Chronic obstructive pulmonary disease （COPD） is a widespread chronic inflammatory respiratory condition characterized by high morbidity， affecting approximately 100 million individuals in China. It represents a significant public health concern and imposes considerable socioeconomic costs. Historically， the rate of early diagnosis for COPD has been low， presenting a persistent challenge in clinical practice. Enhancing early detection therefore remains a critical and urgent priority. This study provides a comprehensive review of existing national-level policies aimed at improving early COPD diagnosis within primary healthcare settings， as well as their regional implementation status. The dual objectives of this analysis are to support the enhancement of early diagnosis rates and to contribute to the optimization of COPD clinical management frameworks.

Objective To observe the effect of human umbilical cord mesenchymal stem cell-derived exosomes （HUC-MSC-Exo） on microglial polarization in neonatal rats with white matter injury （WMI）. Methods Three-day-old Sprague-Dawley rats were randomly divided into sham group （Sham）， hypoxia-ischemia group （HI） and HUC-MSC-Exo group， with 12 rats in each group. Unilateral common carotid artery ligation combined with hypoxia （8% oxygen and 92% nitrogen） was used to construct a WMI rat model. Exosomes were extracted by ultra-high-speed centrifugation and characterized by nanoflow cytometry， western blot experiments and transmission electron microscopy. Brain stereotaxic-assisted inferior ventricular transplantation exo （2×10⁸ particles/μL） was performed and brain tissue samples were collected 14 days after HI. Hematoxylin-eosin （HE） staining was used to observe morphological changes of brain tissue. Nissl staining was used to observe Nissl body formation in brain tissue； Luxol fast blue （LFB） staining was used to observe the formation of myelin sheath in brain tissue. Immunofluorescence staining was used to observe the localized expression of ionic calcium binds adaptor molecule 1 （Iba1）. The protein expression levels of cluster of differentiation 86 （CD86）， inducible nitric oxide synthase （iNOS）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， CD206， arginase-1 （Arg-1）， IL-10 and transforming growth factor-β （TGF-β） were detected by western blot. Results The results of nanoflow cytometry， western blot and transmission electron microscopy showed that the diameter of HUC-MSC-Exo particles was between 30 and 150 nm， and the oval-like shape and membrane-like structure were visible， and the exo markers CD9， CD63 and TSG101 were positive， while calnexin was negative. HE staining， Nissl staining and LFB staining showed that compared with the Sham group， the HI group had brain tissue structure destruction， which was manifested by cell morphological changes， nerve fiber arrangement disorder and vacuolation， Nissl body dissolution or even disappearance， and myelination was blocked. HUC-MSC-Exo significantly reversed the pathological changes in the HI group. The results of immunofluorescence staining and western blot showed that the microglial marker Iba1 was mainly expressed in the subventricular zone （SVZ）， and the expression of Iba1 protein in the SVZ region increased after HI compared with the Sham group （t = 15.95、20.31， P < 0.01）. HUC-MSC-Exo significantly reduced the expression of Iba1 protein in the HI group （t = 10.35、11.01， P < 0.01）. The results of western blot showed that the expressions of M1 microglia markers （CD86 and iNOS） and pro-inflammatory cytokines （TNF-α and IL-1β） were significantly increased after HI （t = 10.98、7.68、15.13、13.13， both P < 0.01）， and the expressions of M2 microglia markers （CD206 and Arg-1） and anti-inflammatory cytokines （IL-10 and TGF-β） were also increased after HI （t = 14.26、9.38、8.82、7.42， both P < 0.01）. HUC-MSC-Exo decreased the protein expression of CD86， iNOS， TNF-α and IL-1β （t = 9.79、5.81、8.06、7.03， all P < 0.01） and increased the protein expression levels of CD206， Arg-1， IL-10 and TGF-β compared to the HI group （t = 12.90、8.16、8.98、9.49， both P < 0.01）. Conclusion HUC-MSC-Exo attenuates WMI in neonatal rats by regulating microglial polarization.

Objective To evaluate the prognostic value of serum tissue factor pathway inhibitor-1 （TFPI-1） combined with nuclear factor-κB （NF-κB） in severe traumatic brain injury （STBI）. Methods The medical records of 127 patients with STBI admitted to the hospital from July 2022 to August 2024 were retrospectively analyzed and followed up for 6 months. They were divided into poor prognosis group （n = 53） and good prognosis group （n = 74） according to the prognosis of STBI patients.The serum NF-κB level， clinical data and serum TFPI-1 level of the two groups were compared. The factors affecting the adverse prognosis of STBI patients was screened， and the value of serum NF-κB and serum TFPI-1 in predicting the adverse prognosis of STBI patients were analyzed. Results The serum NF-κB level in the poor prognosis group was higher than good prognosis group， and the serum TFPI-1 level was lower than good prognosis group（P < 0.05）. The proportion of patients aged > 60 years old was higher than good prognosis group （P < 0.05）. Serum TFPI-1 level （OR = 0.328， 95%CI： 0.156 ~ 0.689） was a protective factor for poor prognosis in STBI patients （P < 0.05）， serum NF-κB level （OR = 3.773， 95%CI： 1.797~7.924） and age > 60 years （OR = 3.543， 95%CI： 1.687 ~ 7.441） were independent risk factors for poor prognosis in STBI patients （P<0.05）. The area under the curve （AUC） of serum TFPI-1 and NF-κB levels and their combined prediction of poor prognosis in STBI patients were 0.784， 0.847 and 0.931， respectively （P < 0.05）， and the AUC value of the combined TFPI-1 and NF-κB levels was higher （P < 0.05）. Conclusion Serum NF-κB combined with serum TFPI-1 has higher prognostic value in STBI patients.

Objective To investigate the expression of regional cerebral oxygen saturation （rSO₂） in preterm infants with brain injury （BIPI） and its relationship with amplitude-integrated electroencephalogram （aEEG） parameters and neurodevelopment. Methods Retrospectively， 116 cases of BIPI （Bilateral Intra-ventricular Perforation） born in the hospital between February 2022 and February 2023 were selected as the study subjects. According to the Expert Consensus on the Diagnosis and Prevention of Premature Infant Brain Injury， these cases were categorized into mild， moderate， and severe groups， with 59，35， and 22 cases， respectively. The study compared the general characteristics of premature infants with different brain injury levels. Regression analysis was conducted to identify the factors affecting brain injury in premature infants， and correlation analyses were performed on aEEG scores， rSO₂， and GMS scores. ROC curve analysis was used to evaluate the value of combining brain oxygen saturation monitoring with aEEG in predicting abnormal whole-body motor quality assessment. Results On the 3rd and 7th days after birth， severe brain-injured premature infants had significantly lower rSO₂ and aEEG scores compared to those with mild and moderate brain injuries （P < 0.05）. At 7 days， these infants also had lower scores for graph continuity， sleep-wake cycles， lower boundary amplitude， bandwidth， total score， rSO₂， gestational age， and birth weight， and a higher proportion of abnormal developmental outcomes （PR+CS） （P < 0.05）. Multivariate logistic regression analysis revealed that the 3-day aEEG total score （OR = 0.448，95%CI：0.094~0.890），7-day aEEG total score （OR = 0.384，95%CI：0.058~0.726），3-day rSO₂ （OR = 0.574，95%CI：0.398~0.750）， and 7-day rSO₂ （OR = 0.431，95%CI：0.115~0.777） were all protective factors for brain injury in premature infants， P < 0.05. Correlation analysis showed that brain oxygen saturation was negatively correlated with aEEG scores and overall motor quality. The prediction value for abnormal overall motor quality using 7-day rSO₂， aEEG， and the combination of 7-day rSO₂ and 7-day aEEG scores was as follows： the positive predictive value for rSO₂ was 86.46%， the negative predictive value was 96.85%， the sensitivity was 92.31%， the specificity was 92.21%， and the cut-off value was 0.845； The positive predictive value （PPV） of aEEG was 78.26%， the negative predictive value （NPV） was 96.86%， the sensitivity was 89.74%， and the specificity was 92.21%， with a cut-off value of 0.820. The positive predictive value （PPV） of 7-day rSO2 combined with 7-day aEEG score was 89.04%， the NPV was 96.88%， the sensitivity was 94.90%， and the specificity was 93.51%， with a cut-off value of 0.884， P < 0.05. ROC curve analysis showed that the AUC of 7-day rSO₂ + 7-day aEEG score was 0.895， De-long test P < 0.005， indicating high predictive value for overall exercise quality. Conclusion Combined with rSO₂ and EEG， the prediction of overall motor quality is better， which may have clinical value for excluding high-risk children.

Objective Based on the diffusion tensor imaging （DTI） technique， this study aims to analyze the impact of early acupuncture intervention on the microstructure of brain white matter fibers， explore the brain mechanisms underlying the arousal effect of acupuncture intervention in comatose patients after traumatic cerebral injury， so as to provide a theoretical basis for early awakening promotion. Methods This study enrolled 32 comatose patients with traumatic brain injury admitted to the Department of Acupuncture and Rehabilitation with a disease course ranging from 10 to 30 days. Participants were randomly allocated into a control group （n = 16） and an acupuncture group （n = 16） using a random number table method. Both groups received conventional awakening-promoting rehabilitation treatment，while the acupuncture group additionally treated with the Xingnao Kaiqiao acupuncture therapy. Before and after the treatment，the Glasgow Coma Scale （GCS） scores and DTI examination were conducted respectively to assess the awakening rate and measure FA values. Explore the correlation between FA values within the acupuncture group and the GCS scores for the regions where inter-group differences occur after treatment. Results After 28 days of treatment in both groups， the awakening rate in the acupuncture group reached 75.00%，significantly higher than that in the control group （43.75%） （P = 0.047）. After treatment，FA values showed a significant increase compared to baseline levels in both groups （P < 0.05）. The acupuncture group exhibited a significantly greater increase in FA values in the midbrain， pons， thalamus， posterior limb of the internal capsule，and the splenium of the corpus callosum compared to the control group （P < 0.05）， while no statistically significant between-group differences were observed in the regions of anterior limb of the internal capsule， genu of the corpus callosum，and the semioval center （P > 0.05）. Correlation analysis revealed FA values in the midbrain， pons， thalamus， posterior internal capsule， and splenium were significantly positively correlated with GCS scores in the acupuncture group after treatment， particularly in the midbrain （r = 0.785） and thalamus （r = 0.739）. Conclusions Acupuncture combined with conventional awakening therapy can effectively improve the consciousness state of comatose patients with TBI. The midbrain， pons， thalamus， posterior limb of the internal capsule， and splenium of the corpus callosum may be the key regions affected by acupuncture. The underlying mechanism may be related to promoting the repair and remodeling of white matter fibers in these critical areas.

Pheochromocytoma and paraganglioma （PPGL） are rare neuroendocrine tumors characterized not only by hemodynamic instability but also by fluctuations in blood glucose levels during the perioperative period. These features are closely associated with significant variations in catechromamine secretion. Hypoglycemia is a common postoperative complication in patients with PPGL and is primarily attributed to rebound insulin secretion and enhanced insulin sensitivity following tumor resection. Postoperative hypoglycemia requires heightened clinical attention due to its often subtle presentation and potential for serious complications. Known risk factors include the presence of an epinephrine-secreting tumor， prolonged operative time， larger tumor size， and a history of end-stage renal disease. Therefore， it is essential to identify high-risk patients preoperatively， ensure meticulous intraoperative monitoring， and implement timely postoperative interventions. This article provides a comprehensive review of recent advances in the epidemiology， underlying mechanisms， clinical diagnosis， management strategies， and prognosis of postoperative hypoglycemia in PPGL. Importantly， it introduces novel research directions and conceptual frameworks for the first time， including the optimal timing and dosage of α-receptor antagonists， potential applications of micro-dose glucagon therapy， and molecular mechanisms with targeted interventions in glucose metabolism regulation. This review aims to address the current lack of standardized perioperative management protocols and to offer innovative and clinically relevant guidance for healthcare professionals.

Objective To investigate the protective effects of Kaempferol （KAE） against hepatic lipid deposition induced by a high-fat diet， as well as the underlying mechanisms. Methods C57BL/6J male mice were fed a high-fat diet for 22 weeks to establish a chronic nonalcoholic steatohepatitis （NASH） model. KAE was administered during the last 8 weeks as an interventional agent to evaluate its effects. Liver lipid deposition was assessed， and the expression levels of endoplasmic reticulum （ER） stress-related proteins， activation of the Farnesoid X Receptor （FXR） signaling pathway， and the expression of lipid synthesis-related genes were analyzed. In vitro， palmitic acid （PA） was used to stimulate AML-12 cells to induce lipid accumulation. Additionally， siRNA targeting FXR was transfected into AML-12 cells to investigate the role of the ER stress-FXR signaling pathway in mediating the effects of KAE. Results The intervention of kaempferol inhibited the rapid weight gain induced by a high-fat diet， reduced serum total cholesterol， triglyceride levels， and ALT activity， effectively alleviated large-scale lipid aggregation in the liver， thereby exerting a protective effect against hepatic lipid deposition in NASH. Mechanistically， KAE decreased hepatic ER stress， promoted the expression of FXR and its activation marker SHP， thereby suppressing the expression of FASN and reducing hepatic lipid synthesis. In vitro， KAE treatment significantly reversed the inhibitory effect of excessive ER stress on FXR activity， as evidenced by the upregulation of FXR activity leading to decreased FASN expression and reduced steatosis in AML-12 cells. Moreover， FXR knockdown markedly abolished the protective effects of KAE on lipid deposition in AML-12 cells exposed to PA， by eliminating the promoting effect of KAE on SHP expression and the SHP-mediated suppression of SREBP1c. Conclusions KAE treatment alleviated ER stress， thereby enhancing FXR/SHP signaling and subsequently suppressing lipid synthesis to reduce hepatic lipid accumulation. These findings suggest that KAE holds therapeutic potential for the management of hepatic steatosis in NASH.

Objective To investigate the causal relationship between abnormal placental lipid metabolism and trophoblast dysfunction in patients with preeclampsia （PE）， and to explore the regulatory effects of PPARγ on trophoblast function under hypoxic conditions. Methods Placental tissues were collected from 30 patients with PE and 30 individuals with normal pregnancies at the General Hospital of Ningxia Medical University between October 2020 and November 2021 for the analysis of lipid deposition. A rat model of PE was established， comprising a sham-operated （Sham） group and a reduced uterine perfusion pressure （Rupp） group， with six rats in each group （n = 12 total）. Human trophoblast cells （HTR-8/SVneo） were cultured in vitro and randomly assigned to four experimental groups： normoxic control， hypoxia， hypoxia+PPARγ agonist （Rosiglitazone）， and hypoxia+PPARγ antagonist （T0070907）. The expression levels of lipid metabolism-related genes and transcription factors （FASN， FABP4， PPARγ， LXRα） were assessed using RT-qPCR. Western blotting was performed to determine the protein expression levels of PPARγ. Cell migration and invasion capacities were evaluated using scratch wound healing and Transwell assays， respectively. Results Placental lipid deposition in the PE group was significantly higher than that in the control group， particularly in the Rupp model mice （P < 0.001）. Under hypoxic conditions， the expression levels of FASN and FABP4 were upregulated in trophoblast cells （P < 0.001）， whereas the expression of PPARγ and LXRα was downregulated （P < 0.001）. Furthermore， treatment with the PPARγ antagonist T0070907 exacerbated the inhibitory effects of hypoxia on cell function （P < 0.001）， significantly reducing cell invasion and migration capacity （P < 0.001）. Additional siRNA-mediated knockdown experiments confirmed that PPARγ deficiency further aggravated hypoxia-induced impairments in cell migration and invasion， and this detrimental effect could not be reversed by Rosiglitazone. Conclusions Abnormal placental lipid metabolism in PE is closely linked to PPARγ-mediated enhancement of lipid synthesis and metabolic dysregulation under hypoxic conditions， which may subsequently impair trophoblast invasion and migration.

Objective To investigate the role of androgen-induced DGAT2-mediated ferroptosis in granulosa cell dysfunction in patients with polycystic ovary syndrome （PCOS）. Methods The human granulosa cell line KGN was exposed to various concentrations of testosterone （1， 10， and 100 μmol/L）. The effects on DGAT2 expression， markers of ferroptosis （GPX4， ROS， MDA）， indicators of lipid metabolism （TG， PUFAs）， lipid droplet accumulation， and cell viability were evaluated. Additionally， DGAT2 knockdown using siRNA in combination with Erastin treatment was performed to further elucidate the role of DGAT2 in ferroptosis regulation. Results Testosterone significantly upregulated DGAT2 expression （P < 0.01）， increased intracellular TG and PUFA levels （P < 0.001）， promoted lipid droplet accumulation， elevated ROS and MDA levels （P < 0.05， P < 0.001）， suppressed GPX4 expression （P < 0.001）， and reduced cell viability （P < 0.001）. DGAT2 knockdown reversed these effects， thereby alleviating ferroptosis and markedly enhancing cell viability （P < 0.001）. Conclusions DGAT2 may be involved in the process of androgen-mediated granulosa cell ferroptosis in patients with PCOS.

Objective To investigate whether orexin A （orexin-A）， orexin receptor 1 （OX1R） and orexin receptor 2 （OX2R） are involved in iron death and lipid peroxidation regulation in chronically unpredictable mild stress （CUMS） depressed rats. Methods Forty rats were randomly divided into a normal group （NC group）， a modeling group （Mod group）， an exogenous Orexin-A group （Orexin-A group，）， and an OX1R/OX2R blocker group （TCS1102 group）， with 10 rats in each group. After modeling， behavioral changes were observed using the absent field test （OFT）， sugar-water preference test （SPT） and forced swimming test （FST）， action potential （PA） and resting membrane potential （Vm） were detected by diaphragm-clamp technique， Orexin-A/OX1R/OX2R protein expression in orbital frontal cortex （OFC） tissues was detected by protein immunoblotting （WB） method， RT-PCR The mRNA expression of glutathione peroxidase 4 （GPX4）， long chain acyl coenzyme A synthase 4 （ACSL4） and cysteine/glutamate transporter light chain （SLC7A11） were detected by RT-PCR method， and the intensity of the expression of rat glial fibrillary acidic protein （GFAP） and lipid peroxidation product 4-hydroxynonenal （4-HNE） was labeled by immunofluorescence. Results Compared with the NC group， there were significant differences in OFT， SPT and FST behavioral in the Mod group （P < 0.01）， with lower number of PA issuance （P < 0.001）， higher Vm （P < 0.01）， and higher expression of Orexin-A/OX1R/OX2R proteins （P < 0.01， P < 0.001， and P < 0.001）. GPX4/SLC7A11 mRNA expression was decreased （P < 0.01）， ACSL4 mRNA expression was elevated （P < 0.01）， and the fluorescence intensity expression of both GFAP and 4-HNE was elevated （P < 0.001）； the number of PA issuance was decreased in the Orexin-A group compared to the Mod group （P < 0.05）， and the Orexin-A/OX1R/ OX2R protein expression was elevated （P < 0.05， P < 0.01）， GPX4/SLC7A11 mRNA expression was decreased （P < 0.05）， ACSL4 mRNA expression was elevated （P < 0.05）， and the fluorescence intensity of GFAP and 4-HNE expression was elevated （P < 0.05， P < 0.01）； the TCS1102 group had higher expression of GFAP and 4-HNE in the behavioral， Orexin-A/OX1R/OX2R protein expression， PA and Vm， GPX4/SLC7A11/ACSL4 mRNA， and GFAP and 4-HNE fluorescence intensity expression showed a reversed trend. Conclusions Orexin-A/OX1R/OX2R is involved in the regulation of iron death and lipid peroxidation in CUMS depressed rats， and the mechanism may be that Orexin-A enhances the excitability of OFC neurons by activating the OX1R/OX2R signaling pathway， up-regulates the expression of the key factor of iron death， ACSL4/4-HNE， and decreases the expression of GPX4/SLC7A11， which promotes lipid peroxidation and iron death.

Objective To evaluate the feasibility of early postoperative bathing within the framework of Enhanced recovery after surgery （ERAS） perioperative management. Methods A total of 156 patients who underwent laparoscopic appendectomy or cholecystectomy in the Department of General Surgery between December 2024 and May 2025 were included in the study. Based on the postoperative bathing protocol selected 24 hours after surgery， patients were randomly assigned to one of three groups： the early bathing-exposed group， the early bathing-covered group， or the control group. In the early bathing-exposed group， patients were permitted to bathe with the surgical incision uncovered 24 hours postoperatively. In the early bathing-covered group， sterile， waterproof dressings were applied to the incision site during bathing to maintain aseptic conditions. The control group followed conventional postoperative care guidelines， which restricted bathing until at least three days after suture removal. The outcomes， including the incidence of surgical site infection， postoperative complications， length of hospital stay， and follow-up data， were systematically recorded and analyzed across all three groups. Results Finally， 54 patients were included in the early bathing-exposed group， 52 in the early bathing-covered group， and 50 in the control group. No statistically significant differences were observed among the three groups in terms of baseline clinical characteristics， including gender， age， primary disease， comorbidities， body mass index （BMI）， surgical procedure， operative duration， or incision classification （all P > 0.05）. Similarly， postoperative comparisons of time to first bathing， incisional infection rates， complication incidence， and length of hospital stay showed no significant intergroup differences （all P > 0.05）. However， with respect to patient satisfaction during hospitalization， both early bathing groups reported significantly higher satisfaction scores compared to the control group， and these differences were statistically significant （all P < 0.05）. Conclusions Compared with the conventional principle of postoperative water restriction， early bathing does not increase the incidence of surgical site infection and contributes to improved patient satisfaction during hospitalization. This approach broadens the scope of early postoperative interventions within the ERAS protocol and warrants further clinical implementation.

Objective To investigate the impact of immunohistochemical detection of omentin-1 （omentin-1）， secreted phosphoprotein 1 （SPP1）， and mismatch repair （MMR） protein expression status on the clinicopathological characteristics and prognosis of endometrial cancer （EC）， in order to provide references for disease assessment， prognosis evaluation， and the development of molecular targeted therapies. Methods A total of 159 patients diagnosed with EC who were admitted to our hospital between December 2019 and December 2021 were enrolled as the study group. Additionally， 152 samples of normal endometrial tissue were collected from patients undergoing hysterectomy due to benign uterine diseases and served as the control group. The expression levels of omentin-1， SPP1， and MMR proteins in endometrial tissues were compared among the study group， the control group， and EC patients with different clinicopathological characteristics and prognostic outcomes. Spearman correlation analysis was performed to evaluate the correlations among these biomarkers in EC tissues. The influencing factors of EC prognosis were analyzed through multivariate logistic regression. Kaplan-Meier survival curves were constructed to assess the association between the expression of these proteins and patient prognosis. Results The positive expression rate of SPP1 and the MMR deletion rate in endometrial tissues of the study group were significantly higher than those in the control group （P < 0.05）， while the positive expression rate of omentin-1 in endometrial tissues was significantly lower than that in the control group （P < 0.05）. In patients with EC exhibiting myometrial invasion ≥1/2， the proportion of omentin-1 negativity was lower compared to omentin-1 positivity （P < 0.05）. Among EC patients with poorly differentiated tumors， the rates of SPP1 positivity and MMR deficiency were significantly increased （P < 0.05）. Spearman correlation analysis revealed that omentin-1 expression was negatively correlated with both MMR protein deletion and SPP1 overexpression （P < 0.05）， whereas MMR deficiency was positively correlated with SPP1 overexpression （P < 0.05）. In the poor prognosis group， the positive expression rate of SPP1 and the deletion rate of MMR were elevated， while omentin-1 expression was reduced in endometrial tissues （P < 0.05）. The results of multivariate logistic analysis showed that omentin-1 negative， SPP1 positive， and MMR deletion were risk factors for the prognosis of EC patients （P<0.05）. Kaplan-Meier survival curves were constructed based on follow-up data （Figures 1–3）， indicating that patients with omentin-1 negativity， SPP1 positivity， and MMR deficiency had significantly worse prognoses （P< 0.05）. Conclusions With the development and progression of the clinicopathological features of EC， abnormalities were observed in the immunohistochemical expression of omentin-1， SPP1， and MMR proteins. Specifically， omentin-1 negativity， SPP1 positivity， and MMR protein deletion were associated with a poorer prognosis in EC patients.

Objective To retrospectively assess the clinical efficacy of acupuncture at the Huiyin point combined with Qingdu wash solution in the treatment of high-risk HPV infection. Methods A total of 264 patients who were initially diagnosed with high-risk HPV infection at the University City Gynecology Department of Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2022 and June 2024 were enrolled in the study. These patients were divided into two groups based on predefined inclusion and exclusion criteria. The observation group included 134 patients who received acupuncture at the Huiyin acupoint combined with Qingdu wash solution， while the control group consisted of 130 patients who did not receive any intervention. The treatment period lasted for three months， during which the short-term clinical efficacy and safety profile were evaluated. Results The HR-HPV clearance rates in the observation group at 3 months and 6 months were 61.9% and 65.7%， respectively， which were significantly higher than those in the control group （16.9% and 21.5%）， and the differences between the two groups were statistically significant （P < 0.001）. Following a three-month treatment regimen， the rate of HR-HPV positive-to-negative conversion in the observation group was significantly higher than that in the control group， with a statistically significant intergroup difference （P < 0.001）. The improvement in traditional Chinese medicine （TCM）-related symptoms was also significantly better in the observation group compared to the control group （P < 0.05）. During the follow-up period， no cases of recurrence were observed in the observation group， whereas the recurrence rate in the control group was 1.5%. Furthermore， no adverse reactions were reported in the observation group throughout the treatment period. Conclusion Acupuncture at the Huiyin point， when combined with Qingdu wash solution， can enhance the therapeutic outcomes of high-risk HPV infection and demonstrates a favorable safety profile.

Objective To investigate the expression levels of serum microRNA-15a （miR-15a）， microRNA-195-5p （miR-195-5p）， and microRNA-33 （miR-33） in pregnant women with gestational diabetes mellitus （GDM） and to explore their associations with maternal and neonatal outcomes. Methods The research subjects were selected from 208 patients with GDM who completed delivery at our hospital between September 2021 and October 2024. Based on maternal pregnancy outcomes， the subjects were categorized into either the poor maternal outcome group or the good maternal outcome group. Similarly， they were classified into the poor perinatal outcome group and the good perinatal outcome group according to perinatal outcomes. Clinical data and serum levels of fasting plasma glucose （FPG）， miR-15a， miR-195-5p， and miR-33 were collected and compared between groups with different maternal and perinatal outcomes. Multivariate logistic regression analysis was conducted to identify risk factors associated with adverse maternal and perinatal outcomes among GDM patients. Additionally， the predictive value of these biomarkers for adverse maternal and perinatal outcomes was evaluated using receiver operating characteristic （ROC） curve analysis. Results Among 208 patients with GDM， 81 experienced adverse maternal pregnancy outcomes （38.94%）. Of the 192 newborns， 51 cases were associated with adverse perinatal outcomes， resulting in an incidence rate of 26.56%. Multivariate logistic regression analysis revealed that a high insulin resistance index （OR = 2.197）， poor glycemic control （OR = 2.482）， a history of adverse pregnancy or childbirth （OR = 2.838）， elevated FPG levels （OR = 1.910）， increased serum expression of miR-15a （OR = 1.988）， miR-195-5p （OR = 2.273）， and miR-33 （OR = 2.479） were independent risk factors for adverse maternal pregnancy outcomes in GDM patients （P < 0.05）. The area under the receiver operating characteristic curve （AUC） for the combined detection of miR-15a， miR-195-5p， and miR-33 was higher than that of FPG alone in predicting maternal pregnancy outcomes， with the combined detection showing the highest AUC （P < 0.05）. Similarly， multivariate logistic regression results also indicated that elevated levels of the aforementioned biomarkers—insulin resistance index （OR = 2.155）， poor glycemic control （OR = 2.408）， history of adverse pregnancy or childbirth （OR = 2.838）， FPG （OR = 2.018）， miR-15a （OR = 2.197）， miR-195-5p （OR = 2.246）， and miR-33 （OR = 3.043）—were independent risk factors for adverse perinatal outcomes in GDM patients （P < 0.05）. The AUC for combined detection of miR-15a， miR-195-5p， and miR-33 was significantly higher than that of FPG alone in predicting perinatal outcomes， with the combination yielding the highest predictive accuracy （P < 0.05）. Conclusions Patients with GDM are at increased risk of adverse maternal and perinatal outcomes. Elevated insulin resistance index， poor glycemic control， a history of adverse pregnancy or childbirth， and increased serum levels of miR-15a， miR-195-5p， and miR-33 were identified as independent risk factors for adverse pregnancy outcomes in individuals with gestational diabetes. The individual measurement of miR-15a， miR-195-5p， and miR-33， as well as their combined detection， demonstrated greater predictive value for pregnancy outcomes in GDM patients compared to FPG alone， with the combined detection showing the highest predictive accuracy.

Objective To investigate the number and categories of cognitive subtypes in individuals with First-Episode Schizophrenia （FES） and to explore the potential neurobiological sleep characteristics associated with these distinct cognitive subtypes. Methods The cognitive functions of 45 patients withFES and 40 healthy controls （HCs） were assessed using the MATRICS Consensus Cognitive Battery （MCCB）. Latent profile analysis was employed to identify and classify the cognitive subtypes of FES patients. Furthermore， a full-night polysomnographic recording was conducted to quantify the characteristics of sleep spindle waves. Subsequently， differences in sleep spindle wave features among the identified cognitive subtypes of FES were analyzed and compared. Results Latent Profile Analysis identified two cognitive subtypes among FES patients： a subtype characterized by severe cognitive impairment （SIS， n = 32） and another with relatively preserved cognitive function （CRP， n = 13）. Compared to healthy controls （HCs， n = 40）， FES patients exhibited increased spindle wave amplitude during both N2 and N3 sleep stages. Further analysis revealed that the spindle wave duration during the N2 stage was significantly longer in the SIS subtype compared to both CRP and HCs. Similarly， in the N3 stage， the spindle wave duration was longer in SIS than in CRP. Additionally， spindle wave frequency during the N3 stage was higher in both SIS and HCs compared to CRP. Conclusions The results of this study suggest that variations in the frequency and duration of spindle waves among different cognitive subtypes may serve as potential neurobiological markers for distinguishing FES cognitive subtypes.

Objective To analyze the factors influencing iodine nutritional status in pregnant women during pregnancy， based on thyroid function and thyroid autoantibody levels， and to explore the association between iodine nutritional abnormalities and pregnancy outcomes. Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were prospectively enrolled in this study. All participants were followed until delivery. Seven cases were lost to follow-up， resulting in a final sample size of 831 participants. Among them， 276 were in the first trimester， 384 in the second trimester， and 171 in the third trimester. Data on urinary iodine concentration （UIC）， urinary creatinine （UCr）， thyroid function indicators， and thyroid autoantibodies were collected. Based on their iodine nutritional status， the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group （including iodine-deficient， iodine-hyper-sufficient， and iodine-excessive subgroups）. This study analyzed the iodine nutritional status of pregnant women during different gestational periods， compared thyroid function indices， prevalence of thyroid diseases， and the positivity rates of thyroid peroxidase antibody （TPOAb）， thyroglobulin antibody （TGAb）， and thyroid-stimulating hormone receptor antibody （TRAb） among different iodine status groups. Additionally， adverse pregnancy outcomes were compared across groups. Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy， and a predictive model was developed to assess its potential predictive value. Results Among the 831 pregnant women included in the study， 373 cases （44.89%） exhibited iodine sufficiency， while 458 cases （55.11%） presented with iodine abnormalities， including 282 cases of iodine deficiency， 144 cases of iodine hypersufficiency， and 32 cases of iodine excess. No statistically significant differences were observed in the iodine nutritional status across different trimesters （P > 0.05）. The serum level of thyroid-stimulating hormone （TSH） was significantly higher in the iodine abnormal group compared to the iodine sufficient group （P < 0.05）. Additionally， the iodine abnormal group demonstrated higher positivity rates of TPOAb alone， TGAb， and TRAb， as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group （all P < 0.05）. These adverse indicators were also significantly elevated in the iodine-deficient， iodine super-sufficient， and iodine overdose subgroups compared to the iodine sufficient group （P < 0.05）. Elevated serum TSH levels and the presence of TPOAb， TGAb， and TRAb were identified as risk factors for iodine abnormalities during pregnancy （P < 0.05）. The predictive model constructed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve （AUC） of 0.876， with a sensitivity of 72.27% and a specificity of 89.01%. Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high， with most cases presenting iodine deficiency. These abnormalities were associated with thyroid function， thyroid autoimmunity， and pregnancy outcomes， but showed no significant correlation with gestational age. Furthermore， the prediction model developed based on identified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during pregnancy.

Objective To investigate the correlation between serum cytotoxic T lymphocyte associated protein 4 （CTLA4）， high mobility group box 1 （HMGB1） and the balance of helper T cell 17 （Th17）/regulatory T cell （Treg）， and to study their diagnostic significance for unexplained recurrent spontaneous abortion （URSA）. Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group， and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group. The levels of serum CTLA4 and HMGB1 in the two groups were detected， the levels of Th17 and Treg in the two groups were detected， the Th17/Treg ratio was calculated， and the general data of the two groups were collected and recorded. Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17， Treg， and Th17/Treg. logistic regression was used to analyze the influencing factors of URSA occurrence. The receiver operating characteristic （ROC） curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA. Results the serum CTLA4 level in the URSA group was lower than that in the healthy group， the HMGB1 level was higher than that in the healthy group， the Th17 level and Th17/Treg were higher than those in the healthy group， and the Treg level was lower than that in the healthy group （P < 0.05）. The serum CTLA4 level was negatively correlated with the Th17 level and Th17/Treg， and positively correlated with the Treg level （P < 0.05）. The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg， and negatively correlated with the level of Treg （P < 0.05）. Pregnancy frequency， serum CTLA4 level， serum HMGB1 level， Th17 level， Treg level， and Th17/Treg are independent influencing factors for the occurrence of URSA （P < 0.05）. The areas under the curve （AUC） of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841， 0.787， and 0.908 respectively， and the Youden indices were 0.652， 0.491， and 0.656 respectively. Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA， which is related to the change of Th17/Treg balance. The levels of serum CTLA4 and HMGB1 have auxiliary diagnostic significance for URSA.

Objective To investigate the prognostic value of serum thrombospondin-1 （THBS-1） combined with Alberta Stroke Program Early CT Score （ASPECTS） in patients with acute cerebral infarction with large vessel occlusion （ACI-LVO）. Methods A total of 198 ACI-LVO patients admitted to the hospital from January 2022 to October 2024 were prospectively enrolled （ACI-LVO group）. Patients were categorized into mild， moderate， and severe subgroups based on National Institutes of Health Stroke Scale （NIHSS） scores， and into good or poor prognosis groups based on 90-day outcomes. Serum THBS-1 levels were measured using ELISA， and ASPECTS scores were calculated. Spearman correlation analysis was used to assess the relationship between THBS-1， ASPECTS， and NIHSS scores. Prognostic factors and predictive values of THBS-1 and ASPECTS were also analyzed. Results Among the 198 patients， 58 had mild， 67 had moderate， and 73 had severe ACI-LVO. Serum THBS-1 levels increased， and ASPECTS scores decreased progressively with worsening disease severity （P < 0.05）. NIHSS scores were positively correlated with serum THBS-1 and negatively correlated with ASPECTS scores （P < 0.05）. The 90-day poor outcome rate was 37.37%（74/198）. Independent risk factors for poor prognosis included older age， modified thrombolysis in cerebral infarction score of 0 ~ 2a， higher NIHSS score， larger infarct volume， hemorrhagic transformation， and elevated THBS-1. A higher ASPECTS score was an independent protective factor （P < 0.05）. The area under the curve （AUC） for predicting prognosis was 0.794 for THBS-1， 0.831 for ASPECTS， and 0.903 for their combination， with the combined model showing superior predictive value （P < 0.05）. Conclusions Elevated serum THBS-1 and decreased ASPECTS scores are associated with increased disease severity and poorer prognosis in ACI-LVO patients. The combination of serum THBS-1 and ASPECTS score provides high predictive value for assessing prognosis in ACI-LVO patients.

Objective To evaluate the predictive significance of contrast?enhanced ultrasound parameters in combination with serum levels of chemokine ligand 9 (CXCL9) and insulin?like growth factor?binding protein 3 (IGFBP?3) for the recurrence of hepatocellular carcinoma following interventional therapy. Methods A total of 212 patients with liver cancer who received interventional therapy at the hospital between June 2022 and November 2023 were selected and categorized into Group A (61 cases) and Group B (151 cases) based on whether tumor recurrence occurred within one year following the intervention. Multivariate logistic regression analysis was conducted to identify potential influencing factors associated with post?treatment recurrence. The predictive performance of contrast?enhanced ultrasound parameters combined with serum biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis. Results The levels of several factors including a tumor with a maximum diameter exceeding 3 cm, presence of microvascular invasion, high peak intensity (PI), short time to peak (TTP), short arrival time (AT), elevated serum CXCL9, and decreased serum IGFBP?3 were identified as independent risk factors for recurrence in patients with hepatocellular carcinoma following interventional therapy (P < 0.05). The area under the curve (AUC) for the combination of PI, TTP, AT, along with serum levels of CXCL9 and IGFBP?3, in predicting recurrence after interventional therapy was significantly higher than that of individual factors alone (P < 0.05). Conclusions The risk of recurrence in patients undergoing interventional therapy for liver cancer is substantial, and it is influenced by a range of independent risk factors. Combining contrast?enhanced ultrasound parameters with serum levels of CXCL9 and IGFBP?3 may enhance the predictive accuracy for tumor recurrence in these patients.

Objective To evaluate the application value of nucleic acid mass spectrometry in detecting ERG11 gene mutations associated with azole resistance in Candida tropicalis （C. tropicalis）， thereby providing a scientific basis for the rational clinical use of azole antifungal agents. Methods Clinical isolates of C. tropicalis were obtained from the Affiliated Hospital of Xuzhou Medical University between July 2023 and November 2024. For each isolate， specific ERG11 mutations （A395T and C461T） were analyzed using Sanger sequencing and nucleic acid mass spectrometry. Sanger sequencing was used as the reference standard to evaluate the performance of mass spectrometry in mutation detection. Results The established nucleic acid mass spectrometry method effectively identified four genotypes of ERG11 （A395T and C461T）， with distinct spectral peaks for each mutation and no cross-interference observed. Among 88 clinical isolates， the sensitivity， specificity， positive predictive value （PPV）， and negative predictive value （NPV） for the A395T mutation were 86.7%， 100%， 100%， and 97.3%， respectively. For the C461T mutation， the corresponding values were 81.3%， 100%， 100%， and 96.0%， respectively. Kappa statistics demonstrated a high level of agreement between mass spectrometry and sequencing results. Conclusions Nucleic acid mass spectrometry exhibits high sensitivity and specificity in the detection of ERG11 mutations， enabling rapid， accurate， and adaptable high-throughput analysis. This makes it a highly effective method for identifying mutations associated with fungal resistance.

Objective To evaluate the predictive value of dual-modality ultrasound， incorporating conventional ultrasound and ultrasound elastography， in combination with S-Detect for cervical lymph node metastasis （CLNM） in patients with papillary thyroid carcinoma （PTC）. Methods A retrospective analysis was conducted on the clinical data of 135 patients diagnosed with PTC who received treatment at the First Affiliated Hospital of Shihezi University between November 2023 and August 2024. For all patients， clinical baseline characteristics， conventional ultrasound findings， ultrasound elastography results， and S-Detect analysis data were collected. Independent predictors of CLNM in PTC were identified， and predictive models were developed. Receiver operating characteristic （ROC） curves were generated to compare the area under the curve （AUC） of the models. The most effective predictive model was selected to construct a risk probability nomogram， and the predictive performance and clinical applicability of this nomogram were subsequently evaluated. Results Age， maximum nodule diameter， boundary characteristics， capsular invasion， transverse-sectional morphological findings assessed by S-Detect， and ECI-based elasticity grading were identified as independent predictors of CLNM in PTC （all P < 0.05）. The AUC of the predictive model constructed using these six variables was 0.890 （95%CI： 0.835 ~ 0.945）. The calibration curve demonstrated strong agreement between predicted and observed outcomes， and decision curve analysis indicated that the nomogram provided a favorable net clinical benefit within a threshold probability range of 2% to 91.5%. Conclusions Age， maximum nodule diameter， boundary characteristics， capsular invasion， sonographic features assessed by S-Detect in the transverse plane， and ECI-based elasticity grading are independent predictors of CLNM in PTC. A nomogram model incorporating these parameters demonstrates effective performance in predicting the likelihood of CLNM.

Objective To construct a Nomogram risk prediction model for early recurrence of hepatocellular carcinoma （HCC） radical hepatectomy based on CT imaging omics and traditional Chinese medicine tongue imaging features. Methods 216 patients who underwent HCC radical hepatectomy in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from September 2018 to September 2022 were selected，the clinical dataes were retrospective analyzed.The patients were randomly divided into modeling set （n = 152） and validation set （n = 64） by 7：3 ratio，the recurrence situation one year after surgery of the two groups were recorded.A recurrence prediction model was constructed by the modeling set of patient dataes， all patients underwent postoperative plain scan combined with enhanced CT examination， and the Imaging omics feature indicators was extracted， the tongue imaging characteristics was recorded，the Cox multivariate model was used to analyze the factors related to postoperative recurrence in the modeling set of patients， and a risk prediction model was constructed，the model was validated by validation set dataes. Results There were 52 patients in the modeling set experienced recurrence within 1 year， the recurrence rate was 34.21%；there were 23 cases of recurrence in the validation set patients within 1 year， the recurrence rate was 35.94%.The Cox multivariate model analysis showed that the Rad-score， Tongue texture and tongue shape were independent influence factors for postoperative recurrence of HCC （P < 0.05）. Based on this， the Nomogram column chart was established.The ROC analysis showed that the AUC of the column chart model for predicting postoperative recurrence in the modeling set and validation set patients were 0.811 and 0.824， the sensitivities were 0.875 and 0.833 respectively， the specificities were 0.617 and 0.750 respectively. Conclusions The early postoperative recurrence of HCC is related to Rad score， tongue texture， and tongue shape. Based on this， the Nomogram prediction model constructed has high accuracy in predicting early postoperative recurrence.

Irritable bowel syndrome （IBS） is a prevalent functional gastrointestinal disorder characterized by a complex etiology involving multiple interacting factors. Accumulating evidence in recent years has indicated that intestinal barrier dysfunction may play a crucial role in the pathogenesis of IBS. This review systematically examines the impact of intestinal barrier dysfunction on IBS， analyzing its associations with the mechanical， immune， chemical， and microbial components of the gut barrier， as well as current clinical treatment approaches. Moreover， this paper highlights the potential of intestinal barrier repair mechanisms as therapeutic targets， which may provide novel insights and directions for understanding the underlying pathophysiological mechanisms and developing effective interventions for IBS.

Parkinson's disease （PD） is a neurodegenerative disorder whose core pathological feature is the abnormal accumulation of pathological α-synuclein （α-syn） in the brain， but there are rare clinical therapeutic modalities that target this. As a hot research topic in recent years， meningeal lymphatic vessels （MLVs） play an important role in central nervous system fluid （CNS） drainage， and can promote the exocytosis and clearance of metabolic wastes such as α-syn from the brain. Regulating the morphology and function of MLVs to promote α-syn exocytosis is likely to become an influential direction for future intervention in PD research and provide new approaches for the clinical therapy of PD. In this article， we will overview 3 aspects of the structure and function of MLVs， the role of MLVs in PD， and the strategy of targeting MLVs to treat PD.