Objective To compare the clinical efficacy of neuroendoscope-assisted evacuation and navigation-assisted puncture drainage in treating thalamic hemorrhage breaking into the ventricle. Methods A retrospective analysis was conducted on the clinical data of 93 patients with thalamic hemorrhage breaking into the ventricle at Taihe Hospital of Wannan Medical College between January 2022 and February 2024. The patients received neuroendoscope-assisted removal of thalamic hematoma combined with contralateral extraventricular drainage (n＝44, neuroendoscope group) and navigation-assisted thalamic hematoma puncture drainage combined with contralateral extraventricular drainage (n＝49, navigation group), respectively. The treatment efficacy, surgical situation, and prognosis between the two groups were compared. Results The neuroendoscope group had longer operation duration, more intraoperative blood loss, higher hospitalization costs than the navigation group (P＜0.05). The neuroendoscope group had higher hematoma clearance rate 3rd after surgery and shorter length of stay than the navigation group (P＜0.05). There was no significant difference in the incidence of intracranial infection after surgery between the two groups. The neuroendoscope group had higher Glasgow coma scale (GCS) score at 1 week after surgery and Glasgow outcome scale (GOS) score at 3 months after surgery (P＜0.01). Conclusions Compared with navigation-assisted puncture, neuroendoscope-assisted evacuation can improve the thalamic hemorrhage clearance rate, shorten the length of stay, and improve the prognosis of patients.

ObjectiveTo explore the effects of different embolic materials for preoperative transarterial embolization （TAE） on surgical resections of sizeable （＞3 cm） Shamblin Ⅱ/Ⅲ carotid body tumors （CBTs） MethodsThis study retrospectively analyzed the data of patients with Shamblin type Ⅱ/Ⅲ carotid body tumors >3 cm in size who underwent TAE at our hospital between January 2010 and August 2025. Based on the adopted embolic agents， the patients were divided into two groups： temporary embolization group （TEG） and permanent embolization group （PEG）. General clinical data， periprocedural details， and postoperative outcomes were collected and compared between the two groups. ResultsA total of 50 patients with 50 lesions were included （n=25 in the TEG and n=25 in PEG group）. Tumor sizes were comparable between the two groups ［（41.22 vs. 42.13） mm， P=0.989］. For the TEG compared with PEG， intraoperative blood loss was （388.19 vs. 155.90） mL （P＜0.001） and operative time was （254.01 vs. 162.22） mins （P=0.007）. The intraoperative vascular reconstruction rate was 16% vs. 12% （P=0.684）， and the complication rate was 36% vs. 12% （P=0.047） in the TEG and PEG. ConclusionsOur results indicate that the use of permanent embolic agents during TAE is optimal. These agents are superior to temporary embolic agents in terms of intraoperative blood loss， operative time， and improved surgical field visualization， which thereby facilitate the surgical resection of Shamblin type Ⅱ/Ⅲ CBTs while reducing postoperative complications.

ObjectiveTo explore the effects of different embolic materials for preoperative transarterial embolization （TAE） on surgical resections of sizeable （＞3 cm） Shamblin Ⅱ/Ⅲ carotid body tumors （CBTs） MethodsThis study retrospectively analyzed the data of patients with Shamblin type Ⅱ/Ⅲ carotid body tumors >3 cm in size who underwent TAE at our hospital between January 2010 and August 2025. Based on the adopted embolic agents， the patients were divided into two groups： temporary embolization group （TEG） and permanent embolization group （PEG）. General clinical data， periprocedural details， and postoperative outcomes were collected and compared between the two groups. ResultsA total of 50 patients with 50 lesions were included （n=25 in the TEG and n=25 in PEG group）. Tumor sizes were comparable between the two groups ［（41.22 vs. 42.13） mm， P=0.989］. For the TEG compared with PEG， intraoperative blood loss was （388.19 vs. 155.90） mL （P＜0.001） and operative time was （254.01 vs. 162.22） mins （P=0.007）. The intraoperative vascular reconstruction rate was 16% vs. 12% （P=0.684）， and the complication rate was 36% vs. 12% （P=0.047） in the TEG and PEG. ConclusionsOur results indicate that the use of permanent embolic agents during TAE is optimal. These agents are superior to temporary embolic agents in terms of intraoperative blood loss， operative time， and improved surgical field visualization， which thereby facilitate the surgical resection of Shamblin type Ⅱ/Ⅲ CBTs while reducing postoperative complications.

Objective To assess the accuracy and consistency of point-of-care testing(POCT)technology in detecting D-dimer(DDI),Procalcitonin(PCT),and N-terminal pro B-type natriuretic peptide(NT-proBNP)in whole blood samples,as well as to validate its feasibility for rapid clinical diagnosis.Methods From July 8 to August 22,2022,a total of 104 paired DDI whole blood and plasma samples,496 paired PCT whole blood and serum samples,and 77 paired NT-proBNP whole blood and serum samples were collected.The consistency and accuracy of test results between whole blood and plasma/serum samples were assessed using the Mann-Whitney U test,regression analysis,relative sensitivity,relative specificity,Youden's index,and Kappa value.Results The test results of DDI,PCT,and NT-proBNP in whole blood and plasma/serum samples demonstrated excellent consistency,with correlation coefficients of r2=0.951 2,r2=0.942 8,and r2=0.991 6,respectively,and all P-values exceeding 0.05.At the medical decision levels,for DDI(0.55 μg/mL),the relative sensitivity,rela-tive specificity,Youden index,and Kappa value were 94.3%,94.1%,0.88,and 0.87,respectively.For PCT(0.5 ng/mL and 2.0 ng/mL),the relative sensitivities were 97.4%and 89.0%,the relative specificities were 95.8%and 98.3%,the Youden indices were 0.93 and 0.87,and the Kappa values were 0.93 and 0.89,respectively.For NT-proBNP(125 pg/mL),the relative sensitivity was 94.1%,the relative specificity was 100%,the Youden index was 0.94,and the Kappa value was 0.87.These findings confirm the high accuracy of whole blood sample testing and the strong concordance between the two methods.Conclusions This study confirmed the efficacy of POCT technology for detecting DDI,PCT,and NT-proBNP in whole blood samples.The results showed a high level of consistency compared to traditional plasma/serum methods,thereby reinforcing the clinical applicability of POCT for rapid diagnosis.

Cancer represents a significant disease that profoundly impacts human health and longevity. Projections indicate a 47% increase in the global cancer burden by 2040 compared to 2020, accompanied by a further rise in the associated economic burden. Consequently, there is an urgent need to discover and develop new alternative drugs to mitigate the global impact of cancer. Natural products (NPs) play a crucial role in the identification and development of anticancer therapeutics. This study identified ustusolate E (UE) and its analog 11α-hydroxy-ustusolate E (HUE) from strain Aspergilluscalidoustus TJ403-EL05, and examined their antitumor activities and mechanisms of action. The findings demonstrate that both compounds significantly inhibited the proliferation and colony formation of AGS (human gastric cancer cells) and 786-O (human renal clear cell carcinoma cells), induced irreversible DNA damage, blocked the cell cycle at the G₂/M phase, and further induced apoptosis in tumor cells. To the best of the authors' knowledge, this is the first report on the anticancer effects of UE and HUE and their underlying mechanisms. The present study suggests that HUE and UE could serve as lead compounds for the development of novel anticancer drugs.
Humans ; Apoptosis/drug effects* ; TOR Serine-Threonine Kinases/genetics* ; Proto-Oncogene Proteins c-akt/genetics* ; Cell Line, Tumor ; Phosphatidylinositol 3-Kinases/genetics* ; Signal Transduction/drug effects* ; Tumor Suppressor Protein p53/genetics* ; Cell Proliferation/drug effects* ; Antineoplastic Agents/pharmacology* ; Sesquiterpenes/pharmacology* ; Aspergillus/chemistry*

A chemical investigation of secondary metabolites (SMs) from Aspergillus nidulans resulted in the identification of five novel dioxopiperazine (DKP)-diphenyl ether hybrids, designated as diphenylemestrins A-E (1-5). These compounds 1-5 represent the first known dimers combining DKP and diphenyl ether structures, with compound 4 featuring an uncommon dibenzofuran as the diphenyl ether component. The structural elucidation and determination of absolute stereochemistry were accomplished through spectroscopic analysis and electronic circular dichroism (ECD) calculations. Notably, diphenylemestrin C (3) exhibited moderate cytostatic activity against NB4 cells, with a half maximal inhibitory concentration (IC₅₀) value of 21.99 μmol·L^-1, and induced apoptosis at higher concentrations.
Aspergillus nidulans/metabolism* ; Diketopiperazines/pharmacology* ; Molecular Structure ; Phenyl Ethers/pharmacology* ; Humans ; Apoptosis/drug effects* ; Cell Line, Tumor

Objective:To identify and validate secreted effector proteins of Chlamydia psittaci ( C. psittaci) through bioinformatic prediction and experimental verification, and to characterize their subcellular localization in host cells. Methods:Potential effector proteins were predicted using bioinformatics tools. Candidate effectors were fused to β-lactamase through the constructed expression vectors, and these vectors were transformed into C. psittaci. The secretion of these candidate effectors was evaluated by β-lactamase translocation assays. Eukaryotic expression vectors of confirmed effectors were transfected into host cells to determine their intracellular localization patterns. Results:Bioinformatic analysis identified 29 candidate effector proteins. Experimental validation confirmed the secretion of five effectors, with four exhibiting cytoplasmic localization and one displaying nuclear localization in host cells.Conclusion:This study characterizes five novel C. psittaci secreted effector proteins, providing critical insights for investigating the molecular pathogenesis of psittacosis.

Objective:To analyze the incidence and perinatal factors of death or severe intraventricular hemorrhage (sIVH) within the first week of life in preterm infants with gestational age <32 weeks.Methods:Based on the online data platform of Sina-northern Neonatal Network, a case-control study was conducted using clinical data from 8 903 preterm infants with gestational age <32 weeks admitted to 35 neonatal intensive care unit (NICU) between 2019 and 2023. Infants were classified by gestational age at birth into very preterm infants and extremely preterm infants. Infants who died or developed sIVH within the first week of life were defined as the case group, while those who survived and did not develop sIVH were defined as the control group. The general information of the infants, maternal perinatal factors, the 5 th minute Apgar score, incidence of hypothermia or early-onset sepsis, and the first arterial blood pH value were compared between the case and control groups of very preterm infants and extremely preterm infants. The χ2 test and Wilcoxon rank-sum test were used for intergroup comparisons. A multivariable logistic regression model was used to analyze the factors for death or sIVH within the first week of life in very preterm and extremely preterm infants. Results:Among the 8 903 preterm infants with gestational age <32 weeks, 4 993 (56.1%) were male, with a gestational age at birth of 30.0 (28.4, 31.0) weeks. A total of 865 cases (9.7%) were death or sIVH within the first week of life. The case group took up 5.8% (426/7 316) and 27.7% (439/1 587) of very preterm infants and extremely preterm infants, respectively. Compared to the control group, the case group of very preterm and extremely preterm infants both had higher incidences of low gestational age, low birth weight, small for gestational age, the 5 th minute Apgar score ≤7, early-onset sepsis, hypothermia at admission, and first arterial blood pH <7.20 (all P<0.001). The proportion of mother′s full course antenatal corticosteroids use were both lower in both case group (both P<0.001). Multivariate Logistic regression analysis revealed several risk factors for death or sIVH within the first week of life in very preterm and extremely preterm infants, including: low gestational age ( OR=0.70 and 0.74, 95% CI 0.60-0.82 and 0.66-0.83, both P<0.001), low birth weight ( OR=0.99 and 0.99, 95% CI 0.99-1.00 and 0.99-1.00, both P<0.05), early-onset sepsis ( OR=1.82 and 2.20, 95% CI 1.42-2.34 and 1.74-2.79, both P<0.001), the 5 th minute Apgar score ≤7 ( OR=1.41 and 2.69, 95% CI 1.10-1.81 and 2.17-3.34, both P<0.01), hypothermia at admission ( OR=1.55 and 1.38,95% CI 1.17-2.07 and 1.08-1.76,both P<0.05) and the first arterial blood pH <7.20 ( OR=2.20 and 2.57, 95% CI 1.70-2.84 and 2.05-3.21, both P<0.001). Multiple births were an independent risk factor only for extremely preterm infants ( OR=1.32, 95% CI 1.02-1.71, P<0.05). Prenatal administration of a full course of antenatal corticosteroids was identified as a protective factor in very preterm and extremely preterm infants ( OR=0.74 and 0.62, 95% CI 0.58-0.95 and 0.51-0.76, both P<0.05). Conclusions:The incidence of death or sIVH within the first week of life remains high in preterm infants with gestational age <32 weeks. The smaller gestational age and lower birth weight, early-onset sepsis, birth asphyxia, hypothermia at admission, and a first arterial blood pH <7.20 were independent risk factors for death or sIVH within the first week of life in preterm infants with gestational age <32 weeks. A full course of antenatal corticosteroids significantly reduced the risk of these adverse outcomes.

Objective:To determine the incidence of acute focal bacterial nephritis (AFBN) in children with febrile urinary tract infections (UTI) and to identify associated risk factors.Methods:A retrospective cohort study included 181 children hospitalized with febrile UTI at Fujian Children′s Hospital from April 2021 to September 2023. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into AFBN group and non-AFBN group based on AFBN diagnosis. The incidence of AFBN within this febrile UTI cohort was determined. The diagnostic value for pre-antibiotic blood white blood cell (WBC) count and C-reactive protein (CRP) level, along with post-treatment fever duration and pyuria duration for AFBN was evaluated using the area under curve (AUC) of the receiver operating characteristic (ROC).Results:The cohort comprised 181 children with febrile UTI (100 boys and 81 girls), age of 0.6 (0.3, 1.0) years. Eleven patients (6.1%) were diagnosed with AFBN. For predicting AFBN, the AUC was 0.71 (95% CI 0.55-0.85, P=0.026) for pre-antibiotic WBC count and 0.80 (95% CI 0.71-0.90, P=0.001) for pre-antibiotic CRP level, with optimal cutoff values of 16.0×10 9/L and 80.1 mg/L, respectively. For post-treatment parameters, the AUC was 0.79 (95% CI 0.69-0.92, P=0.001) for fever duration and 0.84 (95% CI 0.72-0.97, P<0.001) for pyuria duration, with optimal cutoff values of 1.9 d and 5.5 d, respectively. The combination of pre-antibiotic WBC count >16.0×10 9/L and CRP>80.1 mg/L yielded a sensitivity of 0.73 and a specificity of 0.86 for AFBN prediction. Similarly, the combination of post-treatment fever duration ≥2 d and pyuria duration >5 d demonstrated a sensitivity of 0.82 and specificity of 0.88. Conclusions:AFBN incidence was 6.1% in this cohort of children with febrile UTI. AFBN should be highly suspected in febrile UTI children presenting with either a pre-antibiotic WBC count >16.0×10 9/L and CRP >80.1 mg/L, or a post-treatment fever duration ≥2 d and pyuria duration >5 d.

Objective To observe the efficacy of Venovo venous stent for treating post-thrombotic syndrome(PTS)after lower extremity deep venous thrombosis(DVT).Methods A total of 61 patients with PTS after lower extremioty DVT who underwent iliac vein stent implantation were retrospectively enrolled,including 33 cases underwent Venovo stent(Venovo stent group)and 28 cases underwent conventional stent implantation(conventional stent group).The technical success rates and perioperative complications,Villalta score and venous clinical severity score(VCSS)before and 6 and 12 months after treatment,as well as the primary stent patency were compared within and between groups.Results The technical success rate was 100%in both groups,and no significant difference of the incidence of perioperative complications was found between groups(P=0.187).There was no significant difference of Villalta score nor VCSS between groups before treatment(both P＞0.05),while significant decrease of Villalta score was noticed before and 6 or 12 months after treatment within both groups(all P＜0.05).No significant difference of Villalta score nor VCSS was found 6 months after treatment between groups(both P＞0.05),while significant difference of Villalta score and VCSS were observed in Venovo stent group compared with those in conventional stent group 12 months after treatment(both P＜0.05).No significant difference of primary stent patency rate was found between groups 6 and 12 months after treatment(both P＞0.05).Conclusion Venovo venous stent could be used to effectively treat PTS after lower extremity DVT.