A 51-year-old male presented with nasal obstruction, followed by progressive hearing loss and blurred vision. Imaging identified space-occupying lesions in the paranasal sinuses, orbits, and paraspinal regions, while laboratory tests confirmed positive anti-proteinase 3 anti-neutrophil cytoplasmic antibody(PR3- ANCA) immunoglobulin G (IgG)and markedly elevated serum IgG4. Despite treatment with corticosteroids, immunosuppressants, and radiotherapy, the patient exhibited steroid dependency with relentless disease progression. Following multidisciplinary consultation, a diagnosis of inflammatory myofibroblastic tumor (IMT) coexisting with ANCA- associated vasculitis (AAV) was favored, though IgG4-related disease remained a critical differential. Ultimately, profound immunosuppression precipitated a severe herpesvirus infection, leading to disseminated intravascular coagulation and multiple organ dysfunction syndrome. This case underscores the rarity and diagnostic complexity of concurrent IMT and AAV, highlights the therapeutic dilemma of balancing primary disease control against fatal opportunistic infections, and emphasizes the critical role of multidisciplinary collaboration in the diagnosis and treatment of complex diseases.

ObjectiveTo assess changes in the incidence， prevalence， and disability-adjusted life-year （DALY） burden of ulcerative colitis （UC） in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023 （GBD 2023）， and to examine demographic drivers and future trends. MethodsUC data for China， the world， and 204 countries and territories were extracted from the GBD 2023 Results Tool. Age-standardized incidence rate （ASIR）， age-standardized prevalence rate （ASPR）， and age-standardized DALY rate （ASDR）， with 95% uncertainty interval （UI）， were obtained. Joinpoint regression was used to estimate average annual percent change （AAPC） and 95% confidence interval （CI）. Spearman rank correlation， inequality and frontier analyses， Das Gupta decomposition， and autoregressive integrated moving average （ARIMA） models were used to assess associations with the sociodemographic index （SDI）， cross-country burden disparities， demographic drivers， and trends from 2024 to 2035， respectively. ResultsIn 2023， the ASIR， ASPR， and ASDR in China were 0.94， 5.95， and 5.94 per 100 000 population， respectively， lower than the corresponding global estimates of 2.87， 28.48， and 13.82 per 100 000 population. From 1990 to 2023， China’s ASIR and ASPR increased， with AAPCs of 2.720% （95% CI： 2.133%-3.309%） and 2.261% （95% CI： 1.617%-2.908%）， whereas the ASDR decreased （AAPC=-3.056%， 95% CI： -3.449% to -2.662%）. Globally， ASIR increased slightly， whereas ASPR and ASDR decreased. In China， the crude incidence， prevalence， and DALY rates peaked at ages 50-54 years， 60-64 years， and ≥95 years， respectively. ASIR and ASPR were positively correlated with SDI （r_s=0.5794 and 0.6177， both P<0.001）， whereas the correlation between ASDR and SDI was not statistically significant （r_s=0.0666， P=0.343）. In China， epidemiological change contributed most to increases in incident and prevalent cases， and changes in age-specific rates contributed most to the decline in DALYs； globally， population growth and population aging contributed most to the increase in DALYs. By 2035， China’s ASIR， ASPR， and ASDR were projected to be 1.23， 6.37， and 2.55 per 100 000 population， respectively. ConclusionsFrom 1990 to 2023， the age-standardized incidence and prevalence rates of UC increased in China， whereas the age-standardized DALY rate decreased， and peaks in absolute burden generally shifted toward middle-aged and older age groups. The projected directions may persist. These findings may provide reference for long-term UC management and health-resource planning.

ObjectiveTo assess changes in the incidence， prevalence， and disability-adjusted life-year （DALY） burden of ulcerative colitis （UC） in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023 （GBD 2023）， and to examine demographic drivers and future trends. MethodsUC data for China， the world， and 204 countries and territories were extracted from the GBD 2023 Results Tool. Age-standardized incidence rate （ASIR）， age-standardized prevalence rate （ASPR）， and age-standardized DALY rate （ASDR）， with 95% uncertainty interval （UI）， were obtained. Joinpoint regression was used to estimate average annual percent change （AAPC） and 95% confidence interval （CI）. Spearman rank correlation， inequality and frontier analyses， Das Gupta decomposition， and autoregressive integrated moving average （ARIMA） models were used to assess associations with the sociodemographic index （SDI）， cross-country burden disparities， demographic drivers， and trends from 2024 to 2035， respectively. ResultsIn 2023， the ASIR， ASPR， and ASDR in China were 0.94， 5.95， and 5.94 per 100 000 population， respectively， lower than the corresponding global estimates of 2.87， 28.48， and 13.82 per 100 000 population. From 1990 to 2023， China’s ASIR and ASPR increased， with AAPCs of 2.720% （95% CI： 2.133%-3.309%） and 2.261% （95% CI： 1.617%-2.908%）， whereas the ASDR decreased （AAPC=-3.056%， 95% CI： -3.449% to -2.662%）. Globally， ASIR increased slightly， whereas ASPR and ASDR decreased. In China， the crude incidence， prevalence， and DALY rates peaked at ages 50-54 years， 60-64 years， and ≥95 years， respectively. ASIR and ASPR were positively correlated with SDI （r_s=0.5794 and 0.6177， both P<0.001）， whereas the correlation between ASDR and SDI was not statistically significant （r_s=0.0666， P=0.343）. In China， epidemiological change contributed most to increases in incident and prevalent cases， and changes in age-specific rates contributed most to the decline in DALYs； globally， population growth and population aging contributed most to the increase in DALYs. By 2035， China’s ASIR， ASPR， and ASDR were projected to be 1.23， 6.37， and 2.55 per 100 000 population， respectively. ConclusionsFrom 1990 to 2023， the age-standardized incidence and prevalence rates of UC increased in China， whereas the age-standardized DALY rate decreased， and peaks in absolute burden generally shifted toward middle-aged and older age groups. The projected directions may persist. These findings may provide reference for long-term UC management and health-resource planning.

Alzheimer disease(AD)is a neurological disease characterized by cognitive decline.AD continuum refers to the dynamic development progression from early pathological changes to obvious clinical symptoms,covering the continuous spectrum of subjective cognition decline(SCD)stage,mild cognitive impairment(MCI)stage and dementia stage.As one of the key brain regions involved in early stage,hippocampus(HP)in AD continuum is closely related to the progression of disease.MRI has been widely used in the study of HP in the AD continuum.The progresses in structural and functional MRI research of HP changes in AD continuum were reviewed in this article.

Alzheimer's disease(AD),a neurodegenerative disorder,manifests pathological changes in the brain even during the asymptomatic stage.As the pathological burden intensifies,patients experience functional decline in multiple cognitive domains,including memory,language,spatial perception,executive function,and calculation,and may also exhibit emotional abnormalities.Once AD progresses,treatment becomes extremely chal-lenging.Therefore,early diagnosis and accurate prediction of disease conversion are core tasks in the prevention and treatment of AD,and they are also urgent scientific research challenges to be overcome.Deep learning(DL)models demonstrate considerable advantages in the diagnosis,prediction,classification,and feature extraction of AD,offering new hope for solving this challenging problem.This research commences with a concise introduction to the outcomes of AD and the fundamental knowledge of deep learning.Subsequently,it offers an overview of the imaging studies on the utilization of deep learning for predicting disease transformation from two perspectives.Firstly,it systematically summarizes the existing DL models that have demonstrated innovation in the classification and prediction performance of AD.Secondly,it provides a comprehensive outline of the DL fusion models applied to the diagnosis,classification,and prediction of AD.Finally,this paper expounds upon the impending challenges in the research of this domain.This article demonstrates that deep learning models is cutting-edge trends in the ex-ploration of AD research.

Alzheimer disease(AD)is a neurological disease characterized by cognitive decline.AD continuum refers to the dynamic development progression from early pathological changes to obvious clinical symptoms,covering the continuous spectrum of subjective cognition decline(SCD)stage,mild cognitive impairment(MCI)stage and dementia stage.As one of the key brain regions involved in early stage,hippocampus(HP)in AD continuum is closely related to the progression of disease.MRI has been widely used in the study of HP in the AD continuum.The progresses in structural and functional MRI research of HP changes in AD continuum were reviewed in this article.

Objective:To integrate and analyze the trend of the disease burden of tracheal,bronchus,and lung cancer(TBL)attributable to secondhand smoke in China from 1990 to 2021 and to analyze future projections,aiming to provide data support for the prevention and treatment of TBL in China.Methods:Based on the global burden of disease(GBD)2021 database,TBL with ICD-10 disease classification C33,C34-C34.92 was studied.Using secondhand smoke as a risk factor,the data on TBL mortality and disability-adjusted life year(DALY)due to secondhand smoke in China from 1990 to 2021 were further age-standardized.Using Joinpoint 4.7.1 regression analysis model to calculate annual percentage change(APC)and average annual percentage change(AAPC),Hiplot software was used to plot disease burden data for different ages and genders,and R 4.3.1 software was used to construct a grey model GM(1,1)to predict the predicted value and trend of TBL disease burden attributed to secondhand smoke in China from 2022 to 2031.Results:From 1990 to 2021,the TBL mortality rate,age-standardized mortality rate,and DALY rate attributed to secondhand smoke in China increased from 1.76/100 000,2.63/100 000,and 49.43/100 000 to 4.08/100 000,2.80/100 000,and 95.57/100 000,respectively;the growth was 131.18%,6.45%,and 93.34%;the age-standardized DALY rate decreased from 65.04/100 000 to 63.32/100 000 with the reduction of 2.65%.The results of the Joinpoint regres-sion showed that the AAPC(95%CI)of mortality,age-standardized mortality rate,and DALY rate for TBL were 2.75(2.58-2.93)%,0.16(0.11-0.21)%,and 2.15(2.11-2.18)%,respectively,with an overall increasing trend;the AAPC(95%CI)of age-standardized DALY rate was-0.14(-0.40-0.12)%,with an overall fluctuating and unchanged trend and it was higher in males than in females.In both 1990 and 2021,the TBL mortality rate attributable to secondhand smoke in China gradually increased with age,and the DALY rate first increased and then slowed down with age.The main groups of the burden of disease were the elderly and males.The grey prediction model GM(1,1)showed that the age-standardized mortality rate of TBL attributable to secondhand smoke from 2022 to 2031 showed a slow increasing trend,and the predicted value in 2031 would increase to 2.95/100 000.The age-standardized DALY showed a slow decreasing trend,and the predicted value in 2031 would decrease to 63.83/100 000.Conclusions:From 1990 to 2021,the TBL mortality,age-standardized mortality,and DALY rates attributable to secondhand smoke in China increased,and the age-standardized DALY rate decreased.Men and the elderly are the main groups affected by TBL.Appropriate measures should be formulated to reduce exposure to and contact with secondhand smoke,tak-ing into account gender and age differences.Additionally,efforts should be made to strengthen secondhand smoke prevention and public health education.

Objective To review the research of safe injection protocols for peripheral norepinephrine(pNE),to make clear the main contents of safe injection protocols and the compliance of clinical implementation protocols,and to provide reference for clinical nurses to use drugs safely.Methods Systematic searches were conducted in the PubMed database,the Embase database from the Netherlands,the Web of Science,the Cochrane library,CNKI,Wanfang database,VIP,and the China biomedical literature database for studies related to safe injection protocols for pNE.The search period extended from the establishment of the databases to April 30,2024.Two researchers conducted data extraction and summary analysis of the included literature.Results A total of 10 articles were incorporated,including 2 guidelines,4 observational retrospective cohort studies,2 observational prospective cohort studies,2 ambispective cohort study.All documents provide a complete safe injection scheme of pNE,and its main contents were as follows:the drug concentration should be diluted to 8～64 mg/L;the injection dose should be small,and the maximum dose should not exceed 0.5 μg·kg-1·min-1 or 25 μg/min;a short infusion time was appropriate,among which 4 schemes require≤24 hours;intravenous catheters should be large-bore models,mainly 16,18 and 20 G;selection of infusion sites with favorable venous conditions of upper limb should be selected for injection;during infusion,regular and effective monitoring was required,and the frequency of monitoring should be once an hour,not exceeding a maximum of 2 hours;observation of the puncture site,and must assess whether there was blood return to the venous pathway,develop an emergency plan for drug extravasation.Several studies provided the compliance analysis of the protocol.The items with the highest compliance were using the drug concentration specified in the protocol,with the highest implementation rate of 100.0%.The items with low compliance were:using ultrasonic catheterization or evaluation,with minimum 26.6%;monitor according to the specified time frequency,with a minimum of 36.0%;selection of infusion sites,with a minimum of 65.0%.Conclusion The pNE is safe and feasible in emergency situations,but it comes with numerous risks and limitations.Norepinephrine(NE)should be administered at low concentrations and small doses,using large-caliber venous indwelling needles,and choosing optimal injection sites.Ultrasound assessment and localization can be used if conditions permit.Short-term infusion is preferred,and effective monitoring should be conducted at regular intervals during the infusion.Emergency plans for drug extravasation should be established.Developing safe injection protocols can reduce the incidence of adverse events such as extravasation.

OBJECTIVE To investigate the efficacy and safety of ropivacaine combined with oxycodone for the analgesia of iliac fascia nerve block in patients undergoing hip replacement.METHODS Sixty-six patients who underwent hip replacement at the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from October 2023 to April 2024 were selected and randomly divided into observation group and control group,with 33 cases in each group.Before induction of anesthesia,ultrasound-guided iliac fascial nerve block was performed.Patients in the observation group were treated with 0.33%ropivacaine+0.1 mg/kg oxycodone injection mixture 30 mL,and patients in the control group were treated with 0.33%ropivacaine injection 30 mL.The time of first postoperative rescue analgesia,24 h postoperative analgesic drug consumption,sensory block and motor block effective and maintenance time,satisfaction degree,numerical rating scale(NRS)pain score,Ramsay sedation score,muscle strength score,heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO2),sleep score,anxiety score,and the occurrence of adverse reactions in the two groups were all recorded.RESULTS Compared with the control group,the first rescue analgesia time after operation was significantly prolonged in the observation group,and 24 h postoperative analgesic drug consumption after operation decreased;the effective time of sensory block was significantly shortened,and the maintenance time of sensory block was significantly prolonged,and the satisfaction score was higher;the NRS pain score after iliac fascia nerve block was lower,HR and MAP were lower,and the anxiety score and sleep score 24 and 48 h after operation were lower(P＜0.05).In terms of safety,patients in both groups had adverse reactions after operation,such as hypertension,nausea,vomiting,and dizziness,but there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).CONCLUSIONS Oxycodone combined with ropivacaine shows good efficacy and safety for iliac fascial nerve block analgesia in patients undergoing hip replacement,can significantly prolong the analgesic time of ropivacaine,reduce postoperative analgesic drug consumption,improve the sleep quality of patients,and promote the rapid recovery of patients.

This document targets digital human metabolic chamber platforms and specifies construction standards and testing protocols covering the full lifecycle of " build-test-operate." It encompasses chamber engineering and environmental control, digital platform and cybersecurity architecture, metabolic measurement and multimodal data acquisition, as well as quantitative system performance and data quality indicators with verifiable acceptance tests. By standardizing architecture, interfaces, and quality control, the specification enables multicenter data interoperability and harmonized quality management, providing high-quality, verifiable, and traceable infrastructure to support precision metabolism research and clinical translation in China.