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Objective Acute pulmonary embolism (APE) is a serious complication after off-pump coronary artery bypass grafting (OPCABG). We aimed to analyze the risk factors for APE in patients with OPCABG. Methods In this retrospective, observational study, patients with OPCABG who were treated in our hospital from 1 January 2018 to 31 March 2020 were included. The basic characteristics of patients and results of preoperative laboratory examinations were collected and analyzed. Results A total of 707 patients with OPCABG were included and the incidence of APE was 3.21%. Left ventricular ejection fraction (LVEF), a history of smoking, number of bypass grafting, duration of surgery, and age were significant risk factors for APE in patients with OPCABG. The areas under the curves of LVEF, number of bypass grafting, duration of surgery, and age were 0.773, 0.759, 0.738, and 0.723, respectively. The cutoff values of LVEF, number of bypass grafting, duration of surgery, and age were 59.84, 3.18, 237.42, and 73.28, respectively. Conclusions LVEF, a history of smoking, number of bypass grafting, duration of surgery, and age may be risk factors for APE in patients with OPCABG. Early measures should be taken to target these risks to prevent APE.

Hypoalbuminemia is often considered an independent risk factor for surgical site infections. This study first demonstrated that albumin level ≥ 3.3 g/dL was independently associated with adverse maternal outcomes. In this letter to the editor, we would like to raise some concerns about the study and clarify the interpretation of the results.

The dural-puncture epidural (DPE) and standard epidural (EP) techniques are well-established methods for neuraxial analgesia during labor. However, there is limited knowledge regarding the conversion of DPE-induced labor analgesia to surgical anesthesia during cesarean sections, particularly regarding efficacy and timing. This study will compare the surgical anesthesia onset time between DPE and EP in parturients undergoing emergency cesarean delivery after conversion from labor analgesia. This double-blind, randomized clinical study will include 124 parturients. Parturients aged ≥18 years with singleton pregnancies who request labor analgesia will be randomly assigned to receive either DPE or EP anesthesia in the labor and delivery rooms. Participants will be excluded if they have contraindications to neuraxial anesthesia, back surgery or scoliosis history, significant fetal anomalies, or a known allergy to any of the study medications. Epidural labor analgesia will be maintained using a low concentration of ropivacaine in combination with sufentanil, delivered through the epidural catheter. During delivery, an emergency intrapartum cesarean section following labor analgesia may be necessary among these parturients. Parturients requiring intrapartum cesarean delivery following labor analgesia will be eligible. Epidural extension anesthesia will be administered in the operating room. The primary outcome measure will be the time from chloroprocaine administration to the achievement of a surgical level of anesthesia, defined as a T6 sensory block. Secondary outcomes will include epidural anesthesia quality, incidence of conversion to cesarean section between the two techniques, and maternal and neonatal outcomes. This study will estimate the onset time to achieve surgical anesthesia during epidural extension using a DPE compared to an EP technique. The results may provide a deeper understanding of the advantages of the DPE technique in labor analgesia, as well as determine the onset time and reliability of anesthesia block during conversion from labor analgesia to cesarean delivery. ChiCTR2400089237. Registered September 4, 2024.

Ovarian cancer is a life-threatening disease with a high mortality rate in women. Our previous work presented that long non-coding RNA (lncRNA) activated by transforming growth factor beta (TGF-β) (lncRNA ATB) played a role of oncogene in ovarian cancer. However, whether exosomal lncRNA ATB from ovarian cancer cells could regulate the tumorigenesis of ovarian cancer remains unclear. RT-qPCR assay was performed to evaluate the level of lncRNA ATB in cancer cells (SKOV3 and A2780). In addition, ovarian cancer cells-secreted exosomes were collected with ultracentrifugation. CCK8 assay was performed to detect the viability of ovarian cells and HUVECs. Meanwhile, Western blot was performed to detect the expression of mechanism related protein and tube formation assay was used to observe the angiogenesis of HUVECs. Finally, xenograft mice model was used to verify the role of ovarian cancer cell-derived exosomes in vivo. Ovarian cancer cells-derived exosomes promoted the viability, angiogenesis and migration of HUVECs; however, knockdown of lncRNA ATB in HUVECs reversed these phenomena. In addition, exosomal lncRNA ATB promoted the tumorigenesis of ovarian cancer via regulating miR-204-3p/TGFβR2 axis. Furthermore, ovarian cancer cells-secreted exosomal lncRNA ATB increased tumor growth in vivo. Exosomal lncRNA ATB derived from ovarian cancer cells could improve tumor microenvironment via regulating miR-204-3p/TGFβR2 axis. Thus, this study might provide new knowledge for the treatment of ovarian cancer.

In recent years, the incidence of postpartum hemorrhage has increased globally. Multiple pregnancies and cesarean sections are well-known risk factors for postpartum hemorrhage. No studies have evaluated the associations between fetal growth anomalies and postpartum hemorrhage in women with twin pregnancies undergoing cesarean section. This study aimed to identify the relationship between fetal growth anomalies and postpartum hemorrhage in women with twin pregnancies undergoing cesarean section. This retrospective single-center study included 3,180 women with twin pregnancies at a tertiary hospital between August 2013 and July 2020. Singleton reference charts were used to assess fetal growth restriction at birth. Discordant growth was defined as an intertwin birth weight difference of ≥20%. Logistic regression analyses were used to evaluate the association between fetal growth anomalies and postpartum hemorrhage. Additionally, sensitivity analysis of abnormal placenta and stratification by twin chorionicity were conducted. The overall incidence of postpartum hemorrhage was 4.3%. Twin growth discordance, especially with fetal growth restriction, was associated with an increased risk of postpartum hemorrhage (adjusted odds ratio [AOR] = 1.62, 95% confidence interval [CI], 1.05-2.51, = 0.031; AOR = 1.71; 95% CI, 1.08-2.70, = 0.022; AOR = 1.98, 95% CI, 1.21-3.25, = 0.006, respectively). After stratification, this relationship persisted in dichorionic twins (OR = 1.71, 95% CI, 1.04-2.82, = 0.036; OR = 1.90, 95% CI, 1.13-3.21, = 0.016; OR = 2.48, 95% CI, 1.41-4.38, = 0.002, respectively). However, no significant association was observed in monochorionic twin pregnancies. Growth discordance, especially complicated by fetal growth restriction, was associated with an increased risk of postpartum hemorrhage in women with twin pregnancies undergoing cesarean section, and was more evident in patients with dichorionic twins.

The microstructure of scaffolds is essential for enhancing cell‐extracellular matrix interactions, which are critical for osteochondral regeneration. This study investigates the innovative use of 3D printing to mimic DOUGONG brackets to achieve this goal. Composite scaffolds of β‐tricalcium phosphate, akermanite (AKer), and strontium silicate (SrSiO3) at 1%, 5%, and 10% concentrations were fabricated via 3D printing. The osteogenic differentiation effects on bone marrow mesenchymal stromal cells and chondrogenic promotion effects on chondrocytes of different scaffolds were analyzed in vitro. An osteochondral defect model was created in SD rat knee joints, and various scaffold materials were implanted to evaluate their repair and anti‐inflammatory effects. Characterization showed that SrSiO3 composite scaffolds had uniform pore structures and high porosity with improved mechanical properties and sustained strontium ion release capacities. The Aker/Sr5% scaffold significantly enhanced cell viability and proliferation, inhibited apoptosis, and upregulated osteogenic markers (RUNX2, COL1A1, OCN, OPN) while downregulating inflammatory factors (IL‐6 and TNF‐α). This scaffold also improved the chondrocyte phenotype as indicated by increased chondrogenic markers (COL2A1 and SOX9). Additionally, it excelled in bone volume, bone mineral density, and tissue repair scores. The DOUGONG‐inspired AKer/SrSiO3 composite scaffold promotes osteochondral regeneration by enhancing osteogenesis via the PI3K/Akt signaling pathway and cytokine‐cytokine receptor interaction, while simultaneously facilitating cartilage repair by promoting chondral phenotypes. This work provides a theoretical basis and new strategies for the clinical transformation of osteochondral repair. Akermanite scaffolds promote osteogenic differentiation of BMSCs through regulating the PI3K/Akt signaling pathway, and strontium ions enhance the akermanite effects by mediating the cytokine‐cytokine receptor interaction pathway. Thus, the enhancements of osteogenesis in subchondral bone coupled with the chondral‐promoting effects of chondrocytes facilitated by 3D‐printed DOUGONG brackets improve osteochondral regeneration.

Background Endometriosis (EM) is a gynecological disease that poses severe health risks to women, although its pathogenesis has yet to be fully elucidated. It has been shown that long non-coding RNAs (lncRNAs) are closely associated with EM initiation and have a role in the development of this disease. Previous studies exploring the expression of the lncRNA nuclear paraspeckle assembly transcript 1 (NEAT1) have shown that this lncRNA functions as a tumor promoter in endometrial cancer. However, its exact mechanism of action in EM remains unclear. Objective This report was designed to illustrate the potential molecular mechanisms of lncRNA NEAT1 on EM. Methods Endometrial tissues were extracted from EM model rats and patients with EM. Hematoxylin and eosin staining was applied to detect the morphological changes that occurred in rats after construction of the model. Endometrial stromal cells (ESCs) were extracted from either ectopic endometrium (EC) or eutopic endometrium (EU) tissues from patients with EM. LncRNA NEAT1 and miR-124-3p expression in EM tissues and cells were subsequently evaluated by reverse transcription-quantitative (RT-q)PCR analysis. MTT assay, flow cytometric analysis, western blot assay and Transwell assay were then employed to examine the effect of NEAT1 and miR-124-3p on EC-ESC proliferation, apoptosis, migration and invasion, respectively. The targeted relationship between lncRNA NEAT1 and miR-124-3p was subsequently confirmed by dual-luciferase and co-transfection assays. Results MiR-124-3p was identified as a target of NEAT1, and could be negatively regulated by NEAT1 in EC-ESCs. The expression level of NEAT1 was evidently increased, whereas that of miR-124-3p was decreased, in the EM in vivo model, EM tissues and EC-ESCs from patients with EM. The loss-of-function assays further established that silencing of NEAT1 could inhibit EC-ESC proliferation, migration, and invasion, but it led to the promotion of apoptosis via targeting miR-124-3p. Conclusions NEAT1 is significantly upregulated in EM, promoting malignant behavior in EM through targeting miR-124-3p expression.

To determine the antiemetic efficacy of dexamethasone in the prevention of postoperative sore throat (POST) and postoperative hoarseness (PH). Meta-analysis. Metropolitan university medical center. This systematic review and meta-analysis was conducted and reported in agreement with the PRISMA guideline. We searched online databases of MEDLINE (from 1966 to August 2013), EMBASE (from 1982 to August 2013), Google Scholar, and the Cochrane Database of Systematic Review. Relative ratios (RRs) and 95% confidence interval (CI) were calculated. Four trials with a total of 480 patients were included for the analysis: 283 received prophylactic dexamethasone and 197 received placebo. Pooled result by random-effects model showed that dexamethasone significantly decreased the incidence of POST at 1 hour (RR = 0.51, 95% CI 0.27-0.94, P = .03; P for heterogeneity = .0005, I2 = 83%) and at 24 hour postextubation (RR = 0.46, 95% CI 0.26-0.79, P < .05; P for heterogeneity = .01, I2 = 72%). Our analysis indicated that dexamethasone significantly decreased the incidence of PH at 1 hour (RR = 0.22, 95% CI 0.11-0.46, P < .01; P for heterogeneity = .48, I2 = 0%), but did not affect the incidence of PH at 24 hours postextubation (RR = 0.67, 95% CI 0.37-1.20, P > .1; P for heterogeneity = .12, I2 = 59%). Our meta-analysis suggested that intravenous dexamethasone can effectively reduce the incidence of POST both at 1 and at 24 hours postextubation. In addition, the present study showed that prophylactic dexamethasone reduced the incidence of PH at 1 hours but not at 24 hours postextubation.

Inspired by the Chinese myth of “Nüwa Mending the Sky” (女娲 补天), this cover art transforms ancient symbolism into a vision of regenerative healing. Here, the goddess Nüwa embodies the physicians and engineers who crafted 3D‐printed scaffolds to repair osteochondral defects—damaged joints ravaged by osteoarthritis—represented by the “broken sky.” The “molten stones” Nüwa used to rebuild the heavens become a 3D‐printed DOUGONG (斗拱) bracket structure made from an akermanite/SrSiO3 composite. The DOUGONG structure—a defining feature of traditional Chinese architectural systems—exhibits remarkable load transfer efficiency for both vertical and horizontal forces, owing to its intricate 3D interlocking network architecture. This unique mechanical property, rooted in millennia of structural wisdom, may facilitate cell‐extracellular matrix (ECM) interactions, thereby supporting robust tissue integration. These architecturally inspired scaffolds work in concert: they precisely modulate inflammation and mechanical stimuli to orchestrate the regeneration of healthy osteochondral tissue, turning a mythological act of cosmic repair into a tangible promise of restored joint function. Designed by Jialin Guo, Guangzhou Academy of Fine Arts.

Background: Ovarian cancer is a life-threatening disease with a high mortality rate in women. Our previous work presented that long non-coding RNA (lncRNA) activated by transforming growth factor beta (TGF-[beta]) (lncRNA ATB) played a role of oncogene in ovarian cancer. However, whether exosomal lncRNA ATB from ovarian cancer cells could regulate the tumorigenesis of ovarian cancer remains unclear. Methods: RT-qPCR assay was performed to evaluate the level of lncRNA ATB in cancer cells (SKOV3 and A2780). In addition, ovarian cancer cells-secreted exosomes were collected with ultracentrifugation. CCK8 assay was performed to detect the viability of ovarian cells and HUVECs. Meanwhile, Western blot was performed to detect the expression of mechanism related protein and tube formation assay was used to observe the angiogenesis of HUVECs. Finally, xenograft mice model was used to verify the role of ovarian cancer cell-derived exosomes in vivo. Results: Ovarian cancer cells-derived exosomes promoted the viability, angiogenesis and migration of HUVECs; however, knockdown of lncRNA ATB in HUVECs reversed these phenomena. In addition, exosomal lncRNA ATB promoted the tumorigenesis of ovarian cancer via regulating miR-204-3p/TGF[beta]R2 axis. Furthermore, ovarian cancer cells-secreted exosomal lncRNA ATB increased tumor growth in vivo. Conclusion: Exosomal lncRNA ATB derived from ovarian cancer cells could improve tumor microenvironment via regulating miR-204-3p/TGF[beta]R2 axis. Thus, this study might provide new knowledge for the treatment of ovarian cancer. Keywords: ovarian cancer, exosome, lncRNA ATB, TGF[beta]R2, tumor microenvironment