Objective To identify risk factors for unplanned 30-day readmission （UPR） following immune checkpoint inhibitors （ICIs） treatment in stage Ⅲ—Ⅳ lung cancer patients and to develop/validate a predictive model. Methods We retrospectively analyzed clinical data from stage Ⅲ—Ⅳ lung cancer patients treated with ICIs at our institution （January 2023-May 2024）. Risk factors were preliminarily screened using the Boruta algorithm； independent predictors were identified via logistic regression. A nomogram prediction model was subsequently developed. Model performance was evaluated by： discrimination （receiver operating characteristic curves， ROC）， calibration （calibration plots）， and clinical utility （decision curve analysis， DCA）. Restricted cubic spline （RCS） regression combined with SHapley Additive exPlanations （SHAP） analysis further explored dose-response relationships and threshold effects of key risk factors on UPR. Results Among 284 included patients， the UPR incidence was 30.63%. Independent risk factors identified by logistic regression were： hospital length of stay， Nutritional Risk Screening 2002 （NRS 2002） score， invasive procedures， and Karnofsky Performance Status （KPS） score （all P < 0.05）. The model showed strong discrimination： training set AUC = 0.88 （95% CI： 0.84 ~ 0.93）， sensitivity 84%， specificity 80%； validation set AUC = 0.87 （95% CI： 0.79 ~ 0.95）， sensitivity 82%， specificity 70%. Calibration curves indicated good model fit. Decision curve analysis demonstrated positive net benefit at threshold probabilities of 10%~90%. SHAP analysis prioritized length of stay as the most influential predictor； SHAP-RCS analysis revealed increased UPR risk when： hospital stay > 6.43 days， NRS 2002 > 2.05， KPS < 79.01， or prior invasive procedures. Conclusion The nomogram model incorporating four key risk factors effectively predicts 30-day unplanned readmission risk in stage Ⅲ—Ⅳ lung cancer patients receiving ICI therapy. With robust performance and clinical utility， it may facilitate early identification and intervention for high-risk individuals.

Objective To explore the risk stratification value of the triglyceride-glucose-body mass index （TyG-BMI） for immune-related adverse reactions （irAE） in tumor patients treated with immune checkpoint inhibitors （ICIs）. Methods The clinical data of 204 hospitalized patients with malignant tumors who underwent programmed cell death protein 1/programmed cell death ligand 1 （PD-1/PD-L1） monoclonal antibody treatment at the Third Affiliated Hospital of Sun Yat-sen University from September 2023 to September 2024 were retrospectively collected. All patients were stratified into the TyG-BMI Q1 group， TyG-BMI Q2 group， TyG-BMI Q3 group， and TyG-BMI Q4 group based on the TyG-BMI quartiles， with 51 cases in each group. The clinical data and the incidence of immune-related adverse events （irAE） in the four groups were compared. Multivariate logistic regression analysis was performed to identify the influencing factors of irAE in cancer patients treated with immune checkpoint inhibitors （ICIs）. The receiver operating characteristic curve （ROC） was constructed to evaluate the predictive value of TyG-BMI for irAE. Pearson correlation analysis was carried out to examine the correlation between TyG-BMI levels and inflammatory factor levels， and the receiver operating characteristic curve （ROC） was plotted to assess the predictive value of TyG-BMI for irAE. Results Statistically significant differences were observed in body mass index （BMI）， dyslipidemia， history of diabetes， triglyceride， low-density lipoprotein （LDL-C）， fasting blood glucose， free thyroxine （FT4）， and Eastern Cooperative Oncology Group performance status score （ECOG score） among the four groups （P < 0.05）. Statistically significant differences were also noted in the incidence of any-grade irAE， grade ≥ 3 irAE， endocrine toxicity， and skin toxicity among the four groups （P < 0.05）. Univariate analysis indicated that a higher TyG-BMI was associated with a higher risk of any-grade irAE， grade ≥ 3 irAE， endocrine toxicity， pulmonary toxicity， skin toxicity， and other irAE （P < 0.05）. After adjusting for confounding factors such as age， gender， tumor type， drug category， and tumor stage， the results of multivariate logistic regression demonstrated that TyG-BMI was an independent risk factor for the occurrence of any- grade irAE （OR = 1.517， 95%CI： 1.220 ~ 1.886， P < 0.001）， grade ≥ 3 irAE （OR = 1.215， 95%CI： 1.046 ~ 1.410， P = 0.011）， and endocrine toxicity （OR = 1.331， 95%CI： 1.131 ~ 1.568， P < 0.001）. After further adjusting for white blood cell count （WBC）， hemoglobin （Hb）， platelet count （PLT）， alanine aminotransferase （ALT）， total bilirubin （TBIL）， serum creatinine （Scr）， troponin I （TnI）， and thyroid-stimulating hormone （TSH）， TyG-BMI remained an independent risk factor for the occurrence of any-grade irAE， grade ≥ 3 irAE， and endocrine toxicity （P < 0.05）. The levels of interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， and C-reactive protein （CRP） were compared among the four groups， and the differences were statistically significant （P < 0.05）. Pearson correlation analysis indicated that TyG-BMI was positively correlated with the levels of IL-6， TNF-α， and CRP （r = 0.643， 0.731， 0.894， P < 0.001）. The ROC curve demonstrated that the predictive value of TYG-BMI for any grade of irAE， grade ≥ 3 irAE， and endocrine irAE was higher than that of TyG and BMI （P < 0.05）. Conclusion TyG-BMI can be utilized to assess the risk of immune-related adverse events （irAE） in cancer patients undergoing treatment with immune checkpoint inhibitors （ICIs）， offering references for the formulation of clinical treatment plans and the evaluation of prognosis.

Objective To explore the application of rectus femoris cross-sectional area （RF-CSA）， Tibialis anterior muscle thickness （TA-MT）， and bioelectrical-impedance-analysis （BIA） in the diagnosis of intensive care unit-acquired weakness （ICU-AW）. Methods A single-centre， observational study was carried out on 116 patients who were admitted to the Intensive Care Unit （ICU） of Tianjin Medical University Cancer Hospital because of tumour-related sepsis or septic shock. By examining the patients' general clinical data and using ultrasound and bioimpedance analysis to monitor the changes in indicators such as rectus femoris， tibialis anterior， skeletal muscle index （SMI）， total body water （TBW）， and protein content within 6 hours after the onset of sepsis and 72 hours after the initiation of sepsis treatment， statistical analysis was performed to predict the probability of ICU-AW occurrence. Results Ultimately， a total of 41 patients were diagnosed with ICU-AW. Patients with ICU-AW had a higher proportion of vasoactive drug use and mechanical ventilation， along with elevated Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） and Sequential Organ Failure Assessment （SOFA） scores， which clearly indicated a more severe state of illness. Moreover， group-by-group comparisons showed more significant decreases in RF-CSA， TA-MT， SMI， TBW， and protein content （Protein） in the ICU-AW group （P < 0.05）. In addition， compared to the non-ICU-AW group， ICU-AW patients had lower initial mean Passive Angle （PA） values （3.42° vs. 3.80°） and showed a more rapid increase in PA after aggressive intervention. When it came to the diagnosis of ICU-AW， the change rates of RF-CSA， TA-MT， SMI， TBW， and Protein presented higher Receiver Operating Characteristic-Area Under the Curve （ROC-AUC） values for diagnosing ICU-AW ［0.891 （95%CI： 0.831 ~ 0.952）， 0.830 （95%CI： 0.749 ~ 0.911）， 0.916 （95%CI： 0.862 ~ 0.971）， 0.833 （95%CI： 0.749 ~ 0.917）， and 0.834 （95%CI： 0.758 ~ 0.911）， respectively］. Furthermore， the initial APACHE Ⅱ score showed good diagnostic value， with a ROC-AUC of 0.829 （95%CI： 0.803 ~ 0.917）. In the combined diagnostic model， the joint model that included the SMI change rate and Protein change rate measured by bioimpedance analysis achieved the highest ROC-AUC （0.938， 95%CI 0.895 ~ 0.980）. Conclusion Peripheral muscle ultrasound and bioelectrical impedance analysis can be employed as effective tools for the early detection of ICU-AW in patients with tumor sepsis.

Objective Exploring the Clinical Application Value of Uterine Artery Hemodynamic Parameters and Elastography Scores in Uterine Fibroid Degeneration. Methods A total of 158 patients with uterine fibroids， diagnosed by pathology and treated at our hospital from June 2022 to June 2024， were selected as the study group. Additionally， 150 healthy women who underwent routine health check-ups during the same period were selected as the control group. The study group was further divided into degeneration and non-degeneration subgroups based on the presence or absence of degeneration. Ultrasound was used to observe the location， size， and hemodynamic changes in the uterine arteries of the fibroid patients， and strain elastography was used to assess the elasticity of the lesions. Comparison of various parameters between the two groups was conducted， and receiver operating characteristic （ROC） curves were drawn to evaluate the diagnostic value of uterine artery hemodynamic parameters and elastography scores in the diagnosis of fibroid degeneration. Results There were statistically significant differences （P < 0.05） in the uterine artery hemodynamic parameters （RI， PI， V_min， EDV， PSV） and elastography scores between the study group and the control group. Among the study group， the PI， V_min， PSV， and elastography scores of the degeneration group were significantly different from those of the non-degeneration group （P < 0.05）. The PI， Vmin， PSV， and elastography scores were identified as diagnostic indicators for uterine fibroid degeneration （P < 0.05）. Using PI， V_min， PSV， and elastography scores as test variables and the degeneration and non-degeneration groups as reference standards， ROC curves were drawn. The AUC values for PI， V_min， PSV， and elastography scores were 0.714， 0.690， 0.660， and 0.669， respectively. The AUC for combined diagnosis of these indicators was 0.832. Conclusion Uterine artery hemodynamic parameters （PI， V_min PSV） and elastography scores have high diagnostic value for uterine fibroid degeneration， with the combined diagnostic value being even higher.

Objective To analyze the clinical efficacy of curettage and sterilization for osteoid osteoma under the guidance of orthopedic surgical robot navigation. Methods A total of 60 patients diagnosed with osteoid osteoma who underwent surgical treatment in the Department of Orthopedics at Foshan Hospital of Traditional Chinese Medicine from January 2018 to June 2025 were recruited. These patients were then divided into an experimental group and a control group， with 30 cases in each group. The control group received traditional curettage and inactivation of the lesion， while the experimental group underwent curettage and inactivation of the lesion under the guidance of an orthopedic surgical robot navigation. A comparison was made between the two groups in terms of the positive detection rate of postoperative pathology， the incidence of complications and postoperative recurrence， the patient satisfaction rate， the VAS pain score， the area of the surgical bone window， the number of bone grafts and internal fixations， the intraoperative blood loss， the operation time （defined as the time from skin incision to the final closure of the operation）， the postoperative hospital stay， and the efficacy evaluation. Results The positive detection rate of postoperative pathology in the experimental group was significantly higher than that in the control group （P < 0.05）. After the operation， the VAS pain score of the experimental group was significantly lower than that of the control group （P < 0.05）. The bone window area， intraoperative blood loss， operation time， and postoperative hospital stay in the experimental group were all significantly lower than those in the control group （P < 0.05）. The number of bone grafts in the experimental group was significantly lower than that in the control group （P < 0.05）. The bone graft and internal fixation in the experimental group were slightly lower than those in the control group， the satisfaction rate of the experimental group was slightly higher than that of the control group， the total excellent - and - good rate of the experimental group was slightly higher than that of the control group， and the incidence of complications and postoperative recurrence rate of the experimental group were lower than those of the control group， but there was no significant difference （P > 0.05）. Conclusions The treatment of osteoid osteoma through curettage and degranulation guided by orthopedic surgical robot navigation can alleviate postoperative pain， reduce surgical trauma， shorten the hospital stay， and offers advantages in terms of pathological positive detection， complications， and postoperative recurrence. Therefore， it is worthy of clinical application.

Objective To evaluate the accuracy of a backpropagation neural network （BPNN） model incorporating clinical and imaging features in predicting axillary lymph node burden among breast cancer patients with one to two positive sentinel lymph nodes. Methods We retrospectively analyzed clinical and imaging data from 386 female breast cancer patients who underwent axillary lymph node dissection at three medical centers between January 2021 and December 2024. Based on pathological findings， patients were categorized into a high axillary lymph node burden group （n = 155） and a low burden group （n = 231）. Data from Center 1 and Center 2 （Affiliated Hospital of Guangdong Medical University and Affiliated Yangjiang Hospital of Guangdong Medical University； n = 295） were randomly divided into a training set （n = 207） and an internal validation set （n = 88）， while data from Center 3 （Second Affiliated Hospital of Guangdong Medical University； n=91） served as the external validation cohort. Univariate and multivariate logistic regression analyses were conducted in the training cohort to identify independent risk factors. Four machine learning algorithms， including logistic regression， support vector machine （SVM）， random forest and BPNN were then used to construct predictive models， which were subsequently evaluated in the internal and external validation cohorts. The Shapley additive explanation （SHAP） method was applied to assess and visualize feature importance. Results Univariate and multivariate logistic regression analyses identified the neutrophil-to-lymphocyte ratio （NLR）， peritumoral edema， and axillary lymph node cortical thickening as independent predictors of nodal burden. The BPNN-based model demonstrated superior predictive performance， achieving an area under the receiver operating characteristic curve （AUC） of 0.793. SHAP analysis revealed that peritumoral edema contributed most significantly to model predictions， followed by lymph node cortical thickening and NLR. Conclusions An interpretable BPNN model integrating clinical and imaging characteristics provides reliable prediction of axillary lymph node burden in breast cancer patients. This approach offers valuable support for axillary management and personalized treatment planning.

Objective To explore the predictive value of serum matrix metalloproteinase-2 （MMP-2）， myeloperoxidase （MPO）， and axonal guidance factor 3E （Sema3E） in predicting the prognosis of patients undergoing intracranial aneurysm clipping surgery under general anesthesia. Methods A total of 125 patients who underwent general anesthesia for intracranial aneurysm clipping surgery at Zhangjiakou First Hospital from May 2023 to May 2025 were selected as the study subjects. Patients with Glasgow Outcome Scale （GOS） scores ranging from 1 to 3 one month after surgery were included in the poor prognosis group （29 cases）， while those with scores from 4 to 5 were included in the good prognosis group （96 cases）. The clinical data and the levels of serum MMP-2， MPO， and Sema3E were compared between the two groups. Multivariate logistic regression analysis was used to analyze the risk factors for poor prognosis in patients undergoing general anesthesia for intracranial aneurysm clipping surgery. Receiver Operating Characteristic （ROC） curves were employed to analyze the predictive value of serum MMP-2， MPO， and Sema3E for the prognosis of patients undergoing intracranial aneurysm clipping under general anesthesia. The levels of serum MMP-2， MPO， and Sema3E among patients with different clinical characteristics were compared. Spearman correlation analysis was conducted to investigate the correlation between serum MMP-2， MPO， and Sema3E and clinical features. Results The proportions of patients with Hunt-Hess grade Ⅲ and preoperative Glasgow Coma Scale （GCS） score < 8 in the poor prognosis group were 27.59% and 51.72%， respectively， which were higher than the 10.42% and 5.21% in the good prognosis group （P < 0.05）. The levels of serum matrix metalloproteinase-2 （MMP-2）， myeloperoxidase （MPO）， and semaphorin 3E （Sema3E） in the poor prognosis group were higher than those in the good prognosis group （P < 0.05）. High levels of serum MMP-2， MPO， and Sema3E were independent risk factors for poor prognosis in patients undergoing intracranial aneurysm clipping surgery under general anesthesia （OR = 1.087， 2.807， 2.079， P < 0.05）. The areas under the curve （AUC） for predicting the prognosis of patients undergoing intracranial aneurysm clipping surgery under general anesthesia using serum MMP-2， MPO， Sema3E， and combined detection were 0.747， 0.690， 0.656， and 0.809， respectively. The diagnostic sensitivities were 72.41%， 62.07%， 68.97%， and 86.21%， and the specificities were 72.92%， 73.96%， 66.67%， and 70.83%， respectively. Among them， the AUC of combined detection was the highest （P < 0.05）. The levels of serum MMP-2， MPO， and Sema3E in Hunt-Hess grade Ⅲ patients were higher than those in grade Ⅰ and Ⅱ patients， with grade Ⅱ patients having higher levels than grade Ⅰ patients. Patients with preoperative GCS scores < 8 had higher levels of serum MMP-2， MPO， and Sema3E than those with scores ≥ 8 （P < 0.05）. Serum MMP-2， MPO， and Sema3E were positively correlated with Hunt-Hess grading （r = 0.497， 0.662， 0.595， 0.639， P < 0.05） and negatively correlated with scores of preoperative GCS （r = -0.547， -0.602， -0.697， -0.521， P < 0.05）. Conclusions There was a certain correlation between Hunt-Hess grading， preoperative Glasgow Coma Scale （GCS） score， and the prognosis of patients undergoing intracranial aneurysm clipping surgery under general anesthesia. The levels of serum matrix metalloproteinase-2 （MMP-2）， myeloperoxidase （MPO）， and semaphorin 3E （Sema3E） were closely related to Hunt-Hess grading and GCS score. High levels of serum MMP-2， MPO， and Sema3E were independent risk factors for poor prognosis in patients undergoing intracranial aneurysm clipping surgery under general anesthesia and had high predictive value for patient prognosis. Among them， combined detection had the highest predictive value.

Objective To compare the oncological and functional outcomes between preserving the left colic artery （LCA） and high ligation of the inferior mesenteric artery （IMA） during laparoscopic D3 lymph node dissection for rectal cancer. Methods A total of 162 patients with rectal cancer who received surgical treatment in our hospital from July 2021 to February 2024 were selected. These patients were randomly assigned by computer randomization to the low-position group （preservation of the left colic artery （LCA） with low-position ligation combined with D3 lymph node dissection） and the high-position group（adopted the dassic total mesovectal excision for rectal cancer， and the inferior mesenteric artery was ligated at a high level）， with 81 cases in each group. Surgical parameters， postoperative complications， tumor markers， and postoperative survival were compared between the two groups. Results The low-position group exhibited a longer operative time and a longer duration for lymph node dissection at the IMA root when compared to the high-position group （P < 0.05）. However， it required splenic flexure mobilization less frequently （P < 0.05）. Postoperatively， the serum levels of carcinoembryonic antigen （CEA）， carbohydrate antigen 19-9 （CA19-9）， and carbohydrate antigen 125 （CA125） decreased in both groups （P < 0.05）. In the postoperative period， both the low-position and high-position groups showed increases in LARS （low anterior resection syndrome） and residual urine volume （P < 0.05）， as well as decreases in single voided volume， maximum urinary flow rate， FSFI score， IIEF-5 score， resting anal pressure， and maximum anal sphincter pressure （P < 0.05）. The low-position group had lower LARS scores and residual urine volume than the high-position group （P < 0.05）， whereas the low-position group had higher resting anal pressure and maximum anal sphincter pressure than the high-position group （P < 0.05）. A comparative analysis between the two cohorts revealed that the incidence of anastomotic leakage was significantly lower in the low-position cohort than in the high-position cohort （P < 0.05）. During the 1-year follow-up， no deaths occurred in either group. The low-position group had 9 cases of local recurrence （11.11%） and 2 cases of distant metastasis （2.47%）， while the high-position group had 5 cases of local recurrence （6.17%） and 2 cases of distant metastasis （2.47%）. There was no statistically significant difference in progression-free survival between the two groups （P > 0.05）. Conclusion Under standardized D3 lymph node dissection， preserving the LCA yields oncological outcomes equivalent to those achieved by high IMA ligation. Meanwhile， it offers significant advantages in reducing the risk of anastomotic leakage and better preserving early postoperative defecation and urinary function.

Objective The aim of this study was to investigate the effects and mechanisms of bone marrow mesenchymal stem cell exosomes on the mouse asthma models. Methods C57/6J mice were divided into control group， model group， exosome （5， 10， and 20 μg）， and exosome （20 μg） + RS09 TFA group. After administration of the respective treatment， airway resistance was measured in each group of mice. Hematoxylin and eosin （HE） staining was used to detect airway damage in mice. Enzyme-linked immunosorbent assay （ELISA） was applied to detect the concentrations of inflammatory factors interleukin-4 （IL-4）， interleukin-5 （IL-5）， and interleukin-13 （IL-13） in the alveolar fluid of mice. The colorimetric method was used to determine the concentrations of malondialdehyde （MDA）， catalase （CAT）， and superoxide dismutase （SOD） in the alveolar fluid. Western blot was used to detect the expression of Toll-like receptor 4 （TLR4）， myeloid differentiation factor 88 （MyD88）， and nuclear factor κB （NF-κB） in the lung tissues of mice. Results Compared with the model group， the airway resistance in the exosome 5， 10， 20 μg groups decreased significantly （P < 0.05）； the concentrations of IL-4， IL-5， IL-13， and MDA in the alveolar fluid of mice decreased significantly （P < 0.05）； while the concentrations of CAT and SOD increased significantly （P < 0.05）； additionally， the expression of TLR4， MyD88， and NF-κB were all significantly downregulated （P < 0.05）. Compared with the exosome 20 μg group， the airway resistance in the exosome 20 μg + RS09 TFA group increased significantly （P < 0.05）， the concentrations of IL-4， IL-5， IL-13， and MDA in the alveolar fluid of mice increased significantly （P < 0.05）， while the concentrations of CAT and SOD decreased significantly （P < 0.05）， the expression of TLR4， MyD88， and NF-κB were all significantly upregulated （P < 0.05）. Conclusion Bone marrow mesenchymal stem cell exosomes can alleviate mouse asthma by inhibiting the TLR4/MyD88/NF-κB signaling pathway.

Objective To investigate the alterations in hippocampal circFBXW4 expression within a rat model of perinatal depression， as well as its association with depression-related behaviors and the neurodevelopment of offspring. Methods Pregnant Sprague-Dawley （SD） rats were randomly allocated into a control group and an experimental group. The experimental group was exposed to chronic unpredictable mild stress （CUMS）. The behavioral performances of maternal rats and their offspring were assessed using the sucrose preference test （SPT）， open-field test （OFT）， and elevated plus-maze （EPM）. Serum corticosterone levels and circFBXW4 expression in the maternal brain tissue were determined. Hematoxylin-eosin （HE） staining was carried out on the hippocampal tissue of offspring on postnatal day 7. Moreover， Spearman correlation analysis was employed to evaluate the relationship between circFBXW4 and behavioral indicators. Results When compared with the control group， maternal rats in the CUMS group exhibited a decreased sucrose preference index （U = 104.00， P = 0.049）， a reduced central activity time （t = 7.67， P < 0.001） and distance （t = 6.29， P < 0.001） in the OFT， as well as a decreased open-arm time （U = 122.00， P < 0.001）， distance （U = 118.00， P = 0.001）， and entries （U = 119.50， P < 0.001） in the Elevated Plus-Maze （EPM）. Serum corticosterone levels were elevated （t = -3.56， P = 0.001）， and the expression of hippocampal circFBXW4 was reduced （U = 120.00， P = 0.006）， which showed a negative correlation with sucrose preference and OFT indicators. In the offspring， the CUMS group demonstrated a decreased sucrose preference index （U = 181.00， P < 0.001）， a reduced central activity time （U = 196.00， P < 0.001） and distance （t = 4.87， P < 0.001） in the OFT， and a decreased open-arm time （U = 196.00， P < 0.001） and distance （U = 196.00， P < 0.001） in the EPM. The offspring's serum corticosterone levels were increased （t = -2.46， P = 0.040）. Conclusions circFBXW4 was significantly reduced in the perinatal depression model when compared to the control group， and this reduction was closely associated with maternal depression-like behaviors. Maternal depression had long-lasting effects on offspring， which were manifested as anhedonia， decreased exploratory behavior， and hippocampal structural abnormalities. These findings strongly suggest that circFBXW4 may be involved in perinatal depression and exert intergenerational effects， and it has potential as a molecular biomarker.

Objective To identify risk factors associated with renal impairment in early-onset type 2 diabetes mellitus （EOT2DM） through a multidimensional assessment， so as to provide a scientific basis for establishing an early warning system and optimizing clinical intervention strategies. Methods This retrospective study recruited 541 patients diagnosed with EOT2DM who were admitted to the Department of Endocrinology at the Jiangsu Provincial Hospital of Traditional Chinese Medicine from August 2024 to August 2025. The participants were stratified into two groups according to the presence of abnormal renal impairment indicators： an EOT2DM group with renal impairment （n = 241） and an EOT2DM group without renal impairment （n = 300）. Clinical data were collected and underwent univariate analysis. Variables with a P-value < 0.05 in the univariate analysis， as well as variables with established clinical significance according to previous literature （even if P ≥ 0.05）， were included in a least absolute shrinkage and selection operator （LASSO） logistic regression model to remove redundant variables. Subsequently， multivariate logistic regression analysis was carried out. The optimal cut-off values for significant continuous variables were identified by calculating the Youden's index. Based on these cut-offs， continuous variables were dichotomized into high-risk （≥ cutoff） and low-risk （< cutoff） groups. After covariance adjustment， the adjusted odds ratios （ORs） and their 95% confidence intervals （CIs） were computed to accurately quantify the independent association between the level of each risk variable and the risk of renal impairment in EOT2DM. Receiver Operating Characteristic （ROC） curves were drawn， and the discriminatory ability of each risk factor was evaluated by the area under the ROC curve. Results Multivariate logistic regression analysis has identified six risk factors： sTM （OR = 1.789， AUC = 0.702）， TG （OR = 2.647， AUC = 0.602）， UA （OR = 1.693， AUC = 0.637）， LDL-C （OR = 1.942， AUC = 0.562）， WHR （OR = 2.364， AUC = 0.566）， and carotid plaque （OR = 1.872， AUC = 0.607）. After further refining the strength of the association by using cutoff values， the following four risk factors were determined： sTM， TG， WHR， and carotid plaque. Conclusions Elevated sTM， TG， WHR， and the presence of carotid plaque are independent risk factors for renal impairment in patients with EOT2DM. Among these， sTM demonstrated superior accuracy for renal impairment in EOT2DM and may be more suitable as a clinical assessment tool.

Objective investigate the changes in the expression levels of ferroptosis-related glutathione （GSH）， glutathione peroxidase 4 （GPX4）， homocysteine （Hcy）， and serum iron in the serum of patients with Alzheimer's disease （AD）， analyze their correlation with cognitive function， and evaluate the diagnostic value of serum ferroptosis-related indicators for AD. Methods Thirty-seven patients with AD hospitalized in the Second Affiliated Hospital of Xinjiang Medical University and 35 individuals without cognitive impairment hospitalized during the same period were selected. Neuropsychological assessments were conducted on all patients in the AD group and the control group， and the levels of serum GSH， glutathione peroxidase 4 （GPX4）， homocysteine （Hcy）， and serum iron were detected. The general data of the two groups were compared. The correlations between GSH， GPX4， Hcy， serum iron， and the scores of the Mini-Mental State Examination （MMSE） and the Montreal Cognitive Assessment （MoCA） were analyzed. Univariate and multivariate binary Logistic regression analyses were employed to explore the influencing factors of AD and construct its predictive model. The receiver operating characteristic （ROC） curve was plotted to evaluate the diagnostic value of the prediction model for AD. Results （1） When compared to the control group， the serum levels of GSH （23.573 ± 8.862 μmol/L） and GPX4 （21.767 ± 9.609 μU/mL） in the AD group were significantly lower （P < 0.05）. In the control group， the corresponding levels were GSH （34.380 ± 19.673 μmol/L） and GPX4 （31.345 ± 10.553 μU/mL）. There was no statistically significant difference in the serum levels of iron and Hcy between the two groups （P > 0.05）. （2） Serum GPX4 was positively correlated with MMSE （r = 0.233， P = 0.049） and MoCA （r = 0.296， P = 0.011）， and serum iron was positively correlated with MoCA （r = 0.252， P = 0.033）. （3） Multivariate binary Logistic regression analysis indicated that body mass index （BMI） （OR = 0.794， P < 0.05） and serum GPX4 （OR = 0.917， P < 0.05） were protective factors for the onset of AD. The area under the curve （AUC） for diagnosing AD using serum GPX4 levels was 0.766 （95%CI： 0.656 ~ 0.877）， with a sensitivity of 67.6% and a specificity of 77.1%， and the cut - off value was 44.7 （P < 0.05）. The AUC value for diagnosing AD by combining BMI and GPX4 levels was 0.815 （95%CI： 0.715 ~ 0.914）， with a sensitivity of 81.1% and a specificity of 77.1% （P < 0.05）. Conclusions （1） The expression levels of serum GSH and GPX4 vary between AD patients and the control group. Specifically， these levels are lower in AD patients than in the control group. （2） Serum GPX4 and serum iron are positively correlated with cognitive function. （3） BMI and serum GPX4 are influencing factors of AD， and the prediction model constructed by their combined factors has a certain predictive value for AD.

Objective To explore the association between serum omentin-1 and chemerin levels and the risk of major adverse cardiovascular events （MACE） in elderly patients with coronary heart disease （CHD）. Methods A total of 313 elderly patients with coronary heart disease （CHD） admitted to the Department of Cardiology， Tangshan Workers' Hospital between January 2023 and January 2025 were recruited as study subjects. After excluding 13 patients who were lost to follow-up， 300 patients were ultimately included in the study. The patients were then classified into the major adverse cardiovascular events （MACE） group and the non-MACE group according to the occurrence of MACE. Baseline data， clinical data， and serum levels of omentin-1 and chemerin in the two groups were statistically analyzed. Spearman correlation analysis was employed to investigate the association between serum omentin-1 and chemerin levels and the risk of MACE in elderly CHD patients. LASSO regression and multivariate logistic regression were utilized to identify the risk factors for MACE in elderly CHD patients. Based on the results of multivariate logistic regression analysis， a nomogram prediction model was developed and internally validated using the calibration curve and receiver operating characteristic （ROC） curve. The clinical utility of the model was assessed through decision curve analysis. Results During the follow-up period， 97 patients （32.33%） experienced Major Adverse Cardiovascular Events （MACE） （MACE group）， whereas the remaining 203 patients （67.67%） did not （non-MACE group）. The MACE group exhibited lower serum omentin-1 levels and higher chemerin levels compared to the non-MACE group （P < 0.05）. The results of Spearman correlation analysis indicated that the occurrence of MACE was negatively correlated with the serum omentin-1 level （r = -0.637， P < 0.001） and positively correlated with the serum chemerin level （r = 0.552， P < 0.001） among elderly patients with Coronary Heart Disease （CHD）. Multivariate logistic regression analysis demonstrated that omentin-1 （95%CI： 0.992 ~ 0.997）， chemerin （95%CI： 1.012 ~ 1.058）， Gensini score （95%CI： 1.012 ~ 1.165）， C-reactive protein （CRP） （95%CI： 1.711 ~ 3.627）， and Left Ventricular Ejection Fraction （LVEF） （95%CI： 0.756 ~ 0.895） were influencing factors for MACE in elderly CHD patients （P < 0.05）. ROC curve analysis revealed that the areas under the curve （AUCs） of omentin - 1 and chemerin for predicting MACE in elderly CHD patients were 0.893 （95%CI： 0.852 ~ 0.926） and 0.841 （95%CI： 0.794 ~ 0.880）， respectively. The AUC of the nomogram model constructed based on the results of multivariate logistic regression analysis for predicting MACE in elderly CHD patients was 0.979 （95%CI： 0.956 ~ 0.992）. The calibration curve showed a good agreement between the predicted curve and the ideal curve， suggesting good model calibration. Decision curve analysis indicated that when the risk threshold probability ranged from 0.01 to 0.99， the model could yield better clinical benefits. Conclusions Omentin-1 and chemerin are intricately associated with the occurrence of Major Adverse Cardiovascular Events （MACE） in elderly patients with Coronary Heart Disease （CHD） and possess excellent predictive value. The nomogram model constructed based on indicators such as omentin-1 and chemerin exhibits superior predictive performance and can offer a reference for the clinical assessment of the risk of MACE in elderly patients with CHD.

Objective To explore the value of left ventricular contrast echocardiography and three-dimensional echocardiography Heart Model （3D-HM） parameters in predicting major adverse cardiovascular events （MACE） in patients with coronary heart disease after percutaneous coronary intervention （PCI）. Methods A total of 197 patients with coronary heart disease， diagnosed by coronary angiography and treated with PCI in the Department of Cardiology of the First Hospital of Changsha from June 2023 to December 2024， were selected. Meanwhile， 104 healthy volunteers during the same period were also recruited. The general data， 3D-HM parameters ［left ventricular end-diastolic volume （LVEDV）， left ventricular end-systolic volume （LVESV）， left ventricular ejection fraction （LVEF）］， and myocardial contrast echocardiography （MCE） parameters ［platform peak intensity （A）， curve slope （β）， myocardial blood flow （A × β）， perfusion score index （PSI）］ at the time of admission were compared between the two groups. All patients were followed up for 6 months after PCI. The occurrence of MACE after PCI in patients with coronary heart disease was recorded. Subsequently， the patients were divided into the MACE group （26 cases） and the non-MACE group （171 cases）. The general data， 3D-HM parameters， and MCE parameters before PCI and at 1 week， 3 months， and 6 months after PCI were compared between the two groups of patients. The risk factors for the occurrence of MACE after PCI in patients with coronary heart disease and the predictive value of left ventricular contrast echocardiography and 3D-HM parameters for MACE after PCI in patients with coronary heart disease were evaluated by multivariate logistic regression analysis and receiver operating characteristic curve （ROC）， respectively. Results Compared with healthy volunteers， the left ventricular end-diastolic volume （LVEDV）， left ventricular end-systolic volume （LVESV）， and pressure-strain index （PSI） of patients with coronary heart disease were higher， whereas the left ventricular ejection fraction （LVEF）， A， β， and A × β were lower （P < 0.05）. The proportion of patients with fewer than 4 viable myocardial segments in the major adverse cardiovascular event （MACE） group was higher than that in the non-MACE group （P < 0.05）. When compared with the same group before surgery， in the two groups of patients with coronary heart disease， the LVEDV， LVESV， and PSI at 1 week， 3 months， and 6 months after surgery gradually decreased， reaching the lowest levels at 6 months after surgery. Meanwhile， the LVEF， A， β， and A × β gradually increased， reaching the highest levels at 6 months after surgery （P < 0.05）. Compared with the non-MACE group， the LVEDV， LVESV， and PSI of patients in the MACE group were higher at 1 week， 3 months， and 6 months after surgery， while the LVEF， A， β， and A × β were lower （P < 0.05）. Multivariate analysis indicated that a high level of PSI at 1 week after percutaneous coronary intervention （PCI） （OR = 2.351） was a risk factor for MACE in patients with coronary heart disease after PCI. In contrast， high levels of LVEF （OR = 0.381）， A （OR = 0.500）， β （OR = 0.521）， and A × β （OR = 0.538） at 1 week after PCI were protective factors （P < 0.05）. The results of receiver operating characteristic （ROC） analysis demonstrated that the area under the curve （AUC） of the combination of LVEF， A， β， A × β， and PSI in predicting MACE in patients with coronary heart disease after PCI was 0.891， which was greater than that of LVEF （0.647）， A （0.697）， β （0.676）， A × β （0.681）， or PSI （0.709） （P < 0.05）. Conclusions Left ventricular contrast echocardiography and 3D-HM parameters （LVEF， A， β， A × β， PSI） are strongly associated with the occurrence of major adverse cardiovascular events （MACE） after percutaneous coronary intervention （PCI） in patients with coronary heart disease. The combination of left ventricular contrast echocardiography and 3D-HM parameters exhibits high predictive efficiency for the clinical prognosis of these patients.

Objective To investigate the types and distribution characteristics of common allergens among pediatric patients with allergic rhinitis in Guangzhou. Methods A retrospective analysis was carried out on the clinical data and the results of serum specific IgE （sIgE） tests for inhalant and food allergens of children diagnosed with allergic rhinitis at Yuexiu District Children’s Hospital of Guangzhou between August 2018 and April 2023. The differences in sIgE-positive rates among children were compared based on genders， ages， and residential areas. Results A total of 2197 children diagnosed with allergic rhinitis were incorporated into the analysis. Among inhalant allergens， the top three with the highest sIgE-positive rates were Dermatophagoides pteronyssinus/Dermatophagoides farinae （house dust mites） （47.29%）， dog dander （14.52%）， and cat dander （10.79%）. Among food allergens， the top three with the highest sIgE-positive rates were cow′s milk （3.10%）， egg white/egg yolk （3.05%）， and shrimp （2.46%）. Male patients exhibited a significantly higher sIgE-positive rate for Dermatophagoides pteronyssinus/Dermatophagoides farinae （house dust mites） compared to female patients （P < 0.05）， yet had a significantly lower sIgE-positive rate for dog dander （P < 0.05）. Patients residing in urban areas had significantly higher sIgE- positive rates for Dermatophagoides pteronyssinus/Dermatophagoides farinae （house dust mites）， shrimp， and crab than those in rural areas （P < 0.05）. Conversely， their positive rates for cockroach， Penicillium notatum/Aspergillus fumigatus/Alternaria alternata， ragweed， cat dander， dog dander， and plane tree pollen were all significantly lower than those of rural patients （P < 0.05）. As age increased， the sIgE-positive rate for Dermatophagoides pteronyssinus/Dermatophagoides farinae （house dust mites） gradually rose （P < 0.05）， while the positive rates for Penicillium notatum/Aspergillus fumigatus/Alternaria alternata and various food allergens declined （P < 0.05）. Conclusions Among pediatric patients with allergic rhinitis in Guangzhou， the predominant inhalant allergen is the house dust mite， and the primary food allergen is cow′s milk. The number of patients affected by inhalant allergens is greater than that of those affected by food allergens. Moreover， the distribution of allergens differs among patients of different ages， genders， and residential areas.

Objective To observe the anesthetic effect of remimazolam combined with propofol in ultrasound-guided oocyte retrieval surgery. Methods A total of 145 patients who underwent elective transvaginal ultrasound-guided oocyte retrieval from July 2024 to January 2025 were selected. They were randomly divided into three groups according to the random number table method： the propofol group （Group P）， the 0.05 mg/kg remimazolam combined with 0.1 mg/kg （Group PR₁）， and the 0.1 mg/kg remimazolam combined with propofol group （Group PR₂）. All groups were intravenously infused with sufentanil at 0.1 μg/kg at first. Group PR₁ was intravenously infused with remimazolam at 0.05 mg/kg and propofol at 1 to 3 mg/kg； Group PR₂ was intravenously infused with remimazolam at 0.1 mg/kg and propofol at 1 to 3 mg/kg； Group P was intravenously infused with an equal volume of 0.9% saline and propofol at 1 to 3 mg/kg. The vital signs of the patients in the three groups were recorded at before anesthesia induction （T₀）， after successful induction （T₁）， during puncture （T₂）， 5 minutes after the start of the operation （T₃）， at the time of awakening （T₄）， and 10 minutes after awakening （T₅）. The dosage of propofol， the success rate of sedation， the MOAA/S score at 1 minute after surgery， and the time required for the PADSS score to reach ≥ 9 were recorded. The occurrence of adverse reactions （respiratory depression， hypotension， bradycardia， nausea and vomiting， hiccups） was also recorded. Results Compared with group P， group PR1 and group PR₂ had higher heart rate and blood pressure at T1 （both P < 0.05）. Compared with group P and group PR₁， group PR₂ had lower heart rate and blood pressure at T₂ （both P < 0.05）. Compared with group P， both group PR1 and group PR₂ had lower heart rate and blood pressure at T₃ （both P < 0.05）， with no statistically significant difference in SPO₂ at each time point among the three groups （P > 0.05）. Compared with group P， the propofol dosage in groups PR₁ and PR₂ was reduced （both P < 0.05）， with a higher sedative success rate （both P < 0.05）， and higher MOAA/S scores at 1 minute post-operation （both P < 0.05）； the time required for PADSS scores to reach ≥ 9 was shorter （both P < 0.05）. Compared with group PR₁， group PR₂ used even less propofol （P < 0.05） and had a higher sedative success rate （P < 0.05）. Compared with group P， the incidence of respiratory depression and hypotension was lower in both groups PR₁ and PR₂ （both P < 0.05）. There was no statistically significant difference in the incidence of nausea， vomiting， and hiccups among the three groups （P > 0.05）. Conclusion 0.1 mg/mL of remimazolam combined with propofol has a good anesthetic effect in oocyte retrieval procedures and is worthy of clinical promotion and application.

Objective To investigate the postoperative analgesic efficacy of ultrasound-guided infraspinatus-teres minor interfascial block （ITMIB） in patients who undergo arthroscopic shoulder surgery and to evaluate its impact on diaphragmatic function， motor recovery， and adverse effects. Methods Eighty patients who underwent arthroscopic rotator cuff repair at Zhongshan Hospital of Traditional Chinese Medicine between May 2024 and February 2025 were randomly allocated into the infraspinatus-teres minor interfuscial block group （Group A， n = 40） and the interscalene brachial plexus block group （Group B， n = 40）. Both groups received ultrasound-guided nerve block using 20 mL of 0.375% ropivacaine in combination with general anesthesia. A comparison was made between the two groups regarding resting VAS scores at various postoperative time points， the incidence of diaphragmatic paralysis， the recovery of sensory and motor function in the affected limb， and adverse reactions. Results Four cases in Group A were excluded from the analysis because of insufficient block efficacy， resulting in 36 cases in Group A and 40 cases in Group B available for analysis. There were no significant differences in static Visual Analog Scale （VAS） scores at 6 h， 12 h， and 24 h post-operatively （P > 0.05）. Nevertheless， Group A exhibited higher VAS scores in the Post-Anesthesia Care Unit （PACU） and at 2 h post-operatively compared with Group B （P < 0.05）. Moreover， Group A required a greater amount of flurbiprofen axetil within the first 2 h （P < 0.05）. At T1 （post-block assessment）， the incidence of hemidiaphragmatic paralysis was significantly lower in Group A （0%） than in Group B （90%） （P < 0.05）， and the degree of limb numbness was milder in Group A （P < 0.05）. Additionally， the forearm muscle strength was higher in Group A at T5 and T7 （P < 0.05）. The incidence of paresthesia during block placement was lower in Group A （P < 0.05）. Conclusions For patients undergoing arthroscopic shoulder surgery， ITMIB offers marginally less effective analgesia during the early postoperative period； however， it attains comparable pain relief thereafter. Moreover， it prevents diaphragmatic paralysis， promotes the early restoration of motor function in the affected limb， and does not elevate the risk of adverse reactions. These characteristics render it especially appropriate for patients with respiratory comorbidities.

Objective To investigate the expression levels of urinary ACE2 and PAX2 proteins in children with congenital anomalies of the kidney and urinary tract （CAKUT） and their association with acute kidney injury （AKI）， and to assess the diagnostic value of these proteins as biomarkers for early renal injury in CAKUT. Methods A total of 266 children aged 1 ~ 18 years with CAKUT were enrolled. They were divided into the CAKUT with AKI group （n = 68） and the CAKUT without AKI group （n = 198） in accordance with the Kidney Disease： Improving Global Outcomes （KDIGO） criteria， along with a matched healthy control group （n = 45）. The levels of angiotensin-converting enzyme 2 （ACE2） and paired box 2 （PAX2） in morning urine were measured by means of enzyme-linked immunosorbent assay （ELISA）. Statistical analysis was carried out in combination with renal function indicators such as serum creatinine and estimated glomerular filtration rate （eGFR）. The diagnostic efficacy was assessed via receiver operating characteristic （ROC） curve analysis， and the correlation between the markers and eGFR was investigated using Pearson correlation analysis. Results The levels of urinary ACE2 and PAX2 in the CAKUT-AKI group were significantly higher compared to those in the non - AKI group and the healthy group， and they exhibited a stepwise increase as the AKI stages progressed （P < 0.01）. There was no statistically significant difference between the non - AKI group and the healthy group （P > 0.05）. Both ACE2 and PAX2 demonstrated strong negative correlations with eGFR （r = -0.72， P < 0.01； r = -0.805， P < 0.01）. The area under the curve （AUC） for ACE2 alone in diagnosis was 0.917 （cut-off value 177.8 ng/mg Cr， sensitivity 80.9%， specificity 86.4%）； the AUC for PAX2 alone in diagnosis was 0.853 （cut-off value 11.1 pg/mg Cr， sensitivity 80.3%， specificity 76.1%）； the combined testing AUC increased to 0.956 （sensitivity 88.2%， specificity 87.9%）， which was significantly superior to single indicators （P < 0.01）. Conclusion Urinary ACE2 and PAX2 can be utilized to aid in the diagnosis of CAKUT complicated by acute kidney injury， demonstrating favorable diagnostic efficacy.

Objective To investigate the impact of angiography-guided puncture on the initial success rates of arteriovenous fistula （AVF） punctures in hemodialysis patients and provide clinical evidence to enhance surgical outcomes. Methods A total of 98 hemodialysis patients who underwent AVF puncture at our hospital from September 2024 to August 2025 were randomly divided into the control group and the experimental group （49 cases in each group） using the randomized digital table method. The control group received conventional puncture techniques combined with health education， whereas the experimental group underwent angiography-guided puncture. A comparative analysis was carried out on the single-puncture success rates， complication incidence， pain scores， and dialysis adequacy between the two groups. Results The experimental group attained a single-puncture success rate of 95.92%， which was significantly higher than the 79.59% success rate of the control group （P < 0.05）. The total complication rate （including hematoma， oozing， and infection） in the experimental group was 10.20%， notably lower than the 30.61% rate of the control group （P < 0.05）. The average visual analog scores （VAS） in the experimental group were （2.1 ± 0.8） points， significantly lower than the （3.8 ± 1.2） points of the control group （P < 0.05）. The urea clearance index （Kt/V） in the experimental group reached （1.45 ± 0.15）， considerably higher than the （1.32 ± 0.18） index of the control group （P < 0.05）. Conclusion Angiography-guided puncture exhibits remarkable advantages in enhancing the initial success rates of AVF puncture， minimizing complications， relieving patient pain， and improving dialysis adequacy， rendering it suitable for extensive clinical application.

Objective To analyze the predictive value of yolk sac size morphology and inner diameter changes in early pregnancy on early abortion. Methods A total of 120 pregnant women with early pregnancy admitted to the hospital from January 2023 to December 2024 were selected as research subjects （118 cases were finally included and 2 cases were lost to follow-up）. According to the pregnancy outcomes， they were divided into normal pregnancy group （n = 82） and early abortion group （n = 36）. Baseline data and yolk sac parameters were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the risk factors affecting early abortion， and ROC curve was used to evaluate the predictive value of yolk sac size morphology and inner diameter changes in early pregnancy on early abortion. Results The proportion of age ≥ 35 years old in early abortion group was significantly higher than that in the normal pregnancy group （P < 0.05）. The yolk sac diameter of each gestational week in early abortion group was significantly larger than that in normal pregnancy group （P < 0.05）. The proportion of yolk sac deletion， proportion of abnormal yolk sac diameter and proportion of abnormal yolk sac morphology were significantly higher in early abortion group than those in normal pregnancy group （P < 0.05）. Multivariate Logistic regression analysis showed that age ≥ 35 years old （OR = 1.664， 95%CI： 1.272 ~ 2.176）， yolk sac deletion （OR = 23.927， 95% CI： 9.561 ~ 59.876）， abnormal yolk sac diameter （OR = 30.114， 95%CI： 13.092 ~ 69.269） and abnormal yolk sac morphology （OR = 16.844， 95% CI： 6.359 ~ 44.617） were risk factors for early abortion. ROC curve analysis showed that the abnormal yolk sac morphology had the highest value on predicting early abortion （AUC = 0.862）， followed by abnormal yolk sac diameter （AUC = 0.669） and yolk sac deletion （AUC = 0.611）. Conclusion The abnormal morphology of yolk sac in early pregnancy can be used as an important indicator to predict early abortion and provide scientific basis for early intervention.

Objective To investigate the effect of the frequency of Foley balloon placement after hysteroscopic transcervical resection of adhesion （TCRA） on re-adhesion in patients with severe intrauterine adhesions （IUA）. Methods The clinical data of 128 patients with severe IUA who underwent TCRA at the hospital from January 2022 to January 2025 were reviewed. According to the number of Foley balloon insertions after surgery， they were divided into a control group （single insertion， n = 68） and an observation group （two insertions， n = 60）. The clinical efficacy， IUA scores before and after treatment， menstrual changes， postoperative re-adhesion， and pregnancy status were compared between the two groups. Results The total effective rate reached 90.00% （54/60） in the observation group， which was higher than 76.47% （52/68） in the control group （P < 0.05）. After treatment， the American Fertility Society （AFS） Score of the observation group （3.12 ± 1.06） was lower than that of the control group （4.35 ± 1.21）. The improvement value of IUA score （6.70 ± 1.57） was higher than that of the control group （5.26 ± 1.62） （P < 0.05）. After treatment， menstrual blood volume of the observation group ［（40.22 ± 3.91） mL］ was larger than that of the control group ［（37.39 ± 4.10） mL］， and menstrual period ［（5.06 ± 1.12） d］ was longer than that of the control group ［（4.41 ± 1.20） d］ （P < 0.05）. There was a statistically significant difference in the incidence of re-adhesion between the two groups （15.00% vs. 32.35%， P > 0.05）. Conclusion The placement of Foley balloons twice after TCRA surgery in patients with severe IUA can effectively alleviate the degree of IUA， increase menstrual flow， improve menstruation， and reduce the risk of re adhesion. It is worthy of clinical research.

Ischemia/reperfusion injury （IRI） is the cause of various pathological injuries such as ischemic stroke， acute coronary syndrome， and acute lung injury. Mesenchymal stem cells （MSCs） are adult stem cells with the ability to self-renew and differentiate into multiple lineages， and adipose derived mesenchymal stem cells（ADMSCs） have similar functions. The treatment methods of adipose derived mesenchymal stem cells mainly include transplantation and injection of adipose derived mesenchymal stem cells or their secreted exosomes， which can inhibit inflammatory response， resist oxidative stress， promote tissue repair and regeneration， and regulate immune response. They have the potential to be used as a treatment and improve the prognosis of ischemia-reperfusion injury. Therefore， this article focuses on the research progress of the protective effects of adipose derived mesenchymal stem cells in organs such as the heart， brain， lungs， liver， and kidneys.