Neurocritical care involves complex pathophysiological mechanisms, and its incidence is higher, injuries are more severe, and treatment is more challenging in high-altitude environments. This consensus, based on the latest domestic and international evidence-based medical data, establishes a standardized, goal-oriented framework for neurocritical care management applicable in high-altitude regions and nationwide. The consensus was developed following international standards for evidence quality assessment and underwent two rounds of Delphi expert consultation, resulting in 32 recommendation statements covering three parts: management systems, monitoring and assessment, and core strategies. Key updates include: advocating for the establishment of independent neurocritical care units and implementing precise tiered diagnosis and treatment based on the "Five Differences in Critical Care" concept; constructing a "trinity" multimodal brain monitoring system centered on cerebral blood flow, cerebral oxygenation, and brain function, emphasizing routine bedside transcranial Doppler ultrasound, cerebral oximetry, and continuous electroencephalography monitoring; shifting management strategies from mild hypothermia therapy to targeted temperature management, and defining the "446" target management pathway for the supercritical stage; emphasizing the assessment of static and dynamic cerebrovascular autoregulation functions through multimodal methods to achieve individualized optimal mean arterial pressure management; elevating cerebrospinal fluid management goals to the level of "glymphatic system" function maintenance; implementing a multidisciplinary collaborative, whole-process management model focusing on patients' long-term neurological functional outcomes; de-escalation criteria include multidimensional indicators such as recovery of brain structure, restoration of cerebrovascular autoregulation, improvement in cerebrospinal fluid dynamics, and reduction in biomarker levels; and integrating cutting-edge technologies like artificial intelligence into post-critical care management and rehabilitation planning. This consensus systematically integrates the entire process of neurocritical care management, reflecting the modern connotation of goal-oriented, dynamic, and multimodal integration in neurocritical care medicine. It aims to adapt to new trends such as deepening understanding of pathophysiological mechanisms, the integration of medicine and engineering, and the empowerment of artificial intelligence, thereby further advancing the discipline of critical care medicine.

Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.

This study was aimed at preliminarily assessing the prevalence of latent tuberculosis infection(LTBI)among cattle farming and slaughterhouse workers across Wuxue,Xianning,and Yichang Cities in Hubei Province,and exploring associated risk factors.Data on cattle farming and slaughterhouse workers were gathered via a questionnaire.LTBI detection was performed with a tu-berculin skin test and interferon-gamma release assay,and influencing factors were subsequently analyzed.The LTBI prevalence among cattle farming and slaughterhouse personnel in the three cities was 30.50%,and a higher rate was observed in slaughterhouse workers(39.01%)than cattle farmers(21.63%)(P<0.01).Multifactor analysis indicated that working in slaughterhouses(95%CI:1.582-3.878),having a history of tuberculosis(95%CI:1.377-25.057)or BCG vaccination(95%CI:1.229-3.285),and having a college education or above(95%CI:0.303-0.859)were significant factors influencing LTBI positivity in these personnel.Having more than 30 years of work experience(95%CI:1.303-18.782)was a risk factor for personnel at cattle breeding farms.Among slaugh-terhouse personnel,having a college education or above(95%CI:0.164-0.894),11-20 years of work experience(95%CI:0.122-0.994),or a history of tuberculosis(95%CI:1.661-64.397);performing logistics work(95%CI:3.234-126.424);and working in slaughter-related positions(95%CI:1.209-19.639)were associated with LTBI positivity.Therefore,the slaughterhouse workers in the three cities had higher LTBI rates than the cattle farming workers,thus underscoring the need for increased attention to personnel in logistics and slaughter-related positions.

BACKGROUND:Gambogic acid is highly cytotoxic to breast cancer and can effectively kill triple negative breast cancer stem cells,but the underlying mechanism is still unclear.OBJECTIVE:To investigate the lethal effect of gambogic acid on triple negative breast cancer stem cells as well as the possible mechanisms.METHODS:PharmMapper database was used to predict the target protein of gambogic acid.String website was used to construct the protein interaction network of various drug targets.Active ingredient-target network was constructed by Cytoscape software.KEGG signal pathway enrichment analysis was performed on potential targets by R language software.The effect of different concentrations of gambogic acid on the activity of human breast cancer cell line MDA-MB-231 was detected by CCK-8 assay.The appropriate concentration was screened.MDA-MB-231 stem cells were enriched by cell ball culture method and treated with gambogic acid at different concentrations(0,0.5,1.0,and 2.0 μmol/L)for 24 hours.TUNEL fluorescence staining and flow cytometry were used to detect apoptosis of stem cells.qPCR and western blot assay were used to detect protein C receptor expression.The expression levels of p-PI3K,p-AKT,Caspase-3,and cleaved Caspase-3 were detected by western blot assay.Stem cells were cultured in four groups:Blank control group(stem cells were not treated),siRNA-NC group,siRNA-protein C receptor group,and siRNA-protein C receptor+PI3K agonist group.After culture for 36 hours,the expression levels of p-PI3K,p-AKT,Caspase-3,and cleaved Caspase-3 were detected by western blot assay.RESULTS AND CONCLUSION:(1)Network pharmacology exhibited that the protein C receptor,a marker of triple negative breast cancer stem cells,was one of the targets of gambogic acid.KEGG enrichment analysis involved apoptosis,epithelial growth factor receptor,RAS,and PI3K-AKT signaling pathways.(2)CCK-8 assay results showed that gambogic acid could inhibit the viability of MDA-MB-231 cells,and the median inhibitory concentration IC50 value was(1.18±0.34)μmol/L,so the concentrations of 0.5,1.0,and 2.0 μmol/L were selected for subsequent experiments.(3)TUNEL fluorescence staining and flow cytometry showed that gambogic acid induced apoptosis of triple negative breast cancer stem cells in a dose-dependent manner(P<0.05).qPCR and western blot assay confirmed that gambogic acid down-regulated mRNA and protein expression of protein C receptor,down-regulated Caspase-3,p-PI3K,and p-Akt protein expression,and up-regulated cleaved Caspase-3 protein expression(P<0.05).siRNA-protein C receptor transfection experiments further confirmed that knockdown of protein C receptor expression in triple negative breast cancer stem cells increased cleaved Caspase-3 protein expression(P<0.05),and down-regulated phosphorylation of PI3K/AKT signaling pathway(P<0.05).Application of PI3K agonist 740 Y-P decreased cleaved Caspase-3 protein expression(P<0.05),increased phosphorylation levels of p-PI3K and p-AKT(P<0.05),and improved apoptosis to a certain extent.(4)The results show that gambogic acid may play a role in killing and inducing apoptosis of triple negative breast cancer stem cells by down-regulating protein C receptor,and the further molecular mechanism may be related to the inhibition of PI3K/AKT signaling pathway.

Aim To explore the mechanism of luteolin in alleviating hepatic fibrosis.Methods C57BL/6 mice were randomly divided into the control group,CCl4 group,silybin group(100 mg·kg-1)and luteo-lin group(100 mg·kg-1).After 10-week modeling and 2-week treatment,the serum levels of aminotrans-ferase and liver histopathology were examined.Hepatic fibrosis and autophagy-related gene expression were as-sessed using immunohistochemistry and immunofluores-cence.Human hepatic stellate cell line(LX2)was cultured and divided into control,TGF-β1(10 mg·L-1),TGF-β1+silybin(40 μmol·L-1),TGF-β1+luteolin(40 μmol·L-1).Fibrotic and autophagy-re-lated markers were analyzed using quantitative real-time PCR,Western blot,immunofluorescence and MDC staining.Results Compared with the CCl4 group,the treatment groups showed significantly improved liver function and reduced hepatic fibrosis,with markedly downregulated COL1A1 and α-SMA expression,and luteolin demonstrated superior efficacy.Compared with TGF-β1 group,luteolin treatment significantly de-creased mRNA levels of COL1A1,ACTA2 and MAP1LC3B,while increasing the mRNA level of SQSTM1,the protein levels of COL1A1 and α-SMA de-creased,p62 was enhanced,the LC3Ⅱ/Ⅰ ratio was downregulated,and autophagy was reduced.These effects of luteolin were reversed by autophagy inducer rapamycin.Conclusion Luteolin alleviates liver fi-brosis by decreasing the autophagy of hepatic stellate cells.

Objective To explore the relationship between peripheral blood mitochondrial DNA(mtDNA)copy number and urinary microalbumin(MAlb)in patients with type 2 diabetes mellitus(T2DM).Methods 87 patients with T2DM from the Endocrinology Department of East Hospital of Tongji University were selected based on inclusion criteria.According to urinary MAlb levels,patients were divided into T2DM group(MAlb＜30 mg/L)and MAlb group(MAlb＞30 mg/L).General patient information was collected,and clinical indicators such as blood glucose,lipid profile,glycated hemoglobin and insulin were measured.Peripheral blood mtDNA was extracted and the copy number was detected using real-time quantitative polymerase chain reaction(RT-PCR).Logistic regression analysis was used to identify the risk factors for albuminuria.Results Compared with T2DM group,DM duration,serum creatinine,serum uric acid and copy number of mtDNA in MAlb group increased(P＜0.05),while high density lipoprotein cholesterol decreased(P＜0.05).Logistic analysis showed that the copy number of mtDNA was the influencing factor of MAlb in T2DM patients.Conclusions The peripheral blood mtDNA copy number in T2DM patients is positively correlated with urinary microalbumin,thus providing a potential target for early detection of DKD.

BACKGROUND:Gambogic acid is highly cytotoxic to breast cancer and can effectively kill triple negative breast cancer stem cells,but the underlying mechanism is still unclear.OBJECTIVE:To investigate the lethal effect of gambogic acid on triple negative breast cancer stem cells as well as the possible mechanisms.METHODS:PharmMapper database was used to predict the target protein of gambogic acid.String website was used to construct the protein interaction network of various drug targets.Active ingredient-target network was constructed by Cytoscape software.KEGG signal pathway enrichment analysis was performed on potential targets by R language software.The effect of different concentrations of gambogic acid on the activity of human breast cancer cell line MDA-MB-231 was detected by CCK-8 assay.The appropriate concentration was screened.MDA-MB-231 stem cells were enriched by cell ball culture method and treated with gambogic acid at different concentrations(0,0.5,1.0,and 2.0 μmol/L)for 24 hours.TUNEL fluorescence staining and flow cytometry were used to detect apoptosis of stem cells.qPCR and western blot assay were used to detect protein C receptor expression.The expression levels of p-PI3K,p-AKT,Caspase-3,and cleaved Caspase-3 were detected by western blot assay.Stem cells were cultured in four groups:Blank control group(stem cells were not treated),siRNA-NC group,siRNA-protein C receptor group,and siRNA-protein C receptor+PI3K agonist group.After culture for 36 hours,the expression levels of p-PI3K,p-AKT,Caspase-3,and cleaved Caspase-3 were detected by western blot assay.RESULTS AND CONCLUSION:(1)Network pharmacology exhibited that the protein C receptor,a marker of triple negative breast cancer stem cells,was one of the targets of gambogic acid.KEGG enrichment analysis involved apoptosis,epithelial growth factor receptor,RAS,and PI3K-AKT signaling pathways.(2)CCK-8 assay results showed that gambogic acid could inhibit the viability of MDA-MB-231 cells,and the median inhibitory concentration IC50 value was(1.18±0.34)μmol/L,so the concentrations of 0.5,1.0,and 2.0 μmol/L were selected for subsequent experiments.(3)TUNEL fluorescence staining and flow cytometry showed that gambogic acid induced apoptosis of triple negative breast cancer stem cells in a dose-dependent manner(P<0.05).qPCR and western blot assay confirmed that gambogic acid down-regulated mRNA and protein expression of protein C receptor,down-regulated Caspase-3,p-PI3K,and p-Akt protein expression,and up-regulated cleaved Caspase-3 protein expression(P<0.05).siRNA-protein C receptor transfection experiments further confirmed that knockdown of protein C receptor expression in triple negative breast cancer stem cells increased cleaved Caspase-3 protein expression(P<0.05),and down-regulated phosphorylation of PI3K/AKT signaling pathway(P<0.05).Application of PI3K agonist 740 Y-P decreased cleaved Caspase-3 protein expression(P<0.05),increased phosphorylation levels of p-PI3K and p-AKT(P<0.05),and improved apoptosis to a certain extent.(4)The results show that gambogic acid may play a role in killing and inducing apoptosis of triple negative breast cancer stem cells by down-regulating protein C receptor,and the further molecular mechanism may be related to the inhibition of PI3K/AKT signaling pathway.

Relevant China's literature on the application of brain-computer interface technology in the field of rehabilita-tion of stroke patients was retrieved in the China Knowledge Network database from its establishment to December 31,2024,and CiteSpace visual analysis software was used to analyze the selected literature in terms of trend of annual publica-tion number,author collaboration network,keyword co-occurrences and emergences and to generate a corresponding knowledge map.It's pointed out brain-computer interface technology showed significant application potential for motor function recovery and neurorehabilitation,which had the research hotspots of the cross technologies covering motor imagina-tion,rehabilitation training and virtual reality and the research frontiers of the fusion application of intelligent algorithms of deep learning and pattern recognition.The challenges and future development directions of the field were investigated,and references were provided for promoting the application of brain-computer interface technology to rehabilitation of sroke patients in China.[Chinese Medical Equipment Journal,2025,46(9):65-69]

Relevant China's literature on the application of brain-computer interface technology in the field of rehabilita-tion of stroke patients was retrieved in the China Knowledge Network database from its establishment to December 31,2024,and CiteSpace visual analysis software was used to analyze the selected literature in terms of trend of annual publica-tion number,author collaboration network,keyword co-occurrences and emergences and to generate a corresponding knowledge map.It's pointed out brain-computer interface technology showed significant application potential for motor function recovery and neurorehabilitation,which had the research hotspots of the cross technologies covering motor imagina-tion,rehabilitation training and virtual reality and the research frontiers of the fusion application of intelligent algorithms of deep learning and pattern recognition.The challenges and future development directions of the field were investigated,and references were provided for promoting the application of brain-computer interface technology to rehabilitation of sroke patients in China.[Chinese Medical Equipment Journal,2025,46(9):65-69]

Objective To compare the effect of small optical zone orthokeratology lenses(OK lenses)and repeated low-level red-light(RLRL)therapy in controlling myopia progression for adolescents,and the therapeutic effectiveness of RLRL is evaluated.Methods A retrospective analysis was conducted on the clinical data of 80 adolescent myopic patients in the First Affiliated Hospital of Army Medical University.The patients were divided into the RLRL group and the OK lenses group according to different intervention methods,with 40 cases in each group.Patients in the RLRL group received RLRL therapy combined with single-vision spectacles,and patients in the OK lenses group were treated with OK lenses.The changes of spherical equivalent(SE),axial length and subfoveal choroidal thickness(SFCT)1,3,6,and 12 months after treatment compared with the baseline,and color vision of patients were assessed.Based on the mean baseline axial length of the RLRL group,the patients in this group were subdivided into the short axial group and the long axial group,and the changes of the axial length and SFCT were further analyzed.Results The diopter 1,3,6,and 12 months after treatment in the RLRL group were not significantly different from the baseline(P>0.05).Axial lengths of patients in the RLRL group progressively shortened after treatment and returned close to the baseline 12 months after treatment.In contrast,axial lengths of patients in the OK lens continued to grow within 12 months after treatment;the axial lengths at each time point after treatment of patients in the two groups were significantly different from the baseline(P<0.05).The changes of axial length of patients in the RLRL group at each time point after treatment were significantly smaller than those in the OK lenses group(P<0.05).The SFCT changes of patients in the RLRL group at each time point after treatment were all greater than those in the OK lenses group(P<0.05).The SFCT at each time point after treatment in the RLRL group were significantly different from the baseline(P<0.05),whereas the SFCT at each time point after treatment in the OK lenses group were not significantly different from the baseline(P>0.05).The changes of axial length at each time point after treatment of patients in the long axial group were all greater than those in the short axial group(P<0.05);the SFCT changes 6 months after treatment of patients in the long axial group was greater than that in the short axial group(P<0.05);the SFCT at each time point after treatment of patients in the two groups were signifi-cantly different from the baseline(P<0.05).Color vision tests revealed no abnormities after treatment in the RLRL group and the OK lenses group.Conclusion RLRL therapy is effective in controlling myopia progression and demonstrates superior axial length control compared to orthokeratology lenses.