To investigate the perioperative outcomes and postoperative pregnancy outcomes of patients with intrauterine adhesions(IUA) treated by see-and-treat hysteroscopy and traditional hysteroscopy in transcervical resection of adhesions(TCRA).

A retrospective cohort study was performed on 485 patients with moderate-to-severe IUA who met the inclusion criteria and admitted in our hospital from January 2019 to December 2021. According to surgical approaches, the patients were assigned into a see-and-treat mode group and a traditional mode group. After clinical diagnosis(ultrasound and symptoms) of IUA, the patients from the former group received direct hysteroscopic adhesion separation surgery, and those of the latter group were diagnosed by outpatient hysteroscopy first and then hysteroscopic adhesion separation surgery. The perioperative indicators, postoperative three-dimensional transvaginal ultrasound(3D-TVUS) examination related characteristics, postoperative menstrual recovery, postoperative pregnancy outcomes, obstetric related complications, and neonatal outcomes were collected and compared between the 2 groups.

Among the enrolled 485 patients, there were 277 in the see-and-treat group and 208 in the traditional group. The success rate of surgical treatment was 89.89% in the see-and-treat group and 92.79% in the traditional group, but no statistical difference was seen between them(Chi-square=1.234, P=0.267). 3D-TVUS examination displayed that the see-and-treat mode group obtained better improvement of endometrial morphology, uterine morphology and menstruation after operation than the traditional group(P<0.001). The postoperative pregnancy rate was slightly higher in the see-and-treat group than the traditional mode group(58.84% vs 58.17%, P=0.882). However, the see-and-treat mode showed obvious advantage in the postoperative natural pregnancy rate, with a rate of 90.80%, obviously higher than that in the traditional mode group(81.82%, P=0.026). The live birth rate was 70.55% in the see-and-treat mode group, excluding 1 case with ongoing pregnancy in the second trimester and 1 case with ongoing pregnancy in the third trimester, and the rate was 74.38% in the traditional group, excluding 3 cases with ongoing pregnancy in the third trimester, but there was no statistical difference between the 2 groups(P=0.303). In terms of obstetric-related complications, there were 0 cases of blood transfusion during delivery hospitalization in the see-and-treat group, while there were 7 cases in the traditional group(P=0.003). In neonatal outcomes, the rate of transfer to the pediatric department was 10.43% in the see-and-treat mode group and 22.22% in the traditional mode group(P=0.021). For health economics, the see-and-treat hysteroscopy group demonstrated a significant advantage over the traditional hysteroscopy group(P<0.001). There was no significant difference in pain scores between the 2 groups.

The see-and-treat approach is a safe, feasible, and highly efficient strategy for integrating the diagnosis and treatment of IUA, enabling maximal minimization of surgical trauma while optimizing time and cost efficiency.

To compare the midterm outcomes of the Bentall procedure versus isolated aortic valve replacement (AVR) in patients with bicuspid aortic valve (BAV) complicated with severe stenosis and ascending aortic dilation in order to assess the therapeutic value of these surgical approaches for this complex cardiac condition.

A retrospective cohort study was conducted on 96 eligible patients who underwent surgical treatment in our institute between January 2018 and December 2022. According to surgical approaches, they were divided into an AVR group (65 cases) and a Bentall group (31 cases). Demographic features, comorbidities, preoperative status, and echocardiographic parameters were collected in all patients. Propensity score matching (PSM) was applied in a 1∶1 ratio to balance baseline characteristics. Perioperative indicators and follow-up data were compared and analyzed between matched cohorts after control of cofounding factors.

After PSM, 25 matched pairs were screened out and analyzed with comparable baseline data (all P>0.05). The Bentall group demonstrated significantly more superior intraoperative effective orifice area (EOA, 2.69±0.47 vs 2.35±0.47 cm², P=0.013) and EOA index (EOAI, 1.69±0.30 vs 1.47±0.29 cm²/m², P=0.010), and obviously longer cardiopulmonary bypass time [190.00 (147.00, 257.00) vs 101.00 (88.50, 124.50) min, P<0.01] and aortic cross-clamp time [141.00 (120.00, 166.00) vs 66.00 (55.00, 81.50) min, P<0.01] when compared with the AVR group. During a median follow-up of 28 months, the AVR group had notably larger aortic sinus diameter [32.00 (30.00, 34.00) vs 26.80 (26.00, 28.00) mm, P<0.01] and ascending aortic diameter [38.00 (34.50, 42.00) mm vs 26.00 (26.00, 28.00) mm, P<0.01], with ongoing dilation in the ascending aorta, while the Bentall group maintained stable dimensions. The Bentall group also showed statistically lower peak aortic valve pressure gradients [21.00 (15.50, 27.00) vs 25.00 (19.50, 31.00) mmHg, P=0.049].

Both Bentall procedure and AVR are effective in treatment of BAV complicated with severe stenosis and ascending aortic dilation. But, Bentall procedure offers advantages in hemodynamic optimization and aortic stability.

To evaluate the efficacy and safety of the combination of immunotherapy and targeted therapy and chemotherapy in third-line treatment of patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC).

A retrospective cohort trial was conducted on patients with MSS mCRC treated with third-line immunotherapy combined with targeted therapy and chemotherapy in our hospital from January 2020 to December 2023. The clinical data were collected. Kaplan-Meier survival analysis was employed to analyze progression-free survival (PFS) and overall survival (OS). Objective response rate (ORR), disease control rate (DCR) and other indicators were statistically analyzed to evaluate the clinical efficacy. The incidence and severity of adverse events during the treatment process were recorded to assess the safety.

A total of 80 patients were included in the analysis, 55 in the group of immunotherapy plus targeted therapy and 25 in the group of immunotherapy combined with targeted therapy and chemotherapy. The group of immunotherapy combined with targeted therapy and chemotherapy had significantly longer median PFS (6.3 vs 4.4 months; HR=0.58, 95%CI: 0.35~0.96; P=0.031) and OS (15.5 vs 10.1 months; HR=0.47, 95%CI: 0.27~0.81; P=0.006), and obviously higher ORR (32.0% vs 10.9%; OR=0.26, 95%CI: 0.07~0.79; P=0.021) and DCR (92.0% vs 78.2%; OR=0.31, 95%CI: 0.07~1.52; P=0.132) when compared to the group of immunotherapy plus targeted therapy. The incidence of adverse events at all grade and at grade 3 and above was 96.4% and 32.7% in the group of immunotherapy plus targeted therapy, and 100.0% and 36.0% in the group of immunotherapy combined with targeted therapy and chemotherapy, which mainly included bone marrow hematopoietic inhibition, hand-foot skin reaction, liver function impairment and thyroid function abnormality.

The triple therapy of immunotherapy plus targeted therapy and chemotherapy is a more effective and safer treatment than the double therapy of immunotherapy plus targeted therapy in treatment of MSS mCRC patients.

To explore the potential cuproptosis-related genes （CRGs） in patients with multiple myeloma （MM） and develop a prognostic model for improving prognosis and revealing features of the MM immune microenvironment.

① Transcriptome sequencing data and clinical information were retrieved from the GSE4581 dataset in the Gene Expression Omnibus （GEO） database and the Cancer Genome Atlas-Multiple Myeloma Research Foundation （TCGA-MMRF） database. The 859 patients from the TCGA-MMRF database were assigned into a training set，and the other 414 ones from the GSE4581 dataset into a validation set. LASSO-Cox and multivariate Cox regression analyses were used to construct prognostic models and calculate risk scores. Based on the median risk score，they were categorized into high- and low-risk cohorts. Time-dependent receiver operating characteristic （ROC） and calibration curves were plotted to assess the predictive performance and accuracy of the model. The differences between the high- and low-risk cohorts were explored using Kaplan-Meier survival curve analysis and immune microenvironment correlation analysis. ② RT-qPCR and Western blotting were used to verify the expression of prognostic model genes in MM cell lines and normal bone marrow single-nucleated cells，and CCK-8 assay，flow cytometry，and Western blotting were applied to verify the biological function of UBE2D1 in MM cells.

① LASSO-Cox and multivariate Cox regression analyses revealed that the model consisted of 4 genes，CDKN2A ［HR=1.60 （95%CI：1.24~2.05），P=2.5e-4］，PDE3B ［HR=1.33 （95%CI：1.09~1.62），P=4.2e-3］，UBE2D1 ［HR=1.65 （95%CI：1.20~2.26），P=2.1e-3］ and COA6 ［HR=1.35 （95%CI：1.07~1.71），P=0.01］. In the training set，the time-dependent ROC curves predicted that the area under curve （AUC） value of 1-，3-，and 5-year survival rate was 0.63，0.71，and 0.78，respectively，and in the validation set，the AUC value was 0.656，0.657，and 0.797，respectively. Calibration curve analysis showed excellent agreement in predicting 1-，3-，and 5-year prognosis. In the training set，Kaplan-Meier curves showed that patients in the high-risk cohort had a significantly shorter overall survival （OS） than the low-risk cohort ［HR=2.18 （95%CI：1.58~3.02），P<0.001］，and in the validation set，the high-risk cohort still had a shorter OS than the low-risk cohort ［HR=2.45 （95%CI：1.49~4.05），P<0.001］. Immune correlation analysis revealed that the ratios of immune cells，such as plasma cells and CD4⁺ T cells were significantly lower in the high-risk cohort （P<0.05），and the risk scores were positively correlated with the expression of immune checkpoint CTLA-4，tumor-targeted therapeutic sites TNFSF4 and ENTPD1，and microenvironmental chemokines CXCL16，CCL8，and CCL16 （P<0.05）. ② Remarkable differences were observed in the expression of all 4 prognostic model genes between the MM cell lines and normal bone marrow single-nucleated cells （P<0.05），and knockdown of UBE2D1 notably inhibited the proliferation of MM cells （P<0.05）.

Our prognostic models based on CDKN2A，PDE3B，UBE2D1，and COA6 genes can predict the prognosis of MM patients. The risk scores of the genes are significantly correlated with immune infiltration in the tumor microenvironment，which providing new molecular markers for individualized therapy.

To construct a prognostic model of centrosome amplification-related genes (CARGs) by machine learning and evaluate its prediction performance for the prognosis of esophageal squamous cell carcinoma (ESCC).

CARGs were obtained from Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) datasets. The RNA-sequencing (RNA-seq) transcriptome datasets of ESCC were retrieved from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), and assigned into training and validation sets, respectively. Subsequently, single-sample gene set enrichment analysis (ssGSEA) and weighted gene co-expression network analysis (WGCNA) were employed to screen CARGs. A prognostic model of CARGs was constructed by incorporating 12 machine learning algorithms, and univariate and multivariate Cox regression analyses were applied to evaluate whether the 12 models as an independent prognostic factor or not. Eventually, 15 paired ESCC and adjacent non-tumor tissue samples were collected from the Department of Gastroenterology of the Second Affiliated Hospital of Army Medical University, and real-time quantitative PCR (RT-qPCR) and immunohistochemistry staining were performed to detect the expression of these genes ESCC samples.

Our 9-CARGs prediction model for ESCC prognosis was constructed. RT-qPCR confirmed that the mRNA expression levels of DENR, TRIP13,BRCA2, TTF2, TCFL5 and NUP188 were significantly higher in ESCC tissues than normal tissues (P<0.05), and the protein levels of DENR, TRIP13, TTF2 and TCFL5 were also elevated when compared to normal tissues.

DENR, TRIP13, TTF2 and TCFL5 are highly expressed and closely associated with poor prognosis of ESCC, suggesting their potential roles in the pathogenesis and progression of this malignancy.

To explore the network structural characteristics, core factors, and gender differences in the comprehensive assessment of mental health in military personnel.

A total of 4 105 officers and soldiers were subjected and surveyed using the Comprehensive Mental Health Assessment Questionnaire for Soldiers. Through network analysis, a network model for comprehensive mental health assessment of military personnel was constructed with the R qgraph Package. The core factors of their mental health were explored using the qgraph package, and the reliability of the network structure was evaluated using the bootnet package. Then a comparative analysis was conducted on the network characteristics of comprehensive mental health assessments between male and female participants using permutation tests with the NetworkComparisonTest package in R.

In the network of the comprehensive assessment of military personnel mental health, the strongest association was observed between institutional trust and interpersonal trust, followed by interpersonal trust and sense of meaning in life, adaptability and positive coping, as well as depression and negative emotions, with a regularized partial correlation coefficient of 0.49, 0.45, 0.44, and 0.42, respectively. The core factors were interpersonal trust, work engagement, and institutional trust, with an expected influence of 1.095, 1.060, and 1.039, respectively. The 95% confidence intervals (CIs) obtained from the edge weight accuracy assessment were relatively narrow, and the correlation stability coefficient of the network was 0.75, indicating a stable and reliable network structure. Furthermore, there were significant differences in the network structure of comprehensive mental health assessments between male and female participants (M=0.335, P<0.001), especially in the core factor, interpersonal trust, with particularly significant gender difference (P<0.01).

Interpersonal trust, work engagement, and institutional trust are the core factors in the comprehensive assessment of military personnel’s mental health. There are gender differences in the network structure of the comprehensive assessment of mental health for military personnel.

To investigate the protective effects of ferroptosis inhibitor ferrostatin-1 (Fer-1) on high-altitude hypoxic lung injury and explore novel preventive strategies for high-altitude hypoxia-induced lung injury.

①Eighteen SPF male Wistar rats (5~6 weeks old, 210~230 g) were randomly divided into 3 groups (n=6): normoxic control, hypoxic lung injury, and Fer-1 pretreatment groups. A hypobaric chamber was used to establish a rat model of high-altitude hypoxic lung injury. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed to compare pulmonary protein profiles between normoxic and hypoxic groups, followed by bioinformatics analysis of pathways enriched with differentially expressed proteins (DEPs). Histopathological changes and lung injury scores were assessed with HE staining. ELISA was used to quantify the inflammatory cytokines, flow cytometry and immunofluorescence assay were employed to measure the production of reactive oxygen species (ROS), and spectrophotometry was utilized to determine the contents of Fe²⁺, glutathione (GSH), malondialdehyde (MDA), and superoxide dismutase (SOD) to evaluate oxidative stress and detect ferroptosis-related markers. ② Human bronchial epithelial cells (bronchial epithelium transformed with Ad12-SV40, BEAS-2B) and macrophages induced by tumor human peripheral blood monocytes-1 (THP-1) cells were placed in a low oxygen conditions for 48 h to establish a cellular model of hypoxic lung injury, on which Fer-1 was administered as a preventive group. Ferroptosis markers in BEAS-2B cells and inflammatory cytokine secretion in macrophages were analyzed.

①Proteomics identified 2 962 proteins, with 357 DEPs (199 up-regulated, 158 down-regulated). Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed ferroptosis as the most enriched pathway. Hypoxic lung injury resulted in elevated ROS, MDA, Fe²⁺, and inflammatory cytokines (P<0.05), reduced SOD, GSH, solute carrier family 7 member 11 (SLC7A11), glutathione peroxidase 4 (GPX4), and ferritin heavy chain 1 (FTH1), and increased acyl-coa synthetase long chain family member 4 (ACSL4) (P<0.05). Fer-1 pretreatment significantly mitigated oxidative stress (ROS, MDA, SOD, GSH; P<0.05), up-regulated SLC7A11 and FTH1, down-regulated ACSL4 (P<0.05), and reduced inflammation (P<0.05). ②In cellular models, Fer-1 increased SLC7A11, GPX4, FTH1, GSH, and SOD (P<0.05), declined ROS (P<0.05), and suppressed macrophage inflammatory cytokines (P<0.05).

Fer-1 alleviates high-altitude hypoxic lung injury by inhibiting ferroptosis in pulmonary epithelial cells and attenuating macrophage-driven inflammation, providing experimental evidence for novel therapeutic strategies.

To explore the clinical safety of plasma exchange (PE) combined with early continuous renal replacement therapy (CRRT) and its effects on coagulation and immune functions in patients with polytrauma and hypermyoglobinemia.

A non-randomized controlled study was conducted on 60 patients with severe polytrauma and myoglobinemia hospitalized in our department from January 2021 to December 2024. Based on different blood purification, the patients were divided a control group (CRRT) combined with conventional basic treatment, n=30) and an observation group (PE+CRRT and conventional basic treatment, n=30). Biochemical indicators (myoglobin, Mb), inflammation-related indicators, peripheral blood lymphocyte subsets, coagulation indicators, clinical-related indicators, and scores were observed and compared between the 2 groups before and after treatment.

After 1, 2 and 3 d of treatment, the levels of Mb, creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB), lactate dehydrogenase (LDH), serum creatinine (SCr), blood urea nitrogen (BUN), K⁺, C-reactive protein (CRP), procalcitonin (PCT), IL-6 and D-dimer (D-D), and white blood cell (WBC) count were significantly decreased in both groups (P<0.05). Among them, the observation group obtained obviously lower levels of all above indicators than the control group at the 3 time points (P<0.05). Additionally, notably shorter average length of total hospital stay, shorter average length of trauma intensive care unit stay, and lower score of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) was observed in the observation group than the control group (P<0.05). There were no statistical differences in coagulation function indicators or T lymphocyte subsets between the 2 groups. No complications occurred.

For patients with polytrauma and hypermyoglobinemia, early application of PE+CRRT can effectively reduce serum myoglobin level, improve serum biochemical inicators, renal function and inflammatory status, and maintain homeostasis, but shows no effect on immune or coagulation functions. This approach is worthy of promoting in clinical practice.

To investigate the characteristics of changes in blood uric acid （UA） and detection rate of hyperuricemia （HUA） among officers and soldiers during long-term maritime missions，as well as their related influencing factors.

A total of 100 servicemen were randomly selected from 240 officers and soldiers who will participate in a long-distance voyage mission. Their general information，including age，education level，administrative position，years of service on board，and department，was surveyed. Their annual data of physical examination were retrospectively analyzed and compared with the results of another 335 shore-based servicemen during the same period. On mission day 10 （D10） and day 50 （D50），the venous blood samples were collected from the participants to synchronously measure blood UA level and body composition indicators （body fat mass，BMI，fat percentage，fat mass，muscle mass，and muscle percentage）. Additionally，on D50，Self-Rating Scale of Sleep （SRSS） and Symptom Checklist-90 （SCL-90） were employed to survey their conditions. Seventy service members were randomly selected from the 100 participants to engage in aerobic exercise. The changes in UA level and detection rate of HUA among the mission personnel were analyzed，along with their influencing factors.

The UA level and HUA detection rate in long-term navigation personnel during concurrent annual physical examinations were significantly lower than those in shore-based personnel （P<0.01）. Compared to pre-voyage physical examination results，the UA level and HUA detection rate in long-term navigation personnel were significantly increased from mission day D10 （P<0.001）. Compared to the values at D10，the UA level and HUA detection rate at D50 showed significant decreases （P<0.05），and then essentially returned to pre-mission examination levels （P>0.05）. Aged <32 years was an independent risk factor for new-onset HUA at mission D10 （P<0.05）. <32 years old and aerobic exercise during the voyage were independent influencing factors for HUA outcome （P<0.05）.

Serum UA level and HUA detection rate among officers and soldiers participating in long-term maritime missions are relatively low before departure，but in significant increases during the early stages of the mission，particularly among those aged <32 years. Scientific aerobic exercise during the mission period helps reduce UA level and HUA detection rate，playing a crucial role in guaranteeing physical and mental health.

To investigate the calcium/calmodulin-dependent protein kinase Ⅱ （CaMKⅡ） signaling pathway and expression of brain-derived neurotrophic factor （BDNF） isoforms in mouse model of cognitive dysfunction secondary to repetitive mild traumatic brain injury （rmTBI）.

A total of 63 male C57BL/6J mice （5 weeksd old，werghing 16~17 g） were divided into model group （n=50） and control group （n=13）. The mice of the model group received modified weight drop and repeated head impacts to establish a model of rmTBI，and the mice from the control group were only given anesthetic treatment. From the 30th day after the end of modeling，Morris water maze test was applied to evaluate the spatial learning and memory abilities，and the relative data was evaluate for correlation analysis. According to the taxonomy of cognitive levels，the model group was further stratified into high-，medium- and low-performance groups. After the mice with medium-performance group were eliminated，and the indicators of water maze test were compared among the high-performance，low-performance，and control groups. After the behavioral experiment，Western blotting was conducted to detect the expression of CaMKII，α-amino-3-hydroxy-5-methyl-4-isoxazole-propionicacid receptor （AMPAR） subunits （GluR1，p-GluR1，GluR2），and different isoforms of BDNF （mBDNF，proBDNF） in the prefrontal cortex and hippocampus. The expression levels were compared among the groups.

① There were significant correlations among the water maze-related indicators（P<0.05）. The mice in the model group were divided into 3 groups of high- （n=31），medium- （n=11） and low-performance （n=8） levels through hierarchical clustering，and there were differences in cognitive levels in the high-performance，low-performance and control groups. ② The phosphorylation level of GluR1 in the hippocampus was significantly decreased in the high-performance group than the control group and the low-performance group （P<0.05）. When compared with the control group，the expression of GluR1 and GluR2 in the prefrontal cortex of the low-performance group was increased （P<0.05），and the expression of GluR2 and CaMKⅡ in the prefrontal cortex of the high-performance group was increased （P<0.05）. The low-performance group obtained obviously lower GluR1/GluR2 ratio than the high-performance group （P<0.05）. ③ When compared with the control group，the low-performance group exhibited notably elevated expression of proBDNF and mBDNF （P<0.05） and mBDNF/proBDNF （P<0.05） in the prefrontal cortex and hippocampus，while the high-performance group had enhanced expression of mBDNF in the prefrontal cortex （P<0.05）.

In the chronic phase of rmTBI，prognosis of good cognitive function is accompanied by up-regulation of CaMKⅡ signaling pathway，and the difference in cognitive function is accompanied by the change in proportions of different AMPAR subunits on the postsynaptic membrane. In the cognitive impairment group，there is an overexpression of 2 types of BDNF isoforms and an increase in the conversion rate of mBDNF.