Objective:To compare the efficacy and safety of SRS-Schwab grade 4 osteotomy and vertebral column resection (VCR) in the surgical correction of type II congenital kyphosis (CK).Methods:A retrospective review was conducted on clinical and radiographic data from patients with type II CK who underwent corrective surgery at Nanjing Drum Tower Hospital between June 2008 and December 2021. Patients were divided into two groups based on the osteotomy technique employed: the VCR group (21cases) and the SRS-Schwab grade 4 osteotomy group (19 cases). Clinical parameters, including operative duration, estimated blood loss (EBL), number of segmentation failure levels, number of fused segments, and the use of anterior support cages, were compared between groups. Radiographic parameters included the number of segmentation fusion and measurements of segmental kyphosis (SK) preoperatively, postoperatively, and at the final follow-up. The degree and rate of SK correction were also calculated and compared. Complications such as neurophysiological monitoring events, neurological injury, implant breakage, proximal junctional kyphosis/lordosis (PJK/PJL), sagittal translation (ST), and implant failure were recorded. Additionally, SRS-22 questionnaire scores were assessed preoperatively, postoperatively, and at the latest follow-up.Results:A total of 40 patients were included, with a mean follow-up duration of 48.96±21.31 months (range, 24-96 months). Compared to the SRS-Schwab group, the VCR group had significantly more levels of segmentation defect (3.85±0.79 vs. 2.68±0.54), required more fused segments (8.00±2.23 vs. 5.47±2.04), had longer operative time (358.71±77.06 min vs. 212.52±77.05 min), and greater EBL (963.66±278.49 ml vs. 698.94±222.20 ml), all with statistically significant differences ( P<0.05). No significant differences were observed in local kyphotic angle, correction magnitude, or correction rate between groups postoperatively (P>0.05). Among patients with ≤48 months of follow-up, the SRS-Schwab group showed significantly lower SK (13.00°±16.28° vs. 34.00°±21.37°) and a higher correction rate (82.52%±21.40% vs. 52.84%±24.67%) at final follow-up ( P<0.05). However, no significant differences were observed in patients with >48 months of follow-up ( P>0.05), or in the overall cohort regardless of follow-up duration ( P>0.05). Complication rates were comparable between groups ( P>0.05). One neurophysiological monitoring event, 1 neurological injury, 3 cases of PJK, 1 case of PJL, 2 cases of ST, and 2 implant failures were observed in VCR group. The SRS-Schwab Grade 4 osteotomy group had 1 neurophysiological monitoring event, 1 neurological injury, 4 cases of PJK, 2 cases of ST, and 1 implant failure. The complication rates between the groups were not statistically different ( P>0.05). Both groups showed significant improvements in the self-image domain of the SRS-22 postoperatively and at the final follow-up ( P<0.05). In the function domain, both groups also demonstrated significant improvement at the final follow-up ( P<0.05), while the SRS-Schwab group showed earlier improvement at 3 months postoperatively ( P<0.05). Conclusions:SRS-Schwab grade 4 osteotomy provides comparable correction of segmental kyphosis to VCR but offers the advantages of significantly reduced blood loss and shorter operative time. Both surgical techniques effectively improve patients' quality of life.

Objective To study the seasonal distribution characteristics of polycyclic aromatic hydrocarbons (PAHs) in PM_2.5 in Lianyungang City, and analyze the sources of PAHs pollution, and to evaluate the health risks of PAHs in different seasons. Methods PM2.5 samples were collected regularly from January 2019 to December 2023, and 16 types of PAHs were determined by HPLC. Kruskal-Wallis H test was used to compare the concentrations of PM2.5 and PAHs in different years and seasons. The source of PAHs was analyzed by characteristic ratio and principal component analysis (PCA). Health risks were assessed using the BaP equivalent method and the incremental lifetime cancer risk (ILCR) model. Results The annual exceedance rates of PM_2.5 and BaP in Lianyungang showed a decreasing trend from 2019 to 2023. PM_2.5, total PAHs and PAHs monomers (except Ace, Flu and Acy) all showed significant seasonal differences, with the highest concentration in winter (P<0.001). The average proportion of 4-ring PAHs was the highest and the average proportion of 2-ring PAHs was the lowest. The proportion of 5-6 ring PAHs was relatively high in winter and spring. PM2.5and PAHs were negatively correlated with temperature, relative humidity and precipitation, and were positively correlated with atmospheric pressure. PM_2.5 was negatively correlated with wind speed, while some PAHs monomers were positively correlated with wind speed. The characteristic ratio and PCA results showed that the main sources of PAHs in Lianyungang City were mixed sources of road dust and vehicle emissions, oil pollution sources and biomass combustion sources. The results of ILCR showed that the highest risk was found in adults, with males slightly higher than females. In Lianyungang, the maximum value of ILCR in winter was more than 10-6 in people over 9 years old. Conclusion The main sources of PAHs in PM_2.5 in Lianyungang City are mixed sources of road dust and vehicle emissions, oil pollution sources, and biomass combustion sources. Under the current exposure level of PAHs in PM_2.5, residents have a certain potential carcinogenic risk.

OBJECTIVE To investigate the therapeutic mechanisms of electroacupuncture at"Tianshu"(ST25)and"Sanyinjiao"(SP6)acupoints combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)using serum non-targeted metabolomics.METHODS Male SD rats were randomly divided into blank group,model group,metformin group,electroacupunc-ture group,and acupuncture-medicine combination(electroacupuncture combined with metformin)group.A type 2 diabetes model was established by high-fat diet combined with intraperitoneal injection of streptozotocin.The metformin group was treated with 250 mg·kg-1 metformin by gavage,the electroacupuncture group was treated with bilateral Tianshu and Sanyinjiao,the acupuncture-medicine combination group was treated with metformin by gavage combined with electroacupuncture,and the blank group and model group were treated with normal saline by gavage.All rats were treated 6 times a week for 7 weeks.After the intervention,the blood glucose level in the tail vein of the rats was measured using a blood glucose meter in the fasting state.The blood glucose levels of the rats were measured at 30,60,120,and 240 min after intraperitoneal injection of 50%glucose solution(4 mL·kg-1)to evaluate glu-cose tolerance.The serum insulin level of the rats was detected by ELISA and the insulin resistance index was calculated.The blood biochemical parameters were measured by an automatic blood biochemical analyzer.HE staining was used to evaluate the pathological conditions of the liver and pancreatic tissues of the rats.Ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)technology was used for mass spectrometry detection to identify differential metabolites,and MetaboAnalyst 5.0 was used for pathway enrichment analysis.RESULTS Compared with the blank group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the model group rats were significantly increased(P<0.001),blood TP and GLB were significantly de-creased(P<0.01),AST,ALT,and ALP were significantly increased(P<0.05,P<0.01,P<0.001),and obvious inflammatory cell infiltration and pathological damage were observed in the liver and pancreas tissues;compared with the model group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the acupuncture-medicine combination group were sig-nificantly decreased(P<0.05,P<0.01,P<0.001),blood ALP was significantly decreased(P<0.01),TP and GLB were significant-ly increased(P<0.05),and the pathological damage of the liver and pancreas was significantly improved.Serum metabolomics showed that the metabolic profiles of the groups were well distinguished.Compared with the blank group,the differential metabolites in the model group were enriched in histidine metabolism,thiamine metabolism,taurine and hypotaurine metabolism,ascorbic acid and alde-hyde ester metabolism,valine,leucine and isoleucine biosynthesis pathways;compared with the model group,237 metabolites such as 3-aminoadipic acid,3-oxocyclobutanecarboxylic acid and phosphorylcholine in the acupuncture-medicine combination group were sig-nificantly reduced,and the pathways were enriched in histidine metabolism,linoleic acid metabolism,thiamine metabolism,taurine and hypotaurine metabolism,valine,leucine and isoleucine biosynthesis pathways.CONCLUSION Electroacupuncture combined with metformin can effectively improve the glucose and lipid metabolism of T2DM rats,and its potential mechanism may be related to the regulation of amino acid metabolism.

Objective:To compare the efficacy and safety of SRS-Schwab grade 4 osteotomy and vertebral column resection (VCR) in the surgical correction of type II congenital kyphosis (CK).Methods:A retrospective review was conducted on clinical and radiographic data from patients with type II CK who underwent corrective surgery at Nanjing Drum Tower Hospital between June 2008 and December 2021. Patients were divided into two groups based on the osteotomy technique employed: the VCR group (21cases) and the SRS-Schwab grade 4 osteotomy group (19 cases). Clinical parameters, including operative duration, estimated blood loss (EBL), number of segmentation failure levels, number of fused segments, and the use of anterior support cages, were compared between groups. Radiographic parameters included the number of segmentation fusion and measurements of segmental kyphosis (SK) preoperatively, postoperatively, and at the final follow-up. The degree and rate of SK correction were also calculated and compared. Complications such as neurophysiological monitoring events, neurological injury, implant breakage, proximal junctional kyphosis/lordosis (PJK/PJL), sagittal translation (ST), and implant failure were recorded. Additionally, SRS-22 questionnaire scores were assessed preoperatively, postoperatively, and at the latest follow-up.Results:A total of 40 patients were included, with a mean follow-up duration of 48.96±21.31 months (range, 24-96 months). Compared to the SRS-Schwab group, the VCR group had significantly more levels of segmentation defect (3.85±0.79 vs. 2.68±0.54), required more fused segments (8.00±2.23 vs. 5.47±2.04), had longer operative time (358.71±77.06 min vs. 212.52±77.05 min), and greater EBL (963.66±278.49 ml vs. 698.94±222.20 ml), all with statistically significant differences ( P<0.05). No significant differences were observed in local kyphotic angle, correction magnitude, or correction rate between groups postoperatively (P>0.05). Among patients with ≤48 months of follow-up, the SRS-Schwab group showed significantly lower SK (13.00°±16.28° vs. 34.00°±21.37°) and a higher correction rate (82.52%±21.40% vs. 52.84%±24.67%) at final follow-up ( P<0.05). However, no significant differences were observed in patients with >48 months of follow-up ( P>0.05), or in the overall cohort regardless of follow-up duration ( P>0.05). Complication rates were comparable between groups ( P>0.05). One neurophysiological monitoring event, 1 neurological injury, 3 cases of PJK, 1 case of PJL, 2 cases of ST, and 2 implant failures were observed in VCR group. The SRS-Schwab Grade 4 osteotomy group had 1 neurophysiological monitoring event, 1 neurological injury, 4 cases of PJK, 2 cases of ST, and 1 implant failure. The complication rates between the groups were not statistically different ( P>0.05). Both groups showed significant improvements in the self-image domain of the SRS-22 postoperatively and at the final follow-up ( P<0.05). In the function domain, both groups also demonstrated significant improvement at the final follow-up ( P<0.05), while the SRS-Schwab group showed earlier improvement at 3 months postoperatively ( P<0.05). Conclusions:SRS-Schwab grade 4 osteotomy provides comparable correction of segmental kyphosis to VCR but offers the advantages of significantly reduced blood loss and shorter operative time. Both surgical techniques effectively improve patients' quality of life.

OBJECTIVE To investigate the therapeutic mechanisms of electroacupuncture at"Tianshu"(ST25)and"Sanyinjiao"(SP6)acupoints combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)using serum non-targeted metabolomics.METHODS Male SD rats were randomly divided into blank group,model group,metformin group,electroacupunc-ture group,and acupuncture-medicine combination(electroacupuncture combined with metformin)group.A type 2 diabetes model was established by high-fat diet combined with intraperitoneal injection of streptozotocin.The metformin group was treated with 250 mg·kg-1 metformin by gavage,the electroacupuncture group was treated with bilateral Tianshu and Sanyinjiao,the acupuncture-medicine combination group was treated with metformin by gavage combined with electroacupuncture,and the blank group and model group were treated with normal saline by gavage.All rats were treated 6 times a week for 7 weeks.After the intervention,the blood glucose level in the tail vein of the rats was measured using a blood glucose meter in the fasting state.The blood glucose levels of the rats were measured at 30,60,120,and 240 min after intraperitoneal injection of 50%glucose solution(4 mL·kg-1)to evaluate glu-cose tolerance.The serum insulin level of the rats was detected by ELISA and the insulin resistance index was calculated.The blood biochemical parameters were measured by an automatic blood biochemical analyzer.HE staining was used to evaluate the pathological conditions of the liver and pancreatic tissues of the rats.Ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)technology was used for mass spectrometry detection to identify differential metabolites,and MetaboAnalyst 5.0 was used for pathway enrichment analysis.RESULTS Compared with the blank group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the model group rats were significantly increased(P<0.001),blood TP and GLB were significantly de-creased(P<0.01),AST,ALT,and ALP were significantly increased(P<0.05,P<0.01,P<0.001),and obvious inflammatory cell infiltration and pathological damage were observed in the liver and pancreas tissues;compared with the model group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the acupuncture-medicine combination group were sig-nificantly decreased(P<0.05,P<0.01,P<0.001),blood ALP was significantly decreased(P<0.01),TP and GLB were significant-ly increased(P<0.05),and the pathological damage of the liver and pancreas was significantly improved.Serum metabolomics showed that the metabolic profiles of the groups were well distinguished.Compared with the blank group,the differential metabolites in the model group were enriched in histidine metabolism,thiamine metabolism,taurine and hypotaurine metabolism,ascorbic acid and alde-hyde ester metabolism,valine,leucine and isoleucine biosynthesis pathways;compared with the model group,237 metabolites such as 3-aminoadipic acid,3-oxocyclobutanecarboxylic acid and phosphorylcholine in the acupuncture-medicine combination group were sig-nificantly reduced,and the pathways were enriched in histidine metabolism,linoleic acid metabolism,thiamine metabolism,taurine and hypotaurine metabolism,valine,leucine and isoleucine biosynthesis pathways.CONCLUSION Electroacupuncture combined with metformin can effectively improve the glucose and lipid metabolism of T2DM rats,and its potential mechanism may be related to the regulation of amino acid metabolism.

Objective To explore the molecular mechanism of luteolin in the treatment of cervical cancer based on network pharmacology and molecular docking technology. Methods The drug-like properties of luteolin were analyzed by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The targets of luteolin were obtained from PharmMapper, Super-PRED, and Swiss Target Prediction databases. The targets related to cervical cancer were acquired from GeneCards, OMIM, and PharmGKB databases. The intersection targets of luteolin and cervical cancer were obtained through EVenn, and the "luteolin-intersection targets-cervical cancer" network diagram was constructed by Cytoscape 3.8.1. The STRING database was used to analyze the protein-protein interaction (PPI) network of intersection targets and screen the core targets. The Database for Annotation, Visualization and Integrated Discovery (David) was used to conduct Gene Ontology (GO) gene function analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis of the targets. PyMoL 2.6.0, AutoDockTool 1.5.7 and OpenBabel 2.4.1 software were used to perform molecular docking between the core targets and luteolin. The survival analysis and pan-cancer analysis of the core targets were performed in the GEPIA database. Results A total of 449 targets of luteolin and 1 334 targets related to cervical cancer were obtained; there were 100 intersection targets between luteolin and cervical cancer, of which 24 were core targets, including MMP2, HRAS, MAPK1, AKT1, RHOA and PGR. GO and KEGG enrichment analyses revealed that the intersection targets participated in 455 biological processes, 70 cellular components, 119 molecular functions, and 143 KEGG signaling pathways. Molecular docking revealed a good binding of MMP2 with luteolin. The survival curves of cervical cancer patients showed that the risk ratios of RHOA, MAPK1, MMP2 and AKT1 genes were greater than 1, while those of HRAS and PGR were less than 1. Pan-cancer analysis showed that HRAS and MAPK1 were highly expressed in cervical cancer, and HRAS had significant expression differences. Conclusion Luteolin treats cervical cancer through a multi-target and multi-pathway mechanism.

Post-traumatic stress disorder (PTSD) presents with complex and diverse clinical manifestations, making accurate and objective diagnosis challenging when relying solely on clinical assessments. Therefore, there is an urgent need to develop reliable and objective auxiliary diagnostic models to provide effective diagnosis for PTSD patients. Currently, the application of graph neural networks for representing PTSD is limited by the expressiveness of existing models, which does not yield optimal classification results. To address this, we proposed a multi-graph multi-kernel graph convolutional network (MK-GCN) model for classifying PTSD data. First, we constructed functional connectivity matrices at different scales for the same subjects using different atlases, followed by employing the k-nearest neighbors algorithm to build the graphs. Second, we introduced the MK-GCN methodology to enhance the feature extraction capability of brain structures at different scales for the same subjects. Finally, we classified the extracted features from multiple scales and utilized graph class activation mapping to identify the top 10 brain regions contributing to classification. Experimental results on seismic-induced PTSD data demonstrated that our model achieved an accuracy of 84.75%, a specificity of 84.02%, and an AUC of 85% in the classification task distinguishing between PTSD patients and non-affected subjects. The findings provide robust evidence for the auxiliary diagnosis of PTSD following earthquakes and hold promise for reliably identifying specific brain regions in other PTSD diagnostic contexts, offering valuable references for clinicians.
Humans ; Stress Disorders, Post-Traumatic/diagnostic imaging* ; Neural Networks, Computer ; Algorithms ; Brain/diagnostic imaging* ; Magnetic Resonance Imaging

Objective: To analyze the trends in disease burden of tuberculosis among children under 5 years of age in China from 1990 to 2021, so as to provide insights for future tuberculosis control measures among children in China. Methods: Based on the Global Burden of Disease (GBD) 2021 datasets, the incidence, prevalence, mortality and disability adjusted life year(DALY) of tuberculosis of children under 5 years of age in China and globally were collected from 1990 to 2021. The incidence, prevalence, mortality and DALY rate of tuberculosis were compared by genders and types. In addition,the annual percent change(APC) and the average annual percent change(AAPC) of children s tuberculosis burden in China and globally from 1990 to 2021 were calculated by using the Joinpoint regression model, and the changing trends were analyzed. Results: The numbers of incident, prevalent and dead tuberculosis cases were 9 700, 8 477 800 and 200 among children under 5 years of age in China in 2021, and the DALY due to tuberculosis were 27 100 person years. There were significant reductions in incidence, prevalence, mortality and DALY rate of tuberculosis among children under 5 years of age in China ( AAPC =-5.45%, -1.14%, -12.37%, -11.34 %) and globally( AAPC =-2.38%, -1.41%, -4.66%, -4.56%), and the reductions in the incidence, mortality and DALY rate were more significant in China than globally ( P <0.05).In 1992 and later, the numbers of incident, prevalent and dead tuberculosis cases and the DALY of tuberculosis were higher among male than among female. In addition, the disease burden of drug susceptible tuberculosis appeared a tendency of downward in China from 1990 to 2021, while the incidence and prevalence of extensively drug resistant tuberculosis rose since 2015. Conclusions The disease burden of tuberculosis remarkably reduced among children under 5 years of age in China from 1990 to 2021. However, the burden of disease due to multidrug resistant tuberculosis appeared an upward trend recently. Increased attention is required to be paid to the prevention and control of tuberculosis among children and improved diagnosis and treatment of drug resistant tuberculosis are recommended.

Background The activity in precuneus within default mode network has been reported to be associated with antidepressant response,whereas the relationship between the functional network of precuneus and early response to antidepressant medications remains unclear.Objective To investigate the relationship between precuneus functional connectivity(FC)and early efficacy of antidepressant treatment in patients with major depressive disorder,so as to find a neurobiomarker to predict the early efficacy of antidepressants.Methods A consecutive sample of 47 patients with major depressive disorder who attended the Mental Health Center,West China Hospital of Sichuan University from July 2017 to February 2019 and fulfilled the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)were recruited.Baseline resting-state functional magnetic resonance imaging scan findings and clinical assessments were recorded in participants.All patients treated with antidepressants for two weeks.Improvement was defined as 20%or greater reduction in baseline 16-item Quick Inventory of Depressive Symptoms Self-Report Scale(QIDS-SR16)by treatment exit,and patients were then classified into early improved group(n=27)and non-improved group(n=20).FC values of precuneus and whole brain were calculated using bilateral precuneus as seed region,and baseline precuneus FC values were compared between two groups.Pearson correlation analysis was utilized to explore the correlation between FC values in brain regions with statistically significant differences and QIDS-SR16 total scores and reduction rates.Results FC values between the left precuneus and left precentral gyrus and between the right precuneus and right fusiform gyrus in early improved group were both higher than those in non-improved group(GRF correction,P<0.01).The FC valves between the left precuneus and the left precentral gyrus and between the right precuneus and the right fusiform gyrus were positively correlated with QIDS-SR16 reduction rate(r=0.475,0.297,P<0.05).Conclusion Weakened FC between the left precuneus and left precentral gyrus and between the right precuneus and right fusiform gyrus are related to poor early efficacy to antidepressant treatment,and FC of precuneus may be a potential predictor of early response to antidepressants.

Objective To investigate the publications and citations of Chinese Journal of Schistosomiasis Control from 2011 to 2020, so as to provide insights into improving the journal quality and impact.. Methods All publications were retrieved from 60 issues of 10 volumes of Chinese Journal of Schistosomiasis Control from 2011 to 2020, and publication and citation analyses were performed using a bibliometric method. Results A total of 1 867 articles were published in Chinese Journal of Schistosomiasis Control from 2011 to 2020, with the largest number in 2012 (220 publications) and the lowest in 2020 (135 publications), and original article (36.48%), control experience (17.14%) and control study (10.34%) were the three most common article type. The overall proportion of grant-supported articles was 59.08% (1 103/1 867), and the number of grant per article was (2.34±1.58) grants. The mean duration from submission to publication was (173.48±105.84) days per article, and there was a significant difference in the mean duration from submission to publication among years (F = 30.883, P < 0.01). Jiangsu Province (492 publications, 26.35%), Shanghai Municipality (264 publications, 14.14%) and Hubei Province (230 publications, 12.32%) were the three most productive provinces where the first author lived, and disease control and prevention institutions were the predominant affiliations of the first author (67.22%), with Jiangsu Institute of Schistosomiasis Control, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, and Wannan Medical College as the three most productive affiliations. The number of authors was 5.94 authors per publication, and the proportion of co-authored publications was 95.45% in Chinese Journal of Schistosomiasis Control from 2011 to 2020. Journal article was the predominant type of cited (89.97%), and the mean number of citations was (15.70±11.56) citations per publication, with a significant difference in the mean number of citations per publication among years (F = 2.205, P < 0.05). The impact factors of Chinese Journal of Schistosomiasis Control ranged from 0.877 to 1.676 during the period from 2011 to 2020, and the overall Price index was 47.59%. Conclusions Both the academic impact and national transmissibility of Chinese Journal of Schistosomiasis Control appeared a tendency towards a rise from 2011 to 2020. Seeking high-quality contributions, increasing interdisciplinary integration, shortening the duration from submission to publication, expanding the coverage of publication services and enhancing impact are the future priorities of the journal.