ObjectiveThis study explores the methods of lung tissue extraction and fixation required for pathological studies of fetal rats, based on the unique physiological structure of fetal rat lung tissue and existing lung tissue fixation techniques for adult rats. MethodsSix pregnant adult SD rats at 20.5 days of gestation were subjected to cesarean section to obtain fetal rats. Four healthy fetal rats with similar body weight, vital signs, and respiratory status were selected from each pregnant rat, and they were randomly divided into the following groups using a random number table: direct lung infiltration group, lung infiltration group after intratracheal infusion, whole-body infiltration group of fetal rats, and whole-body infiltration group after intratracheal infusion of fetal rats. To systematically compare and analyze the anatomical morphology under different fixation methods, lung tissues from four groups of fetal rats were harvested, perfused, and fixed, and the gross morphology of lung tissues in each group was observed. Paraffin sections were prepared and stained with Hematoxylin-Eosin (H&E). The histological morphology of the whole lung, alveoli, and bronchi was further examined under optical microscopy. ResultsIn the direct lung infiltration group, the hilar structures were unclear, lung lobation was indistinct, the shape was irregular, lung cavities were small, and alveoli and bronchi were shrunken. In the lung infiltration group after intratracheal infusion, the hilar structures were clear, lobation was pronounced, the shape was regular, lung cavities were large, and alveoli and bronchi were full. Both the whole-body infiltration group and whole-body infiltration group after intratracheal infusion of fetal rats exhibited visible lungs, hearts, skins, and other organs. The lung tissues of both groups showed obvious lobulation, irregular shape, and damage at the margins of lung lobes. In the whole-body infiltration group, the thoracic cavities of the fetus were flattened, lung cavities were small, and alveoli and bronchi were shrunken. In the whole-body infiltration group after intratracheal infusion of fetal rats, the fetal thoracic cavities were full, lung cavities were large, and alveoli and bronchi were relatively full. ConclusionThe lung infiltration after intratracheal infusion method for fetal rat lung tissue fixation outperforms direct lung infiltration, whole-body infiltration of fetal rats, and whole-body infiltration after intratracheal infusion of fetal rats in terms of preservation of the lung tissue's original morphology, paraffin sectioning, staining, and pathological observation and analysis. The embedding, sectioning, and staining processes are also simple and save consumables. Therefore, intratracheal infusion followed by lung infiltration method is recommended for fixation in histopathological observation of fetal rat lung tissue.

Objective:To explore the influence of value orientation brief therapy (VBT) on anxiety and depression symptoms, social function, coping style and self-acceptance level of major depressive disorder adolescents with anxious distress.Methods:From June 2021 to June 2022, seventy adolescent major depressive disorder patients with anxious distress were included in the study, who were randomly divided into study group(35 people, 31 people completed)and control group (35 people, 30 people completed). The study group was given routine treatment combined with VBT, while the control group was given routine treatment only. Before and after treatment, Hamilton anxiety scale(HAMA), Hamilton depression scale (HAMD), social disability screening schedule (SDSS), coping style questionnaire(CSQ) and self-acceptance questionnaire (SAQ) were used to evaluate the two groups, and SPSS 26.0 software was used to statistically analyze the data of the two groups. Paired sample t-test was used for intra-group comparison, and independent sample t-test was used for inter-group comparison. Results:After 6 weeks of treatment, the scores of HAMA((6.03±3.58) vs (14.03±7.06), t=5.55, P<0.01), HAMD((8.77±5.52 ) vs (16.50±7.59), t=4.56, P<0.01)and SDSS((4.23±1.50) vs (6.63±0.96), t=7.43, P<0.01)in the study group were significantly lower than those in the control group, the differences were statistically significant. The scores of self-acceptance((19.23±1.33) vs (13.47±1.46), t=-16.12, P<0.01)and self-evaluation ((19.87±2.87) vs (12.77±1.68), t=-11.75, P<0.01) in the SAQ scale and the scores of problem-solving((8.71±2.30) vs (6.23±3.45), t=3.31, P<0.05) and rationalization ((6.20±3.11) vs (4.67±2.43), t=2.13, P<0.05) in the CSQ questionnaire were significantly higher than those in the control group, the differences were statistically significant. The total effective rate of the study group(90.3%(28/31) vs 66.7%(20/30), χ2=5.09, P<0.05) was significantly higher than that of the control group, the difference was statistically significant. Conclusion:The effect of routine treatment combined with VBT is better, which can effectively improve anxiety and depression symptoms, social function and coping style, and enhance self-acceptance and self-evaluation in adolescent major depressive disorder patients, which is worthy of clinical application.

Objective To investigate and compare the effects of electroacupuncture and dexamethasone on lung function and histomorphology and behavior in the offspring of perinatal nicotine exposure(PNE)rats.Methods Twenty-four pregnant Sprague-Dawley rats were randomly divided into control,model,electroacupuncture shallow needling,and dexamethasone groups using the random number table method(n=6 rats per group).A pulmonary dysplasia model in offspring rats with PNE was prepared by cervicodorsal subcutaneous injection with nicotine,and successful establishment of the model was confirmed by demonstrating statistically significant differences in growth parameters,lung function,and lung morphology compared to the control group.From the sixth day of maternal conception,the control group received cervicodorsal subcutaneous injection with 0.9%sodium chloride solution(1 mg/kg once per day),and the remaining groups were similarly injected with nicotine(1 mg/kg once per day).Concurrent with the nicotine injections,the electroacupuncture shallow needling group received electroacupuncture interventions at the"Zusanli"(ST 36)acupoint on both sides once a day for 20 min.In contrast,the offspring rats in the dexamethasone group received intraperitoneal dexamethasone injections from postnatal day 8(1.5 mg/kg once per day for 3 days),with a later dose of 0.75 mg/kg once per day for 4 days.Following successful model establishment,four offspring per rat were retained in each group using the random number table method.Until the 21st day after the birth of the offspring,using the random number table method,one offspring randomly selected from the four retained offspring per rat in each group was assigned to growth parameter assessment including body weight,lung weight,and lung index;simultaneously,one offspring was randomly selected for pulmonary function which was detected by a small animal pulmonary function machine,with the parameters of forced vital capacity(FVC),functional residual capacity(FRC),dynamic lung compliance(Cdyn),peak expiratory flow(PEF),peak inspiratory flow(PIF),and airway resistance(RL);concurrently,one offspring was randomly selected for hematoxylin and eosin staining to observe the histomorphology of the lung tissue,alveolar numbers,and mean alveolar septal thickness;additionally,one offspring was randomly selected for Morris water maze testing to evaluate the effects of the two intervention methods on learning and memory capabilities in offspring rats with PNE.Results Compared with the control group,the body weight,lung weight,lung index,FVC,PEF,FRC,Cdyn,alveolar number,platform crossing times,target quadrant time percentage,and target quadrant path percentage in the Morris water maze experiment were significantly decreased in the offspring rats of the model group(P<0.01).In contrast,PIF,RL,average thickness of alveolar septa,and latency of the Morris water maze experiment were significantly increased in the offspring rats of the model group(P<0.01).Compared with the model group,both electroacupuncture shallow needling group and dexamethasone group exhibited significant increases in body weight,lung weight,lung index,FVC,PEF,FRC,Cdyn,and alveolar numbers(P<0.05,P<0.01),along with significant decreases in PIF,RL values,and mean alveolar septal thickness(P<0.01).However,in the Morris water maze experiment,compared with the model group,the electroacupuncture shallow needling group demonstrated significantly more platform crossing times and a higher target quadrant time percentage and target quadrant path percentage(P<0.01),coupled with reduced latency period(P<0.01),whereas the dexamethasone group showed no significant differences compared to the model group.Compared to the electroacupuncture shallow needling group,the dexamethasone group showed significantly less platform crossing times and a lower target quadrant time percentage and target quadrant path percentage,coupled with increased latency period(P<0.01).Conclusion Both electroacupuncture and dexamethasone demonstrated protective effects on lung development in PNE offspring rats by ameliorating lung histomorphology and pulmonary function.However,offspring receiving late,small-dose,short-course dexamethasone exhibited inferior learning and memory capabilities,whereas the electroacupuncture group showed significantly superior cognitive performance compared to the dexamethasone group.

Objective:To explore the influence of value orientation brief therapy (VBT) on anxiety and depression symptoms, social function, coping style and self-acceptance level of major depressive disorder adolescents with anxious distress.Methods:From June 2021 to June 2022, seventy adolescent major depressive disorder patients with anxious distress were included in the study, who were randomly divided into study group(35 people, 31 people completed)and control group (35 people, 30 people completed). The study group was given routine treatment combined with VBT, while the control group was given routine treatment only. Before and after treatment, Hamilton anxiety scale(HAMA), Hamilton depression scale (HAMD), social disability screening schedule (SDSS), coping style questionnaire(CSQ) and self-acceptance questionnaire (SAQ) were used to evaluate the two groups, and SPSS 26.0 software was used to statistically analyze the data of the two groups. Paired sample t-test was used for intra-group comparison, and independent sample t-test was used for inter-group comparison. Results:After 6 weeks of treatment, the scores of HAMA((6.03±3.58) vs (14.03±7.06), t=5.55, P<0.01), HAMD((8.77±5.52 ) vs (16.50±7.59), t=4.56, P<0.01)and SDSS((4.23±1.50) vs (6.63±0.96), t=7.43, P<0.01)in the study group were significantly lower than those in the control group, the differences were statistically significant. The scores of self-acceptance((19.23±1.33) vs (13.47±1.46), t=-16.12, P<0.01)and self-evaluation ((19.87±2.87) vs (12.77±1.68), t=-11.75, P<0.01) in the SAQ scale and the scores of problem-solving((8.71±2.30) vs (6.23±3.45), t=3.31, P<0.05) and rationalization ((6.20±3.11) vs (4.67±2.43), t=2.13, P<0.05) in the CSQ questionnaire were significantly higher than those in the control group, the differences were statistically significant. The total effective rate of the study group(90.3%(28/31) vs 66.7%(20/30), χ2=5.09, P<0.05) was significantly higher than that of the control group, the difference was statistically significant. Conclusion:The effect of routine treatment combined with VBT is better, which can effectively improve anxiety and depression symptoms, social function and coping style, and enhance self-acceptance and self-evaluation in adolescent major depressive disorder patients, which is worthy of clinical application.

Objective:To explore the impact of different blood transfusion thresholds on clinical outcomes in children with severe traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted. Clinical data was collected from 64 children with severe TBI who received red blood cell transfusions and were admitted to the Pediatric Intensive Care Unit (PICU) of Beijing Children′s Hospital between January 2020 and December 2024. Data included basic clinical characteristics, mortality rate, neurological recovery (measured by Glasgow coma scale (GCS) at discharge, pediatric cerebral performance category (PCPC) score), length of stay in the PICU, duration of mechanical ventilation, and incidence of complications. Patients were divided into a liberal transfusion group (hemoglobin >70-<100 g/L at first transfusion) and a restrictive transfusion group (hemoglobin ≤70 g/L at first transfusion). Stratified analysis was performed based on age (children >5 and children ≤5 years old). Comparisons between groups were conducted using the independent samples t test, Mann-Whitney U test, χ2 test or Fisher′s exact test. Results:Among the 64 children with severe TBI (43 males and 21 females), the age was 4.9 (2.3, 10.0) years. There were 33 cases in the liberal transfusion group and 31 cases in the restrictive transfusion group. No statistically significant differences were observed in baseline data, including gender, age, trauma mechanism, GCS at admission, surgical intervention, presence of multiple injuries, or comorbidities (sepsis, shock, ventilator-associated pneumonia and acute kidney injury) between the 2 groups (all P>0.05). There were no statistically significant differences between the liberal and restrictive transfusion groups in mortality rate, GCS and PCPC score at discharge, length of PICU stay, duration of mechanical ventilation, or transfusion volume (all P>0.05). In the stratified analysis, 38 children aged over 5 years were included. The restrictive transfusion subgroup, which included 19 children, had a significantly longer PICU length of stay compared to the liberal transfusion subgroup, which also included 19 children (29.5 (18.0, 36.3) vs. 17.0 (6.3, 25.8) d, Z=2.11, P=0.035). Conclusions:There were no significant differences in PICU mortality or neurological functional recovery between the liberal and restrictive blood transfusion strategies in children with severe TBI. However, among children aged over than 5 years, a restrictive transfusion strategy might be associated with a longer length of PICU stay.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Artificial intelligence (AI) technologies are being widely applied in radiotherapy. However, the integration of AI into clinical workflows of radiotherapy faces a series of challenges, such as poor model interpretability, domain shifts between clinical application and training data, and the inherent model uncertainties. Therefore, case-specific quality assurance (QA) is essential before deploying AI models in clinical practice. This paper reviews and summarizes QA methodologies for the application of AI models in radiotherapy across four key areas: image registration, image generation, region of interest segmentation, and treatment planning.

Purpose: This study aimed to assess the impact of aerobic exercise at different intensities over an eight-week period on the expression and activation of cortical synaptic proteins, with the potential to reduce anxiety and improve memory in young mice. Methods: Seven-week-old C57BL/6 mice were subjected to treadmill exercises at low (n = 10), moderate (n = 10), and high intensity (n = 10) for eight weeks. Behavioral assessments were conducted to evaluate anxiety and cognitive function. To explore the underlying mechanisms, we measured the phosphorylated levels of extracellular signal-regulated kinase (ERK), cyclic adenosine monophosphate response-binding protein (CREB), protein kinase (AKT), adenosine monophosphate activated protein kinase (AMPK), synapsin (S9, S549, S609), and PSD-95 in the cortex, as these are associated with synaptic strength. Additionally, the expression of doublecortin (DCX), a neurogenic factor, was analyzed in the hippocampus. Results: Exercise led to reductions in depressive and anxiety-related behaviors and elevated the levels of phosphorylated ERK, CREB, AKT, AMPK, synapsin (S9, S549, S609), and PSD-95 in the cortex of young mice. Furthermore, exercise increased DCX expression in the hippocampus. Moderate-intensity exercise yielded more pronounced effects than other intensities. Conclusion The findings of this research indicate that consistent moderate-intensity exercise increases synaptic strength and reduces depression and anxiety in young mice by activating multiple factors.

Purpose: This study aimed to assess the impact of aerobic exercise at different intensities over an eight-week period on the expression and activation of cortical synaptic proteins, with the potential to reduce anxiety and improve memory in young mice. Methods: Seven-week-old C57BL/6 mice were subjected to treadmill exercises at low (n = 10), moderate (n = 10), and high intensity (n = 10) for eight weeks. Behavioral assessments were conducted to evaluate anxiety and cognitive function. To explore the underlying mechanisms, we measured the phosphorylated levels of extracellular signal-regulated kinase (ERK), cyclic adenosine monophosphate response-binding protein (CREB), protein kinase (AKT), adenosine monophosphate activated protein kinase (AMPK), synapsin (S9, S549, S609), and PSD-95 in the cortex, as these are associated with synaptic strength. Additionally, the expression of doublecortin (DCX), a neurogenic factor, was analyzed in the hippocampus. Results: Exercise led to reductions in depressive and anxiety-related behaviors and elevated the levels of phosphorylated ERK, CREB, AKT, AMPK, synapsin (S9, S549, S609), and PSD-95 in the cortex of young mice. Furthermore, exercise increased DCX expression in the hippocampus. Moderate-intensity exercise yielded more pronounced effects than other intensities. Conclusion The findings of this research indicate that consistent moderate-intensity exercise increases synaptic strength and reduces depression and anxiety in young mice by activating multiple factors.