Objective To evaluate the feasibility and accuracy of virtual preoperative planning and 3D-printed templates for pre-contoured plates for the treatment of posterior wall fractures of the acetabulum.Methods A retrospective analysis of 29 patients with posterior acetabular wall fractures treated between August 2017 and March 2021 were divided into 2 groups based on whether to use preoperative virtual planning and 3D printed template.In 3D-printing group,there were 14 patients,includ-ing 10 males and 4 females;aged from 21 to 53 years old;CT-based virtual surgical planning was done using Mimics and 3-Matic software and 3D-printed templates for pre-contoured plates were adopted.In conventional group,there were 15 patients,including 10 males and 5 females;aged from 19 to 55 years old;conventional method of intra-operative contouring to adapt the plate to the fracture region was adopted.Blood loss,surgical time,radiographic quality of reduction,and hip function were compared between groups.Results The difference in operation time and intraoperative blood loss was significant(P＜0.05).Twenty-three patients were followed up from 12 to 30 months,and the fractures in both groups healed with a healing time of 3 to 6 months.At the last follow-up,the Merle d'Aubign-Postel score of the 3D printed group was lower than that of the conven-tional group(P＜0.05),with no significant differences in walking ability,hip mobility and total score(P＞0.05).In 3D printing group,6 cases were excellent,5 cases were good,3 cases were fair;in conventional group,5 cases were excellent,5 cases were good,4 cases were fair,1 case was worse;no significant difference between two groups(P＞0.05).Conclusion Virtual preopera-tive planning and 3D-printed templates for pre-contoured plates can reduce operative time and the blood loss of surgery,im-prove the quality of reduction.This method is efficient,accurate and reliable to treat acetabular posterior wall fractures.

Objective:To investigate the application value of single-sperm sequencing in resolving the carrier status of preim-plantation genetic testing(PGT)for chromosomal structural rearrangements in Robertsonian translocations.Methods:Haplotypes were constructed by single-sperm isolation combined with single-sperm sequencing for a patient with 45,XY,der(13;14)(q10;q10).Twenty single-sperm samples were isolated by mechanical braking and subjected to whole-genome amplification(WGA),and then the Asian Screening Array(ASA)gene chip was used to detect the 183 708 single nucleotide polymorphisms(SNP)of the WGA products.The single sperm associated with the translocation that could be used as haplotype inference was detected by copy number variation(CNV)sequencing,and the chromosomal haplotypes with normal and Robertsonian translocations were inferred.Three biopsy samples of embryonic trophoblast cells were used as the objects.After whole-genome amplification,high-throughput sequencing was employed to determine the status of the translocation chromosome carried by the embryos.The available blastocysts were selected for transfer,and the amniotic fluid samples were taken at 18 weeks of gestation to confirm whether the fetus carried the pathogenic muta-tion.Results:A total of 6 037 SNP sites were screened by single-sperm sequencing,and 30 sites selected to distinguish normal and translocation haplotypes.Preimplantation haplotype analysis showed that all the three embryos were euploids without Robertsonian translocation chromosome.Genetic testing of amniotic fluid in the second trimester confirmed that the karyotype of the fetus was 46,XN,carrying no Robertsonian translocation chromosome.Conclusion:For male carriers of Robertsonian translocation,single sperm sequencing can be used to screen SNP sites to construct haplotypes for distinguishing normal and Robertsonian translocation em-bryos,and to provide a basis for embryo selection by preimplantation chromosomal structural genetic testing.

With the increasing prevalence of obesity and diabetes mellitus, the incidence rate of metabolic dysfunction-associated steatotic liver disease (MASLD) is on the rise. MASLD has become the most common chronic liver disease, affecting more than 30% of the global population and causing serious social and economic burden. Numerous studies have shown that the development of MASLD is associated with an increased risk of heart and blood vessel disease (CVD). In 2010, the American Heart Association proposed the concept of ideal cardiovascular health (ICH); in 2022, the scoring criteria were updated with the introduction of the Life′s Essential 8 (LE8), comprising 4 ideal cardiovascular behaviors (optimal diet, exercise, no smoking, mean sleep 7-9 h/d) and 4 ideal cardiovascular conditions (blood pressure<120/80 mmHg (1 mmHg=0.133 kPa) with no medication, no history of diabetes mellitus and fasting blood glucose<5.6 mmol/L or HbA1c<5.7%, non-high density lipoprotein cholesterol<3.36 mmol/L, body mass index<25 kg/m 2). It aims to provide clear, actionable goals for CVD prevention by providing a direct, simple way to quantify health behaviors. A growing number of studies also confirm that the higher level of LE8 metrics is closely associated with the lower risk of MASLD. This article reviews the latest research progress on ICH metrics for reducing risk of MASLD, in order to provide references for early and effective prevention and comprehensive management of MASLD patients.

Neural tube defects are a common neurodevelopmental disease,which can be divided into open and closed types.The main symptoms are anencephaly,encephalocele and cranial spina bifida.The relationship between Wnt signaling and neurogenesis has been a popular area in recent years.The Wnt signaling pathway includes Wnt/β-catenin,planar polar cell pathway and Wnt/Ca2+pathway,which plays an important role in neural tube development.This article reviews the current state of research on the Wnt signaling pathway and elucidates the role it plays in the process of neural tube closure,providing insights for the development of drugs related to the prevention and treatment of neural tube defects.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective:To explore the value of high frequency ultrasound scoring combined with serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) in evaluating the prognosis of neonatal respiratory distress syndrome (NRDS) in children.Methods:A total of 106 children with NRDS who were treated at Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University from March 2021 to December 2022 were selected. According to the discharge outcome, NRDS patients were divided into a poor prognosis group ( n=11) and a good prognosis group ( n=95), and the clinical data differences between the two groups were compared. At the same time, NRDS patients were divided into mild to moderate group ( n=75) and severe group ( n=31) based on the severity of the disease. The differences in high-frequency ultrasound scores of the lungs and serum levels of IL-6, CRP, and PCT were analyzed in children with different disease severity levels of NRDS. Logistic multiple regression analysis was used to identify the influencing factors of prognosis; receiver operating characteristic (ROC) curve analysis of lung high-frequency ultrasound score, IL-6, and their combination predicted the prognostic value of NRDS in children. Results:The gestational age, birth weight, and high-frequency ultrasound scores of the lungs in the poor prognosis group were significantly lower than those in the good prognosis group (all P<0.05); The proportion of diabetes in pregnancy, the proportion of severe disease, the first use time of pulmonary surfactant (PS) and the level of IL-6 in the poor prognosis group were significantly higher than those in the good prognosis group (all P<0.05). The serum levels of IL-6, CRP, and PCT in severe children were significantly higher than those in mild to moderate children (all P<0.05); The high-frequency ultrasound score of the lungs in severe children was significantly lower than that in mild to moderate children ( P<0.05). Logistic regression analysis showed that gestational age, pulmonary high-frequency ultrasound score, gestational diabetes, disease severity, and IL-6 were the influencing factors for poor prognosis of children with NRDS (all P<0.05). The area under the ROC curve for predicting poor prognosis in children with NRDS using high-frequency ultrasound score, IL-6, and their combination were 0.745, 0.802, and 0.786, respectively. Conclusions:The severity of NRDS in children is related to the high-frequency ultrasound score of the lungs and serum levels of IL-6, CRP, and PCT. At the same time, the high-frequency ultrasound score of the lungs and IL-6 are related to the prognosis of NRDS children, and have certain application value in predicting the prognosis of children.

Objective To observe the value of cardiac MR(CMR)compressed sensing(CS)sequence and conventional movie(CM)sequence for evaluating biventricular function in patients with congenital heart disease(CHD).Methods A total of 71 patients with CHD,including 31 cases with regular heart rhythm(regular heart rhythm group)and 40 cases with arrhythmia(arrhythmia group)were prospectively collected and scanned with CM and CS sequences.The scanning time of 2 sequences were recorded,and subjective scores of imaging quality of 2 kinds of images were compared.The differences,consistency and correlation between quantitative parameters of biventricular function measured on 2 kinds of images were analyzed.Results The acquisition time of CS was(18.87±1.75)s,of CM was(147.56±5.23)s,which was shortened by 87.21％than CS.The quality of both 2 kinds of images met the diagnostic requirements.The subjective scores of CS images were lower than that of CM in regular heart rhythm group(4[3,5]vs.4[4,5],Z=-2.070,P=0.038),while of CS images were higher than that of CM images in arrhythmia group(4[4,4]vs.3[4,4],Z=-2.673,P=0.008).No significant difference of the left ventricular function parameters was detected obtained based on 2 kinds of images in all 71 cases,nor in regular heart rhythm group as well as in arrhythmia group(all P＞0.05).Meanwhile,the right ventricular(RV)end-diastolic volume index(EDVI)obtained based on CM and CS images were not significantly different(all P＞0.05),but significant differences of ejection fraction(EF),end-systolic volume index(ESVI)and stroke volume index(SVI)were found in all 71 cases,in regular heart rhythm group and in arrhythmia group(all P＜0.05).CMR parameters of biventricular function measured on CM and CS images were all consistent and positively correlated(all P＜0.05).Conclusion CS sequence could be used to accurately assess biventricular function of CHD patients,significantly improve imaging quality and shorten scanning time.

Objective:To investigate the clinical value of prospective ECG-gated high-pitch protocol scanning of third generation DSCT in the diagnosis of pediatric congenital heart disease (CHD).Methods:A total of 243 children with confirmed CHD who were expected to undergo surgical treatment were prospectively collected and randomly divided evenly into 3 groups, with first group for prospective ECG-gated high-pitch scanning in third generation DSCT (Flash 3rd), second group for prospective ECG-gated high-pitch scanning in second generation DSCT (Flash 2nd) and third group for prospective sequential scanning in third generation DSCT (Sequence 3rd). The SD value and SNR of aortic root and pulmonary artery of each child were recorded. The 5-point system is adopted with subjective scoring. Based on the result of operation, the diagnosis accuracy in 3 groups was analyzed. Results:The E values in Flash 3rd, Flash 2nd and Sequence 3rd group were 0.24 (0.19, 0.27), 0.11 (0.10, 0.14) and 0.44 (0.39, 0.48) mSv ( H=207.04, P<0.05), respectively. Subjective scores of group Flash 3rd and Sequence 3rd were significantly higher than that of group Flash 2nd [4 (4, 4) vs. 4(3, 4) vs. 3(3, 3), H=124.05, P<0.05] and no difference between these two groups. SD value of aortic root and pulmonary artery of group Flash 3rd and Sequence 3rd were significantly lower than that of group Flash 2nd( H= -40.27-33.38, P<0.05). SNR of aortic root and pulmonary artery of group Flash 3rd was significantly higher than that of group Flash 2nd and Sequence 3rd ( H=-0.90-51.42, P<0.05). Diagnosis accuracy of intracardiac malformation for group Flash 2nd was significantly lower than that of Flash 3rd and Sequence 3rd (77.7%, 90.9%, 88.9%, K=9.36, P<0.05), and there was no significant difference between the latter two groups. There was no difference in diagnosis accuracy of extracardiac malformation among 3 groups (88.6%, 94.8%, 92.2%, K=3.11, P=0.21). Conclusions:The prospective ECG-gated high-pitch scanning in third generation DSCT can take into account radiation dose and image quality, which has important clinical value in the diagnosis of CHD.

Lipopolysaccharides (LPS) are major outer membrane components of Gram-negative bacteria. Unlike most Gram-negative bacteria, Acinetobacter baumannii can still survive and acquire polymyxin resistance after complete loss of LPS. Previous studies of LPS-deficient Acinetobacter baumannii mostly focused on LPS-deficient strains induced by polymyxin, whose background was complex and unstable. To investigate LPS loss-mediated polymyxin resistant-Acinetobacter baumannii, this study constructed a stable and clear background LPS-deficient strain by knocking out lpxC gene in Acinetobacter baumannii ATCC 19606 with CIRSPR/Cas9, and then studied the phenotypic changes of the lpxC-deficient strain including morphology, growth rate, antibiotic susceptibility, virulence, membrane permeability, and membrane potential. Animal experiments were approved by the Animal Care and Welfare Committee Institute of Medicinal Biotechnology, CAMS and PUMC (approval number: IMB-20240119D₉). The results indicated that the lpxC gene of Acinetobacter baumannii ATCC 19606 was successfully knocked out. After losing the lpxC, the strain underwent the morphological change from rod-shaped to spherical. Furthermore, it leads to reduced growth rate, enhanced membrane permeability, decreased membrane potential, lower virulence, and increased antibiotic susceptibility to β-lactams, quinolones, aminoglycosides, macrolides, glycopeptides. The lpxC deletion results in significant changes in membrane homeostasis and adaptability of Acinetobacter baumannii. Understanding the phenotypic changes of colistin-resistant Acinetobacter baumannii mediated by LPS loss is useful for exploring the resistance mechanism of Acinetobacter baumannii and developing new therapeutic strategies.

Outer membrane vesicles (OMVs) are nanoscale vesicles secreted by Gram-negative bacteria. As a unique bacterial secretion, OMV secretion can help bacteria maintain the outer membrane stability or remove harmful substances. Studies have shown that local separation of outer membrane and peptidoglycan layers led by abnormalities in outer membrane protein function, abnormal structure or excessive accumulation of LPS, and erroneous accumulation of phospholipids in the outer leaflet, which can all lead to bacterial outer membrane protrusion and eventually bud formation of OMVs. Since OMVs are mainly composed of bacterial outer membrane and periplasmic components, the pathogen associated molecular patterns (PAMPs) on their surface can trigger strong immune responses. For example, OMVs can recruit and activate neutrophils, polarize macrophages to secrete large amounts of inflammatory factors. More importantly, OMVs can act as adjuvants to induce dendritic cell (DC) maturation to enhance adaptive immune response in the body. At the same time, OMVs are derived from bacteria, which make it easy to modify. The methods by genetic engineering and others can improve their tumor targeting, give them new functions, or reduce their immunotoxicity, which is conducive to their application in tumor therapy. OMVs not only induce apoptosis or pyroptosis of tumor cells, but also regulate the host immune system, which makes OMVs themselves have a certain killing effect on tumors. In addition, the tendency of neutrophils to inflammatory tumor sites and the formation of neutrophil extracellular traps enable OMVs to target tumor sites, and the suitable size and the characteristic that they are easily taken up by DCs give OMVs a certain lymphatic targeting ability. Therefore, OMVs are often employed as excellent drug or vaccine carriers in tumor therapy. This review mainly discusses the biological mechanism of OMVs, the regulatory effects of OMVs on immune cells, the functional modification strategies of OMVs, and their research progress in tumor therapy.