Objective: To explore the relationship between serum homocysteine (Hcy), interleukin-5 (IL-5), folate and core symptoms in children with autism spectrum disorders, so as to provide potential biomarkers for early diagnosis and intervention of diseases. Methods: A total of 106 children with autism spectrum disorders and 106 healthy children with matched sex and age in Lu an People s Hospital were enrolled as autism group and healthy group between May 2020 to December 2023. On the day of admission, levels of serum Hcy, IL-5 and folate were detected. The core symptoms in autism group were evaluated by Autism Behavior Checklist (ABC), Wechsler Preschool and Primary Scale of Intelligence-fourth edition(WPPSI-IV), Childhood Autism Rating Scale (CARS) and Social Responsiveness Scale (SRS). The levels of serum Hcy, IL-5 and folate in the two groups were compared by t- test. The relationship between serum Hcy, IL-5, folate and core symptoms in children with autism spectrum disorders was determined by Pearson correlation analysis. Results: The levels of serum Hcy and IL-5 in autism group were (7.48±0.32) μmol/L and (345.77±32.51) pg/mL, higher than those in healthy group [(6.11±0.54) μmol/L, (274.04±25.17) pg/mL], while folate level was lower than that in healthy group [(15.24±3.47) ng/mL, (22.51±4.69) ng/mL], the differences were statistically significant ( t =22.47, 17.96, 12.83, all P < 0.05 ). In autism group, levels of serum Hcy and IL-5 were positively correlated with scores of ABC, CARS and SRS ( r =0.29, 0.53 , 0.54; 0.45, 0.41, 0.50), while negatively correlated with WPPSI-IV score ( r =-0.28, -0.26)(all P <0.05). The folate level was negatively correlated with scores of ABC, CARS and SRS ( r =-0.55, -0.40, -0.25), while positively correlated with WPPSI-IV score ( r =0.41) (all P <0.05). Conclusion Children with ASD show elevated serum Hcy and IL-5 alongside decreased folate,and three markers correlate with core symptoms and intellectual level.

ObjectiveTo investigate the effects of Yiqi Wenyang Huoxue Lishui components on the cardiac function and mitochondrial energy metabolism in the rat model of chronic heart failure （CHF） and explore the underlying mechanism. MethodsThe rat model of CHF was prepared by transverse aortic constriction （TAC）. Eight of the 50 SD rats were randomly selected as the sham group， and the remaining 42 underwent TAC surgery. The 24 SD rats successfully modeled were randomized into model， trimetazidine （6.3 mg·kg^-1）， and Yiqi Wenyang Huoxue Lishui components （60 mg·kg^-1 total saponins of Astragali Radix， 10 mg·kg^-1 total phenolic acids of Salviae Miltiorrhizae Radix et Rhizoma， 190 mg·kg^-1 aqueous extract of Lepidii Semen， and 100 mg·kg^-1 cinnamaldehyde） groups. The rats were administrated with corresponding agents by gavage， and those in the sham and model groups were administrated with the same amount of normal saline at a dose of 10 mL·kg^-1 for 8 weeks. Echocardiography was used to examine the cardiac function in rats. Enzyme-linked immunosorbent assay was employed to determine the serum levels of N-terminal pro-B-type natriuretic peptide （NT-ProBNP）， hypersensitive troponin（cTnI）， creatine kinase （CK）， lactate dehydrogenase （LD）， free fatty acids （FFA）， superoxide dismutase （SOD）， and malondialdehyde （MDA）. The colorimetric assay was employed to measure the levels of adenosine triphosphate （ATP）， adenosine diphosphate （ADP）， and adenosine monophosphate （AMP） in the myocardial tissue. The pathological changes in the myocardial tissue were observed by hematoxylin-eosin staining and Masson staining. The Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase activities in the myocardial tissue were determined by the colorimetric assay. The ultrastructural changes of myocardial mitochondria were observed by transmission electron microscopy. Western blot was employed to determine the protein levels of ATP synthase subunit delta （ATP5D）， glucose transporter 4 （GLUT4）， and carnitine palmitoyltransferase-1 （CPT-1）. The mitochondrial complex assay kits were used to determine the activities of mitochondrial complexes Ⅰ， Ⅱ， Ⅲ， and Ⅳ. ResultsCompared with the sham group， the model group showed a loosening arrangement of cardiac fibers， fracture and necrosis of partial cardiac fibers， inflammatory cells in necrotic areas， massive blue fibrotic tissue in the myocardial interstitium， increased collagen fiber area and myocardial fibrosis， destroyed mitochondria， myofibril disarrangement， sparse myofilaments， and fractured and reduced cristae. In addition， the rats in the model group showed declined ejection fraction （EF） and fractional shortening （FS）， risen left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular end-systolic posterior wall thickness （LVPWs）， left ventricular end-diastolic volume （LVVOLd）， and left ventricular end-systolic volume （LVVOLs）， elevated levels of NT-ProBNP， cTnI， CK， MDA， FFA， and LD， lowered level of SOD， down-regulated protein levels of GLUT4 and CPT-1， decreased activities of Na⁺-K⁺-ATPase， Ca²⁺-Mg²⁺-ATPase， and respiratory complexes Ⅰ-Ⅳ， and declined levels of ATP5D， ATP， ADP， and AMP （P<0.05， P<0.01）. Compared with the model group， the Yiqi Wenyang Huoxue Lishui components and trimetazidine groups showed alleviated pathological damage of the mitochondria and mycardial tissue， risen EF and FS， declined LVIDd， LVIDs， LVPWd， LVPWs， LVVOLd， and LVVOLs， lowered levels of NT-ProBNP， cTnI， CK， MDA， FFA， and LD， elevated level of SOD， up-regulated protein levels of GLUT4 and CPT-1， increased activities of Na⁺-K⁺-ATPase， Ca²⁺-Mg²⁺-ATPase， and respiratory complexes Ⅰ-Ⅳ， and elevated levels of ATP5D， ATP， ADP， and AMP （P<0.05， P<0.01）. ConclusionYiqi Wenyang Huoxue Lishui components can improve the cardiac function， reduce myocardial injury， regulate glucose and lipid metabolism， optimize the utilization of substrates， and alleviate the damage of mitochondrial structure and function， thus improving the energy metabolism of the myocardium in the rat model of CHF.

Invasive fungal infections (IFIs) have become prominent global health threats, escalating the burden on public health systems. The increasing occurrence of invasive fungal infections is due primarily to the extensive application of chemotherapy, immunosuppressive therapies, and broad-spectrum antifungal agents. At present, therapeutic practices utilize multiple categories of antifungal agents, such as azoles, polyenes, echinocandins, and pyrimidine analogs. Nevertheless, the clinical effectiveness of these treatments is progressively weakened by the emergence of drug resistance, thereby substantially restricting their therapeutic utility. Consequently, there is an imperative need to expedite the discovery of novel antifungal agents. This review seeks to present an exhaustive synthesis of novel antifungal drugs and candidate agents that are either under current clinical investigation or anticipated to progress into clinical evaluation. These emerging compounds exhibit unique benefits concerning their modes of action, antimicrobial spectra, and pharmacokinetic characteristics, potentially leading to improved therapeutic outcomes relative to conventional antifungal regimens. It is anticipated that these novel therapeutic agents will furnish innovative treatment modalities and enhance clinical outcomes in managing invasive fungal infections.

Objective To evaluate the short-term clinical effect of arthroscopic repair of rotator cuff injury with all-suture anchor using a prospective and single-cohort clinical trial.Methods Twenty-five patients with rotator cuff injuries(1.5 cm0.05).Conclusion Arthroscopic rotator cuff repair with all-suture anchor is feasible and safe,and has good short-term clinical effect.

Sarcomatoid carcinoma of the renal pelvis accounts for a very low percentage of malignant tumors in the renal pelvis and has a poor prognosis. This article reported a patient with sarcomatoid carcinoma of the renal pelvis. The patient presented with macroscopic hematuria as the first symptom, and CT suggested left renal occupancy, unilateral nephrectomy was performed, and pathology suggested sarcomatoid carcinoma of the renal pelvis. Three weeks after surgery, a follow-up CT showed tumor recurrence. Programmed death 1(PD-1)inhibitor was given once every 3 weeks. Repeated CT examination after 24 weeks of continuous treatment suggested that the recurrent tumor disappeared. The patients was followed-up for 42 months without tumor recurrence or metastasis.

Acute kidney injury (AKI) is a devastating complications of end-stage of liver disease (ESLD), seriously affecting the prognosis of patients. With the deepening understanding of the pathogenesis, the definition, staging, diagnosis and treatment of ESLD with AKI have been gradually optimized. This article reviews the evolution of definition, pathogenesis, diagnosis and treatment of ESLD with AKI, to provide reference for early recognition, precise diagnosis and standardized treatment of this condition.

BACKGROUND:The assessment of asymmetric gait quality plays a pivotal role in guiding rehabilitation training;however,the link between gait quality and kinematic-kinetic gait parameters remains ambiguous. OBJECTIVE:To formulate a machine-learning model for evaluating gait quality based on gait parameters,identify factors sensitive to gait quality from asymmetric gait parameters,investigate the relationship between gait indicators and gait quality,and provide guidance for asymmetric gait training and rehabilitation. METHODS:An asymmetric gait database was established through the creation of asymmetric conditions.Kinematic and kinetic data were collected from 8 young and 8 elderly subjects(all male,right dominant population)during gait tests.Gait quality for each test data set was assessed using symmetry indices,resulting in the creation of a gait parameter-gait quality dataset.Utilizing the Random Forest algorithm,a gait quality evaluation model was developed and key quality parameter factors were identified through differential analysis.This model was iteratively refined.The model's performance was evaluated through 10-fold cross-validation,and its effectiveness was verified using the cross-validation dataset. RESULTS AND CONCLUSION:(1)A gradient test was designed to categorize gait quality into optimal,suboptimal,intermediate,and poor groups,with 759,329,133,and 125 instances,respectively.(2)The application of the Random Forest algorithm in gait quality assessment was explored.A relationship model was established between gait indicators and gait quality,yielding a predictive model accuracy of 95.99%.(3)The 13 main parameters significantly influencing asymmetric gait quality were identified through the Random Forest model's feature importance ranking.(4)An analysis of gait quality sensitivity factors using the 13 important parameters led to the identification of five key sensitivity indexes.The Random Forest model utilizing these sensitivity factors achieved a predictive accuracy of 94.20%.

By consulting the ancient Chinese herbal books， medical books and formularies of the past dynasties， and combining with modern research data， this paper makes a systematic textual research on the name， origin， place of origin， traditional quality evaluation， harvesting and processing of Selaginellae Herba， so as to provide a basis for the development and utilization of the relevant famous classical formulas. According to the textual research， Juanbai is the correct name of the herbal medicine in all dynasties， and there are also aliases such as Baozu， Qiugu， Jiaoshi and Jiusi Huanhuncao. The origin of Selaginellae Herba in the ancient herbal books was Selaginella tamariscina in all dynasties. Since the Republic of China， S. pulvinata has been gradually used as another origin of Selaginellae Herba. In ancient times， the producing area of S. tamariscina was mainly in Shandong， Hebei， Henan， Shaanxi， Jiangsu and Sichuan， etc. Nowadays， it is produced all over the country. S. pulvinata is mainly produced in Guangxi， Fujian， Sichuan， Guizhou， Yunnan， Hebei and so on. Since the recent times， it is concluded that the quality of the green color， complete and unbroken is good. Before the Qing dynasty， it was recorded that the harvesting time of Selaginellae Herba was generally from April to July， and it was expanded to all year round since the Qing dynasty. After harvesting， remove the sediment（sand and mud）， cut off the fibrous roots and dry in the shade or in the sun. The processing methods in all dynasties were mainly carbonizing by stir-frying and stir-bake to brown， and some ancient books contained the processing method of brine boiling， which was rarely used in modern times. Based on the results， it is recommended that S. tamariscina should be used as the base material of Selaginellae Herba. Because of more impurities， it should be fully purified to ensure the cleanliness of the herb， and the processing method can be based on the prescription requirements， if the processing requirements are not specified， the raw products can be used， charcoal products is recommended for use as an hemostatic.

Objective:To investigate the clinicopathological features and molecular genetic characteristics of esophageal carcinoma with ductal differentiation, and to summarize the experiences in its diagnosis and treatment.Methods:A total of 17 cases of esophageal carcinoma with ductal differentiation diagnosed in Ningbo Clinical Pathological Diagnosis Center, Ningbo, China from June 2011 to December 2022 were collected. The clinical information and pathological diagnosis was reviewed. The tumor histological features and immunohistochemical results were analyzed. The next-generation sequencing was performed to detect and analyze the gene mutations in tumor samples.Results:The 17 patients included in this study were 54-77 years old, with a median age of 66 years. There were 16 males and 1 female. Among them, 9 cases were mainly carcinoma with ductal differentiation. The squamous epithelium on the tumor′s surface was accompanied by high-grade intraepithelial neoplasia. The tumor and atypical squamous epithelium were transitional, and the focus was accompanied by various proportions of squamous cell carcinoma component (less than 10%). The other 8 cases were mostly squamous cell carcinoma, basaloid squamous cell carcinoma or sarcomatoid carcinoma with various degrees of tumor specific differentiation and focal area of carcinoma with ductal differentiation (less than 10%). The tumor cells in the area with ductal differentiation were mainly arranged in small tubes, while the tubes showed a double-layer structure, including the inner cells and outer cells of the lumen. Immunohistochemical results showed that the outer cells of the tumorous tubules expressed p63, p40, CK5/6 and CK34βE12, while the inner cells expressed CK7. Compared with esophageal squamous cell carcinoma reported in the literature, the frequency of gene mutations such as MYC ( P=0.002), TP63 ( P=0.002), CDKN1C ( P=0.002) and NFE2L2 ( P=0.045) was significantly lower in this group of cases. At the signaling pathway level, the mutation frequency of NOTCH signaling pathway ( P=0.041) was significantly higher, while the mutation frequencies of NRF2 pathway ( P=0.013) and PI3K pathway ( P=0.009) were significantly lower than that of esophageal squamous cell carcinoma. Conclusion:Esophageal carcinoma with ductal differentiation is a type of esophageal carcinoma with unique morphology, and its molecular changes are also significantly different from those of conventional esophageal squamous cell carcinoma.

Objective To investigate the application value of slice encoding for metal artifact correction-view angle tilting(SEMAC-VAT)in chronic hip pain after total hip arthroplasty(THA).Methods A total of 22 patients who underwent TH A and required MRI reassessment for chronic hip pain were enrolled.All patients underwent coronal and axial short time inversion recovery(STIR)and SEMAC-VAT sequence scans.The prosthesis and surrounding artifact areas of STIR sequence and SEMAC-VAT sequence images were measured respectively.Likert scores were assigned to evaluate prosthesis clarity and visibility of surrounding anatomical structures.The number of abnormal lesions detected was recorded.Paired t-test and rank-sum test were used for comparisons between groups.Results Among the 22 patients,the mean prosthesis and surrounding artifact areas measured in coronal and axial STIR sequences were(73.08±11.28)cm2 and(34.36±8.47)cm2,respectively.For SEMAC-VAT sequences,the corresponding values were(44.30±8.41)cm2 and(23.08±5.85)cm2,respectively.These differences were statistically significant(t=13.942,8.659,P＜0.05).SEMAC-VAT sequences had higher Likert scores on coronal and axial prosthesis clarity and surrounding anatomical structures visibility than STIR sequences(P＜0.05).Additionally,SEMAC-VAT sequences were more effective in detecting abnormal lesions than STIR sequences(P＜0.05).Conclusion Compared to STIR sequences,SEMAC-VAT sequences significantly reduce metal artifacts and enhance image quality in the assessment of chronic hip pain after THA.This technique is advantageous in detecting more positive signs,facilitating the evaluation of hip images in patients with chronic pain after TH A,and subsequently clarifying the etiology of pain.