Objective To explore the feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis. Methods The clinical data of patients with primary palmar hyperhidrosis who underwent high-definition thoracoscopic sympathicotomy in Taikang Xianlin Drum Tower Hospital from June to July 2023 were retrospectively analyzed. Intraoperative visualization rates and anatomical variations of sympathetic ganglia were recorded, and the consistency between white-light thoracoscopy and near-infrared fluorescence imaging was compared. Additionally, surgical videos from previous fluorescence-guided procedures were reviewed. Results Finally 100 patients were collected, including 54 females and 46 males, with an average age of (21.92±6.56) years. All patients underwent endoscopic thoracic sympathicotomy at R3 level. The overall intraoperative ganglion visualization rate was 92.5% (740/800), with G2-G5 rates of 95.5% (191/200), 94.0% (188/200), 94.0% (188/200), and 86.5% (173/200), respectively. Ganglion variations occurred in 32.0% (237/740), predominantly at G3 (29.8%) and G4 (42.6%). In 5 indocyanine green-enhanced patients, the concordance rate between white-light and near-infrared fluorescence imaging was 100.0% (38/38). Video analysis of 14 near-infrared fluorescence-guided surgeries demonstrated a 99.1% (107/108) consistency rate. Postoperative palmar hyperhidrosis improvement reached 100.0% (100/100) with no Horner’s syndrome. Conclusion With the wide clinical application of high-definition thoracoscopy, accurate thoracic sympathicotomy has the feasibility of clinical application.

T-cell inhibitory receptors(IR)are involved in the composing of co-inhibitory signaling pathways between T cells and immune cells,and transmit immunosuppressive signals to limit immune effects of T cells such as activation and proliferation.Ab-normal co-inhibitory signals may destroy the peripheral immune tolerance of the body,leading to hyperresponsiveness of various organ-specific autoimmunity.Rheumatoid arthritis(RA)is a complex systemic disease in which there is an immune disorder centered on T cells.In this process,the abnormal expression and distribution of T-cell IR are fully involved in the imbalance of T-cell subsets and pathological immune responses,affecting the development and progression of the disease.Targeting T-cell IR and its ligands and thus strengthening the co-inhibitory signaling pathway mediated by them has been studied for suppressing immune responses and maintain-ing immune tolerance,but their potential for clinical application in RA remains to be explored.In the present,we review the advances of T-cell IR involved in the immunopathology of RA,and discusses the therapeutic prospects of targeting these receptors.

Objective To explore the effects of mental fatigue on attention maintenance function by electroencephalogram(EEG)signal characteristics and cortical source analysis.Methods A total of 25 healthy males were recruited as subjects and contingent negative variation(CNV)auditory paradigm was used to assess the differences in EEG characteristics before and after mental fatigue,with the average amplitude of CNV at different processing stages as the analysis indices.Then,the 3-dimensional distribution of cortical current density changes of CNV after mental fatigue were calculated by standardized low-resolution electromagnetic tomography analysis(sLORETA).Results The reaction time of the CNV signal remained unchanged following mental fatigue(P＞0.05),while the lapse rate exhibited a significant increase(P＜0.05).Besides,mental fatigue was related to a notable decrease in the amplitude of CNV early components(500-1 000 ms after warning stimulus)at the central and central parietal electrodes,and a significant reduction in the amplitude of CNV late components(2 550-3 050 ms after warning stimulus)at the prefrontal,frontal,central,and central parietal electrodes(all P＜0.05).The results of sLORETA source analysis showed that the brain activity in the left posterior insular cortex decreased after mental fatigue during the late component of CNV(P＜0.05).Conclusion The decreased activation of the posterior insula,which plays a crucial role in sensorimotor information integration,could potentially serve as a neural mechanism for the reduction of CNV amplitude and the impairment of attention maintenance function following mental fatigue.

Exosomes are closely related to the occurrence and development of various diseases. Exosomes from different sources and the bioactive molecules they carry can participate in the formation process of urinary calculi through mechanisms such as regulating inflammatory responses，autophagy，and crystal nucleation. In addition，exosomes can also serve as delivery platforms for precise treatment of urinary calculi patients based on targeted markers，which has become a new hot spot in the research of the mechanism and treatment of urinary calculi in recent years. This article reviews the current research progress of exosomes in the formation mechanism of urinary calculi.

Exosomes are closely related to the occurrence and development of various diseases. Exosomes from different sources and the bioactive molecules they carry can participate in the formation process of urinary calculi through mechanisms such as regulating inflammatory responses，autophagy，and crystal nucleation. In addition，exosomes can also serve as delivery platforms for precise treatment of urinary calculi patients based on targeted markers，which has become a new hot spot in the research of the mechanism and treatment of urinary calculi in recent years. This article reviews the current research progress of exosomes in the formation mechanism of urinary calculi.

T-cell inhibitory receptors(IR)are involved in the composing of co-inhibitory signaling pathways between T cells and immune cells,and transmit immunosuppressive signals to limit immune effects of T cells such as activation and proliferation.Ab-normal co-inhibitory signals may destroy the peripheral immune tolerance of the body,leading to hyperresponsiveness of various organ-specific autoimmunity.Rheumatoid arthritis(RA)is a complex systemic disease in which there is an immune disorder centered on T cells.In this process,the abnormal expression and distribution of T-cell IR are fully involved in the imbalance of T-cell subsets and pathological immune responses,affecting the development and progression of the disease.Targeting T-cell IR and its ligands and thus strengthening the co-inhibitory signaling pathway mediated by them has been studied for suppressing immune responses and maintain-ing immune tolerance,but their potential for clinical application in RA remains to be explored.In the present,we review the advances of T-cell IR involved in the immunopathology of RA,and discusses the therapeutic prospects of targeting these receptors.

Objective:To investigate the clinical significance of a new classification system for atlas fractures based on pre- and post-treatment CT features, with a focus on diagnosis and treatment.Methods:A retrospective analysis was conducted on 75 cases of cervical vertebra fractures treated at the Sixth Hospital of Ningbo City between January 2015 and December 2020. The study included 44 males and 31 females, with an average age of 53.3±13.0 years (range: 27-81 years). The fractures were classified according to the Landells classification, resulting in 12 cases of type I, 13 cases of type II, 33 cases of type III, 9 cases that were difficult to classify due to fracture lines located at anatomical junctions, and 8 cases that could not be classified using the Landells classification due to diverse injury mechanisms. To establish a new preliminary classification for cervical vertebra fractures, the researchers considered whether the fracture line in the CT images involved the facet joint surface of the atlas, the impact on bilateral half-rings, and the displacement distance of the fracture ends. Five spinal surgeons were randomly selected to classify the CT images of the 75 patients using the new classification method. After one month, the imaging data of the 75 cases of cervical vertebra fractures were randomized and reclassified to assess the reliability and repeatability of the classification.Results:The new cervical vertebra fracture classification method comprised three types based on whether the fracture line involved the facet joint surface of the atlas: type A (no involvement of the facet joint surface of the atlas), type B (involvement of one side of the facet joint surface with intact contralateral half-ring), and type C (involvement of one side of the facet joint surface with fractured contralateral half-ring). Additionally, based on the maximum displacement distance between the fracture ends (>4 mm), six subtypes were identified: subtype 1 (≤4 mm displacement) and subtype 2 (>4 mm displacement). Consequently, the subtypes were classified as A1, A2, B1, B2, C1, and C2. According to the new classification method, the 75 patients included 17 cases of A1, 12 cases of A2, 7 cases of B1, 13 cases of B2, 12 cases of C1, and 14 cases of C2. The classification demonstrated excellent consistency, as assessed by the five doctors, with Kappa values of 0.85 and 0.91 for reliability and repeatability, respectively. At the final follow-up, all conservatively treated patients achieved bone healing, while four surgically treated patients experienced non-union of the fracture ends but exhibited good fusion between the atlas and axis. The remaining surgically treated patients achieved bony union without complications such as loosening or fracture of internal fixation.Conclusion:The new cervical vertebra fracture classification method, based on CT imaging features, comprehensively covers common clinical cases of cervical vertebra fractures and demonstrates excellent consistency. It provides valuable clinical guidance for the diagnosis and treatment of cervical vertebra fractures.

Humans ; Child ; Child, Preschool ; Pinealoma ; Prognosis ; Brain Neoplasms/diagnosis* ; Pineal Gland

Engineered probiotics can serve as therapeutics based on their ability of produce recombinant immune-stimulating properties. In this study, we built the recombinant Bacillus subtilis WB800 expressing antimicrobial peptide KR32 (WB800-KR32) using genetic engineering methods and investigated its protective effects of nuclear factor-E2-related factor 2 (Nrf2)‍-Kelch-like ECH-associated protein 1 (Keap1) pathway activation in intestinal oxidative disturbance induced by enterotoxigenic Escherichia coli (ETEC) K88 in weaned piglets. Twenty-eight weaned piglets were randomly distributed into four treatment groups with seven replicates fed with a basal diet. The feed of the control group (CON) was infused with normal sterilized saline; meanwhile, the ETEC, ETEC+WB800, and ETEC+WB800-KR32 groups were orally administered normal sterilized saline, 5×10¹⁰ CFU (CFU: colony forming units) WB800, and 5×10¹⁰ CFU WB800-KR32, respectively, on Days 1‍‒‍14 and all infused with ETEC K88 1×10¹⁰ CFU on Days 15‍‒‍17. The results showed that pretreatment with WB800-KR32 attenuated ETEC-induced intestinal disturbance, improved the mucosal activity of antioxidant enzyme (catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx)) and decreased the content of malondialdehyde (MDA). More importantly, WB800-KR32 downregulated genes involved in antioxidant defense (GPx and SOD1). Interestingly, WB800-KR32 upregulated the protein expression of Nrf2 and downregulated the protein expression of Keap1 in the ileum. WB800-KR32 markedly changed the richness estimators (Ace and Chao) of gut microbiota and increased the abundance of Eubacterium_rectale_ATCC_33656 in the feces. The results suggested that WB800-KR32 may alleviate ETEC-induced intestinal oxidative injury through the Nrf2-Keap1 pathway, providing a new perspective for WB800-KR32 as potential therapeutics to regulate intestinal oxidative disturbance in ETEC K88 infection.
Animals ; Swine ; Enterotoxigenic Escherichia coli ; Kelch-Like ECH-Associated Protein 1 ; Bacillus subtilis ; NF-E2-Related Factor 2 ; Antioxidants ; Oxidative Stress

Objective:To explore the impact of clinical features, serological indicators, and pulmonary function test (PFT) on the prognosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).Methods:Clinical data of RA-ILD patients who were diagnosed by HRCT and were followed up in Changhai Hospital or Yancheng First People's Hospital from 2011 to 2021 were collected Respiratory functional impairment of the patients was evaluated according to the changes of HRCT score and PFT, and the patients were divided into progressive group and stable group. COX survival analysis and ROC curve were used to determine the factors related to the progression of RA-ILD.Results:Finally 98 RA-ILD patients were included. The mean age of ILD onset was (62.9±12.1) years old, the median course of RA was 7.0 (1.0, 15.3)years, and the median follow-up time was 36.5 months (14.0, 79.5). There were 49 cases in the progressive group, and the clinical characteristics and laboratory tests of the two groups were compared. The results showed that: progressive time [(23(8.5,43.0)months vs 63(32.5,90.9) months, Z=-4.55, P=0.001)], HRCT score [(115(109,135) vs 111(105,116), Z=-2.70, P=0.007)], forced vital capacity(FVC) predicted [(70.1±15.7)% vs (80.8±19.7)%, t=2.12, P=0.039)], diffusing capacity of the lungs for CO(DLCO) predicted [(57.5±16.3)% vs (83.4±18.8)%, t=4.87, P=0.001)], male [(44.9% vs 18.4%, χ2=7.97, P=0.005)], UIP pattern [(36(73.5%) vs 9(18.4%), χ2=29.96, P<0.001)], RF>200 U/ml[(21(65.6%) vs 18(41.9%), χ2=4.15, P=0.042)], anti-CCP>75 U/ml [(42(91.3%) vs 35(71.4%), χ2=6.10, P=0.013], all had significantly different between the two groups. In multivariate analyses, UIP[ HR(95% CI)=3.25(1.62,6.50), P<0.001], anti-CCP antibody >75 U/ ml[ HR(95% CI)=3.85 (1.20,12.33), P=0.023] and smoking [ HR (95% CI): 5.74(1.10, 30.13), P=0.039] were significantly correlated with the progression of pulmonary fibrosis in RA-ILD patients. PFT was performed in only 44 patients with RA-ILD. The univariate analyses and ROC curve suggested that DLCO predicted [ HR (95% CI)=1.04 (1.02,1.06), P<0.001] was a significant risk factor for the progression of RA-ILD, and the area under curve (AUC) of DLCO was 0.845 [95% CI=(0.729,0.961)]. Conclusion:UIP pattern, high titer of anti-CCP antibody, smoking, and reduced DLCO predicted % may be potential predictors for poor prognosis of RA-ILD patients.