Background: and Purpose Live cell-based assays (LCBA) are increasingly used for serological antibody detection due to their ability to preserve antigen conformation, offering moderately higher sensitivity than fixed cell-based assays. However, the clinical necessity of prioritizing LCBA for the detection of aquaporin-4 immunoglobulin G (AQP4-IgG) in neuromyelitis optica spectrum disorder (NMOSD) remains unclear, especially when compared to its established role in diagnosing myelin oligodendrocyte glycoprotein antibody-associated disease. Methods: We compared the performance of live cell-based assays using immunofluorescence (LCBA-IF) and fixed cell-based assays using immunofluorescence (FCBA-IF) in detecting AQP4-IgG in 90 cases of NMOSD meeting 2015 International Panel for Neuromyelitis Optica Diagnosis criteria, alongside 40 controls. Additionally, we further investigated the relationship between AQP4-IgG titers as measured by LCBA-IF and FCBA-IF and clinical parameters in NMOSD patients. Results: Results showed 96.9% agreement between LCBA-IF and FCBA-IF (Cohen’s κ=0.935), with a strong Spearman correlation (0.977, p<0.001). Both methods demonstrated 100% specificity, with LCBA-IF showing slightly higher sensitivity compared to FCBA-IF. Within LCBAIF-tested groups, statistically significant differences in annualized relapse rates were observed across all pairwise comparisons (low-titer vs. moderate-titer, low-titer vs. high-titer, and moderate-titer vs. high-titer; all p<0.050). However, this association reached statistical significance in some FCBA-IF-tested groups. Conclusions Overall, there is a strong concordance between LCBA-IF and FCBA-IF in detecting AQP4-IgG, where LCBA-IF shows slightly higher sensitivity. Furthermore, there is a potential link between elevated AQP4-IgG titers and an increased risk of relapse, and this correlation may appear more pronounced when using LCBA-IF.

Objective:To investigate the characteristics of m6A methylation modification patterns in mRNA of patients with major depressive disorder (MDD) and its effect in the pathogenesis of the disease.Methods:From March 2022 to May 2023, five untreated MDD patients were assigned to the MDD group, and five healthy individuals were enrolled as the healthy control group at the First Psychiatric Hospital of Harbin.Microarray analysis was performed to determine the m6A modification profiles and gene expression patterns of mRNA in MDD. Gene ontology (GO) enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis were conducted to elucidate the effect of m6A methylation in the development of depression. Finally, methylated RNA immunoprecipitation combined with quantitative PCR (MeRIP-qPCR) was used to validate the m6A methylation levels of key mRNAs (GRM4, CAMKK2). Data were analyzed using R software (version 4.2.0) with t-test and Fisher's exact test. Results:Significant differences in m6A-modified mRNAs were observed between MDD patients and healthy controls. A total of 513 mRNAs (180 hypermethylated and 333 hypomethylated) exhibited differential m6A modifications in MDD patients. GO and KEGG analysis revealed that hypermethylated mRNAs were primarily enriched in neuroactive ligand-receptor interactions, while hypomethylated mRNAs were associated with the AMP-activated protein kinase (AMPK) signaling pathway. Additionally, a total of 350 differentially expressed mRNAs were identified (171 upregulated and 179 downregulated), enriched in the cyclic adenosine monophosphate (cAMP) and tumor necrosis factor (TNF) signaling pathways. MeRIP-qPCR results demonstrated that the m6A methylation level of GRM4 in MDD patients (25.40±2.38) was significantly higher than that in healthy controls (9.40±1.00) ( t=13.88, P<0.05), whereas the methylation level of CAMKK2 (19.63±6.60) was significantly lower than that in healthy controls (30.51±7.20) ( t=2.48, P<0.05). Conclusion:The m6A modification expression profile is abnormal in patients with major depressive disorder, which may be involved in the pathogenesis and development of MDD, and the identification of key pathways may provide new clues and evidence for the development of more effective therapeutic targets for MDD.

Objective:To investigate the clinical characteristics of patients with multiple myeloma(MM)complicated by bone lesions and the risk factors associated with bone lesions.Methods:The clinical data of 294 newly diagnosed MM patients in Gansu Provincial Hospital from January 2017 to June 2021 were retrospectively analyzed.The patients were divided into the bone lesion group(154 cases)and the non-bone lesions group(140 cases)based on the presence of absence of bone lesions at diagnosis.The general data and laboratory parameters were compared between the two groups.The risk factors for bone lesions in MM patients were analyzed by logistic regression analysis,and the characteristic(ROC)curves were plotted to assess the predictive value of each risk factor for the occurrence of bone lesions in MM patients.Results:Compared to the non-bone lesion group,the bone lesion group had significantly higher serum calcium levels and significantly greater proportions of patients with Durie-Salmon(DS)stage Ⅲ,and bone pain(all P＜0.05).Logistic regression analysis showed that elevated serum calcium(OR=5.135,95％CI:1.931-13.653,P=0.001),DS stage Ⅲ(OR=1.841,95％CI:1.019-3.328,P=0.043),and bone pain(OR=8.208,95％CI:4.761-14.151,P＜0.001)were independent risk factors for bone lesions in MM patients.ROC curve analysis showed that serum calcium(AUC=0.619,95％CI:0.555-0.683,P＜0.001)and bone pain(AUC=0.743,95％CI:0.692-0.793,P＜0.001)had predictive value for bone lesions in MM patients.Conclusion:MM patients have a high incidence of bone lesions,and active monitoring and management of risk factors may improve treatment outcomes and prognosis.

Alcohol abuse is a global public health problem.Excessive drinking not only damages digestive tract,cardiovascu-lar and endocrine systems,but also damages central nervous system(CNS).Recent studies have shown that alcohol interacts with neu-roimmune system to alter neuroimmune signaling and molecular expression,thereby leading to neuroinflammation and regulating a wide range of brain functions.Microglia is main cell of CNS involved in neuroimmune responses.Microglia is activated by alcohol and acts on neurons,leading to neuropsychiatric diseases,such as neuronal loss,abnormal synaptic connections,cognitive decline and motor dysfunction.Alcohol chronically stimulates digestive tract and also affects microglia along gut-brain axis.Neural properties of microglia and related immune factors and their important roles in neuroinflammation provide a new insight into neuroimmune mecha-nisms underlying alcohol-induced changes in brain function and behavior.This review discusses progress of role of microglia and their immune signaling in alcohol-induced neuroinflammation,and provides theoretical basis for further research on neurobiological mecha-nism and treatment of alcohol abuse.

Purpose To investigate the clinicopathological features,diagnosis,and molecular genetic characteris-tics of central nervous system(CNS)high-grade neuroepithelial tumors with BCOR alterations.Methods Five cases of CNS high-grade neuroepithelial tumors harboring BCOR alterations were collected.Using immunohistochemistry and molecular detection to analyze its clinical and histological characteristics,and review relevant literatures.Results A-mong the 5 patients,3 cases with EP300 ∷ BCOR tumor(male-to-female ratio 2∶1).These tumors were located in supratentorial regions(right temporal lobe,right frontotemporal lobe,and right frontal lobe).The 2 patients with BCOR-ITD tumors were younger,both with tumors located in the left cerebellum.Imaging studies revealed well-defined large mass lesions in all cases.Histologically,all 5 cases tumor exhibited ependymoma-like or oligodendroglioma-like morphology,featuring uniformly oval or round cells.Focal areas showed increased cellular density,nuclear enlarge-ment,and readily identifiable mitotic figures indicative of anaplastic features.A rich capillary network was frequently observed in the stroma.Palisading necrosis,microcystic changes,and microcalcifications were present in 3 cases.Im-munohistochemically,all 5 cases consistently expressed vimentin and CD56,focal Olig-2 positivity,variable S-100 ex-pression,and were uniformly negative for GFAP.BCOR immunostaining was weakly positive in 1 case with an EP300∷ BCOR fusion and strongly positive in 2 cases with BCOR-ITD.NGS identified an EP300 ∷ BCOR fusion in 3 cases,and Sanger sequencing confirmed the ITD in exon 15 of BCOR gene in 2 cases.During a follow-up period of 8 to 77 months,one pediatric patient with a BCOR-ITD tumor died,while the remaining four patients were alive with no evi-dence of recurrence or metastasis.Conclusion BCOR-ITD and EP300 ∷ BCOR fusion tumors are similar in morphology and immunophenotype,and the incidence rate of BCOR fusion tumors may be underestimated.NGS sequencing based on DNA and RNA and DNA methylation spectrum analysis are helpful for accurate diagnosis of this type of tumor.

Objective:To explore the trajectory of changes in electronic health literacy in young and middle-aged patients with coronary heart disease (CHD) combined with diabetes mellitus (DM) after percutaneous coronary intervention (PCI), and to analyze its relationship with unplanned readmission within 30 days.Methods:A convenience sample of 210 young and middle-aged CHD patients with DM who underwent PCI in the Department of Cardiology, Xinxiang Central Hospital, from February 2023 to June 2024 was selected. The e-Health Literacy Scale (eHEALS) was used to assess electronic health literacy at the 3rd day (T 1), 15th day (T 2), and 30th day (T 3) after PCI. Unplanned readmission within 30 days after discharge was recorded. Latent class growth model (LCGM) was used to identify categories and characteristics of electronic health literacy trajectories. Kaplan-Meier method was applied to plot the cumulative incidence of 30-day unplanned readmission, and the Log-Rank test was used to compare differences among different trajectory types. Results:A total of 207 patients completed the entire survey and follow-up, with a valid response rate of 98.57% (207/210). eHEALS scores gradually increased after PCI, with scores of (6.75±1.31), (11.55±3.31), and (15.56±5.75) at T 1, T 2, and T 3, respectively. Two potential categories were identified: persistent low-level type (85 cases, 41.06%) and gradually improving type (122 cases, 58.94%). Twenty-six patients experienced unplanned readmission within 30 days, with an incidence of 12.56%. The proportions of unplanned readmission within 30 days were 20.00% (17/85) in the persistent low-level group and 7.38% (9/122) in the gradually improving group, with a statistically significant difference (χ 2=7.268, P=0.007). Kaplan-Meier cumulative risk function analysis showed that the cumulative incidence of 30-day unplanned readmission in the gradually improving group was lower than that in the persistent low-level group, with a statistically significant difference (Log-Rank=7.683, P=0.006) . Conclusions:Young and middle-aged CHD patients with DM after PCI show trajectory characteristics in electronic health literacy. Although the electronic health literacy of some patients gradually improved after PCI, persistent low-level literacy was still common, and patients in the persistent low-level group had a higher risk of 30-day unplanned readmission, which deserves clinical attention.

Objective:To explore the trajectory of changes in electronic health literacy in young and middle-aged patients with coronary heart disease (CHD) combined with diabetes mellitus (DM) after percutaneous coronary intervention (PCI), and to analyze its relationship with unplanned readmission within 30 days.Methods:A convenience sample of 210 young and middle-aged CHD patients with DM who underwent PCI in the Department of Cardiology, Xinxiang Central Hospital, from February 2023 to June 2024 was selected. The e-Health Literacy Scale (eHEALS) was used to assess electronic health literacy at the 3rd day (T 1), 15th day (T 2), and 30th day (T 3) after PCI. Unplanned readmission within 30 days after discharge was recorded. Latent class growth model (LCGM) was used to identify categories and characteristics of electronic health literacy trajectories. Kaplan-Meier method was applied to plot the cumulative incidence of 30-day unplanned readmission, and the Log-Rank test was used to compare differences among different trajectory types. Results:A total of 207 patients completed the entire survey and follow-up, with a valid response rate of 98.57% (207/210). eHEALS scores gradually increased after PCI, with scores of (6.75±1.31), (11.55±3.31), and (15.56±5.75) at T 1, T 2, and T 3, respectively. Two potential categories were identified: persistent low-level type (85 cases, 41.06%) and gradually improving type (122 cases, 58.94%). Twenty-six patients experienced unplanned readmission within 30 days, with an incidence of 12.56%. The proportions of unplanned readmission within 30 days were 20.00% (17/85) in the persistent low-level group and 7.38% (9/122) in the gradually improving group, with a statistically significant difference (χ 2=7.268, P=0.007). Kaplan-Meier cumulative risk function analysis showed that the cumulative incidence of 30-day unplanned readmission in the gradually improving group was lower than that in the persistent low-level group, with a statistically significant difference (Log-Rank=7.683, P=0.006) . Conclusions:Young and middle-aged CHD patients with DM after PCI show trajectory characteristics in electronic health literacy. Although the electronic health literacy of some patients gradually improved after PCI, persistent low-level literacy was still common, and patients in the persistent low-level group had a higher risk of 30-day unplanned readmission, which deserves clinical attention.

Objective:Accelerating the cultivation and development of new quality productive forces is an inherent requirement for the coordinated development of health care industry and economic society in the new era.Methods:Based on the technology-organization-environment framework,it explores the complex causal mechanism of multi-factor synergy affecting the allocation of medical resources and the coordinated development of economy and society driven by new quality productive forces.By constructing the"time+space"two-dimensional dynamic coupling coordination degree model and grey prediction model,the specific improvement path of the allocation of medical resources and the coordinated development of economy and society in the"13th Five-Year Plan","14th Five-Year Plan"and"15th Five-Year Plan"periods are explored from the perspective of configuration.Results:During the period from the"13th Five-Year Plan"to the"15th Five-Year Plan",the degree of coordination between medical resource allocation and economic and social coupling 31 provinces(cities)generally showed an upward trend,but there were large regional disparities.From the grouping results,it can be seen that the grouping path of the coordinated development of medical resource allocation and economy and society in the"13th Five-Year Plan"and"14th Five-Year Plan"periods shows significant differences.It is expected that technology-organization-driven,technology-environment-driven and organization-environment-driven paths will be formed in the"15th Five-Year Plan"period.Conclusion:It is necessary to accelerate the formation of the agglomeration advantage of technology and talent factors,appropriately increase the financial support for the western region,and achieve coordinated development of regional integration.

Purpose To investigate the clinicopathological features,diagnosis,and molecular genetic characteris-tics of central nervous system(CNS)high-grade neuroepithelial tumors with BCOR alterations.Methods Five cases of CNS high-grade neuroepithelial tumors harboring BCOR alterations were collected.Using immunohistochemistry and molecular detection to analyze its clinical and histological characteristics,and review relevant literatures.Results A-mong the 5 patients,3 cases with EP300 ∷ BCOR tumor(male-to-female ratio 2∶1).These tumors were located in supratentorial regions(right temporal lobe,right frontotemporal lobe,and right frontal lobe).The 2 patients with BCOR-ITD tumors were younger,both with tumors located in the left cerebellum.Imaging studies revealed well-defined large mass lesions in all cases.Histologically,all 5 cases tumor exhibited ependymoma-like or oligodendroglioma-like morphology,featuring uniformly oval or round cells.Focal areas showed increased cellular density,nuclear enlarge-ment,and readily identifiable mitotic figures indicative of anaplastic features.A rich capillary network was frequently observed in the stroma.Palisading necrosis,microcystic changes,and microcalcifications were present in 3 cases.Im-munohistochemically,all 5 cases consistently expressed vimentin and CD56,focal Olig-2 positivity,variable S-100 ex-pression,and were uniformly negative for GFAP.BCOR immunostaining was weakly positive in 1 case with an EP300∷ BCOR fusion and strongly positive in 2 cases with BCOR-ITD.NGS identified an EP300 ∷ BCOR fusion in 3 cases,and Sanger sequencing confirmed the ITD in exon 15 of BCOR gene in 2 cases.During a follow-up period of 8 to 77 months,one pediatric patient with a BCOR-ITD tumor died,while the remaining four patients were alive with no evi-dence of recurrence or metastasis.Conclusion BCOR-ITD and EP300 ∷ BCOR fusion tumors are similar in morphology and immunophenotype,and the incidence rate of BCOR fusion tumors may be underestimated.NGS sequencing based on DNA and RNA and DNA methylation spectrum analysis are helpful for accurate diagnosis of this type of tumor.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.