Real-time, noninvasive programmed death-ligand 1 (PD-L1) testing using molecular imaging has enhanced our understanding of the immune environments of neoplasms and has served as a guide for immunotherapy. However, the utilization of radiotracers in the imaging of human brain tumors using positron emission tomography/computed tomography (PET/CT) remains limited. This investigation involved the synthesis of [¹⁸F]AlF-NOTA-PCP2, which is a novel peptide-based radiolabeled tracer that targets PD-L1, and evaluated its imaging capabilities in orthotopic glioblastoma (GBM) models. Using this tracer, we could noninvasively monitor radiation-induced PD-L1 changes in GBM. [¹⁸F]AlF-NOTA-PCP2 exhibited high radiochemical purity (>95%) and stability up to 4 h after synthesis. It demonstrated specific, high-affinity binding to PD-L1 in vitro and in vivo, with a dissociation constant of 0.24 nM. PET/CT imaging, integrated with contrast-enhanced magnetic resonance imaging, revealed significant accumulation of [¹⁸F]AlF-NOTA-PCP2 in orthotopic tumors, correlating with blood-brain barrier disruption. After radiotherapy (15 Gy), [¹⁸F]AlF-NOTA-PCP2 uptake in tumors increased from 9.51% ± 0.73% to 12.04% ± 1.43%, indicating enhanced PD-L1 expression consistent with immunohistochemistry findings. Fractionated radiation (5 Gy × 3) further amplified PD-L1 upregulation (13.9% ± 1.54% ID/cc) compared with a single dose (11.48% ± 1.05% ID/cc). Taken together, [¹⁸F]AlF-NOTA-PCP2 may be a valuable tool for noninvasively monitoring PD-L1 expression in brain tumors after radiotherapy.

According to the World Health Organization's world report on hearing, nearly 2.5 billion people worldwide will suffer from hearing loss by 2050, which may contribute to a severe impact on individual life quality and national economies. Sensorineural hearing loss (SNHL) occurs commonly as a result of noise exposure, aging, and ototoxic drugs, and is pathologically characterized by the impairment of mechanosensory hair cells of the inner ear, which is mainly triggered by reactive oxygen species accumulation, inflammation, and mitochondrial dysfunction. Though recent advances have been made in understanding the ability of cochlear repair and regeneration, there are still no effective therapeutic drugs for SNHL. Chinese herbal medicine which is widely distributed and easily accessible in China has demonstrated a unique curative effect against SNHL with higher safety and lower cost compared with Western medicine. Herein we present trends in research for Chinese herbal medicine for the treatment of SNHL, and elucidate their molecular mechanisms of action, to pave the way for further research and development of novel effective drugs in this field.

Objective:To explore the medication law for treating chronic atrophic gastritis (CAG) through data mining methods.Methods:Literature on experiences in treating CAG was retrieved from CNKI, Wanfang data, and VIP from the establishment of the databases to December 31, 2023. The information on syndromes, treatment methods, and prescriptions was extracted for frequency statistics, clustering analysis, complex networks analysis were performed.Results:A total of 313 articles were included in the study, involving 581 experienced prescriptions, involving 5 kinds of TCM disease names, with "epigastric pain" as the most, followed by "fullness"; high-frequency syndromes included spleen-stomach qi deficiency syndrome, stomach collateral stasis syndrome, stomach yin deficiency syndrome, spleen-stomach damp-heat syndrome, liver-stomach qi stagnation syndrome; the main treatment methods used were promoting blood circulation and removing blood stasis, invigorating spleen and replenishing qi, regulating qi and harmonizing stomach, soothing liver and regulating qi, etc. The number of prescription drugs was mainly in 10-15 kinds of Chinese materia medica; a total of 321 kinds of Chinese materia medica were shared, and the top five Chinese medicines ranked by frequency were Atractylodis Macrocephalae Rhizoma, Poria, Paeoniae Radix Alba, Citri Reticulatae Pericarpium, Coptidis Rhizoma. The medicinal properties were mainly warm and neutral, and the tastes were mostly bitter, sweet and pungent. The meridians were mainly spleen, stomach, lung and liver meridians. The clustering analysis of high-frequency medication was mainly divided into 6 categories. The association rule analysis of Chinese materia medica and the complex network of Chinese materia medica showed the core compatibility and prescription of 5 high-frequency syndromes, respectively, showing the combination of Xiangsha Liujun Decoction, Chaihu Shugan Powder, Banxia Xiexin Decoction, Shashen Maidong Decoction and other classical prescriptions for syndrome differentiation and treatment combined with the experience of improving gastric mucosal lesions.Conclusion:Tonifying qi, removing blood stasis and detoxifying are the feature methods to treat CAG, embodying a "point surface combination" medication strategy that combines holistic diagnosis and syndrome differentiation and treatment with improvement of local mucosal lesions.

Objective To investigate the characteristics of bone marrow megakaryocytes in patients with idiopathic thrombocytopenic purpura (ITP) complicated with positive for antinuclear antibody (ANA) but cannot be diagnosed as rheumatic immune diseases. Methods Newly diagnosed ITP patients in the First Hospital Affiliated to Sun Yat-sen University were retrospectively selected and divided into ITP1 group (ITP patients with positive ANA) and ITP2 group (ITP patients with negative rheumatic indicators). Degree of thrombocytopenia, the total number of bone marrow megakaryocytes, and the ratios of various types of megakaryocytes at the initial diagnosis were compared between the two groups. Results A total of 42 newly diagnosed ITP patients were included, with 20 cases in the ITP1 group and 22 cases in the ITP2 group. There were no significant differences in general information such as gender and age between the two groups (P>0.05). The platelet (PLT) count was (7.55±0.96)×10⁹/L in the ITP1 group, which was lower than (10.23±1.21)×10⁹/L in the ITP2 group, but there was no significant between-group difference (t=1.697, P=0.097). Compared with the ITP2 group, the total number of megakaryocytes in the ITP1 group was significantly decreased (t=3.071, P < 0.01), and the ratio of granular megakaryocytes was significantly increased while the ratio of naked nuclear megakaryocytes was significantly decreased (P < 0.05); there were no significant differences in the ratios of immature and platelet-producing megakaryocytes between the two groups (P>0.05). Conclusion Patients with ITP and positive ANA have a tendency of decreased PLT, and a more significant maturation disorder of bone marrow megakaryocytes, with a lower degree of megakaryocyte proliferation compared to patients without positive ANA. ANA may exacerbate the severity of ITP by aggravating the developmental disorder of bone marrow megakaryocytes.

Purpose/Significance To alleviate digital health technology anxiety in elderly patients with chronic diseases.Method/Process A convenience sampling method is used to survey 1 222 elderly patients with chronic diseases in tertiary,secondary,and commu-nity hospitals in Shanghai,China,with respect to demographic information,the level of anxiety about digital health technologies,and the conditions of individual use of digital health technologies.Logistic regression analyse is used to investigate the factors influencing anxiety in the use of digital health technologies among elderly patients with chronic diseases.Result/Conclusion Elderly patients with chronic diseases as a whole have low moderate levels of anxiety about digital health technologies.Educational level,per capita monthly income,experience of using digital health technologies,and learning ability are independent factors affecting anxiety about digital health technolo-gies among elderly patients with chronic diseases.Aging-friendly design,assistance and support,improved facility accessibility,and precise training should be implemented so as to increase the acceptance and use of digital health technologies among elderly chronic dis-ease patients.

Purpose To investigate the characteristics of 18F-Florbetaben(18F-FBB)β-amyloid(Aβ)PET imaging in different brain regions of Alzheimer's disease(AD)patients with different degrees of cognitive impairment,and to explore the correlation between Aβ deposition and cognitive dysfunction.Materials and Methods A total of eighteen patients with a clinical diagnosis of probable AD from August 2022 to October 2023 were retrospectively included in Huashan Hospital.All patients had Aβ abnormal deposition in the brain as confirmed by 18F-FBB PET imaging.According to the severity of symptoms,they were divided into the AD-induced mild cognitive impairment(MCI)group(8 cases)and the dementia group(10 cases).In addition,12 healthy controls were included.First,the standardized uptake value ratio of abnormal Aβ deposition in the frontal lobe,lateral parietal lobe,lateral temporal lobe,anterior and posterior cingulate gyrus,and compound cortex was semi-quantitatively calculated and compared among the three groups based on the subjects'brain MRI and automated anatomical labeling template.The correlation between the degree of Aβ deposition in the brains of AD patients and cognitive scale scores(mini-mental state examination,Montreal cognitive assessment)was then further analyzed.Results The standardized uptake value ratio values of Aβabnormal deposition in the frontal lobe,lateral temporal lobe,lateral parietal lobe,anterior and posterior cingulate cortex and compound cortex in the AD-induced MCI and dementia groups were significantly higher than those in the healthy controls(t=7.442-9.151,all P＜0.05).However,there was no significant difference in the standardized uptake value ratio values of Aβ abnormal deposition in the above brain regions between the MCI and dementia groups(t=0.312-0.996,all P＞0.05).In addition,there was no significant correlation between the degree of Aβ deposition in the brain and the cognitive scale scores(mini-mental state examination,Montreal cognitive assessment)in the AD-induced MCI and dementia groups(r=-0.049-0.050,all P＞0.05).Conclusion Aβ deposition in the brains of AD-induced MCI and dementia is significantly higher than in the healthy controls.However,Aβ deposition cannot identify AD patients with different degrees of cognitive impairment,reflecting that Aβ deposition has certain limitations in assessing the severity of clinical symptoms of AD.

Objective Based on the Pressure-State-Response (PSR) model and Environmental health indicators (EHIs), the comprehensive environmental health risk index of the Yangtze River economic belt is assessed to evaluate the comprehensive environmental health risk of the study area from 2016 to 2020. Methods Reference to the results of the Second National Pollution Source Census, a comprehensive environmental health risk assessment system was established. Twenty three representative indicators covering the four directions of economy, society, environment and health were selected. The above indicators were standardized using the range method, and each indicator was weighted using the entropy weight method. Results From 2016 to 2020, the comprehensive risk of environmental health in the Yangtze River Economic Belt showed a downward trend. The comprehensive health risk index decreased from 0.5450 to 0.3255, and the risk level has changed from "medium risk" to "low risk". Conclusion The overall environmental health of the Yangtze River Economic Belt has been improving, but it is still necessary to note that with the economic development, the regional pressure risk index has been rising rapidly, and corresponding measures should be taken to maintain the balanced development of economic and environmental health.

Metatarsal Bones/surgery* ; Thumb/abnormalities* ; Metacarpal Bones/surgery* ; Plastic Surgery Procedures

Objective:To evaluate the short-term outcomes of modified reverse Sauvé-Kapandji technique in treating the congenital radioulnar synostosis.Methods:A retrospective analysis was performed on the data of 46 congenital radioulnar synostosis patients were treated with modified reverse Sauvé-Kapandji technique in Beijing Jishuitan Hospital from December 2018 to January 2020, including 38 males (45 sides), 8 females (9 sides), average age 6.6 (3.2, 8.1) years old. All the patients were classified as type III according to Cleary-Omer classification and were followed up for at least 1 year. All the patients were treated with same operation, in which 1.5 cm shaft was resected at the proximal radius, allogeneic graft tendon was used as interposition, and rotational osteotomy was performed in the middle of the ulnar shaft, with intramedullary needle or Kirschner wire fixation, depending on the intramedullary width of ulnar shaft. The radiological features were collected and recorded preoperatively and at the latest follow-up, together with the following evaluation indexes: modified Morrey tasks score, subjective function score, active forearm rotation range without compensation, active forearm rotation range with wrist joint compensation, and active forearm rotation range with wrist and shoulder joint compensation.Results:All patients were followed up for 14.6±3.4 months (range, 11.2-19.5 months). The uncompensated forearm rotation Angle was 0.0°±0.0° before surgery and 62.3°±23.7° after surgery. The forearm rotation angles before and after surgery with wrist compensatory surgery were 86.9°±29.4° and 133.2°±27.9°, respectively. The forearm rotation angles before and after surgery with wrist and shoulder joint compensatory surgery were 205.2°±42.7° and 245.2°±35.8°, respectively. There were statistically significant differences in the above indexes before and after surgery ( t=8.71, P<0.001; t=2.54, P=0.030; t=5.05, P<0.001). Ulnar union was observed in 31 patients (37 sides) after the operation, and the union duration was 6.1±2.3 months. There were 15 patients (17 sides) ulnar shafts faced with postoperative delayed union, the union duration was 8.4±1.6 months and were recovered after prolonging brace fixation and orthopedic shock wave treatment. The scores of subjective function and improved Morrey tasks of the 43 sides with good pseudo-joint were 12.1 (0.0, 20.8) and 0.7 (0.0, 1.0) points, respectively, which were improved compared with 33.9 (25.0, 41.6) and 3.2 (2.0, 4.0) points before surgery. The differences were statistically significant ( Z=-2.44, P=0.015; Z=-2.83, P=0.005). There were 11 forearms with postoperative pseudo-joint re-ankylosis, the average forearm rotation ranges without compensation was 11.4°±10.5°(range, 0°-30°), the average forearm rotation ranges with wrist compensation was 98.6°±15.9° (range, 80°-120°), the average forearm rotation ranges with wrist and shoulder compensation was 231.7°±16.9° (range, 210°-255°). The average subjective function scores was 26.7 (8.3, 39.6). The average modified Morrey tasks scores was 1.2 (0, 2), and there were no other postoperative complications. Conclusion:The reverse Sauvé-Kapandji technique showed a satisfying short-term outcome, and can be a new choice of treatment for type III congenital radioulnar synostosis.

Objective:To explore the risk factors affecting the incidence of acute kidney injury(AKI)after liver transplantation(LT).Methods:From November 2019 to November 2022, clinical data were retrospectively reviewed for 105 recipients of classic orthotopic LT.There are 89 males and 16 females with an age range of(50.52±10.35)years.They are assigned into two groups of AKI(66 cases)and non-AKI(39 cases)according to the AKI diagnostic and staging criteria of Global Kidney Disease Prognosis Organization in 2012.General profiles and clinical data(e.g.previous medical history, MELD score, total bilirubin, albumin, serum creatinine level, coagulation function, anhepatic phase and time to surgery)of two groups of recipients are compared.The factors with statistically significant differences are included into multivariate Logistic regression analysis for obtaining independent risk factors for early AKI post-LT.Results:Among them, 66 patients developed AKI within 7 days post-operation with an incidence rate of 62.86%(66/105).The clinical stages of AKI are Ⅰ(46 cases, 69.70%), Ⅱ(10 cases, 15.15%)and Ⅲ(10 cases, 15.15%).Statistically significant inter-group differences exists in age, abdominal surgery history, preoperative serum level of creatinine, operative duration, anhepatic phase and intraoperative plasma transfusion(all P<0.05).Multivariate Logistic regression analysis indicated that abdominal surgery history( OR=5.803, 95% CI: 1.008~33.401, P=0.049), anhepatic phase( OR=1.054, 95% CI: 1.008~1.101, P=0.020)and preoperative serum level of creatinine( OR=0.968, 95% CI: 0.943~0.994, P=0.016)are independent risk factors for early AKI after classical orthotopic LT recipients. Conclusions:Abdominal surgery history, anhepatic phase, and preoperative serum level of creatinine are independent risk factors for early AKI in classic orthotopic LT recipients.