Objective This study reports on the obligatory parasitism of water mites Arrenurus sp. on Anopheles messeae at the Manzhouli Port, Inner Mongolia, China. Methods Duing July 2024, a survey on the mosquito diversity was conducted at the Manzhouli Port. Captured mosquitoes and their ectoparasites were identified to species level. Results A total of 1840 adult mosquitoes were collected, representing species from three genera: Culex(Cx. modestus, Cx. pipiens pallens), Aedes(Ae. dorsalis, Ae. flavidorsalis, Ae. flavescens), and Anopheles (An. messeae). Among all the mosqutioes specimens,3 out of 150 captured An. messeae were found to carry ectoparasitic mites, with number of 2,4,27 mites separately. Morphological and molecular identification reached the same result as water mites(Hydrachnidiae, Hydracrina). COI gene sequence showed 94% similarity with the closest species Arrenurus truncatellus. Conlusions Literature review suggests water mites are host-specific parasitism of mosquito species and herein with the first record of Arrenurus sp. parasiting on An. Messeae in the most high-latitude region globally.

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 observe the in vitro induced drug resistance mechanisms of polymyxin B-resistant Acin-etobacter baumannii and explore the in vitro antimicrobial activity of polymyxin B combined with melatonin.METHODS Totally 10 strains of polymyxin B-sensitive A.baumannii were clinically isolated from the Affiliated Li Huili Hospital of Ningbo university between Jan.2021 to Dec.2021 and were induced to the polymyxin B-resistant strains by means of in vitro induction method.The drug resistance mechanisms of the polymyxin B-resistant A.baumannii strains were explored by polymerase chain reaction(PCR)combined with sequencing analysis.The minimum inhibitory concentrations(MICs)of the single and joint use of polymyxin B and melatonin were detected by using broth microdilution checkerboard.The antibacterial effect of polymyxin combined with melatonin was e-valuated by calculating fractional inhibitory concentration index(FICI).The strains that showed the remarkable synergistic effect for the antimicrobial activity were chosen to determine the time-kill curves.RESULTS Among the polymyxin B-induced drug-resistant A.baumannii strains,there were gene mutations at various loci of polymyxin resistance genes pmrB,lpxA and lpxD.The MIC of polymyxin B against A.baumannii strains declined after the combined use of polymyxin B and melatonin.The combined use of the two drugs that showed synergistic effect for antimicrobial activity accounted for 80.00％(8/10),the additive effect 20.00％(2/10).The time-kill curve showed that the combined use of polymyxin B and melatonin showed remarkable antibacterial effect at the 24th hour.CONCLUSIONS The drug resistance gene mutations that are mediated by chromosomes are the major drug resist-ance mechanisms of the A.baumannii strains to polymyxin B.The combined use of polymyxin B and melatonin may reverse the drug resistance of the A.baumannii to polymyxin B.

Objective To compare the application effects of plankton multiplex polymerase chain reac-tion-capillary electrophoresis(PCR-CE),SYBR Green Ⅰ real-time quantitative PCR(qPCR)and microwave digestion-vacuum filtration-automated scanning electron microscopy(MD-VF-Auto SEM)in the diagnosis of drowning.Methods Lung,liver and kidney tissues from 212 drowned corpses and 30 non-drowned corpses were examined respectively by the three drowning-related plankton testing methods,and the detection rates of plankton in each tissue by three methods were compared.Results In drowned corpses,the total detection rates of PCR-CE,qPCR,and MD-VF-Auto SEM were 93.9%,96.2%,and 95.3%,respectively,with no statistically significant difference(P>0.05).The detection rate of lung tissue by MD-VF-Auto SEM(100%)was higher than those of PCR-CE and qPCR(P<0.05),and there was no significant difference in the detection rates of the three methods in liver or kidney tissues(P>0.05).In non-drowning corpses,a small number of diatoms(less than 10 cells/10 g)were detected by MD-VF-Auto SEM method,only in liver and kidney tissues,while the other two methods yielded negative results for all tissues.Conclusion All three methods have good efficacy in the examination of drowned corpses.The MD-VF-Auto SEM method directly observes diatom morpho-logical characteristics through scanning electron microscopy,and the qualitative and quantitative analy-ses are intuitive and accurate.It has great advantages in the examination of difficult degradation samples.The PCR-CE method and qPCR method have a low sample demand(0.5 g),are easy to operate and have short detection time(4-7 h).They are easy to be applied in the grassroots depart-ments and are suitable for the rapid determination of drowned corpses in routin cases.The combina-tion of the two DNA methods with the MD-VF-Auto SEM method can increase the detection rate of plankton,ensuring the reliability of examination results.This combined use is of significant importance in the application of drowning diagnosis.

Objective:To construct a predictive model of ≥ grade 2 radiation esophagitis (RE) in patients with esophageal cancer during concurrent radiochemotherapy (CRT) based on machine learning (ML) algorithm.Methods:A retrospective analysis was conducted on the clinical data of 276 patients with esophageal cancer who had received CRT at Lu'an Hospital of Anhui Medical University from January 2018 to January 2023. The occurrence of RE was evaluated according to grading criteria of RE developed by American Radiation Therapy Oncology Group, with ≥ grade 2 RE as the outcome event. After screening variables through the least absolute shrinkage and selection operator (LASSO) regression, the dataset was re-established. The dataset was then divided into training set ( n=193) and testing set ( n=83) in a 7∶3 ratio and included in four ML models: random forest (RF) , decision tree (DT) , extreme gradient boosting (XGBoost) , and support vector machine (SVM) . In the models, data training and model optimization were conducted in the training set, and model performance was evaluated in the testing set using the receiver operator characteristic (ROC) curve. The area under the curve (AUC) , accuracy, precision, sensitivity, and F1 score were calculated to assess the model. SHAP analysis was used to explain the optimal model. Results:By the end of follow-up, 91 cases (32.97%) of esophageal cancer patients had experienced ≥ grade 2 RE during CRT. There were statistically significant differences in tumor lesion length ( Z=-5.53, P<0.001) , Karnofsky performance status (KPS) score ( χ2=5.92, P=0.015) , the Eastern Cooperative Oncology Group (ECOG) score ( χ2=4.01, P=0.045) , hypertension ( χ2=15.35, P<0.001) , diabetes ( χ2=13.06, P<0.001) , white blood cell count ( Z=-6.59, P<0.001) , neutrophil count ( Z=-6.72, P<0.001) , and radiotherapy dose ( χ2=9.81, P=0.002) between ≥ grade 2 RE occurrence group ( n=91) and no occurrence group ( n=185) . After LASSO regression screening, 7 characteristic variables were ultimately selected, which were tumor lesion length, ECOG score, KPS score, neutrophil count, hypertension, diabetes, and radiotherapy dose. ROC curve analysis showed that the XGBoost model had better predictive performance, with an AUC of 0.90, accuracy of 0.82, precision of 0.80, sensitivity of 0.73, and F1 score of 0.76. The AUC, accuracy, precision, sensitivity, and F1 score of RF model were 0.89, 0.78, 0.76, 0.48, and 0.59, respectively. The AUC, accuracy, precision, sensitivity, and F1 score of DT model were 0.72, 0.72, 0.44, 0.60, and 0.52, respectively. The AUC of SVM model was 0.74, with an accuracy of 0.82, precision of 0.52, sensitivity of 0.88, and F1 score of 0.65. The XGBoost model was explained using SHAP analysis, which indicated that the tumor lesion length, neutrophil count, hypertension, diabetes, and radiotherapy dose had a strong predictive ability for the occurrence of ≥ grade 2 RE during CRT in esophageal cancer patients. Conclusions:The model established based on the XGBoost method has good predictive performance for the occurrence of ≥ grade 2 RE in esophageal cancer patients during CRT. Meanwhile, combined with SHAP analysis, it can provide an intuitive understanding of the impact of important features in the model on the outcome.

Objective To investigate the effects of low background radiation environments in deep underground settings on the biological behavior of NP69 human nasopharyngeal epithelial cells(NP69 cells)and the underlying molecular mechanisms.Methods A parallel control experimental design was adopted and NP69 cells were synchronously cultured in settings of three underground depths at the China in situ Deep-Underground Facility&Life Observatory(DeUFO)—ground level(DeUFO-0 m),1 000 m underground(DeUFO-1 000 m),and 1 500 m underground(DeUFO-1 500 m).Changes in cell proliferation and migration capabilities were assessed using the Cell Counting Kit-8(CCK-8)assay and scratch assay,respectively.High-throughput RNA sequencing(RNA-Seq)was performed to identify differentially expressed genes(DEGs).Functional annotation and pathway enrichment analysis of the DEGs were performed using the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)databases.Results CCK-8 assay revealed that,after 72 h of culture,the absorbance value of the DeUFO-0 m group was 1.35 times and 1.27 times those of the those of the DeUFO-1 000 m and DeUFO-1 500 m groups,respectively(both P<0.000 1).After 96 h of culture,the absorbance value of the DeUFO-0 m group was 1.52 times and 1.41 times those of the DeUFO-1 000 m and DeUFO-1 500 m groups,respectively(both P<0.000 1).Colony formation assays revealed that the number of cell colonies in the DeUFO-0 m group was 1.59 times and 1.27 times those in the DeUFO-1 000 m group and DeUFO-1 500 m group,respectively(both P<0.001).The scratch assay revealed that the 36-hour wound healing rate of the DeUFO-0 m group was 2.22 times and 4.00 times those of the DeUFO-1 000 m group and DeUFO-1 500 m group,respectively(both P<0.000 1).Transwell assays revealed that the number of migrating cells in the DeUFO-0 m group was 2.08 times and 2.56 times those in the DeUFO-1 000 m group and DeUFO-1 500 m group,respectively(both P<0.000 1).Transcriptome sequencing analysis revealed consistent upregulation of CELF2,CELF4,CGB8,GRHL2,and DMRTA2 genes in the DeUFO-1 000 m and DeUFO-1 500 m groups.Pathway enrichment analysis indicated significant enrichment of extracellular matrix(ECM)remodeling-associated pathways and gene expression regulation pathways in the experimental groups(false discovery rate[FDR]<0.05).Conclusion The low background radiation environment in deep underground settings suppresses the proliferation and migration activities of NP69 cells by mediating ECM remodeling and post-transcriptional regulatory mechanisms through the regulation of target genes such as the CELF family.This study provides experimental evidence for establishing a dose-response relationship between environmental radiation and cellular effects.

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 explore the clinical application value of artificial intelligence（AI）-assisted training in enhancing the accuracy of nuchal translucency（NT）identification，standardization of measurement，and diagnostic efficacy for abnormalities among ultrasound residents.Methods:A retrospective collection of 300 standard fetal NT ultrasound images was conducted at the Center for Medical Ultrasound，Suzhou Hospital Affiliated of Nanjing Medical University from January 2018 to June 2024. The AI model performed NT measurements and diagnoses once. Four sonographers of different seniority levels（including two resident physicians）independently conducted NT measurements and diagnoses twice. Prior to the experiment，the middle-age and resident sonographers had uniformly completed traditional theory training. Following the first independent measurements，the two resident sonographers received additional AI-assisted training，after which all 4 sonographers performed the second independent measurements. A fetal medicine expert evaluated blindly all the results and compared the differences in NT recognition accuracy，measurement standard rate and diagnosis accuracy between the middle-age sonographer（traditional training only）and two resident sonographers（traditional + AI-assisted training）.Results:For the middle-aged sonographer who only received traditional lecture-based training，the accuracy of NT recognition，standardization rate of measurement，or diagnostic accuracy were not significantly improved befroe and after the training，and the diffrence was not statistically significant（ χ2=0.189，1.887，0.326；all P>0.05）. In contrast，the second-year resident（Resident 2）and first-year resident（Resident 1），who received both traditional lecture-based training and AI training，demonstrated some improvements in the accuracy of NT measurement site recognition，though the differences were not statistically significant（ χ2=1.301，2.418；all P>0.05）. However，both residents did significant improvements in the standardization rate of NT measurement（ χ2=25.768，17.035；all P<0.05）. In terms of diagnostic accuracy，Resident 1 did significant improvement（ χ2=10.180， P<0.05），while Resident 2 also did some improvement，though the difference was not statistically significant（ χ2=2.573， P>0.05）. Conclusions:The AI-assisted training system enhances the ability of ultrasound resident sonographers to recognize，measure，and diagnose NT，providing a novel and efficient training model for standardized residency training in ultrasound specialties.

OBJECTIVE To observe the in vitro induced drug resistance mechanisms of polymyxin B-resistant Acin-etobacter baumannii and explore the in vitro antimicrobial activity of polymyxin B combined with melatonin.METHODS Totally 10 strains of polymyxin B-sensitive A.baumannii were clinically isolated from the Affiliated Li Huili Hospital of Ningbo university between Jan.2021 to Dec.2021 and were induced to the polymyxin B-resistant strains by means of in vitro induction method.The drug resistance mechanisms of the polymyxin B-resistant A.baumannii strains were explored by polymerase chain reaction(PCR)combined with sequencing analysis.The minimum inhibitory concentrations(MICs)of the single and joint use of polymyxin B and melatonin were detected by using broth microdilution checkerboard.The antibacterial effect of polymyxin combined with melatonin was e-valuated by calculating fractional inhibitory concentration index(FICI).The strains that showed the remarkable synergistic effect for the antimicrobial activity were chosen to determine the time-kill curves.RESULTS Among the polymyxin B-induced drug-resistant A.baumannii strains,there were gene mutations at various loci of polymyxin resistance genes pmrB,lpxA and lpxD.The MIC of polymyxin B against A.baumannii strains declined after the combined use of polymyxin B and melatonin.The combined use of the two drugs that showed synergistic effect for antimicrobial activity accounted for 80.00％(8/10),the additive effect 20.00％(2/10).The time-kill curve showed that the combined use of polymyxin B and melatonin showed remarkable antibacterial effect at the 24th hour.CONCLUSIONS The drug resistance gene mutations that are mediated by chromosomes are the major drug resist-ance mechanisms of the A.baumannii strains to polymyxin B.The combined use of polymyxin B and melatonin may reverse the drug resistance of the A.baumannii to polymyxin B.

Objective:To investigate the diagnostic value of fetal cardiac ultrasound view visualization in the first trimester for congenital heart disease（CHD）.Methods:A retrospective analysis was performed on 13 323 singleton fetuses who underwent first-trimester（11-13 +6 weeks）ultrasound screening at the Ultrasound Medicine Center，the Affiliated Suzhou Hospital of Nanjing Medical University from January 2018 to June 2024. Cardiac views including the four-chamber view（4CV），left ventricular outflow tract view（LVOT），and Results:The study group showed significantly higher rates of "poorly visualized" 4CV，LVOT，and 3VT than the control group（2.70% vs. 0.14%， P=0.005；36.49% vs. 4.76%， P<0.001；36.49% vs.2.46%， P<0.001）. The efficacies of combination 1（any view abnormal）and combination 2（any view "poorly visualized" or "abnormal"）were comparable，with AUCs of 0.86 and 0.85（ P=0.424）. The AUCs of combination 3（3VT "poorly visualized" or any view "abnormal"）and combination 4（4CV "poorly visualized" or any view "abnormal"）were 0.88 and 0.86（ P=0.424），all significantly higher than combination 5（LVOT "poorly visualized" or any view "abnormal"，AUC=0.84，all P<0.05）. Conclusions:"Poorly visualized" cardiac views in the first trimester demonstrate good diagnostic efficacy for CHD，particularly when 3VT or 4CV are affected，warranting heightened clinical vigilance for fetal cardiac anomalies.