Attention deficit hyperactivity disorder (ADHD), a prevalent neurodevelopmental disorder influenced by both genetic and environmental factors, remains poorly understood regarding how its polygenic risk score (PRS) impacts functional networks and symptomology. This study capitalized on data from 11,430 children in the Adolescent Brain Cognitive Development study to explore the interplay between PRS_ADHD, brain function, and behavioral problems, along with their interactive effects. The results showed that children with a higher PRS_ADHD exhibited more severe attention deficits and rule-breaking problems, and experienced sleep disturbances, particularly in initiating and maintaining sleep. We also identified the central executive network, default mode network, and sensory-motor network as the functional networks most associated with PRS and symptoms in ADHD cases, with potential mediating roles. Particularly, the impact of PRS_ADHD was enhanced in children experiencing heightened sleep disturbances, emphasizing the need for early intervention in sleep issues to potentially mitigate subsequent ADHD symptoms.
Humans ; Attention Deficit Disorder with Hyperactivity/physiopathology* ; Male ; Female ; Sleep Wake Disorders/physiopathology* ; Adolescent ; Child ; Brain/diagnostic imaging* ; Multifactorial Inheritance ; Genetic Predisposition to Disease

Objective: To review the current development of artificial intelligence (AI) technology in the field of transfusion medicine. Methods: A systematic search was conducted in the Clarivate Web of Science Database from inception to December 2024 for literature related to AI and transfusion. A total of 4 775 publications were identified. Based on inclusion and exclusion criteria, 133 original studies were ultimately included and analyzed using a narrative synthesis approach. Results: Research on AI in transfusion has surged since 2020 (accounting for 77% of all publications), with China ranking second globally in publication volume. Among the included studies, 69.2% focused on predicting individual transfusion needs, followed by inventory management (8.3%), diagnosis and prediction of adverse transfusion reactions (6.0%), factors influencing transfusion outcomes (5.3%), blood group identification (5.3%), blood quality testing (4.5%), and precise blood volume measurement (1.5%). Additionally, 4.5% of the studies were published in journals with an impact factor greater than 10; 19.5% developed software or applications; 31.5% were multi-center studies; 48.1% utilized decision tree methods, while 31.5% employed neural network approaches; and 14.2% conducted external validation of the algorithms. Conclusion: AI demonstrates significant potential in transfusion risk prediction, decision support, and blood management. However, challenges remain, including limited model generalizability, insufficient algorithm interpretability, and barriers to clinical translation. The deep integration of AI with transfusion medicine will accelerate the advent of precision transfusion era, maximizing blood resource utilization, reducing waste, and ensuring transfusion safety.

Theory and technology of Medical Immunology are widely used in scientific research.Our teaching and research group uses experimental teaching of Medical Immunology as a platform to carry out practice of scientific research project-based experi-mental system among"5+3"integration students.By completing a mini-project research including experimental design-experimental operation-research article writing,students cultivated scientific research thinking and exercised scientific research practice ability,and generally reported that the course is very difficult,but after completing it,it is very rewarding.

With the rapid development of artificial intelligence(AI),how to digitize the teaching of Medical Immunology is a new challenge posed by the times and education.This study is based on the advanced teaching model of Medical Immunology,which includes lectures-PAD class-flipped classrooms-expert lecture.By introducing knowledge mapping and AI teaching assistant into the entire learning process,the students not only deepen their understanding of the knowledge system of Medical Immunology,but also ex-ercise their ability to apply immunological knowledge to solve practical clinical problems,enhance their self-learning ability,expres-sion ability,communication ability,on-site performance ability,and cultivate a spirit of unity,cooperation,and exploration.The practice of empowering Medical Immunology teaching with digital intelligence achieves the integration of theory and application,the linkage between in class and out of class teaching,the connection between commonalities and individualities,and the union of abili-ties and qualities in Medical Immunology teaching.It also provides practical basis for exploring the implementation path of digital intel-ligence empowerment in Medical Immunology teaching.

Objective To investigate the expression levels and diagnostic value of long non coding RNA(lncRNA)DNA damage inducible transcript 4 like protein 4 antisense RNA1(lncRNA DDIT4-AS1)and long chain non coding RNA(lncRNA)radial spoke head protein 9 homolog 4(RSPH9-4)in serum of patients with bacterial meningitis.Methods A total of 94 patients with meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were regarded as the bacterial meningitis group.According to the severity of damage to the central nervous system caused by bacterial meningitis,they were further separated into a general group(n=63)and a severe group(n=31).94 patients with suspected meningitis upon admission but excluded meningitis after examination were selected as the non bacterial meningitis group.A total of 94 patients diagnosed with bacterial meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were selected as the bacterial meningitis group 94 healthy volunteers who underwent physicalexamination were as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect the expression levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in serum samples of all personnel.Spearman analysis was applied to analyze the correlation between serum levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 with the severity of bacterial meningitis.Multivariate Logistic analysis was applied to analyze the influencing factors of bacterial meningitis.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis.Results Compared with the control group,the expression levels of serum lncRNA DDIT4-AS1(1.35±0.27,1.67±0.35 vs 1.01±0.18)and lncRNA RSPH9-4(1.30±0.25,1.56±0.32 vs 1.00±0.19)were increased in non bacterial meningitis group and bacterial meningitis group(t=10.159,16.259;9.263,14.589),compared with the non bacterial meningitis group,the expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in the bacterial meningitis group were increased(t=7.019,6.208),and the differences were statistically significant(all P<0.05),respectively.Compared with the general group,the expression levels of serum lncRNA DDIT4-AS1(1.88±0.38 vs 1.56±0.31)and lncRNA RSPH9-4(1.79±0.35 vs 1.45±0.28)were increased in the severe group,and the differences were statistically significant(t=4.361,5.088,all P＜0.05).Spearman correlation analysis results showed that serum levels of lncRNA DDIT4-AS1,lncRNA RSPH9-4 were positively correlated with the severity of bacterial meningitis(r=0.524,0.548,all P<0.05).The expression levels of PCT,LDH and CRP in patients with bacterial meningitis were higher than those in patients without bacterial meningitis,and the differences were statistically significant(t=7.459,4.234,8.565,all P<0.05).Multivariate Logistic analysis showed that PCT,LDH,CRP,lncRNA DDIT4-AS1 and lncRNA RSPH9-4 were influencing factors for bacterial meningitis(Wald χ2=4.768～12.035,all P＜0.05).The receiver operating characteristic(ROC)curve results showed that the combined diagnosis of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis had a significantly larger area under the curve(AUC)than the diagnosis of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 alone,and the differences were statistically significant(Z=2.426,2.545,all P<0.05).Conclusion The expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 are elevated in patients with bacterial meningitis,and the combination of the two has high diagnostic value for the disease.

Objective:To analyze the etiological characteristics of Clostridium ramosum DZS3717106 isolated from the blood of a patient with septic shock secondary to perianal abscess and the immunological characteristics of the patient. Methods:The isolate was subjected to morphological observation, mass spectrometry, antibiotic susceptibility testing, and 16S rRNA sequencing. Biochemical and cytological test results of the patient were collected. Flow cytometry was used to detect T cell subsets. Impacts of the virulence factors of the isolate on the host immune system were evaluated.Results:DZS3717106 was an anaerobic Clostridium with pleomorphic rod-shaped cells and spores. It was sensitive to penicillin G, piperacillin/tazobactam, and metronidazole, but resistant to clindamycin. It carried various virulence and resistance genes. The patient was immunocompromised with abnormal IL-6, IL-8, and IL-10 levels. Conclusions:Septic shock caused by Clostridium ramosum is rare, and more research is needed on the causes and epidemiology. DZS3717106 infection triggers over-activated inflammatory response in the patient, which may be closely related to the occurrence and development of septic shock.

Theory and technology of Medical Immunology are widely used in scientific research.Our teaching and research group uses experimental teaching of Medical Immunology as a platform to carry out practice of scientific research project-based experi-mental system among"5+3"integration students.By completing a mini-project research including experimental design-experimental operation-research article writing,students cultivated scientific research thinking and exercised scientific research practice ability,and generally reported that the course is very difficult,but after completing it,it is very rewarding.

Objective:To analyze the etiological characteristics of Clostridium ramosum DZS3717106 isolated from the blood of a patient with septic shock secondary to perianal abscess and the immunological characteristics of the patient. Methods:The isolate was subjected to morphological observation, mass spectrometry, antibiotic susceptibility testing, and 16S rRNA sequencing. Biochemical and cytological test results of the patient were collected. Flow cytometry was used to detect T cell subsets. Impacts of the virulence factors of the isolate on the host immune system were evaluated.Results:DZS3717106 was an anaerobic Clostridium with pleomorphic rod-shaped cells and spores. It was sensitive to penicillin G, piperacillin/tazobactam, and metronidazole, but resistant to clindamycin. It carried various virulence and resistance genes. The patient was immunocompromised with abnormal IL-6, IL-8, and IL-10 levels. Conclusions:Septic shock caused by Clostridium ramosum is rare, and more research is needed on the causes and epidemiology. DZS3717106 infection triggers over-activated inflammatory response in the patient, which may be closely related to the occurrence and development of septic shock.

With the rapid development of artificial intelligence(AI),how to digitize the teaching of Medical Immunology is a new challenge posed by the times and education.This study is based on the advanced teaching model of Medical Immunology,which includes lectures-PAD class-flipped classrooms-expert lecture.By introducing knowledge mapping and AI teaching assistant into the entire learning process,the students not only deepen their understanding of the knowledge system of Medical Immunology,but also ex-ercise their ability to apply immunological knowledge to solve practical clinical problems,enhance their self-learning ability,expres-sion ability,communication ability,on-site performance ability,and cultivate a spirit of unity,cooperation,and exploration.The practice of empowering Medical Immunology teaching with digital intelligence achieves the integration of theory and application,the linkage between in class and out of class teaching,the connection between commonalities and individualities,and the union of abili-ties and qualities in Medical Immunology teaching.It also provides practical basis for exploring the implementation path of digital intel-ligence empowerment in Medical Immunology teaching.

Objective To investigate the expression levels and diagnostic value of long non coding RNA(lncRNA)DNA damage inducible transcript 4 like protein 4 antisense RNA1(lncRNA DDIT4-AS1)and long chain non coding RNA(lncRNA)radial spoke head protein 9 homolog 4(RSPH9-4)in serum of patients with bacterial meningitis.Methods A total of 94 patients with meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were regarded as the bacterial meningitis group.According to the severity of damage to the central nervous system caused by bacterial meningitis,they were further separated into a general group(n=63)and a severe group(n=31).94 patients with suspected meningitis upon admission but excluded meningitis after examination were selected as the non bacterial meningitis group.A total of 94 patients diagnosed with bacterial meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were selected as the bacterial meningitis group 94 healthy volunteers who underwent physicalexamination were as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect the expression levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in serum samples of all personnel.Spearman analysis was applied to analyze the correlation between serum levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 with the severity of bacterial meningitis.Multivariate Logistic analysis was applied to analyze the influencing factors of bacterial meningitis.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis.Results Compared with the control group,the expression levels of serum lncRNA DDIT4-AS1(1.35±0.27,1.67±0.35 vs 1.01±0.18)and lncRNA RSPH9-4(1.30±0.25,1.56±0.32 vs 1.00±0.19)were increased in non bacterial meningitis group and bacterial meningitis group(t=10.159,16.259;9.263,14.589),compared with the non bacterial meningitis group,the expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in the bacterial meningitis group were increased(t=7.019,6.208),and the differences were statistically significant(all P<0.05),respectively.Compared with the general group,the expression levels of serum lncRNA DDIT4-AS1(1.88±0.38 vs 1.56±0.31)and lncRNA RSPH9-4(1.79±0.35 vs 1.45±0.28)were increased in the severe group,and the differences were statistically significant(t=4.361,5.088,all P＜0.05).Spearman correlation analysis results showed that serum levels of lncRNA DDIT4-AS1,lncRNA RSPH9-4 were positively correlated with the severity of bacterial meningitis(r=0.524,0.548,all P<0.05).The expression levels of PCT,LDH and CRP in patients with bacterial meningitis were higher than those in patients without bacterial meningitis,and the differences were statistically significant(t=7.459,4.234,8.565,all P<0.05).Multivariate Logistic analysis showed that PCT,LDH,CRP,lncRNA DDIT4-AS1 and lncRNA RSPH9-4 were influencing factors for bacterial meningitis(Wald χ2=4.768～12.035,all P＜0.05).The receiver operating characteristic(ROC)curve results showed that the combined diagnosis of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis had a significantly larger area under the curve(AUC)than the diagnosis of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 alone,and the differences were statistically significant(Z=2.426,2.545,all P<0.05).Conclusion The expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 are elevated in patients with bacterial meningitis,and the combination of the two has high diagnostic value for the disease.