Objective: To investigate the hematological characteristics of the rare McLeod phenotype associated with X-linked chronic granulomatous disease, KEL and XK gene analysis, identification of unexpected antibodies, serological characteristics of high-frequency antigen antibodies, and transfusion strategies. Methods: Serological methods were employed to determine the ABO, Rh, and other blood group system antigen phenotypes of the child, along with screening and identification of unexpected antibodies. The titers of high-frequency antigen antibodies were measured using tube antihuman globulin and microcolumn gel card techniques. Kell blood group typing was performed using serological and genotyping methods, while XK gene sequencing was conducted via next-generation sequencing. Peripheral blood smears from the child's mother were examined for erythrocyte morphology. Results: The child's serological results were as follows: blood group O, ccDEE, MM, Le(a-b+), JK(a+b+), Fy(a+b-), and Kell phenotype K-k+, Kp(a-b+). Plasma analysis revealed alloantibodies anti-C、e, as well as a high-frequency antigen antibody anti-KL, with titers of 512 (tube method) and 2 048 (microcolumn gel method). Genotyping results showed KEL genotype K-k+, Kp(a-b+), Js(a-b+), while XK gene NGS identified a hemizygous deletion of exons 1-3 (XK N. 01), consistent with XK: -1 or Kx-(McLeod). The mother's peripheral blood smear exhibited prominent acanthocytes. Conclusion: The hematological features of this rare McLeod phenotype with X-CGD include weakened Kell antigen expression and a complete exon deletion in the XK gene. Early clinical attention should be given to the symptoms and laboratory diagnosis of X-linked chronic granulomatous disease in pediatric patients. XK genotyping for McLeod phenotype should be prioritized to guide cautious transfusion strategies, preventing life-threatening complications due to incompatible blood products.

OBJECTIVE: To observe the effect of acupuncture on chondrocyte autophagy in rats of knee osteoarthritis (KOA) and explore its underlying mechanisms. METHODS: Forty male SPF-grade SD rats were randomized into a blank group, a model group, a suspension group, an acupuncture group, and a combined therapy group, 8 rats in each one. Except the blank group, KOA model was prepared by the injection with papain. The suspension exercise therapy (10 min each time, three times daily), acupuncture (at "Yanglingquan" [GB34], "Zusanli" [ST36], and "Dubi" [ST35] on the right side, 30 min each intervention, once daily) and the combined therapy (the suspension exercise therapy combined with acupuncture) were delivered in the suspension group, the acupuncture group and the combined therapy group, respectively. The intervention of each group was performed continuously for 6 days, and 4 consecutive weeks, at the interval of 1 day. Before and after intervention, Lequesne MG score was assessed in the rats. After intervention, HE staining was adopted to observe the cartilaginous tissue morphology of the right knee joints, and Mankin score was evaluated; the serum levels of interleukin (IL)-1β, IL-6, and tumor neurosis factor-α (TNF-α) were measured using ELISA; the real-time PCR was provided to determine the mRNA expression of collagen protein type Ⅱ(COL2), collagen protein type Ⅹ (COL10), phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), mammalian target of rapamycin (mTOR), and autophagy-regulated protein (Beclin-1) in the cartilaginous tissue of the right knee joint; Western blot was employed to detect the protein expression of PI3K, phosphorylated PI3K (p-PI3K), Akt, phosphorylated Akt (p-Akt), mTOR, phosphorylated mTOR (p-mTOR) and Beclin-1 in the cartilaginous tissue of the right knee joint. RESULTS: Compared with the blank group, the rats in the model group showed the higher Lequesne MG score (P<0.01), thinner cartilage of the right knee, reduced chondrocytes and disordered arrangement, and higher Mankin score (P<0.01). Besides, in the model group, the serum levels of IL-1β, IL-6 and TNF-α were elevated (P<0.01), the mRNA expression of COL2 and Beclin-1 and the protein expression of Beclin-1 decreased (P<0.01), the mRNA expression of COL10, PI3K, Akt and mTOR, and the protein expression of p-PI3K, p-Akt and p-mTOR increased (P<0.01) in the cartilaginous tissue of the right knee joint. Compared with the model group, in the suspension group, the acupuncture group and the combined therapy group, the Lequesne MG scores were reduced (P<0.01), the cartilage of the right knee was thickened, the arrangement of chondrocytes was improved, and the Mankin scores were lower (P<0.01). Besides, in these intervention groups, the serum levels of IL-1β, IL-6 and TNF-α were reduced (P<0.01), the mRNA expression of COL2 and Beclin-1 and the protein expression of Beclin-1 increased (P<0.05, P<0.01), the mRNA expression of COL10, PI3K, Akt and mTOR, and the protein expression of p-PI3K, p-Akt and p-mTOR decreased (P<0.05, P<0.01) in the cartilaginous tissue of the right knee joint. When compared with the suspension group and the acupuncture group, in the combined therapy group, the Lequesne MG score was reduced (P<0.01), and the Mankin score was reduced (P<0.05, P<0.01). Besides, the serum levels of IL-1β, IL-6 and TNF-α were reduced (P<0.05), the mRNA expression of COL2 and Beclin-1 and the protein expression of Beclin-1 increased (P<0.05), the mRNA expression of COL10, PI3K, Akt and mTOR, and the protein expression of p-PI3K, p-Akt and p-mTOR decreased (P<0.05, P<0.01) in the cartilaginous tissue of the right knee joint. CONCLUSION Acupuncture can promote cartilage regeneration of knee joint and autophagy in KOA rats, alleviate inflammation, so as to retard cartilage degeneration, which may be possibly associated with the PI3K/Akt/mTOR signaling pathway.
Animals ; Male ; Acupuncture Therapy ; Proto-Oncogene Proteins c-akt/genetics* ; TOR Serine-Threonine Kinases/genetics* ; Osteoarthritis, Knee/physiopathology* ; Phosphatidylinositol 3-Kinases/genetics* ; Rats ; Signal Transduction ; Rats, Sprague-Dawley ; Chondrocytes/metabolism* ; Humans ; Autophagy ; Acupuncture Points

Objective To analyze the research hotspots and frontier trends in the field of physical therapy for Parkinson's disease(PD)from 2014 to 2023.Methods Relevant literatures published from January,2014 to December,2023 were retrieved from the Web of Science Core Collection.CiteSpace 6.3.R1 was used to conduct bibliometric analysis,generating visual maps of coun-tries,institutions,keyword co-occurrence,burst terms,timelines and clustering,and they were summarized based on both visual results and literature content.Results A total of 400 articles were included.The United States had the highest publication volume,followed by China,Italy and Brazil,and the international collaboration was relatively active.Major contributing institutions included Northwestern University,Rush University,Karolinska Institutet and Universidade de S?o Paulo.Keyword co-oc-currence analysis showed that researches mainly focused on interventions such as exercise,postural control,aero-bic exercise and transcranial direct current stimulation.Burst detection analysis showed that keywords with high attention in recent years included motor symptoms,executive function,resistance training and noninvasive brain stimulation.The timeline map indicated a shift in research themes from early focus on electrical stimulation to in-tegrated interventions involving both motor and cognitive functions.Conclusion Over the past decade,researches on physical therapy for PD has shown steady growth,with increasing diver-sity in intervention strategies.There is a clear trend toward multidimensional integration and interdisciplinary col-laboration.Future studies should strengthen interventions targeting non-motor symptoms and promote the clinical application of new rehabilitation technologies.

Objective:To investigate the incidence of mild cognitive impairment(MCI)and malnutrition among centenarians, as well as to explore the relationship between cognitive impairment and nutritional status.Methods:A cross-sectional study was conducted between November and December 2023, involving 121 elderly individuals aged ≥ 100 years in the Baoshan District of Shanghai.The survey collected general information and included the Ascertain Dementia 8-item Questionnaire(AD8), the Mini Nutritional Assessment Short-Form(MNA-SF), and anthropometric nutritional measurements such as waist circumference(WC), hip circumference(HC), arm circumference(AC), calf circumference(CC), and grip strength.The prevalence of MCI and malnutrition among centenarians was calculated, and the correlation between MCI and MNA-SF scores, along with anthropometric nutritional measurement indicators, was analyzed.Results:The age range of centenarians was between 100 and 105 years, with an average age of 101.0±3.5 years.The majority of centenarians were female(76.9%), illiterate(58.7%), and lived with family members(73.6%).All participants had medical insurance(100%).Most had no history of long-term smoking 118(97.5%), long-term alcohol consumption 108(89.3%), long-term use of health supplements 109(90.1%), long-term tea or coffee habits 114(94.2%), chronic medical conditions 84(69.4%), or family history of dementia 102(84.3%).Additionally, 62(51.2%)reported their health status over the past year as general.According to the AD8 screening results, the negative and positive detection rates of MCI in centenarians were 79(65.3%)and 47(34.7%), respectively.Based on the MNA-SF scoring results, the detection rates of normal nutrition, malnutrition risk, and malnutrition among centenarians were 36(29.8%), 61(50.4%), and 24(19.8%), respectively.There was a statistically significant difference in AC between the non-MCI group and the MCI group among centenarians( t=0.01, P=0.03).The AD8 scores of centenarians were significantly negatively correlated with AC, CC, and MNA-SF scores( r=-0.20, r=-0.26, r=-0.29; all P<0.05). Conclusions:The cognitive function of centenarians is associated with their nutritional status, indicating that higher cognitive abilities correlate with better nutritional status.

Objective To study the effectiveness of combining antidepressant drug with high-frequency repeated transcranial magnetic stimulation(rTMS)in treating adolescent depression and explore its impact on electroencephalogram.Methods 60 cases of adolescent depression,who admitted to Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University from September to December 2024 were selected and randomly divided into control group and observation group,with 30 cases in each group.Patients of control group were treated with selective serotonin reuptake inhibitor(SSRI),while patients of observation group received the same SSRI treatment in addition to high-frequency rTMS.The treatment lasted for 2 weeks.Both groups were assessed by using 24-item Hamilton depression rating scale(HAMD-24)and depression self-rating scale for children(DSRSC)before the start of treatment and at the end of two weeks of treatment.Adverse reactions were recorded throughout the treatment,and electroencephalogram monitoring was taken before and after treatment.Results Observation group showed a significantly higher treatment response rate compared to control group(P<0.05).After two weeks of treatment,HAMD-24 and DSRSC scores in observation group were notably lower than those in control group(P<0.01).Both groups exhibited improvements in brain wave power(δ,θ,α,β)after treatment(P<0.05),with observation group demonstrating superior β wave power compared to control group(P<0.01).Additionally,a negative correlation was found between α and β wave power in the left frontal region and DSRSC scores in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Compared with SSRI treatment,rTMS combined with SSRI treatment can more effectively improve depressive symptoms,increase α and β brainwave power,and the combination therapy does not increase the incidence of adverse reactions,demonstrating good safety.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective To analyze the research hotspots and frontier trends in the field of physical therapy for Parkinson's disease(PD)from 2014 to 2023.Methods Relevant literatures published from January,2014 to December,2023 were retrieved from the Web of Science Core Collection.CiteSpace 6.3.R1 was used to conduct bibliometric analysis,generating visual maps of coun-tries,institutions,keyword co-occurrence,burst terms,timelines and clustering,and they were summarized based on both visual results and literature content.Results A total of 400 articles were included.The United States had the highest publication volume,followed by China,Italy and Brazil,and the international collaboration was relatively active.Major contributing institutions included Northwestern University,Rush University,Karolinska Institutet and Universidade de S?o Paulo.Keyword co-oc-currence analysis showed that researches mainly focused on interventions such as exercise,postural control,aero-bic exercise and transcranial direct current stimulation.Burst detection analysis showed that keywords with high attention in recent years included motor symptoms,executive function,resistance training and noninvasive brain stimulation.The timeline map indicated a shift in research themes from early focus on electrical stimulation to in-tegrated interventions involving both motor and cognitive functions.Conclusion Over the past decade,researches on physical therapy for PD has shown steady growth,with increasing diver-sity in intervention strategies.There is a clear trend toward multidimensional integration and interdisciplinary col-laboration.Future studies should strengthen interventions targeting non-motor symptoms and promote the clinical application of new rehabilitation technologies.

Objective To study the effectiveness of combining antidepressant drug with high-frequency repeated transcranial magnetic stimulation(rTMS)in treating adolescent depression and explore its impact on electroencephalogram.Methods 60 cases of adolescent depression,who admitted to Department of Psychiatry,the First Affiliated Hospital of Kunming Medical University from September to December 2024 were selected and randomly divided into control group and observation group,with 30 cases in each group.Patients of control group were treated with selective serotonin reuptake inhibitor(SSRI),while patients of observation group received the same SSRI treatment in addition to high-frequency rTMS.The treatment lasted for 2 weeks.Both groups were assessed by using 24-item Hamilton depression rating scale(HAMD-24)and depression self-rating scale for children(DSRSC)before the start of treatment and at the end of two weeks of treatment.Adverse reactions were recorded throughout the treatment,and electroencephalogram monitoring was taken before and after treatment.Results Observation group showed a significantly higher treatment response rate compared to control group(P<0.05).After two weeks of treatment,HAMD-24 and DSRSC scores in observation group were notably lower than those in control group(P<0.01).Both groups exhibited improvements in brain wave power(δ,θ,α,β)after treatment(P<0.05),with observation group demonstrating superior β wave power compared to control group(P<0.01).Additionally,a negative correlation was found between α and β wave power in the left frontal region and DSRSC scores in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Compared with SSRI treatment,rTMS combined with SSRI treatment can more effectively improve depressive symptoms,increase α and β brainwave power,and the combination therapy does not increase the incidence of adverse reactions,demonstrating good safety.

Objective:To investigate the incidence of mild cognitive impairment(MCI)and malnutrition among centenarians, as well as to explore the relationship between cognitive impairment and nutritional status.Methods:A cross-sectional study was conducted between November and December 2023, involving 121 elderly individuals aged ≥ 100 years in the Baoshan District of Shanghai.The survey collected general information and included the Ascertain Dementia 8-item Questionnaire(AD8), the Mini Nutritional Assessment Short-Form(MNA-SF), and anthropometric nutritional measurements such as waist circumference(WC), hip circumference(HC), arm circumference(AC), calf circumference(CC), and grip strength.The prevalence of MCI and malnutrition among centenarians was calculated, and the correlation between MCI and MNA-SF scores, along with anthropometric nutritional measurement indicators, was analyzed.Results:The age range of centenarians was between 100 and 105 years, with an average age of 101.0±3.5 years.The majority of centenarians were female(76.9%), illiterate(58.7%), and lived with family members(73.6%).All participants had medical insurance(100%).Most had no history of long-term smoking 118(97.5%), long-term alcohol consumption 108(89.3%), long-term use of health supplements 109(90.1%), long-term tea or coffee habits 114(94.2%), chronic medical conditions 84(69.4%), or family history of dementia 102(84.3%).Additionally, 62(51.2%)reported their health status over the past year as general.According to the AD8 screening results, the negative and positive detection rates of MCI in centenarians were 79(65.3%)and 47(34.7%), respectively.Based on the MNA-SF scoring results, the detection rates of normal nutrition, malnutrition risk, and malnutrition among centenarians were 36(29.8%), 61(50.4%), and 24(19.8%), respectively.There was a statistically significant difference in AC between the non-MCI group and the MCI group among centenarians( t=0.01, P=0.03).The AD8 scores of centenarians were significantly negatively correlated with AC, CC, and MNA-SF scores( r=-0.20, r=-0.26, r=-0.29; all P<0.05). Conclusions:The cognitive function of centenarians is associated with their nutritional status, indicating that higher cognitive abilities correlate with better nutritional status.