong association between ALG13 genetic variants， glycosylation defects， and epilepsy. This review systematically integrates， for the first time， the structural and functional aspects of the ALG13 gene， as well as the evidence of the association between its mutations and epilepsy， and the potential mechanisms of action. Through a multi-dimensional analysis，it provides important clinical guidance for in-depth exploration of the relationship between the ALG13 gene and epilepsy， the development of precise diagnosis， and the research and development of targeted drugs.

Objective To investigate the protective effect of epigallocatechin gallate （EGCG） on 1?methyl?4?phenyl?1，2，3，6?tetrahydropyridine （MPTP）?induced Parkinson's disease model mice. Methods Twenty?eight male C57BL/6J mice aged 6 ~ 8 weeks were randomly divided into four groups： the control group， the model group， the low?dose EGCG group［25 mg/（kg·d）］， and the high?dose EGCG group［50 mg/（kg·d）］. A Parkinson's disease （PD） mouse model was established by intraperitoneal injection of MPTP at a dose of 30 mg/ （kg·d） for 7 consecutive days. The protective effect of EGCG on MPTP?induced Parkinson's model mice was analyzed through behavioral index detection and Western blot method. Results （1）In the behavioral tests， compared with the model group， the movement distance and speed of mice treated with low?and high?dose EGCG were significantly improved （both P values < 0.001）. The mice in the high?dose EGCG treatment group also showed a significant advantage in the percentage of the central path distance （P < 0.001）. （2）Compared with the control group， the deposition of α?synuclein in the model group increased significantly （P < 0.001）. Compared with the model group， both the low?and high?dose EGCG groups reduced the deposition of α?synuclein （both P < 0.001）. （3）Compared with the control group， the expression levels of Beclin 1 and LC3 proteins in the substantia nigra region of mice in the model group decreased significantly （both P < 0.001）， while the expression level of p62 protein increased significantly （P < 0.001）. After treatment with EGCG， compared with the model group， the expression levels of Beclin 1 and LC3 proteins in mice of the low?dose EGCG group increased to varying degrees （P < 0.01； P < 0.001）， and the expression level of p62 protein decreased significantly （P < 0.001）. In the high?dose EGCG group， the expression levels of Beclin 1 and LC3 proteins increased significantly （both P < 0.001）， and the expression level of p62 protein decreased significantly （P < 0.001）. Conclusion EGCG reduces alpha?synuclein deposition via the autophagy?lysosomal pathway and protects against MPTP-induced Parkinson's disease model mice.

Objective To investigate the impact of high-frequency repetitive transcranial magnetic stimulation （rTMS） combined with biofeedback-assisted dry swallowing training on treating dysphagia following a stroke. Methods A total of 152 patients with dysphagia after stroke， admitted to the hospital from January 2022 to January 2024， were randomly divided into four groups using a random number table， with 38 cases in each group. The biofeedback group received biofeedback-assisted dry swallowing training， the magnetic stimulation group received high-frequency rTMS on the unaffected side， the combined group received both biofeedback-assisted dry swallowing training and high-frequency rTMS on the unaffected side， and the placebo group received conventional swallowing training and sham rTMS. All interventions lasted for 4 weeks. Clinical efficacy was recorded， and pre- and post-treatment assessments of the upper esophageal sphincter （UES） opening time， opening degree， and pharyngeal contraction duration were performed using multifunctional esophageal manometry. Additionally， swallowing function， nutritional status， neurological function， and quality of life were compared. Results The clinical efficacy of the combined group was higher than that of the biofeedback and magnetic stimulation groups. Post-treatment UES opening time， opening degree， and pharyngeal contraction duration were （205.33 ± 29.01） ms， （1.14 ± 0.34） cm， and （559.19 ± 63.48） ms， respectively， which were significantly better than those in the other 3 groups （P < 0.05）. The swallowing function scores of the combined group were （6.04 ± 0.83） and （20.03 ± 3.26） points， and significant improvements were observed in swallowing function， nutritional status， neurological function， and quality of life （P < 0.05）. Conclusion High-frequency rTMS combined with biofeedback-based dry swallowing training significantly improves the efficacy in the treatment of dysphagia after stroke.

Objective To evaluate the prognostic value of syndecan-1， VE-cadherin， and neuron-specific enolase（NSE） in elderly patients with sepsis-associated encephalopathy（SAE）. Methods Elderly patients with septic shock admitted to the ICU of the First Hospital of Changsha between January 2022 and August 2024 were enrolled in this study. Serum levels of syndecan-1， VE-cadherin， and NSE were measured on the first and third days following ICU admission in these elderly patients with septic shock. The optimal cut-off values， sensitivity， and specificity of syndecan-1， VE-cadherin， and NSE for predicting SAE were further analyzed. Results Ninety-six elderly patients with septic shock were enrolled in this study， comprising 40 cases in the SAE group and 56 cases in the non-SAE group. Sequential organ failure assessment scores， acute physiology and chronic health evaluation scores， and 28-day mortality rates were significantly higher in the SAE group compared to the non-SAE group （P < 0.05）. The serum levels of syndecan-1， VE-cadherin， and NSE on both the first and third days were significantly elevated in the SAE group compared to the non-SAE group （P < 0.05）. Elevated serum levels of syndecan-1， VE-cadherin， and NSE on the third day were identified as independent risk factors for SAE. On the third day， serum syndecan-1 levels （AUC = 0.798， 95%CI： 0.709 ~ 0.886， optimal cutoff = 160.80 ng/mL， sensitivity = 71.43%， specificity = 72.50%）， serum VE-cadherin levels （AUC = 0.847， 95%CI： 0.768 ~ 0.927， optimal cutoff = 2，429.00 ng/mL， sensitivity = 78.57%， specificity = 82.50%）， and serum NSE levels （AUC = 0.765， 95%CI： 0.670 ~ 0.861， optimal cutoff = 14.24 ng/mL， sensitivity = 53.57%， specificity = 92.50%） were all effective predictors of SAE. Notably， the combination of syndecan-1， VE-cadherin， and NSE （AUC = 0.877， 95%CI： 0.806 ~ 0.949， sensitivity = 85.71%， specificity = 80.00%） demonstrated superior performance in predicting SAE. Conclusions Secondary SAE in elderly patients with septic shock is closely associated with blood-brain barrier dysfunction and brain injury. The serum levels of syndecan-1， VE-cadherin， and NSE on the third day demonstrated significant predictive value for SAE. Moreover， the combined assessment of syndecan-1， VE-cadherin， and NSE exhibited superior performance in predicting SAE.

Objective To investigate the predictive value of serum microRNA （miRNA） -143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction （ACI） after thrombolysis. Methods From February 2022 to February 2024， 121 patients with acute cerebral infarction （ACI） who visited the hospital （all treated with thrombolysis） were selected as the study group. They were assigned into mild and moderate to severe groups based on the severity of their condition. They were into good prognosis group and poor prognosis group based on their postoperative condition. In addition， another 121 healthy individuals who underwent physical check ups during the same period were as the control group. The qRT-PCR method was applied to detect the expression levels of miR-143-3p and miR-188-5p. Pearson correlation was applied to analyze the correlation between serum miR-143-3p， miR-188-5p and NIHSS score. The influencing factors of poor prognosis in ACI patients after thrombolysis were analyzed using multiple logistic regression. ROC curve was plotted to analyze the predictive value of serum miR-143-3p and miR-188-5p for poor prognosis after thrombolysis in ACI patients. Results The serum miR-143-3p level in the study group was higher than that in the control group （P < 0.05）， and the miR-188-5p level was lower than that in the control group （P < 0.05）； The serum miR-143-3p and NIHSS score in the mild， moderate and severe groups were increased in turn， and the level of miR-188-5p was decreased in turn （P < 0.05）； Serum miR-143-3p was negatively correlated with miR-188-5p （P < 0.05）； Diabetes， time from onset to thrombolysis， NIHSS score at admission， miR-143-3p and miR-143-3p were the influencing factors of poor prognosis in ACI patients after thrombolysis； The AUC of the joint of serum miR-143-3p and miR-188-5p in predicting poor prognosis after thrombolysis in ACI patients was 0.871， and the joint of the two was better than their individual predictions （Z = 2.683， 2.703， P < 0.05）. Conclusions The level of serum miR-143-3p in ACI patients is significantly increased， and the level of serum miR-188-5p is significantly decreased， which is a poor prognostic factor for ACI patients after thrombolysis. The combination of the two has higher diagnostic value.

With the rapid advancements in minimally invasive spine surgery and the increasingly sophisticated concept of visualization， transforaminal endoscopic lumbar discectomy （TELD） has become a primary treatment for lumbar disc herniation. Among the critical preoperative steps in TELD， foraminalplasty plays a pivotal role， as its quality directly impacts surgical outcomes and postoperative recurrence rates. This article systematically reviews the evolution of foraminalplasty techniques， evaluates the selection and application of plasty sites， examines factors influencing stability after lumbar foraminalplasty， and highlights recent advancements in computer-assisted navigation. The goal is to serve as a comprehensive reference for clinicians.

Objective To investigate the effect of Lactobacillus plantarum LB12 on kidney calcium oxalate stones in rats. Methods A total of 24 male SD rats aged 6 ~ 8 weeks were randomly divided into four groups： control group， model group， LB12 group， and LB12 intervention group， with 6 rats in each group. The control group and LB12 group had free access to water， and were gavaged with 2 mL of normal saline in the morning. In the evening， the control group received 2 mL of normal saline， while the LB12 group received 2 mL of Lactobacillus plantarum LB12 suspension. The model group and LB12 intervention group were given 1% ethylene glycol in drinking water and 2 mL of 2% ammonium chloride solution via gavage in the morning. In the evening， both groups received 2 mL of normal saline and 2 mL of Lactobacillus plantarum LB12 suspension， respectively. After the experiment， the body weight change trend of the rats was recorded， and the levels of urinary calcium， urinary oxalate， serum creatinine， blood urea nitrogen， renal SOD， and MDA were measured. Additionally， H&E staining， VK staining， immunohistochemistry， ROS fluorescence analysis， and Western blot （WB） were performed on kidney tissues. Results Lactobacillus plantarum LB12 demonstrated a 12.34% oxalate degradation rate in vitro. Further animal experiments indicated that Lactobacillus plantarum LB12 alleviated the weight loss trend in the model rats and reduced the levels of urinary calcium， urinary oxalate， serum creatinine， urea nitrogen， and MDA， while increasing SOD levels （P < 0.05）. Histopathological analysis revealed that the LB12 intervention group had significantly fewer renal crystals compared to the model group， with lower expressions of IL-6 and ROS （P < 0.01）. Western blot analysis demonstrated that Lactobacillus plantarum LB12 inhibited the expression of TLR4， NF-κB， and OPN proteins （P < 0.01）. Conclusions Lactobacillus plantarum LB12 can effectively alleviate the oxidative stress damage caused by calcium oxalate stones to the kidneys and reduce kidney crystal formation in rats. Furthermore， it inhibits the expression of TLR4/NF-κB and OPN， making it a potential therapeutic approach for the prevention and treatment of kidney calcium oxalate stones.

Objective To investigate the role of circular RNA， circMYCBP2， which is highly expressed in lymph node （LN） metastatic bladder cancer （BCa） tissues， in enhancing BCa cell adhesion and mediating lymphovascular invasion （LVI）， and to evaluate its clinical relevance and potential therapeutic value. Methods High-throughput sequencing identified circRNAs with high expression in LN metastatic BCa tissues. Further validation of their expression in bladder cancer tissues was conducted through clinical samples. The coding ability of circMYCBP2 was predicted by circBank bioinformatics website， and the encoded short peptide was detected by immunoprecipitation（co-IP）combined with silver staining and Western blot （WB）. Then， by constructing BCa cells with overexpression and knockdown of circMYCBP2 in vitro，the invasive ability of BCa cells was verified by wound healing and transendothelial cell migration assays. The underlying mechanism of circMYCBP2 in the formation of LVI was explored through RNA pulldown， qRT-PCR and WB. Results High-throughput sequencing and clinical sample validation confirmed that circMYCBP2 is highly expressed in LN metastatic BCa.In vitro experiments demonstrated that circMYCBP2 overexpression significantly enhanced BCa cell migration across lymphatic endothelial cells. Mechanistically，circMYCBP2 encodes the short peptide MYCBP2-227aa via an IRES-dependent mechanism by interacting with EIF3H.Overexpression of MYCBP2-227aa increased the mRNA stability of VCAM-1， thereby enhancing the invasive capacity of UM-UC-3 cells. Conclusions CircMYCBP2 encodes the short peptide MYCBP2-227aa through an EIF3H-mediated， IRES-dependent translation mechanism.MYCBP2-227aa regulates VCAM-1 expression and promotes the invasive behavior of BCa cells. Our findings elucidate the critical biological role and molecular mechanism of circMYCBP2 in the formation of LVI and LN metastasis of BCa， providing a potential biomarker and therapeutic target for early lymphatic metastasis in BCa.

Objective Investigation into the impact of modified Chevron osteotomy on asymptomatic flatfoot following hallux valgus correction. Methods A retrospective analysis was performed on 118 patients （120 feet） who underwent modified Chevron osteotomy for hallux valgus between January 2018 and December 2022. Based on the Meary angle， the patients were categorized into two groups： an asymptomatic flatfoot group （49 cases， 50 feet） and a non-flatfoot group （69 cases， 70 feet）. Preoperative general data and radiographic parameters were compared between the two groups at baseline and during the last follow-up. These parameters included the talonavicular coverage angle （TNCA）， talus-second metatarsal angle （T2MT） on weight-bearing anteroposterior foot radiographs， and the Meary angle on lateral radiographs. Results There were no significant differences in preoperative general data between the two groups （P > 0.05）. In the asymptomatic flatfoot group， the Meary angle demonstrated a improvement （P < 0.001） when comparing radiographic parameters intra-group between preoperation and the last follow-up. In the non-flatfoot group， TNCA and T2MT increased （P < 0.05）. Inter-group comparisons revealed that preoperatively， TNCA， T2MT， and the Meary angle were significantly worse in the asymptomatic flatfoot group compared to the non-flatfoot group （P < 0.05）. At the last follow-up， there were no significant differences in TNCA and T2MT between the two groups （P > 0.05）； however， the Meary angle remained significantly lower in the asymptomatic flatfoot group than in the non-flatfoot group （P < 0.05）. Conclusions The modified Chevron osteotomy significantly enhances the medial longitudinal arch in patients with hallux valgus and asymptomatic flatfoot， although its effect on correcting abduction is relatively limited. In patients with hallux valgus but without flatfoot， this procedure does not substantially alter the medial longitudinal arch； however， it can induce abduction， which aids in the correction of hallux valgus. This study confirms that the modified Chevron osteotomy effectively improves foot arch structure in asymptomatic flatfoot cases while addressing hallux valgus， without worsening the flatfoot condition.

Objective To analyze the risk factors and effective predictive indicators for postpartum hemorrhage （PPH） in pregnant women with severe pre-eclampsia （sPE） in singleton pregnancies. The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients. Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1， 2016， to December 31， 2022. Among these， 95 cases were complicated by PPH. A comparative analysis was performed between the sPE group and the sPE with PPH group. Results （1） The incidence of assisted reproductive technology， intrapartum blood loss， placental abruption， elevated D-dimer levels， increased monocyte counts， and higher SIRI levels were significantly higher in the PPH group， whereas platelet counts were significantly lower （P < 0.05）. （2） The results indicated that intrapartum blood loss， D-dimer levels， and platelet counts were independently associated with PPH in pregnant women with sPE. （3） The area under the curve （AUC） for intrapartum blood loss， D-dimer， and platelet counts were 0.805， 0.717， and 0.571， respectively. The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL. The combined AUC for intrapartum blood loss and D-dimer was 0.859. （4） Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section （P < 0.001）. The corresponding optimal cutoff values were 285 mL and 375 mL， respectively. Conclusions Intrapartum haemorrhage， D-dimer levels， and platelet count were identified as independent risk factors for PPH in pregnant women with sPE. Specifically， pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section， along with a D-dimer level greater than 2.295 μg/mL， demonstrated an increased likelihood of developing PPH. Therefore， it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

Objective To explore the correlation between the immune status of patients with multiple myeloma （MM） and the dynamic changes in peripheral blood red blood cell distribution width standard deviation （RDW-SD）， serum free light-chain κ/λ ratio （sFLCR）， and soluble B-cell maturation antigen （sBCMA）， as well as their implications for prognosis. This study aims to provide a reference for evaluating disease progression and assessing patient outcomes. Methods 182 MM patients admitted to the hospital between July 2019 and July 2021 were enrolled as the study group. All selected patients were followed up for 3 years， with 6 cases lost to follow-up， resulting in a final cohort of 176 patients. These patients were further divided into two groups based on their prognosis： the poor-prognosis group （53 cases） and the good-prognosis group （123 cases）. Additionally， 50 healthy volunteers who underwent health check-ups during the same period were randomly selected as the control group. The immune status of both the study group and the control group was compared. Univariate analysis was conducted to identify factors associated with poor prognosis in MM patients， and Cox regression analysis was performed to determine risk factors for poor prognosis. The good-prognosis group was designated as the negative group， while the poor-prognosis group was designated as the positive group. The predictive value of peripheral blood RDW-SD， serum sFLCR， and sBCMA-both individually and in combination-for poor prognosis in MM patients was evaluated by constructing receiver operating characteristic （ROC） curves. The area under the curve （AUC） was calculated， and the optimal cut-off value was determined using the Youden index. Finally， the predictive value of the combined test was analyzed by fitting an appropriate equation. Results Levels of peripheral blood Th17 cells and platelet-to-lymphocyte ratio （PLR） were significantly higher in the study group compared to the control group （P < 0.05）， while the level of peripheral blood regulatory T cells （Tregs） was significantly lower than that in the control group （P < 0.05）. Additionally， levels of peripheral blood RDW-SD and serum sBCMA were significantly higher in the poor prognosis group compared to the good prognosis group （P < 0.05）， whereas the serum level of sFLCR was significantly lower than that in the good prognosis group （P < 0.05）. Cox regression analysis revealed that elevated peripheral blood RDW-SD （HR = 1.091， 95%CI： 1.027 ~ 1.159）， reduced serum sFLCR （HR = 1.095， 95%CI： 1.035 ~ 1.159）， and increased serum sBCMA （HR = 1.095， 95% CI： 1.016 ~ 1.165） were independent risk factors for poor prognosis in patients with MM （P < 0.05）. ROC curve analysis demonstrated that the combination of peripheral blood RDW-SD， serum sFLCR， and sBCMA assays achieved an AUC value of 0.880 for predicting poor prognosis in MM patients， which was significantly higher than those of the three individual assays （AUC values： 0.805， 0.786， 0.780； P < 0.05）. The sensitivity and specificity of this combined assay were 94.34% and 68.29%， respectively. Conclusions MM patients exhibited abnormal immune status and poor prognosis， which was associated with elevated levels of peripheral blood RDW-SD and serum sBCMA， as well as reduced serum sFLCR. Moreover， the combination of peripheral blood RDW-SD， serum sFLCR， and sBCMA demonstrated superior predictive value for poor prognosis in MM patients.

Objective To investigate the impact of diabetes stratification on the recovery of shoulder joint function following arthroscopic rotator cuff repair. Methods Between January 2020 and April 2024， a total of 216 patients who underwent arthroscopic rotator cuff repair at our hospital were enrolled in this study. According to preoperative blood glucose control status， the patients were categorized into four groups： Group A （non?diabetic patients）， Group B （diabetic patients with well?controlled blood glucose）， Group C （diabetic patients with mild dysglycemia）， and Group D （diabetic patients with severe dysglycemia）. All participants received standardized arthroscopic rotator cuff repair surgery and followed the same postoperative rehabilitation protocol. We assessed inflammatory factor levels， shoulder joint range of motion， Visual Analog Scale （VAS） pain scores， and Constant?Murley scores both preoperatively and at 1， 2， 3， and 6 months post?surgery. Furthermore， we examined rotator cuff thickness， axillary pouch width， and complication rates at the 6?month follow?up. A multivariate logistic regression model was employed to identify factors influencing shoulder function recovery after arthroscopic rotator cuff repair. Results At 1， 3， and 6 months post-surgery， the levels of ESR （erythrocyte sedimentation rate） and CRP （C-reactive protein） in Groups A， B， C， and D exhibited a gradual increase （P < 0.05）. Simultaneously， the shoulder joint flexion， abduction， external rotation， internal rotation， and extension angles in all groups demonstrated a gradual decrease （P < 0.05）. The VAS pain scores in Group D were significantly higher at 1， 3， and 6 months compared to Groups A， B， and C （P < 0.05）， while the Constant-Murley scores in Group D were significantly lower than those in Groups A， B， and C （P < 0.05）. No significant differences in VAS or Constant-Murley scores were observed between Groups A， B， and C （P > 0.05）. The rotator cuff thickness and axillary pouch width in Group D were significantly greater than those in Groups A and B （P < 0.05）. Furthermore， the incidence of superficial incision infection in Group D was significantly higher than that in Group A （P < 0.05）. Multivariate Logistic regression analysis revealed that age， HbA_1c levels， and complete tear were risk factors for impaired shoulder function recovery after arthroscopic rotator cuff repair （P < 0.05）， whereas early repair served as a protective factor （P < 0.05）. Conclusion Poor blood glucose control in diabetic patients markedly compromises shoulder joint function and structural recovery after arthroscopic rotator cuff repair， leading to more severe postoperative pain， a higher incidence of incision infections， and a delayed resolution of the inflammatory response.

Objective To investigate the efficacy of treating adhesive small intestinal obstruction using blind insertion of a nasal ileus catheter in combination with continuous enteral nutrition. Methods The data of patients with adhesive small intestinal obstruction admitted to our department from January 2022 to December 2023 were retrospectively collected. Group A was treated with blind insertion of a nasal jejunal decompression catheter， whereas Group B was managed with a nasogastric tube. Continuous enteral nutrition was initiated after the resolution of intestinal obstruction in both groups. The nutritional indices， abdominal improvement， inflammatory markers， and complication rates were compared between the two groups before and after treatment. Results In terms of nutritional indices， the scores for Alb， Pa， and NRS2002 in Group A were significantly higher than those in Group B on the 7th day （P < 0.05）. Regarding abdominal improvement indices， Group A demonstrated significantly better outcomes than Group B in daily average decompression drainage volume， daily average reduction in abdominal circumference， relief time for abdominal distension and pain， recovery time for exhaust， defecation， time to resumption of enteral nutrition， and total hospitalization duration （P < 0.05）. Concerning inflammatory indices， CRP， IL-6， and WBC levels in Group A were significantly lower than those in Group B on both the 4th and 7th days post-treatment （P < 0.05）. With regard to complications， Group A exhibited fewer cases of EN intolerance， reflux， and conversion due to conservative treatment ineffectiveness compared to Group B （P < 0.05）. Conversely， Group B had fewer instances of water and electrolyte imbalance compared to Group A （P < 0.05）. Conclusion Adhesive small intestinal obstruction treated with blind insertion of a nasal ileus catheter combined with continuous enteral nutrition is a safe and effective approach， making it worthy of promotion in clinical practice.

Objective To assess the mid-term clinical prognosis and radiological outcomes of a novel expandable PEEK（polyetheretherketone） vertebral replacement device used for anterior and middle column reconstruction in the thoracolumbar spine of osteoporotic patients. Methods A retrospective analysis was performed on 52 patients with single-segment osteoporotic thoracolumbar fractures who underwent vertebral body replacement surgery between January 2020 and December 2023. The surgical procedures included either a thoracoscopic or minimally invasive anterior approach， combined with posterior short-segment cement-augmented screw fixation. According to the type of replacement material used， patients were categorized into two groups： the novel PEEK group and the titanium Mesh cage group. Data on surgical time， intraoperative blood loss， and postoperative complications were collected. The Visual Analogue Score （VAS）， Oswestry Disability Index （ODI）， local kyphotic angle （LKA）， fusion segment height （D-line）， anterior vertebral body height （AVBH）， and posterior vertebral body height （PVBH） were assessed at three stages： preoperatively， immediately postoperatively， and during the final follow-up. Results All patients were successfully discharged. In the PEEK group， the average operative time was （235.28 ± 58.69） minutes， and intraoperative blood loss was （680.00 ± 163.30） mL. The mean follow-up duration was （14.12 ± 2.44） months. The VAS score decreased significantly from （7.44 ± 0.87） preoperatively to （2.24 ± 0.93） at the final follow-up， and the ODI score also decreased significantly from （42.64 ± 4.86） preoperatively to （11.84 ± 3.73） at the final follow-up， indicating substantial improvement in symptoms and function （P < 0.05）. At the final follow-up， LKA， D-line， and AVBH exhibited partial loss compared to immediate postoperative values （P > 0.05）， but they remained significantly improved compared to preoperative values （P < 0.05）. The postoperative complication rate was 12.00% （3/25）， and the fusion rate at the final follow-up was 100.00%. Similarly， the Mesh group effectively improved patient symptoms， function， and vertebral height （P < 0.05）. However， at the final follow-up， the PEEK group demonstrated significantly better LKA， D-line， and AVBH values compared to the Mesh group （P < 0.05）. Conclusion The short-segment cement-augmented internal fixation in combination with the novel expandable PEEK replacement device represents a viable solution for anterior column reconstruction in osteoporotic thoracolumbar fractures， as evidenced by its mid-term outcomes of effective pain relief， significant functional improvement， sustained maintenance of vertebral height， and successful deformity correction.

Objective To investigate the predictive capacity of the Triglyceride-Glucose （TyG） index and the Triglyceride-Glucose-Body Mass Index （TyG-BMI） for the development of hyperuricemia （HUA） in a health examination population， and to identify suitable indicators as risk assessment tools for HUA. Methods This study ultimately included 12 004 participants from a health examination cohort. According to SUA levels， the participants were categorized into a normal group （n = 9 952） and a hyperuricemia （HUA） group （n = 2 052）. The TyG index and TyG-BMI index were calculated， and participants were further stratified into four groups （Q1—Q4） based on the quartiles of these indices. Binary logistic regression analysis was performed to assess the association between TyG， TyG-BMI， and HUA. The predictive value of TyG， TyG-BMI， and their combination for HUA was evaluated using Receiver Operating Characteristic （ROC） curves and the Area Under the Curve （AUC）. Subgroup analyses were carried out by gender and age. Results The TyG and TyG-BMI indices were significantly elevated in the HUA group compared to the normal group. The prevalence of HUA was markedly higher in the TyG-Q4 and TyG-BMI-Q4 groups than in the other three corresponding quartile groups. Binary logistic regression analysis revealed a positive association between TyG， TyG-BMI levels， and the risk of HUA. The AUC values for predicting HUA using TyG， TyG-BMI， and their combination were 0.700， 0.747， and 0.822， respectively. Specifically， for males， the AUC values were 0.641， 0.674， and 0.709， respectively， whereas for females， they were 0.742， 0.776， and 0.829， respectively. Among individuals younger than 60 years old， the AUC values were 0.716， 0.759， and 0.835， respectively， while for those aged 60 years or older， the values were 0.614， 0.645， and 0.731， respectively. Conclusions TyG and TyG-BMI are significantly associated with the risk of HUA. Specifically， TyG-BMI demonstrates superior predictive performance compared to TyG alone. Moreover， the combination of TyG and TyG-BMI further improves predictive accuracy， particularly among female and middle-aged or younger populations.

Objective Investigating the correlation between fluctuations in proliferation-inducing ligand （APRIL）， M-type phospholipase A2 receptor antibody （PLA2R Ab）， and 25-hydroxyvitamin D₃ ［25-（OH）D₃］ levels and their impact on the severity and prognosis of primary membranous nephropathy （PMN）. Methods A prospective study design was employed， wherein 100 confirmed PMN patients from Xingtai People's Hospital were recruited as the PMN group， and 100 healthy volunteers served as the control group. The levels of APRIL， PLA2R Ab， and 25-（OH）D₃ were compared between the two groups of participants， stratified by PMN disease stage and treatment outcomes. A simple linear correlation analysis was conducted to evaluate the correlation between APRIL， PLA2R Ab， and 25-（OH）D₃ with renal function indicators. Additionally， a multiple regression model was utilized to analyze the associations between these indicators and patient treatment outcomes as well as prognosis. Results The levels of APRIL and PLA2R Ab in the MN group were significantly higher than those in the control group， whereas the levels of 25-（OH）D₃ were significantly lower than those in the control group （P < 0.05）. Among 100 patients with PMN， there were 20 in stage I， 42 in stage Ⅱ， 34 in stage Ⅲ， and 4 in stage Ⅳ. The levels of APRIL and PLA2R Ab in stage Ⅲ+Ⅳ patients were significantly higher than those in stage Ⅰ+Ⅱ patients， while the level of 25-（OH）D₃ was significantly lower in stage Ⅲ+Ⅳ patients compared to stage Ⅰ+Ⅱ patients （P < 0.05）. In PMN patients， serum APRIL and PLA2R-Ab levels were negatively correlated with urea nitrogen （BUN）， creatinine （Scr）， and 24-h urinary protein （P < 0.05）. Additionally， APRIL and PLA2R-Ab levels were positively correlated with total protein （TP） and albumin （ALB） （P < 0.05）， while serum 25-（OH）D₃ levels were negatively correlated with BUN， Scr， and 24-h urinary protein （P < 0.05）. After treatment， 42 patients achieved complete remission， while 58 patients did not meet the remission criteria. Serum APRIL and PLA2R-Ab levels in the remission group were significantly lower than those in the non-remission group both before treatment and after 12 months of treatment. Furthermore， serum 25-（OH）D₃ levels in the remission group were significantly higher than those in the non-remission group both before treatment and after 12 months of treatment （P < 0.05）. Conclusions Elevated levels of serum APRIL and PLA2R antibodies， which contribute to immune dysfunction， are closely associated with the onset and severity of PMN. Renal impairment leads to a substantial reduction in serum 25-（OH）D₃ levels. Collectively， these three indicators serve as critical markers for the occurrence， progression， and prognosis of PMN.

Objective To explore the factors influencing comorbid cardiovascular disease in schizophrenia and to construct a column-line graphical model. Methods Clinical data of 586 schizophrenic patients in the hospital from June 2023 to October 2024 were retrospectively collected. The study included 100 patients with comorbid cardiovascular disease and 486 patients without co-morbid cardiovascular disease， which were divided into the comorbidity group （n = 100） and the non-comorbidity group （n = 486）. Propensity score matching （PSM） was used to reduce between-group bias. The clinical data， electrocardiogram parameters ［QT corrected by heart rate （QTc）， Tp-Te interval corrected by heart rate （TP-Tec）］， and Kynurenine （KYN） metabolites ［tryptophan （TRP）， KYN， and kynurenic acid （KYNA）］ were statistically analyzed in both groups. Logistic regression equation was used to screen the influencing factors of comorbid cardiovascular disease in schizophrenia. A nomogram model was constructed and validated. Results （1） BMI， smoking， alcohol consumption， sleep disorders， QTc， TP-Tec， TRP， KYN， and KYNA were all high-risk factors for co-morbid cardiovascular disease in schizophrenia （P < 0.05）. （2） The diagnostic AUC for the nomogram model was 0.876， and there was a good concordance between diagnostic and observational results； and the threshold probability of a net patient benefit was higher when the threshold probability was between 5% and 100%. Conclusion The nomogram model constructed based on QTc， TP-Tec， TRP， KYN， KYNA， etc. can help improve the diagnostic value of schizophrenia comorbid cardiovascular disease， guide clinical diagnosis and treatment， and reduce cardiovascular disease.

Objective To investigate the effectiveness and safety of combining Omalizumab with compound glycyrrhetinic acid glycoside in the management of chronic urticaria that exhibits poor response to antihistamine therapy. Methods 92 patients with chronic urticaria who were treated with H1 antihistamines and still had symptoms from February 2022 to February 2024 in the hospital were selected as the study subjects. The study participants were randomly assigned to either the observation group， consisting of 46 cases， or the control group， also comprising 46 cases， using a random number table method. The control group received subcutaneous injection of omalizumab for treatment. The observation group was treated with oral compound glycyrrhizin tablets on the basis of the control group. After 24 weeks of treatment， compare the efficacy， adverse reactions， Urticaria Activity Score over 7 days （UAS7）， Dermatology Life Quality Index （DLQI）， Immunoglobulin （Ig） E， and High Sensitivity C-reactive protein （hs CRP） between the two groups， and record the recurrence rate. Results After treatment， the UAS7， DLQI， IgE and hs-CRP of both groups of patients decreased compared to before treatment， and the observation group demonstrated lower results compared to the control group （P < 0.05）. After treatment， the overall effectiveness rate in the observation group exceeded that of the control group（P < 0.05）， and the recurrence rate was lower than that of the control group （P < 0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups of drugs （P > 0.05）. Conclusion The combination therapy of omalizumab and compound glycyrrhetinic acid glycoside in the treatment of chronic urticaria patients with low response to antihistamines helps reduce IgE expression， improve treatment effectiveness， lower recurrence rates， and does not increase adverse drug reactions.

Objective To evaluate the safety and efficacy of ciprofol in the anesthesia of elderly patients undergoing bronchoscopy. Methods A total of 96 elderly patients （≥ 65 years old） undergoing fiberoptic bronchoscopy under sedation and anesthesia were randomly assigned to either the ciprofol group （Group C， n = 48） or the propofol group （Group P， n = 48）. In Group C， anesthesia was induced with an intravenous injection of sufentanil at 0.1 μg/kg and ciprofol at 0.3 mg/kg. In Group P， anesthesia was induced with an intravenous injection of sufentanil at 0.1 μg/kg and propofol medium/long-chain fat emulsion at 1.5 mg/kg. Hemodynamic parameters， including heart rate （HR）， mean arterial pressure （MAP）， and peripheral oxygen saturation （SpO₂）， were recorded at five time points： before anesthesia induction （T₁）， immediately after the bronchoscope passed through the glottis （T₂）， immediately after it reached the carina （T₃）， immediately after the bronchoscope was withdrawn from the nostril post-procedure （T₄）， and upon full consciousness after leaving the recovery room （T₅）. Additionally， the success rate of sedation and anesthesia， cough severity scores， induction time （t₁）， bronchoscopy duration （t₂）， recovery time （t₃）， and orientation recovery time （t₄） were documented for both groups. Intraoperative complications， such as hypotension， hypoxemia （SpO₂ < 90%）， injection pain during induction， airway interventions （e.g.， jaw support， mask ventilation）， and the number of additional sedative doses administered， were also recorded. Results Compared with T₁， MAP in both groups decreased at T₂ and T₃ （P < 0.05）. Compared with group P， group C exhibited a higher MAP at T₂ and T₃ （P < 0.05）. between the two groups in terms of sedation success rate， induction time， cough score， examination time， recovery time， and orientation recovery time （P > 0.05）. Compared with group P， group C demonstrated lower incidences of hypotension， hypoxemia， injection pain， and fewer airway intervention events （P < 0.05）. Conclusions Compared with propofol， ciprofol in combination with sufentanil demonstrates superior circulatory stability， a lower incidence of respiratory system-related adverse reactions， and reduced injection pain. Therefore， it can be safely and effectively utilized for painless bronchoscopic diagnosis and treatment in elderly patients.

Objective To investigate the relationship between the morphology and elasticity of the levator ani muscle （LAM） and stress urinary incontinence （SUI）， and to develop a multimodal diagnostic model for SUI based on LAM morphology and elasticity parameters， while evaluating the diagnostic performance of this model. Methods From September 2020 to September 2022， 147 female patients with SUI from the Affiliated Hospital of North China University of Science and Technology were enrolled as the SUI group （case group）， while 144 women without SUI during the same period were selected as the non-SUI group （control group）. Transperineal ultrasonography was conducted to measure the anteroposterior diameter （LH-A1） and transverse diameter （LH-D1） of the levator hiatus at rest， the resting area of the levator hiatus （LA1）， as well as the anteroposterior diameter （LH-A2）， transverse diameter （LH-D2）， and area （LA2） of the levator hiatus during the maximum Valsalva maneuver. Additionally， ultrasonography was used to observe LAM injury （LA-MI） during pelvic muscle contraction. Shear wave elastography （SWE） was also performed transperineally to record the elastic modulus values of the puborectalis muscle at rest （E1） and during pelvic muscle contraction （E3）. The differences in ultrasound parameters between the two groups were compared， and a logistic regression model was constructed for multivariate analysis to establish a diagnostic model for SUI. The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test. The diagnostic performance of individual indicators and the diagnostic model for SUI was evaluated using the receiver operating characteristic （ROC） curve. Finally， the clinical utility of the model was assessed using decision curve analysis. Results There were statistically significant differences in age， BMI， LH-A1， LH-D1， LA1， LH-A2， LH-D2， LA2， LA-MI， E1， and E3 between the two groups （P < 0.05）. Multivariate logistic regression analysis revealed that age， BMI， LH-A1， LA2， LA-MI， E1， and E3 were significantly associated with SUI （P < 0.05）. Based on these findings， a diagnostic model for SUI was established： PRESUI = 0.261 × age + 0.904 × BMI-4.300 × LH-A1 + 1.166 × LA2-2.815 × LA-MI + 0.587 × E1-0.631 × E3-1.258. The model demonstrated excellent goodness-of-fit （P = 0.983）. The ROC curve analysis indicated that age， BMI， LH-A1， LA2， LA-MI， E1， and E3 all exhibited diagnostic efficacy for SUI （AUC > 0.500， P < 0.05）. Notably， the AUC of the constructed diagnostic model for SUI was 0.996 （95%CI： 0.992 ~ 1.000）， suggesting that the diagnostic accuracy of the model surpassed that of individual indicators. When the cut-off value of the diagnostic model was set at 0.437， the sensitivity reached 98.0%， and the specificity was 97.2%. Furthermore， the decision curve analysis demonstrated that the diagnostic model provided substantial net clinical benefit within the threshold probability range of 0.1 to 1.0. Conclusions The morphology and elasticity of the LAM are significantly altered in women with SUI. The SWE technique demonstrates potential application value for quantitatively assessing the elasticity of the LAM. Furthermore， the diagnostic model constructed based on age， BMI， LH-A1， LA2， LA-MI， E1， and E3 exhibits high clinical application value.

Objective To assess the accuracy and consistency of point-of-care testing （POCT） technology in detecting D-dimer （DDI）， Procalcitonin （PCT）， and N-terminal pro B-type natriuretic peptide （NT-proBNP） in whole blood samples， as well as to validate its feasibility for rapid clinical diagnosis. Methods From July 8 to August 22， 2022， a total of 104 paired DDI whole blood and plasma samples， 496 paired PCT whole blood and serum samples， and 77 paired NT-proBNP whole blood and serum samples were collected. The consistency and accuracy of test results between whole blood and plasma/serum samples were assessed using the Mann-Whitney U test， regression analysis， relative sensitivity， relative specificity， Youden′s index， and Kappa value. Results The test results of DDI， PCT， and NT-proBNP in whole blood and plasma/serum samples demonstrated excellent consistency， with correlation coefficients of r2 = 0.951 2， r2 = 0.942 8， and r2 = 0.991 6， respectively， and all P-values exceeding 0.05. At the medical decision levels， for DDI （0.55 μg/mL）， the relative sensitivity， relative specificity， Youden index， and Kappa value were 94.3%， 94.1%， 0.88， and 0.87， respectively. For PCT （0.5 ng/mL and 2.0 ng/mL）， the relative sensitivities were 97.4% and 89.0%， the relative specificities were 95.8% and 98.3%， the Youden indices were 0.93 and 0.87， and the Kappa values were 0.93 and 0.89， respectively. For NT-proBNP （125 pg/mL）， the relative sensitivity was 94.1%， the relative specificity was 100%， the Youden index was 0.94， and the Kappa value was 0.87. These findings confirm the high accuracy of whole blood sample testing and the strong concordance between the two methods. Conclusions This study confirmed the efficacy of POCT technology for detecting DDI， PCT， and NT-proBNP in whole blood samples. The results showed a high level of consistency compared to traditional plasma/serum methods， thereby reinforcing the clinical applicability of POCT for rapid diagnosis.

Objective To investigate the diagnostic potential of combining 3.0T magnetic resonance imaging （MRI） T2 mapping sequences with serum nesfatin-1 levels for detecting early osteoarthritis （OA） in elderly knees. Methods 97 elderly patients with knee osteoarthritis （OA group） and 52 elderly individuals undergoing physical examinations （control group） were recruited from a hospital between May 2023 and May 2024. Based on X-ray findings， the OA group was further divided into an early-stage subgroup and a non-early-stage subgroup. All participants underwent 3.0T MRI T2 mapping sequence scans to measure the T2 values in the knee cartilage region， and serum nesfatin-1 levels were assessed. Differences in these indicators were compared between groups. Additionally， a receiver operating characteristic （ROC） curve was constructed to evaluate the diagnostic value of these parameters for early-stage knee OA in elderly individuals. Results Among 97 elderly patients with knee OA， 35 cases were classified into the early-stage group， and 62 cases were categorized into the non-early-stage group. The T2 values in five cartilage regions of the knee and serum nesfatin-1 levels were significantly higher in the OA group compared to the control group （ P < 0.05）. Moreover， these values were significantly lower in the early-stage group than in the non-early-stage group （ P < 0.05）. The areas under the curve （AUC） for diagnosing early-stage OA using T2 values in knee cartilage regions and serum nesfatin-1 levels ranged from 0.774 to 0.871. Notably， the AUC for combined diagnosis reached 0.939 （ P < 0.05）. Conclusion 3.0T MRI using the T2 mapping sequence in combination with serum nesfatin-1 level detection demonstrates high diagnostic value for early OA in elderly patients with knee involvement.

Objective To evaluate and compare the performance of the Chronic Kidney Disease Epidemiology Collaboration （CKD-EPI） equation， the abbreviated Modification of Diet in Renal Disease （aMDRD） equation， the Cockroft-Gault （C-G） formula， the Mayo Clinic Quadratic （MCQ） equation， and the Berlin Initiative Study 1 （BIS1） equation in determining renal function among critically ill patients， and to identify the most appropriate method for clinical application. Methods Critically ill patients admitted to the Intensive Care Units of the Department of Geriatric Medicine at the First Affiliated Hospital of Nanjing Medical University （Jiangsu Province Hospital） between June 2020 and June 2022 were included. Their renal function was assessed within 48 hours of admission using the 24-hour creatinine clearance rate （CrCl_24h） as the reference standard， and compared with the CKD-EPI equation， aMDRD equation， C-G formula， MCQ equation， and BIS1 equation. The precision and accuracy of each equation in evaluating renal function in critically ill patients were analyzed. Results Total of 534 patients were included in the study. （1） The aMDRD equation exhibited the least bias （-3.91）， yet the accuracy of the five estimated glomerular filtration rate （eGFR） equations was relatively low， ranging from 42.9% to 63.1%. （2） For renal function grading， the weighted κ agreement values between the CKD-EPI equation， aMDRD equation， C-G formula， MCQ equation， BIS1 equation， and CrCl_24h were 0.464， 0.555， 0.403， 0.405， and 0.159， respectively （all P < 0.001）. （3） Among patients with severe kidney function decline ［CrCl_24h ≤ 60 mL/（min·1.73 m²）］， the eGFR value derived from the C-G formula was the lowest， while that from the BIS1 equation was the highest. In patients with normal or moderately reduced renal function ［60 mL/（min·1.73 m²）^{< CrCl_24h ≤ 130 mL/（min·1.73 m2）］， the eGFR value of the C-G formula remained the lowest， whereas the MCQ equation yielded the highest eGFR value. For patients with augmented renal function ［CrCl_24h > 130 mL/（min·1.73 m2）］， the eGFR value of the BIS1 equation was the lowest， and the aMDRD equation produced the highest eGFR value. （4） When renal function was severely decreased or augmented ［CrCl_24h > 130 mL/（min·1.73 m2）］， the accuracy of the CKD-EPI and MCQ equations declined. Conversely， as creatinine clearance increased， the accuracy of the aMDRD equation improved gradually. The C-G formula demonstrated an opposite trend compared to the aMDRD equation， and the BIS1 equation exhibited low accuracy across all groups. （5） The optimal critical values ［mL/（min·m2）］ for diagnosing augmented renal clearance （ARC） using the five eGFR equations were as follows： eGFR_CKD-EPI： 91.1， eGFR_aMDRD： 99.84， eGFR_C-G： 76.27， eGFR_MCQ： 100.87， eGFR_BIS1： 82.36. Conclusions The precision and accuracy of the five eGFR equations are relatively low， making them unsuitable for assessing renal function in critically ill patients. Collecting 24-hour urine to calculate creatinine clearance remains an essential method for evaluating renal function in this population. In the absence of early CrCl_24h data upon ICU admission， the cut-off values of the eGFR equations may serve as a tool for the early identification of ARC. Additionally， the aMDRD equation can provide a rough estimate of creatinine clearance in critically ill patients.}

Objective To investigate the efficacy of acupuncture combined with moxibustion based on "Yuan?Luo Point Pairing" in treating insomnia related to cerebral infarction， and its effects on serum hypothalamic secretin-1 （Hcrt-1）， 5-hydroxytryptamine （5-HT）， and slow wave EEG. Methods 120 patients with cerebral infarction related insomnia admitted to our hospital from July 2022 to July 2024 were selected as the research subjects. They were randomly divided into an observation group and a control group， with 60 cases in each group， using a random number table method. The control group was treated with routine western medicine， and the observation group was treated with acupuncture combined with moxibustion based on "Yuan?Luo Point Pairing" on the basis of the control group. Compared the clinical efficacy， TCM syndrome score， sleep quality， serum Hcrt-1 and 5-HT， EEG slow wave indicators， and treatment safety of two groups. Results The effective rate of observation group was higher than control group （P < 0.05）. After treatment， the traditional Chinese medicine syndrome scores of observation group were lower than control group（P < 0.05）， including timidity， palpitations， shortness of breath， lazy speech， and no complexion. After treatment， the sleep quality indicators of the observation group， including sleep latency and rapid eye movement sleep were lower than those of the control group， while the total sleep time and sleep efficiency were higher than group control （P < 0.05）. After treatment， the serum Hcrt-1 and 5-HT levels of observation group were lower than group control （P < 0.05）. the slow waves in EEG， including θ and δ waves of observation group had lower frequencies than the control group and higher amplitudes than control group（P < 0.05）. Conclusions Acupuncture combined with moxibustion based on "Yuan?Luo Point Pairing" has significant therapeutic effects on insomnia related to cerebral infarction. It can reduce traditional Chinese medicine syndromes， improve sleep quality， lower serum Hcrt-1 and 5-HT levels， improve slow wave state of EEG in patients， and has good treatment safety.

Although fertility-preserving treatment strategies have demonstrated significant clinical efficacy in patients with early-stage endometrial cancer （EC） and atypical endometrial hyperplasia （AEH）， some patients who experience recurrence still express a strong desire for fertility and request conservative retreatment. This poses new challenges for clinical management. This article reviews the latest research advances in retreatment for recurrent patients and synthesizes findings from previous studies to draw the following conclusions. First， before formulating a retreatment plan， it is crucial to comprehensively evaluate key factors such as tumor characteristics， fertility intentions， and overall health status of the patient. These factors collectively determine the feasibility and appropriateness of an individualized retreatment strategy. Second， studies have shown that retreatment options for AEH/EC are diverse， with high-dose oral progestin remaining the primary approach. Combining progestin with metformin， GnRH-a， and hysteroscopic resection can enhance treatment outcomes. Individualized treatment plans should be tailored to the specific conditions of each patient. Based on literature analysis， the complete remission （CR） rate of retreatment ranges from 81.1% to 88.6%， with a pregnancy rate of 26.5% ? 50.0% and a live birth rate of 14.3% ? 29.0%. However， the recurrence rate remains high at 24.5% ? 45.5%， significantly higher than that of initial treatment. This indicates that while retreatment has achieved some success in disease control and fertility preservation， the risk of recurrence still requires significant attention. Therefore， a strict monitoring and follow-up system must be established during retreatment. Additionally， studies have identified factors associated with a higher risk of recurrence， including age over 35， overweight or obesity， polycystic ovarian syndrome， metabolic syndrome， high pathological grade， and advanced clinical stage. On the other hand， pregnancy following CR， weight loss， and maintenance therapy serve as protective factors against disease recurrence. Patients are encouraged to actively engage in weight management during treatment and consider initiating assisted reproductive technology promptly after achieving CR to optimize pregnancy outcomes while minimizing the risk of recurrence. Future research should prioritize investigating precision treatment strategies informed by molecular classification and identifying predictive biomarkers， thereby enabling the development of more personalized and precise treatment plans tailored to individual patients.