Objective To assess the therapeutic effects of electroacupuncture (EA) in a rat model of diabetic cystopathy (DCP) and examine its impact on the expression of transient receptor potential vanilloid 1 (TRPV1) in the dorsal root ganglion (DRG). Methods Sixty male Sprague-Dawley rats were divided into four groups: control, DCP, EA, and sham EA (n = 10). DCP was induced using a high-fat diet, followed by streptozotocin injection. EA was administered at the Pangguangshu (BL 28) and Sanyinjiao (SP 6) acupoints for 8 weeks. Bladder function, structure, and molecular changes were evaluated using ultrasonography, urodynamic tests, bladder weight measurements, histological staining (hematoxylin and eosin and Masson’s trichrome staining), transmission electron microscopy, immunohistochemical analysis, and western blot for TRPV1 expression in the DRG. Results The DCP group exhibited significantly increased bladder weight, wall thickness, collagen fiber expression, maximum bladder capacity (MBC), post-void residual (PVR), and leakage point pressure, along with reduced bladder compliance (BC) and voiding efficiency (V%) compared with the Control group (all P < .05). EA treatment significantly decreased bladder weight (P = .003), collagen deposition (P = .002), wall thickness (P = .027), MBC (P = .046), and PVR (P = .023), and increased BC (P = .048) and V% (P = .022) compared with sham EA. Ultrastructural damage in DRG neurons was markedly ameliorated by EA. TRPV1 protein expression in the DRG was significantly higher in the EA group than in the sham EA group (immunohistochemistry: P = .003; western blot: P = .001). Conclusion EA alleviates bladder dysfunction and remodeling in DCP rats, an effect associated with upregulated TRPV1 expression in the DRG, reduced bladder fibrosis, and preserved neuronal ultrastructure. These findings suggest a potential role for TRPV1 signaling in mediating the therapeutic effects of EA, warranting further functional investigation.

ObjectiveTo observe the effect of electroacupuncture （EA） on hypothalamic-pituitary-gonadal （HPG） axis function and the expression of key enzymes for testosterone synthesis in high-fat diet-induced obese male rats， so as to explore its mechanism in improving obesity-related reproductive dysfunction.MethodsThirty-two 6-week-old male Wistar rats were randomly divided into control， model， EA and non-acupoint EA groups （n=8 in each group）. The obesity model was established through high-fat diet feeding for 8 weeks. EA was applied to “Zusanli” （ST36）， “Shenshu” （BL23）， and “Sanyinjiao” （SP6） for 30 min， 5 d a week for 4 weeks. The body weight， body mass index （BMI） and Lee’s index of rats were detected. The levels of serum gonadotropin-releasing hormone （GnRH）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， testosterone， estradiol （E2） and lipid metabolism indexes were detected by ELISA and enzymic method. The epididymal sperm concentration and motility were assessed， and the sperm deformity rate was calculated. The morphological changes of testis were observed by HE staining. The protein and mRNA expression of steroid-regulated acute protein （StAR）， cytochrome P450 side chain cleavage enzyme （P450scc）， 17α-hydroxylase/17，20-lyase （CYP17A）， 3β-hydroxysteroid dehydrogenase （3β-HSD） and 17β-hydroxysteroid dehydrogenase （17β-HSD） were detected by Western blot and PCR， respectively.ResultsCompared with the control group， the body weight， BMI， Lee’s index， the levels of serum TC， TG， LDL-C， OxLDL and E2， the deformity rate were significantly increased （P<0.05） in the model group， while the levels of HDL-C， GnRH， testosterone， FSH and LH， the sperm concentration and motility， the protein and mRNA expression of key enzymes in testosterone synthesis were significantly decreased （P<0.05）. Compared with the model and the non-acupoint EA groups， the indexes mentioned above were significantly improved in the EA group （P<0.05）. Except for increased StAR protein expression， no significant differences were found in other indicators between the non-acupoint EA group and the model group.ConclusionEA can effectively improve reproductive dysfunction in obese male rats. The mechanism may be related to restoring the functional balance of the HPG axis， up-regulating the expressions of key testosterone synthesis enzymes， and promoting testosterone production.

Globalization has driven a surge in noncommunicable diseases, including metabolic disorders, which are major global health challenges. These disorders, fueled by high-calorie diets, sedentary lifestyles, and gut microbiota imbalances, disrupt energy metabolism, gastrointestinal function, and vitamin and trace element homeostasis. Sertoli cells provide the metabolic and structural support essential for germ cell development within the seminiferous epithelium. This review examines how metabolic disorders affect male reproductive health, focusing on glucose, lipid, and vitamin metabolism, as well as the gut-testis axis, in relation to Sertoli cell function and the blood-testis barrier (BTB) integrity. Glucose metabolism in Sertoli cells provides lactate to germ cells, which is crucial for spermatogenesis. However, metabolic stressors, such as diabetes, impair glucose transport and lactate production, compromising energy supply. Lipid metabolism, including fatty acid oxidation and lipid droplet dynamics, is essential for energy homeostasis in Sertoli cells. Moreover, the gut microbiota further influences Sertoli cells and BTB integrity via metabolites, such as short-chain fatty acids, which enhance barrier function and reduce inflammation. Conversely, dysbiosis and microbially derived lipopolysaccharides induce oxidative stress and immune responses, leading to BTB disruption and infertility. Deficiencies or imbalances in the levels of these vitamins and trace elements can impair spermatogenesis. This review highlights the complex interplay between metabolic pathways and Sertoli cell function, their collective impact on male fertility, and provides a basis for developing targeted therapeutic strategies, including metabolic modulators, vitamin supplementation, and gut microbiota interventions, to mitigate the effects of metabolic disorders on spermatogenesis and fertility.

BACKGROUND AND PURPOSE:Effective management of glycolipid metabolism is key to reducing the risk of cardiovascular disease in patients with metabolic syndrome (MetS). Chinese patent medicines (CPMs), a type of standardized herbal formulation, are widely used in China. This study compared the efficacy, safety, and cost-effectiveness of CPMs as adjunctive therapies for glycolipid regulation in MetS via network meta-analysis (NMA), providing a reference for clinical decision-making. METHODS:By October 2024, we searched eight databases for randomized controlled trials (RCTs) investigating the use of CPMs in the treatment of MetS. The impact of CPMs on lipid profiles, blood glucose levels, and insulin resistance indicators was evaluated using methods including surface under the cumulative ranking curve (SUCRA). The cost-effectiveness analysis was conducted on the basis of the market price in China and SUCRA rankings. RESULTS:A total of 25 RCTs involving 17 CPMs were included. The results revealed that combining specific CPMs with conventional treatment had significant beneficial effects on lipid and glucose metabolism. Hedan tablet was revealed to be the most effective at regulating the levels of lipids, when both efficacy and cost were considered. Shenqi Jiangtang granule and Jiangzhi Jianfei capsule had the greatest beneficial effects on glucose metabolism and insulin resistance. CONCLUSION:CPMs have the potential to serve as effective adjunctive therapies for glycolipid regulation in patients with MetS. However, given the limited number and quality of studies included in this NMA, these conclusions should be interpreted with caution. Further high-quality RCTs are warranted to validate and update the current evidence.

Background: Tarsal tunnel syndrome (TTS) is a condition in which the tibial nerve (TN) (or its terminal branches) is compressed by the flexor retinaculum (FR) and the deep fascia of the abductor hallucis muscle at the tarsal tunnel, causing symptoms that negatively impact the patient's quality of life, including numbness, a sensation of a foreign object, coldness, and pain. FR release via microtrauma using needle -knife has proven to be effective in China and is widely used by clinicians. The traditional acupotomy, however, is the "blind knife" treatment, which cannot guarantee patient safety due to risk of injury to important structures, particularly the neurovascular bundle. Compared with the conventional treatments, ultrasound -guided percutaneous FR release possesses noteworthy advantages including high efficacy and safety. Methods: Percutaneous release of the FR was performed on 51 formalin-fixed specimens. The specimens were divided into two groups: an ultrasound -guided acupotomy pushing group comprising 20 legs (group U) and a nonultrasound-guided acupotomy pushing group comprising 31 legs (group N). After high -frequency ultrasound exploration, those with clear vascular imaging were included in group U; otherwise, they were included in group N. The FR was released percutaneously, soft tissue was dissected layer by layer, and anatomical data were recorded. Results: There no cases of injury in group U (0%) and four in group N (12.9%). Among the different intervention methods, there were no significant differences in tissue injury types ( chi 2 =2.80; P=0.09). The percentage of released FR in group U was 80.00% while that in group N was 61.29% ( chi 2 =1.977; P=0.16), which did not represent a significant difference between the two groups. However, group U had a significantly greater release length than that in the group N ( t =3.359; P=0.002), indicating that the flexor release length guided by ultrasound is significantly greater than the unguided one. Conclusions: Ultrasound -guided percutaneous release of the FR using a needle -knife can provide greater length and percentage of released FR while maintaining a comparable safety rate to the unguided procedure.

BackgroundsObservational studies suggest that air pollutants, including particulate matter and nitrogen compounds, could elevate asthma and allergic rhinitis health risks. Nevertheless, the exact nature of the causal relationship between air pollution and asthma and allergic rhinitis remains unknown. This study utilizes the Mendelian randomization (MR) technique to explore the potential causal links between air pollution components (PM2.5, PM2.5–10, PM10, NO₂, and nitrogen dioxide) and the incidence of allergic rhinitis and asthma.MethodsA MR study utilized summary statistics from GWAS that are publicly accessible. The inverse variance weighting (IVW) approach served as the foundational analysis technique. To ensure robustness, supplementary methodologies such as the weighted median, MR-Egger regression, simple mode, and weighted model were also applied. Heterogeneity was evaluated using Cochran’s Q test, and the presence of pleiotropy was determined through MR-Egger regression. The MR-PRESSO test was employed for outlier detection, and the analysis’s sensitivity was scrutinized via a leave-one-out strategy.ResultsThe IVW technique showed a strong correlation between PM10 and asthma (OR = 0.625, 95% CI = 0.396–0.988, p = 0.044). No significant associations were found between asthma and other air pollutants such as PM2.5, PM2.5–10, NO₂, or nitrogen dioxide. Similarly, allergic rhinitis showed no causal relationships with any studied air pollution metrics. Pleiotropy was absent in the findings. Sensitivity analyses, employing the leave-one-out method, confirmed the stability of these results, unaffected by individual single nucleotide polymorphisms (SNPs).ConclusionThis Mendelian randomization study establishes a causal link between PM10 exposure and asthma, suggesting that interventions to reduce air pollution may decelerate the adverse progression of asthma.

This study aimed to summarize the characteristics of the top 100 most-cited publications on Peyronie’s disease (PD) research and to analyse past and current research hotspots and trends. The SCI-E database of the Web of Science Core Collection (WoSCC) provided us with the top 100 most-cited publications in PD research, from which we took the following information: general trend of publication, year of publication, nation/region, institution, journal, author, and keywords. VOSviewer (version 1.6.18) and Excel (version 2016) were used for information analysis. Through a standardized search, we ultimately found 1019 papers in the field of PD research, from which we extracted the 100 articles that had received the highest citations. The articles were published between 1949 and 2016. The United States is a major contributor to PD research (n = 67). The University of California, Los Angeles, was the institution with the largest number of articles (n = 11). These articles were published in 16 journals, with the largest number appearing in the Journal of Urology (n = 47). The author with the most articles was Levine LA (n = 9). Gelbard MK’s articles had the highest citation frequency (n = 1158). Erectile dysfunction (n = 19) was the keyword with the highest frequency, indicating that PD-related erectile dysfunction was the leading focus of research in this field. Most of the keywords that have appeared in the past decade are related to the clinical treatment of PD. Therefore, we believe that improving patients’ erectile function to the greatest extent in clinical treatment is the frontier and hot spot of future research.

Scopel‐Theanine (l‐Thea) is an amino acid which is naturally present in tea leaves. It has been associated with possible health advantages, including obesity prevention, but the underlying molecular mechanisms have not been elucidated.Methods and resultsA multiomics approach is utilized to examine the mechanism by which l‐Thea exerts its antiobesity effects. This study reveals that l‐Thea administration significantly ameliorates high‐fat diet (HFD)‐induced obesity in rats by improving body weight and hyperlipidemia. l‐Thea mitigates HFD‐induced inflammation and reverses hepatic and colonic damage, and intestinal barrier. This research verifies that the preventive effect of l‐Thea on obesity in rats induced by an HFD with colitis is accomplished by suppressing the phosphorylation of important proteins in the NF‐κB/mitogen‐activated protein kinase (MAPK) pathways. Metabolome analysis reveals that l‐Thea regulates HFD‐induced metabolic disorders, specifically through modulation of steroid hormone biosynthesis. Microbiome analysis reveals that l‐Thea mitigates HFD‐induced dysbiosis by increasing the relative abundance of obesity‐associated probiotic bacteria, including Blautia coccoides and Lactobacillus murinus, while simultaneously suppressing the abundance of pathogenic bacteria.Conclusionsl‐Thea alleviates colitis generated by an HFD by restoring the integrity of the intestinal barrier, suppressing inflammation through regulation of MAPK/NF‐κB signaling pathways, and enhancing microbial metabolism in colon.

L-theanine (L-Thea), an amino acid that is found in tea, possesses significant nutraceutical properties. This study aimed to investigate the anti-cardiac injury caused by obese mechanism of L-Thea by transcriptome and metabolome. L-Thea enhanced serum biochemical indicators and reduced inflammatory cytokine levels in serum and cardiac tissues, and cardiac injury associated with high-fat diet (HFD)-induced obesity in rats. Transcriptome data revealed that the amelioration of cardiac injury was associated with aldosterone synthesis and secretion. The metabolome indicated that the cardiac disorder induced by an HFD is influenced by the contents of succinic acid and 4-hydroxyphenylacetic acid. The joint analysis of transcriptome and metabolome showed that L-Thea reversed cardiac injury mainly through amino acid metabolism, nucleotide metabolism, energy metabolism, and endocrine system pathways. Collectively, L-Thea has the potential to serve as a dietary supplement for the prevention or management of cardiac injury induced by obesity.

BackgroundTai Chi Chuan (TCC) may have a positive impact on physical and psychological well-being in breast cancer patients, but the evidence remains limited and inconclusive. This systematic review aims to evaluate the effects of TCC on the quality of life (QoL) and psychological symptoms in women patients with breast cancer.MethodsThis review has been registered on PROSPERO (ID: CRD42019141977). Randomized controlled trials (RCTs) of TCC for breast cancer were searched from eight major English and Chinese databases. All trials included were analyzed in accordance with the Cochrane Handbook. The primary outcomes were QoL, anxiety, and depression in patients with breast cancer. Fatigue, sleep quality, cognitive function, and inflammatory cytokine were the secondary outcomes.ResultsFifteen RCTs involving a total of 1,156 breast cancer participants were included in this review. The methodological quality of included trials was generally poor. The pooled results suggested that TCC-based exercise could significantly improve QoL [standardized mean difference (SMD)=0.35, 95%CI: 0.15–0.55, I2 = 0, model: fixed, IV], anxiety [weighted mean difference (WMD)=−4.25, 95%CI: −5.88 to −2.63, I2 = 0, model: fixed, IV], and fatigue (SMD=−0.87, 95%CI: −1.50 to −0.24, I2 = 80.9%, model: random, DL) compared other controls, with moderate to low certainty of evidence. The improvement of QoL and fatigue by TCC was also clinically meaningful. However, TCC-based exercise failed to show any between-group differences in depression, sleep quality, cognitive function, and inflammatory cytokine. Post-hoc analysis revealed that TCC-based exercise outperformed the other exercise in improving shoulder function with very low certainty of evidence.ConclusionOur findings manifested that TCC-based exercise is helpful for improving the QoL, anxiety, and fatigue in patients with breast cancer within the range of comparisons covered in this study. However, the results must be treated with great caution because of the methodological flaws of included trials. Larger, well-designed, and conducted randomized controlled trials with longer follow-up is warranted in the future to evaluate the important outcomes of TCC for breast cancer.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141977, identifier, CRD42019141977.

Bisphenol A (BPA) is a prevalent endocrine disruptor found in natural environments. Exposure to BPA has been associated with male infertility. The natural phytochemical icariin (ICA) has demonstrated significant promise for the treatment of male infertility. However, its effectiveness is limited due to its low bioavailability, poor water solubility, and insufficient targeting abilities. Herein, novel nanoparticles are generated from the natural silk fibroin, which are used to load ICA. The efficient drug delivery system (ICA-SNPs) result in significantly focused drug distribution to spermatogonium, enhancing the anti-infertility properties of ICA, and can effectively mitigate spermatogenesis dysfunction induced by BPA, control serum sex hormone levels, and enhance testicular ultrastructure. Additionally, the ICA-SNPs restore spermatogenesis dysfunction primarily via the hormone biosynthesis, spermatogonium meiosis process, and glycerophospholipid metabolism.

Background This study aimed to compare the effectiveness and safety of the percutaneous first extensor compartment performed by acupotomy procedure with or without ultrasonic (US) guidance. Methods The percutaneous release was performed with an acupotomy on 40 wrists of cadavers, which was divided into US guidance operation and blind operation. Each arm was dissected and assessed regarding the amount of release and the extent of neurovascular and tendon injury. An analysis of finite biomechanical elements based on wrists specimen data is analyzed to observe the stress of the first extensor tendon compartment. A prospective study observed the pain visual analogue score(VAS) and Patient-Rated Wrist Evaluation (PRWEB) changes after the ultrasound guidance or blind acupotomy treatment in 30 dQD patients. Results The success rate in the ultrasound-guided technique was 85%, and the blind technique was 70% in the cadaver study, both techniques without neurovascular injury. There was no statistically significant difference between the two groups in measuring the distance from the incision marks to the blood vessels and nerves (P > 0.05). According to the biomechanical analysis, the tendon friction rubs when the wrist is upright. When the wrist is flexed, the tendon and tendon sheath is stressed in the bone ridges. In this prospective study, both ultrasound guidance and blind acupotomy treatment achieved well improvements in pain and function (P < 0.05), but the results with no statistically significant between groups (P > 0.05). Conclusion Both blind and US-guided percutaneous release by acupotomy of the first extensor tendon compartment can get a good result. US-guided techniques can improve the success rate during acupotomy operations, especially for beginners and followers.

目的 探讨超声引导针刀松解术在四肢末端病中的安全性和准确性.方法 于北京大学医学部人体解剖学教研室选取福尔马林固定过的人体标本20具,研究时间为 2019年 3月至 2022年6月.将标本分为传统操作组及超声引导组,每组 10 具,并在同一入路途径下进行针刀松解操作,传统操作组在非可视条件下进行针刀松解操作,超声引导组在高频探头引导下进行操作.针刀松解操作后留针,逐层解剖,观测针刀路径,比较桡骨茎突狭窄性腱鞘炎、屈指肌狭窄性腱鞘炎、腕管综合征、踝管综合征 4 种疾病传统操作及超声引导下操作的成功率、准确性、损伤率.结果 超声引导组中腕管综合征的操作成功率高于传统操作组,差异有统计学意义(P＜0.05);超声引导组中屈指肌狭窄性腱鞘炎、腕管综合征、踝管综合征的操作松解效率均高于传统操作组,差异有统计学意义(P＜0.05);超声引导组操作损伤率低于传统操作组,差异有统计学意义(P＜0.05).结论 超声引导下针刀松解技术在四肢末端病操作的安全性及准确性高,值得临床推广.

Objective:This study aimed to determine the safety and accuracy of ultrasound-guided acupotomy percutaneous loosening of the transverse carpal ligament.Methods:The 100 upper limb specimens were equally divided into the ultrasound-guided acupotomy group (U) and the nonultrasound-guided acupotomy group (N). For the U group, we simulated ultrasound-guided acupotomy loosening of the transverse carpal ligament in a human specimen, and for the N group, we performed the loosening of the transverse carpal ligament through the same approach under nonultrasound-guided conditions. The safety and accuracy of the two methods were compared through measurement.Results:In the ultrasound-guided group, the injury rate of nerves, blood vessels and tendons caused by needle-knife release was 0%. In the non-ultrasound-guided group, the rate of nerve, blood vessel and tendon damage was 6 percent, 12 percent and 20 percent, respectively. χ 2 test (Fisher exact test) was performed for the nerve and blood vessel damage rates in the two groups (PN  > 0.05, PA  < 0.05), the difference in nerve damage rates was not statistically significant, but the difference in blood vessel damage rates was statistically significant. Pearson's χ 2 test was performed on the tendon injury rates of the two groups (PF  < 0.05), and the difference was statistically significant. In the ultrasound-guided group, the proportion of acupotomy marks greater than or equal to half of the width of the transverse carpal ligament was 86%, and the non-ultrasound-guided group was 36%. The accuracy of the two surgical methods was tested by Pearson's χ 2 test (PL  < 0.05), and the difference was statistically significant. According to the measurement, the ultrasound-guided acupotomy technology had high safety and accuracy.Conclusion:In this study, we designed a new method for cutting the transverse carpal ligament under ultrasound guidance, which is different from surgery. These results indicate that this is a safe and accurate method of interventional treatment of carpal tunnel syndrome.

Male hypogonadism can seriously affect male health and fertility, yet comprehensive bibliometric and visualization analyses of research in this area have been lacking. This study aimed to examine the distribution of literature, identify research hotspots, and discern development trends in male hypogonadism by analyzing 4026 English documents published between 2000 and 2023 using bibliometric and visual analyses. The results indicated a significant increase in publications and citations related to male hypogonadism over the past two decades, with the United States, the University of Florence, Maggi M, and the Journal of Clinical Endocrinology & Metabolism recognized as the most productive and highly cited country, institution, author, and journal, respectively. The article titled “The GPR54 gene as a regulator of puberty” received the highest number of citations. The keywords were categorized into four distinct clusters, including the etiology and pathogenesis of male hypogonadism, symptoms of late-onset hypogonadism, testosterone replacement therapy and its contraindications, the correlation between male hypogonadism and metabolic syndrome (MetS), obesity, and the epidemiology of male hypogonadism. The most frequently co-occurring keywords were “hypogonadism”, “testosterone”, and “men”, while “oxidative stress” was the most prominent burst keyword. The analysis also identified “male infertility” and “oxidative stress” as the primary burst keywords in the last five years, indicating their emerging high-interest topics. Overall, this study provides a comprehensive overview of male hypogonadism research, offering valuable insights for researchers interested in this area, including potential collaborators, current research hotspots, and future research directions.

目的:通过网络药理学探讨强精片治疗解脲支原体感染男性不育症的潜在作用机制，并对解脲支原体模型雄性大鼠的相关作用靶点进行实验验证。方法:通过TCMSP收集强精片的活性成分和潜在靶点，使用Genecard数据库筛选解脲支原体感染男性不育症的疾病靶点；将疾病靶点与药物预测靶点取交集，借助Cytoscape3.7.2软件构建交集靶点网络，利用Bioconductor平台和R语言进行GO和KEGG富集分析。采用解脲支原体感染雄性大鼠模型，检查精子质量、血清T含量，采用HE染色、电镜观察睾丸结构，Elisa检测血清IL-17、IL-1β、TNF-ɑ含量，免疫组化检测睾丸组织TRAF6、NF-κB P65蛋白表达，探讨强精片治疗解脲支原体感染男性不育症的潜在机制。结果:共获得槲皮素、山柰酚、木犀草素、淫羊藿苷、五味子苷、人参皂苷Re等109个强精片活性成分及286个可用于后续分析的靶点，249个解脲支原体感染男性不育症靶点，映射得出43个药物-疾病共同靶点。GO富集结果表明，强精片治疗解脲支原体男性不育症的可能机制主要是对细菌来源分子及氧化应激的细胞因子及其受体结合反应。KEGG通路分析提示主要与TNF信号通路、IL-17信号通路、NK-κB信号通路、感染信号通路等信号通路相关，JUN、IL6、MAPK14、IL1B、IL4、MAPK1等是其关键作用蛋白。动物实验验证表明强精片可以改善解脲支原体感染雄性大鼠精液质量，提高血清T含量，改善睾丸组织结构，降低大鼠血清IL-17、IL-1β、TNF-α含量，降低睾丸组织TRAF6、NF-κB P65蛋白表达，抑制IL-17通路，发挥抗炎及免疫作用。结论:网络药理学显示强精片可以通过多通路多靶点对解脲支原体感染男性不育症的免疫及炎症相关机制进行调节，实验验证表明强精片可以抑制IL-17通路，改善解脲支原体感染大鼠睾丸组织结构及生精功能，发挥治疗作用。

Objective:The present study aimed to assess the efficacy and safety of ultrasound-guided percutaneous A1 pulley release using a needle knife.Methods:The author performed percutaneous A1 pulley release in 84 cadaveric hands fixed with 10% formalin. The cadaveric hands were divided into three groups: 28 hands in each group (group U: ultrasound-guided needle knife pushing group, group N: non-ultrasound-guided needle knife pushing group, group T: classical needle knife operation puncture group). Percutaneous A1 pulley release was performed, the soft tissue was dissected layer by layer, and the relevant anatomical data were measured.Results:The injured cases were as follows: group U, 29 (20.7%); group N, 36 (25.7%); and group T, 28 (20.0%). There is no significant difference between different tissue injury types in different intervention methods. The missed release cases were as follows: group U, 8 (5.7%); group N, 4 (2.9%); and group T, 13 (9.3%). The percentage of released A1 pulley were as follows: group U, 71.4% ± 30.7%; group N, 66.0% ± 20.3%; and group T, 61.0% ± 30.4%. The percentage of released A1 pulley of the three groups were compared: group U > group N > group T, and there was statistical difference between the three groups. The full release rates of the three groups were compared: group U(31.4%) > group N(15.7%) > group T(13.6%), and there were significant difference in the full release of A1 pulley between group U and group T, group N.Conclusion:Based on the cadaver specimen, the length and percentage of released A1 pulley is longer by ultrasound-guided percutaneous A1 pulley release using a needle-knife. and there was no statistical difference in the injury rate between the three techniques.Type of Study and Clinical Relevance:Clinical anatomic study. To test the efficacy and safety of ultrasound-guided percutaneous A1 pulley release using a needle knife in cadaveric hands, and provide an anatomically based support in clinic.

Pediatric adrenocortical carcinomas (ACC) are rare aggressive neoplasms with heterogeneous prognosis, and often produce a most lethal malignant tumor, whereas its aetiology is still unclear. The aim of the present study was to identify the factors responsible for the development of pediatric ACC, a better understanding of the disease, and investigate new molecular biomarkers and therapeutic targets. To identify the key genes and miRNAs linked to pediatric ACC, as well as their potential molecular mechanisms, the GSEGSE75415 and GSE169253 microarray datasets were analyzed. A total of 329 differentially produced genes (DEGs) and 187 differentially produced miRNAs (DEMs) were obtained after analyzing the GSEGSE75415 and GSE169253 datasets, respectively. Next, 3,359 genes were obtained by overlapping the target mRNAs of DEMs. Following protein-protein interaction network and Gene Ontology analysis, the ten nodes with the highest degrees were screened as hub genes. Among them, the highly expressed hub genes, MAPK1 and EP300, were associated with a worse overall survival. Additionally, hsa-miR-376, hsa-miR-148, hsa-miR-139, and hsa-miR-1305 were strongly associated with poorer survival. We proposed that the hub genes (MAPK1, EP300, hsa-miR-376, hsa-miR-148, hsa-miR-139, and hsa-miR-1305) may have a definite impact on cellular proliferation and migration in adrenocortical tumors. The roles of these hub genes in adrenocortical tumors may provide novel insight to improve the diagnosis and treatment of patients with pediatric ACC.