Objective To explore the CT and MRI characteristics of pancreatic mucinous cystic neoplasm with associated invasive carcinoma(MCN-AIC)and their clinical application.Methods A retrospective analysis was conducted on the CT and MRI manifes-tations,clinical presentations,and laboratory results of 10 patients with pathologically confirmed MCN-AIC.Results Four of 10 patients presented to the clinic with abdominal pain.Plain CT showed all 10 lesions with hypointensity,and enhanced CT showed 8 lesions with mild delayed enhancement.MRI showed 8 lesions with limited diffusion on diffusion weighted imaging(DWI).2 lesions had cal-cification and 8 lesions had no calcification.6 lesions were located at the pancreatic head,3 at the pancreatic tail,and remaining one at the pancreatic neck.In addition,main pancreatic duct dilatation in 6 leisons,no main pancreatic duct dilatation in 4 lesions,thickened cyst wall in 10 lesions,wall nodules in 4 lesions,no wall nodules in 6 lesions,and intratumoral segregations in 5 lesions,5 lesions without segregations.Conclusion The CT and MRI manifestations of MCN-AIC have certain characteristics and play an important role in imaging diagnosis,which can provide a reference basis for the treatment.

Objective To explore the CT and MRI characteristics of pancreatic mucinous cystic neoplasm with associated invasive carcinoma(MCN-AIC)and their clinical application.Methods A retrospective analysis was conducted on the CT and MRI manifes-tations,clinical presentations,and laboratory results of 10 patients with pathologically confirmed MCN-AIC.Results Four of 10 patients presented to the clinic with abdominal pain.Plain CT showed all 10 lesions with hypointensity,and enhanced CT showed 8 lesions with mild delayed enhancement.MRI showed 8 lesions with limited diffusion on diffusion weighted imaging(DWI).2 lesions had cal-cification and 8 lesions had no calcification.6 lesions were located at the pancreatic head,3 at the pancreatic tail,and remaining one at the pancreatic neck.In addition,main pancreatic duct dilatation in 6 leisons,no main pancreatic duct dilatation in 4 lesions,thickened cyst wall in 10 lesions,wall nodules in 4 lesions,no wall nodules in 6 lesions,and intratumoral segregations in 5 lesions,5 lesions without segregations.Conclusion The CT and MRI manifestations of MCN-AIC have certain characteristics and play an important role in imaging diagnosis,which can provide a reference basis for the treatment.

Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

Cognitive impairment is one of the manifestations of nervous system injury,which is mainly closely related to neurodegeneration,and the incidence rate is increasing year by year,which has seriously affected the health level of the population.The gut microbiota plays an important role in the health of the body and participates in the regulation of the cognitive behavior of body.The microbiome-gut-brain axis acts as a bridge connecting gut microbiota and the nervous system,and plays a regulatory role between gut microbiota and the nervous system.Therefore,this review summarizes the latest progress in the effects of gut microbiota and nervous system on the cognitive ability of body through the bidirectional regulation of neurotransmitters,gut microbiota derivatives,neuroinflammation,oxidative stress,autophagy and their crosstalk through the microbial-intestinal-brain axis,and providing a reference for the clinical research of targeted transplantation of gut microbiota for preventing and treating cognitive disorders.

Cognitive impairment is one of the manifestations of nervous system injury,which is mainly closely related to neurodegeneration,and the incidence rate is increasing year by year,which has seriously affected the health level of the population.The gut microbiota plays an important role in the health of the body and participates in the regulation of the cognitive behavior of body.The microbiome-gut-brain axis acts as a bridge connecting gut microbiota and the nervous system,and plays a regulatory role between gut microbiota and the nervous system.Therefore,this review summarizes the latest progress in the effects of gut microbiota and nervous system on the cognitive ability of body through the bidirectional regulation of neurotransmitters,gut microbiota derivatives,neuroinflammation,oxidative stress,autophagy and their crosstalk through the microbial-intestinal-brain axis,and providing a reference for the clinical research of targeted transplantation of gut microbiota for preventing and treating cognitive disorders.

Objective To explore its application value of LNM in patients with gastric adenocarcinoma based on the construction of a radiomic nomogram prediction model for preoperative lymph node metastasis in gastric adenocarcinoma using enhanced CT imaging features and parameters.Methods 131 patients with gastric adenocarcinoma who underwent radical gastric cancer surgery(Billroth Ⅱ)+lymph node dissection in our hospital from August 2019 to October 2023 were retrospectively analysed,and the preoperative enhancement CT extracted lesions,histological features of lymph node images,and pathological examination of LNM were recorded respectively,and the statistically significant Enhanced CT image histological features and parameters,multifactorial logistic regression to analyse the independent risk factors of gastric adenocarcinoma LNM(+)and construct a column-line diagram,and evaluate its performance.The performance and clinical value of the prediction model were evaluated using subject work characteristic(ROC)curves,and the column-line diagram was internally validated.Results The results of univariate analysis showed that the maximum diameter of the tumour,the lymph node status,the short-axis length and volume of the largest lymph node in the lymph node group and the sum of the short-axis lengths of all the lymph nodes were associated with the occurrence of LNM,and the difference was statistically significant(P＜0.05);multifactorial logistic regression analysis suggested that the maximum diameter of the tumour was ≥15 mm and the lymph node status was positive in the enhanced CT imaging examination,maximum lymph node short-axis length ≥ 7 mm in the lymph node group,the sum of short-axis lengths of all lymph nodes ≥ 11 mm,and the maximum lymph node short-axis volume ≥ 300 mm3 in the lymph node group were the independent risk factors for gastric adenocarcinoma patients with LNM(+)(P＜0.05);the area under the curve of the model was plotted using a ROC curve with an AUC=0.816(95％ CI 0.810-0.939),with the sensitivity of 0.91 and the specificity of 0.86.Model validation was performed using the BOOTSTRAP method containing 500 resamples,and the results suggested that the differences between the fitted curves and the ideal curves of the constructed column-line graphical model were not significant,and the validity and reliability were good.Conclusion The radiomic nomogram prediction model based on enhanced CT imaging features and parameters can effectively predict preoperative lymph node metastasis in gastric adenocarcinoma,providing strong support for clinical decision-making in gastric adenocarcinoma patients.

ObjectiveTo observe the clinical efficacy of acupuncture combined with bloodletting and cupping in the treatment of chronic spontaneous urticaria（CSU） and to explore its potential mechanisms of action. MethodsSeventy CSU patients were randomly divided into loratadine group and acupuncture + bloodletting group， with 35 patients in each group. The loratadine group received oral loratadine tablets， 10 mg once daily in the evening. The acupuncture + bloodletting group received acupuncture at Zhongwan （CV 12）， Guanyuan （CV 4）， Tianshu （ST 25）， Zusanli （ST 36）， Sanyinjiao （SP 6）， Xuehai （SP 10）， Quchi （LI 11）， Hegu （LI 4）， Taichong （LR 3）， Baihui （GV 20）， and Shenting （GV 24）， once daily，along with bloodletting and cupping at Dazhui （GV 14） and Geshu （BL 17）， every other day. Both groups were treated for 4 weeks. The 7-day urticaria activity score（UAS7） was assessed before and after the treatment， and levels of serum immunoglobulin E （IgE）， interleukin-4 （IL-4）， interleukin-5 （IL-5）， eosinophil cationic protein （ECP）， plasma tissue factor （TF）， activated factor Ⅶ （FⅦa）， prothrombin fragment 1+2 （F1+2）， D-dimer （D-D） and complement component 5a （C5a） were detected. ResultsA total of 65 patients were included in the final analysis， 32 in the loratadine group and 33 in the acupuncture + bloodletting group. Before treatment， there was no significant difference in UAS7 score， serum IgE， IL-4， IL-5， ECP levels， or plasma TF， FⅦa， F1+2， D-D， C5a levels between groups （P＞ 0.05）. After treatment， both groups showed significant reductions in UAS7 score， serum IgE， IL-4， IL-5， and plasma TF， FⅦa， F1+2， D-D， and C5a levels compared to those before treatment （P＜0.01）. However， after treatment， there was no significant difference in UAS7 score and serum ECP， IgE， IL-4， IL-5 levels between groups （P＞0.05）. The acupuncture + bloodletting group showed lower plasma TF， FⅦa， F1+2， D-D and C5a levels compared to the loratadine group （P＜0.05 or P＜0.01）. ConclusionAcupuncture combined with bloodletting and cupping can effectively improve the skin symptoms of CSU patients and reduce the levels of inflammatory factors. The potential mechanism of action may involve the regulation of the coagulation-complement-mast cell activation axis， thereby inhibiting mast cell degranulation.

BACKGROUND:The development of artificial intelligence in the medical field is rapidly advancing,with increasing research on its applications in the field of bone trauma.Through bibliometric analysis,this paper analyzed the research hotspots of artificial intelligence in the field of bone trauma in recent years,and predicted the future research trend. OBJECTIVE:To summarize the development history,research status,hot spots,and future development trends of artificial intelligence technology in the field of bone trauma to provide new insights for future research. METHODS:This study selected relevant literature from the Web of Science core database,covering the period from the inception to August 2023,and retrieved 420 articles related to the application of artificial intelligence,machine learning,and deep learning in the field of bone trauma.After manual screening,202 articles related to this article were exported,and Citespace software was used for visual analysis of cooperation of countries,institutions,cited journals,citation analysis,keyword co-occurrence,and other aspects. RESULTS AND CONCLUSION:(1)The overall number of publications from the 202 selected articles showed an upward trend,indicating significant research potential for future studies.The country with the highest centrality and the highest publication volume was the United States.The University of California(USA)was the most prolific research institution.(2)The top five most commonly used keywords in bone trauma research using artificial intelligence were deep learning,artificial intelligence,bone density,machine learning,and diagnosis.The keyword with the highest centrality was bone density,and the keyword with the highest frequency was deep learning.(3)The top 10 most cited reference papers provided comprehensive insights into the feasibility of applying artificial intelligence techniques to the diagnosis of bone trauma from various perspectives.Among them,eight papers focused on bone and joint injuries and deep convolutional neural networks.One paper discussed the use of deep learning in detecting osteoporosis in CT scans to prevent fragility fractures,while another paper explored the correlation between the application of artificial intelligence in identifying changes in skin texture and the recognition of bone characteristics.(4)In the future,the research hotspots of artificial intelligence will mainly focus on the specific study of fractures caused by bone and joint trauma and osteoporosis.The research trend mainly focuses on improving the performance of artificial intelligence algorithms,using new artificial intelligence technologies to accurately classify and quickly and efficiently diagnose bone injuries,especially for the diagnosis of complex and hidden fractures.By establishing finite element analysis models,more standardized evaluations of bone injuries can be achieved.

Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

Objective:To investigate the safety and efficacy of transcatheter aortic valve replacement (TAVR) with self-expandable bioprosthetic valves (Evolut PRO, Medtronic Inc.) in elderly patients with aortic stenosis.Methods:This single-center, single-arm, retrospective cohort study included all consecutive patients who underwent TAVR using Evolut PRO at West China Hospital of Sichuan University between May 2022 and July 2024, and collected all their data at baseline, postoperative, and 30 days. The primary endpoint was all-cause mortality, and secondary endpoints included cardiac mortality, stroke, permanent pacemaker implantation(PPI), bleeding events, vascular and peripheral access complications, acute kidney injury, and hemodynamic data.Results:70 patients were included in the study, including 25 of (35.7%) tricuspid aortic valve (TAV), 23 (32.9%) of Type 0 bicuspid aortic valve (BAV) 20 (28.6%) of Type 1 BAV, and 2 (2.9%) of Type 2 BAV. The mean age was (72.9±6.6) years, 37 (52.9%) were male, and 70 (100%) had a New York Heart Association (NYHA) grade Ⅲ or Ⅳ. Sixty-nine (98.6%) achieved successful surgery, and 1 patient (1.4%) was converted intraoperatively to open-chest surgery. At 30 days, all-cause and cardiovascular mortality were 0, the incidence of stroke was 0, the rate of PPI was 8.7%, and no moderate or greater paravalvular leaks were observed. All patients improved to Class Ⅰ or Ⅱ after receiving TAVR. The mean aortic valve gradient (AVG) decreased from (54.1 ± 18.0 )mmHg(1mmHg=0.133kPa) at baseline to (10.5 ± 5.2)mmHg at 30 days. There were no significant differences in the results among the Type 0 BAV, Type 1/2 BAV, and TAV groups.Conclusion:Evolut PRO is safe and effective in early clinical treatment of elderly patients with aortic valve stenosis.