Abstract:Depression，as a neuropsychiatric disorder with high prevalence，strong concealment and high relapse rate，is a serious threat to human physical and mental health. The hippocampus，a key brain region for regulating emotional and cognitive functions，has been found to have persistent neurogenesis in its dentate gyrus during adulthood. In recent years，a large amount of evidence suggests that adult hippocampal neurogenesis processes are closely related to the pathophysiology of depression. However，the causal association between adult hippocampal neurogenesis and the pathology of depression has not been systematically summarized. In this review，we summarized four aspects of evidence supporting the‘adult hippocampal neurogenesis hypothesis’of depression：the reduction of adult hippocampal neurogenesis induces depressive phenotypes and related pathologies；depression models reduce adult hippocampal neurogenesis；the increased adult hippocampal neurogenesis exerts antidepressant effect；and current antidepressants treatment increases adult hippocampal neurogenesis. This review is the first to comprehensively and systematically summarize the causal role of adult hippocampal neurogenesis in depression，providing new perspectives on the mechanisms of depression and antidepressants.

Abstract:Depressive disorder，as a common mental health condition，imposes a significant burden on both patients and society. However，its early diagnosis and precise treatment remain challenging，highlighting the urgent need for objective and reproducible neural biomarkers. In recent years，event - related potentials（ERPs），as a neurophysiological tool characterized by high temporal resolution，cost-effectiveness，and non-invasiveness，have opened new avenues for the diagnosis and treatment of depressive disorders. The article reviews the latest advances in the research of various ERP components in depressive disorders，with a particular focus on their potential applications and current challenges in the diagnosis，differential diagnosis，and treatment outcome evaluation of depressive disorders. The aim is to provide insights and references for future research and application of ERPs as neurobiological markers in the diagnosis and therapeutic evaluation of depressive disorders.

Abstract:Objective：This study aims to verify the anti-inflammatory effect of baicalin（BA）in an inflammatory environment and explore its influence on the odontogenic/osteogenic differentiation of human dental pulp stem cells（hDPSC），providing a reference for the vital pulp therapy of pulpitis. Methods：Select the early inflammatory pulp tissue of the human teeth for making frozen sections and conducting HE staining，interleukin（IL）-1β immunohistochemical staining，as well as IL-1β and inducible nitric oxide synthase（iNOS） immunofluorescence staining. Human monocyte leukemia cells（THP-1）were differentiated into macrophages and polarized to the M1 subtype under the induction of lipopolysaccharide（LPS）and interferon-γ（IFN-γ）. Then，cells were treated with BA（50 μmol/L）， the expression levels of iNOS，IL-1β，and IL-8 were analyzed using immunofluorescence，real-time quantitative PCR（RT-qPCR），and Western blot. Additionally，the expression changes of LC3B，Beclin-1，and P62 were assessed by Western blot to monitor autophagic flux alterations in macrophages. To further investigate the relationship between inflammation inhibition and autophagy，we employed the autophagy inhibitor 3-MA to block autophagic flux and re-evaluated the expression changes of IL-1β and IL-8. Supernatants from macrophages cultured under various conditions were collected，and the conditioned medium was prepared and added to mineralized hDPSC. The odontogenic/osteogenic differentiation ability of hDPSC in an inflammatory environment was analyzed by alkaline phosphatase ALP staining，alizarin reds（ARS）staining，RT - PCR，and Western blot. Results：The expression of IL - 1β and iNOS around the inflammatory area of early pulpitis tissue was significantly increased. After induced by LPS and IFN-γ，macrophages were polarized from M0 to M1，and the expressions of iNOS，IL-1β and IL-8 significantly increased. After co-incubation with 50 μmol/L BA for 24 hours，the polarization degree of M1 macrophages significantly decreased，the mRNA levels of IL - 1β and IL - 8 significantly decreased compared with the M1 group. Compared with the M1 group，the expressions of LC3B -Ⅱ and Beclin -1 increased after the addition of BA，while the expression of P62 was inhibited. After 3 - MA blocked autophagy，the mRNA levels of IL - 1β and IL - 8 significantly increased. After adding the supernatant of M1 macrophages to hDPSC and inducing mineralization for 7~21 days，the ALP activity of hDPSC decreased，the calcium salt deposition significantly reduced，and the expressions of ALP，DSPP，RUNX2，OPN and COL - 1 significantly decreased. When adding the supernatant of M1 macrophages treated with BA，the ALP activity of hDPSC significantly increased，the calcium salt deposition significantly increased，and the expressions of ALP，DSPP，RUNX2，OPN and COL-1 significantly increased. Conclusion：BA can inhibit inflammatory responses by activating autophagy，thereby enabling hDPSC to function in an inflammatory microenvironment.

Abstract:Objective：To examine the expression of F - box protein（FBXO）6 in glioma tissues and cells and its impact on the proliferation and invasion of glioma cells，and to explore the upstream regulatory mechanism of FBXO6 expression. Methods：The CGGA database was used to analyze the expression of FBXO6 in tumor tissues of glioma patients and its correlation with patient prognosis. RT-PCR and Western blot were performed to check the expression levels of FBXO6 in glioma cell lines（U251，U373，and U87），and U87 cells with the highest expression were screened out. RT-PCR，Western blot，CCK-8，and Transwell experiments were carried out to detect the effects of FBXO6 overexpression and silencing on the proliferation and invasion of U87 cells. U87 cells were treated with U0126（an ERK1/2 inhibitor），SP600125（a JNK inhibitor），and Perifosine（an Akt1 inhibitor），and Western blot was conducted to examine the expression and phosphorylation levels of ERK1/2，JNK and Akt1. Subsequently，RTPCR and Western blot were used to detect the expression changes of FBXO6，and then CCK - 8 and Transwell experiments were performed to measure the proliferation and invasion capabilities of U87 cells. FBXO6 was overexpressed in U87 cells，which were then treated with Perifosine， and RTPCR，Western blot，CCK -8，and Transwell experiments were carried out to investigate the levels of FBXO6 expression，cellproliferation，and invasion. Results：FBXO6 is highly expressed in glioma tissue，and its expression level is positively correlated with the degree of malignancy. It is also closely associated with the poor prognosis of patients. All three glioma cell lines，namely U251， U373，and U87，expressed FBXO6，with U87 cells showing the most significant expression. The proliferation and invasion of U87 cells were significantly enhanced after FBXO6 overexpression，while these were significantly weakened after FBXO6 silencing. The Akt1 inhibitor could significantly down - regulate the expression of FBXO6 in U87 cells，whereas the ERK1/2 and JNK inhibitors had no significant effect on FBXO6 expression. The Akt1 inhibitor could significantly reduce the proliferation and invasion of U87 cells，and FBXO6 overexpression could antagonize the above effects. Conclusion：Activation of Akt1 in glioma cells up-regulates the expression of the FBXO6 gene，promoting cell proliferation and invasion.

Abstract:Objective：To explore the mechanism of MT -RNR2-like protein 1（MTRNR2L1）- mediated regulation of PANoptosis during the development of chronic obstructive pulmonary disease（COPD），and to provide new ideas for finding the pathogenesis of COPD. Methods：Bulk RNA sequencing（Bulk RNA-seq）data and single cell RNA sequencing（scRNA-Seq）data from COPD patients in Gene Expression Omnibus（GEO）were used to explore the cellular composition in COPD patients’lung tissues and to analyze the pathways involved in the development of the disease. PANoptosis was simulated in smoke/lipopolysaccharide（LPS）-exposed mice，and MTRNR2L1 and PANoptosis protein expression levels were assessed to clarify their roles in the development of COPD. Results：Bulk RNA -seq demonstrated the altered expression of T cell response - related genes between the COPD patients and the normal controls. scRNA-seq confirmed decreased CD8+ T cells and increased epithelial cells in the COPD patients compared with controls. MTRNR2L1 was upregulated in COPD patient immune and epithelial cells，then those of controls PANoptosis-related genes were reduced in lungs， CD8 + T cells and epithelial cells of COPD patients then those of controls：Smoke/LPS-exposed mouse lungs exhibit alveolar damage， increased expression of PANoptosis-related proteins，while MTRNR2L1 overexpression significantly inhibited cellular PANoptosis and downregulated the levels of ZBP1，Caspase -3，GSDMD，and MLKL. Conclusion：The differentially expressed genes in CD8 + T cells and epithelial cells were enriched in pathways related to PANoptosis，suggesting the involvement of PANoptosis in the development of COPD. The process of PANoptosis in the onset and development of COPD was associated with increased expression of PANoptosis - related proteins. MTRNR2L1 exhibited an inhibitory effect on PANoptosis，and regulating PANoptosis may provide new therapeutic opportunities for reducing lung injury and improving lung ventilatory function.

Abstract:Objective：To compare the efficacy of three conventional imaging tests，mammography（MG），ultrasonography（US），and magnetic resonance imaging（MRI），in assessing the lesion size of ductal carcinoma in situ（DCIS）or DCIS with microinvasion（DCISMI），and explore their potential value in guiding breast - conserving surgery. Methods：We retrospectively collected case files of patients with pathologically confirmed DCIS/DCIS -MI in our hospital，and compared the lesion sizes assessed by the three imaging modalities with the“gold standard”pathological size，and evaluated the accuracy and consistency of the different imaging modalities by using McNemar’s test and Bland-Altman’s method. Univariate and multivariate analyses were used to identify the clinicopathologic features that influenced the accuracy of the assessment，followed by subgroup analyses. Finally，the influencing factors leading to falsenegative -imaging results were explored and analyzed. Results：A total of 263 patients with DCIS/DCIS-MI were enrolled in this study. Regarding the measurement mean deviation，MRI mostly overestimated（+3.5 mm）lesions，while MG（-2.5 mm）and US（-1.4 mm） underestimated them. Consistency analysis suggested that MRI had the strongest correlation with pathological findings（r=0.853）and the narrowest range of 95% limits of agreement（95% LOA）（-1.73~2.44 cm），which was superior to MG（r=0.561）and US（r=0.614）. McNemar test indicated MRI’s superiority over US/MG（P ＜ 0.05），while combined US+MG achieved comparable accuracy to MRI（P= 0.921）. Logistic regression analysis showed that age ＞60 years at diagnosis（OR=0.322），tumor diameter 16-40 mm（OR=3.019），and ≥ 41 mm（OR=6.146）significantly affected the accuracy of MG assessment（all P ＜ 0.05）. Tumor diameters of 16-40 mm（OR=2.270） and ≥41 mm（OR=4.237）and ductal dilatation sign（OR=1.728）significantly increased the risk of US assessment error（all P ＜ 0.05）. Moderate -to - severe breast background parenchymal enhancement（OR=2.139）and non -mass -like foci of enhancement（OR=2.655） significantly increased the risk of MRI assessment error（all P ＜ 0.05）. Subgroup analyses suggested comparable performance for lesions ≤15 mm，US preference for 16-40 mm lesions，and MRI advantage for ≥41 mm lesions. In addition，the HER2 expression status （OR=0.100）and the Ki67 expression level（OR=0.297）were independent predictors for MG detection failure（all P ＜ 0.05）. Conclusion：Preoperative MRI is beneficial for guiding precise breast-conserving surgery in DCIS/DCIS-MI patients，particularly for lesions ≥41 mm. In clinical practice at primary hospitals，the combined use of US and MG can be promoted. For patients with low HER2 and Ki67 expression，the possibility of false-negative results should be considered during preoperative MG evaluation.

Abstract:Objective：To evaluate the clinical value of deep learning（DL）- based reconstruction algorithm for half - Fourier acquisition single - shot turbo spin echo（HASTE）T2 - weighted imaging（T2WI）in pancreatic magnetic resonance imaging（MRI）. Methods：A total of 69 patients underwent pancreatic conventional BLADE-TSE-T2WI and based on deep learning HASTE-DL-T2WI sequences scanning using 3.0T MR. The overall image quality，pancreatic sharpness，biliary duct clarity，and artifacts were subjectively scored using a Likert 5-point scale. The contrast to noise ratio（CNR）and signal to noise ratio（SNR）of normal pancreatic tissue and the lesion in both sequences were measured and compared，and the scan time was recorded. Results：The HASTE - DL sequence scored significantly higher in overall image quality，pancreatic sharpness，and bile duct clarity than the BLADE - TSE sequence（P ＜ 0.001），with no statistical difference in artifact scores（P ＞ 0.05）. The SNR of normal pancreatic tissue，lesion SNR，and CNR in HASTE-DL images were superior to those of BLADE-TSE sequence（P ＜ 0.001）. Additionally，the scanning time of HASTEDL was reduced by 78% compared to BLADE -TSE. Conclusion：Compared to BLADE -TSE sequence，HASTE -DL provides better overall image quality，superior pancreatic sharpness and bile duct clarity，higher SNR and CNR，and significantly shorter scan time. Thus，HASTE-DL T2WI demonstrates excellent clinical utility in pancreatic MRI.

Abstract:Objective：To investigate the molecular diagnostic value of whole exome sequencing（WES）in the genetic etiology of intellectual disability（ID）or global developmental delay（GDD）and to analyze of genetic characteristics in the Chinese cohort. Methods：Patients with ID/GDD who were enrolled in Children’s Hospital of Nanjing Medical University from January 2019 to December 2021 were selected as the study objects. Inclusion criteria adhered to clinical guidelines for significant developmental milestone delays，with exclusion of non-genetic factors（e. g.，perinatal hypoxia，infection，metabolic abnormalities）. We retrospectively analyzed sequence variants and copy number variations（CNVs）detected by Triowhole exome sequencing（TrioWES）or proband-only WES，classifying variants according to the American College of Medical Genetics and Genomics（ACMG）guidelines，with pathogenic （P）/likely pathogenic（LP）variants defined as positive results. Results：1 096 patients with ID/GDD ranged in age from 1 month to 15 years，with a median age of 24（12，48）months，including 716 males and 380 females. The overall positive diagnostic rate was 35.31% （387/1 096），with monogenic variants identified in 271 patients and CNVs in 116 patients. Among the monogenic variants，MECP2 gene was the most common one（12/271，4.43%），primarily associated with Rett syndrome，followed by SYNGAP1 and DDX3X. For CNVs，5.17%（6/116）patients were aneuploidies，with 7q11.23 deletions（associated with Williams syndrome）being the most common （8.62%，10/116）. Autosomal dominant inheritance accounted for 71.96%（195/271）of monogenic variants，while X-linked inheritance represented 19.93%（54/271）. Sanger sequencing confirmed de novo origins in 68.27%（185/271）of detected variants. Clinical phenotypic analysis demonstrated a significantly higher positive rate in isolated ID/GDD cases compared to those with comorbid autism spectrum disorder（ASD）or attention-deficit/hyperactivity disorder（ADHD）（P ＜ 0.05）. Conclusion：The combined analysis of WES and CNV significantly enhances the molecular diagnostic yield for ID/GDD. High frequencies of MECP2 variants and 7q11.23 deletions represent high-frequency findings in the Chinese pediatric cohort. De novo variants constitute the primary genetic etiology in this cohort. These findings support the implementation of WES as a first-line clinical diagnostic tool for ID/GDD.

Abstract:Objective：This study aimed to evaluate the prognostic value of the renal chronicity score in patients with diabetic kidney disease（DKD）and compare it with the traditional DKD Research Committee of the Renal Pathology Society（RPS）pathological classification. Methods：Clinical and pathological data from 129 patients diagnosed with DKD through renal biopsy at the First Affiliated Hospital of Nanjing Medical University between January 2014 and September 2020 were retrospectively analyzed. Based on the renal chronicity score，patients were categorized into three groups：minimal（n=34），mild（n=50），and moderate-severe（n=45）. The clinical characteristics and pathological indicators of each group were compared，and these results were evaluated against the DKD RPS pathological classification. The Cox regression analysis was used to identify factors influencing poor renal outcomes. The Kaplan Meier survival curves were employed to compare cumulative renal event -free survival rates，and the receiver operating characteristic （ROC）curve analysis was performed to assess the diagnostic value of the renal chronicity score，both alone and in combination with estimated glomerular filtration rate（eGFR）and 24-hour urinary protein to predict renal outcomes. Results：Patients with higher renal chronicity scores exhibited more severe renal dysfunction，greater anemia，and higher pathological grades according to the DKD RPS pathological classification. The Kaplan - Meier’s survival analysis showed that patients with higher renal chronicity scores had significantly lower cumulative survival rates without renal endpoint events，indicating poorer prognosis（P ＜ 0.05）. The Cox regression analysis identified a higher renal chronicity score as an independent risk factor for renal endpoint events（P ＜ 0.05）. The ROC curve analysis demonstrated that the diagnostic value of the renal chronicity score was slightly lower than that of the DKD RPS pathological classification（area under the curve，AUC=0.651 vs. 0.875），although no statistically significant difference was found between the two methods. When combined with eGFR and 24 - hour urinary protein，the AUC for the renal chronicity score increased to 0.810. Conclusion：Higher renal chronicity scores in patients with DKD are associated with more severe renal impairment and serve as independent risk factors for poor renal prognosis. Combining the renal chronicity score with clinical indicators，such as eGFR and 24- hour urinary protein，significantly enhances the accuracy of prognostic assessment

Abstract:Objective：To identify the International Classification of Functioning，Disability，and Health（ICF）core Sets for urinary incontinence in older women. Methods：A preliminary questionnaire was developed through a literature search on urinary incontinence in older women across Chinese and international databases. Two professional researchers independently extracted key concepts from the literature and mapped them to corresponding ICF categories to develop a preliminary questionnaire. The questionnaire was administered to 100 eligible female urinary incontinence patients；categories identified by ＞30% of patients as significantly impactful were compiled as Core Set Ⅰ. Simultaneously，35 healthcare professionals were surveyed，with categories endorsed by ＞50% of clinicians forming Core Set Ⅱ. The intersection of Core Sets Ⅰ and Ⅱ constituted the final ICF core sets for older women with urinary incontinence. Results：The ICF Core Sets for urinary incontinence in older women includes 29 core items：8 for“body function”，2 for “body structure”，8 for“activity and participation”，and 11 for“environmental factors”. Conclusion：The study initially established a core set of ICF items for urinary incontinence in older women，providing an operable theoretical model for evidence - based rehabilitation management in clinical practice.

Abstract:Objective：To investigate the predictive value of N - terminal pro - brain natriuretic peptide（NT - proBNP）and high - sensitivity cardiac troponin T（hs-cTnT）for long-term mortality risk in patients with acute ischemic stroke（AIS），and to develop and validate corresponding prediction models. Methods：This single - center retrospective study consecutively enrolled AIS patients who underwent thrombectomy at the First Affiliated Hospital of Nanjing Medical University between January and December 2022，with a 2- year follow up. Cox regression and LASSO regression were used to identify factors associated with all-cause mortality. Three predictive models were constructed：a basic model，Model 1（basic model + NT-proBNP），and Model 2（basic model+hs-cTnT），the predictive performance of these models was compared. Results：A total of 230 AIS patients were included in the final analysis and were randomly assigned to the training set（n=146）and testing set（n=84）at a 3∶2 ratio. During follow-up，83 all-cause mortality events occurred，with a mortality rate of 37.2%. Multivariate Cox regression showed that for every 1 000 pg/mL increase in NT-proBNP，the 2-year all-cause mortality increased by 27%（HR=1.27，95% CI：1.15-1.40，P ＜0.001），while ln（hs-cTnT）elevation showed no significant association with mortality risk（HR =1.11，95% CI：0.89-1.38，P=0.372）. Cox regression and LASSO regression identified the following mortality- related variables：history of atrial fibrillation，postoperative National Institutes of Health Stroke scale（NIHSS）score，baseline hemoglobin，white blood cell count，and random blood glucose，which formed the basic model. The area under the curve（AUC）values for the basic model were 0.816（training set）and 0.778（testing set）. Model 1 achieved higher AUC values（0.866 and 0.799， respectively），demonstrating improved predictive ability. Model 2 showed limited improvement（AUC=0.811 and 0.788）. Conclusion： NT - proBNP is an independent predictor of all - cause mortality in AIS patients and enhances performance of traditional clinical indicator models，supporting individualized management of AIS.

Abstract:Objective：To explore the relationship between frailty and atrial fibrillation（AF）recurrence after catheter ablation in elderly AF patients. Methods：A prospective study was conducted，including 292 elderly patients who underwent catheter ablation for AF between June 2023 and December 2023 at the First Affiliated Hospital of Nanjing Medical University，the Third People’s Hospital of Nantong，and the People’s Hospital of Jingjiang. Baseline data were collected before the operation，and the patients were categorized based on the Frailty Scale into three groups：frail group（≥3 points），pre-frail group（1-2 points）and non-frail group（0 points）. The differences among the groups were compared. After one year of follow-up，patients were divided into two groups based on whether AF recurrence occurred：the recurrence group and the non-recurrence group. The clinical characteristics of the two groups were compared， and univariate and multivariate logistic regression analyses were performed to assess the relationship between frailty and AF recurrence after catheter ablation，as well as other risk factors for AF recurrence. The cumulative incidence of AF recurrence within one year post-surgery was analyzed using Kaplan-Meier，and the log-rank test was used to compare the recurrence risk between groups. Results：A total of 292 elderly AF patients were included，with 94 in the non -frail group，138 in the pre -frail group，and 60 in the frail group. During the one-year follow-up，52 patients（17.8%）experienced AF recurrence. The recurrence rate in the frail group was significantly higher than in the non -frail and pre -frail groups[38.33%（23/60）vs. 10.64%（10/94）vs. 13.77%（19/138），P ＜ 0.001]. Multivariate logistic regression analysis，after adjusting for demographic and clinical factors，showed that frailty was significantly associated with a higher recurrence rate of AF after catheter ablation（OR=3.430，95% CI：1.219-10.233，P=0.032）. AF type（persistent AF），body mass index（BMI），N -terminal pro B -type natriuretic peptide（BNP），and left atrial diameter（LAD）were independent risk factors for AF recurrence after catheter ablation in elderly patients. Conclusion：Frailty is significantly associated with AF recurrence after catheter ablation in elderly AF patients，and can serve as a reliable predictor of AF recurrence following the post-ablation.

Abstract:Objective：To evaluate the clinical effect of three - dimensional（3D）reconstruction images of coronary CT angiography （CCTA）in preoperative planning of off-pump coronary artery bypass grafting（OPCABG）. Methods：The clinical data of 158 patients who underwent OPCABG from January 2021 to March 2023 in the department of cardiovascular surgery of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Among them，113 patients underwent OPCABG guided by coronary angiography（CAG）（conventional group）. On the basis of CAG，CCTA and 3D reconstruction of images were completed in 45 cases to assist OPCABG（3D group），and the operation was guided by comprehensive analysis of the results of the two imaging examinations. The outcome measures included operation time，intraoperative blood loss，ventilator usage time，postoperative monitoring period and hospital stay，postoperative atrial fibrillation，acute kidney injury，secondary tracheal intubation，cerebral infarction，cardiovascular adverse events and other complications，and 1 year postoperative cardiac ultrasound and CCTA follow-up results. Results：There was no significant difference between the two groups in the ventilator usage time，the postoperative monitoring period，the time of hospital stay，and the results of CCTA and cardiac ultrasound follow-up 1 year after surgery（P ＞ 0.05）. However，the operation time of the 3D group was（250.7 ± 41.4）min and the conventional group was（271.0 ± 57.2）min，and the differences between the two groups were statistically significant（P ＜ 0.05）. Moreover，the amount of blood loss during the 3D group was less than that of the conventional group （P < 0.05）. Conclusion：Compared with conventional CAG guided OPCABG，the addition of CCTA can shorten the operation time， reduce the amount of intraoperative blood loss，and obtain better surgical results.

Abstract:Objective：To compare the hemodynamic effects of propofol and remimazolam during the perioperative period in Stanford type B aortic dissection patients. Methods：Eighty patients were randomized to receive propofol（Group P）or remimazolam（Group R） for anesthesia. Mean arterial pressure（MAP）and bispectral index（BIS）values were recorded at anesthesia onset（T0），tracheal intubation（T1），5 minutes after intubation（T2），procedure completion（T3），airway extubation（T4），and 5 minutes after airway extubation（T5）. The percentage change in MAP during anesthesia induction and the peri - extubation period were calculated and compared between the two groups. Results：No significant differences in BIS values were observed between the two groups at any time point（P ＜ 0.05）. During anesthesia induction，the percentage change in MAP was higher in Group P（22.6%±6.5%）compared to Group R（13.7%±6.9%），with a statistically significant difference（P ＜ 0.001）. Similarly，the average percentage change in MAP during the peri - extubation period was higher in Group P（21.3% ± 6.2%）than in Group R（11.7% ± 5.8%），showing a statistically significant difference（P ＜ 0.001）. Conclusion：Remimazolam exerted a milder cardiovascular depression effect compared to propofol when delivering same sedation，which has certain positive significance for reducing perioperative complications in these patients.

Abstract:Objective：To investigate the clinical effect of 0.05% cyclosporine A and 0.1% tacrolimus eye drops in the treatment of severe dry eye associated with Sjögren’s syndrome. Methods：Fifty - six patients（112 eyes）with severe dry eye related to Sjögren’s syndrome，treated at the Department of Ophthalmology，Wuxi People’s Hospital Affiliated to Nanjing Medical University from October 2021 to November 2023，were enrolled. Patients were randomly divided into the tacrolimus group（n=28，56 eyes）and the cyclosporine A group（n=28，56 eyes）using a random control table. The tacrolimus group received 0.1% tacrolimus eye drops twice daily，while the cyclosporine A group received 0.05% cyclosporine A eye drops four times daily. Both groups underwent standard treatment for 8 weeks. Follow - up assessments included the Standard patient evaluation of eye dryness（SPEED），touch tear film break - up time （TBUT），Schirmer I test（SIt），corneal fluorescein staining（CFS）score before and after treatment. Results：There were no significant differences in baseline clinical data，pre -treatment SPEED scores，and TBUT between the two groups. Compared to pre -treatment， SPEED score and TBUT were improved in both groups after treatment. The tacrolimus group showed a more significant improvement in TBUT，whereas the Cyclosporine A group demonstrated a better improvement in SPEED scores. There were no significant differences between the two groups before treatment in CFS score and SIt index. Both groups showed improvement in CFS scores and SIt post - treatment，with similar improvement levels in CFS scores but a more significant improvement in SIt in the Cyclosporine A group. There were no significant differences in the morphology of meibomian gland and lipid layer thickness between the two groups before treatment. Post-treatment，both groups showed improvement in these parameters，with the tacrolimus group exhibiting more significant improvements. Some patients experienced transient irritation symptoms after using the two eye drops，and their irritation symptoms were relieved within 20 minutes after medication. Conclusion：Both 0.1% tacrolimus and 0.05% cyclosporine A have good therapeutic effects in severe dry eye associated with Sjögren’s syndrome，of which 0.05% cyclosporine A has more obvious advantages in improving patient comfort and reducing dry eye symptoms，while 0.1% tacrolimus has better effects in improving meibomian gland morphology and lipid layer thickness.

Abstract:Persistent high-risk human papilloma virus（HPV）infection is the main cause of cervical lesions. Cervical cancer is the fourth most frequent malignancy among women globally，posing a severe threat to women’s health and lives. Intestinal flora can have anti - tumor effects through immunomodulation，inflammatory response，and metabolite synthesis，according to numerous research conducted in recent years. Research on the relationship between intestinal flora and cervical cancer has revealed notable variations in the diversity and composition of intestinal flora between patients with the disease and healthy controls. These findings have also raised the possibility that certain intestinal flora may serve as biomarkers for cervical cancer prevention and early detection. Furthermore， through the estrogen-mediated“gut-vaginal axis”，intestinal flora can interact with the vaginal microbiome，thereby affecting vaginal microecology，HPV infection，and cervical lesions. However，existing studies are mainly based on cross-sectional analyses with small sample sizes and a lack of longitudinal studies and experimental evidence. More thorough research is still required to elucidate the precise linkages and mechanisms of action. The article reviews the research progress on the relationship between intestinal flora and HPV infection and cervical lesions by summarizing the existing research results.

Abstract:At present，the domestic and international lung cancer screening guidelines recommend the use of low - dose spiral computed tomography（LDCT）for lung cancer screening，which significantly improved the detection rate of early - stage lung adenocarcinoma. According to the recommendation of the Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer（2024 edition），patients with stage ⅠA（T1a/b/cN0）lung adenocarcinoma who undergo surgery with negative surgical margins（R0）can be followed up regularly after surgery without adjuvant therapy（classⅠrecommendation，evidence-based）. Recent clinical studies have revealed that the prognosis of patients with stage ⅠA lung adenocarcinoma who only receive surgical treatment is influenced by multiple factors. Although no unified treatment standard has been established，the issue of whether postoperative adjuvant therapy is necessary is still of great research value. This article reviewed the impact of factors such as tumor size，solid component ratio，micropapillary and solid subtype proportions，lymphovascular invasion（LVI），and the presence of spread through air spaces（STAS）on the prognosis of stageⅠA lung adenocarcinoma，and discussed the latest postoperative adjuvant treatment plans and their outcomes，providing new insights into the postoperative treatment of stageⅠA lung adenocarcinoma.

Abstract: