Objective To investigate the relationship between lead exposure and the clinical heterogeneity of amyotrophic lateral sclerosis(ALS).Methods Baseline data were collected from 49 ALS patients hospitalized at the PLA General Hospital.Blood metal levels(copper,zinc,calcium,magnesium,iron,lead)were measured by graphite furnace atomic absorption spectrometry.The Revised ALS Functional Rating Scale(ALSFRS-R)was used to assess the severity of motor function impairment.Patients were grouped by site of onset and ALSFRS-R score,then blood metal levels were compared between two groups.General linear regression,ROC curves and Logistic regression models were applied to analyze the correlation between blood lead levels and disease severity to identify risk factors affecting motor function in ALS patients,and analyze its predictive value.Results The differences of blood metal levels between bulbar onset patients and non-bulbar onset patients were no statistical significance(all P＞0.05).Blood lead levels were significantly lower in the high ALSFRS-R score group than in the low ALSFRS-R score group,and the difference was significant(P=0.02).Blood lead levels were negatively correlated with ALSFRS-R scores in ALS patients(Y=-0.1267X+45.86,R2=0.08937,P=0.04).The area under the ROC curve was 0.70,indicating that blood lead had predictive value for ALS severity.The Logistic regression model demonstrated that elevated blood lead level was an independent risk factor for the severity of ALS disease(OR=1.107,95％CI:1.006-1.219,P=0.04).Conclusions Blood lead levels in ALS patients correlated with disease severity and exhibited predictive utility.Elevated blood lead was an independent risk factor for the severity of motor function impairment in ALS.

BACKGROUND:Observational studies have found a dual effect of lipids and immune cells on osteoarthritis progression,but the exact mechanism of action is not yet clear.OBJECTIVE:To investigate whether the causal relationship between lipids and knee osteoarthritis is regulated by immune cells.METHODS:179 lipids were obtained from the Linda Ottensman database,731 immune cell-associated single nucleotide polymorphisms were obtained from Open GWAS as instrumental variables,and genome-wide association data for knee osteoarthritis were obtained from the Osteoarthritis Genetics Consortium.First,we used a two-sample Mendelian randomization method to investigate the causal relationships between lipids and knee osteoarthritis,between immune cells and knee osteoarthritis,and between lipids and immune cells from a genetic perspective.In addition,Bayesian-weighted Mendelian randomization verified the causal relationship between lipids and knee osteoarthritis,and reverse Mendelian randomization and Steiger directionality test assessed the positive relationship.Second,sensitivity analyses were performed,including Cochran's Q test to eliminate heterogeneity,MR-PRESSO global test and MR-Egger intercept to rule out horizontal pleiotropy,and leave-one-out method to assess the effect of individual single nucleotide polymorphism drivers on random estimates.Finally,the mediating effect of specific immune cell traits in the causal relationship between lipids and knee osteoarthritis was determined by a two-step Mendelian randomization method.RESULTS AND CONCLUSION:The inverse variance weighting method and Bayesian-weighted algorithm together identified eight lipid species that were causally associated with knee osteoarthritis.The results of Cochran's Q,MR-PRESSO,and MR-Egger intercept were not statistically significant(P<0.05).Meanwhile,a total of three sets of mediated relationships were calculated,with the lowest mediation percentage of 11.85%and the highest of 45.48%.These findings indicate the level of immune cells plays a potential role in the regulatory process of lipids and knee osteoarthritis,which provides new perspectives for in-depth exploration of knee osteoarthritis.

Objective To construct a dynamic framework for bidirectional transitions of mild cognitive impairment(MCI),quantifying both rare reversion and high-risk progression trajectories in cognitive dynamics.Methods Patients diagnosed with MCI at baseline from 2005 to 2022 and completed at least two follow-up visits were selected from the Alzheimer's Disease Neuroimaging Initiative(ADNI),and a retrospective cohort was constructed.Demographic information,APOEε4 genotype,and neuropsychological scales data were collected.Longitudinal cognitive assessments were functionally reconstructed using multivariate functional principal component analysis(MFPCA),with functional principal components(FPCs)extracted based on cumulative variance contribution rate(PVE＞90％).Functional multi-state Markov models were developed to estimate inter-state transition intensities,year to year transition probabilities,and covariate effects.Results Among 1,019 MCI patients(4,657 follow-up visits),93(9.1％)reverted to normal cognition,while 359(35.2％)progressed to Alzheimer's disease(AD).Longitudinal trajectory analysis revealed significant heterogeneity:progressive MCI＞stable MCI＞reverted MCI in the first functional principal component(MFPC1)scores.The transition intensity for MCI reversion(0.020)was approximately one-fourth of the AD progression risk(0.086),but the post-reversion cognitive re-impairment intensity was 0.138.Reduced MFPC1(HR=0.993,95％Cl:0.991,0.995)and elevated MFPC2(HR=1.004,95％Cl:1.001,1.007)were closely associated with MCI reversion.Conclusion MCI exhibits marked heterogeneity in longitudinal cognitive trajectories.Although reversion is rare,reversed patients remain at high risk of cognitive re-impairment.

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 design a search and rescue simulation training system to enhance medical command,search and rescue capabilities of the PLA air force.Method A search and rescue simulation training sysgtem was designed based on the war gaming theory and developed with C/S architecture,C++language and MongoDB database for data storage,which was composed of four subsystems for scenario setting,action coordination and commanding operation simulation.The scenario setting subsystem included 3 modules of map editing setting,scenario editing and organization preparation;the action coordination subsystem had 5 modules of deduction process control,deduction coordination intervention,deduction status monitoring,perspective control and addition of deduction conditions;the commanding operation subsystem involved in 3 modules of command and control,real-time information query and operation command;the operation simulation subsy-stem consisted of 3 modules of agent search,rescue and treatment simulation,operation ruling and operation intelligence management.Results The system developed facilitated search,rescue and commanding training-related teaching and search and rescue program rehearsal verification,and thus comprehensively enhanced the trainee's capabilities in search,rescue,commanding and decision making.Conclusion The system developed integrates effectively medical commanding with operational commanding during search and rescue,providing a novel means for air force search and rescue operations and medical service simulation training.[Chinese Medical Equipment Journal,2025,46(4):15-20]

Objective To investigate the changes of diameter of the main trunk of the extracranial segment of the facial nerve,local hemodynamics and facial muscle thickness in patients with peripheral facial palsy(PFP)at acute stage by high frequency ultrasound(HFUS).Methods Sixty patients with acute PFP were enrolled as the PFP group,and 30 healthy people were selected as the control group.The following facial param-eters were scanned and recorded using HFUS:diameter of the main trunk of the extracranial segment of the facial nerve(FN-d),facial artery diameter(FA-d),facial artery systolic velocity(FA-Vs),facial artery diastolic velocity(FA-Vd),facial artery resistance index(FA-RI),frontalis muscle thickness(FM-t),depressor anguli oris muscle thickness(DAO-t),and depressor labii inferioris muscle thickness(DLI-t).The feasibility of facial param-eters in the diagnosis of acute-phase peripheral facial palsy(PFP)was evaluated,with intra-group and inter-group variability comparisons performed.Pearson correlation analysis was conducted to evaluate the relationship between acute-phase facial parameters and House-Brackmann(H-B)scale scores in PFP patients.Results(1)The H-B score of the PFP group was significantly lower than that of the control group,and the difference was statistically significant(P＜0.05).(2)The reliability of repeated measurements of facial parameters by different testers is good(ICC＞0.75).(3)The FN-d and FA-RI values on the affected side of PFP group were higher than those on the healthy side and control group,and FA-Vs,FA-Vd,DAO-t and DLI-t values were lower than those on the healthy side and control group,with statistical significance(P＜0.05).(4)The FN-d and FA-RI values of the affected side in the PFP group were negatively correlated with the H-S scale score(r=-0.847,P＜0.05;r=-0.863,P＜0.05);FA Vs,FA Vd,DAO-t,DLI-t are positively correlated with H-S scale scores(r=0.808,P＜0.05;r=0.757,P＜0.05;r=0.836,P＜0.05;r=0.694,P＜0.05).Conclusions HFUS can effectively detect the characteristic changes such as the increase in the diameter of the extrcranial facial nerve trunk,local microcircula-tion disturbance and facial muscle atrophy in patients with PFP in the acute stage,and the increase and decrease of FN-d,FA Vs,FA Vd,FA-RI,DAO-t,and DLI-t can accurately reflect the improvement or progress of PFP,which has important guiding significance for clinical disease monitoring and efficacy evaluation.

Objective To investigate the relationship between lead exposure and the clinical heterogeneity of amyotrophic lateral sclerosis(ALS).Methods Baseline data were collected from 49 ALS patients hospitalized at the PLA General Hospital.Blood metal levels(copper,zinc,calcium,magnesium,iron,lead)were measured by graphite furnace atomic absorption spectrometry.The Revised ALS Functional Rating Scale(ALSFRS-R)was used to assess the severity of motor function impairment.Patients were grouped by site of onset and ALSFRS-R score,then blood metal levels were compared between two groups.General linear regression,ROC curves and Logistic regression models were applied to analyze the correlation between blood lead levels and disease severity to identify risk factors affecting motor function in ALS patients,and analyze its predictive value.Results The differences of blood metal levels between bulbar onset patients and non-bulbar onset patients were no statistical significance(all P＞0.05).Blood lead levels were significantly lower in the high ALSFRS-R score group than in the low ALSFRS-R score group,and the difference was significant(P=0.02).Blood lead levels were negatively correlated with ALSFRS-R scores in ALS patients(Y=-0.1267X+45.86,R2=0.08937,P=0.04).The area under the ROC curve was 0.70,indicating that blood lead had predictive value for ALS severity.The Logistic regression model demonstrated that elevated blood lead level was an independent risk factor for the severity of ALS disease(OR=1.107,95％CI:1.006-1.219,P=0.04).Conclusions Blood lead levels in ALS patients correlated with disease severity and exhibited predictive utility.Elevated blood lead was an independent risk factor for the severity of motor function impairment in ALS.

Neuraminidase(NA),a glycoprotein on the surface of the influenza virus,plays a crucial role in viral escape and serves as a stable target for drug candidates.Monoclonal antibodies targeting the NA active site can bind to multiple influenza virus subtypes and inhibit the spread of influenza virus through various mechanisms,such as neutralizing,mediating antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotox-icity.In vivo experiments have shown that human monoclonal antibodies targeting the influenza virus NA can ef-fectively exert preventive and therapeutic effects,rescuing mice infected with lethal doses and reducing viral ti-ters in lungs of mice.This article provides a review of the currently reported human monoclonal antibodies targe-ting NA of Influenza A and Influenza B viruses,providing new ideas and prospects for the subsequent development of anti-influenza drugs.

OBJECTIVE To investigate the incidence of hospital-associated infections among the children with acute leukemia and analyze the economic burden so as to provide scientific bases for formulating the hospital infec-tion management strategies.METHODS A total of 140 children with acute leukemia who were hospitalized in pedi-atric hematology department of the First Affiliated Hospital of Shandong First Medical University and underwent hematopoietic stem cell transplantation from Jan.1,2018 to Jun.30,2024 were recruited as the research subjects.The clinical data,incidence of infections and cost data were collected.The infection group and the non-infection group were matched in a 1∶1 ratio by propensity score matching method.The length of hospital stay and costs of medical items were compared between the infection group and the non-infection group.The economic burden due to the hospital-associated infections was estimated.RESULTS Of the 140 children,59 had hospital-as-sociated infections,with the incidence of infections 42.14％.A total of 125 children who conformed to the inclu-sion and exclusion criteria were included in the study,among whom 53 pairs were matched successfully by propen-sity score matching method.The median hospitalization cost was 230,125.79 yuan in the infection group after the matching,189,880.90 yuan in the non-infection group,and there was significant difference between the two groups(Z=-2.038,P=0.042).The direct economic burden due to the hospital-associated infections in the chil-dren with acute leukemia was 40,244.89 yuan.The median costs of western medicine,self-pay and antibiotics were increased most remarkably among all the costs of medical items(all P＜0.05).CONCLUSION The targeted surveillance of hospital-associated infections and early warning of suspected cases are the major strategies to reduce the incidence of infections and relieve the economic burden.

The blood products industry,both domestically and internationally,exhibits distinct features in product research,development,and technological innovation.International companies possess extensive expertise in developing immunoglobulins,coagulation factors,and recombinant plasma protein products,demonstrating continuous advancements-particularly in specific immunoglobulin development,long-acting formulation optimization,and manufacturing process improvements.In recent years,Chinese enterprises have also achieved notable progress in related fields,especially in immunoglobulin process refinement and the development of novel recombinant coagulation factor products.However,there remains significant scope for improvement in areas such as the application of recombinant protein technologies,efficient utilization of plasma resources,and the adoption of advanced manufacturing techniques.Additional challenges include the accumulation of patented technologies,the supply of critical raw materials,and access to comprehensive epidemiological data.Driven by ongoing advances in gene recombination technologies,innovations in drug delivery systems,digital transformation,and the rise of personalized medicine,the blood products industry is poised for broader development prospects.To foster sustained and stable domestic industry growth and enhance global competitiveness,Chinese blood product enterprises should intensify their technological accumulation,upgrade manufacturing processes,and optimize plasma resource utilization.