Objective To investigate the diagnosis and treatment of 2 cases with spontaneous renal vascular rupture, and discuss the possible causes and treatment methods of this disease. Methods The clinical data and treatment methods of the 2 patients with spontaneous renal vascular rupture treated with renal artery embolization in Universal Global Xi'an Beihuan Hospital were analyzed. Relevant literature was reviewed to summarize the possible causes of this condition. Results The patients had no obvious history of trauma and no obvious abnormal coagulation function, and sought treatment due to sudden lumbar and abdominal pain. Laboratory tests revealed significantly decreased hemoglobin level, and elevated blood glucose (27.8, 27.6mmol/L). Abdominal computed tomography (CT) indicated perirenal hematoma and active bleeding. The bleeding arteries were located at the terminal branches of the anterior renal artery. Precise embolization was performed using CT angiography and selective renal artery angiography plus embolization, achieving an immediate hemostasis success rate of 100%. Postoperative hemoglobin level stabilized, and follow-up CT scans showed significant absorption of the perirenal hematoma without significant deterioration of renal function. Based on literature review and case analysis, the possible cause of spontaneous renal vascular rupture in these two patients was renal vascular sclerosis due to long-term diabetes. Other common etiologies of this condition included renal tumor, vascular malformation, and hypertension. Conclusion Spontaneous renal vascular rupture is rare. Renal artery embolization, as aminimally invasive treatment, can effectively control bleeding and protect renal function. The specific pathogenesis of this condition still requires further investigation. Long-term diabetes mellitus with poor blood glucose control may be associated factors, but more evidence is needed.

ObjectiveTo investigate the application value of a predictive model constructed based on quantitative imaging parameters and serum tumor markers in predicting the postoperative prognosis of patients with pancreatic ductal adenocarcinoma （PDAC）. MethodsA retrospective study was conducted among 146 patients with PDAC who underwent radical resection in Hebei Medical University Fourth Hospital from April 2020 to March 2023， and the patients were divided into a training set with 102 patients and a validation set of 44 patients at a ratio of 7∶3 using the completely randomized method. All patients underwent enhanced computed tomography （CT） and multi-parametric magnetic resonance imaging scans， and CT values in the arterial phase， the venous phase， and the delayed phase were recorded， as well as apparent diffusion coefficient （ADC） at b = 800 s/mm² and signal intensity （SI） of T₂ weighted imaging. The serum levels of carbohydrate antigen 19-9 （CA19-9） and carcinoembryonic antigen （CEA） were also measured. The independent-samples t test was used for comparison of continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. Kaplan-Meier survival curves were plotted for survival analysis； the univariate and multivariate Logistic regression analysis was used to investigate the association of clinical and imaging indicators with prognosis； the least absolute shrinkage and selection operator （LASSO）-Cox regression model was used to identify the important influencing factors for prognosis， and a prognostic prediction model was constructed. The receiver operating characteristic （ROC） curve was used to analyze the predictive value of the model in predicting prognosis in both the training set and the validation set. ResultsThe Kaplan-Meier survival curve analysis showed a median survival time of 33.00 months in the training set and 32.00 months in the validation set， with no significant difference between the training set and the validation set （P>0.05）. The univariate analysis showed that patient age， degree of tumor differentiation， lymph node metastasis， tumor stage， vascular invasion， CA19-9， CEA， ADC value， and SI value were significantly associated with the survival prognosis of patients （χ²=5.906， 13.116， 12.807， 17.277， 14.611， 7.275， 14.339， 9.506， and 13.137， all P<0.05）. The LASSO-Cox multivariate regression analysis showed that six factors were incorporated into the regression model， i.e.， tumor stage （HR=8.934， 95%CI： 3.215 — 21.562， P<0.001）， lymph node metastasis （HR=2.971， 95%CI： 1.298 — 5.647， P=0.002）， CA19-9 （HR=3.948， 95%CI： 1.758 — 8.994， P<0.001）， CEA （HR=1.965， 95%CI： 1.083 — 3.664， P=0.039）， ADC value （HR=2.873， 95%CI： 1.307 — 6.037， P=0.003）， and SI value （HR=3.107， 95%CI： 1.264 — 7.339， P=0.001）. The nomogram model constructed based on these factors had an area under the ROC curve of 0.845 （95%CI： 0.774 — 0.915） in the training set and 0.919 （95%CI： 0.870 — 0.967） in the validation set. ConclusionThe combined model of quantitative imaging parameters and serum tumor markers constructed based on LASSO-Cox regression can effectively predict the postoperative prognosis of PDAC patients， thereby helping to identify high-risk patients and guide decision-making for adjuvant therapy.

Objective To evaluate the clinical utility of hematoma drainage supported by a multi scenario artificial intelligence(AI)system in the treatment of minor hypertensive thalamic hemorrhage(HTH)with significant neurological dysfunction.Method A retrospective analysis was conducted on minor HTH patients with significant neurological damage and incomplete interruption of corticospinal tract(CST)on the affected side.Patients in the study group received Robot of Stereotactic Surgery(ROSS)assisted drainage surgery supported by AI systems in multiple scenarios such as image reading,surgery,and follow-up.The control group received standard pharmacological treatment.Comparative analyses were performed between two groups regarding regional cerebral blood flow(rCBF),changes in rCBF(ΔrCBF),Glasgow Coma Scale(GCS),changes in GCS(ΔGCS)after 14 days of treatment and National Institutes of Health Stroke Scale(NIHSS),changes in NIHSS(ΔNIHSS),Modified Rankin Scale(mRS),changes in mRS(ΔmRS)after 90 days of treatment.to evaluate the application value of multi scenario AI system supported hematoma drainage surgery in this patient population.Results A total of 88 cases were included,with 41 in the study group and 47 in the control group.The GCS and ΔGCS values of the study group and the control group at 14 days of post-treatment were 13.4±1.6 vs 13.3±1.5 and 1.1(0.8,1.9)vs.1.1(0.9,1.8),respectively with no statistically significant difference(P>0.05).At 14 days post-treatment,statistically significant difference were observed in the rCBF of the posterior limb of the internal capsule[(379.0±55.1)mL/(kg·min)vs.(263.0±34.4)mL/(kg·min)]and the ΔrCBF[(240.0±60.6)mL/(kg·min)vs.(121.0±43.9)mL/(kg·min)].At 90 day post-treatment,statistically significant difference were also found in the NIHSS scores(3.5±1.6 vs.6.4±2.1),ΔNIHSS(-4.1±1.7 vs.-0.9±0.6),mRS scores(1.1±0.3 vs.2.3±1.0),and ΔmRS[-2.1(-2.9,-1.1)vs.-0.8(-1.4,-0.6)](P<0.05).Conclusion Hematoma drainage surgery supported by multi scenario AI systems can significantly benefit minor HTH patients with significant neurological damage and incomplete interruption of CST on the affected side.

Speech prosody is a supra segmental feature of voice,which plays an important role in daily com-munication.Cochlear implantation(CI)can help the hearing-impaired children to normalize their speech,but CI children still have varying degrees of speech prosody obstacles.This paper summarizes the perception,production characteristics and intervention strategies of CI children's speech prosody at home and abroad,in order to attract the attention of education,medical,rehabilitation and academic fields to CI children's speech prosody research,and to provide reference for future intervention of CI children's speech prosody.

Objective To investigate the clinical efficacy of internal decompression based on white matter tract preservation in the treatment of malignant middle cerebral artery infarction(MMCAI).Methods A retrospective analysis was conducted on 54 patients with MMCAI.Patients were divided into a study group(n=26)and a control group(n=28)according to the surgical approach.Patients in the study group underwent preoperative fusion of CT,CTP,DWI,and DTI imaging data within a neuronavigation system.This fusion visualized the spatial relationships between the infarct core(IC),ischemic penumbra,and the corticospinal tract(CST).Subsequently,IC resection combined with decompressive craniectomy(DC)was performed while protecting the CST.Patients in the control group underwent DC alone.Key outcome measures included:changes in fractional anisotropy(FA)within the affected CST projection area at 1 month postoperatively;and 6-month postoperative mRS score,mortality,and surgical complications at 6 months postoperatively.Results At 1 month postoperatively,FA in the affected CST projection area were significantly higher in the study group than in the control group(0.092±0.013 vs.0.082±0.008,P<0.05).At the 6-month follow-up,the postoperative mRS score in the study group was significantly lower than that in the control group[2.3(1.3,4.5)vs.3.9(2.4,5.5),P<0.05]and a lower mortality rate(11.5%vs.39.3%,P<0.05)compared to the control group.However,there were no statistically significant differences between the two groups in the incidence of postoperative intracranial hemorrhage,intracranial infection,or epilepsy(P>0.05).Conclusion Internal decompression based on white matter tract protection combined with DC can reduce mortality and contribute to improving function outcomes in patients with MMCAI.

Objective To investigate the effectiveness and safety of infarct core resection combined with decompressive craniectomy(DC)based on corticospinal tract(CST)protection in the treatment of massive cerebral infarction(MCI)with malignant brain edema.Methods This study retrospectively enrolled MCI patients with malignant brain edema who underwent internal decompression combined with DC at Xingtai Central Hospital from January 2021 to June 2024.The enrolled patients were divided into a control group and an experimental group base on the intracranial internal decompression method used.All patients underwent CT perfusion(CTP),CT angiography(CTA),diffusion-weighted imaging(DWI),and diffusion tensor imaging(DTI)within 24 h of admission.Preoperative imaging data was automatically processed using an artificial intelligence diagnostic system.For the experimental group,the imaging data was fused within a neuro-navigation system preoperatively to visualize the spatial relationships between the infarct core,ischemic penumbra,and CST and infarct core resection combined with DC was performed while protecting the CST through neuro-navigation.The control group underwent anterior temporal lobectomy combined with DC.Baseline and clinical data were collected from both groups,including gender,age,smoking history,alcohol consumption history,diabetes,hypertension,hyperlipidemia,hyperhomocysteinemia,atrial fibrillation history,responsible occluded vessel(internal carotid artery,middle cerebral artery),preoperative infarct volume on DWI,preoperative ischemic penumbra volume,preoperative the National Institutes of Health stroke scale(NIHSS)score,time from onset to surgery,intraoperative procedure duration,intraoperative blood loss,preoperative and 1-month postoperative fraction anisotropy(FA)values of the CST on the affected side,modified Rankin scale(mRS)score at 6 months postoperatively,and surgery-related complications within 1 month postoperatively(intracranial hemorrhage[operative site oozing,hemorrhagic transformation]and intracranial infection[surgical incision site infection,empyema,brain abscess,meningitis]).6-month follow-up after surgery were conducted through outpatient visit or telephone calls and prognosis of patients was evaluated using the mRS(with mRS of 0-3 defined as good prognosis,4-6 as poor prognosis,and 6 indicating death).The effectiveness indicators included FA value of the affected CST at 1 month postoperatively,good prognosis rate after surgery at 6 months,and 6-month mortality rate after surgery.The safety indicators included the incidence rates of surgical complications(intracranial hemorrhage and infection)within 1 month postoperatively.Based on preoperative DTI images,all patients were further divided into a CST-intact(infarct core did not invade CST,CST morphology intact or deformed/shifted)and a CST-damaged(infarct core invaded CST,CST disrupted or interrupted)subgroup for analysis.Results A total of 62patients(37 males,25 females,age 49-60 years,mean[55±4]years)were enrolled in this study.With 28 patients in the experimental group and 34 in the control group.(1)No significant differences were found in baseline or clinical data between the experimental and control groups(all P＞0.05),and the reoperative FA values of the affected CST were showed no significant differences(P=0.588).(2)The efficacy and safety metrics were evaluated.For the efficacy indices,at 1 month after the surgery,FA values of the affected CST increased significantly compared to preoperative values in both groups(0.409±0.051 vs.0.312±0.052 in the experimental group,and,0.381±0.048 vs.0.319±0.049 in control group;both P＜0.05),and the FA value was significantly higher in the experimental group than that in the control group(0.409±0.051 vs.0.381±0.048,P=0.030).At the 6-month follow-ups,the good prognosis rate was significantly higher in the experimental group than that in the control group(39.3％[11/28]vs.14.7％[5/34],P=0.028).No significant difference in the 6-month mortality rate were observed between the two groups(P=0.787).For the safety indices,no significant differences were found in the incidence rates of intracranial hemorrhage or intracranial infection within 1 month postoperatively between the two groups(both P＞0.05).(3)For further subgroup analysis,no significant differences were found in baseline or clinical data between the CST-damaged subgroup and the CST-intact subgroup in both the experimental and control groups(all P＞0.05).In CST-intact subgroup,FA values of the affected CST increased significantly at 1 month postoperatively compared to preoperatively in the study group(0.428±0.047 vs.0.342±0.045,P＜0.05)and the control group(0.401±0.051 vs.0.347±0.048,P＜0.05).While in the CST-damaged subgroup,no significant differences were found in FA value of the affected CST 1 month postoperatively compared with that preoperatively in both the experimental and control groups(bothP＞0.05).A significantly higher FA values 1 month postoperatively(0.428±0.047 vs.0.401±0.051,P=0.036)and good prognosis rate(9/12 vs.4/16,P=0.020)were observed in the CST-intact subgroup of the experimental group comparing with that of the control group,while there was no statistically significant difference in the 6-month mortality rate between the groups within the CST-intact subgroup(P=1.000).There were no statistically significant differences between the experimental group and the control group in both efficacy and safety indices within the CST-damaged subgroup(all P＞0.05).Conclusions Infarct core resection combining DC with CST protection demonstrates superior neurological functional improvement in comparison with anterior temporal lobectomy combining DC in treating MCI with malignant brain edema,particularly for patients with an intact CST before surgery(as indicated in patients'preoperative imaging results).This(infarct core resection combining DC with CST protection)approach does not increase the incidence of surgical complications.Prospective large sample controlled studies are required for further validation.

To introduce the general thinking, guidelines, work objectives and elaboration process of the general technical requirements adopted by volume Ⅳ of the Chinese Pharmacopoeia 2025 Edition, and to summarize and figure out the main characteristics on dosage forms, physico-chemical testing, microbial and biological testing, reference standards and guidelines The newly revised general chapters of pharmacopoeia give full play to the normative and guiding role of the Chinese Pharmacopoeia standard, track the frontier dynamics of international drug regulatory science and the elaboration of monographs, expand the application of state-of-the-art technologies, and steadily promote the harmonization and unification with the ICH guidelines； further enhance the overall capacity of TCM quality control, actively implement the 3 R principles on animal experiments, and practice the concept of environmental-friendly； replace and/or reduce the use of toxic and hazardous reagents, strengthen the requirements of drug safety control This paper aims to provide a full-view perspective for the comprehensive, correct understanding and accurate implementation of general technical requirements included in the Chinese Pharmacopoeia 2025 Edition.

Objective To evaluate the clinical utility of hematoma drainage supported by a multi scenario artificial intelligence(AI)system in the treatment of minor hypertensive thalamic hemorrhage(HTH)with significant neurological dysfunction.Method A retrospective analysis was conducted on minor HTH patients with significant neurological damage and incomplete interruption of corticospinal tract(CST)on the affected side.Patients in the study group received Robot of Stereotactic Surgery(ROSS)assisted drainage surgery supported by AI systems in multiple scenarios such as image reading,surgery,and follow-up.The control group received standard pharmacological treatment.Comparative analyses were performed between two groups regarding regional cerebral blood flow(rCBF),changes in rCBF(ΔrCBF),Glasgow Coma Scale(GCS),changes in GCS(ΔGCS)after 14 days of treatment and National Institutes of Health Stroke Scale(NIHSS),changes in NIHSS(ΔNIHSS),Modified Rankin Scale(mRS),changes in mRS(ΔmRS)after 90 days of treatment.to evaluate the application value of multi scenario AI system supported hematoma drainage surgery in this patient population.Results A total of 88 cases were included,with 41 in the study group and 47 in the control group.The GCS and ΔGCS values of the study group and the control group at 14 days of post-treatment were 13.4±1.6 vs 13.3±1.5 and 1.1(0.8,1.9)vs.1.1(0.9,1.8),respectively with no statistically significant difference(P>0.05).At 14 days post-treatment,statistically significant difference were observed in the rCBF of the posterior limb of the internal capsule[(379.0±55.1)mL/(kg·min)vs.(263.0±34.4)mL/(kg·min)]and the ΔrCBF[(240.0±60.6)mL/(kg·min)vs.(121.0±43.9)mL/(kg·min)].At 90 day post-treatment,statistically significant difference were also found in the NIHSS scores(3.5±1.6 vs.6.4±2.1),ΔNIHSS(-4.1±1.7 vs.-0.9±0.6),mRS scores(1.1±0.3 vs.2.3±1.0),and ΔmRS[-2.1(-2.9,-1.1)vs.-0.8(-1.4,-0.6)](P<0.05).Conclusion Hematoma drainage surgery supported by multi scenario AI systems can significantly benefit minor HTH patients with significant neurological damage and incomplete interruption of CST on the affected side.

Humans and animals have a fundamental ability to use experiences and environmental information to organize behavior. It often happens that humans and animals make decisions and prepare actions under uncertain situations. Uncertainty would significantly affect the state of animals' minds, but may not be reflected in behavior. How to "read animals' mind state" under different situations is a challenge. Here, we report that neuronal activity in the medial prefrontal cortex (mPFC) of rats can reflect the environmental uncertainty when the task situation changes from certain to uncertain. Rats were trained to perform behavioral tasks under certain and uncertain situations. Under certain situations, rats were required to simply repeat two nose-poking actions that each triggered short auditory tone feedback (single-task situation). Whereas under the uncertain situation, the feedback could randomly be either the previous tone or a short musical rhythm. No additional action was required upon the music feedback, and the same secondary nose-poking action was required upon the tone feedback (dual-task situation); therefore, the coming task was uncertain before action initiation. We recorded single-unit activity from the mPFC when the rats were performing the tasks. We found that in the dual task, when uncertainty was introduced, many mPFC neurons were actively engaged in dealing with the uncertainty before the task initiation, suggesting that the rats could be aware of the task situation change and encode the information in the mPFC before the action of task initiation.
Animals ; Prefrontal Cortex/cytology* ; Uncertainty ; Neurons/physiology* ; Male ; Rats ; Rats, Long-Evans ; Action Potentials/physiology* ; Acoustic Stimulation

Objective To investigate the clinical efficacy of internal decompression based on white matter tract preservation in the treatment of malignant middle cerebral artery infarction(MMCAI).Methods A retrospective analysis was conducted on 54 patients with MMCAI.Patients were divided into a study group(n=26)and a control group(n=28)according to the surgical approach.Patients in the study group underwent preoperative fusion of CT,CTP,DWI,and DTI imaging data within a neuronavigation system.This fusion visualized the spatial relationships between the infarct core(IC),ischemic penumbra,and the corticospinal tract(CST).Subsequently,IC resection combined with decompressive craniectomy(DC)was performed while protecting the CST.Patients in the control group underwent DC alone.Key outcome measures included:changes in fractional anisotropy(FA)within the affected CST projection area at 1 month postoperatively;and 6-month postoperative mRS score,mortality,and surgical complications at 6 months postoperatively.Results At 1 month postoperatively,FA in the affected CST projection area were significantly higher in the study group than in the control group(0.092±0.013 vs.0.082±0.008,P<0.05).At the 6-month follow-up,the postoperative mRS score in the study group was significantly lower than that in the control group[2.3(1.3,4.5)vs.3.9(2.4,5.5),P<0.05]and a lower mortality rate(11.5%vs.39.3%,P<0.05)compared to the control group.However,there were no statistically significant differences between the two groups in the incidence of postoperative intracranial hemorrhage,intracranial infection,or epilepsy(P>0.05).Conclusion Internal decompression based on white matter tract protection combined with DC can reduce mortality and contribute to improving function outcomes in patients with MMCAI.