Objective To investigate the anesthetic efficacy and impact on the circulatory system of ultra-fast-track anesthesia(UFTA) in thoracoscopic lobectomy. Methods A total of 594 patients undergoing thoracoscopic lobectomy in the Department of Cardiovascular Surgery, Huangshi Central Hospital from January 2023 to August 2025 were retrospectively selected as the research subjects. They were divided into a conventional group(traditional anesthesia technique, n = 286) and a UFTA group(ultra-fast-track anesthesia technique,n = 308) according to the anesthesia technique used. Anesthesia effects, circulatory system indicators, stress indicators, sedative effect, pain degree, and adverse reactions were compared between the two groups. Results Operative time, anesthesia time, extubation time, anesthesia recovery room stay, intensive care unit stay, and postoperative hospital stay were significantly shorter in the UFTA group than in the conventional group, and the number of patients extubated in the operating room was significantly higher in the UFTA group than in the conventional group(t/χ2/P =4.682, 3.641, 62.108, 28.791, 58.672, 29.507; all P<0.001). Immediately after tracheal intubation(T2) and 5 minutes after tracheal extubation(T3), heart rate(HR), invasive arterial pressure(IBP), central venous pressure(CVP), and pulmonary artery wedge pressure(PAWP) were significantly lower in the UFTA group than in the conventional group(t/P = 7.093, 11.219,5.026, 5.491, 4.545, 3.939, 5.966, 5.541; all P<0.001). Cortisol(Cor) and myeloperoxidase(MPO) levels were significantly lower in the UFTA group than in the conventional group, while superoxide dismutase(SOD) levels were significantly higher(t/P = 8.047, 9.487, 15.873; all P<0.001). At 2, 6, and 12 hours postoperatively, the VAS score was lower in the UFTA group than in the conventional group, and the Ramsay sedation score was higher(t/P = 4.455, 7.999, 2.393/<0.001,<0.001, 0.017).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion UFTA technique can optimize anesthesia management for patients undergoing thoracoscopic lobectomy, maintain circulatory stability, reduce stress responses, enhance sedation and analgesic effects, and promote postoperative recovery, making it highly valuable for clinical promotion.

Objective To investigate the expression levels and clinical significance of serum ferroptosis suppressor protein 1(FSP1), glutathione peroxidase 4(GPX4), and reduced glutathione/oxidized glutathione(GSH/GSSG) ratio in endometriosis(EMT). Methods From September 2023 to September 2025, 89 patients with EMT admitted to the Department of Gynecology of Changshu Hospital of Traditional Chinese Medicine in Jiangsu Province were selected as the EMT group, and89 patients with non-EMT who underwent surgery for benign lesions were selected as the control group. The degree of EMT tissue damage was evaluated by the American Fertility Association revised staging(r-AFS), which was divided into stage Ⅰ(n = 29), stage Ⅱ(n = 23), stage Ⅲ(n = 21), and stage Ⅳ(n = 16). Serum levels of FSP1, GPX4, GSH, and GSSG were detected by enzyme-linked immunosorbent assay, and the GSH/GSSG ratio was calculated. Spearman rank correlation analysis was used to analyze the correlation between each index and r-AFS stage. Multivariate logistic regression analysis was used to analyze the correlation with EMT and its intensity. The value of differential diagnosis of EMT was evaluated by receiver operating characteristic(ROC) curve analysis. Results Serum FSP1 level in the EMT group was significantly higher than that in the control group, while GPX4 level and GSH/GSSG ratio were significantly lower than those in the control group(t = 12.406,14.182, 7.028, all P<0.001). FSP1 levels progressively increased from stage Ⅰ to Ⅳ, while GPX4 levels and GSH/GSSG ratio progressively decreased from stage Ⅰ to Ⅳ(F = 19.869, 35.775, 10.761, all P<0.001). FSP1 was positively correlated with r-AFS stage(rs= 0.604, P = 0.011), while GPX4 and GSH/GSSG ratio were negatively correlated with r-AFS stage(rs=-0.537,-0.592,P = 0.017, 0.006). Increased menstrual days, history of dysmenorrhea, and elevated FSP1 were independent risk factors for EMT [OR(95%CI) = 1.146(1.066-1.232), 1.171(1.078-1.275), 1.217(1.050-1.409)]. Elevated GPX4 and elevated GSH/GSSG ratio were independent protective factors for EMT [OR(95%CI) = 0.903(0.853-0.956), 0.830(0.761-0.907)].The AUCs of FSP1, GPX4, GSH/GSSG ratio, and their combination for diagnosing EMT were 0.803, 0.798, 0.805, and 0.921,respectively. The combined diagnostic value of the three was superior to that of each individual marker(Z = 2.376, 2.432,2.336; P = 0.013, 0.011, 0.014). Conclusion Serum FSP1 is upregulated, while GPX4 and GSH/GSSG ratio are decreased in patients with EMT, which are closely related to the degree of tissue damage. Early combined detection of these three markers can serve as biomarkers for the diagnosis of EMT and evaluation of tissue damage.

Objective To investigate the expression and clinical significance of serum glycated albumin/glycated hemoglobin ratio(GA/HbA1c), lymphocyte-to-C-reactive protein ratio(LCR), and bilirubin-to-albumin ratio(BAR) in children with type 1 diabetes mellitus complicated by diabetic ketoacidosis(T1DM combined with DKA) of different severities. Methods A total of 84 children with T1DM combined with DKA admitted to the Department of Pediatrics, Jianyang People' s Hospital of Sichuan Province from October 2022 to October 2025 were enrolled as the DKA group, 84 children with simple T1DM as the T1DM group, and 84 healthy children undergoing physical examination during the same period as the healthy control group. Children with T1DM combined with DKA were further divided into a mild subgroup(n = 29), a moderate subgroup(n = 32), and a severe subgroup(n = 23). Pearson correlation analysis was used to evaluate the correlation between serum GA/HbA1c, LCR, BAR levels and the severity of T1DM-DKA. ROC curve analysis was performed to assess the diagnostic value of each index for severe T1DM-DKA, and decision curve analysis(DCA) was used to evaluate the clinical net benefit of diagnosing severe T1DM-DKA. Results Serum GA/HbA1cand BAR levels: DKA group>T1DM group>healthy control group. Serum LCR levels: DKA groupmoderate subgroup>mild subgroup. Serum LCR levels: severe subgroup

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Objective To explore the possible mechanism by which notoginsenoside Ft1(NFt1) regulates the Nrf2/HO-1/GPX4 pathway to induce ferroptosis and inhibit the progression of hepatocellular carcinoma(HCC). Methods Human HCC cell line Hep G2 was treated with different concentrations of NFt1(0, 0.5, 1, 2, 4, 6, 8, 10, and 20 μmol/L), and cell viability was determined by CCK-8 assay. Hep G2 cells were divided into six groups: control group; low-, medium-, and highdose NFt1 groups(2, 4, and 6 μmol/L); Erastin group(10 μmol/L); and NFt1(6 μmol/L) + Fer-1(1 μmol/L) group. Colony formation assay, scratch assay, and Transwell assay were used to detect cell proliferation, migration, and invasion. A Ferro Orange fluorescent probe was used to detect Fe2+content. The d CFH-DA fluorescent probe was used to detect oxidative stress.MDA and GSH levels were detected by commercial kits. Western blot was used to detect ferroptosis-related proteins and Nrf2/HO-1/GPX4 pathway-related protein expression. Subcellular localization and expression of Nrf2 were detected by immunofluorescence. JC-1 fluorescent probe was used to evaluate mitochondrial membrane potential. Mitochondrial ultrastructure was detected by transmission electron microscopy. Results NFt1 significantly inhibited the viability of Hep G2 cells in a time-and concentration-dependent manner(all P<0.05). Compared with the control group, the number of colonies formed, migration rate, and invasion rate of Hep G2 cells in the NFt1 low-, medium-, and high-dose groups were decreased. Relative Ferro Orange fluorescence intensity, average ROS fluorescence intensity, and MDA levels gradually increased, while GSH levels, Nrf2, HO-1, GPX4, and x CT protein expression, and nuclear Nrf2 average fluorescence intensity gradually decreased in a concentrationdependent manner(all P<0.05). The fluorescence ratio of JC-1 polymer/monomer in Hep G2 cells in the high-dose NFt1 group and Erastin group decreased, showing decreased mitochondrial volume, increased double-layer membrane density, decreased mitochondrial cristae, and mitochondrial outer membrane rupture(all P<0.05). Compared with the high-dose NFt1 group, the JC-1 polymer/monomer fluorescence ratio in Hep G2 cells in the NFt1 + Fer-1 group increased, and the mitochondrial damage characteristics were reversed(P<0.05). There was no significant difference in the above indicators between the high-dose NFt1 group and the Erastin group(P>0.05). Conclusion NFt1 may induce ferroptosis in HCC cells by inhibiting the activation of the Nrf2/HO-1/GPX4 pathway, which may be closely related to the damage of mitochondrial structure and function.

This article reports a rare case of placental mesenchymal dysplasia(PMD) with clinical data and conducts a literature review.