Background: and Purpose Criteria for amyloid-related imaging abnormalities in anti-amyloid therapy are based on T2* gradient-recalled echo (GRE), but susceptibility-weighted imaging (SWI) is widely used, creating uncertainty. This study quantitatively compared the detectability of SWI and GRE for cerebral microbleeds and established evidence supporting distinct microbleed criteria for each. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed and Embase were searched for studies directly comparing SWI and GRE up to August 8, 2024. Study quality was assessed with QUADAS-2. The pooled proportion of microbleed detection and detection ratio were calculated. Subgroup analyses were performed based on magnetic field strength (1.5 T vs. 3 T) and SWI slice thickness (<2 mm vs. ≥2 mm), equipment vendor, and study quality. Results: Thirteen studies were included. SWI detected cerebral microbleeds approximately 1.6times more effectively than GRE. At 3.0 T and 1.5 T, SWI exhibited 1.7-fold and 1.5-fold greater detectability, respectively. SWI with thinner slices (<2 mm) showed a 1.9-fold improvement, while thicker slices (≥2 mm) showed a 1.3-fold improvement. Subgroup analyses revealed no significant differences between vendors (0.61 vs. 0.60, p=0.89), or by study quality (0.61 vs. 0.59,p=0.89). Conclusions SWI detects cerebral microbleeds about 1.6 times more effectively than GRE, highlighting important differences between the two techniques. Cautious exploration of adjusted thresholds may be needed, and prospective validation in therapy-specific cohorts will be essential before clinical application.

OBJECTIVE To construct a predictive model for evaluating the efficacy of a triple antiemetic regimen （neurokinin- 1 receptor antagonist+5-hydroxytryptamine 3 receptor antagonist+dexamethasone） for preventing nausea and vomiting induced by highly emetogenic chemotherapy （HEC） based on interpretable deep learning algorithms. METHODS Clinical data of cancer patients who received HEC and were treated with the standard triple antiemetic regimen in the oncology department of Tianjin Medical University General Hospital from January 2018 to December 2022 were collected retrospectively. Demographic， clinical and metabolism-related variables were integrated. After data pre-processing， two deep learning algorithms （deep random forest and dense neural network） and four machine learning algorithms （support vector machine， categorical boosting， random forest and decision tree） were used to build predictive models. Subsequently， model performance evaluation and model interpretability analysis were conducted. RESULTS Among the six candidate models， the deep random forest model demonstrated the best predictive performance on the test set， with an area under the receiver operating characteristic curve of 0.850， an accuracy of 0.911， a precision of 0.805， a recall of 0.783， an F1 score of 0.793， and a Brier score of 0.075. Interpretability analysis revealed that creatinine clearance rate （Ccr） was the key predictive factor， and low Ccr levels， female gender， younger age， highly emetogenic drugs （particularly cisplatin-containing chemotherapy regimens）， and anticipatory nausea and vomiting were positively correlated with the risk of HEC-related nausea and vomiting. CONCLUSIONS The deep random forest model exhibits the best performance in predicting the efficacy of triple antiemetic regimen for preventing HEC-related nausea and vomiting. The key predictors in this model primarily include Ccr，anticipatory nausea and vomiting， gender， age， and highly emetogenic drugs.

Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Plant-derived extracellular vesicles (PDEVs) are nanoscale extracellular vesicles secreted by plant cells, characterized by a lipid bilayer structure. These vesicles carry a variety of bioactive molecules, including proteins, nucleic acids, and lipids, and play essential roles in intercellular communication and physiological regulation in plants. Compared to animal-derived extracellular vesicles, PDEVs offer several advantages, such as a broad range of sources, high biocompatibility, low immunogenicity, and low production costs. Furthermore, PDEVs have demonstrated remarkable potential as natural nanocarriers for drug delivery, due to their ability to efficiently traverse biological barriers, such as the blood-brain barrier, making them promising candidates for drug delivery systems. This review systematically elaborates on the complex composition of PDEVs, which consists of lipids, proteins, and nucleic acids, the typical structural characteristics of their lipid bilayers ranging from 30 to 150 nm, and their versatile loading capabilities as drug carriers, efficiently encapsulating various types of therapeutic agents such as hydrophilic small molecules, hydrophobic drugs, nucleic acids, and proteins. We systematically summarize the recent advancements in strategies for enhancing the loading efficiency of PDEVs, which include methods such as co-incubation, ultrasound-assisted loading, electroporation, freeze-thaw cycles, and microfluidic technology. These techniques are evaluated based on their underlying principles, suitable drug types, and their respective advantages. In addition to loading strategies, we focus on the engineered approaches to achieve targeted delivery using PDEVs, such as genetic engineering modifications, chemical ligand conjugation, membrane fusion technology, and polyethylene glycol (PEG) modification. We discuss the mechanisms of these strategies in enhancing targeting efficiency, prolonging in vivo circulation time, and improving therapeutic efficacy. Further, this review highlights the application of PDEVs in various disease models, including tumor, skin inflammation, metabolic disorders, and neurodegenerative diseases, showcasing their therapeutic potential as multifunctional delivery platforms. The ability of PDEVs to encapsulate diverse therapeutic agents and target specific tissues or cells opens up new avenues for the treatment of complex diseases, offering advantages over conventional drug delivery systems. However, despite the promising applications of PDEVs, several challenges remain in their development and clinical translation. These challenges include variability in source materials, standardization of preparation processes, quality control, scalability of production, and the need for clinical validation. To overcome these obstacles, the integration of advanced technologies such as artificial intelligence-assisted design and multi-omics analysis is proposed as a way to facilitate the precise development of PDEVs. These emerging technologies hold the potential to further enhance the precision and effectiveness of plant-based drug delivery systems, ultimately advancing the field of precision medicine. In conclusion, the use of PDEVs as a platform for drug delivery represents a promising area of research with the potential to revolutionize therapeutic strategies. Their ability to encapsulate and deliver a wide variety of bioactive molecules, along with their inherent advantages in biocompatibility and versatility, makes them a valuable tool in the development of more efficient and targeted therapeutic interventions. Continued research and innovation in this field will pave the way for the clinical implementation of PDEVs in the treatment of various diseases, offering new hope for more effective and sustainable therapeutic options.

Objective To investigate the etiology and treatment of dysuria shortly after holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH), so as to improve the therapeutic efficacy. Methods A retrospective analysis was conducted on 1361 BPH patients who received HoLEP at our hospital during Mar. 2018 and Mar. 2025. All patients underwent ultrasound, computed tomography (CT), urethral probing or radiography, cystourethroscopy, and urodynamic testing. The causes, treatments and prognosis of dysuria after operation were summarized. Results ninety-eight patients (7.2%) experienced dysuria within 3 months after surgery, and all patients received initial urethral dilation. Among the 62 cases with urethral stricture, 28 were treated with urethral dilation (average of 8 sessions), 16 underwent external urethral incision, 8 underwent anterior urethroplasty, and 10 underwent transurethral plasma incision for urethral stricture. Of the 12 cases with residual prostate tissue, 5 underwent urethral plasma prostatectomy and 7 received medication. All of the 12 cases with bladder neck contracture underwent transurethral plasma incision of the bladder neck and local drug injection. Five cases with intravesical blood clots underwent urethral blood clot irrigation, 2 of which developed active bleeding and then underwent electrocoagulation. Four cases with detrusor dysfunction had catheters re-indwelled for one week followed by medication. Two cases with stone and one case with tissue fragment impacted in the urethra underwent urethral holmium lithotripsy and cystoscopic removal. All patients underwent reoperation successfully and experienced complete resolution or significant improvement of urinary difficulties. Conclusion A certain proportion of patients experience dysuria after HoLEP, with diverse etiologies. The combination of prevention and treatment can reduce the incidence of dysuria.

To understand the background of Escherichia coli(E.coli)carried by artificially bred sika deer and the biological characteristics of the isolated strains,such as drug resistance and pathogenicity,in April 2024,we collected 184 fresh deer fecal samples from four deer farms in Luxiang Township,Shuangyang District,Changchun City,Jilin Province,for isolation and cultivation of E.coli.The isolates were tested for drug resistance and biochemical identification with a BD PhoenixTM-100 Automated Microbiology System.The virulence genes were detected with PCR,and the strains were molecularly typed with ERIC-PCR.A total of 165 E.coli strains were isolated from 184 samples of deer feces,with an isolation rate of 89.67%.Twenty strains had a drug resistance phenotype,and the drug resistance rate was 12.12%;these strains included 15 strains of multi-drug resistant bacteria and 11 strains of ESBL-producing bacteria.Virulence gene detection indicated that the sika deer isolates carried multiple diarrhea-associated virulence genes,such as EAST-1(12.12%),eae(1.21%),stx1(7.88%),stx2(7.27%),and STa(1.82%).ERIC-PCR demonstrated that the isolates showed high polymorphism.The ESBL-producing E.coli carried by sika deer are likely to spread drug resistance in the community and livestock population.Some isolates carried multiple diarrhea-associated virulence genes,thus posing a human transmission risk.Therefore,monitoring of drug resistance and virulence genes must be strengthened,and antibiotics must be used reasonably during the breeding process to avoid excessive use and misuse.

Complex liver resection (CLR) is a collective term for surgical procedures addre-ssing complex invasion of intrahepatic vasculobiliary structures that cannot be radically resected through conventional methods. The ex vivo liver resection and autotransplantation (ELRA) and its modified techniques have significantly enhanced the technical feasibility of CLR implementation. In recent years, advancements in modified ELRA techniques and derivative procedures, including conversion resection, in-situ hypothermic perfusion, and auxiliary liver transplantation, have further diversified CLR methodologies, offering more personalized treatment options for CLR candidates. Given the complexity of such cases and substantial variations in surgical approach selection, improving procedural safety and scalability remains a critical challenge in CLR practice. The authors review the current application of modified techniques based on ELRA in CLR, evaluate the clinical significance based on institutional experiences, and propose future directions and individual selection for advancing the safe implementation of CLR.

Objective:To investigate the feasibility and safety of endoscopic surgery in the treatment of fibro-adipose vascular anomaly (FAVA).Methods:Clinical data of FAVA patients who underwent endoscopic treatment admitted to Xi’an International Medical Center Hospital from October 1, 2019 to April 1, 2024 were retrospectively analyzed, including gender, age of onset, age of diagnosis, lesion location, operation time, intraoperative blood loss, hospital stays, incision complications, etc. Before endoscopy, magnetic resonance imaging and ultrasound were routinely used to locate the lesion range, and the surgical position and Trocar location were selected according to different lesion sites.Descriptive statistical analysis was conducted using SPSS version 26.0.Results:40 cases of FAVA patients were admitted during the period, all of whom underwent endoscopic radical resection, including 15 males and 25 females. The age of onset was 8 (6, 12.5) years. The age of diagnosis was 11 (8, 22.5) years. There were 31 patients with stage Ⅰ and 9 patients with stage Ⅱ. 31 cases involved the calf, of which 21 involved the calf triceps (gastrocnemius, soleus) and 9 involved the thigh, of which 1 patient had lesions originating from the fascia around the sciatic neurovascular bundle. 11 cases (27.5%) were converted to open surgery. The operative time was 192.5 (107, 292.5) min. The intraoperative blood loss was 35 (10, 87.5) ml. The length of hospital stay for endoscopic surgery was 9 (7, 11) d. The postoperative follow-up time was 11.5 (3.5, 13.5) months. Of the 40 patients, 39 were cured completely without residual pain or joint movement disorder after operation. Postoperative dorsiflexion function of the ankle joint was mildly limited in one patient classified as stage Ⅱ. There was no incision complication and recurrence.Conclusion:For patients with stage Ⅰ and Ⅱ FAVA, endoscopic surgery has concealed incisions, indistinct scars, definite therapeutic effects and high safety.

Objective To establish a ultrahigh-performance liquid chromatography-orbitrap high-resolution mass spectrometry(UHPLC-Orbitrap HRMS)method for the determination of the genotoxic impurity N-nitroso propranolol(NPPN)in propranolol hydrochloride sustained-release tablets.Methods The test sample was ultrasonically extracted using methanol as the solvent,then centrifuged and filtered before injection analysis.Chromatographic separation was performed using a 2.7 μm particle size C18 UHPLC column with a mobile phase of 0.1％formic acid(A)in water and 0.1％formic acid(B)in acetonitrile,using gradient elution.Mass spectrometry was conducted with an HESI ion source in positive ion parallel reaction monitoring(PRM)scan mode,monitoring the NPPN fragment ion at m/z 72.080 8,and quantification was performed using the standard curve method.Results The calibration curve was in good linearity in the range of 0.51-20.30 ng·mL-1 with excellent correlation coefficient(r)of 0.9999.The recoveries of NPPN at three levels(low,medium,and high)were in the range of 95.4％～98.3％,while the RSDs were from 2.5％to 4.2％.The limit of detection(LOD)was 0.20 ng·mL-1 while the limit of quantitfication(LOQ)was 0.51 ng·mL-1.This analytical method was used to determine NPPN in six batches of propranolol hydrochloride sustained release tablet samples.NPPN was detected in all six samples,among which the detection amount of 3 batches have exceeded the acceptable limit.Conclusion This method is sensitive,accurate,and fast,making it useful for pharmaceutical companies in controlling production processes and providing robust technical support for regulatory authorities.

Objective:To prospectively analyze and evaluate the clinical efficacy of fire needle acupuncture selection based on CT localization in the treatment of lung cancer-related cough.Methods:A total of 36 patients with lung cancer-related cough who were admitted to the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2020 to December 2023 were prospectively included as research samples.According to the random number table method,they were divided into control group(18 cases)and observation group(18 cases).The control group was treated with routine etiological treatment and symptomatic treatment,while the observation group was treated with fire needle acupuncture selection based on CT localization on the basis of the control group.The course of treatment was 28 days.The efficacy improvement rate after 28 days of treatment,visual analogue scale(VAS),le icester cough questionnaire in mandarin-Chinese(LCQ-MC)and levels of peripheral serum cytokines interleukin-6(IL-6)and interleukin-8(IL-8)before and after 28 days of treatment were compared between the two groups.Results:After 28 days of treatment,the efficacy improvement rate of curative effect,VAS score and LCQ-MC score in the observation group were significantly higher than those in the control group(P＜0.05).The levels of IL-6 and IL-8 in the two groups were significantly lower than those before treatment(P＜0.05),but there was no significant difference between the two groups(P＞0.05).Conclusion:The treatment of fire needle acupuncture selection guided by CT localization can significantly improve the therapeutic effect of patients with lung cancer-related cough,effectively reduce the cough symptoms of patients,improve the quality of life of patients,and alleviate the inflammatory response in the body.