In recent years，significant progress has been made in diabetes research both domestically and internationally，new diagnosis and treatment techniques and methods have been constantly emerging，and clinical research evidence has been continuously accumulated and updated. To keep pace with these important developments，the Diabetes Branch of the Chinese Medical Association has actively organized experts to update the China Guidelines for the Prevention and Treatment of Diabetes. This update aims to provide a more comprehensive and scientific guide for diabetes prevention and treatment，greatly promote the standardized and integrated management of diabetes by clinicians，and ensure that patients receive standardized and personalized treatment plans to improve therapeutic outcomes and quality of life.

Over the years，the American Diabetes Association（ADA） has been actively committed to the development and promotion of standards for the diagnosis，treatment，and daily care of diabetes. Since 1989，it has updated the diabetes diagnosis and treatment standards every year，which have become one of the most authoritative guidelines in diabetes and have been recognized and adopted by various countries. On December 10，2024，the 2025 Standards of Care in Diabetes were released，incorporating the latest evidence-based medicine content related to diabetes and its complications and comorbidities. It aims to provide guidance on the diagnosis，treatment，and management of the condition for clinicians，patients and their families，and researchers. This article interprets the major updates from the Standards.

Osteoporotic vertebral compression fractures（OVCFs） are common orthopedic conditions that can lead to spinal pain and deformity，which greatly affects the quality of life of patients. Currently，there are various treatment methods for OVCFs，but there is still a lack of standards for optimal treatment modalities. Therefore，this article introduces the current treatment methods and characteristics of epidemiology for OVCFs，in order to improve the awareness of this disease among clinicians and provide a reference for selecting more appropriate treatment regimens. Conservative treatment measures，such as bracing and analgesia，are the basic treatment measures for OVCFs，and anti-osteoporosis drugs play a crucial role in management. Minimally invasive procedures，including percutaneous vertebroplasty and percutaneous balloon kyphoplasty，remain the primary surgical interventions，and traditional open surgeries are also an important part of treatment，such as anterior spinal fusion，combined anterior and posterior spinal fusion，posterior spinal fusion with three-column osteotomy，and posterior spinal fusion with vertebroplasty. Furthermore，surgeons should focus on the accumulation of related surgical techniques and skills during surgery to effectively address the challenges and complications associated with surgical interventions. Finally，scientific and appropriate treatment methods should be selected for patients，in order to improve long-term treatment outcomes and increase the degree of satisfaction among patients.

Objective To investigate the flow cytometry cell sorting regimen for M1 macrophages and the association between M1 macrophage polarization and nonalcoholic fatty liver disease（NAFLD）. Methods High-fat diet（HFD） was used to establish a mouse model of NAFLD. Twelve C57BL/6 mice were randomly divided into control group（normal diet） and HFD group using a random number table and were fed for 24 weeks. Metabolic markers including blood glucose and blood lipids were measured；quantitative real-time PCR was used to measure the factors associated with M1 macrophages in mice；HE staining was used to observe liver pathology. The Percoll gradient centrifugation method was used to collect liver Kupffer cells，and flow cytometry was used to measure M1 macrophages in mouse liver（sorting regimen：FSC-A/SSC-A for grouping and removing red blood cells and impurities in the liver；FITC CD45（+）/PE-cy7 CD11c^low for grouping leukocytes；APC CD115（+）/Percp cy5.5 CD11b^high for the screening of monocytes；Apc-cy7 F4/80^low/PE Ly-6C^high for separating M1 macrophages）. Results Compared with the control group at week 24，the HFD group had significant increases in the indicators of body weight [（28.35±1.71） g vs. （38.43±4.41） g，P<0.001），liver weight [（1.03±0.18） g vs. （1.85±0.41） g，P=0.003），fasting blood glucose [（10.23±1.58） mmol/L vs. （7.07±0.58） mmol/L，P˂0.001）]，insulin [（18.62±3.84） pg/mL vs. （28.84±8.3） pg/mL，P˂0.001）]，triglyceride [（2.97±0.67） mmol/L vs. （4.05±0.99） mmol/L，P=0.01）]，cholesterol[（0.23±0.06） mmol/L vs. （0.55±0.17） mmol/L，P<0.001）]，alanine aminotransferase [5.67（3.16，9.23） U/L vs. 35.86（19.68，58.33） U/L，P=0.003]，and aspartate aminotransferase [53.14（38.18，64.40） U/L vs. 155.10 （113.60，192.20） U/L，P<0.001]，and there was a significant increase in M1 macrophage polarization in NAFLD mice [42.00%（26.50，45.50） vs. 9.95%（3.1，12），P=0.003]. There were significant increases in the mRNA levels of IL-β，IL-6，F4/80，and TNF-α in the liver of mice induced by HFD. Conclusion The flow cytometry sorting regimen can be used to measure M1 macrophages in the liver. Significant aggravation of inflammatory response is observed in NAFLD，and M1 macrophage polarization is positively correlated with the onset of NAFLD.

Thyroid-associated ophthalmopathy（TAO） is a progressive eye disease characterized by immune-mediated inflammation of the extraocular muscles and orbital connective tissue. TAO tends to have complex and diverse symptoms and signs， with the features of diversity and concealment， which seriously affect the quality of life of patients. The pathogenesis of TAO is closely associated with thyroid autoimmunity. This article reviews the pathogenesis， clinical features， and treatment of TAO.

Pyroptosis is a proinflammatory form of regulated cell death that can lead to the activation of inactive cytokines and the cleavage of gasdermin D in cells. The main pathological outcome of inflammatory bladder disease is the loss of bladder compliance，and cell pyroptosis plays an important role in this process. Some studies have shown that cell pyroptosis is regulated by various mechanisms such as DNA methylation and mitochondrial DNA oxidative damage，which intervene in the biological behavior of bladder urothelial cells in interstitial cystitis and induce impairment of bladder compliance. Therefore，this article reviews the regulatory mechanisms of cell pyroptosis in interstitial cystitis and the potential role of pyroptosis in inflammatory bladder diseases，in order to explore potential diagnostic biomarkers for interstitial cystitis and facilitate the prevention and treatment of interstitial cystitis.

Amino acids are essential nutrients for the survival of all cells in the body，and their metabolic processes are closely associated with tumor development and progression. The metabolic changes of the essential amino acid tryptophan have a significance impact on tumor microenvironment. Tryptophan is mainly metabolized to kynurenine （KYN） by indoleamine 2，3-dioxygenase and tryptophan 2，3-dioxygenase，and the accumulation of KYN and the deficiency of tryptophan cause alterations in the immune status in tumor microenvironment，which in turn affects tumor development and progression. Based on the current studies on tryptophan，this article systematically discusses the influence of abnormal tryptophan metabolism on tumors and the interventions targeting this pathway，in order to provide a reference for subsequent tumor therapy.

Alzheimer’s disease（AD） is a neurodegenerative disease with highly heterogeneous pathological and clinical manifestations，and it is the most common cause of dementia. This heterogeneity poses challenges for diagnosis，treatment，and evaluating novel pharmacological efficacy. This review summarizes the latest progress in the major clinical subtypes of AD based on clinical manifestations，genetic，and pathological features. Early-onset and late-onset AD clinical subtypes may share the same symptoms but differ in etiology，age of onset，mode of presentation，disease progression，and associated comorbidities. Typical and atypical AD differ significantly in clinical manifestations，pathological features，and diagnostic criteria. Research on AD subtypes based on imaging and omics data has also made considerable progress. This review also outlines the molecular pathological heterogeneity of AD. A deep understanding of these heterogeneities is crucial for diagnosis，the formulation of pharmacological treatment strategies，and clinical management.

As the population ages，the incidence of diabetes continues to climb. Diabetic peripheral neuropathy （DPN） occurs in about half of diabetic patients. DPN is characterized by the loss of peripheral nerve function from distal to proximal，with the main symptom of diffuse and persistent spontaneous intractable pain，which is one of the most common chronic complications of diabetes. DPN has a high mortality rate and poor prognosis，and the pathogenesis is not fully clear. The current focus of clinical treatment for DPN is to alleviate the clinical symptoms，as well as to control blood glucose and reduce the risk of adverse cardiovascular events. This study investigated the pathogenesis，diagnosis，and treatment of DPN and summarized the latest research progress to provide new ideas for clinical diagnosis and treatment of DPN.

Objective To investigate the influencing factors for dysphagia in the elderly，to construct a predictive model for dysphagia，and to provide a theoretical basis for clinical practice. Methods In this case-control study，the patients with dysphagia who attended Department of Geriatrics in the first affiliated hospital of Chongqing Medical University from March 2016 to June 2023 were enrolled as case group，and the patients without dysphagia who attended the same department during the same period of time were enrolled as control group. The correlation analysis，least absolute shrinkage and selection operator（LASSO） regression，and multivariate logistic regression analysis were used to investigate the influencing factors for dysphagia；the 10-fold cross-validation Extreme Gradient Boosting（XGBoost） model was used to predict dysphagia，and the SHapley additive exPlanations（SHAP） method was used for model visualization. Results There were 1009 cases in the case group and 2125 cases in the control group. The correlation analysis and LASSO regression analysis identified 12 factors for the multivariate logistic regression analysis，and the results showed that sarcopenia，increasing age，children or caretakers as caregivers，frail health，poor oral health，poor self-care ability，depression，and cognitive impairment were risk factors for dysphagia（odds ratio［OR］>1，P<0.05），and female sex and participation in community activities were protective factors against dysphagia（OR<1，P<0.05）. The XGBoost model had a good predictive efficacy，with an accuracy rate of 0.795，a precision rate of 0.711，a sensitivity of 0.613，a specificity of 0.881，an F1 value of 0.661，and an area under the ROC curve of 0.855. The SHAP plot showed that the top five important characteristics were caregiver，oral score，frail health condition，activities of daily living，and cognitive function. Conclusion There are various influencing factors for dysphagia in the elderly，and the elderly patients with poor oral health，frailty，dependence on others for daily life，and cognitive impairment should be taken seriously in clinical practice. The XGBoost model has a good performance in predicting dysphagia in the elderly，which can provide a reference for clinical practice.

Objective To construct a mouse model of house dust mite（HDM）-induced allergic asthma with cognitive impairment. Methods C57 BL/6 mice aged 6-8 weeks were used as the study subjects. HDMs were used intranasally to induce allergic asthma in mice（HDM group）. Simultaneously，a normal saline control group（NS group） and a blank control group（CN group） were established. At week 2 and month 1 of model construction，cognitive ability was tested using Barnes maze；pulmonary function was determined by nebulization with acetyl-β-methylcholine chloride solution，and pathological changes in lung and brain tissues were evaluated using hematoxylin-eosin staining，immunohistochemistry，and Western blotting. Results At week 2，there were no significant differences in the enhanced pause（Penh），inflammatory cell infiltration around the bronchi，time and frequency of mice finding escape boxes，and changes in mature neuronal marker neuronal nuclei antigen（NeuN） and synaptophysin in the brain in the HDM group compared with the CN and NS groups；no neuroinflammation occurred in the brain. At month 1，compared with the CN and NS groups，the HDM group showed a significant increase in Penh and a large amount of inflammatory cell infiltration around the bronchi；the time of mice finding escape boxes significantly increased（F=19.600，P<0.001），and the frequency significantly decreased（F=10.150，P=0.002）；the NeuN-positive area in the hippocampus of mice significantly decreased（F=6.449，P=0.012），and synaptophysin was significantly reduced（F=16.200，P=0.004）；activation of microglial cells and neuroinflammation occurred. Conclusion This study successfully constructed a mouse model of HDM-induced allergic asthma with cognitive impairment，providing a good animal model for exploring the mechanism of cognitive impairment caused by allergic asthma and drug intervention research.

Objective To investigate the feasibility of improving quality of life through outcome self-reporting and clinical intervention based on the Ureteral Stent Symptom Questionnaire（USSQ） for patients with upper tract urolithiasis. Methods We enrolled 106 patients with upper urinary tract calculi from June 2023 to June 2024 who underwent ureteral stent placement at The First Affiliated Hospital of Chongqing Medical University. We applied the USSQ to monitor the patients’ outcomes through their self-reports，and used the data to inform clinical interventions. The feasibility of this USSQ-based approach for improving patients’ quality of life was evaluated. Results The main symptoms after ureteral stent placement were pain and hematuria，while frequency，urgency，fever，and sexual problems were less common. The USSQ score was highest on the third day after operation，and thereafter declined in all the dimensions. except the additional problem. After intervention，the total USSQ score （57.5±10.1 vs. 51.6±8.9，t=2.981，P=0.004） and urinary symptom score （30.8±5.3 vs. 26.7±5.6，t=3.478，P<0.001） were significantly decreased. USSQ-based outcome self-reporting and clinical intervention could reduce symptom scores and improve patients’ quality of life. Conclusion USSQ-based outcome monitoring and management are feasible and effective for improving the quality of life of patients with upper tract urolithiasis.

Objective To investigate the role of heat shock transcription factor 1（HSF1） in hepatitis B virus X protein（HBx）-driven migration and invasion of hepatocellular carcinoma（HCC） cells，and to preliminarily explore the mechanism of HSF1 mediating HBx-driven HCC progression. Methods 4D label-free quantitative proteomics and Western blot were used to analyze the effect of HBx on HSF1 expression. HBx was overexpressed in the HCC cell lines Huh7 and MHCC97H，and its impact on the mRNA and protein levels and stability of HSF1 was assessed by RT-PCR and Western blot. The Cancer Genome Atlas database was used to analyze the expression of HSF1 in hepatitis B virus（HBV）-associated HCC tissues and its relationship with tumor stage/grade and patient prognosis，and Western blot was used to measure the expression of HSF1 in HBV-associated HCC tissues. HBx was overexpressed in HCC cells，followed by HSF1 knockdown or cell treatment with the HSF1 inhibitor KRIBB11，and Transwell migration and invasion assay，scratch assay，and F-actin staining experiment were performed to analyze the role of HSF1 in HBx-driven HCC cell migration and invasion. GEO and HCMDB datasets were used to identify the downstream target of HSF1，and the role of downstream target c-Myb in HSF1-mediated HBx-driven HCC progression. Results HBx upregulated HSF1 protein levels without significantly affecting its mRNA expression，through enhancing HSF1 protein stability. HSF1 was highly expressed in HBV-associated HCC tissues，and its elevated expression correlated with tumor stage/grade and poor prognosis. HBx overexpression significantly promoted the migration，invasion，wound-healing capacity，and pseudopodia formation capacity of Huh7 and MHCC97H cells，while HSF1 knockdown or KRIBB11 treatment significantly attenuated the HBx-driven migration and invasion of HCC. HSF1 promoted the expression of the metastasis-associated protein c-Myb，and c-Myb overexpression in HSF1-knockdown HCC cells restored the promotive effect of HBx on HCC cell migration and invasion. Conclusion HBx enhances HSF1 protein stability to promote its expression. Upregulation of c-Myb by HSF1 plays a pivotal role in HBx-driven HCC cell migration and invasion. Targeting HSF1 may help to delay the progression of HBV-associated HCC.

Objective To investigate the association between albumin-corrected anion gap（ACAG） and short- to long-term death outcomes in patients with acute pancreatitis（AP）. Methods This retrospective study was based on the Medical Information Mart for Intensive Care-IV database，and the adult patients who were diagnosed with AP and were admitted to the intensive care unit were enrolled in this study. Cox regression risk analysis，receiver operating characteristic（ROC） curve analysis，Kaplan-Meier survival curve analysis，restricted cubic spline，and subgroup analysis were used to investigate the value of ACAG in predicting the death outcome of AP patients. Results A total of 444 patients were enrolled in this study，and according to the death status of the patients on day 28 after admission，the patients were divided into survival group with 412 patients and death group with 32 patients，with a mortality rate of 7.2% on day 28 after admission. The multivariate Cox regression analysis showed that ACAG was an independent predictive factor for all-cause mortality rate on day 28 after admission in AP patients（hazard ratio［HR］=1.18，95%CI=1.05-1.32），while it was not an independent predictive factor for death outcome on days 90（HR=1.05，95%CI=0.97-1.14） and 180（HR=1.01，95%CI=0.94-1.09） and at 1 year（HR=1.02，95%CI=0.95-1.10）. The ROC curve analysis showed that ACAG had an area under the ROC curve（AUC） of 0.732（95%CI=0.632-0.832） in predicting 28-day death outcome，which was better than that of AG（AUC=0.665，95%CI=0.550-0.781） and serum albumin（Alb）（AUC=0.655，95%CI=0.550-0.761） and was similar to that of Sequential Organ Failure Assessment（SOFA） score（AUC=0.745，95%CI=0.651-0.838）. The ROC curve showed that the optimal cut-off value of ACAG was 21.375. Based on the cut-off value of ACAG of 21.375，the patients were divided into high-value group and normal-value group，and the Kaplan-Meier curve analysis showed that the patients with a high level of ACAG had a significantly higher mortality rate than those with normal ACAG（P<0.001）. The subgroup analysis showed that the results were stable. Conclusion ACAG can be used as an independent predictive factor for all-cause mortality rate on day 28 after admission in AP patients，with a better efficacy than AG and Alb and a similar efficacy to SOFA. However，it is not significantly associated with 90-day，180-day，and 1-year death outcomes in AP patients.

Endometrial cancer（EC） is one of the common malignant tumors of the female reproductive system，and the conventional treatment methods including surgery and radiochemotherapy have a limited therapeutic effect. CD8⁺ T cells are the main effector cells in tumor microenvironment（TME） and are also the main target cells for immunotherapy that have emerged in recent years. This article briefly elaborates on the cytotoxic effect of CD8⁺T cells in TME through the three pathways of the perforin-granzyme pathway，the FAS pathway，and the secretion of cytokines，and the changes in the peripheral environment of patients with EC may affect the functions of CD8⁺ T cells. This article also summarizes the application of CD8⁺ T cells as the targets for EC treatment，in order to provide new ideas for clinical treatment.

Objective To investigate the carriage of the thalassemia gene in sperm donors in Chongqing，China by analyzing the thalassemia screening and gene mutation types of sperm donors in Chongqing Human Sperm Bank（CHSB），and to provide a reference for thalassemia screening in sperm donors in Chongqing. Methods Blood samples were collected from 488 sperm donors in CHSB（donors with all tests qualified during the quarantine） from December 2021 to August 2024. A complete blood count analysis was performed to measure the mean corpuscular volume（MCV） and mean corpuscular hemoglobin（MCH）. Polymerase chain reaction（PCR）/agarose gel electrophoresis was used to detect deletional α-thalassemia mutations. PCR and DNA reverse dot blot hybridization were used to detect 3 common non-deletional α-thalassemia mutations and 17 common β-thalassemia mutations. The test results were then analyzed. Results Among the 488 sperm donors aged 25.64±4.95 years，15（3.07%，all Han nationality） tested positive for thalassemia. This carriage rate was lower than that of the thalassemia population in Chongqing（9.24%）. Among the 15 thalassemia carriers，13 had deletional α-gene mutations（-α3.7 genotype in 11 cases［73.33%］， -α4.2 genotype in 1 case［6.67%］，and -SEA genotype in 1 case ［6.67%］），and 2 had non-deletional α-gene mutations（both with the WSM heterozygous mutation）. There was only 1 case of abnormal MCV and MCH2 indicators among thalassemia carriers（screening positive rate was 6.67%）. Conclusion Thalassemia screening in sperm donors in CHSB reveals a low thalassemia carriage rate，reflecting geographic （predominantly Sichuan and Chongqing origins） and demographic （healthy men of childbearing potential） characteristics. Given the significant impact of thalassemia on the offspring conceived through sperm donation，it is recommended to conduct thalassemia gene screening among sperm donors in human sperm banks.

Objective To investigate the safety and feasibility of one-stage flexible ureteroscopic lithotripsy without ureteral access sheath or ureteral stent in the treatment of upper ureteral calculi and renal calculi with a long diameter of ≤10 mm. Methods A total of 70 patients with upper ureteral calculi or renal calculi with a long diameter of ≤10 mm who were admitted to Guang’an Hospital，West China Hospital of Sichuan University，from January 2023 to June 2024 were enrolled and randomly divided into experimental group （without ureteral access sheath or ureteral stent） and control group （with ureteral access sheath and ureteral stent），with 35 patients in each group. The patients in the experimental group did not use a ureteral access sheath or a ureteral stent，while those in the control group used the ureteral access sheath and the ureteral stent. The two groups were compared in terms of preoperative data，intraoperative complications，stone clearance rate，length of hospital stay，hospital costs，and postoperative complications. Results There were no significant differences between the two groups in preoperative data such as age，body mass index，sex，previous history of stone surgery，affected side，maximum stone diameter，C-reactive protein，aggregation system separation，preoperative CT value of stones，and stone location. The experimental group had a significantly shorter time of operation than the control group［（44.94±52.60） minutes vs. （52.60±14.22） minutes，t=2.240，P=0.030］. There were no significant differences between the two groups in intraoperative data such as ureteral injury，intraoperative leukocyte changes，and intraoperative blood loss. The experimental group had significantly lower hospital costs than the control group［（8041.89±1287.57） yuan vs. （13 011.63±1 780.21） yuan，t=13.450，P=0.000］. There were no significant differences between the experimental group and the control group in the postoperative data such as the length of hospital stay，the recurrence of calculi on CT at 1 and 3 months after surgery，stone clearance rate，postoperative urinary tract irritation，postoperative ureteral injury，postoperative hematuria，and postoperative hydronephrosis（P>0.05）. Conclusion One-stage flexible ureteroscopic lithotripsy without ureteral access sheath or ureteral stent is safe and feasible in the treatment of upper ureteral calculi and renal calculi with a long diameter of ≤10 mm and can effectively reduce hospital costs and time of operation.

Lidocaine，as an amide local anesthetic，is widely used in cancer patients in the perioperative period. This article summarizes the effect of lidocaine on cell proliferation，invasion，and metastasis of common tumors in clinical practice based on both basic and clinical studies，including breast cancer，gastric cancer，colon cancer，and lung cancer，and it also reviews the clinical application of lidocaine in the perioperative treatment of patients with these four types of cancer. It is necessary to explore the mechanism of action of lidocaine in various types of cancer，develop individualized administration regimens based on the treatment characteristics of different tumors，and optimize perioperative treatment strategies for cancer patients through novel formulations，which may provide a theoretical basis for lidocaine in assisting tumor therapy in the perioperative period.

Objective To investigate the application effect of a novel zipper device in wound healing after incision and drainage of cutaneous abscesses in children，and to explore its optimal intervention timing. Methods A total of 50 children who attended the outpatient service of Department of Pediatric surgery from September 2023 to September 2024 were enrolled and divided into two groups according to the parity of the date of visit. The 26 children with the odd date of visit were enrolled as experimental group，and the 24 children with the even date of visit were enrolled as control group. The same anti-infective dressings were used for wound dressing in both groups after incision and drainage，and when there was a significant reduction in wound exudate and the fresh granulation tissue emerged at wound base，the zipper device was used for the children in the experimental group，and dressing change was performed for the children in the control group until the wound was completely healed. The two groups were compared in terms of wound healing time，healing rate，and the total costs of dressing change，and the multiple linear regression model and the restricted cubic spline （RCS） model were used to analyze the association between the intervention time of the zipper device and wound healing time. Results Compared with the control group，the experimental group had a significantly shorter wound healing time，a significantly higher wound healing rate，and significantly lower total costs of dressing change（P<0.001）. The multiple linear regression model showed that the infection size of skin abscess and the intervention time of the zipper device were strongly associated with wound healing time （P<0.05）. After adjustment for infection size，the RCS model analysis showed a significant linear dose-response relationship between intervention time and wound healing time （P_nonlinear=0.406），and wound healing time shortened with the reduction in intervention time （P<0.001）. Conclusion The application of the novel zipper device can help with the healing of cutaneous abscesses in children，and it is recommended to apply the device as early as possible after control of wound infection，in order to promote early wound healing.

Objective To compare the efficacy of various machine learning models in predicting renal function decline after robot-assisted partial nephrectomy（RAPN），and to provide evidence for clinical risk stratification. Methods This study retrospectively included the clinical data of 733 patients with renal cell carcinoma undergoing RAPN at the Urology Department of The First Affiliated Hospital of Chongqing Medical University from January 2019 to December 2023. Demographic characteristics，laboratory indicators，and perioperative parameters were integrated to construct seven machine learning models. Key predictors were interpreted using Shapley additive explanations（SHAP）. Model performance was evaluated using the area under the receiver operating characteristic curve （AUC）. Results The random forest model demonstrated the best predictive performance（AUC=0.84）. SHAP analysis identified neutrophil-to-lymphocyte ratio，tumor diameter，the international normalized ratio of prothrombin time，white blood cell count，and intraoperative blood loss as significant factors influencing postoperative renal function decline. Conclusion This study provides a potential predictive tool for clinical practice，aiding in identifying high-risk patients and optimizing postoperative management strategies.

Objective To investigate the phenomenon of hippocampal ferroptosis and its change in a rat model of chronic constriction injury（CCI） of the sciatic nerve，as well as the association between hippocampal ferroptosis and emotional disorders induced by neuropathic pain. Methods A total of 32 male Sprague-Dawley rats were randomly divided into Sham group，CCI group，CCI+F group，and CCI+E group，with 8 rats in each group. The rats in the CCI+F group and the CCI+E group were given intraperitoneal injection of Ferrostatin-1（10 mg/kg） and Erastin（10 mg/kg），respectively，since day 7 after surgery for two consecutive days. Mechanical withdrawal threshold（MWT），paw withdrawal latency（PWL），and open field test（OFT） were measured before surgery and on days 7 and 14 after surgery. On day 14 after surgery，the rats were sacrificed to collect hippocampal tissue；Western blot was used to measure the levels of GPX4，xCT，and FTH1；related kits were used to measure the expression levels of MDA and GSH；HE staining，Nissl staining，and immunofluorescent staining were performed；transmission electron microscopy was used to observe the structural changes of the mitochondria. Results In terms of behavioristics，compared with the Sham group，the CCI group had significant reductions in MWT and PWL on day 7 after surgery（P<0.001），with further reductions from day 7 to day 14 after surgery（P<0.001）；compared with the CCI group，the CCI+F group had significant increases in MWT and PWL on day 14 after surgery（P<0.001），and the CCI+E group had no significant change in MWT and a significant reduction in PWL（P<0.01）. In terms of the OFT test，compared with the Sham group，the CCI group had significant reductions in total distance and number of central squares crossed （P<0.001） and a significant increase in immobility time（P<0.001）；compared with the CCI group，the CCI+F group had significant increases in total distance and number of central squares crossed and a significant reduction in immobility time，while the CCI+E group had no significant changes in these indices. In terms of biochemical results，compared with the Sham group，the CCI group had significant reductions in GPX4，xCT，and FTH1（P<0.01），a significant increase in MDA，and a significant reduction in GSH；compared with the CCI group，the CCI+F group had significant increases in GPX4，xCT，and FTH1（P<0.05），a significant reduction in MDA（P<0.001），and a significant increase in GSH（P<0.01），and the CCI+E group had significant reductions in xCT and FTH1，with no significant changes in MDA and GSH. In terms of morphology，compared with the Sham group，the CCI group had damage and necrosis of hippocampal neurons，significant reductions in Nissl bodies and c-Fos level（P<0.05），and significantly damaged mitochondrial cristae on day 14 after surgery；compared with the CCI group，the CCI+F group had intact structures of hippocampal neurons，significant increases in Nissl bodies and c-Fos（P<0.05），and relatively intact mitochondria，while there were no significant differences in c-Fos and Nissl bodies between the CCI+E group and the CCI group. The pairwise linear correlation analysis of PWL，MWT，GPX4，OFT，and c-Fos on day 14 after surgery showed a significantly positive correlation between any two indicators（P<0.01）. Conclusion Peripheral nerve injury triggers ferroptosis in the hippocampus and causes anxiety and depression，thereby aggravating ferroptosis and accelerating the development of central hyperalgesia.

Objective To explore the effects of transcription factor adenovirus E4 promoter-binding protein（E4BP4） in regulating pathological myocardial fibrosis through the adenosine monophosphate-activated protein kinase（AMPK）-transforming growth factor （TGF）-β1/Smad homolog 3（SMAD3） pathway. Methods A mouse model of myocardial fibrosis was established，and the expression of E4BP4 was determined in the model group and the sham-operation group. Primary cardiac fibroblasts were isolated，cultured，activated by angiotensin Ⅱ（Ang Ⅱ），and divided into the following groups：Ang Ⅱ+E4BP4 group （transfected with E4BP4 overexpression plasmids），Ang Ⅱ+siE4BP4 group （transfected with E4BP4 interfering plasmids），Ang Ⅱ group，and control group（without Ang Ⅱ treatment）. The fluorescence intensity of ɑ-smooth muscle actin（α-SMA） was determined by the immunofluorescence assay，the cell viability by the cell counting kit，the expression of E4BP4，α-SMA，collagen type Ⅰ（collagen Ⅰ），and collagen type Ⅲ（collagen Ⅲ） by polymerase chain reaction，and the protein expression of TGF-β1，AMPK，and SMAD3 by Western blot. Results Compared with the sham-operation group，the model group showed significantly increased myocardial fibrosis degree（38.46±1.21 vs. 3.39±0.39，t=-78.564，P=0.000） and E4BP4 protein expression（0.96±0.03 vs. 0.75±0.03，t=-11.480，P=0.000）. In vitro experiments found that the mean fluorescence intensity（0.05±0.01 vs. 0.42±0.03，F=677.591，P=0.000），cell viability（91.30±2.39 vs. 123.74±2.60，F=132.696，P=0.000），and the levels of α-SMA（1.26±0.09 vs. 3.59±0.86，F=52.274，P=0.000），collagen Ⅰ（1.16±0.11 vs. 3.79±0.89，F=55.336，P=0.000），collagen Ⅲ（1.23±0.13 vs. 2.92±0.36，F=119.929，P=0.000），TGF-β1（0.66±0.04 vs. 0.96±0.02，F=142.954，P=0.000），and p-SMAD3/SMAD3（0.81±0.03 vs. 1.37±0.02，F=739.609，P=0.000） in the Ang Ⅱ+siE4BP4 group were significantly lower than those in the Ang Ⅱ+E4BP4 group. The expression of p-AMPK/AMPK in the Ang Ⅱ+siE4BP4 group was significantly higher than that in the Ang Ⅱ+E4BP4 group（0.89±0.01 vs. 0.58±0.02，F=284.541，P=0.000）. Conclusion E4BP4 plays a crucial role in the regulation of fibrosis. Inhibition of E4BP4 expression exerts an anti-fibrotic effect by activating AMPK and inhibiting TGF-β1/SMAD3 pathway.

Objective To investigate the current status of depression and its correlation with psychological resilience in patients with acute aortic dissection（AAD） after discharge. Methods This study was conducted among 67 patients with AAD who were treated in Department of Cardiothoracic Surgery，Chongqing Emergency Medical Center，from June 2023 to June 2024 and received telephone follow-up and questionnaire survey，and basic data were collected from all patients，including sex，age，dissection type，educational level，length of hospital stay，discharge time，and hospital costs. Self-Rating Depression Scale（SDS） and Connor-Davidson Resilience Scale（CD-RISC） were distributed，and finally 49 valid questionnaires were included for statistical analysis. SDS and CD-RISC scores were compared between AAD patients with different basic data variables，and the Pearson correlation analysis was used to investigate the correlation of SDS score with psychological resilience and the scores of each dimension. The multiple linear regression analysis was further performed. Results The incidence rate of depression was 36.73% among the patients with AAD. With the basic data as variables，there was a significant difference in SDS score between the patients with different sexes and discharge times（P<0.05），and there was a significant difference in CD-RISC score between the patients with different sexes and educational levels（P<0.05）. The Pearson correlation analysis showed that SDS score was negatively correlated CD-RISC score（r=-0.408，P=0.004），and SDS score was also negatively correlated with the scores of the dimensions of strength，resilience，and optimism in psychological resilience（r=-0.283，-0.319，-0.493，all P<0.05）. There was a linear regression relationship between the dimension of optimism and the SDS score of depression. Conclusion There is a relatively high risk of depression in patients with AAD，and there is a significant negative correlation between psychological resilience and depressive state. Strengthening the construction of psychological resilience in AAD patients is important to prevent the risk of depression in AAD patients.

Objective To investigate the effects of dictyophora polysaccharides（DIP） on cognitive dysfunction induced by chronic alcohol exposure in rats. Methods Sixty male Sprague-Dawley（SD） rats were randomly divided into five groups（n=12）：control group （normal saline），DIP group［DIP_H，DIP administered by gavage at 300 mg/（kg·d） for 28 consecutive days］，alcohol group［EtOH，60% alcohol administered by gavage at 10 mg/（kg·d） for 28 consecutive days］，low-dose DIP treatment group［EtOH+DIP_L，60% alcohol administered at 10 mg/（kg·d） and DIP administered at 100 mg/（kg·d） by gavage，with an interval of 6 hours between doses，for 28 consecutive days］，and high-dose DIP treatment group［EtOH+DIP_H，60% alcohol administered at 10 mg/（kg·d） and DIP administered at 300 mg/（kg·d） by gavage，with an interval of 6 hours between doses，for 28 consecutive days］. On day 25 of gavage，water maze training was provided for the rats for 4 days. On day 29，a water maze test was performed to determine the memory and learning functions of the rats；HE staining was used to evaluate the edema and inflammation of the liver and brain tissues； presence of inflammatory cells and the expression of myelin basic protein（MBP） in brain tissue were measured using immunohistochemical staining； Western blot was used to measure the expression of 2，2-cyclic nucleotide-3-phosphodiesterase（CNP） in the hippocampal tissue；the structural integrity of the myelin sheath was evaluated using LuxoL fast blue（LFB） staining and transmission electron microscopy. Results Compared with the control group，the EtOH group showed a significantly increased escape latency，reduced expression of MBP，and decreased density of the myelin sheath. DIP intervention significantly improved cognitive dysfunction in rats，increased the expression of MBP and CNP，and reduced myelin damage. Conclusion At a dose of 300 mg/kg，DIP may ameliorate cognitive dysfunction induced by chronic alcohol exposure by protecting the structural and functional integrity of myelin sheaths.

Objective To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose（FDG） positron emission tomography（PET）/computed tomography（CT） （¹⁸F-FDG PET/CT） metabolic parameters combined with clinical characteristics in treated patients with esophageal squamous cell carcinoma（ESCC）. Methods The clinical data of 75 patients （65 males and 10 females，age of 63.41±7.75 years） with pathologically confirmed ESCC in * Hospital from January 2015 to November 2021 were retrospectively analyzed. All patients underwent ¹⁸F-FDG PET/CT examination after treatment. The relevant parameters of ¹⁸F-FDG PET/CT were determined：whole body SUVmax（SUVmaxwb）； SUVmean and metabolic tumor volume（MTV） were measured with 40% SUVmax as the critical value，and whole body MTV（MTVwb） and whole body total lesion glycolysis（TLGwb） were calculated. Kaplan-Meier survival curves and Cox proportional hazards model were used to evaluate the relationship between PET parameters and overall survival（OS）. Results Fifty-two（69.3%） patients died. PET-positive patients exhibited a 6.029-fold increased risk of death compared with PET-negative patients（P<0.001），with the median survival time of 22.3 months and 43.2 months，respectively. PET-positive patients were categorized based on median parameters of PET：SUVmaxwb=11.09，MTVwb=27.07 cm³，and TLGwb=162.34 g. Kaplan-Meier survival curves and log-rank tests revealed the correlations of pathological classification，M stage，post-PET anti-tumor treatment，MTVwb，and TLGwb with OS. M stage emerged as an independent predictor for OS（hazard ratio=5.698，95%CI=1.791-18.123，P=0.003）. Patients positive for both PET imaging and serology had a 6.112-fold higher death risk compared with those negative for PET imaging（P<0.001）. Conclusion ¹⁸F-FDG PET/CT volume metabolism parameters are significant prognostic predictors for treated patients with ESCC，and patients positive for PET imaging and tumor markers are associated with a poor prognosis.

Objective To investigate the effect of ear acupoint bean pressing on gastrointestinal motility and related hormones after laparoscopic surgery in patients with hysteromyoma，and to explore the therapeutic mechanism of ear acupoint bean pressing. Methods Patients undergoing laparoscopic myomectomy in the Department of Gynecology of The People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from May 2022 to December 2023 were randomly divided into an experimental group and a control group，with 57 patients in each group. The experimental group was treated with postoperative routine nursing and ear acupoint bean pressing （targeting the spleen，stomach，and sympathetic），and the control group was treated with postoperative routine nursing and sham ear acupoint bean pressing （containing no Vaccaria seed，targeting the spleen，stomach，and sympathetic）. After the intervention，the time to first postoperative passing of flatus and defecation，clinical efficacy，and changes in gastrointestinal hormone levels were compared between the two groups. Results The time to first postoperative passing of flatus ［20.31 （17.52，22.38） h vs. 21.51（18.53，28.15） h］ and defecation ［35.32 （31.47，39.17） h vs. 38.12 （33.44，42.78） h］ in the experimental group was lower than that in the control group（P<0.05），and the clinical efficacy was better than that in the control group（P<0.05）. There were no significant differences in motilin（MTL），gastrin（GAS），somatostatin （SS），and substance P（SP） levels between the two groups before operation（P>0.05）. The MTL and GAS levels were increased and the SS and SP levels were decreased after operation. The MTL［（451.52±54.33） pg/mL vs. （476.24±56.35） pg/mL］ and GAS［150.50 （133.93，164.52） pg/mL vs. 173.44 （154.45，184.63） pg/mL］ levels at 24 h after operation in the experimental group were lower than those in the control group（P<0.05），and the SS［38.34（33.24，40.23） pg/mL vs. 33.36（29.13，38.76） pg/mL］ level at 24 h after operation was higher than that in the control group（P<0.05），with no significant change in the SP level（P>0.05）. The results of repeated measures analysis of variance and generalized estimation equation showed that there were significant differences in the time effect and interaction effect of MTL（P<0.05），a significant difference in the time effect of SP（P<0.05），and significant differences in the time effect，intergroup effect，and interaction effect of GAS and SS（P<0.05）. Conclusion Ear acupoint bean pressing has significant effect on abdominal distension after laparoscopic surgery in patients with hysteromyoma，effectively regulates the level of gastrointestinal motility related hormones，and promotes the recovery of gastrointestinal function.

Objective To investigate the influence of inner cell mass and trophectoderm cytoplasmic strings during blastocyst expansion on embryonic development and pregnancy outcome. Methods A retrospective cohort analysis was performed for the clinical data of patients who received pre-implantation genetic testing for aneuploidy （PGT-A） and underwent single blastocyst transplantation in our hospital from June 2019 to December 2021. A total of 530 patients were enrolled，and genetic testing was performed for 2132 blastocysts. According to the presence or absence of cytoplasmic strings during blastocyst expansion，the blastocysts were divided into cytoplasmic strings（+） group with 534 blastocysts and cytoplasmic strings（-） group with 1598 blastocysts，and quality and PGT-A results were compared between the two groups. After the transfer of euploid blastocysts，pregnancy outcome was compared between the 115 blastocysts with cytoplasmic strings and the 415 blastocysts without cytoplasmic strings. Results The rates of cytoplasmic strings（+） in the high-，average-，and low-quality blastocyst groups were 30.19%，24.62%，and 12.63%，respectively. The correlation analysis showed a correlation coefficient of -0.115（P<0.001） between embryo quality and the rate of cytoplasmic strings（+）. There was no significant difference in euploidy rate between the two groups（45.3% vs. 44.6%）. There were no significant differences between the euploid blastocysts with cytoplasmic strings and those without cytoplasmic strings in implantation rate（72.17% vs. 66.02%，P=0.213），miscarriage rate（14.46% vs. 12.77%，P=0.691），and live birth rate（61.74% vs. 57.59%，P=0.424）. Conclusion The presence of cytoplasmic strings is associated with the morphological quality of blastocysts，while it has no impact on embryo ploidy or clinical outcome after euploid embryo transfer. Further research is needed to confirm the impact of cytoplasmic strings on embryonic development.

Objective To investigate the therapeutic effect of platelet-rich plasma（PRP） combined with Xianling Gubao Capsule on rats with osteoarthritis（OA） and the changes in the levels of related factors. Methods Anterior cruciate ligament transection was performed to establish a rat model of OA，and after modeling，the rats were randomly divided into control group，model group，Xianling Gubao Capsule group，PRP group，and Xianling Gubao Capsule+PRP group，with 10 rats in each group. After intervention，ELISA was used to measure the serum levels of IL-1β and TNF-α； knee articular cartilage was collected，and qPCR and Western blot were used to measure the mRNA and protein expression levels of MMP3，MMP13，Col2，Aggrecan，and p-p38； Micro-CT was used to assess the changes in bones around the knee joint； HE staining and SF staining were used to observe the changes in knee articular cartilage. Results ELISA showed that PRP combined with Xianling Gubao Capsule significantly reduced the serum levels of the inflammatory factors such as IL-1β and TNF-α（P<0.05）. The results of qPCR and Western blot showed that PRP combined with Xianling Gubao Capsule significantly reduced the expression levels of MMP3，MMP13，and p-p38 and increased the expression levels of Col2 and Aggrecan in knee articular cartilage（P<0.05）. Micro-CT，HE staining，and SF staining showed a certain degree of improvement in knee articular cartilage degeneration in the Xianling Gubao Capsule+PRP group （P<0.05）. Conclusion PRP combined with Xianling Gubao Capsule exerts a therapeutic effect on rats with OA，possibly by regulating the p38MAPK signaling pathway.

Cancer-related cognitive impairment is a common and serious complication in children with leukemia，which affects the quality of long-term survival and has adverse impact on their schooling，life，and socialization. Through a literature review，this article summarizes the sentinel factors for cancer-related cognitive impairment，including insomnia，anxiety，depression，high-dose methotrexate exposure，decreased lysophosphatidylcholine levels and elevated sphingomyelin concentrations in cerebrospinal fluid，MTHFR1298 genotype，and increases in inflammatory factors（TNF-α，IL-6，and IL-8）. The existing assessment tools for sentinel factors lack sensitivity and specificity，and subsequent large-sample multicenter studies should be conducted to validate the accuracy of the above indicators in predicting cancer-related cognitive impairment in children with leukemia，so as to achieve early intervention and improve the quality of long-term survival.

Objective To explore the application value of a novel bag respirator assisted ventilation device in postoperative transport under general anesthesia with laryngeal mask. Methods A total of 133 patients in postoperative transport who underwent elective bronchoscopy or treatment under general anesthesia with laryngeal mask in the First Affiliated Hospital of Chongqing Medical University， from June to August 2023 were selected. The patients were randomly divided into control group（n=65） and experimental group（n=68），and received manual bag respirator assisted ventilation and the novel bag respirator assisted ventilation device during their postoperative transport，respectively. The pulse oxygen saturation（SpO₂），heart rate（HR），and ventilation frequency during transport，transport duration，and transport-related adverse events were compared between the two groups. Results The difference in SpO₂ was significant when comparing the two groups（F_{between groups}=18.588，P<0.001），and the SpO₂ of patients in the experimental group was significantly higher than that of patients in the control group during and after transport（P<0.001）. The difference in HR was not significant when comparing the two groups（F_{between groups}=0.089，P=0.766），but it was significant between the control and experimental groups before and after transport（F_{time point}=12.430，P<0.001）； the HR in the control and experimental groups before and during transport was significantly lower than that after transport（all P<0.001）. The ventilation frequency of the experimental group was significantly lower than that of the control group（P<0.001）. The transport duration in the experimental group was longer than that in the control group，but the difference was not significant（P=0.987）. Both groups successfully completed the trial without transport-related adverse events and achieved safe transport. Conclusion Compared with the manual bag respirator assisted ventilation technology，the novel bag respirator assisted ventilation device for respiratory support during postoperative transport in patients under general anesthesia with laryngeal mask is more able to reduce the impact on the patient’s hemodynamics and conducive to the maintenance of the patient’s stable vital signs，showing a good clinical application value. It is expected to be a safe and effective ventilation method during intrahospital transport in some patients under general anesthesia.

Objective To investigate the interventional and protective effect of low-dose L-carnitine（LC） against reproductive system damage in male Wistar rats during acute exposure to simulated high-altitude environment. Methods A total of 24 specific pathogen-free male Wistar rats，aged 12 weeks，were randomly divided into control group，high-altitude model group，and LC intervention group ［intraperitoneal injection of LC at a dose of 50 mg/（kg·d）］，with 8 rats in each group. The rats in the control group were fed under normal conditions（at an altitude of approximately 1 500 m），those in the high-altitude model group，and those in the LC intervention group were fed in a hypobaric oxygen chamber（at a simulated altitude of 6 000 m）. The rats were sacrificed after 3 days. The testis was collected to calculate testicular index；the semen was collected from the epididymis，and the Weili sperm quality analysis system was used to assess sperm quality；blood samples were collected from the abdominal aorta，and ELISA kits were used to measure the serum levels of testosterone（T），luteinizing hormone（LH），and follicle-stimulating hormone（FSH）；testicular tissue samples were collected，and biochemical kits were used to measure the activity of reactive oxygen species（ROS），malondialdehyde（MDA），and superoxide dismutase（SOD）；testicular tissue was collected to prepare HE and electron microscopy sections，and a light microscope and a transmission electron microscope were used for observation. Results Compared with the blank control group，the high-altitude model group had significant increases in the levels of T，LH，and FSH（P<0.01），testicular tissue damage under the light microscope，and changes in the morphology of spermatogenic cells，including mitochondrial alterations，membrane edema，loss of cristae，swelling of the matrix，and local dissolution，as well as significant increases in the levels of ROS and MDA（P<0.01） and a significant reduction in SOD activity（P<0.01）. Compared with the high-altitude model group，the LC intervention group had a significant increase in the level of T（P<0.01），significant reductions in the levels of FSH and LH（P<0.01），and significant improvements in the pathological changes of testicular tissue，with no marked mitochondrial injury，and there were significant reductions in the levels of ROS and MDA（P<0.01） and a significant increase in SOD activity（P<0.01）. There was no significant difference in testicular index between groups（P>0.05）. The high-altitude model group had a significantly lower sperm count than the blank control group（P<0.05），while there was no significant difference in sperm count between the LC intervention group and the blank control group（P>0.05）；there was no significant difference in sperm motility between groups（P>0.05）. Conclusion Low-dose LC can improve reproductive system damage in rats during acute exposure to simulated high-altitude environment，possibly by alleviating oxidative stress response.

Objective To investigate the correlation and causal relationship between neonatal birth weight and urinary microproteins and creatinine in adulthood. Methods Genome-wide association studies were conducted to extract genetic loci with significant influence from dataset as instrumental variables，and they were analyzed by inverse variance weighted（IVW），weighted median，MR Egger，and MR-PRESSO methods to investigate the causal relationship between neonatal birth weight and urinary microproteins and creatinine in adulthood. A retrospective analysis was performed for 113 neonates who were admitted to Department of Neonatology，Shanxi Children’s Hospital，from January 2005 to January 2007，and related data were collected during the neonatal and adult stages. A Pearson correlation analysis was used to determine the correlation between neonatal birth weight and urinary microproteins and creatinine in adulthood. Results The MR-IVW test showed that neonatal birth weight had a statistically significant correlation with urinary microproteins（P=0.037） and urinary creatinine（P=0.015） in adulthood. The retrospective study showed that there were no significant differences between the two groups in all variables except body weight（P>0.05）. In addition，the Pearson correlation analysis showed that neonatal birth weight was negatively correlated with urinary microproteins（r=-0.78，P=0.015） and was positively correlated with urinary creatinine（r=0.78，P=0.018）. Conclusion Neonatal birth weight is negatively correlated with urinary microproteins and is positively correlated with urinary creatinine in adulthood.

Objective To investigate the specific role of circTRRAP in acute myocardial infarction（AMI）. Methods The method of hypoxia for 24 hours was used to induce the model of myocardial infarction，and the dual-luciferase reporter assay was used to investigate the interaction between circTRRAP，SMAD2，and miR-323-3p. After knockdown and overexpression of miR-323-3p and overexpression of SMAD2 through transfection with si-circTRRAP，the expression levels of proinflammatory cytokines ［interkeukin-6（IL-6） and tumor necrosis factor-α（TNF-α）］，oxidative stress markers ［malondialdehyde（MDA） and superoxide dismutase（SOD）］，and apoptotic factors［Bcl-2-associated X protein（Bax），B-cell lymphoma-2（Bcl-2），and cleaved caspase-3］were measured to investigate the role of circTRRAP，SMAD2，and miR-323-3p in myocardial infarction. Results In the model of myocardial infarction injury，the levels of circTRRAP and SMAD2 were significantly increased by more than 50%，whereas there was a significant reduction in the expression of miR-323-3p. The downregulation of circTRRAP led to a reduction in SMAD2 expression by promoting miR-323-3p expression. SMAD2 was negatively correlated with miR-323-3p，but it was positively correlated with the expression of circTRRAP. The downregulation of circTRRAP or SMAD2 or the upregulation of miR-323-3p could increase cell viability and reduce the apoptosis rate of cardiomyocytes. Conclusion Downregulation of circTRRAP can inhibit inflammation and alleviate AMI via the miR-323-3p/SMAD2 axis.

Objective To investigate the pulmonary function in patients with Parkinson’s disease（PD） and the association between pulmonary function and motor symptoms. Methods A total of 104 PD patients were included in the study，and a portable spirometer was used to assess pulmonary function. According to the results of pulmonary function，the patients were divided into ventilation dysfunction group with 37 patients and non-ventilation dysfunction with 67 patients，and clinical data were compared between the two groups. Univariate and multivariate logistic regression analyses were used to investigate the factors associated with abnormal pulmonary function，and a Spearman correlation analysis was used to investigate the correlation between pulmonary function parameters and motor symptoms. Results There were significant differences in the scores of bradykinesia and postural gait between the two groups（P<0.05），and the logistic regression analysis showed a positive correlation between pulmonary ventilation dysfunction and postural gait score（regression coefficient β=0.171，95%CI=1.015-1.386，P=0.032）. There were significant differences between the patients with different stages of PD in the pulmonary function parameters of the percentage of forced vital capacity in predicted value（t=2.143，P=0.034），the percentage of forced expiratory volume in 1 second（t=2.118，P=0.037），the percentage of predicted peak expiratory flow（t=2.002，P=0.048），maximum expiratory pressure as a percentage of predicted value（t=2.412，P=0.018），and maximum inspiratory pressure as a percentage of predicted value（t=2.119，P=0.036）. Conclusion The pulmonary function parameters of PD patients are lower than expected values，and the incidence rate of pulmonary ventilation dysfunction is 35.58%，with the main manifestation of restrictive ventilatory dysfunction. There is a correlation between pulmonary function and motor symptoms in PD patients.

Traumatic spinal cord injury and bladder injury are both common surgical injuries. Metabolomics studies are the qualitative and quantitative analysis of all metabolites in a specific part of the organism and the science of the changing laws of these metabolites under external influences or disease conditions. The technology is mainly to analyze the metabolites in body fluids，cells，and tissues，and has become one of the important means for discovering biomarkers. The psychopathology of spinal cord injury is very complex. Blood metabolomics allows differential analysis of the substances in blood and has great value for exploring the disease process and mechanism.

Objective To investigate the efficacy and safety of a new airway opening device with automatic position adjustment. Methods From January 4 to March 15，2021，the purposive sampling method was used to select 360 patients who underwent bronchoscopy examination or treatment. According to the random sequence generated by a computer，the research assistant adjusted the position angle（PA） as 90°（90° PA group），95°（95° PA group），and 100°（100° PA group），respectively，to open the airway of subjects，and the bronchoscope entered the airway to obtain the image of the best glottic view. All subjects were followed up immediately after study and at 0.5，1，3，6，12，and 24 hours after study to observe device-related adverse events. The primary outcome measure was the Cormack-Lehane（CL） grade for glottic exposure，and the secondary outcome measures were the incidence rate of adverse events and Visual Analogue Scale（VAS） score. Results More than 80.0% of the subjects had CL grade I glottic exposure，and there was no significant difference in CL grade between the three PA groups（χ² =1.942，P>0.05）. The CL grade of some subjects was optimized at an angle of 100°. No device-related adverse events were reported，and the VAS score was 0. Conclusion The device can effectively and safely open the airway of subjects undergoing bronchoscopy at a PA of 90°-100°，and although it has no obvious advantage in improving glottic exposure at different levels of PA，it is recommended to select the PA of 100° to open the airway.

Objective To investigate the mid-term efficacy of Pulsar-18 stent in the treatment of spontaneous isolated superior mesenteric artery dissection（SIDSMA） through a retrospective analysis. Methods A retrospective analysis was performed for the data of patients with SIDSMA who received treatment with Pulsar-18 stent from April 2019 to March 2021. Basic information was collected，such as sex，age，underlying disease，and radiological features，and the patients were observed in terms of the improvement in clinical symptoms，stent patency rate，and vascular remodeling during follow-up. Results A total of 45 patients were included in this study，with 41 male patients and 4 female patients. The patients had an age of 45-72 years，and the patients with hypertension accounted for 48.89%（22/45）. The surgical success rate was 100%. A total of 63 stents were placed for the 45 patients，with a stent diameter ranging from 5 mm to 7 mm. There were no perioperative complications such as acute thrombosis of the stent，and the probability of hematoma at the puncture point was 0%. The stent patency rate was 100% at 3 months，6 months，1 year，and 2 years after stent placement，and the complete vascular remodeling rate was 64.4%，82.2%，82.2%，and 86.7%，respectively. One patient developed bloody stool at 5 months after surgery and was diagnosed with duodenal ulcer，and the patient fully recovered after endoscopic hemostasis. The other patients had no recurrent abdominal pain，new-onset aneurysms，or enlargement of the false lumen within 2 years. Conclusion Pulsar-18 stent placement is an effective treatment method for SIDSMA and can provide a high rate of complete vascular remodeling，with a high patency rate during mid-term follow-up.

Objective To develop a predictive model for selecting patients with high-risk localized prostate cancer（HRLPC） who are suitable for preoperative maximum androgen blocking（MAB） therapy. Methods This study was conducted among 96 patients with HRLPC who were diagnosed based on transrectal biopsy and underwent radical prostatectomy in Department of Urology，The First Affiliated Hospital of Chongqing Medical University，from January 1，2021 to June 30，2024，and all patients received MAB therapy for 3 months before surgery and were followed up for 6 months after surgery. Related data were collected from all patients，including baseline demographic features，laboratory data，imaging findings，perioperative data，and follow-up information. At first，the association between prostate-specific antigen density（PSAD） stratification after MAB therapy and pathological and biochemical benefits was analyzed to determine the optimal PSAD group，then machine learning was used to identify important variables and establish a predictive model，and finally，the model was evaluated using the ROC curve，the calibration curve，and clinical applicability assessment. Results The low PSAD group ［PSAD <0.17 ng/（mL∙cm³）］ showed the best results of perioperative outcomes，pathological downgrading，the rate of undetectable PSA after -surgery，recovery from urinary incontinence，and PSA follow-up（P<0.05）. The model was established based on prostate volume，low-density lipoprotein cholesterol，PSAD，smoking history，total cholesterol，PSA，and body mass index，and this predictive model had good performance （with an area under the ROC curve of 0.769） and showed a certain degree of clinical applicability. Conclusion Patients in the low PSAD group tend to have better pathological and biochemical benefits. This study provides a reliable predictive model to assist in the individualized treatment of patients with HRLPC.