Objective To investigate the value of ¹⁸F-FDG PET/CT metabolic parameters in the prognostic assessment of nasopharyngeal cancer patients. Methods The clinical data and PET/CT metabolic parameters of 185 nasopharyngeal cancer patients were retrospectively analyzed. The collected parameters were SUV_max, MTV, TLG, total metabolic tumor volume (TMTV) and whole-body total lesion glycolysis (WTLG). The ROC curve was used to determine the optimal cut-off values of PET/CT metabolic parameters. Univariate and multivariate Cox regression models were used to screen the independent prognostic factors. Kaplan–Meier curves were used to analyze the survival differences. Results The results of univariate Cox regression analysis showed that age, pathologic type, WTLG, TMTV, MTV, and TLG were closely associated with OS and PFS; and SUV_max was associated with PFS (P<0.05). Multivariate Cox regression analysis results showed that age, TMTV, and WTLG were the independent prognostic factors for OS and PFS (P<0.05). The combination of WTLG with T/N staging (AUC=0.781 and 0.781) and TMTV with T/N staging (AUC=0.800 and 0.790) yielded greater predictive accuracy than that of WTLG and TMTV alone (AUC=0.724 and 0.719) or T/N staging (AUC=0.593 and 0.575). Conclusion TMTV and WTLG are important prognostic predictors of nasopharyngeal carcinoma. TLG and MTV of primary lesions are prognostic factors for patients’ PFS and OS. SUV_max has limited prognostic value. Systemic metabolic indexes (TMTV and WTLG), when combined with T/N staging, can optimize prognostic stratification.

The construction of experimental animal models plays an important supporting role in research into the mechanisms of action of Chinese medicines.There have been increasing reports of the construction and evaluation of animal models of spleen deficiency;however,the construction method have involved different standards and there has been insufficient objectification of the evaluation indexes.In this review,we summarize the construction and evaluation method of animal models of spleen deficiency from the aspects of animal selection,model establishment,macroscopic characterization,behavioral experiments,and objective indexes of spleen deficiency,with a view to providing theoretical guidance for the construction of experimental animal models of spleen deficiency and references for the selection of animal model platforms for spleen deficiency.

Klebsiella pneumoniae(K.pneumoniae)is important zoonotic pathogen causing multiple local and systemic infections.At present,the drug resistance of K.pneumoniae is serious,and mul-tiple drug-resistant strains continue to emerge.Even the incidence of drug-resistant K.pneumoniae infection is increasing year by year.In this study,K.pneumoniae clinical isolate 71Y was used as the starting strain,and a phage with strong lytic activity was successfully obtained from sewage samples.The phage was named vB_KpnP_71Y(abbreviated as P71Y),the general biological char-acteristics and genome of P71Y were further studied and analyzed.P71Y can form clear plaque with a diameter of 2-5 mm and a translucent halo ring on the host bacterium 71Y lawn.Electron micros-copy observation shows that P71Y is a member of the order Autographiviridae and family Caudovi-rales.The incubation period for P71Y infected with K.pneumoniae is about 3 minutes,and one in-fection cycle lasts for about 50 minutes.Each infection of a bacterium can produce approximately 58 progeny phage virus particles.Cleavage spectra showed that the phage could lysate K20 and K57 serotypes of K.pneumoniae.The phage had good stability at 4-50 ℃ and pH values of 3-12.Genom-ic analysis revealed that P71Y contained a double-stranded DNA with a total length of 39 700 bp and a G+C content of 53％.There are a total of 53 coding genes,P71Y does not carry virulence factors and drug resistance genes,which has shown genetic safety.This study isolated a novel lytic phage that can cleave multiple serotypes of K.pneumoniae,which provided experimental materials for the study of the interaction between bacteriophages,different serotypes of K.pneumoniae,and the application of phage for the prevention and controlling of infections caused by multi-drug-re-sistant K.pneumoniae.

Objective:To analyze the clinical and imaging features of patients with COVID-19-related osmotic demyelination syndrome (ODS).Methods:COVID-19-related ODS cases diagnosed in the Department of Neurology, Peking Union Medical College Hospital from January 2020 to September 2023 were retrospectively reviewed. And their past medical history, possible triggers, clinical manifestations, imaging manifestations, treatment and prognosis were summarized.Results:A total of 5 patients with COVID-19-related ODS were included. Electrolyte disturbances acted as an inducement of ODS in all patients (5/5),4 of whom with hyponatremia. Four of 5 patients first presented with disturbance of consciousness, followed by predominant dystonia. Imaging of all patients (5/5) showed isolated extrapontine myelinolysis (EPM). With the prolongation of the course of disease, such signal intensity could return to normal, and lesions showed atrophic changes in some patients. The patients′ clinical symptoms were partly relieved within a few days to a few months after treatment.Conclusions:COVID-19-related ODS is mostly associated with hyponatremia, and EPM is more common. COVID-19 should be considered as a risk factor for ODS.

Interactions between brain-resident and peripheral infiltrated immune cells are thought to contribute to neuroplasticity after cerebral ischemia. However, conventional bulk sequencing makes it challenging to depict this complex immune network. Using single-cell RNA sequencing, we mapped compositional and transcriptional features of peri-infarct immune cells. Microglia were the predominant cell type in the peri-infarct region, displaying a more diverse activation pattern than the typical pro- and anti-inflammatory state, with axon tract-associated microglia (ATMs) being associated with neuronal regeneration. Trajectory inference suggested that infiltrated monocyte-derived macrophages (MDMs) exhibited a gradual fate trajectory transition to activated MDMs. Inter-cellular crosstalk between MDMs and microglia orchestrated anti-inflammatory and repair-promoting microglia phenotypes and promoted post-stroke neurogenesis, with SOX2 and related Akt/CREB signaling as the underlying mechanisms. This description of the brain's immune landscape and its relationship with neurogenesis provides new insight into promoting neural repair by regulating neuroinflammatory responses.
Humans ; Ischemic Stroke ; Brain/metabolism* ; Macrophages ; Brain Ischemia/metabolism* ; Microglia/metabolism* ; Gene Expression Profiling ; Anti-Inflammatory Agents ; Neuronal Plasticity/physiology* ; Infarction/metabolism*

Hepatitis C is one of the main causes of liver cancer.With the application of direct-acting antiviral agents,more than 95%of patients can achieve the eradication of hepatitis C virus and obtain sustained virologic response(SVR).Effective antiviral therapy can change the natural course of hepatitis C and reduce the risk of liver cancer;however,some patients are still affected by age,sex,liver fibrosis,diabetes,hepatic steatosis,alcohol consumption,and genetic factors and become the high-risk population of liver cancer.Therefore,it is needed to further clarify and improve the identification and prediction of high-risk populations of liver cancer after SVR of hepatitis C.This article reviews the risk factors and predictive models for liver cancer after SVR in patients with hepatitis C,in order to provide a basis for identifying the high-risk population of liver cancer after SVR of hepatitis C in clinical practice.

Objective:To establish a method for the determination of triclocarban (TCC) and triclosan (TCS) in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) after purification by QuEChERS.Methods:In May 2022, urine samples were extracted by acetonitrile, purified by QuEChERS, separated by Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm), and eluated with water-acetonitrile as mobile phase gradient at a flow rate of 0.3 ml/min. The detection was conducted in negative ion mode (ESI -) and multiple reaction monitoring (MRM) scanning, it was quantified with a internal standard method, and the methodology was verified. Results:The linear ranges of TCC and TCS were 0.5-100.0 μg/L and 1.0-100.0 μg/L, and the correlation coefficients were 0.9997 and 0.9991, respectively. The limits of detection and quantitation of TCC and TCS were 0.17 and 0.33 μg/L, and 0.5 and 1.0 μg/L, respectively. The recoveries of TCC and TCS were 100.1%-102.8% and 96.7%-108.6%, and the relative standard deviations were 4.9%-6.7% and 4.1%-8.3%, respectively, at 2.0, 10.0 and 80.0 μg/L.Conclusion:QuEChERS-UPLC-MS/MS method is simple, rapid, sensitive and reproducible, and can be used for rapid and accurate simultaneous detection of TCC and TCS exposure levels in occupational population.

Objective·To evaluate the relationship between anxiety level,alexithymia degree and quality of life in patients with anxiety disorders.Methods·Anxiety disorder patients admitted to the outpatient department of Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine from October 1,2020 to March 31,2023 were selected as the research subjects,and 438 patients were ultimately included after exclusion.Among them,there were 271 patients with generalized anxiety disorder,101 patients with panic disorder,48 patients with social anxiety disorder,12 patients with agoraphobia,and 6 patients with specific phobia.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale-17(HAMD-17),the twenty-item Toronto Alexithymia Scale(TAS-20)and World Health Organization Quality of Life Scale-Brief Form Questionnaire(WHOQOL-BREF)were used to assess the patients'anxiety level,depression level,alexithymia degree and quality of life,respectively,and the scale scores of patients with different subtypes of anxiety disorders were evaluated.Spearman correlation coefficient was used to analyze the correlation between anxiety level,depression level,alexithymia degree and quality of life in patients with anxiety disorders.Stepwise regression model was used to analyze the key variables affecting the quality of life in patients with anxiety disorders.Results·There were no significant differences in HAMA score,HAMD-17 score and TAS-20 score among patients with different subtypes of anxiety disorders,but the differences in WHOQOL-BRIEF score were statistically significant(H=10.076,P=0.039).The results of Spearman correlation analysis showed that the WHOQOL-BRIEF score of anxiety disorder patients was negatively correlated with HAMA score,HAMD-17 score and TAS-20 score(r=-0.256,P=0.000;r=-0.311,P=0.000;r=-0.342,P=0.000).The results of stepwise regression analysis showed that age,HAMA score,HAMD-17 score and TAS-20 score had significant impact on the quality of life of patients(all P<0.05).Conclusion·The quality of life in patients with different subtypes of anxiety disorders is different.The anxiety level,depression level and alexithymia degree are the key variables affecting their quality of life.

Objective:To establish a method for the determination of triclocarban (TCC) and triclosan (TCS) in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) after purification by QuEChERS.Methods:In May 2022, urine samples were extracted by acetonitrile, purified by QuEChERS, separated by Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm), and eluated with water-acetonitrile as mobile phase gradient at a flow rate of 0.3 ml/min. The detection was conducted in negative ion mode (ESI -) and multiple reaction monitoring (MRM) scanning, it was quantified with a internal standard method, and the methodology was verified. Results:The linear ranges of TCC and TCS were 0.5-100.0 μg/L and 1.0-100.0 μg/L, and the correlation coefficients were 0.9997 and 0.9991, respectively. The limits of detection and quantitation of TCC and TCS were 0.17 and 0.33 μg/L, and 0.5 and 1.0 μg/L, respectively. The recoveries of TCC and TCS were 100.1%-102.8% and 96.7%-108.6%, and the relative standard deviations were 4.9%-6.7% and 4.1%-8.3%, respectively, at 2.0, 10.0 and 80.0 μg/L.Conclusion:QuEChERS-UPLC-MS/MS method is simple, rapid, sensitive and reproducible, and can be used for rapid and accurate simultaneous detection of TCC and TCS exposure levels in occupational population.

Objective:To investigate the status of disaster preparedness of pediatric nurses and its influencing factors, as well as the impact path of psychological capital and perceived organizational support on disaster preparedness.Methods:This was a cross-sectional study. A total of 361 pediatric nurses from Henan Provincial People ′s Hospital, the Third Affiliated Hospital of Zhengzhou University, Fuwai Central China Cardiovascular Hospital were sampled from August to October 2021. They were investigated by the general information questionnaire, psychological capital questionnaire, perceived organizational support questionnaire and disaster preparedness questionnaire. SPSS25.0 was used to analyze the questionnaire and scale data, and AMOS23.0 was used to construct a structural equation model about the disaster preparedness of pediatric nurses. Results:The scores of disaster preparedness from pediatric nurses was 4.65 ± 0.92. The level of disaster preparedness was significantly positively correlated with psychological capital and perceived organizational support ( r=0.690, 0.525, both P<0.05). Disaster training and emergency drill 2 dimensions of psychological capital questionnaire (hope, resilience), perceived organizational support were independent contributing factors ( P<0.05). Psychological capital had direct effect on disaster preparedness. And the direct effect was 0.77, the indirect effect was 0.11, the total effect was 0.88, and the direct effect of perceived organizational support on disaster preparedness was 0.21. Conclusions:The score of disaster preparedness of pediatric nurses was in the middle level. Hospital managers should strengthen the training of pediatric nurses in disaster knowledge, operational and simulation exercise, pay attention to the level of nurses' psychological capital and perceived organizational support, so as to provide reference for the follow-up clinical pediatric disaster nursing education and management.