Patients with Takayasu arteritis combined with aortic valve disease often have a poor prognosis following surgical valve replacement, frequently encountering complications such as perivalvular leakage, valve detachment, and anastomotic aneurysm. This article presents a high-risk case wherein severe aortic valve insufficiency associated with Takayasu arteritis was successfully managed through transcatheter aortic valve implantation via the transapical approach. The patient had satisfactory valve function with no complications observed during the six-month postoperative follow-up. This case provides a minimally invasive and feasible alternative for the clinical management of such high-risk patients.

ObjectiveTo investigate the functional role and underlying molecular mechanisms of fumarylacetoacetate hydrolase （FAH） in the progression of glioblastoma （GBM）. MethodsDifferential expression analysis was performed on the TCGA-GBM， GSE4290， and GSE116520 datasets. Weighted gene co-expression network analysis （WGCNA） was used to identify key modules， and Cox regression and risk modeling were used to screen prognostic genes. Immune infiltration analysis of prognostic genes was carried out by using single-cell RNA sequencing panels. The clinical expression signature of FAH in GBM was analyzed in the TCGA and HPA databases. The functional role of FAH was validated by in vitro and in vivo experiments， and pathway analysis was performed to explore the underlying mechanisms. ResultsA total of 152 overlapping genes were identified across the three GBM datasets （P<0.05）. WGCNA revealed that the turquoise module was most strongly associated with tumor purity， stromal score， immune score， and ESTIMATE score （P<0.001）. Compared with normal tissues， three prognostic genes （CTSD， FAH， and THBD） were upregulated in GBM and correlated with immune infiltration （P<0.05）. FAH mRNA and protein levels were elevated in GBM tissues relative to normal tissues， and its expression was significantly associated with age stratification and TP53 mutation （P<0.05）. CCK-8 assay results showed that， compared with the shNC group， the proliferative activity of GBM cells in the shFAH group was reduced （P<0.001）. Transwell migration and invasion assays demonstrated that， relative to the shNC group， the numbers of migrated and invaded cells in the shFAH group decreased （P<0.05）. Western blot analysis revealed that the protein expression levels of PI3K， p-AKT， and p-mTOR in the shFAH group decreased compared with those in the shNC group （P<0.05）. In vivo subcutaneous xenograft experiments further confirmed that tumor volume and weight significantly decreased in the shFAH group compared with the shNC group （P<0.001）. ConclusionFAH promotes GBM progression by activating the PI3K/AKT/mTOR signaling pathway and may serve as a potential therapeutic target for GBM.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Metastatic castration-resistant prostate cancer (mCRPC) implies highly heterogeneous molecular tumor behavior, rapid disease progression and poorer prognosis, seriously threatening the lives of patients.Therefore, early identification and treatment are significant.Among the current clinical treatment regimens for mCRPC, abiraterone acetate, enzalutamide and docetaxel have demonstrated improvement in overall survival (OS).Furthermore, patients carrying homologous recombination repair mutation (HRRm) are sensitive to poly ADP-ribose polymerase inhibitors (PARPi).For patients with positive prostate specific membrane antigen (PSMA), Lutetium-177 (177Lu)-PSMA-617 radiation ligand therapy is a new and effective treatment method.Radium-223 has also been used as the first-line treatment for patients with bone pain symptoms.However, due to the rapid updates in the field of mCRPC drug therapy, clinicians find it difficult to keep up with the latest developments in this area.Emerging drugs have great potential, such as immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs), but more evidence is needed, and molecular markers helping predict the efficacy of these drugs should be explored.This article reviews the advances in the drug therapy of mCRPC, with the aim of providing reference for clinical practice.

Objective:To describe the epidemiological characteristics and changes of febrile seizure(FS)among children under 6 years old in Ningbo City,Zhejiang Province from 2015 to 2021.Methods:Based on the Ningbo Regional Health Information Platform,a dynamic cohort was established using vacci-nation registration information,and the cases of FS were identified by the diagnostic results of Chinese terms or International Classification of Diseases 10th revision(ICD-10)R56.0 code in the electronic medical records.The first visit of FS during the observation period was defined as a new case,and a re-currence case was defined as the case with a visit interval of more than 7 days.The 95％confidence in-terval(CI)of FS incidence density was calculated by the Poisson distribution.Results:From January 2015 to June 2020,there were 1.3 million children under 6 years old in Ningbo,with male accounting for 52.87％.The median follow-up time was 2.83(1.55-4.00)years.During the follow-up period,12 776 new onset cases had FS,with more males than females,with an overall incidence density of 4.34(95％CI:4.27-4.40)/1 000 person-years and a recurrence rate of 21.63％.There was a higher inci-dence density in children who were male,born in Ningbo and of non-mobility.The incidence density of FS was higher in urban areas than in rural and rural-urban fringe areas,and the incidence density was different among districts and counties.The peak density was found in children aged 18-23 months[8.42(95％CI:8.11-8.74)/1 000 person-years].From 2015 to 2019,the incidence density in-creased with calendar year(Ptrend＜0.001),and the highest was 5.62(95％CI:5.43-5.81)/1 000 person-years.The incidence density of FS decreased significantly during the period between 2020 and 2021.The incidence density was higher in winter.Conclusion:From 2015 to 2019,the overall inci-dence density of FS in children under 6 years old in Ningbo City presented an increasing trend.More at-tention should be paid to the health education,the improvement of the health maintenance model,the en-hancement of the cognition of FS,the identification and treatment of FS among high-risk population and regions so as to prevent its recurrence and reduce the disease burden during the corona virus disease 2019(COVID-19)epide-mic.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.

This study analyzed soil-transmitted nematode infection surveillance data for children 3-9 years of age in Shaanxi Province from 2016 to 2023,to provide a scientific basis for control strategies for soil-transmitted nematode infections in children in the province.Since 2016,according to the requirements of the National Schistosomiasis and Soil-transmitted Nematode Surveillance Program(Trial),several counties and districts in Shaanxi Province were selected as surveillance sites every year.According to geo-graphical position,the surveillance sites were divided into five areas:east,west,south,north and middle,and one administrative vil-lage(community)was selected in each area for monitoring.The eggs of soil-transmitted nematodes(hookworm,Ascaris lumbricoides,Trichuris trichiura,and Enterobius vermicularis)were detected with the Kato-Katz technique in children 3-9 years of age at each sur-veillance site,and the eggs of Enterobius vermicularis were detected again with the cellophane tape anal swab method.The infection rate and intensity for E.vermicularis were calculated.Detection was performed in 12 462 children 3-9 years old at 75 surveillance sites in Shaanxi Province from 2016 to 2023;84 cases of soil-borne nematode infections were detected,and the overall infection rate was 0.67%.The infection rates for Ascaris lumbricoides and E.vermicularis were 0.18%(22/12 462)and 0.50%(62/12 462),respec-tively,and the infection rates for Trichuris trichiura and hookworm were not found.The infection rates of soil-transmitted nematodes in children were 1.28%(16/1 250),0.16%(2/1 252),1.25%(17/1 365),1.20%(18/1 494),0.17%(2/1 169),1.45%(20/1 382),0.00,and 0.36%(9/251),respectively.A linear trend was observed among years(χ2=11.973,P<0.001).The infection rates in the Weifen Basin ecological region,Loess Plateau ecological region,and Qinba Mountains ecological region were 0.51%,1.19%,and 0.72%,respectively,and the differences were statistically significant(χ2=9.726,P=0.008).Significant differences in infection rates were observed among scattered children(1.63%),preschool children(0.66%),and students(0.57%)(χ2=11.189,P=0.004).No significant differences in infection rates were observed by gender,age,and education level.Compared with the infection rates in the entire country and other provinces,the infection rate of soil-transmitted nematodes among children in Shaanxi Province was low,and the main infection species were Ascaris lumbricoides and E.vermicularis.The infection rates greatly varied within Shaanxi Prov-ince,possibly because of differences in economic development levels,children′s living habits,and personal hygiene status across re-gions.In the future,comprehensive control measures should be taken to strengthen the monitoring and control of key areas,popula-tions,and parasite species.

Objective:To observe the therapeutic effect of Edaravone Dexborneol combined with aspirin and clopidogrel in the treatment of acute ischemic stroke(AIS).Methods:82 AIS patients were randomly divided into control group(treated with aspirin and clopidogrel,n=41)and observation group(treated with Edaravone Dexborneol on the basis of control group,n=41)by random number table method.National Institutes of Health Stroke Scale(NIHSS),Montreal Cognitive Assessment Scale(MoCA),Barthel Index(BI),serum biochemical indicators[neuron specific enolase(NSE),superoxide dismutase(SOD),brain-derived neurotrophic factor(BDNF),malondialdehyde(MDA)],intracranial hemodynamic indicators[bilateral anterior cerebral artery(ACA),bilateral middle cerebral artery(MCA),bilateral posterior cerebral artery(PCA)],and incidence of adverse reactions during treatment were compared between the two groups.Results:The total clinical effective rate,MoCA,BI score,BDNF,SOD,and the average flow rates of ACA,MCA,and PCA in the observation group 14 d after treatment were higher than those in control group,NIHSS score,NSE,and MDA were lower than those in control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Edaravone Dexborneol combined with aspirin and clopidogrel in AIS treatment can significantly improve intracranial hemodynamics,regulate nerve factors,reduce nerve function damage,and has good safety.

Objective:To analyze the epidemic characteristics and trends of visceral leishmaniasis (VL) in Shaanxi Province, and provide a basis for formulating control strategies.Methods:The information on VL cases in Shaanxi Province from January 2012 to December 2024 were obtained from the Shaanxi Provincial Infectious Disease Reporting Management System, and demographic data were collected from the Shaanxi Statistical Yearbook. Descriptive epidemiological method was used to analyze the prevalence and the distribution by the three dimensions (time, region, and population). Joinpoint 4.9.1.0 software and Geoda 1.6 software were used for regression analysis and spatial clustering analysis, respectively. SuperMap 8C software was used for visualization.Results:From January 2012 to December 2024, a total of 304 cases of VL were reported in Shaanxi Province, with an annual incidence rate of 0.06/100 000. VL cases occurred in all months of the year in Shaanxi Province with no significant seasonality, yet the onset was predominantly concentrated from April to August(52.30%, 159/304). The majority of cases were male (61.51%, 187/304), aged 5 months to 4 years (17.11%, 52/304), and farmers (67.11%, 204/304). A total of 54 districts (counties, cities) of 10 cities in the province had reported cases, mainly concentrated in Weinan City (49.34%, 150/304). Joinpoint regression analysis revealed a significant overall upward trend in the VL incidence rate in Shaanxi Province from 2012 to 2024 [average annual percent change (AAPC) = 12.60%, 95% confidence interval ( CI): 6.01% - 19.62%, t = 3.95, P < 0.001]. The year 2020 was identified as a turning point in the trend. The incidence rate showed a rapid upward trend from 2012 to 2020 [annual percent change (APC) = 23.75%, 95% CI: 13.33% - 35.12%, t = 5.62, P < 0.001]. Global spatial autocorrelation analysis indicated significant positive spatial autocorrelation in VL incidence in 2012, 2014, 2015, 2018, and 2022 (Moran's I > 0, Z > 1.96, P < 0.05). Local spatial autocorrelation analysis identified 12 "high-high" clustering areas from 2012 to 2024, mainly located in Shangluo City in southern Shaanxi Province, and Weinan City and Yan'an City in northern Shaanxi Province. Conclusions:From 2012 to 2024, VL cases in Shaanxi Province are predominantly male farmers. The incidence of VL shows an overall upward trend, with significant spatial clustering. The prevention and control situation is severe. It is imperative to strengthen control measures, including vector disinfection and health education, to effectively control the spread and transmission of VL.

The floating thrombus in the brachiocephalic artery is relatively rare and difficult to diagnose,and it is prone to be missed.This article reports a case of a patient with a floating thrombus in the brachiocephalic artery who underwent endovascular treatment via a combined radial artery and femoral artery approach.The patient presented with slurred speech,weakness in the left limbs,and dizziness.A cranial DWI examination revealed acute cerebral infarction in the right cerebral hemisphere and bilateral cerebellum.A neck CTA examination showed a floating thrombus in the brachiocephalic artery.Currently,there is no consensus on the treatment of floating thrombi in the brachiocephalic artery.The effect of conservative medical treatment for this patient was poor,and endovascular treatment was administered.The vertebral artery and carotid artery protection umbrellas were deployed via the radial artery approach to prevent intraoperative embolism events.A stent was deployed via the femoral artery approach to adhere to the thrombus.A follow-up neck CTA examination of the patient after the operation indicated that the stent was in a good position with complete thrombus apposition.