Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To summarize the clinical symptoms of cyclic vomiting syndrome（CVS）in children and investigate its association with small intestinal bacterial overgrowth（SIBO）.Methods:A total of 89 children who were diagnosed as CVS and improved lactulose hydrogen breath test (LHBT) in the Pediatric Department of Beijing Tsinghua Changgung Hospital from June 2020 to June 2023 were selected as CVS group.Simultaneously，50 healthy children with physical examination in our hospital were selected as the control group. According to the results of LHBT,the children with CVS were divided into SIBO group (LHBT positive) and non-SIBO group (LHBT negative). The clinical data of children in each group were compared.Results:Among the 89 CVS patients，there were 42 males and 47 females，with a mean age of（7.50±3.54）years.Common accompanying symptoms included excessive sleepiness（76 cases，85.39%），anorexia(62 cases，69.66%），constipation（55 cases，61.80%），abdominal pain（34 cases,38.20%）and so on. There were no significant differences in age and gender between children in CVS group and control group ( P>0.05). The body mass index of CVS group was lower than that of control group.The positive rate of LHBT was higher than that of the control group (56.18% vs. 8.00%),the difference was statistically significant ( P<0.05),and the concentrations of hydrogen and methane in CVS group were higher than those of the control group at different time points( P<0.05).Among 89 children with CVS,there were 50 cases in SIBO group and 39 cases in non-SIBO group. There were no significant differences in gender,age and body mass index between the two groups ( P>0.05). The constipation rate and moderate/severe disease rate in SIBO group were higher than those in non-SIBO group (88.00% vs. 28.21%,94.00% vs. 43.59%),and the differences were statistically significant ( P<0.05). Conclusion:The incidence of SIBO in children with CVS is higher,and SIBO may play a key role in CVS. CVS children with SIBO have higher disease severity.

Objective:To assess the nutritional status and risk of children with cyclic vomiting syndrome（CVS）and to provide a clinical evidence for nutritional support.Methods:A total of 160 children diagnosed with CVS and 160 healthy controls were prospectively enrolled in the study，who were admitted to Beijing Tsinghua Changgung Hospital from April 2021 to February 2024.Nutritional status was assessed by anthropometric indices（height，weight，and body mass index），and it was expressed in standard deviation score（Z score）.Nutritional risk screening tool STRONGkids was applied to nutritional risk screening，and the laboratory assessment（albumin，pre-albumin，hemoglobin，urea nitrogen and creatinine）were measured.Results:Among the 160 cases，there were 73 males and 87 females，including 18 cases of mild seizures and 142 cases of moderate and severe seizures，with the average onset age of（47.54±2.96）months and an average diagnosis age of（74.89±3.68）months.The average duration from the first attack to diagnosis was（27.35±2.36）months，and the average course of the disease was（41.35±2.63）months.The malnutrition rate of children in CVS was 36.9%（59/160），of which 18.1%（29/160）was severely malnourished.There was a statistically significant difference in the weight-for-age Z-score（WAZ），height-for-age Z-score（HAZ），and body mass index-for-age Z-score（BAZ）between the CVS group and the control group（ P<0.001）.We found a statistically significant difference in laboratory indicators（albumin，pre-albumin，hemoglobin，urea nitrogen and creatinine）between the two groups（all P<0.001）and hemoglobin was positively correlated with WAZ，HAZ and BAZ（ r=0.346,0.250,0.277，all P<0.01）.Using the STRONGkids nutritional risk screening tool，there were 43 cases with moderate nutritional risk and 117 cases with high nutritional risk，and children with high nutritional risk were likely to have lower WAZ，HAZ and BAZ than the children with moderate nutritional risk，and there was a significant difference in WAZ，HAZ，BAZ，hemoglobin，and creatinine between the two groups（ P<0.05）.And there was a correlation between the degree of CVS attack and nutritional risk grouping（ r=0.543， P<0.001）. Conclusion:Children with CVS have a high incidence of malnutrition，and the serum albumin，prealbumin，hemoglobin，urea nitrogen and creatinine levels are of great value for nutritional assessment.The STRONGkids score method helps to evaluate nutritional risk in children with CVS.

Objective:To investigate the characteristics of gut microbiota distribution in children with cyclic vomiting syndrome（CVS）complicated by constipation.Methods:The children with CVS, aged from 1 to 16 years, who were admitted to Beijing Tsinghua Changgung Hospital from June 2022 to January 2024, were divided into constipation group and normal group(non-constipation group) according to whether they were complicated with constipation or not.The clinical data and stool samples of children were collect. The abundance, diversity and composition of intestinal flora in fecal samples of two groups were detected by metagenomics sequencing.Results:A total of 20 children with CVS were collected, including 10 patients in constipation group and 10 patients in normal group.There were no significant differences in general demographic data between the two groups, including age at admission, age at first onset, body mass index, gender distribution, disease severity, endoscopic findings, and abdominal pain patterns.Microbiome analysis yielded 470 operational taxonomic units (OTUs), with 414 OTUs identified in normal group and 56 OTUs in constipation group. The abundance and diversity of intestinal flora in constipation group were significantly lower than those in normal group. Principal coordinate analysis and principal component analysis indicated significant structural differences in gut microbiota composition between the two groups. LEfSe analysis revealed distinct taxonomic patterns between the two groups, with the normal group demonstrating predominant representation of Firmicutes at the phylum level, while the constipation group showed higher relative abundance of Bacteroidetes and Actinobacteria. KEGG pathway analysis revealed that the carbon metabolism pathways was significantly enriched in the constipation group.Conclusion:There are significant differences in intestinal flora between CVS children with and without comorbid constipation.Bacteroides and Actinomycetes play an important role in constipation of children with CVS. The diversity and metabolic function of intestinal flora may be one of the pathological mechanisms of CVS complicated with constipation.

Objective To investigate the feasibility and safety of bedside transesophageal echocardiography(TEE)-guided atrial septostomy in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods Eight patients(2 females and 6 males)who developed pulmonary edema during VA-ECMO treatment between January 2020 and October 2024 were enrolled.All patients underwent bedside TEE-guided atrial septal puncture,followed by gradual balloon dilation using an Inoue balloon(diameter:18-24 mm).The endpoint for dilation was defined as mean left atrial pressure＜15 mmHg.Post-procedure evaluation included assessment of the septal defect size,mean left atrial pressure,and improvement in bilateral pulmonary edema.Results The mean age of all 8 patients was(43.50±16.84)years old.Atrial septostomy was successfully performed in all patients.The mean balloon dilation diameter was(22.75±2.68)mm,resulting in a mean septal defect size of(6.31±0.37)mm.The mean left atrial pressure significantly decreased from(26.63±1.77)mmHg pre-procedure to(12.75±1.28)mmHg post-procedure(P＜0.001).All patients demonstrated marked improvement in bilateral pulmonary edema,and six patients also showed a significant reduction in the severity of mitral regurgitation following the procedure.No procedure-related complications were observed.Conclusions Bedside TEE-guided atrial septostomy is safe and effective for reducing left heart loading during ECMO support and improving pulmonary edema.

Objective To evaluate the application value of stereotactic robotic surgery driven by a multi scenario AI system in the elderly with severe hypoperfusion in the internal capsule area and minor HTH.Methods A retrospective analysis was conducted on 101 minor HTH patients com-plicated with severe hypoperfusion in the internal capsule area identified by an AI diagnostic sys-tem in our department from January to October 2024.Among them,48 cases who underwent ster-eotactic robotic drainage with AI system support were assigned into the study group,and 53 cases of conventional drug treatment were into the control group.The general clinical data were com-pared between the two group.Improvement rate of rCBF 14 d after treatment,effective rate 90 d after treatment,favorable prognosis rate,and incidence of shunt dependent hydrocephalus were compared between the two groups to evaluate the application value of AI-assisted stereotactic ro-botic surgery in these patients.Results The study group had significantly higher improvement rate of rCBF 14 d after treatment,better effective rate and larger ratio of favorable prognosis 90 d after treatment when compared with the control group(60.4％vs 39.6％,P＜0.05;62.5％vs 41.5％,P＜0.05;64.6％vs 43.4％,P＜0.05).Conclusion Stereotactic robotic assisted drainage driven by multi scenario AI system can significantly improve the prognosis of the elderly minor HTH patients complicated with severe hypoperfusion in the internal capsule area.

Heatstroke,especially in high-temperature and high-humidity environments,is a life-threatening acute heat-injury disease that seriously endangers human health.Timely and effective on-site treatment is crucial for patients'survival and prognosis.Early recognition,rapid assessment,and on-site cooling are the core of pre-hospital treatment of heatstroke.Currently,there is a lack of standardized application procedures for pre-hospital emergency care of heatstroke.Therefore,the"Expert Consensus on Pre-hospital Emergency Management of Heatstroke(2024 edition)"was initiated by the Expert Group on Heatstroke Prevention of the People's Liberation Army and developed in collaboration with experts from local pre-hospital emergency care,emergency departments,and intensive care units.This consensus focuses on heatstroke prevention,on-site and ambulance-based treatment,and early emergency room interventions,and puts forward 10 evidence-based recommendations,aiming to provide a reference for scientific and standardized pre-hospital emergency care of heatstroke.

AIM To investigate the effects of Xuesaitong Capsules(Panax notoginseng saponins)on ischemia/reperfusion injury in a mouse model of skin frostbite.METHODS The mice were randomly divided into the control group,the model group,the dexamethasone group(1 mg/kg),and the low-dose,medium-dose,and high-dose Xuesaitong Capsules groups(0.036,0.072,and 0.144 g/kg),with eight mice in each group.A frostbite model was established using a dry ice-cooled ceramic(ferrite)magnet.On the 2nd day after modeling,each group started its corresponding dosing by gavage for 14 consecutive days.The wound healing,histopathological changes,and serum levels of high-sensitivity C-reactive protein(hs-CRP),thromboxane B2(TXB2),6-keto-prostaglandin F1α(6-K-PGF1α),nitric oxide(NO)and endothelin(ET)were assessed using ELISA.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)levels in skin tissues were measured biochemically.The protein expressions of tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,Toll-like receptor(TLR)4 and phosphorylated nuclear factor-KB p65(p-NF-κB p65)in skin tissues were determined by Western blot.Additionally,LncRNA H19 mRNA expression in skin tissues was evaluated using RT-qPCR.RESULTS After the final administration,compared with the control group,the model group exhibited partial scab detachment,wound healing,and larger wound areas;hyperkeratosis with incomplete keratinization,detachment of the dermis and subcutaneous tissue,partial loss of appendages,subcutaneous edema,and dilated,congested,and hemorrhagic stromal vessels with extensive lymphocyte infiltration revealed by the histopathological examination;elevated serum levels of hs-CRP,TXB2,and ET(P＜0.05,P＜0.01);decreased 6-K-PGF1α and NO levels(P＜0.05,P＜0.01);reduced SOD activity in skin tissues(P＜0.01);increased MDA levels(P＜0.01);and upregulated protein expressions of TNF-α,IL-1β,IL-6,TLR4 and p-NF-κB p65,as well as LncRNA H19 mRNA expression(P＜0.05,P＜0.01).Compared with the model group,the group intervened with high-dose Xuesaitong Capsules displayed reduced wound areas(P＜0.01);decreased serum levels of hs-CRP,TXB2 and ET(P＜0.05,P＜0.01);increased 6-K-PGF1α and NO levels(P＜0.05,P＜0.01);enhanced SOD activity(P＜0.05,P＜0.01);reduced MDA level in skin tissues(P＜0.05,P＜0.01);and down-regulated TNF-α,IL-1β,IL-6,TLR4 and p-NF-κB p65 protein expressions and suppressed LncRNA H19 mRNA expression in skin tissues as well(P＜0.05,P＜0.01).CONCLUSION Xuesaitong Capsules alleviate ischemia/reperfusion injury in frostbite-injured mice by exerting anti-inflammatory and anti oxidative stress effects and restoring vascular endothelial function mediated by the downregulation of LncRNA H19 expression and inhibition of the TLR4/NF-κB signaling pathway.

Aim To explore the mechanism of Bushen Tongfu prescription(BSTF)regulating gut microbiota and improving learning and memory ability of Alzhei-mer's disease(AD)model mice.Methods APP/PS1 mice were administered by BSTF for eight weeks.The spatial learning and memory ability of mice were detected by Morris water maze.The changes in the gut microbiota abundance and diversity of mice were detec-ted by 16S rDNA technology.The morphological chan-ges of hippocampus were observed by HE staining.The expression of the activation of microglia in hippocampus was detected by immunofluorescence.The expressions of pro-inflammatory factors of TLR4,NF-κB and IL-6 in brain tissue were detected by Western blot.Results Compared with the model group,the escape latency and swimming path were shortened,the times of target crossings after removing the platform increased in BSTF groups(P＜0.05),the α-diversity increased and the abundance of gut microbiota was regulated,the mor-phological structure and pathological damage of hipp-ocampal cells were improved,the co-expression of iN-OS/Iba1 decreased and the co-expression of Arg1/Iba1 increased significantly(P＜0.01),the transformation of M1 to M2 of microglial cells was promoted,and the expression of TLR4,NF-κB and IL-6 protein decreased significantly.Conclusions BSTF can improve the learning and memory ability of APP/PS1 mice,and its mechanism may be related to regulating the gut micro-biota and the LPS/TLR4/NF-κB pathway,inhibiting the activation of pro-inflammatory microglia,reducing inflammation in hippocampus and improving the patho-logical damage of hippocampal cells.