ObjectiveTo investigate the impact of virtual reality (VR)-based psychotherapy on the negative attentional bias of individuals with depressive symptoms and to compare the effects of VR self-help cognitive restructuring training and VR psychotherapy placebo in improving the negative attentional bias of people with depressive symptoms.MethodsA total of 50 individuals with depressive symptoms were selected as participants and were randomly divided into an intervention group and a control group. The intervention group and control group were given the VR cognitive restructuring training and the VR psychotherapy placebo interventions, respectively. The study employed eye-tracking technology and dot-probe paradigm to measure negative attentional bias, while the 9-item Patient Health Questionnaire (PHQ-9), Hamilton Depression Rating Scale (HAMD), 7-item anxiety scale (GAD-7), and Hamilton Anxiety Rating Scale (HAMA) were used to assess depressive and anxiety symptoms. Changes in negative attentional bias indicators (gaze duration and count) and depressive and anxiety symptoms before and after intervention were compared between the two groups.ResultsThe results showed that both groups exhibited a main effect of time on fixation duration and count (P=0.068, P=0.001), but there was no statistically significant difference between the two groups. After the intervention, depressive and anxiety symptoms in both groups were significantly alleviated, and the VR cognitive restructuring training showed a more pronounced effect in symptom alleviation.ConclusionVR psychotherapy is effective in reducing depressive and anxiety symptoms, but there is no difference in the improvement of negative attentional bias when compared to the placebo control group.

ObjectiveTo investigate the expression of phosphoglycerate dehydrogenase (PHGDH) in gastric cancer and its role in resistance to the chemotherapy drug oxaliplatin.MethodsPHGDH-overexpressing and knockdown gastric cancer cell-derived organoid models were established. The half maximal inhibitory concentration (IC50) values of oxaliplatin in organoids with differential PHGDH expression were determined using the cell counting kit-8 (CCK-8) assay. DNA damage was assessed via Western blotting analysis of -H2AX (Ser139) levels. Oxidative stress levels were evaluated by measuring GSH/GSSG and NADPH/NADP+ ratios and reactive oxygen species (ROS) level. Cell migration assays and subcutaneous xenograft tumor experiments in BALB/c nude mice were conducted to assess the effects of PHGDH expression on oxaliplatin resistance. Additionally, survival prognosis in gastric cancer patients with differential PHGDH expression was analyzed using TCGA data.ResultsExperimental results showed that elevated PHGDH expression was significantly associated with the oxaliplatin resistance of gastric cancer cells. Stimulation of gastric cancer organoids with oxaliplatin significantly reduced the phosphorylation level of H2AX (P<0.000 1), thereby diminishing the DNA damage caused by oxaliplatin, while knockdown of PHGDH enhanced cellular sensitivity to oxaliplatin (P<0.000 1), inhibiting gastric cancer cell proliferation and migration capabilities (P<0.000 1). High expression of PHGDH leaded to an increase in the intracellular GSH/GSSG and NADPH/NADP+ ratios in gastric cancer cells (P<0.000 1, P<0.001), along with a decrease in ROS levels (P<0.000 1). In vivo experiments further confirmed that under oxaliplatin stimulation, the volume of PHGDH overexpressing patient-derived organoids xenografts (PDOX) was significantly larger than that in the control group (P<0.01). Analysis of the TCGA database revealed that patients with high PHGDH expression experienced significantly shorter disease-specific survival and progression-free survival than those with lower expression of PHGDH (HR=2.23, 95% CI: 1.43-3.47, P<0.001; HR=1.70, 95%CI: 1.19-2.44, P=0.004), with consistent results observed across different stages and grades of gastric cancer.ConclusionPHGDH plays a pivotal role in regulating oxaliplatin resistance in gastric cancer cells, suggesting its potential as a therapeutic target and prognostic biomarker.

ObjectiveTo explore the current status and influencing factors of missed examination items among individuals aged 60 years and above undergoing physical examinations, and to put forward countermeasures.MethodsData were collected from 732 individuals aged 30 to 60 years and 732 individuals aged 61 to 90 years who underwent physical examinations at the Physical Examination Department of Shanghai East Hospital from February to August 2024. The 30-60 age group was designated as the control group, and the 61-90 age group was designated as the study group. The missed examination rates, causes of omitted tests, and examination times in the two groups were compared.ResultsThere were significant differences in missed examination rate and examination time between control and study group [20.09% (147/732) vs 39.07 (286/732) and (89±22.35) min vs (145±37.66) min, respectively] (both P<0.000 1). The most commonly missed examination items included Internal Medicine, Otolaryngology, electrocardiogram (ECG), Gynecology, and stool and urine tests. The main reasons for missed examinations included personal preference, examination environment, educational level, and carelessness.ConclusionThe main reasons for missed examinations in the elderly include personal preference, examination environment, educational level and carelessness. Missed screenings may lead to the loss of early diagnosis opportunities for certain critical diseases, affecting timely treatment and prognosis. Based on these influencing factors, relevant measures can be formulated to reduce the missed examination rate, shorten examination time, and improve satisfaction among elderly individuals undergoing physical examinations.

ObjectiveTo evaluate the efficacy and safety of various hyperthermic intraperitoneal chemotherapy (HIPEC) combined with systemic chemotherapy in patients with malignant ascites (MA) secondary to gastrointestinal malignancies.MethodsClinical data of 50 patients with advanced gastrointestinal malignancies and MA treated with HIPEC plus best supportive care (BSC) at Shanghai Tenth People's Hospital, Tongji University from January 2019 to January 2023 were retrospectively analyzed. Short-term therapeutic outcomes were assessed using the Chinese Clinical Guidelines for Hyperthermia in Oncology (2022 Edition), while long-term survival was evaluated via Kaplan-Meier analysis.ResultsThe treatment responses included complete response in 5 cases (CR: 10%, 5/50), partial response in 6 cases (PR: 12%, 6/50), stable disease in 30 cases (SD: 60%, 30/50), and progressive disease in 9 patients (PD: 18%, 9/50), yielding an objective response rate (ORR) of 22% and disease control rate (DCR) of 82%. The median progression-free survival (PFS) and overall survival (OS) was 7.39 months and 12.26 months, respectively. Analysis of tumor markers before and after treatment revealed a negative correlation between therapeutic efficacy and CA125 levels (P=0.001).ConclusionHIPEC demonstrates clinically meaningful efficacy and survival benefits with a favorable safety profile in advanced gastrointestinal malignancies complicated by MA. Lobaplatin-based regimens exhibites superior therapeutic outcomes compared to cisplatin or paclitaxel. Serum CA125 may serve as a predictive biomarker for poor prognosis.

ObjectiveTo detect the expression of CD1d in various tumor cell lines, and to explore the sensitivity of iNKT cells in killing different tumor cell lines.MethodsA variety of tumor cell lines were prepared into single cell suspensions, the tumor cells were incubated with CD1d antibody, and the expression of CDld in various tumor cell lines was detected by flow cytometry. The iNKT cell and tumor cells were co-incubated according to the effect-target ratio of E:T=10:1, 5:1 and 1:1. The killing effect of iNKT cells on tumor cells was monitored by RTCA esight imaging, the expression of molecules on the surface of iNKT cells was detected by flow cytometry, and the cytokine secretion after activation of iNKT cells was detected by ELISA.ResultsThe CD1d expression was detected in Jurkat, Jeko-1, U2OS, A375 and Hep-3B cell lines, and the positive rates was 98.40%, 93.80%, 67.10%, 43.80% and 11.00%, respectively. While tumor cell lines Huh7, OVCAR3, MKN45, AGS, H460, MKN7 and MDA-MB-453 were CD1d negative. Activated iNKT cells expressed NK cell activation receptors CD226 and NKG2D, and at the same time, they could rapidly secrete large amounts of cytokines and cytotoxic molecules such as IFN and Granzyme B.ConclusionThe iNKT cell has extensive killing ability against CD1d positive (except Jeko-1 cells) and negative tumor cell lines, and the killing effect is the strongest when target ratio is high. -Galcer can enhance the killing ability of iNKT cells on CD1d positive tumor cell lines.

ObjectiveTo investigate the influencing factors of weight in hospitalized patients with schizophrenia (SCZ).MethodsThe demographic data, physical measurement indicators and laboratory nutritional metabolism indicators from 401 hospitalized SCZ patients hospitalized in Shanghai Putuo Mental Health Center were collected. The patients were divided into 4 groups according to body mass index (BMI): low weight group, normal weight group, overweight group, and obesity group. The general information and nutritional indicators of the 4 groups were compared, and the risk factors for abnormal weight in SCZ patients were analyzed too.ResultsAmong the hospitalized SCZ patients, 31 cases were underweight, accounting for 7.7% (31/401), 158 cases had normal weight, accounting for 39.4% (158/401), 134 cases were overweight, accounting for 33.4% (134/401); 78 cases were obese, accounting for 19.5% (78/401). There was no statistically significant differences in gender, marriage status, educational level, comorbidities, smoking history, alcohol consumption history, albumin, total cholesterol, fasting blood glucose and low-density lipoprotein among the 4 groups (all P>0.05). There were statistically significant differences in age, course of disease, length of hospital stay, systolic and diastolic blood pressure, history of antipsychotic drugs using, hemoglobin, lymphocyte counts, red blood cell, white blood cell, total protein, prealbumin, triglycerides, high-density lipoprotein and uric acid among the 4 groups (all P<0.05). Multivariate regression analysis showed that referring to the patients with normal weight, low systolic blood pressure was a risk factor for low weight (P<0.05); young age, high red blood cell, and high triglyceride were risk factors for overweight (all P<0.05); young age, short hospital stay, high systolic blood pressure, high red blood cell, high triglyceride, low high-density lipoprotein and combined use of antipsychotic drugs were risk factors for obesity (all P<0.05).ConclusionSCZ patients often experience abnormal weight, mainly overweight and obesity. Early attention, targeted and reasonable nutritional interventions should be provided to reduce the incidence of complications in SCZ patients, improve quality of life, shorten hospital stay, and reduce treatment costs.

ObjectiveExploring the impacting factors associated with the three dimensions of occupational burnout including emotional exhaustion, depersonalization, and reduced professional accomplishment and the moderating role of social support among primary mental health medical staff.MethodsIt was a cross-sectional study. Convenience sampling method was used, and self-report data were collected electronically between February 14, 2023 and August 31, 2023 from primary mental health medical staff working in communities in Shanghai. A total of 371 valid questionnaires were collected. The occupational burnout was evaluated by the Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS), which consists of three dimensions: emotional exhaustion (EE), depersonalization (DP), and reduced professional accomplishment (PA). Levels of social support were measured by the social support rating scale (SSRS). Multivariate linear regression was used to analyze the effects of demographic and occupational factors on EE, DP, and reduced PA scores. Regression-based statistical moderation effect was conducted with the PROCESS macro of SPSS, to explore the potential role of social support as a moderator.ResultsCompared to primary mental health medical staff in Beijing and Chengdu, the staff in Shanghai had a higher proportion of permanent contracts, a greater percentage of doctors, and a higher level of education. Multivariate linear regression showed that perceived workload, job satisfaction, and professional background predicted the level of EE. Team cooperation status, perceived workload, and job satisfaction predicted the level of DP. Team cooperation status and job satisfaction could predict PA scores. Social support significantly moderated the effects of workload on EE and DP. A weaker association between workload and EE was observed in staff with high-level social support than in low-level ones (simple slope 0.81 vs 1.53, P=0.001). Similar moderating effects were found between workload and DP (simple slope 0.45 vs 1.25, P=0.001).ConclusionBoth demographic and occupational factors predicts burnout levels. Social support negatively moderates the positive effects of workload on EE and DP levels. Teamwork within community mental health service should be enhanced, with a focus on the professional background of primary mental health medical staff and the level of social support in the work environment. Additionally, it is important to address the high prevalence of perceived heavy workload and low job satisfaction among these staff, to improve the effective management of patients with severe mental disorders in the community.

ObjectiveTo construct a Split-TurboID system based on a fragment complementation strategy to achieve efficient and specific labeling of intercellular interaction proteins.MethodsNonactive fragments of secretion-targeted Split-TurboID and direct interaction-mediated Split-TurboID were engineered, and their cellular expression and localization were validated. The labeling efficiency of the Split-TurboID system was evaluated by Western blotting, immunofluorescence and flow cytometry.ResultsThe Split-TurboID system, reconstituted through spontaneous interaction or bait protein induction, was successfully established. Western bloting, immunofluorescence, and flow cytometry analyses demonstrated that N-TurboID and C-TurboID fragments could exhibit high mutual affinity upon proximity, forming an active TurboID enzyme. Subsequent biotin labeling enabled the detection of secretory protein interactions and direct cell-cell contacts.ConclusionThe Split-TurboID technology provides an efficient, flexible, and highly specific biotinylation-based method for investigating intercellular interactions, offering a powerful tool to investigate intercellular communication.

ObjectiveTo investigate the changes of serum A20 level in patients with type 2 diabetes mellitus (T2DM) and its related factors.MethodsIt was a cross-sectional study. A total of 156 T2DM patients visited the Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University and 182 community non-diabetic subjects (age≥50 years) receiving health checkups from 2022 to 2023 were selected as the research subjects. Clinical data were collected, blood biochemistry, grip strength, simple physical fitness test and serum A20 levels were measured. Comparisons between groups were performed using independent sample t test, non-parametric test and chi-square test. The Pearson correlation analysis was used to evaluate the relationship between serum A20 level and other clinical data. Multiple linear regression analysis was used to evaluate the correlation between LnA20 and fasting blood glucose and glycosylated hemoglobin. Univariate and multivariate logistic regression analyses were conducted to explore the relationship between A20 and T2DM.ResultsThe thigh circumference, calf circumference, left hand grip strength, right hand grip strength, hemoglobin, A20 level, total cholesterol and high density lipoprotein cholesterol were all lower in the T2DM group than those in the control group (all P<0.05), while the waist circumference, waist to hip ratio, fasting blood glucose and glycosylated hemoglobin were all higher than those in the control group (all P<0.001). Pearson correlation analysis showed that in non-T2DM subjects, serum A20 levels was negatively correlated with fasting blood glucose and glycosylated hemoglobin (both P< 0.05). In the overall study population, serum A20 levels was negatively correlated with waist to hip ratio, fasting blood glucose and glycosylated hemoglobin, while positively correlated with hemoglobin (all P<0.05). Multiple linear regression analysis revealed that in T2DM patients, after adjusting for waist to hip ratio and hemoglobin, the correlations of LnA20 with fasting blood glucose and glycosylated hemoglobin were not statistically significant. In non-T2DM subjects, after adjusting for waist to hip ratio and hemoglobin, LnA20 remained independently negatively associated with fasting blood glucose and glycosylated hemoglobin (both P<0.05). In the overall study population, after adjusting for waist to hip ratio and hemoglobin, LnA20 was independently negatively associated with fasting blood glucose and glycosylated hemoglobin (both P<0.05). Multivariate logistic regression analysis showed that for each unit increase in A20, the risk of T2DM decreased by 60% (P<0.05).ConclusionSerum A20 level is decreased in patients with T2DM. Besides, serum A20 level is negatively correlated with fasting blood glucose and glycosylated hemoglobin in non-T2DM population and all subjects. A decline in serum A20 level may be a risk factor for T2DM.

Thrombotic disease is a common vascular disease with high mortality and morbidity, it can occur in all blood vessels of the body. The key to diagnosing thrombotic disease lies in thrombus screening, but the formation of thrombus is insidious and unpredictable, so rapid and accurate thrombus screening is crucial in the diagnosis and treatment of thrombotic disease. This review summarizes various thrombus screening and rapid detection methods in recent years, and is expected to provide a reference for the development and clinical application of new thrombus detection methods.

ObjectiveTo investigate the efficacy and safety of drug-coated balloons (DCBs) in the treatment of long-segment occlusive femoropopliteal arterial lesions.MethodsIt was a retrospective cohort study. The clinical data of 117 patients (122 affected limbs) who underwent successful interventional treatment for long-segment occlusive lesions of lower extremity arteriosclerosis obliterans in the Department of Vascular Surgery of Shanghai East Hospital from January 2018 to January 2022 were analyzed. All the lesions were TASC C/D grade lesions, with a mean lesion length of (21.6±7.1) cm. Among them, 65 patients (68 affected limbs) received conventional balloon angioplasty+ lower extremity artery stenting (control group), and 52 patients (54 affected limbs) underwent drugcoated balloon angioplasty (experimental group), with bailout stents implanted when necessary. The primary patency rates and freedom from target lesion revascularization (F-TLR) rates at 12 and 24 months after treatment were analyzed by Kaplan-Meier survival curves, and the occurrence of negative events such as death and amputation was observed.ResultsThe operations of all 117 patients (122 affected limbs) were successful. In the experimental group, 23 affected limbs (42.6%) had bailout stents implanted simultaneously. The Kaplan-Meier curves showed that the primary patency rates at 12 and 24 months were 61.76% (42/68) and 45.59% (31/68) in the control group, and 77.78% (42/54) and 62.96% (34/54) in the experimental group, respectively. The F-TLR rates at 12 and 24 months were 73.53% (50/68) and 55.88% (38/68) in the control group, and 83.33% (45/54) and 74.07% (40/54) in the experimental group, respectively; the differences between the two groups were statistically significant (both P<0.05). In the subgroup analysis of the experimental group, there was no statistically significant differences in the primary patency rates and F-TLR rates at 12 and 24 months between the drug-coated balloon alone subgroup and the bailout stent subgroup (primary patency rates: 70.96% (22/31), 61.29% (19/31) vs 86.96% (20/23), 65.22% (15/23), both P>0.05; F-TLR rates: 77.4% (24/31), 70.97% (22/31) vs 91.30% (21/23), 78.26% (18/23), both P>0.05).ConclusionDCB has a relatively good medium-term therapeutic effect in the treatment of long-segment arteriosclerotic occlusive femoropopliteal arterial lesions. For cases with poor immediate results of DCB treatment, the combination with bailout stenting is a feasible treatment approach.

ObjectiveTo investigate the relationship between clinical characteristics and laboratory indicators with the 30-day mortality risk in patients with spontaneous intracerebral hemorrhage (ICH).MethodsA retrospective analysis was conducted on medical records of 363 ICH patients admitted to the neurology wards of two hospitals in Shanghai from December 2019 to December 2021. A total of 360 cases were included, with 310 in the survival group and 50 in the mortality group. Clinical features and laboratory indicators were collected, and univariate and multivariate Logistic regression analyses as well as ROC analysis were performed.ResultsThe 30-day mortality rate of ICH patients was 13.89%. The age, NIHSS score, and hemorrhage volume were significant factors correlated with the mortality risk. Among laboratory indicators, there were significant differences in red blood cell count, D-dimer, hemoglobin level, and random blood glucose between the surviving and deceased groups. Multivariate Logistic regression analysis revealed that NIHSS score (OR=1.163, 95%CI: 1.111-1.219, P<0.001) and FT3 level (OR=0.501, 95%CI: 0.273-0.919, P=0.026) were independent factors associated with 30-day mortality risk in ICH patients. ROC analysis indicated that the NIHSS model, 1/FT3 model, and composite model all had good predictive efficacy.ConclusionNIHSS score and FT3 level are important indicators for assessing the 30-day mortality risk in ICH patients, it may assist clinicians in better evaluating and managing the mortality risk in these patients.

The “study aversion syndrome” describes a set of emotional and behavioral maladaptations, in students who are supposed to be in school but repeatedly and persistently refuse to attend, resulting in school absence. This article reviews the evolution and classification of related concepts such as school phobia, school absence and school refusal. The concept of “study aversion syndrome” is proposed to provide a reference for clinical prevention and intervention.

ObjectiveTo investigate the impact of unfractionated heparin (UFH) on the expression of Syndecan-1 in the small intestine epithelium in mice with sepsis.MethodsTwenty-four 8-week-old female C57BL/6J mice were randomly divided into control group, UFH group, lipopolysaccharide (LPS) group, and LPS+UFH group, with 6 mice in each group. The LPS group was injected with 10 mg/kg LPS intraperitoneally; the LPS+UFH group was injected with 400 U/kg UFH via the tail vein 1 hour after injection of LPS; the UFH group was given 400 U/kg UFH; the control group was given an equal amount of saline. Four hours after modeling, serum and jejunal tissue were collected from each group, and the serum Syndecan-1 was measured by enzyme-linked immunosorbent assay (ELISA). HE staining was performed to assess the pathological changes of jejunal tissue. RT-qPCR, Western blot and immunofluorescence methods were used to detect the expression of Syndecan-1 in jejunum and its mRNA and protein expression, respectively.ResultsHE staining for the jejunal tissue in the control/UFH group was found normal; the LPS group showed moderate abnormalities, with loose arrrangement of intestinal villi and shortened length in the field of view, some epithelial cells in the mucosal layer were eroded and shed, inflammatory cell infiltration was observed in the tissue. The pathological score and injury degree of the LPS+UFH group showed improvement when compared to the LPS group. The serum Syndecan-1 in the LPS group was (79.58±1.69) ng/mL, which was significantly higher than that in the control and UFH groups [(38.85±1.66) ng/mL and (39.48±1.70) ng/mL, respectively, both P<0.01], while it was (55.08±2.16) ng/mL in the LPS+UFH group, significantly lower than that in LPS group (P<0.01). The mRNA expression of Syndecan-1 in the LPS group was significantly lower than those in the control/UFH group, reaching approximately 38% of the control group (P<0.01); the mRNA expression of Syndecan-1 in the LPS+UFH group was about 68% of the control group, which was much higher than that in the LPS group (P<0.01). Meanwhile, the protein expression of Syndecan-1 in the LPS group was significantly lower than that in the control and UFH groups, reaching approximately 40% (P<0.01), while the LPS+UFH group showed an increase to 77% (P<0.01). Immunofluorescence showed that LPS group had less positive expression of Syndecan-1 in jejunal epithelial cells than that in the control and UFH groups, about 26% (P<0.01). The positive expression of Syndecan-1 in LPS+UFH group was significantly higher than that in the LPS group (P< 0.01).ConclusionUFH can positively regulate the expression of Syndecan-1 in the intestinal epithelium of LPS-induced sepsis mice, reduce its degradation and shedding level, and improve the barrier function of the intestinal epithelium.

ObjectiveTo investigate the relationship between estrogen levels and the efficacy and safety of anastrozole combined with growth hormone in pubertal male children with advanced bone age and short stature.MethodsA retrospective analysis was performed on the clinical data of 59 male patients with advanced bone age and short stature who were treated in the Department of Pediatrics, East Hospital Affiliated to Tongji University from January 2015 to December 2021. All patients received combined treatment with anastrozole (1 mg/d, oral) and recombinant human growth hormone [rhGH, 0.15-0.2 IU/(kg·d), subcutaneous injection before bedtime], with regular follow-up every 6 months. Clinical efficacy (predicted adult height and changes in bone age, sex hormone levels (including testosterone, estradiol, etc.), auxiliary clinical indicators (vitamin D levels, insulin-like growth factor-1, etc.), and adverse events were observed.ResultsAfter 24 months of treatment, the mean PAH increased significantly by (9.23±3.37) cm. There was no statistically significant difference in bone age changes before and after treatment (P>0.05). After 12 months of treatment, E2 levels decreased significantly by (15.33±0.66) pg/mL, while testosterone levels increased by (14.67±0.63) pg/mL. Transient alanine aminotransferase (ALT) elevation occurred in 2 cases (4.80%) within 6 months after treatment. Adverse events observed at 12 months included hyperuricemia (23 cases, 37.5%), hyperandrogenemia (12 cases, 20.30%), and vitamin D insufficiency (12 cases, 25.8%). The increase in PAH after 12 months was significantly negatively correlated with E2 levels (r=-0.541, P< 0.001), positively correlated with bone age increment (r=0.318, P=0.018), and negatively correlated with changes in uric acid levels (r=-0.401, P=0.002). The ROC curve for predicting hyperuricemia after 12 months showed an area under the curve (AUC) of 0.81 for E2 (P<0.001), with a sensitivity of 75%, specificity of 95.70%, and an optimal cutoff value of 0.70 corresponding to an E2 concentration of 11.67 pg/mL.ConclusionThe combination of anastrozole and growth hormone improves predicted height and significantly delays bone age progression in pubertal males with advanced bone age. Sex hormone concentrations exhibit dynamic changes and relative stability during treatment. Reversible adverse events such as hyperuricemia and hyperandrogenemia occur during follow-up, requiring close monitoring. E2 levels have high predictive value for hyperuricemia after 12 months of treatment, providing a reference for clinical practice.

ObjectiveTo explore the causal relationship between alterations in brain resting-state functional networks and polycystic ovary syndrome (PCOS) through two-sample Mendelian randomization (MR) analysis.MethodsThis study utilized the Genome-Wide Association Study (GWAS) database to obtain instrumental variables related to brain functional networks (exposure) from the UK Biobank (UKB), with PCOS as the outcome variable from the FinnGen database. All participants were of European ancestry. Genetic instruments were selected based on genomewide significance, linkage disequilibrium, and strength. When the number of instrumental variables was one, Wald Ratio analysis was used; otherwise, inverse variance weighted (IVW), MR-Egger regression, and weighted median (WM) methods were employed for MR analysis to assess causality. Cochran's Q test, MR-PRESSO, and MR-Egger intercept analysis were conducted to evaluate heterogeneity and pleiotropy.ResultsThe Wald Ratio analysis revealed that at the level of paired functional connectivity, the central executive network and default mode or the central executive network located between the frontal and temporal lobes were positively correlated with the risk of PCOS (Wald Ratio OR=6.77, 95%CI: 1.34-34.36, P=0.021). Conversely, increased activation of the attention or central executive or salience mode network and the motor network located between the parietal and postcentral or precentral regions were negatively correlated with the risk of PCOS (Wald Ratio OR=0.19, 95% CI: 0.04-0.98, P=0.048). The heightened activation of the visual network and the central executive network, located between the cuneus or occipital and frontal lobes, were positively correlated with the risk of PCOS (Wald Ratio OR=3.73, 95% CI: 1.01-13.82, P=0.049). The IVW analysis showed that among the amplitude characteristic traits, the increased activation of limbic network (node) located in the frontal lobe was positively correlated with the risk of PCOS (IVW OR=2.22, 95% CI: 1.0-4.71, P=0.039); the increased activation of limbic network (node) located in the temporal or orbitofrontal region was positively correlated with the risk of PCOS (IVW OR=2.39, 95% CI: 1.17-4.86, P=0.016). The results of the auxiliary analysis were consistent with the direction and range of the values and OR values obtained by the IVW method. The results were robust, and no evidence of heterogeneity or pleiotropy was found. Reverse MR analysis showed that, using the IVW analysis method, at the level of pairwise functional connectivity, PCOS was negatively correlated with the increased activation of default mode or central executive and default mode or salience networks located in the occipital precuneus-temporal lobe or frontal lobe or supplementary motor area (IVW OR=0.96, 95% CI: 0.93-1.00, P=0.024); PCOS was negatively correlated with the increased activation of central executive or salience and central executive or salience networks located in the parietal-frontal lobe (IVW OR=0.97, 95% CI: 0.94-1.00, P=0.044).ConclusionThere is a certain causal relationship between brain resting-state functional networks and risk of PCOS. Variations in activity within specific networks may modulate susceptibility to PCOS. PCOS may also be involved in the changes of the brain's resting-state networks. The findings lend support to the central origin theory of PCOS and provide genetic evidence for this hypothesis.

ObjectiveTo explore the value of high frequency linear transabdominal probe in ultrasound imaging of fetal heart at 11-13+6 weeks of gestation.MethodsFive hundred and seventy women with singleton pregnancies at 11-13+6 weeks of gestation receiving ultrasonic examinations in the Obstetrics and Gynecology Hospital of Tongji University from March 2024 to May 2024 were enrolled. The fetal hearts were examined using high frequency linear transabdominal probe and convex transabdominal probe, and the images were stored.ResultsThe image display rates and high quality rates with transabdominal high frequency linear probe were higher than those with transabdominal convex probe (both P<0.05). The larger the gestational age, the higher the display rate of the basic cardiac views of the fetus. At 13-13+6 weeks of gestation, the display rate of the four-chamber view of the fetus with the two probes was both 100% (P>0.05). At 11-11+6 weeks and 12-12+6 weeks of gestation, the display rates of the four-chamber heart view of the fetus with transabdominal high frequency linear probe were both higher than those with transabdominal convex probe (both P<0.05). The differences were statistically significant (P<0.05). At 11-11+6 weeks, 12-12+6 weeks and 13-13+6 weeks of gestation, the display rates of left ventricular outflow tract view, three-vessel view and right ventricular outflow tract view with transabdominal high-frequency linear array probe were all higher than those with transabdominal convex probe, and the differences were statistically significant (all P<0.05).ConclusionThe high frequency linear transabdominal probe has advantages in ultrasound imaging of fetal heart at first trimester, it can provide important basis for early diagnosis of congenital heart disease.

Duodenal mucosal resurfacing (DMR) is an innovative endoscopic procedure aimed at treating obesity and type 2 diabetes mellitus (T2DM). This technique modifies the intestinal mucosa, enhances food transit, and regulates the secretion of gastrointestinal hormones, which collectively increases satiety and improves insulin sensitivity. Postoperatively, patients often experience significant weight loss and better glycemic control. This article explores the potential mechanisms by which DMR may alleviate metabolic disorders and evaluates its effectiveness in managing T2DM, obesity, nonalcoholic fatty liver disease (NAFLD), and polycystic ovary syndrome (PCOS).

ObjectiveTo evaluate the short-term efficacy and safety of gastric interposition for digestive tract reconstruction after proximal gastrectomy.MethodsA retrospective study was conducted on 47 patients with Siewert Ⅱ-Ⅲ adenocarcinoma of the esophagogastric junction (AEG) who received radical surgery in the Department of Genera1 Surgery of Yangpu Hospital Tongji University between January 2021 and October 2023. Among them, 32 cases underwent total gastrectomy with Roux-en-Y anastomosis (TGRY), and 15 cases received proximal gastrectomy with gastric interposition anastomosis (PGGI). Surgical safety and efficacy were compared between the two groups.ResultsThe baseline characteristics between TGRY group and PGGI group were comparable (All P>0.05). No significant difference was observed between the two groups in the intraoperative and postoperative recovery indicators, including intraoperative blood loss, postoperative complication rate and length of postoperative hospitalization, etc (all P>0.05). There were 2 (13.3%) cases of Clavien-Dindo grade ≥Ⅱ complications in the PGGI group, but no severe complications such as anastomotic leakage or stenosis occurred. Moreover, no tumor recurrence or metastasis was detected in either group of patients within 6 months after surgery. The nutritional indicators of PGGI group were significantly better than those of TGRY group at postoperative 6 months, including body mass index, serum albumin, hemoglobin and mean corpuscular volume (all P<0.05). No megaloblastic anemia was observed in the PGGI group. The incidences of digestive discomfort (Visick scale 2-4) (6.7% vs 37.5%, P=0.037) and reflux esophagitis (Los Angeles grade B-D) (7.1% vs 42.3%, P=0.030) in the PGGI group were both significantly lower than those in the TGRY group 6 months after the surgery.ConclusionPGGI is safe and feasible for the patients with AEG. Compared with TGRY, PGGI can effectively improve patients' nutritional status and quality of life after surgery, and does not increase the risk of postoperative complications.

In recent years, labor pain management has received significant attention from the state and society. Dural puncture epidural (DPE) is a novel technology for labor analgesia and the focus of recent researches. The DPE technique expedits labor analgesia onset and reduces maternal and fetal adverse events related to direct intrathecal injection of opioids. This article reviews recent clinical studies on labor analgesia related to DPE.

ObjectiveTo develop more efficient approaches for inhibiting the growth of Fusobacterium nucleatum (F. nucleatum).MethodsThe effects of inhibiting Fusobacterium nucleatum of D-phenyllactic acid (D-PLA) and hydroxypropyl--cyclodextrin (HP--CD) were explored by the concentration gradient method, the effect of D-PLA combined with HP--CD on inhibiting the growth of Fusobacterium nucleatum was explored by the checkerboard method, and the molecular structure mechanism underlying drug combination effects was analyzed. During the experimental process, the spectrophotometry was used to test the growth of F. nucleatum within 48 hours, and then the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by integrating the growth curve and the plate inoculation results to evaluate the antibacterial effect. The conjugation molecular structure model was constructed by the quantum chemical QM calculations combined with energy data.ResultsD-PLA had inhibitory effect on the growth of F. nucleatum, the MIC was 0.6 mg/mL while MBC was 4.5 mg/mL. The MIC of HP--CD was 1.0 mg/mL against Fusobacterium nucleatum.ConclusionThe combination of D-PLA and HP--CD shows a fractional inhibitory concentration (FIC) index of 0.25 (<0.5), forms an envelope structure at the molecular level, and exhibits synergistic antibacterial effects against Fusobacterium nucleatum.