Objective: To analyze changes in tuberculosis infection among junior high school students before and after tuberculosis exposure, so as to provide a reference for improving school tuberculosis prevention and control measures and policy formulation. Methods: Retrospectively collect data on a tuberculosis outbreak that occurred in a grade of a junior high school in Chongqing in 2025, including tuberculosis screening records of students in this grade upon their enrollment in 2022 (1 156 students) and after two tuberculosis outbreaks in 2023 (206 students) and 2025 (171 students). The Wilcoxon signed rank test for paired design was used to compare the induration diameters of the subjects, and the Chi square test was adopted to analyze the rate of tuberculosis infection among students. Results: In the tuberculosis outbreak in 2023, the rate of tuberculosis infection among close contacts ( 11.84 %) and the rate of tuberculosis infection among freshrman at school enrollment (12.89%) showed no statistically significant difference ( χ 2=0.25, P >0.05). The rate of tuberculosis infection of close contacts in the 2025 tuberculosis outbreak (55.56%) was higher than that in the 2023 outbreak (11.84%) ( χ 2=30.42, P <0.01). Among the 106 students included in the cohort analysis, the median induration diameter was 3.50 (1.50, 7.50) mm in 2023 and 8.75 (4.25, 11.50) mm in 2025, with a statistically significant difference ( Z=-5.76, P <0.01). There was no statistically significant difference between the infection rate in 2022 (16.98%) and that in 2023 (10.38%) ( χ 2=1.96, P =0.16). The infection rate in 2025 (43.40%) was higher than those in 2022 and 2023 ( χ 2=17.55, 29.39, both P <0.017). The seroconversion rate of students in the same class in 2025 ( 58.00 %) was higher than that of students in different classes (16.07%), with a statistically significant difference ( χ 2=20.19, P <0.01). All 72 individuals with latent tuberculosis infections identified during the pandemic in 2023 and 2025 refused to undergo prophylactic treatment. Conclusions The lack of preventive treatment may be the underlying cause of the successive outbreaks during the epidemic. Early detection of infection sources and standardized outbreak management are crucial to controlling the spread of the epidemic.

Objective: To delineate the epidemiologic profile of rifampicin resistant pulmonary tuberculosis (RR-PTB) among students in Chongqing, so as to provide evidence for effectively controlling RR-PTB outbreaks in schools. Methods: Individual level surveillance records of 395 student RR-PTB cases reported from 2015 to 2024 were extracted from the China Information System for Disease Control and Prevention. The Joinpoint regression analysis was employed to quantify temporal trends in the registration rate of student RR-PTB cases, and the comparison of RR-PTB registration rates with different demographic characteristics and different regions was performed using Chi-square test. Results: From 2015 to 2024, a total of 395 student RR-PTB cases were identified, with the registration rate ranged from 0.07 per 100 000 to 1.47 per 100 000, showed a fluctuating upward trend ( AAPC= 35.22%, t =4.13, P <0.01). A turning point was detected in 2017, rates rose during 2015-2017 (APC=295.23%， t =4.62， P < 0.01 ) and plateaued thereafter (APC=-0.47%， t =-0.12， P =0.91). The proportion of RR-PTB cases occurring among students increased both among all RR-PTB cases (1.54% in 2015, 7.48% in 2024) and all student pulmonary tuberculosis cases (0.20% in 2015, 7.17% in 2024), with significant linear trends ( χ 2 trend =33.55,159.98, both P <0.01). The majority of cases were enrolled in senior high school (50.38%), classified as retreatment (53.92%), of Han ethnicity (75.95%), and diagnosed with multidrug resistant tuberculosis(53.16%). There were significant differences in the composition of different ethnicity, registration category and resistance pattern between different years( χ 2=23.47, 17.23, 59.64，all P <0.05). The South-Eastern Wuling Mountainous Region exhibited the highest notification rate (3.96 per 100 000), whereas the western region had the lowest rate ( 0.47 per 100 000). County level jurisdictions reported higher rates than district level ones (2.16 per 100 000 vs 0.63 per 100 000 ). Statistically significant differences were observed in the RR-PTB reported rates among students across different districts and counties( χ 2=418.05,167.05,both P <0.01). Conclusions From 2015 to 2024, the registration rate of detected student RR-PTB cases in Chongqing showed an increasing trend. Students have become one of the key populations for drug resistant TB prevention and control. Intensified health education and active case finding should be implemented to enhance proactive surveillance capabilities.

With the adjustment of China's fertility policies, the proportion of advanced maternal age pregnancies has increased, making early identification of critical conditions in this population essential for successful treatment. This article systematically reviews the development of obstetric early warning management systems and advances in machine learning-based artificial intelligence for risk assessment in high-risk pregnant women. As artificial intelligence technology continues to evolve, future developments will include intelligent electronic medical record systems for high-risk pregnant women, generate clinical decision support solutions for early warning management, and establish coordinated critical care systems for severely ill pregnant women.

Objective To explore the perfusion distribution of vertebral arteries(VA)in healthy adults,and to observe the impact of VA diameter on perfusion distribution based on territorial arterial spin labeling(t-ASL)technique.Methods A total of 228 healthy adult volunteers were prospectively recruited.t-ASL imaging was utilized to analyze VA perfusion patterns in supratentorial region.Bilateral VA diameters,absolute inter-side VA diameter differences,as well as perfusion volumes(PV)supplied by each VA to supratentorial,cerebellar and their combined were recorded.Pearson correlation analysis was performed to analyze the correlations of VA diameters with PVsupratentorial,PVcerebellar and PVsupratentorial+cerebellar.Results Five patterns of distinct perfusion distribution were identified in supratentorial region,leading to participant stratification into 5 groups.Significant differences of absolute inter-side VA diameter differences was found among groups(P＜0.001).The mean bilateral VA diameter,PVsupratentorial,PVcerebellar and PVsupratentorial+cerebellar was(1.94±0.49)mm,(91.77±49.34)cm3,(74.72±27.68)cm3 and(166.49±59.53)cm3,respectively.VA diameter showed low-moderate positive correlations with PVsupratentorial,PVcerebellar and PVsupratentorial+cerebellar(r=0.483,0.179,0.484,all P＜0.001).Conclusion Perfusion imaging of t-ASL could visualize various perfusion distribution forms of VA in supratentorial region.Diameter of VA had certain impact on both spatial distribution characteristics and quantitative perfusion volumes.

Objective To investigate the regulation of macrophage polarization and foaminess by homocysteine(Hcy)and its potential underlying mechanisms.Methods ELISA and flow cytometry were used to detect the effect of Hcy treatment on the polarization of macrophages.The contents of various forms of intracellular cholesterol were detected,and the effects of Hcy on intracellular lipid accumulation and ox-LDL uptake were evaluated by oil red O staining and Dil-oxLDL.RT-qPCR and Western blot were used to detect mRNA and pro-tein expression of key genes modified by N6-methyladenosine(m6 A).Results Hcy promoted M1 polarization of macrophages and ox-LDL-induced foam macrophages and promoted ox-LDL uptake as well as intracellular lipid accumulation.In addition,Hcy upregulated methyltransferase like 3(METTL3)expression,and the tendency of Hcy to promote macrophage M1 polarization and foaminess was markedly reduced after inhibition or knockdown of METTL3 expression.Conclusions Hcy significantly promotes macrophage M1 polarization and foaminess,an effectthat may be attenuated by METTL3 silencing.

Objective To explore the perfusion distribution of vertebral arteries(VA)in healthy adults,and to observe the impact of VA diameter on perfusion distribution based on territorial arterial spin labeling(t-ASL)technique.Methods A total of 228 healthy adult volunteers were prospectively recruited.t-ASL imaging was utilized to analyze VA perfusion patterns in supratentorial region.Bilateral VA diameters,absolute inter-side VA diameter differences,as well as perfusion volumes(PV)supplied by each VA to supratentorial,cerebellar and their combined were recorded.Pearson correlation analysis was performed to analyze the correlations of VA diameters with PVsupratentorial,PVcerebellar and PVsupratentorial+cerebellar.Results Five patterns of distinct perfusion distribution were identified in supratentorial region,leading to participant stratification into 5 groups.Significant differences of absolute inter-side VA diameter differences was found among groups(P＜0.001).The mean bilateral VA diameter,PVsupratentorial,PVcerebellar and PVsupratentorial+cerebellar was(1.94±0.49)mm,(91.77±49.34)cm3,(74.72±27.68)cm3 and(166.49±59.53)cm3,respectively.VA diameter showed low-moderate positive correlations with PVsupratentorial,PVcerebellar and PVsupratentorial+cerebellar(r=0.483,0.179,0.484,all P＜0.001).Conclusion Perfusion imaging of t-ASL could visualize various perfusion distribution forms of VA in supratentorial region.Diameter of VA had certain impact on both spatial distribution characteristics and quantitative perfusion volumes.

With the adjustment of China's fertility policies, the proportion of advanced maternal age pregnancies has increased, making early identification of critical conditions in this population essential for successful treatment. This article systematically reviews the development of obstetric early warning management systems and advances in machine learning-based artificial intelligence for risk assessment in high-risk pregnant women. As artificial intelligence technology continues to evolve, future developments will include intelligent electronic medical record systems for high-risk pregnant women, generate clinical decision support solutions for early warning management, and establish coordinated critical care systems for severely ill pregnant women.

Objective: To investigate the value of left ventricular global longitudinal strain( LVGLS) in predicting early chemotherapy related cardiotoxicity in breast cancer patients after chemotherapy． Methods : Eighty-six breast cancer patients were enrolled in this study and received 6 cycles of doxorubicin + cyclophosphamide．Conventional echocardiography parameters were measured before chemotherapy ( T0 ) ，immediately after chemotherapy ( T1 ) ，6 months(T2) and 12 months after chemotherapy ( T3 ) ． LVGLS was obtained by 2D speck tracing imaging (2DSTI) ，and the relative change of LVGLS( △LVGLS) was calculated at T1．With the occurrence of cardiotoxicity as the clinical outcome，receiver operating characteristic ( ROC) curve was plotted．The parameters were analyzed at T1 to evaluate the value of △LVGLS in predicting cardiotoxicity. Results: ① Although the change in LVEF was not different between T0 and T1 (P ＞0. 05) ，LVEF decreased significantly at T2 and T3 (P ＜0. 05) . ② Compared with T0，LVGLS decreased at T1，which was further damaged at T2 and T3 (P＜0. 05) . ③ Seven patients (8. 1% ) developed chemotherapy-related cardiotoxicity．LVGLS and △LVGLS were correlated with cardiotoxicity at T1 stage ，and △LVGLS was more significant ( r = 0. 64，P ＜0. 001 ) . ROC curve analysis showed that a △LVGLS ＞12% at T1 predicted cardiotoxicity，with sensitivity of 92. 2% ，specificity of 76% ，and area under the curve was 0. 88. Conclusion The LVGLS decreased earlier than LVEF in breast cancer patients after doxorubicin treatment. △LVGLS ＞12% is a good predictor of cardiotoxicity in patients with breast cancer.

Abstract This prospective observational study included 361 benign and malignant breast nodules from 258 women who had underwent breast grayscale ultrasound and had been confirmed pathologically. A total of 396 image features of lesion areas in ultrasonic images were extracted. The radiomic signature was developed using least absolute shrinkage and selection operator algorithms after feature selection using the minimum redundancy maximum relevance method. Receiver operating characteristic curve(ROC)and calibration curve were used to test the performance of the model. The area under the ROC curve(AUC), accuracy, sensitivity, specificity, Youden index for the training cohort were 0.84,0.761,0.840,0.715,0.603. And the AUC, accuracy, sensitivity, specificity, Youden index for the validation cohort were 0.84,0.716, 0.823, 0.654, 0.536. The diagnostic results of data from the radiomics model were basically consistent with the actual situation. Radiomics based on grayscale ultrasound performs well in the differentiation of malignant from benign breast nodules which effectively avoids the subjective diagnosis, and has good clinical application value.

Tuberculous meningitis is the most common and serious type of central nervous system tuberculosis, with high mortality and disability rate, which has attracted extensive attention of global public health. The high mortality rate and disability rate of tuberculosis meningitis may be related to its lack of specific clinical and imaging characteristics, insufficient attention from clinicians, lack of early sensitive and specific diagnostic testing techniques, delay in treatment, and restricted penetration of anti-TB drugs into the blood-brain barrier or/and MDR-TB, etc. This article reviews the disease burden of TBM, chemotherapy drugs and regimens, anti-inflammatory agents, aspirin, interventional and surgical treatment to provide reference for clinical management of this disease.