ObjectiveTo investigate the mechanism by which 2，3，5，4'-tetrahydroxyldiphenylethylene-2-O-glucoside （THSG） mitigates cerebral ischemia/reperfusion （CI/R） injury by regulating mitochondrial calcium overload and promoting mitophagy. MethodsSixty male SD rats were randomized into sham， model， SAS （40 mg·kg^-1）， and low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） THSG groups， with 10 rats in each group. The middle cerebral artery occlusion/reperfusion （MCAO/R） model was established by the modified Longa suture method. An oxygen-glucose deprivation/reoxygenation （OGD/R） model was constructed in PC12 cells. Neurological deficits were assessed via Zea Longa scoring， and cerebral infarct volume was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Structural and functional changes of cortical neurons in MCAO/R rats were assessed by hematoxylin-eosin and Nissl staining. PC12 cell viability was detected by cell counting kit-8 （CCK-8） assay， and mitochondrial calcium levels were quantified by Rhod-2 AM. Immunofluorescence was used to detect co-localization of PTEN-induced kinase 1 （PINK1） and leucine zipper/EF-hand-containing transmembrane protein 1 （LETM1） in neurons. Transmission electron microscopy （TEM） was employed to observe mitochondrial morphology in neurons. Western blot was employed to analyze the expression of translocase of outer mitochondrial membrane 20 （TOMM20）， autophagy-associated protein p62， microtubule-associated protein light chain 3 （LC3）， cysteinyl aspartate-specific proteinase-9 （Caspase-9）， B-cell lymphoma 2-associated protein X （Bax）， and cytochrome C （Cyt C）. ResultsCompared with the sham group， the model group exhibited increased infarct volume （P<0.01） and neurological deficit scores （P<0.01）， neuronal structure was disrupted with reduced Nissl bodies. （P<0.01）， mitochondrial swelling/fragmentation， decreased PINK1/LETM1 co-localization （P<0.01）， upregulated protein levels of LC3Ⅱ/LC3Ⅰ， TOMM20， Caspase-9， Bax， and Cyt C （P<0.01）， downregulated protein level of p62 （P<0.05）， weakened PC12 viability （P<0.01）， and elevated mitochondrial calcium level （P<0.01）. Compared with the model group， THSG and SAS groups showed reduced infarct volumes （P<0.05，P<0.01） and neurological deficit scores （P<0.05，P<0.01）， mitigated mitochondrial damage， and increased PINK1/LETM1 co-localization （P<0.01）. Medium/high-dose THSG and SAS alleviated the neurological damage， increased Nissl bodies （P<0.05，P<0.01）， downregulated the protein levels of p62， TOMM20， Caspase-9， Bax， and Cyt C （P<0.05，P<0.01）， and elevated the LC3Ⅱ/LC3Ⅰ level （P<0.05，P<0.01）. High-dose THSG enhanced PC12 cell viability （P<0.01）， increased PINK1/LETM1 co-localization （P<0.01）， and reduced mitochondrial calcium （P<0.01）. ConclusionTHSG may exert the neuroprotective effect on CI/R injury by activating the PINK1-LETM1 signaling pathway， reducing the mitochondrial calcium overload， and promoting mitophagy.

ObjectiveTo investigate the mechanism by which 2，3，5，4'-tetrahydroxyldiphenylethylene-2-O-glucoside （THSG） mitigates cerebral ischemia/reperfusion （CI/R） injury by regulating mitochondrial calcium overload and promoting mitophagy. MethodsSixty male SD rats were randomized into sham， model， SAS （40 mg·kg^-1）， and low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） THSG groups， with 10 rats in each group. The middle cerebral artery occlusion/reperfusion （MCAO/R） model was established by the modified Longa suture method. An oxygen-glucose deprivation/reoxygenation （OGD/R） model was constructed in PC12 cells. Neurological deficits were assessed via Zea Longa scoring， and cerebral infarct volume was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Structural and functional changes of cortical neurons in MCAO/R rats were assessed by hematoxylin-eosin and Nissl staining. PC12 cell viability was detected by cell counting kit-8 （CCK-8） assay， and mitochondrial calcium levels were quantified by Rhod-2 AM. Immunofluorescence was used to detect co-localization of PTEN-induced kinase 1 （PINK1） and leucine zipper/EF-hand-containing transmembrane protein 1 （LETM1） in neurons. Transmission electron microscopy （TEM） was employed to observe mitochondrial morphology in neurons. Western blot was employed to analyze the expression of translocase of outer mitochondrial membrane 20 （TOMM20）， autophagy-associated protein p62， microtubule-associated protein light chain 3 （LC3）， cysteinyl aspartate-specific proteinase-9 （Caspase-9）， B-cell lymphoma 2-associated protein X （Bax）， and cytochrome C （Cyt C）. ResultsCompared with the sham group， the model group exhibited increased infarct volume （P<0.01） and neurological deficit scores （P<0.01）， neuronal structure was disrupted with reduced Nissl bodies. （P<0.01）， mitochondrial swelling/fragmentation， decreased PINK1/LETM1 co-localization （P<0.01）， upregulated protein levels of LC3Ⅱ/LC3Ⅰ， TOMM20， Caspase-9， Bax， and Cyt C （P<0.01）， downregulated protein level of p62 （P<0.05）， weakened PC12 viability （P<0.01）， and elevated mitochondrial calcium level （P<0.01）. Compared with the model group， THSG and SAS groups showed reduced infarct volumes （P<0.05，P<0.01） and neurological deficit scores （P<0.05，P<0.01）， mitigated mitochondrial damage， and increased PINK1/LETM1 co-localization （P<0.01）. Medium/high-dose THSG and SAS alleviated the neurological damage， increased Nissl bodies （P<0.05，P<0.01）， downregulated the protein levels of p62， TOMM20， Caspase-9， Bax， and Cyt C （P<0.05，P<0.01）， and elevated the LC3Ⅱ/LC3Ⅰ level （P<0.05，P<0.01）. High-dose THSG enhanced PC12 cell viability （P<0.01）， increased PINK1/LETM1 co-localization （P<0.01）， and reduced mitochondrial calcium （P<0.01）. ConclusionTHSG may exert the neuroprotective effect on CI/R injury by activating the PINK1-LETM1 signaling pathway， reducing the mitochondrial calcium overload， and promoting mitophagy.

ObjectiveTo investigate the microbial contamination status of commercially available ready-to-eat (RTE) foods in Songjiang District of Shanghai, to verify the potential food safety hazards, so as to provide a scientific basis for the local regulation of RTE foods and the prevention of foodborne diseases. MethodsA total of 882 food samples from 9 categories of RTE foods were collected in Shanghai from 2017 to 2022. Salmonella, Listeria monocytogenes, Vibrio parahaemolyticus, Staphyloccus aureus and Bacillus cereus were detected according to the standard operating procedures in the Manual for China National Food Contamination and Harmful Factors Risk Monitoring, and which were determined with reference to relevant standards. ResultsA total of 77 samples were found to carry foodborne pathogens, with a total detection rate of 8.73%. Among the 5 foodborne pathogens, Bacillus cereus had the highest detection rate (8.35%), followed by Vibrio parahaemolyticus (5.05%), and the difference of detection rates among the 5 foodborne pathogens was statistically significant (χ²=112.307, P<0.001). Among the 9 categories of RTE food products, the detection rate of foodborne pathogens in RTE fermented/non-fermented soybean products was the highest (27.50%), followed by cold noodles (17.33%) and raw edible aquatic products (9.50%), and the difference in the detection rates of foodborne pathogens among different RTE food categories was statistically significant (χ²=45.909, P<0.001). The detection rate of foodborne pathogens in the third quarter of the year was 10.99%, significantly higher than that in other quarters (χ²=10.329, P=0.016). The detection rate of foodborne pathogens in samples from supermarkets was highest (15.08%), followed by snack bars (11.58%), with a statistically significant difference (χ²=14.108, P=0.015). ConclusionFoodborne pathogens contamination is found in commercially available RTE foods in Songjiang District of Shanghai, especially in RTE fermented/non-fermented soybean products, RTE cold noodles and raw edible aquatic products from supermarkets, snack bars and farm products markets during summer and autumn. Therefore, it is crucial to strengthen supervision and management to avoid the foodborne diseases.

Intramedullary needle(IMN)has the advantages of high healing rate and low incidence of complications in treatment of tibial fracture,and has become one of the most commonly used fixation methods for the treatment of tibial fracture.However,due to the patient's own factors,fracture location and fracture type,infection and surgical treatment,bone nonunion after IMN still occurs in clinic.Bone nonunion leads to the increase of medical cost and prolonged the hospitalization time of patients,which causes great pain to patients,and also brings great challenges to the treatment of orthopedic surgeons.Therefore,this paper reviews the influencing factors of bone nonunion after IMN for tibial fracture,in order to provide reference for clinical treatment.

Objective To observe the value of SS-3DUNet model based on spatially separable convolutions for automatically segmenting anal fistula in enhanced MR T1WI.Methods Totally 2 405 pelvic axial enhanced MR T1WI of 29 patients with anal fistula were retrospectively analyzed,and 1 537 images from 19 cases were randomly selected as training set,424 images from 5 cases were as validation set,444 images from 5 cases were as test set.A SS-3DUNet model was constructed based on spatially separable convolutions to automatically segment anal fistula in enhanced MR T1WI,and inter-layer feature enhancement module was incorporated to improve the location of fistula features.The model was trained in training set and the best one was selected based on validation set.Taking the results of manual labeling by clinicians,the efficacy of SS-3DUNet model for automatically segmenting anal fistulas was observed based on test set.Results The time of SS-3DUNet automatically segmenting anal fistula in a single image in test set was 0.59-0.61 s,and the coincidence of the boundary of fistula segmented by the model and manual label was high.The average Dice similarity coefficient,sensitivity and accuracy of SS-3DUNet for automatically segmenting anal fistula in test set was 0.746,70.04%and 82.93%,respectively.Conclusion SS-3DUNet model based on spatially separable convolutions could effectively automatically segmenting anal fistula in enhanced T1WI.

Objective:To investigate the value of immunoglobulin heavy chain(IgH)gene rearrangement in monitoring minimal residual disease(MRD)in multiple myeloma(MM)received autologous hematopoietic stem cell transplantation(auto-HSCT).Methods:The clinical data of 26 MM patients who received auto-HSCT in the Department of Hematology,Wuhan First Hospital from 2018 to 2022 were collected.IgH rearrangement was detected by multiplex PCR combined with capillary electrophoresis fragment analysis to evaluate minimal residual disease(MRD),and the outcome of the disease was analyzed statistically.Results:Among the 26 MM patients,18 were males and 8 were females,with a median age of 59(41-70)years.The median follow-up time after transplantation was 33(7-52)months.Compared with the IgH rearrangement negative group(n=17),the proportion of CR and sCR of patients with IgH rearrangement positive in bone marrow samples before auto-HSCT at 3 months after transplantation was lower(1/9 vs 14/17),and the duration of remission(DOR)after transplantation was shorter(10.78±4.35 vs 15.88±5.22 months),with statistically significant difference in DOR between the two groups(P＜0.05).Compared with IgH rearrangement negative group(n=21),the proportion of CR and sCR of patients with positive IgH rearrangement results from peripheral blood stem cell collection at 3 months after transplantation was lower(0/5 vs 15/21),the duration of remission(DOR)after transplantation was shorter(9.60±4.83 vs 15.19±5.11 months),and the difference in DOR between the two groups was statistically significant(P＜0.05).During the follow-up period,5 patients(5/9)with positive IgH rearrangement results in bone marrow specimens died,and all patients with negative IgH rearrangement results survived.Four patients(4/5)with positive IgH rearrangement results by peripheral blood stem cell samples died,while one patient(1/21)with negative IgH rearrangement results died.In both bone marrow and peripheral blood stem cell samples,the survival time of IgH rearrangement-positive patients after transplantation was shorter than that of IgH rearrangement-negative patients(P＜0.05).Logistic regression analysis showed that gender,disease stage,the proportion of bone marrow smear plasma cells at initial diagnosis,stem cell mobilization plan,efficacy evaluation before transplantation(≥ CR and＜CR),and CD34+cell count had no effect on IgH rearrangement results of stem cell collection(P＞0.05).Conclusion:By detecting IgH rearrangement of MM patients receiving auto-HSCT,the depth of MRD can be further evaluated,which has a certain guiding significance for the efficacy and prognosis of the disease.

Objective:To investigate the impact of ionizing radiation(IR)on the structure and function of the testis and pro-vide some strategies for the prevention and treatment of IR-induced damage(IRD).Methods:Using radiation dose simulation,se-men analysis,hormone testing,electron microscopy and single-cell transcriptome sequencing,we assessed and analyzed a case of IRD.We established a mouse model of IRD to validate the results of single-cell sequencing,and investigated the specific biological mecha-nisms of IRD and potential strategies for its intervention.Results:IR at 1-2 Gy significantly reduced sperm concentration and mo-tility,which gradually recovered after 12 months but the percentage of morphologically normal sperm remained low.It also caused im-balanced levels of various steroid hormones,decreased testosterone and dehydroepiandrosterone sulfate,increased progesterone,prolac-tin,luteinizing hormone,and follicle-stimulating hormone.Electron microscopy revealed damages to the testis structure,including loss of germ cells,atrophy of the seminiferous tubules,nuclear membrane depression of the spermatocytes,mitochondrial atrophy and de-formation,and reduction of mitochondrial cristae.Single-cell sequencing indicated significant changes in the function of the Leydig cells and macrophages and disrupted lipid-related metabolic pathways after IRD.Administration of L-carnitine to the mouse model im-proved lipid metabolism disorders and partially alleviated IRD to the germ cells.Conclusion:Ionizing radiation can cause disorders of testicular spermatogenesis and sexual hormones and inhibit lipid metabolism pathways in Leydig cells and macrophages.Improving lipid metabolism can alleviate IRD to germ cells.

Objective:To comprehensively evaluate the skin thickness, blood flow grades, skin stiffness, and post-treatment changes in ultrasound indices in patients with different clinical types of port-wine stains (PWS) by multimodal ultrasound, and to explore the application value of multimodal ultrasound in the quantitative evaluation of and efficacy assessment for PWS.Methods:An observational study was conducted, including 298 patients with PWS. High-frequency ultrasound was used to measure the thickness of and blood flow signals in skin lesions, and shear wave elastography to measure the maximum Young's modulus (Emax) and maximum shear wave propagation velocity (Cmax) of the skin layers. Differences in various ultrasound indices were analyzed between skin lesions and surrounding normal skin. After photodynamic therapy, ultrasound re-evaluation was performed on 124 patients to analyze changes in ultrasound indices before and after treatment. Statistical analysis was conducted using t test, analysis of variance, and rank sum test. Results:In 106 patients with pink PWS, the skin thickness was 1.41 ± 0.28 mm, the blood flow was mainly rated as grade 0 (81%), the Emax was 16.24 ± 1.82 kPa, and the Cmax was 2.28 ± 0.09 m/s. There were no significant differences in the above indices between normal skin and treated skin (all P > 0.05). In the 121 patients with purplish red PWS, the skin thickness was 1.86 ± 0.23 mm; the blood flow was mainly rated as grade 1 (45%), which was higher than that of normal skin; after treatment, both the skin thickness and blood flow grades were decreased ( P < 0.05) ; there were no significant differences in the Emax and Cmax between purplish red PWS lesions (16.41 ± 1.82 kPa, 2.32 ± 0.13 m/s, respectively) and normal skin or treated skin (all P > 0.05). In the 71 patients with thickened PWS, the skin thickness was 2.51 ± 0.32 mm, the blood flow was mainly trated as grade 3 (55%), the Emax was 22.22 ± 2.46 kPa, and the Cmax was 2.75 ± 0.11 m/s, which were all significantly higher than those of normal skin (all P < 0.05) ; all the indices were decreased after treatment. Conclusions:Multimodal ultrasound can be used for the quantitative assessment of different clinical types of PWS and their treatment outcomes. Purplish red PWS and thickened PWS showed thicker skin layers and higher blood flow grades, and thickened PWS showed higher skin stiffness values. All ultrasound indices were decreased after treatment.

Objective To investigate the levels of serum folate and vitamin B12(VB12)and their association with the level of neurodevelopment in preschool children with autism spectrum disorder(ASD).Methods A total of 324 ASD children aged 2-6 years and 318 healthy children aged 2-6 years were recruited.Serum levels of folate and VB12 were measured using chemiluminescent immunoassay.The Social Responsiveness Scale and the Childhood Autism Rating Scale were used to assess the core symptoms of ASD children,and the Gesell Developmental Schedule was employed to evaluate the level of neurodevelopment.Results The levels of serum folate and VB12 in ASD children were significantly lower than those in healthy children(P＜0.05).Serum folate levels in ASD children were positively correlated with gross and fine motor developmental quotients(P＜0.05),and serum VB12 levels were positively correlated with adaptive behavior,fine motor,and language developmental quotients(P＜0.05).In ASD children aged 2 to＜4 years,serum folate levels were positively correlated with developmental quotients in all domains(P＜0.05),and serum VB12 levels were positively correlated with language developmental quotient(P＜0.05).In male ASD children,serum VB12 levels were positively correlated with language and personal-social developmental quotients(P＜0.05).Conclusions Serum folate and VB12 levels in preschool ASD children are lower than those in healthy children and are associated with neurodevelopmental levels,especially in ASD children under 4 years of age.Therefore,maintaining normal serum folate and VB12 levels may be beneficial for the neurodevelopment of ASD children,especially in ASD children under 4 years of age.[Chinese Journal of Contemporary Pediatrics,2024,26(4):371-377]

Objective:To compare the antiosteoporosis effect of conventional treatment and conventional treatment combined with Denosumab after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 211 patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from September 2020 to September 2022. All the patients were female, aged 56-90 years [(71.4±8.1)years]. The bone mineral density T-score of the lumbar spine was (-2.6±1.0)SD before operation. Fracture segments included T 1-T 9 in 45 patients, T 10-L 2 in 146, and L 3-L 5 in 69. Of all, 174 patients were treated with single-segment surgery, 25 with two-segment surgery and 12 with surgery involving three or more segments. According to the wishes of the patients, 107 patients were treated with daily oral administration of calcium and active Vitamin D after PKP (conventional treatment group) and 104 patients with Denosumab combined with the conventional treatment after PKP (Denosumab therapy group). The bone mineral density T-scores of the lumbar spine of the two groups were compared before surgery and at the last follow-up. The visual analogue scale (VAS) and Oswestry disability index (ODI) before surgery, at 3 days, 6 months after surgery, and at the last follow-up were evaluated and the refracture rate after surgery was detected. Possible adverse effects after medication during anti-osteoporosis treatment were observed in two the groups. Results:All the patients were followed up for 12-24 months [(13.5±2.0)months]. Before surgery, the bone mineral density T-score of the lumbar spine was (-2.7±1.1)SD in the Denosumab therapy group and (-2.5±0.8)SD in the conventional treatment group ( P>0.05). At the last follow-up, the bone mineral density T-score of the lumbar spine was (-2.1±1.1)SD in the Denosumab therapy group, significantly higher than (-2.5±0.9)SD in the conventional treatment group ( P<0.05). In the Denosumab therapy group, the bone mineral density T-score of the lumbar spine at the last follow-up was significantly increased compared to that before surgery ( P<0.01), while there was no significant difference in the conventional treatment group ( P<0.05). Before surgery and at 3 days after surgery, the VAS scores and ODI values were (8.5±0.9)points, (2.8±0.8)points, 48.7±4.8 and 25.6±4.0 in the Denosumab therapy group, which was not statistically different from those in the conventional treatment group [(8.5±1.3)points and (2.8±0.9)points, 47.9±7.0 and 25.9±3.7] ( P>0.05). At 6 months after surgery and at the last follow-up, the VAS scores and ODI values were (2.2±0.8)points, (1.7±0.8)points, 24.2±3.6 and 23.2±4.1 in the Denosumab therapy group, significantly lower than those of the conventional treatment group [(2.8±0.9)points, (2.8±1.1)points, 26.4±3.2 and 27.3±4.0] ( P<0.01). The VAS scores at each time point after surgery in both groups decreased significantly compared with those before surgery ( P<0.05). The VAS scores continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while no significant difference was found among those at different time points in the conventional treatment group ( P>0.05). The ODI values at each time point after surgery in both groups significantly decreased compared to those before surgery ( P<0.05). The ODI values continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while in the conventional treatment group, no significant difference was found between those at 6 months after surgery and those at 3 days after surgery ( P>0.05) and they were improved at the last follow-up compared with those at 3 days after surgery ( P<0.05). The refracture rate after surgery was 6.7% (7/104) in the Denosumab therapy group, significantly lower than 16.8% (18/107) in the conventional treatment group ( P<0.05). No serious complications were observed during the antiosteoporosis period in either group. Conclusion:Compared with daily oral administration of Calcium and active Vitamin D after PKP, the conventional treatment combined with Denosumab after PKP can effectively increase the bone density, relieve pain continuously, improve functional restoration, and reduce the risk of refracture in OVCF patients.