Objective To explore the mechanism by which the sanguis draconis flavones(SDF)regulates the reactive oxygen species(ROS)/thioredoxin-interacting protein(TXNIP)pathway to mediate cell pyroptosis and improve cerebral ischemia-reperfusion injury(CIRI)in rats.Methods The experimental rats were randomly divided into the control group(Ctrl),the CIRI group,the low-dose SDF group(SDF-L),the high-dose SDF group(SDF-H),and the SDF-H+ROS/TXNIP pathway activator,trimethylamine oxide(TMAO)group(SDF-H+TMAO).Among them,except for the control group,the remaining rats all needed to establish the CIRI rat model by the modified suture method.Zea Longa scoring was performed on rats from each group.ELISA was used to detect the levels of serum inflammatory factors interleukin(IL)-1β,IL-18 and oxidative stress-related factors superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-Px).Flow cytometry was used to measure the ROS levels.Cerebral edema was detected.Cerebral infarction was detected by 2,3,5-triphenyl tetrazolium chloride(TTC)staining.HE staining was used to detect the pathological changes of brain tissue.Immunohistochemistry was used to detect the expression of pyrolytic effector protein dermolin D(GSDMD).Western blotting was used to detect the expression of proteins related to the ROS/TXNIP pathway.Results Compared with the control group,a large area of cerebral infarctions were observed in the brain tissue of the CIRI group,accompanied by mild hemorrhage and obvious infiltration of inflammatory cells.Neuronal cells underwent degeneration and necrosis,with sparse and disordered arrangement.The phenomena of nuclear condensation and nucleolus lysis were obvious.The Zea Longa score,cerebral infarction volume,brain tissue water content,levels of IL-1β,IL-18,ROS,MDA,and the expressions of GSDMD,TXNIP,nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),apoptosis-related punctate protein(ASC),and Caspase-1 increased,while the activities of SOD and GSH-Px decreased(P＜0.05).Compared with the CIRI group,the pathological damage of brain tissues in the SDF-L group and the SDF-H group was significantly improved.The Zea Longa score,cerebral infarction volume,brain tissue water content,levels of IL-1β,IL-18,ROS,MDA,and the expressions of GSDMD,TXNIP,NLRP3,ASC,and Caspase-1 decreased.The activities of SOD and GSH-Px increased(P＜0.05);TMAO treatment partially reversed the improvement effect of SDF on CIRI in rats.Conclusion SDF ameliorates cerebral CIRI in rats by inhibiting ROS/TXNIP pathway-mediated pyroptosis.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Objective:To evaluate the efficacy of gadolinium ethoxybenzyl- diethy-lenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI features in the preoperative prediction of tertiary lymphoid structures (TLS) within hepatocellular carcinoma (HCC) lesions.Methods:This retrospective cross-sectional study included clinical and pathological data from 297 HCC patients treated at the Southwest Hospital, Army Medical University between June 2021 and November 2022. Based on postoperative pathology, patients were categorized into TLS-negative ( n=93) and TLS-positive ( n=204) groups. MRI features of HCC lesions using Gd-EOB-DTPA enhancement and relevant clinical data were analyzed. Intergroup comparisons of imaging features and laboratory findings were performed using independent sample t-test, Mann-Whitney U test, χ2 test, or Fisher exact test, as appropriate. The logistic regression analysis was conducted to identify independent predictors of TLS positivity. A predictive model was constructed and visualized using a nomogram. The model′s predictive performance and clinical utility were assessed using the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The area under the ROC curve (AUC) was compared using the DeLong test. Results:Significant differences were observed between the TLS-negative and TLS-positive groups in alpha-fetoprotein (AFP) levels, intratumoral hemorrhage, and peritumoral satellite nodules in the hepatobiliary phase ( P<0.05). Multivariate logistic regression identified intratumoral hemorrhage ( OR=0.123, 95% CI 0.070-0.216, P<0.001) and peritumoral satellite nodules in the hepatobiliary phase ( OR=0.236, 95% CI 0.093-0.596, P=0.002) as independent predictive factors for TLS-positivity. The imaging model based on these two features yielded an AUC of 0.764 (95% CI 0.709-0.809) for predicting TLS-positivity. When combined with AFP levels, the resulting clinical-imaging model achieved a superior AUC of 0.784 (95% CI 0.732-0.829), which was significantly higher than that of the imaging model alone ( Z=2.20, P=0.028). A nomogram was constructed based on the clinical-imaging model. The calibration curve demonstrated good predictive performance of the nomogram, and the DCA showed that the curve remained above the default line across a range of reasonable threshold probabilities, indicating that patients could derive clinical benefit. Conclusion:A nomogram model based on Gd-EOB-DTPA enhanced MRI features combined with AFP levels can effectively predict the presence of TLS in HCC.

Purpose To explore the predictive value of CT-enhanced for tumor mutation burden(TMB)in hepatocellular carcinoma(HCC).Materials and Methods A total of 22 patients with pathologically confirmed HCC after undergoing radical resection in the First Affiliated Hospital,Army Medical University(Third Military Medical University)from January 2020 to January 2023 were collected,all of whom were quantified for TMB.Clinical,laboratory tests,CT imaging characteristics and follow-up of patients were recorded.Variables with P<0.2 were screened by stepwise regression analysis for independent risk factors for TMB.The area under the curve of receiver operating characteristic was used to assess the diagnostic efficacy.Results High TMB level was a risk factor for disease-free survival after HCC surgery(HR=1.115,P<0.05).According to the optimal cut-off value,TMB was classified into a high-risk group(>9.25 mutation/Mb)and low-risk group(≤9.25 mutation/Mb).Univariate analysis of intratumor ischemia or necrosis was statistically different between the high-risk and low-risk groups(P=0.005),and only intratumor ischemia or necrosis was an independent risk factor for predicting high TMB level by stepwise regression analysis(P<0.05).The area under the curve for predicting disease-free survival was 0.833(95%CI 0.615-0.956,P<0.001),with a sensitivity of 100.0%and a specificity of 66.7%.Conclusion High TMB level is associated with poor prognosis after HCC resection.Intratumor ischemia or necrosis have certain clinical value in predicting high TMB level,and are expected to provide a reference basis for personalized diagnosis and treatment of HCC patients.

OBJECTIVE: Poxviruses are zoonotic pathogens that infect humans, mammals, vertebrates, and arthropods. However, the specific role of ticks in transmission and evolution of these viruses remains unclear. METHODS: Transcriptomic and metatranscriptomic raw data from 329 sampling pools of seven tick species across five continents were mined to assess the diversity and abundance of poxviruses. Chordopoxviral sequences were assembled and subjected to phylogenetic analysis to trace the origins of the unblasted fragments within these sequences. RESULTS: Fifty-eight poxvirus species, representing two subfamilies and 20 genera, were identified, with 212 poxviral sequences assembled. A substantial proportion of AT-rich fragments were detected in the assembled poxviral genomes. These genomic sequences contained fragments originating from rodents, archaea, and arthropods. CONCLUSION Our findings indicate that ticks play a significant role in the transmission and evolution of poxviruses. These viruses demonstrate the capacity to modulate virulence and adaptability through horizontal gene transfer, gene recombination, and gene mutations, thereby promoting co-existence and co-evolution with their hosts. This study advances understanding of the ecological dynamics of poxvirus transmission and evolution and highlights the potential role of ticks as vectors and vessels in these processes.
Animals ; Poxviridae/physiology* ; Ticks/virology* ; Phylogeny ; Transcriptome ; Evolution, Molecular ; Poxviridae Infections/virology* ; Genome, Viral

Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the clinical value of enhanced magnetic resonance imaging (MRI)-based deep learning model in preoperative prediction of proliferative hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinical data of 906 HCC patients who were admitted to The First Affiliated Hospital of Army Medical University and The Second Affiliated Hospital of Chongqing Medical University from May 2017 to October 2022 were collected. There were 769 males and 137 females, aged (53.2±10.9)years. Of the 906 patients, 815 cases who were admitted to The First Affiliated Hospital of Army Medical University were divided into the training set of 634 patients and the internal validation set of 181 patients using a random number table method with a ratio of 8:2, and 91 patients who were admitted to The Second Affiliated Hospital of Chongqing Medical University were divided into the external validation set. The training set was used to construct the prediction model, while the validation set was used to validate the prediction model. Observation indicators: (1) analysis of factors influencing the pathological classification of HCC patients; (2) deep learning imaging features of HCC patients; (3) evaluation of the efficacy of prediction model for proliferative HCC; (4) validation of the prediction model for proliferative HCC; (5) prognosis of HCC patients. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Multivariate analysis was conducted using the binary Logistic regression model. The model perfor-mance was evaluated through five-fold cross-validation, and receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of the model based on the area under curve (AUC), sensitivity, and specificity. The Delong test was used to compare the diagnostic performance of models. The Hosmer-Lemeshow test was employed to evaluate the calibration of models. The optimal cutoff value of the prediction model was determined by the maximum Youden index, with the value >0.175 indicating high-risk patients and value ≤0.175 indicating low-risk patients.The Kaplan-Meier method was used to calculate the survival rate and the Log-rank test was used for survival analysis. Results:(1) Analysis of factors influencing the pathological classification of HCC patients. Of 634 patients in the training set, there were 190 cases of proliferative HCC and 444 cases of non-proliferative HCC. Results of multivariate analysis showed that alpha fetoprotein (AFP) ≥400 μg/L and tumor diameter >5 cm were independent risk factors for pathological type of HCC as proli-ferative [ odds ratio=1.73, 1.88, 95% confidence interval ( CI) as 1.19-2.50, 1.30-2.71, P<0.05]. (2) Deep learning imaging features of HCC patients. In the training set of 634 patients, the probability predicted by MRI-based deep learning model was 84.8%(30.5%,95.4%) for proliferative HCC and 5.8%(3.2%,12.5%) for non-proliferative HCC, showing a significant difference between them ( Z=-16.01, P<0.05). (3) Evaluation of the efficacy of prediction model for proliferative HCC. In the training set, the AUC of clinical prediction model for proliferative HCC was 0.63(95% CI as 0.59-0.68, P<0.05), with sensitivity of 54.74% and specificity of 64.19%. The AUC of MRI-based deep learning prediction model was 0.90(95% CI as 0.87-0.93, P<0.05), with sensitivity of 80.53% and specificity of 86.94%. The AUC of combined MRI-based deep learning with clinical prediction model was 0.90 (95% CI as 0.87-0.93, P<0.05), with sensitivity of 83.16% and specificity of 86.04%. Results of Delong test showed that there was a significant difference between the combined MRI-based deep learning with clinical prediction model and the clinical prediction model ( P<0.05), and there was no signifi-cant difference between the combined MRI-based deep learning with clinical prediction model and the MRI-based deep learning prediction model ( P>0.05). Results of Hosmer-Lemeshow test showed good calibration for the clinical prediction model, the MRI-based deep learning prediction model and the combined MRI-based deep learning with clinical prediction model ( χ2=0.84, 6.38, 3.93, P>0.05), indicating that the predicted probabilities of these three prediction models matched the actual risk well. (4) Validation of the prediction model for proliferative HCC. Results of validation of the prediction model in internal validation set showed the AUC of MRI-based deep learning prediction model for proliferative HCC was 0.84(95% CI as 0.77-0.91, P<0.05), with sensitivity of 82.35% and specificity of 77.69%. Results of validation of the prediction model in external validation set showed the AUC of MRI-based deep learning prediction model for proliferative HCC was 0.81(95% CI as 0.71-0.92, P<0.05), with sensitivity of 70.00% and specificity of 81.69%. (5) Prognosis of HCC patients. Of the 906 patients, the 1-, 3-, and 5-year recurrence-free survival rates for 645 proliferative HCC patients were 56.9%, 31.4%, and 29.1%, respectively, and the 1-, 3-, and 5-year recurrence-free survival rates for 261 non-proliferative HCC patients were 88.8%, 68.6%, and 56.0%, respectively. There were significant differences in recurrence-free survival time between proliferative HCC and non-proliferative HCC patients of the training set, internal validation set and external validation set ( P<0.05). The 1-, 3-, 5-year recurrence-free survival rates for 331 high-risk HCC patients were 64.6%, 50.4%, 43.6%, versus 88.5%, 71.9%, 62.7% for 575 low-risk HCC patients. There were significant differences in recurrence-free survival time between high-risk HCC patients and low-risk HCC patients of the training set, internal validation set and external validation set ( P<0.05). Conclusion:The MRI-based deep learning model can effectively predict proliferative HCC and recurrence-free survival of patients before the surgery.

OBJECTIVES: To study the clinical and genetic characteristics of osteopetrosis (OPT) in children. METHODS: A retrospective analysis was performed on the clinical data of 14 children with OPT. Whole-exome sequencing was used to detect pathogenic genes, and clinical phenotypes and genotypic features were summarized. RESULTS: Among the 14 children (10 males and 4 females), the median age at diagnosis was 8 months. Clinical manifestations included systemic osteosclerosis (14 cases, 100%), anemia (12 cases, 86%), infections (10 cases, 71%), thrombocytopenia (9 cases, 64%), hepatosplenomegaly (8 cases, 57%), and developmental delay (5 cases, 36%). Malignant osteopetrosis (MOP) cases had lower platelet counts, creatine kinase isoenzyme, and serum calcium levels, but higher white blood cell counts, lactate dehydrogenase, and alkaline phosphatase levels compared to non-MOP cases (P<0.05). Genetic testing identified 15 variants in 12 patients, including 8 variants in the CLCN7 gene (53%), 6 in the TCIRG1 gene (40%), and 1 in the TNFRSF11A gene (7%). Three novel CLCN7 variants were identified: c.2351G>C, c.1215-43C>T, and c.1534G>A. All four patients with TCIRG1 variants exhibited MOP clinical phenotypes. Of the seven patients with CLCN7 variants, 4 presented with intermediate OPT, 2 with benign OPT, and 1 with MOP. CONCLUSIONS Clinical phenotypes of OPT in children are heterogeneous, predominantly involving CLCN7 and TCIRG1 gene variants, with a correlation between clinical phenotypes and genotypes.
Humans ; Osteopetrosis/genetics* ; Male ; Female ; Infant ; Child, Preschool ; Retrospective Studies ; Vacuolar Proton-Translocating ATPases/genetics* ; Child ; Chloride Channels/genetics* ; Mutation ; Receptor Activator of Nuclear Factor-kappa B

Objective To analyze the correlation between lesion volume,lesion mass,and maximum lesion diameter in the assessment of advanced hepatocarcinoma with lung metastasis,and to evaluate the application value of total volume response and total mass response of lung metastatic lesions in efficacy assessment.Methods A retrospective analysis was conducted on the CT imaging data of 20 patients clinically confirmed with hepatocarcinoma and lung metastases,followed by subsequent follow-up to monitor their survival outcomes.Volume measurement software was used to measure the volume of lesions before and after treatment.We recored lesion diameter,volume measurements and CT values,calculated the mass of the lesions.The correlation between lesion volume,mass and diameter was analyzed,as well as the correlation between the change rates of volume,mass and lesion diameter.Additionally,the total volume and total mass of all lesions were calculated.The correlation between the change rates of total volume/total mass and the change rate of pulmonary lesion diameter under the RECIST 1.1 criteria,as well as the correlation with changes in patients'tumor markers,were analyzed.Furthermore,the overall volume response and overall mass response of lesions were evaluated based on changes in total volume and total mass,and their consistencies with the RECIST 1.1 criteria for efficacy evaluation were analyzed.Finally,univariate Cox regression analysis was performed to explore the association between these variables and patient survival outcomes.Results There was strong correlation between lesion volume,mass and tumor diameter(r=0.771,0.775),between the rate of change in mass and the rate of change in lesion diameter(r=0.846),and between the rates of change in total volume/total mass and the rate of change in pulmonary lesion diameter under the RECIST 1.1 criteria(r=0.800,0.896).The correlation between the rates of change in total volume/total mass and patients'tumor markers was not statistically significant.There was moderate correlation between the rate of change in volume and the rate of change in lesion diameter(r=0.692).The evaluation results of total volume response and total mass response for pulmonary lesions in advanced hepatocarcinoma with lung metastasis were generally consistent with the RECIST 1.1 criteria(Kappa=0.486,0.426).Univariate Cox regression analysis revealed that total lesion volume(P=0.047)and total lesion mass(P=0.049)were independent prognostic factors for survival outcomes.Conclusion Lesion volume,mass,and diameter,as well as their respective change rates,were found to be interrelated.Furthermore,total lesion volume and total lesion mass were identified as independent prognostic factors for survival outcomes.The total volume response and total mass response are promising evaluation methods in evaluating the efficacy of lung metastasis of hepatocarcinoma,which are different from the RECIST 1.1 evaluation criteria.