Approximately 30%-40% of epilepsy patients do not respond well to adequate anti-seizure medications (ASMs), a condition known as pharmacoresistant epilepsy. The management of pharmacoresistant epilepsy remains an intractable issue in the clinic. Its early prediction is important for prevention and diagnosis. However, it still lacks effective predictors and approaches. Here, a classical model of pharmacoresistant temporal lobe epilepsy (TLE) was established to screen pharmacoresistant and pharmaco-responsive individuals by applying phenytoin to amygdaloid-kindled rats. Ictal electroencephalograms (EEGs) recorded before phenytoin treatment were analyzed. Based on ictal EEGs from pharmacoresistant and pharmaco-responsive rats, a convolutional neural network predictive model was constructed to predict pharmacoresistance, and achieved 78% prediction accuracy. We further found the ictal EEGs from pharmacoresistant rats have a lower gamma-band power, which was verified in seizure EEGs from pharmacoresistant TLE patients. Prospectively, therapies targeting the subiculum in those predicted as "pharmacoresistant" individual rats significantly reduced the subsequent occurrence of pharmacoresistance. These results demonstrate a new methodology to predict whether TLE individuals become resistant to ASMs in a classic pharmacoresistant TLE model. This may be of translational importance for the precise management of pharmacoresistant TLE.
Epilepsy, Temporal Lobe/diagnosis* ; Animals ; Drug Resistant Epilepsy/drug therapy* ; Electroencephalography/methods* ; Rats ; Anticonvulsants/pharmacology* ; Neural Networks, Computer ; Male ; Humans ; Phenytoin/pharmacology* ; Adult ; Disease Models, Animal ; Female ; Rats, Sprague-Dawley ; Young Adult ; Convolutional Neural Networks

Objective:To analyze the clinicopathological characteristics and prognostic factors of patients with Castleman disease (CD).Methods:A retrospective case-series study was conducted. A total of 85 patients newly diagnosed with CD in the First Affiliated Hospital of Air Force Medical University between July 2007 and August 2024 were collected. Their clinical characteristics and prognostic factors were analyzed.Results:Among the 85 patients, 45 had unicentric Castleman disease (UCD) and 40 had multicentric Castleman disease (MCD). In the UCD group, females were more commonly affected (64.4%, 29/45), with a median age of onset of 39 years. The primary lesions were mainly located in the retroperitoneum, neck, abdomen, and axilla; and the hyaline vascular subtype was the predominant pathological type (69.4%, 25/36). In the MCD group, males were more frequently affected (62.5%, 25/40), with a median age of onset of 50 years; and the plasmacytic subtype was the main pathological type (68.2%, 15/22). Compared with UCD patients, MCD patients presented more systemic symptoms and signs [85.0% (34/40) vs. 13.3% (6/45), χ2 = 43.66, P < 0.001], splenomegaly [42.5% (17/40) vs. 2.2% (1/45), χ2 = 20.58, P < 0.001], hepatomegaly [25.0% (10/40) vs. 0 (0/45), χ2 = 10.46, P = 0.001], edema or effusion in serous cavity [67.5% (27/40) vs. 8.9%(4/45), χ2 = 31.40, P < 0.001], hematological system involvement [32.5% (13/40) vs. 0 (0/44), χ2 = 16.92, P < 0.001], and renal involvement [22.5% (9/40) vs. 2.3%(1/44), χ2 = 6.36, P = 0.012]. Laboratory findings showed that the levels of hemoglobin and albumin in MCD patients were lower than those in UCD patients, while white blood cell count in MCD patients was higher than that in UCD patients. Additionally, MCD patients exhibited elevated levels of C-reactive protein, interleukin-6, vascular endothelial growth factor, erythrocyte sedimentation rate, and ferritin compared to UCD patients (all P < 0.05). Among UCD patients, 40 cases underwent simple surgical resection, with no deaths during follow-up and the 5-year overall survival (OS) rate of 100.0%; among MCD patients, 34 cases received chemotherapy, 4 received siltuximab, 3 died during follow-up with a 5-year OS rate of 87.5%; and there was no statistically significant difference in OS between the MCD and UCD groups ( χ2 = 3.67, P = 0.055). Among MCD patients, the OS of those with renal involvement (9 cases) was worse than that of those without renal involvement (31 cases) ( χ2 = 8.39, P = 0.004). Conclusions:CD is a highly heterogeneous disorder. Surgical resection is the primary treatment for UCD, with a favorable prognosis. Chemotherapy is the main treatment for MCD, with a relatively poor prognosis.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective: To explore prevalence and associated factors of nonalcoholic fatty liver disease (NAFLD) in overweight and obese children in Hohhot City, so as to provide the oretical basis for developing health education plans and implementing prevention and treatment of NAFLD in children. Methods: A total of 156 overweight and obese children was enrolled from 4 primary schools in Hohhot City using cluster sampling method during 28th Aug. 2022 to 5th Mar. 2023. Height and weight were measured and body mass index was calculated, and fasting blood was taken in the early morning for fasting blood glucose, alanine aminotransferase, aspartate aminotransferase. Single factor analysis was conducted using ttest, χ2 test and Fishers exact probability method, while multivariate analysis was conducted using Logistic regression analysis and subject characteristic curves. Results: The differences in age, waist circumference, hip circumference, fasting glucose, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, uric acid, and triglyceride were statistically significant between the nonNAFLD and the NAFLD group (U/t=1 070.0-2 164.0, P<0.05). Significant differences were observed in aspartate aminotransferase (AST) and uric acid levels (AST OR=1.16, 95%CI=1.04-1.28; uric OR=1.01, 95%CI=1.00-1.01, P<0.05). The area under a receiver operating characteristic were 0.737 for aspartate aminotransferase and 0.665 for uric acid, respectively. Conclusions The prevalence of NAFLD is high in overweight/obese children in Hohhot, and both elevated aspartate aminotransferase and hyperuricemia could increase the risk of NAFLD in overweight/obese children. Special attention should be paid to the NAFLD in overweight and obese children. It is recommended to reduce both BMI and uric level in the prevention and treatment of NAFLD to achieve better treatment outcomes.

Objective:To investigate the difference in the proportions of T-lymphocyte subsets and the immunological monitoring profiles between patients with B-lymphoproliferative disorder(B-LPD) and healthy individuals.Methods:This clinical observational study involved 194 B-LPD patients [122 males, 72 females, average age (64±20)] treated in Qilu Hospital of Shandong University from May 14th, 2022 to January 19th, 2024. The patient cohort included 76 cases of chronic lymphocytic leukemia (CLL), 23 cases of diffuse large B-cell lymphoma (DLBCL), 17 cases of follicular lymphoma (FL), 12 cases of hair-cell leukemia (HCL), 10 cases of lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM), 26 cases of mantle cell lymphoma (MCL), 20 cases of marginal zone lymphoma (MZL), and 10 cases of unclassified CD5 -B lymphocytic proliferative disease unclassified (B-LPD-U). At the same time, 45 health control (HC) samples [22 males, 23 females, aged 62(±17)] from the medical examination center of our hospital in November 18th, 2023 were collected. The T cell subsets were meticulously analyzed using flow cytometry, including CD4 +naive T cell [CD4 +TN (CD3 +CD4 +CD45RA +CD62L +) ], CD4 +central memory T cell [CD4 +TCM (CD3 +CD4 +CD45RA -CD62L +) ], CD4 +terminally differentiated effector memory cells expressing CD45RA [CD4 +TEMRA (CD3 +CD4 +CD45RA +CD62L -) ], CD4 +effector memory T cell [CD4 +TEM (CD3 +CD4 +CD45RA -CD62L -) ], CD8 +TN (CD3 +CD8 +CD45RA +CD62L +), CD8 +TCM (CD3 +CD8 +CD45RA -CD62L +), CD8 +TEMRA (CD3 +CD8 +CD45RA +CD62L -), CD8 +TEM (CD3 +CD8 +CD45RA -CD62L -), naive regulatory T cell [nTreg (CD3 +CD4 +CD127 dim+CD25 +CD45RA +) ], memory Treg [mTreg (CD3 +CD4 +CD127 dim+CD25 +CD45RA -) ] and activated Treg [aTreg (CD3 +CD4 +CD127 dim+CD25 +HLA-DR +) ]. The difference of T cell subsets data were compared by Mann-Whitney test. Result:The proportionof CD3 +T cells within lymphocyte in B-LPD groups (CCL group 13.15%, DLBCL group 41.75%, FL group 30.52%, HCL group 34.24%, LPL/WM group 40.58%, MCL group 20.67%, MZL group 26.36%, CD5 -B-LPD-U group 17.49%) was significantly lower than HC group (64.85%). The percentage of CD4 +T cells in B-LPD groups (CCL group 46.63%, DLBCL group 40.76%, FL group 42.77%, HCL group 43.81%, LPL/WM group 43.02%, MCL group 45.58%, MZL group 43.95%, CD5 -B-LPD-U group 46.91%) was also significantly lower than HC group (54.61%). Conclusions:B-LPD diseases impair T cell immune function. The increased presence of CD4 +TEM, the reduced level of CD8 +TEMRA and the elevated aTreg suggest that B-LPD may suppress CD8 +T cell-mediated cytotoxicity and enhance the immunosuppressive activity of Treg.

Objective:To investigate the difference in the proportions of T-lymphocyte subsets and the immunological monitoring profiles between patients with B-lymphoproliferative disorder(B-LPD) and healthy individuals.Methods:This clinical observational study involved 194 B-LPD patients [122 males, 72 females, average age (64±20)] treated in Qilu Hospital of Shandong University from May 14th, 2022 to January 19th, 2024. The patient cohort included 76 cases of chronic lymphocytic leukemia (CLL), 23 cases of diffuse large B-cell lymphoma (DLBCL), 17 cases of follicular lymphoma (FL), 12 cases of hair-cell leukemia (HCL), 10 cases of lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM), 26 cases of mantle cell lymphoma (MCL), 20 cases of marginal zone lymphoma (MZL), and 10 cases of unclassified CD5 -B lymphocytic proliferative disease unclassified (B-LPD-U). At the same time, 45 health control (HC) samples [22 males, 23 females, aged 62(±17)] from the medical examination center of our hospital in November 18th, 2023 were collected. The T cell subsets were meticulously analyzed using flow cytometry, including CD4 +naive T cell [CD4 +TN (CD3 +CD4 +CD45RA +CD62L +) ], CD4 +central memory T cell [CD4 +TCM (CD3 +CD4 +CD45RA -CD62L +) ], CD4 +terminally differentiated effector memory cells expressing CD45RA [CD4 +TEMRA (CD3 +CD4 +CD45RA +CD62L -) ], CD4 +effector memory T cell [CD4 +TEM (CD3 +CD4 +CD45RA -CD62L -) ], CD8 +TN (CD3 +CD8 +CD45RA +CD62L +), CD8 +TCM (CD3 +CD8 +CD45RA -CD62L +), CD8 +TEMRA (CD3 +CD8 +CD45RA +CD62L -), CD8 +TEM (CD3 +CD8 +CD45RA -CD62L -), naive regulatory T cell [nTreg (CD3 +CD4 +CD127 dim+CD25 +CD45RA +) ], memory Treg [mTreg (CD3 +CD4 +CD127 dim+CD25 +CD45RA -) ] and activated Treg [aTreg (CD3 +CD4 +CD127 dim+CD25 +HLA-DR +) ]. The difference of T cell subsets data were compared by Mann-Whitney test. Result:The proportionof CD3 +T cells within lymphocyte in B-LPD groups (CCL group 13.15%, DLBCL group 41.75%, FL group 30.52%, HCL group 34.24%, LPL/WM group 40.58%, MCL group 20.67%, MZL group 26.36%, CD5 -B-LPD-U group 17.49%) was significantly lower than HC group (64.85%). The percentage of CD4 +T cells in B-LPD groups (CCL group 46.63%, DLBCL group 40.76%, FL group 42.77%, HCL group 43.81%, LPL/WM group 43.02%, MCL group 45.58%, MZL group 43.95%, CD5 -B-LPD-U group 46.91%) was also significantly lower than HC group (54.61%). Conclusions:B-LPD diseases impair T cell immune function. The increased presence of CD4 +TEM, the reduced level of CD8 +TEMRA and the elevated aTreg suggest that B-LPD may suppress CD8 +T cell-mediated cytotoxicity and enhance the immunosuppressive activity of Treg.

Objective: To investigate the association of the risk of overweight/obesity in children and adolescents with their early life factors and parental weight. Methods: From June 1 to June 30 of 2022, the stratified randomized cluster sampling method was used to collect information using questionnaires from 5 370 primary and secondary school students in Hohhot City, Inner Mongolia Autonomous Region, and multivariate analysis were performed using multiple Logistic regression model estimation in a generalized linear model for parental BMI and early life factors in children and adolescents. Results: The prevalence of overweight/obesity was 32.2% , and the prevalence of overweight/obesity among male students was 37.8%, which was higher than that of female students 26.1% χ 2= 84.59 , P <0.01). The results of the multirariate Logistic regression anaysis showed that the prevalence of overweight/obesity was higher in only paternal overweight ( OR=1.52, 95%CI =1.30-1.77), only maternal overweight ( OR=1.61, 95%CI = 1.31 -1.97), and parentl overweight ( OR=2.42, 95%CI =2.03-2.87)( P <0.05). The risk of overweight/obesity was higher in children with high birth weight ( OR=1.29, 95%CI =1.08- 1.55 ), children born by caesarean section ( OR=1.32, 95%CI =1.17- 1.48 ), and children whose mothers gained excessive weight during pregnancy ( OR=1.24, 95%CI =1.06-1.46), and the results were statistically significant ( P <0.05). Conclusions Overweight parents, excessive maternal weight gain during pregnancy, cesarean delivery, and high birth weight are associated with increased risk of overweight/obesity in children and adolescents. Attention should be paid to these aspects in obesity prevention and control.

Objective To analyze the micronucleus levels of peripheral blood lymphocytes of medical radiation workers, and to provide a basis for radiation protection to reduce occupational hazards caused by ionizing radiation. Methods A total of 1072 medical radiation workers were selected into radiation group, and 329 healthy adults who underwent pre-employment occupational physical examination and intended to be radiation workers were selected into control group. The micronucleated lymphocyte frequency was determined by whole blood micro-culture. Results There were no significant differences in micronucleated cell frequency and micronucleus frequency between the radiation group and the control group (both P > 0.05). The detection rate of micronucleus abnormalities in the radiation group was significantly higher than that in the control group (P < 0.001). Female radiation workers had significantly higher micronucleated cell frequency, micronucleus frequency, and the detection rate of micronucleus abnormalities than male radiation workers (all P < 0.001). Between different types of work, significant differences were observed in micronucleated cell frequency and micronucleus frequency (both P < 0.05), but not in the detection rate of micronucleus abnormalities (P > 0.05). Radiation workers with different lengths of working showed significant differences in micronucleated cell frequency (P < 0.05), micronucleus frequency (P < 0.05), and the detection rate of micronucleus abnormalities (P < 0.001). Significant differences were observed in micronucleated cell frequency and micronucleus frequency between different age groups (both P < 0.05). The Spearman’s rank correlation analysis showed that micronucleated cell frequency and micronucleus frequency were positively correlated with the age of radiation workers (both P < 0.001). Conclusion The micronucleus frequency of radiation workers was related to the type and length of work, and had a positive correlation with age. Radiation protection should be enhanced for workers engaged in medical radiation for a long period, especially female workers and workers with a long length of service.

Genomic studies of cancer cell alterations,such as mutations,copy number variations(CNVs),and translocations,greatly promote our understanding of the genesis and development of cancers.However,the 3D genome architecture of cancers remains less studied due to the complexity of cancer genomes and technical difficulties.To explore the 3D genome structure in clin-ical lung cancer,we performed Hi-C experiments using paired normal and tumor cells harvested from patients with lung cancer,combining with RNA sequenceing analysis.We demonstrated the feasibility of studying 3D genome of clinical lung cancer samples with a small number of cells(1×104),compared the genome architecture between clinical samples and cell lines of lung cancer,and identified conserved and changed spatial chromatin structures between normal and cancer sam-ples.We also showed that Hi-C data can be used to infer CNVs and point mutations in cancer.By integrating those different types of cancer alterations,we showed significant associations between CNVs,3D genome,and gene expression.We propose that 3D genome mediates the effects of cancer genomic alterations on gene expression through altering regulatory chromatin structures.Our study highlights the importance of analyzing 3D genomes of clinical cancer samples in addition to cancer cell lines and provides an integrative genomic analysis pipeline for future larger-scale studies in lung cancer and other cancers.