Objective To investigate the role of upstream stimulatory factor 1 (USF1) in the proliferation of hepatocellular carcinoma (HCC) cells. Methods A pan-cancer analysis based on the TCGA database was performed to compare the relative mRNA expression levels of USF1 between tumor tissues and adjacent normal liver tissues from patients with HCC. Immunohistochemistry and immunofluorescence staining were used to assess USF1 protein expression in tumor tissues and adjacent normal tissues. Hep3B cells were divided into groups A1-D1, and Huh7 cells into groups A2-D2. Cells in groups A1 and A2 received no treatment; the remaining cells were transfected with siNC (groups B1 and B2), siUSF1#1 (groups C1 and C2), or siUSF1#2 (groups D1 and D2). Cell viability was measured using the CCK-8 assay, colony-forming ability using the colony formation assay, and proliferation capacity using EdU staining. Results Pan-cancer analysis based on the TCGA database showed that the relative mRNA expression level of USF1 was significantly higher in HCC tumor tissues than in adjacent normal liver tissues (t=6.84,P<0.05). Immunochemistry and immunofluorescence staining similarly showed significantly increased USF1 protein expression in tumor tissues. According to the CCK-8 assay, at 48-96 h of culture, cell viability in groups C1 and D1 and groups C2 and D2 was significantly lower than that in groups B1 and B2, respectively (F=4.74-413.67,q=2.89-31.86,P<0.05). Colony formation and EdU assays showed that the numbers of colonies and the proportions of EdU-positive cells in groups C1 and C2 and groups D1 and D2 were significantly lower than those in groups B1 and B2 (F=113.87-390.29,q=18.37-34.42,P<0.05). Conclusion USF1 expression is upregulated in the tumor tissues of patients with HCC, and suppressing USF1 expression may inhibit the proliferation of HCC cells.

Objective To investigate the regulatory role of the peroxisome proliferator-activated receptor gamma (PPARγ)-nuclear factor erythroid 2-related factor 2 (Nrf2)-heme oxygenase-1 (HO-1) signaling pathway in ferroptosis in the hippocampal tissue of rats with status epilepticus (SE). Methods A total of 57 male Wistar rats were selected, among which 47 rats were randomly selected and were given intraperitoneal injection of lithium chloride, scopolamine hydrobromide, and pilocarpine to induce SE, and the remaining 10 rats were included as control group and were given intraperitoneal injection of an equal volume of normal saline. The Racine scale was used to assess the severity of seizure, and the rats with stage Ⅳ or higher seizures and a duration of >60 minutes were selected and randomly divided into SE group, activator group, and inhibitor group, with 10 rats in each group. The rats in the activator group were given injection of the PPARγ agonist rosiglitazone, while those in the inhibitor group were given injection of the PPARγ inhibitor T0070907; the rats in the control group and the SE group were given injection of an equal dose of normal saline. Intraperitoneal injection was performed once every other day for 21 days. On day 22, the rats were sacrificed and hippocampal tissue was dissected. A transmission electron microscope was used to observe mitochondrial ultrastructure in hippocampal tissue of rats in the control group and the SE group; RT-qPCR and Western blot were used to measure the relative mRNA and protein expression levels of PPARγ, Nrf2, HO-1, and glutathione peroxidase 4 (Gpx4) in the hippocampal tissue of rats in each group; colorimetry was used to measure the levels of Fe²⁺, glutathione (GSH), and malondialdehyde (MDA) in the hippocampal tissue of rats in each group. Results Compared with the control group, the SE group had reductions in mitochondrial vo-lume and mitochondrial cristae, significant increases in the levels of Fe²⁺ and MDA and the relative mRNA and protein expression levels of PPARγ, Nrf2, and HO-1, and significant reductions in the level of GSH and the relative mRNA and protein expression levels of Gpx4 (F=28.090-153.500,t=12.350,2.355,q=6.216-20.510,P<0.05). Compared with the SE group, the activator group had significant reductions in the levels of Fe²⁺ and MDA and significant increases in the level of GSH and the relative mRNA and protein expression levels of Nrf2, HO-1, and Gpx4 (q=7.271-16.540,P<0.05). Compared with the SE group, the inhibitor group had significant increases in the levels of Fe²⁺ and MDA and significant reductions in the level of GSH and the relative mRNA and protein expression levels of Nrf2, HO-1, and Gpx4 (q=2.603-12.190,P<0.05). Conclusion Activation of the PPARγ-Nrf2-HO-1 signaling pathway can alleviate pathological alterations in rats with SE by inhibiting ferroptosis in hippocampal tissue.

Objective To investigate the effect of Epstein-Barr virus (EBV) on the expression of acetyl-CoA carboxylase 1 (ACC1) in gastric cancer cells and its potential underlying mechanism. Methods Transcriptomic and proteomic analyses were performed to identify differentially expressed genes and proteins between the human gastric adenocarcinoma cell line AGS and EBV-infected AGS (AGS-EBV) cells. The relative mRNA and protein expression levels of ACC1 in the AGS and AGS-EBV cells were determined by quantitative real-time PCR (qRT-PCR) and Western blotting (WB). A stable cell model overexpressing LMP2A (AGS-LMP2A cells) was constructed by lentiviral transduction of the AGS cells, with AGS cells transduced with an empty vector (AGS-NC cells) serving as the control. The relative mRNA and protein expression levels of ACC1 in these two cell types were measured by qRT-PCR and WB, respectively. Results Transcriptomic and proteomic analyses showed that, compared with the AGS cells, the differentially expressed genes and proteins in the AGS-EBV cells were mainly enriched in the fatty acid metabolism and fatty acid synthesis pathways, with ACC1 gene and protein expression levels significantly downregulated. The qRT-PCR and WB results showed that the relative mRNA and protein expression levels of ACC1 were significantly lower in the AGS-EBV cells than in the AGS cells (t=7.426, 2.733,P<0.05). In addition, the relative mRNA and protein expression levels of ACC1 were significantly lower in the AGS-LMP2A cells than in the AGS-NC cells (t=5.139,3.449,P<0.05). Conclusion EBV infection may downregulate the expression of ACC1 in gastric cancer cells through its encoded protein LMP2A.

Objective To investigate the effect of anlotinib on the proliferation, migration, invasion, and epithelial-me-senchymal transition (EMT) of human lung squamous cell carcinoma NCI-H226 cells. Methods Human lung squamous cell carcinoma NCI-H226 cells were divided into control group (group A), anlotinib treatment groups at different concentrations (10, 20, and 40 μmol/L) (groups B-D), anlotinib (20 μmol/L)+PI3K/AKT signaling pathway inhibitor LY294002 (30 μmol/L) treatment group (group E), and anlotinib (20 μmol/L)+PI3K/AKT signaling pathway activator SC79 (10 μmol/L) treatment group (group F). CCK-8 assay was used to measure cell viability; scratch assay was used to measure the migration rate of cells; Transwell assay was used to measure the invasion ability of cells; RT-qPCR was used to measure the relative mRNA expression levels of the EMT-related genes E-cadherin, N-cadherin, Vimentin, and fibelectin (FN) in cells, and Western blotting was used to measure the relative protein expression levels of PI3K, AKT, p-PI3K, p-AKT, E-cadherin, N-cadherin, Vimentin, and FN in cells. Results The results of the experiment showed that compared with group A, groups B-D had significant reductions in cell viability, cell migration rate, the number of invasive cells, and the relative protein expression levels of p-PI3K and p-AKT (F=49.315-145.576,t_LSD=2.459-251.731,P<0.05). Compared with group A, group C had significant reductions in the relative mRNA and protein expression levels of N-cadherin, Vimentin, and FN and significant increases in the mRNA and protein expression levels of E-cadherin (F=30.554-136.286,t_LSD=4.158-8.315,P<0.05). Compared with group C, group E had significant reductions in cell viability, cell migration rate, invasion ability, the relative protein expression levels of p-PI3K and p-AKT, and the relative mRNA and protein expression levels of N-cadherin, Vimentin, and FN, and group F had significant increases in the above indicators (t_LSD=3.221-11.079,P<0.05). Compared with group C, group E had significantly higher relative mRNA and protein expression levels of E-cadherin, while group F had significantly lower expression levels than group C (t_LSD=2.195-7.213,P<0.05). Conclusion Anlotinib can inhibit the proliferation, migration, invasion, and EMT of human lung squamous cell carcinoma NCI-H226 cells, possibly by inhibiting the activation of the PI3K/AKT signaling pathway.

Objective To investigate the application and advantages of different staining methods in the morphological observation of non-decalcified bone tissue sections containing implants. Methods Rabbit mandibular bone tissue containing hydroxyapatite were collected and prepared into 50 μm thin sections using a hard tissue grinding system, and after various staining procedures, the sections were sealed with neutral gum and observed under an optical microscope. Results After hematoxylin-eosin staining, the tissue showed a relatively monotonous color, with a red color for bone tissue and an unclear boundary between new bone and original mineralized bone. After Weigert hematoxylin-toluidine blue staining, bone tissue showed a blue color, new bone was deeply stained with a more distinct boundary between new bone and original mineralized bone, and osteoblast nuclei showed a blue color. After Weigert hematoxylin-Ladewig staining, bone tissue showed a blue color, the attached soft tissue showed a yellow color, unmineralized bone and osteoid had a dark yellow color, and osteoblast nuclei appeared yellowish-brown. After Weigert hematoxylin-Van Gieson (VG) staining, bone tissue appeared bright red, new bone was deeply stained, and the attached soft tissue, osteoblasts, osteoid, and unmineralized bone appeared light yellow. After methylene blue-acid fuchsin staining, bone tissue appeared red, new bone was deeply stained, attached soft tissue appeared blue, osteoblast nuclei appeared dark blue, cell matrix appeared light blue, and osteoid appeared purple-gray. After Goldner trichrome staining, bone tissue appeared green, new bone was deeply stained, and osteoid appeared orange-red and orange-yellow alternately. After Von Kossa staining, the areas with calcium salt deposition appeared dark brown, original mineralized bone appeared light gray, and soft tissue, osteoblasts, and loose connective tissue appeared yellowish-brown. Conclusion Weigert hematoxylin-VG staining or Weigert hematoxylin-toluidine blue staining is recommended for high-precision measurement of the ratio of new bone to original mineralized bone and the area of bone integration; methylene blue-acid fuchsin staining or Goldner trichrome staining is recommended for simultaneous observation of the mineralization status of bone tissue (osteoid/new bone/original mi-neralized bone) and the condition of soft tissue/cells; Von Kossa staining is recommended for analyzing the osteogenic activity of bone tissue or observing the calcified area.

Objective To investigate the relationship between adiponectin (APN) and human placental lactogen (hPL) levels in maternal peripheral blood, umbilical cord blood, and amniotic fluid and the occurrence of gestational diabetes mellitus (GDM) and neonatal birth weight, and to analyze the correlation between APN and hPL. Methods A total of 41 pregnant women with GDM who delivered at the West Coast Campus of The Affiliated Hospital of Qingdao University between January and May 2023 were included in the GDM group, and 41 healthy pregnant women who delivered during the same period were included in the control group. APN and hPL levels in maternal peripheral blood, umbilical cord blood, and amniotic fluid were measured and compared between the two groups. Correlations between APN and hPL, as well as between APN, hPL, and neonatal birth weight, were analyzed using Spearman’s correlation analysis. Results The levels of APN in maternal peripheral blood, amniotic fluid, and umbilical cord blood, and the level of hPL in umbilical cord blood, were significantly lower in the GDM group than in the control group (t=-2.956--2.436,P<0.05). In the control group, APN and hPL levels in umbilical cord blood were positively correlated with neonatal birth weight (r=0.389,0.346,P<0.05), whereas in the GDM group, APN and hPL levels in umbilical cord blood were negatively correlated with neonatal birth weight (r=-0.324,-0.447,P<0.05). In the GDM group, the hPL le-vel in umbilical cord blood was positively correlated with the APN level (r=0.341,P<0.05). Conclusion Decreased APN levels in maternal peripheral blood, umbilical cord blood, and amniotic fluid, as well as decreased hPL levels in umbilical cord blood, may be associated with the development of GDM. The correlation between APN and hPL levels in umbilical cord blood and neonatal birth weight may be influenced by maternal glucose metabolism. Increased APN levels in umbilical cord blood may have a promoting effect on hPL expression.

Objective To investigate the sedative effect of dexmedetomidine nasal spray combined with midazolam oral solution in children before surgery. Methods A total of 60 children who underwent elective surgery in the Department of Oral and Maxillofacial Surgery at our hospital were enrolled and divided into dexmedetomidine group (group D) and dexmedetomidine+midazolam group (group DM), with 30 children in each group. The children in group D were given dexmedetomidine nasal spray before surgery, and those in group DM were given dexmedetomidine nasal spray combined with midazolam oral solution before surgery. Ramsay sedation score and PSAS score were recorded at 45 min after administration, and Frankl score was recorded at the time of venipuncture; perioperative adverse reactions were also recorded; the 5-minute electrocardiographic RR interval was collec-ted from each child on day 1 before surgery (T₀) and after entering the surgical room in a supine position (T₁) for heart rate variability (HRV) analysis. Results At 45 min after drug administration, compared with group D, group DM had significantly hig-her Ramsay sedation score and Frankl score during venipuncture and a significantly lower PSAS score (t=-4.26-5.77,P<0.05). The results of HRV analysis showed that compared with the data at T₀, both groups had a significant reduction in heart rate (HR) at T₁ (t=52.296,16.255,P<0.05) and a significant increase in standard deviation of all normal-to-normal intervals (SDNN) at T₁ (t=-10.100,-7.750,P<0.05); group D had a significant reduction in deceleration capacity (DC) (t=-9.827,P<0.05), and group DM had a significant reduction in low-frequency power/ high-frequency power (LF/HF) ratio and a significant increase in log total power (TP) (t=7.037,-7.576,P<0.05). Compared with group D at T₁, group DM had a significant increase in SDNN (t=-4.169,P<0.05), a significant reduction in LF/HF ratio (t=2.734,P<0.05), and a significant increase in logTP (t=-18.141,P<0.05). Furthermore, no adverse reactions such as bradycardia or respiratory depression were observed in the perioperative pe-riod in either group. Conclusion Dexmedetomidine nasal spray combined with midazolam oral solution can achieve adequate sedation in children before surgery, with few adverse reactions, and therefore, it holds promise for clinical application as a modified preoperative drug combination.

Objective To investigate the influence of the interaction between the Notch signaling pathway and Toll like receptor 4 (TLR4) on the function of CD14⁺ monocytes in patients with coronary heart disease. Methods A total of 101 patients with coronary heart disease who were admitted to our hospital from April 2019 to August 2020 were enrolled, and according to their disease conditions, they were divided into stable angina pectoris (SAP) group, unstable angina pectoris (UAP) group, and acute myocardial infarction (AMI) group; meanwhile, 40 individuals who underwent physical examination during the same period of time were enrolled as control group. Fasting peripheral venous blood samples were collected from each group of subjects, and mononuclear cells were isolated. RT-qPCR was used to measure the mRNA expression levels of Notch1, Notch2, and TLR1-10 in mononuclear cells. Magnetic-activated cell sorting was performed to isolate CD14⁺ monocytes from peripheral blood mononuclear cells for the three groups of patients with coronary heart disease, and after stimulation and culture with the Notch signaling pathway inhibitor DAPT and the TLR4 agonist CRX-675, the mRNA expression levels of Toll like receptor 2 (TLR2), TLR4, Toll like receptor 9 (TLR9), Notch1, HES1, and HES5 were measured; ELISA was used to measure the levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the supernatant of cell culture; Western blotting was used to measure the relative protein expression levels of TIR domain adaptor molecule (TRIF), myeloid differentiation factor 88 (MyD88), and nuclear factor-kappa B (NF-κB) p65 subunit in cells. Results Compared with the control group, the three groups of patients with coronary heart disease had significantly higher mRNA expression levels of Notch1,TLR2, TLR4, and TLR9 in peripheral blood mononuc-lear cells, with the highest expression levels in the AMI group (F=10.295-16.558,t_LSD=7.918-18.271,P<0.05). After DAPT stimulation, all three groups of patients with coronary heart disease had a significant reduction in the mRNA expression level of TLR4 in peripheral blood CD14⁺ monocytes (t=5.871-9.069,P<0.05), and the AMI group had a significantly greater reduction than the UAP group and the SAP group (F=5.522,t_LSD=2.613, 2.625,P<0.05). After CRX-675 stimulation, all three groups of patients with coronary heart disease had significant increases in the mRNA expression levels of Notch1, HES1, and HES5 in peripheral blood CD14⁺ monocytes (t=9.218-17.483,P<0.05), and the AMI group had significantly greater increases than the UAP group and the SAP group (F=30.133-212.120,t_LSD=4.921-11.107,P<0.05). After CRX-675 stimulation, all three groups of patients with coronary heart disease had significant increases in the levels of TNF-α and IL-6 in the supernatant of perip-heral blood cell culture (t=5.806-8.129,P<0.05). For all three groups of patients with coronary heart disease, the levels of TNF-α and IL-6 in the supernatant of peripheral blood cell culture after co-stimulation with DAPT and CRX-675 were significantly lower than those after CRX-675 stimulation alone (t=5.216-9.063,P<0.05), and the AMI group had significantly greater reductions than the UAP group and the SAP group (F=104.894,4.798,t_LSD=2.440-10.977,P<0.05). For all three groups of patients with coronary heart disease, the protein expression levels of TRIF and NF-κB p65 in peripheral blood CD14⁺ monocytes after co-stimulation with DAPT and CRX-675 were significantly lower than those after CRX-675 stimulation alone (t=5.052-9.921,P<0.05), and the AMI group had significantly greater reductions than the UAP group and the SAP group (F=4.580,4.200,t_LSD=2.414-3.461,P<0.05). Conclusion The interaction between the Notch signaling pathway and TLR4 can lead to disease progression by affecting the function of CD14⁺ monocytes in patients with coronary heart disease.

Objective To investigate the value of texture analysis based on contrast-enhanced CT images in assessing regional lymph node metastasis in patients with gastric cancer. Methods Clinical data were collected from 174 patients with pathologically confirmed gastric cancer who underwent radical gastrectomy, and according to postoperative pathological results, the patients were divided into non-lymph node metastasis group with 49 patients and lymph node metastasis group with 125 patients. The CT Kinetics texture analysis software was used to extract 8 texture features (Mean value-A, Skewness-A, Kurtosis-A, Entropy-A, Mean value-V, Skewness-V, Kurtosis-V, and Entropy-V) of primary gastric cancer lesions, which were compared between the two groups. The receiver operating characteristic (ROC) curve were plotted to analyze the performance of CT texture features of primary gastric cancer lesions in assessing regional lymph node metastasis. Results There were significant differences in Entropy-A and Entropy-V of primary gastric cancer lesions between the lymph node metastasis group and the non-lymph node metastasis group (t=-5.592, -5.557,P<0.05), while there were no significant differences between the two groups in Mean value-A, Skewness-A, Kurtosis-A, Mean value-V, Skewness-V, and Kurtosis-V (P>0.05). Entropy-A and Entropy-V had an area under the ROC curve (AUC) of 0.751 and 0.754, respectively, in assessing regional lymph node metastasis in patients with gastric can-cer, with a cut-off value of 9.47 and 9.84, respectively, a sensitivity of 74.4% and 56.8%, respectively, and a specificity of 69.4% and 85.7%, respectively. Conclusion The texture analysis of primary gastric cancer lesions based on contrast-enhanced CT images has a certain value in assessing regional lymph node metastasis, and increases in the texture parameters Entropy-A and Entropy-V may indicate greater tumor heterogeneity and a higher probability of regional lymph node metastasis.

Objective To investigate the association between coagulation function in the acute stage and in-hospital mortality within one week after admission in patients with severe traumatic brain injury (sTBI). Methods A total of 412 patients with sTBI who were admitted to our hospital from June 2016 to March 2021 were enrolled, and according to their prognosis at 1 week after admission, they were divided into survival group with 350 patients and death group with 62 patients. The two groups were compared in terms of baseline data, Glasgow Coma Scale (GCS) score on admission, and coagulation parameters on admission. A binary logistic regression analysis was performed for significantly different indicators to identify the influencing factors for in-hospital mortality within one week. Results There were significant differences between the two groups in GCS score, the le-vels of fibrinogen, fibrinogen degradation products, and D-dimer in plasma, activated partial thromboplastin time, international normalized ratio, and platelet count on admission (t=-13.11-8.83,P<0.01). The logistic regression analysis showed that the levels of fibrinogen, fibrinogen degradation products, and D-dimer in plasma, activated partial thromboplastin time, and platelet count were influencing factors for in-hospital mortality within one week in sTBI patients (P<0.05). Conclusion The levels of fibrinogen, fibrinogen degradation products, and D-dimer in plasma, activated partial thromboplastin time, and platelet count in the acute stage of sTBI are influencing factors for in-hospital mortality within one week, and these indicators can be used to predict the poor prognosis of sTBI patients in clinical practice.

Objective To evaluate the prenatal diagnostic performance of combined ultrasonography and magnetic resonance imaging (MRI) for placenta accreta in pregnant women. Methods A total of 65 patients with suspected prenatal placenta accreta admitted to our hospital from January 2019 to December 2023 were enrolled. Preoperative ultrasonography and MRI fin-dings (including all MRI signs), as well as postoperative pathological findings, were collected. The final diagnosis for each patient was based on the surgical pathology results. A receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of each modality, and Kappa statistics were applied to compare the consistency of ultrasonography, MRI, and combined ultrasonography and MRI with surgical pathological results. Results Among the 65 patients, 54 cases of placenta accreta were confirmed by surgical pathology. Ultrasonography showed a sensitivity of 100.00%, but a relatively low specificity (45.45%) and an accuracy of 90.77%, demonstrating moderate agreement with the pathological results (Kappa=0.581). MRI exhibited high sensitivity (96.30%) and specificity (100.00%), with an accuracy of 96.92% and strong agreement with the pathological results (Kappa=0.898). Combined ultrasonography and MRI achieved 100.00% sensitivity, specificity, and accuracy, and yielded perfect agreement with the pathological results (Kappa=1.000). Among the MRI signs, “intraplacental dark bands or he-terogenous signal intensity” showed the highest sensitivity (92.59%), while “interruption of low-signal myometrial band or discontinuous” demonstrated the highest specificity (100.00%). Conclusion Combined ultrasonography and MRI provide superior prenatal diagnostic performance for placenta accreta compared with either modality alone, significantly improving diagnostic accuracy and reliability.

Objective To investigate the value of histogram analysis of CT values based on multislice CT (MSCT) in the differential diagnosis of odontogenic keratocyst (OKC) and ameloblastoma (AME) of the jaw. Methods A total of 32 patients with pathologically confirmed OKC and 59 patients with pathologically confirmed AME of the jaw were included in this study, and FireVoxel software was used for image processing and histogram analysis to obtain various histogram parameters, including the mean, standard deviation, variance, coefficient of variation, skewness, kurtosis, entropy, and percentiles (1st, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 99th) of CT values for lesions. The two-independent-samples t test or the Mann-Whitney U test was used for comparison of histogram parameters between OKC and AME of the jaw. A receiver operating characteristic (ROC) curve analysis was used to investigate the diagnostic efficacy of each parameter, and the area under the ROC curve (AUC) was also calculated. Results There were significant differences in the 5th and 10th percentiles of histogram parameters between OKC and AME of the jaw (Z=4.486, 2.058,P<0.05), among which the 5th percentile had the largest AUC of 0.835, with a cut-off value of -4 HU for the highest diagnostic efficacy on the ROC curve. Conclusion Histogram analysis of CT values based on MSCT can help with the differential diagnosis of OKC and AME of the jaw, and the 5th percentile shows the best diagnostic efficacy.

Objective To investigate the association between baseline serum alkaline phosphatase (ALP) levels and prognosis in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone. Methods The cli-nicopathologic data of 55 patients with mCRPC who received abiraterone therapy were retrospectively analyzed. Baseline serum ALP levels were measured before treatment and categorized into a high-ALP group and a normal-ALP group according to the normal cutoff (125 U/L). Differences in clinicopathological characteristics between the two groups were assessed by the log-rank test, and Kaplan-Meier survival curves were generated. A Cox regression analysis was performed to evaluate the association of baseline serum ALP level with overall survival (OS) and prostate-specific antigen progression-free survival (PSA-PFS). Results There were no significant differences in baseline characteristics between the two group, including age, number of patients with prior chemotherapy, Eastern Cooperative Oncolgy Group (ECOG) score, type of androgen deprivation therapy (ADT), Gleason score, initial se-rum PSA level, metastatic sites, neutrophil count, serum albumin level, and lactate dehydrogenase level (P>0.05). The Kaplan-Meier survival analysis results showed that both OS and PSA-PFS were shorter in the high-ALP group than in the normal-ALP group (χ²=8.91,7.44,P<0.05). The results of multivariable Cox regression analysis indicated that high neutrophil count (HR=27.71,P<0.05) and high baseline serum ALP level (HR=2.83,P<0.05) were predictors of shorter OS, while previous chemotherapy history (HR=3.11,P<0.05) and high baseline serum ALP level (HR=0.38,P<0.05) were associated with shorter PSA-PFS. Conclusion Baseline serum ALP may serve as an important prognostic biomarker for mCRPC patients receiving abiraterone therapy. Patients with lower baseline serum ALP tend to have a more favorable prognosis.

Objective To investigate the effect and safety of intravenous drip combined with local infiltration of trane-xamic acid on blood loss in patients with single-segment lumbar spinal stenosis (LSS) undergoing unilateral biportal endoscopic unilateral laminectomy for bilateral decompression (UBE-ULBD). Methods The patients with single-segment LSS who met the inclusion criteria and underwent UBE-ULBD from March 2023 to August 2024 were enrolled and randomly divided into intravenous group (tranexamic acid [TXA] was administered via intravenous drip before incision closure), combined group (TXA was administered via intravenous drip combined with local infiltration before incision closure), and control group (the incision was sutured directly), with 38 patients in each group. The three groups were compared in terms of general clinical data, postoperative drainage volume, the reduction in hemoglobin (HGB) (the difference between the level of HGB before surgery and the level of HGB on day 1 after surgery), postoperative coagulation markers, length of postoperative hospital stay, and complications. Results Compared with the intravenous group and the control group, the combined group had a significant reduction in postoperative drainage volume, and the combined group had a significantly lower postoperative drainage volume than the intravenous group (F=44.364,t_LSD=2.717-7.194,P<0.05). Compared with the control group, the intravenous group and the combined group had a significantly lower degree of reduction in HGB (F=35.495,t_LSD=6.544,7.891,P<0.05), and there was no significant difference in the degree of reduction in HGB between the intravenous group and the combined group (P>0.05). There were no significant differences in postoperative coagulation markers and length of hospital stay between the three groups (P>0.05). At the 3-month follow-up after surgery, no related complications were observed in any group. Conclusion Intravenous drip and local infiltration of TXA can significantly reduce postoperative blood loss in patients with single-segment LSS undergoing UBE-ULBD surgery, without exerting a significant impact on coagulation function or increasing the incidence rate of postoperative complications.

Objective To investigate the differentially expressed genes (DEGs) associated with miR-21 between hepatocellular carcinoma (HCC) tissue and normal tissue, as well as their biological function in the development and progression of HCC. Methods The GSE65892 dataset with good data integrity was obtained from the GEO database. GEO2R tool was used to import data into R language, and the limma package was used to identify miR-21-related DEGs. DAVID database was used to perform gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of miR-21-related DEGs. A protein-protein interaction (PPI) network was constructed for miR-21-related DEGs to identify hub genes, and the Kaplan-Meier survival curve was used to investigate the value of these hub genes in predicting the prognosis of HCC patients. Results A total of 74 miR-21-related DEGs were identified in the GSE65892 dataset, with 23 upregulated genes and 51 downregulated genes. The GO functional annotation and KEGG pathway enrichment analyses showed that these DEGs were involved in the biological processes such as cellular response to lipopolysaccharide and angiogenesis. The PPI network analysis identified 18 downregulated and 2 upregulated hub genes, and the survival analysis showed that 8 hub genes (RBM12, HNRNPD, CXCL8, TRA2A, DDIT3, RPS24, LRRC57, and CXCL2) were significantly associated with poor prognosis in HCC patients. Conclusion RBM12, HNRNPD, CXCL8, TRA2A, DDIT3, RPS24, LRRC57, and CXCL2 are the miR-21-related DEGs that are significantly associated with poor prognosis of patients. These genes participate in the development and progression of HCC by regulating immune function and cell differentiation, proliferation, and apoptosis.

Esophageal cancer is a malignancy with high incidence and mortality rates, and most patients are already at locally advanced stage at diagnosis. Conventional standard treatments, such as definitive concurrent chemoradiotherapy (dCRT), still have limitations in efficacy. Immunotherapy can activate systemic antitumor immune response, and its combination with dCRT can further amplify antitumor effects, playing an important role in the treatment of locally advanced esophageal cancer. Immunotherapy combined with dCRT is gradually becoming a key component of comprehensive treatment strategies for esophageal cancer; howe-ver, the optimal combination approach remains unclear, and its specific benefits require further confirmation through large-sample clinical trials and long-term follow-up data. This review systematically summarizes the research advances in immunotherapy for locally advanced esophageal cancer from the perspectives of antitumor mechanisms, predictive biomarkers of immunotherapy efficacy, and clinical applications of immunotherapy combined with dCRT, and discusses future research directions for combination immunotherapy, with the aim of providing a basis for optimizing treatment strategies for locally advanced esophageal cancer.

Intrauterine adhesions (IUA) is a common gynaecological condition that significantly impacts female reproductive health. Radiological examinations, such as ultrasound, magnetic resonance imaging (MRI), and hysterosalpingography (HSG), are the main methods for the diagnosis of IUA. Ultrasound has the advantages of noninvasiveness and convenience and is widely used for the preliminary screening for IUA; MRI shows higher accuracy and specificity in the evaluation of complex and moderate-to-severe IUA; HSG, as a traditional diagnostic tool for IUA, plays a key role in the preliminary screening and morphological assessment of IUA. The combined use of multiple imaging techniques can achieve complementary advantages and thus significantly improve the accuracy and specificity of IUA diagnosis. This article systematically reviews the application, advantages, and limitations of the aforementioned imaging modalities in the diagnosis of IUA, as well as the combined use of different imaging techniques, in order to provide a comprehensive reference for clinicians and promote the precise diagnosis and treatment of IUA.

At present, the puncture approaches for percutaneous vertebroplasty (PVP)/penetrating keratoplasty (PKP) include unilateral pedicular approach, bilateral pedicular approach, and extrapedicular approach. This article summarizes 14 puncture approaches for PVP/PKP that are commonly used in clinical practice, including application conditions, optimalindications, and technical risks. In recent years, the extrapedicular approach has gained increasing popularity. Compared to traditional bilateral transpedicular techniques, the extrapedicular approach demonstrates advantages in reducing operative time, minimizing tissue trauma, lowering radiation exposure, and decreasing material costs. Importantly, it overcomes the anatomical limitation of the lateral pedicle wall on needle angulation in unilateral transpedicular puncture, allowing greater lateral inclination to position the needle tip near the vertebral midline, thereby facilitating symmetrical cement diffusion along the central axis. For thoracic and upper lumbar vertebrae, the extrapedicular approach is prioritized to mitigate the risk of spinal cord injury. Conversely, in the lower lumbar region, the unilateral transpedicular approach is recommended to avoid potential lumbar artery damage associated with extrapedicular puncture. The puncture path should be determined before surgery based on the technical advantages of the operator, and an appropriate surgical procedure should be selected based on the morphology of the fractured vertebra and related key parameters.