Objective To analyze the epidemic and clinical characteristics of pertussis cases in Changping District, Beijing and improve the clinical diagnosis level, and to provide a scientific basis for pertussis prevention and control. Methods Descriptive epidemiological methods were used to analyze pertussis cases in Changping District, Beijing from 2023 to 2024. Results A total of 565 cases were reported in Changping District, Beijing from 2023 to 2024, with an average annual incidence of 12.45/100 000. There were 285 males (50.44%) and 280 females (49.56%). The top five towns and streets with the highest number of reported cases were Beiqijia (90 cases), Longzeyuan (71 cases), Shahe (57 cases), Huilongguan (48 cases) and Tiantongyuan South (46 cases), accounting for 55.22% of all cases. The top three towns and streets with the highest incidence rate were Tiantongyuan South (19.72/100 000), Longzeyuan (19.49/100 000) and Beiqijia (14.55/100 000). The incident peak period was from October 2023 to April 2024, with a total of 422 cases reported, accounting for 74.69%. The age of cases ranged from 29 days to 73 years old. There were 67 cases under 1 year old, with the highest incidence rate (263.10/100 000), followed by the 5-9 years old group (149.98/100 000). The 5-9 years old group had the highest proportion of cases, accounting for 301 cases (49.05%). A total of 513 cases (90.80%) had a history of pertussis vaccine immunization, and 455 cases (80.53%) had been vaccinated with 4 doses of pertussis vaccine. The median interval from onset to diagnosis of whooping cough was 18 days and the median duration of cough was 11 days. Conclusion The highest incidence of pertussis is among infants under 1 year old, followed by the 5-9 years old group. Children of appropriate age should be vaccinated in time according to the latest national immunization strategy. Medical institutions should improve diagnostic capability and increase monitoring sensitivity.

Objective:To establish and optimize the cutoff values of D-dimer (D-D) for excluding suspected acute pulmonary embolism (APE).Methods:A retrospective cross-sectional study was conducted by recruiting a total of 428 patients with suspected APE complaining of chest pain, hemoptysis, dyspnea, etc., who underwent computed tomography pulmonary angiography (CTPA) in the Emergency Department of the First Hospital of Jilin University from January 1st, 2022, to October 31st, 2024, taken as observation group. The Median age was 64.0 (55.0, 72.0) years old with male and female 214 respectively. Data collection included clinical manifestations(hemoptysis, swelling and pain in the lower limbs), deep vein thrombosis (DVT) history, Wells scores, laboratory results, CTPA and vascular ultrasound foundings. According to CTPA results, observation group was divided into APE group (233 cases) and non-APE group (195 cases); according to Wells scoring, observation group was divided into APE at low, moderate, or high pre-test probability subgroups. Meanwhile, 196 healthy individuals in the same period were included as the health control group. D-D levels were compared among different groups. Receiver operating characteristic (ROC) curve analysis was used to determine the D-D cutoff values for excluding APE, and the area under the curve (AUC) and negative predictive value (NPV) were evaluated.Results:D-D levels in the CTPA-APE group, CTPA-non APE group, and the healthy control group were [7.77 (4.10, 16.58)] mg/L, [0.53 (0.24, 0.94)] mg/L, and [0.21 (0.15, 0.32)] mg/L, respectively, with statistically significant differences ( P<0.05). In the APE group, D-D levels within low-, moderate-, and high-probability subgroups were [7.48 (3.87, 15.85)] mg/L, [7.92 (4.08, 13.90)] mg/L, and [21.39 (7.92, 89.68)] mg/L, respectively, with statistically significant differences among subgroups ( P<0.05), while no significant difference between low-and moderate-probability subgroups ( P>0.05). For suspected APE with low-probability, exclusive D-D level was 0.62 mg/L with AUC and NPV at 1.000 and 100% taking healthy control group as negative control, and 1.65 mg/L with AUC and NPV at 0.989 and 94.00% taking non-APE group as negative control, while the optimized D-D level was 1.10 mg/L adjusted by NPV ≥98%. For suspected APE with low to moderate-probability, the exclusive D-D level was 0.55 mg/L with AUC and NPV at 0.997 and 99.00% taking healthy control group as negative control, and 1.64 mg/L with AUC and NPV at 0.979 and 92.60%, while the optimized D-D level was 0.55 mg/L adjusted by NPV ≥98%. Conclusion:This study established and optimized the exclusive diagnostic cutoff value of D-D for suspected APE in Emergency Department integrated with the Wells scoring, which may effectively reduce the false-positive rate while improve the clinical application for APE exclusion using D-D.

Objective To explore the value of 3D and 2D radiomics features models based on multiparameter MRI in predicting Ki-67 expression(with 14%and 20%as the critical values,respectively)in breast cancer.Methods The MRI images of 147 patients with pathologically confirmed Luminal breast cancer were analyzed retrospectively.The patients were randomly divided into training set and test set according to the ratio of 7︰3.The 3D and 2D radiomics features of intratumor and peritumor were extracted from diffusion weighted imaging(DWI),dynamic contrast enhancement(DCE)mask(S0)and DCE phase 3(S3)images.Then the models were constructed by multiple pipeline combinations of three feature normalization methods,two feature dimensionality reduction methods,four feature selection methods,and ten classifiers.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the prediction performance of the models in order to select the best 3D and 2D single parame-ter(DWI,S0,S3)and multiparameter combination(S0+S3,S0+DWI,S3+DWI,S0+S3+DWI)models.Finally,the differ-ences between the models were compared by De Long test.Results With 14%as the critical value,the AUC of 3D and 2D models in the training set were 0.726-0.824 and 0.707-0.835,respectively,and those in the test set were 0.724-0.82 and 0.701-0.805.With 20%as the critical value,the AUC of 3D and 2D models in the training set were 0.743-0.868 and 0.793-0.881,respectively,and those in the test set were 0.738-0.853 and 0.743-0.814.There was no significant statistical difference between 3D and 2D models with the same parameter in the two critical values standards.Conclusion The multiparameter MRI-based radiomics models can bet-ter predict the expression of Ki-67 in breast cancer,and the models based on intratumor and peritumor 3D and 2D features have the same prediction efficiency.

Objective To investigate the impact of chronic observational social defeat stress on multidimensional behaviors in female mice,including social interaction,emotion,and cognition,as well as the underlying molecular mechanisms.Methods Adult female C57BL6N mice were divided into a stress group and a control group.Behavioral assessment were conducted through social interaction tests,anxiety-like behavior tests,and cognitive tests(novel object recognition and spatial memory).Synaptic plasticity-related proteins in the hippocampus were detected using Western blot.Results Behavioral tests revealed that the stress group showed reduced social interaction time compared to the control group[(106.2±9.31)s vs.(156.5±14.81)s,P<0.05].In a novel environment,the stress group consumed less food than the control group[(0.10±0.01)g vs.(0.16±0.02)g,P<0.05].Cognitive tests demonstrated that the stress group exhibited impaired novel object recognition[(52.17%%±2.67%)vs.(65.91%±5.23%)]and spatial memory[(61.84%±3.14%)vs.(74.13%±1.94%)]compared to the control group(P<0.05).Western blot analysis showed that the expression of hippocampal synaptic plasticity-related proteins,including the glutamate ionotropic receptor N-methyl-D-aspartate(NMDA)receptor subunit NR2A[(0.66±0.05)vs.(0.89±0.08)]and brain-derived neurotrophic factor(BDNF)[(0.81±0.05)vs.(1.14±0.06)],was significantly decreased in the stress group(P<0.05).Conclusion Chronic observational social defeat stress induces social withdrawal,anxiety-like behaviors,and cognitive deficits in female mice.These effects may be associated with reduced expression of NR2A and BDNF in the hippocampus.

In recent years,the potential role of mitochondrial dynamics imbalance in the pathogenesis of various psychiatric disorders has attracted growing attention.Mitochondria regulate energy metabolism,oxidative stress,apoptosis,and neuronal function through dynamic processes such as fission and fusion.Disruption of these processes may impair synaptic function and neural network stability.In schizophrenia,depression,bipolar disorder,Alzheimer disease,and autism spectrum disorders,studies have reported dysregulated expression of mitochondrial fission-related proteins DRP1 and FIS1,as well as fusion-related proteins MFN1,MFN2,and OPA1,accompanied by structural and functional mitochondrial impairments,neuronal apoptosis,and synaptic loss.Evidence from clinical studies,animal models,and cell experiments further supports that these mitochondrial dynamics abnormalities are closely associated with cognitive deficits,emotional disturbances,and neurodegenerative changes.Although mitochondrial dynamic dysfunction alone cannot fully explain the onset of psychiatric disorders,it may represent a potential biological mechanism that offers new insights into disease mechanisms and provide a theoretical basis for developing targeted intervention strategies.

In recent years,the potential role of mitochondrial dynamics imbalance in the pathogenesis of various psychiatric disorders has attracted growing attention.Mitochondria regulate energy metabolism,oxidative stress,apoptosis,and neuronal function through dynamic processes such as fission and fusion.Disruption of these processes may impair synaptic function and neural network stability.In schizophrenia,depression,bipolar disorder,Alzheimer disease,and autism spectrum disorders,studies have reported dysregulated expression of mitochondrial fission-related proteins DRP1 and FIS1,as well as fusion-related proteins MFN1,MFN2,and OPA1,accompanied by structural and functional mitochondrial impairments,neuronal apoptosis,and synaptic loss.Evidence from clinical studies,animal models,and cell experiments further supports that these mitochondrial dynamics abnormalities are closely associated with cognitive deficits,emotional disturbances,and neurodegenerative changes.Although mitochondrial dynamic dysfunction alone cannot fully explain the onset of psychiatric disorders,it may represent a potential biological mechanism that offers new insights into disease mechanisms and provide a theoretical basis for developing targeted intervention strategies.

Objective To investigate the impact of chronic observational social defeat stress on multidimensional behaviors in female mice,including social interaction,emotion,and cognition,as well as the underlying molecular mechanisms.Methods Adult female C57BL6N mice were divided into a stress group and a control group.Behavioral assessment were conducted through social interaction tests,anxiety-like behavior tests,and cognitive tests(novel object recognition and spatial memory).Synaptic plasticity-related proteins in the hippocampus were detected using Western blot.Results Behavioral tests revealed that the stress group showed reduced social interaction time compared to the control group[(106.2±9.31)s vs.(156.5±14.81)s,P<0.05].In a novel environment,the stress group consumed less food than the control group[(0.10±0.01)g vs.(0.16±0.02)g,P<0.05].Cognitive tests demonstrated that the stress group exhibited impaired novel object recognition[(52.17%%±2.67%)vs.(65.91%±5.23%)]and spatial memory[(61.84%±3.14%)vs.(74.13%±1.94%)]compared to the control group(P<0.05).Western blot analysis showed that the expression of hippocampal synaptic plasticity-related proteins,including the glutamate ionotropic receptor N-methyl-D-aspartate(NMDA)receptor subunit NR2A[(0.66±0.05)vs.(0.89±0.08)]and brain-derived neurotrophic factor(BDNF)[(0.81±0.05)vs.(1.14±0.06)],was significantly decreased in the stress group(P<0.05).Conclusion Chronic observational social defeat stress induces social withdrawal,anxiety-like behaviors,and cognitive deficits in female mice.These effects may be associated with reduced expression of NR2A and BDNF in the hippocampus.

Objective To explore the value of 3D and 2D radiomics features models based on multiparameter MRI in predicting Ki-67 expression(with 14%and 20%as the critical values,respectively)in breast cancer.Methods The MRI images of 147 patients with pathologically confirmed Luminal breast cancer were analyzed retrospectively.The patients were randomly divided into training set and test set according to the ratio of 7︰3.The 3D and 2D radiomics features of intratumor and peritumor were extracted from diffusion weighted imaging(DWI),dynamic contrast enhancement(DCE)mask(S0)and DCE phase 3(S3)images.Then the models were constructed by multiple pipeline combinations of three feature normalization methods,two feature dimensionality reduction methods,four feature selection methods,and ten classifiers.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the prediction performance of the models in order to select the best 3D and 2D single parame-ter(DWI,S0,S3)and multiparameter combination(S0+S3,S0+DWI,S3+DWI,S0+S3+DWI)models.Finally,the differ-ences between the models were compared by De Long test.Results With 14%as the critical value,the AUC of 3D and 2D models in the training set were 0.726-0.824 and 0.707-0.835,respectively,and those in the test set were 0.724-0.82 and 0.701-0.805.With 20%as the critical value,the AUC of 3D and 2D models in the training set were 0.743-0.868 and 0.793-0.881,respectively,and those in the test set were 0.738-0.853 and 0.743-0.814.There was no significant statistical difference between 3D and 2D models with the same parameter in the two critical values standards.Conclusion The multiparameter MRI-based radiomics models can bet-ter predict the expression of Ki-67 in breast cancer,and the models based on intratumor and peritumor 3D and 2D features have the same prediction efficiency.

Objective:To establish and optimize the cutoff values of D-dimer (D-D) for excluding suspected acute pulmonary embolism (APE).Methods:A retrospective cross-sectional study was conducted by recruiting a total of 428 patients with suspected APE complaining of chest pain, hemoptysis, dyspnea, etc., who underwent computed tomography pulmonary angiography (CTPA) in the Emergency Department of the First Hospital of Jilin University from January 1st, 2022, to October 31st, 2024, taken as observation group. The Median age was 64.0 (55.0, 72.0) years old with male and female 214 respectively. Data collection included clinical manifestations(hemoptysis, swelling and pain in the lower limbs), deep vein thrombosis (DVT) history, Wells scores, laboratory results, CTPA and vascular ultrasound foundings. According to CTPA results, observation group was divided into APE group (233 cases) and non-APE group (195 cases); according to Wells scoring, observation group was divided into APE at low, moderate, or high pre-test probability subgroups. Meanwhile, 196 healthy individuals in the same period were included as the health control group. D-D levels were compared among different groups. Receiver operating characteristic (ROC) curve analysis was used to determine the D-D cutoff values for excluding APE, and the area under the curve (AUC) and negative predictive value (NPV) were evaluated.Results:D-D levels in the CTPA-APE group, CTPA-non APE group, and the healthy control group were [7.77 (4.10, 16.58)] mg/L, [0.53 (0.24, 0.94)] mg/L, and [0.21 (0.15, 0.32)] mg/L, respectively, with statistically significant differences ( P<0.05). In the APE group, D-D levels within low-, moderate-, and high-probability subgroups were [7.48 (3.87, 15.85)] mg/L, [7.92 (4.08, 13.90)] mg/L, and [21.39 (7.92, 89.68)] mg/L, respectively, with statistically significant differences among subgroups ( P<0.05), while no significant difference between low-and moderate-probability subgroups ( P>0.05). For suspected APE with low-probability, exclusive D-D level was 0.62 mg/L with AUC and NPV at 1.000 and 100% taking healthy control group as negative control, and 1.65 mg/L with AUC and NPV at 0.989 and 94.00% taking non-APE group as negative control, while the optimized D-D level was 1.10 mg/L adjusted by NPV ≥98%. For suspected APE with low to moderate-probability, the exclusive D-D level was 0.55 mg/L with AUC and NPV at 0.997 and 99.00% taking healthy control group as negative control, and 1.64 mg/L with AUC and NPV at 0.979 and 92.60%, while the optimized D-D level was 0.55 mg/L adjusted by NPV ≥98%. Conclusion:This study established and optimized the exclusive diagnostic cutoff value of D-D for suspected APE in Emergency Department integrated with the Wells scoring, which may effectively reduce the false-positive rate while improve the clinical application for APE exclusion using D-D.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.