To report 3 cases of acute generalized exanthematous pustulosis (AGEP) caused by hydroxychloroquine. All the 3 patients were females, aged 23, 30, and 28 years respectively. In cases 1 and 3, the rashes appeared 4 days and 12 days respectively after the treatment with hydroxychloroquine for systemic lupus erythematosus; case 2, who was 8 weeks pregnant, developed rashes 10 days after starting hydroxychloroquine treatment for antiphospholipid syndrome. All the 3 patients had high fever, and clinically presented with generalized round or oval-shaped edematous erythema on the face, neck, trunk and limbs, covered with a large number of pinhead-sized pustules, and with multiple erythema multiforme-like lesions on the trunk and both upper limbs, including targetoid lesions. Mutations in the IL36RN gene were identified in all the 3 patients: a homozygous mutation c.115+6T>C in the IL36RN gene was found in case 1, and her parents were heterozygous carriers; case 2 inherited the heterozygous mutation c.115+6T>C in the IL36RN gene from her mother; the heterozygous mutation c.115+6T>C found in case 3 was a de novo mutation. A diagnosis of AGEP was made in all the 3 cases. Cases 1 and 2 received subcutaneous injections of adalimumab in addition to the treatment of their underlying diseases, and skin lesions markedly regressed after 1 week of treatment; case 3 was treated with high-dose glucocorticoids, and lesions subsided after 4 weeks; no significant adverse reactions were observed in cases 1 and 2, however, femoral head necrosis was noted in case 3. During a follow-up period of 42 months, none of the patients experienced recurrence, and case 2 gave birth to a healthy baby boy after 8-month treatment.

Cholesterol on the cell membrane plays a crucial role in regulating membrane proteins,influencing cell functions,and the occurrence and development of tumors.The CD44 receptor protein is closely associated with tumor invasion and metastasis.Therefore,developing biosensors capable of in-situ simultaneous monitoring of cholesterol and CD44 receptor protein on the cell membrane is of great significance for disease diagnosis.In this study,a spatially resolved strategy dual-signal multifunctional electrochemiluminescence(ECL)sensor was designed.The positive potential luminescent probe(ALC)was prepared by combining gold nanostars with luminol and cholesterol oxidase(ChOx),and the negative potential luminescent probe(CZA)was prepared by combining carbon quantum dots(CQD)with ZIF-8 and gold nanoparticles(AuNPs).The dual probes were fixed on dual working electrodes respectively to construct a spatial resolution dual signal sensor,and the signals were independently output with K2S2O8 as co-reactant.When the measurement signal of ALC probe was enhanced due to enzymatic catalysis of cholesterol,CZA synchronously output the internal reference signal,realizing ratio ECL detection of cholesterol,with a linear range of 50 nmol/L-1600 μmol/L and a detection limit of 20 nmol/L.Furthermore,after the double probes were respectively modified with folic acid(FA)and hyaluronic acid(HA),a spatially resolved dual-functional cell sensor was constructed by capturing human hepatoma cells HepG2 through ligand-receptor specific recognition.This sensor enabled the simultaneous monitoring of cholesterol-ChOx catalytic reaction and CD44-HA recognition on the cell membrane,as well as the quantitative detection of cancer cells and cholesterol on the cell membrane.The results showed that the linear detection range for HepG2 cell was 100-10000 cell/mL.By reducing cholesterol on the cell membrane using methyl-β-cyclodextrin(MβCD)downregulated CD44 expression,it was found that the cholesterol content was positively correlated with CD44 expression on the cell membrane.The control experiments showed that the analysis method was feasible.The designed ECL sensor could be used to detect cholesterol ratiometrically and provided a new method for the simultaneous analysis of multiple functional molecules in cells.

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.

Objective To analyze the MRI artifact of the inner ear structure in patients with peripheral vertigo acquired by using 3D fast imaging employing steady state acquisition(3D FIESTA-C)and 3D fast spin echo(3D-Cube T2).Methods Data of 63 patients with peripheral vertigo treated in the Department of Otolaryngology,The First Affiliated Hospital of Xi'an Jiaotong University,from October 2023 to June 2024 were filtered for analysis.The patients consisted of 16 males and 47 females,aged 18 to 60 years old.Two senior radiologists independently evaluated the quality of the acquired images through the two MRI sequences.Kappa test was used to evaluate the consistency of the two radiologists' subjective judgments,and Wilcoxon signed-rank test was used to compare the image quality between each sequence.The accuracy of 3D FIESTA-C,3D-Cube T2 and combination of the two sequences was calculated in the presentation of inner ear structure.Results The overall image quality of 3D-Cube T2 was better than that of 3D FIESTA-C(Z=-11.670,P＜0.001),and the accuracy of 3D FIESTA-C combined with 3D-Cube T2 was superior to that of each sequence in demonstrating the semicircular canals.The demonstration accuracy of horizontal semicircular canal among three scan protocols was statistically different(P＜0.001).Conclusion 3D FIESTA-C has the advantage in detecting horizontal semicircular canal,and 3D-Cube T2 always provides high quality images of upper semicircular canal.Compared with each scanning sequence,3D FIESTA-C combined with 3D-Cube T2 can effectively avoid misdiagnosis or missed diagnosis of semicircular canal structures in the patients with peripheral vertigo.

Objective:To establish a pure water direct dilution-inductively coupled plasma mass spectrometry (ICP-MS) detection method for rapid determination of urinary iodine.Methods:Pure water was used to directly dilute the urine samples. The washing solution was 5.0 g/L ascorbic acid, the internal standard solution was 5.0 g/L ascorbic acid and 100 μg/L 128Te, the standard solution was prepared with the solution of lyophilized urine iodine biological component analysis reference material. The method was evaluated in terms of linear range, detection limit, quantification limit, precision and method comparision experiment. Results:The linear correlation coefficient of the standard curve for iodine concentration range from 0 to 50.0 μg/L was 0.999 7, with a detection limit of 0.2 μg/L and a quantification limit of 0.6 μg/L. The spiked recovery rates of low, medium, and high concentration iodine standard solutions added to actual urine samples were 100.8%, 99.1% and 99.7%, respectively, with relative standard deviations of 0.8%, 1.3% and 1.6%, respectively. There was no statistically significant difference ( t = - 0.14, P = 0.890) between the results of measuring actual urine and assessment urine using this method and "Determination of Iodine in Urine-Part 2: Inductively Coupled Plasma Mass Spectrometry (WS/T 107.2-2016)". Conclusions:We have successfully established a pure water direct dilution-ICP-MS method for determining urinary iodine. This method provides accurate and highly sensitive results, making it suitable for sudden public health emergencies and large-scale clinical measurement of urinary iodine.

To report 3 cases of acute generalized exanthematous pustulosis (AGEP) caused by hydroxychloroquine. All the 3 patients were females, aged 23, 30, and 28 years respectively. In cases 1 and 3, the rashes appeared 4 days and 12 days respectively after the treatment with hydroxychloroquine for systemic lupus erythematosus; case 2, who was 8 weeks pregnant, developed rashes 10 days after starting hydroxychloroquine treatment for antiphospholipid syndrome. All the 3 patients had high fever, and clinically presented with generalized round or oval-shaped edematous erythema on the face, neck, trunk and limbs, covered with a large number of pinhead-sized pustules, and with multiple erythema multiforme-like lesions on the trunk and both upper limbs, including targetoid lesions. Mutations in the IL36RN gene were identified in all the 3 patients: a homozygous mutation c.115+6T>C in the IL36RN gene was found in case 1, and her parents were heterozygous carriers; case 2 inherited the heterozygous mutation c.115+6T>C in the IL36RN gene from her mother; the heterozygous mutation c.115+6T>C found in case 3 was a de novo mutation. A diagnosis of AGEP was made in all the 3 cases. Cases 1 and 2 received subcutaneous injections of adalimumab in addition to the treatment of their underlying diseases, and skin lesions markedly regressed after 1 week of treatment; case 3 was treated with high-dose glucocorticoids, and lesions subsided after 4 weeks; no significant adverse reactions were observed in cases 1 and 2, however, femoral head necrosis was noted in case 3. During a follow-up period of 42 months, none of the patients experienced recurrence, and case 2 gave birth to a healthy baby boy after 8-month treatment.

Objective To analyze the MRI artifact of the inner ear structure in patients with peripheral vertigo acquired by using 3D fast imaging employing steady state acquisition(3D FIESTA-C)and 3D fast spin echo(3D-Cube T2).Methods Data of 63 patients with peripheral vertigo treated in the Department of Otolaryngology,The First Affiliated Hospital of Xi'an Jiaotong University,from October 2023 to June 2024 were filtered for analysis.The patients consisted of 16 males and 47 females,aged 18 to 60 years old.Two senior radiologists independently evaluated the quality of the acquired images through the two MRI sequences.Kappa test was used to evaluate the consistency of the two radiologists' subjective judgments,and Wilcoxon signed-rank test was used to compare the image quality between each sequence.The accuracy of 3D FIESTA-C,3D-Cube T2 and combination of the two sequences was calculated in the presentation of inner ear structure.Results The overall image quality of 3D-Cube T2 was better than that of 3D FIESTA-C(Z=-11.670,P＜0.001),and the accuracy of 3D FIESTA-C combined with 3D-Cube T2 was superior to that of each sequence in demonstrating the semicircular canals.The demonstration accuracy of horizontal semicircular canal among three scan protocols was statistically different(P＜0.001).Conclusion 3D FIESTA-C has the advantage in detecting horizontal semicircular canal,and 3D-Cube T2 always provides high quality images of upper semicircular canal.Compared with each scanning sequence,3D FIESTA-C combined with 3D-Cube T2 can effectively avoid misdiagnosis or missed diagnosis of semicircular canal structures in the patients with peripheral vertigo.

Objective:To establish a pure water direct dilution-inductively coupled plasma mass spectrometry (ICP-MS) detection method for rapid determination of urinary iodine.Methods:Pure water was used to directly dilute the urine samples. The washing solution was 5.0 g/L ascorbic acid, the internal standard solution was 5.0 g/L ascorbic acid and 100 μg/L 128Te, the standard solution was prepared with the solution of lyophilized urine iodine biological component analysis reference material. The method was evaluated in terms of linear range, detection limit, quantification limit, precision and method comparision experiment. Results:The linear correlation coefficient of the standard curve for iodine concentration range from 0 to 50.0 μg/L was 0.999 7, with a detection limit of 0.2 μg/L and a quantification limit of 0.6 μg/L. The spiked recovery rates of low, medium, and high concentration iodine standard solutions added to actual urine samples were 100.8%, 99.1% and 99.7%, respectively, with relative standard deviations of 0.8%, 1.3% and 1.6%, respectively. There was no statistically significant difference ( t = - 0.14, P = 0.890) between the results of measuring actual urine and assessment urine using this method and "Determination of Iodine in Urine-Part 2: Inductively Coupled Plasma Mass Spectrometry (WS/T 107.2-2016)". Conclusions:We have successfully established a pure water direct dilution-ICP-MS method for determining urinary iodine. This method provides accurate and highly sensitive results, making it suitable for sudden public health emergencies and large-scale clinical measurement of urinary iodine.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Vesicular glutamate transporter 2(VGlut2)is expressed in the PVN of the hypothalamic paraventricular nucleus(PVNVG1ut2)as an excitatory neurotransmitter,which regulates food intake and energy metabolism and plays an important role in maintaining homeostasis.However,it is not clear that the upstream and downstream projection network of PVNVGut2 neurons hinders the anal-ysis of glutamatergic neuron circuit function.Anterograde and retrograde tracer viruses were injec-ted into the PVN of VGlut2 mice by stereotactic brain injection technique to find the input and output nuclei of PVNVGlut2 neurons.Anterograde tracing results showed that PVNVGlut2 neurons pro-jected to the downstream medial amygdala(MeAD)and arcuate nucleus(ARC).Retrograde trac-ing results showed that PVNVGlut2 received input from the prefrontal nucleus(Pr),the reticular tegmental nucleus(RtTg),and the hypoglossal nucleus(12N).In addition,VGlut2 was found to be co-expressed with neuronal nitric oxide synthase(nNOS)neurons in the PVN.The anatomical net-work of PVNVG1ut2 neurons was analyzed by virus tracking tool,which laid the anatomical founda-tion for further study on the functional regulation of PVNVGlut2.