Chemotherapy-induced peripheral neurotoxicity (CIPN) is a severe dose-limiting adverse event of chemotherapy. Presently, the mechanism underlying the induction of CIPN remains unclear, and no effective treatment is available. In this study, through metabolomics analyses, we found that nab-paclitaxel therapy markedly increased serum serotonin [5-hydroxtryptamine (5-HT)] levels in both cancer patients and mice compared to the respective controls. Furthermore, nab-paclitaxel-treated enterochromaffin (EC) cells showed increased 5-HT synthesis, and serotonin-treated Schwann cells showed damage, as indicated by the activation of CREB3L3/MMP3/FAS signaling. Venlafaxine, an inhibitor of serotonin and norepinephrine reuptake, was found to protect against nerve injury by suppressing the activation of CREB3L3/MMP3/FAS signaling in Schwann cells. Remarkably, venlafaxine was found to significantly alleviate nab-paclitaxel-induced CIPN in patients without affecting the clinical efficacy of chemotherapy. In summary, our study reveals that EC cell-derived 5-HT plays a critical role in nab-paclitaxel-related neurotoxic lesions, and venlafaxine co-administration represents a novel approach to treating chronic cumulative neurotoxicity commonly reported in nab-paclitaxel-based chemotherapy.
Paclitaxel/toxicity* ; Animals ; Albumins/adverse effects* ; Serotonin/metabolism* ; Mice ; Humans ; Male ; Female ; Venlafaxine Hydrochloride/therapeutic use* ; Neurotoxicity Syndromes/metabolism* ; Middle Aged ; Schwann Cells/metabolism* ; Peripheral Nervous System Diseases/drug therapy* ; Antineoplastic Agents

Objective To explore the value of dual factor combined detection using tuberculosis(TB)specific cy-tokines interferon-γ(IFN-γ)and interleukin-2(IL-2)in TB diagnosis in patients with human immunodeficiency vi-rus(HIV)infection,and the influencing factors for underdiagnosis.Methods HIV-infected patients admitted to and underwent TB-related examination in the Department of Infectious Diseases in Hezhou People's Hospital from July 2022 to September 2024 were collected.According to the clinical diagnosis criteria,patients were divided into the HIV infection with TB group(HIV/TB group)and the HIV infection without TB group(control group).Diag-nostic efficacy of dual factor combined detection was evaluated.HIV/TB group was further divided into a true-posi-tive group and a false-negative group based on the detection results.The independent influencing factors for underdia-gnosis was analyzed using multivariate logistic regression.Results A total of 306 patients were included in the analysis,with an average age of(55.69±14.02)years.There were 105 patients in the HIV/TB group and 201 in the control group.The sensitivity and specificity of dual factor combined detection for TB in all HIV-infected pa-tients were 72.4％(76/105)and 87.1％(175/201),respectively.There was a statistically significant difference in sensitivity(x2=9.488,P=0.009)and no statistically significant difference in specificity(x2=5.846,P=0.054)among the three CD4+T lymphocyte count gradients in the dual factor detection.Among them,patients with CD4+T cell count＜100 cells/μL had lower sensitivity(58.8％)in dual factor detection than patients with CD4+T cell count ≥200 cells/μL(88.9％)and 100-199 cells/μL(81.5％),differences were both statistically significant(both P＜0.05).In HIV/TB co-infected patients with CD4+T lymphocyte count ≥100 cells/μL,the general sensi-tivity and the specificity of dual factor combined detection were 85.2％(46/54)and 82.0％(91/111),respectively.Multivariate analysis showed that CD4+T lymphocyte count was an independent influencing factor for the underdia-gnosis in HIV/TB patients conducting dual factor combined detection(P＜0.05),while age,gender,pathogen re-sults,and the presence or absence of TB had no statistically significant impact on the results of dual factor combined detection(all P＞0.05).Conclusion Dual factor combined detection using tuberculosis-specific cytokines IFN-γand IL-2 has a high diagnostic value in the diagnosis of TB in HIV-infected patients,especially in those with CD4+T lymphocyte count ≥100/μL,which can provide auxiliary diagnostic value for the clinical diagnosis of HIV infection combined with TB.

With the intensification of population aging, the incidence of mild cognitive impairment (MCI) has significantly increased, making early screening and intervention crucial for delaying the progression of dementia. However, traditional scales are susceptible to factors such as cultural and educational levels and the experience of the operator, and they have limitations such as insufficient sensitivity and low standardization. There is an urgent need to develop efficient, objective, and precise assessment methods. This article aims to systematically review the latest research progress, application value, and challenges of artificial intelligence (AI) technology in the intelligent assessment of MCI, and explore its potential to promote the early identification and auxiliary diagnosis of MCI. AI-driven intelligent assessment technologies, especially those based on multimodal data fusion and machine learning /deep learning algorithms, have shown significant advantages in MCI screening and diagnosis, breaking through the bottlenecks of traditional methods and enhancing objectivity, efficiency, and dynamic monitoring capabilities, providing a new paradigm for early precise intervention. Although there are challenges such as data standardization, algorithm transparency, privacy, and insufficient model interpretability, as well as clinical translation, through continuous technological optimization, strengthening ethical norms, and multi-center collaboration, intelligent assessment is expected to become a core tool for future cognitive assessment and early prevention and control of MCI, promoting precise and individualized cognitive health management.

With the intensification of population aging, the incidence of mild cognitive impairment (MCI) has significantly increased, making early screening and intervention crucial for delaying the progression of dementia. However, traditional scales are susceptible to factors such as cultural and educational levels and the experience of the operator, and they have limitations such as insufficient sensitivity and low standardization. There is an urgent need to develop efficient, objective, and precise assessment methods. This article aims to systematically review the latest research progress, application value, and challenges of artificial intelligence (AI) technology in the intelligent assessment of MCI, and explore its potential to promote the early identification and auxiliary diagnosis of MCI. AI-driven intelligent assessment technologies, especially those based on multimodal data fusion and machine learning /deep learning algorithms, have shown significant advantages in MCI screening and diagnosis, breaking through the bottlenecks of traditional methods and enhancing objectivity, efficiency, and dynamic monitoring capabilities, providing a new paradigm for early precise intervention. Although there are challenges such as data standardization, algorithm transparency, privacy, and insufficient model interpretability, as well as clinical translation, through continuous technological optimization, strengthening ethical norms, and multi-center collaboration, intelligent assessment is expected to become a core tool for future cognitive assessment and early prevention and control of MCI, promoting precise and individualized cognitive health management.

Objective To explore the value of dual factor combined detection using tuberculosis(TB)specific cy-tokines interferon-γ(IFN-γ)and interleukin-2(IL-2)in TB diagnosis in patients with human immunodeficiency vi-rus(HIV)infection,and the influencing factors for underdiagnosis.Methods HIV-infected patients admitted to and underwent TB-related examination in the Department of Infectious Diseases in Hezhou People's Hospital from July 2022 to September 2024 were collected.According to the clinical diagnosis criteria,patients were divided into the HIV infection with TB group(HIV/TB group)and the HIV infection without TB group(control group).Diag-nostic efficacy of dual factor combined detection was evaluated.HIV/TB group was further divided into a true-posi-tive group and a false-negative group based on the detection results.The independent influencing factors for underdia-gnosis was analyzed using multivariate logistic regression.Results A total of 306 patients were included in the analysis,with an average age of(55.69±14.02)years.There were 105 patients in the HIV/TB group and 201 in the control group.The sensitivity and specificity of dual factor combined detection for TB in all HIV-infected pa-tients were 72.4％(76/105)and 87.1％(175/201),respectively.There was a statistically significant difference in sensitivity(x2=9.488,P=0.009)and no statistically significant difference in specificity(x2=5.846,P=0.054)among the three CD4+T lymphocyte count gradients in the dual factor detection.Among them,patients with CD4+T cell count＜100 cells/μL had lower sensitivity(58.8％)in dual factor detection than patients with CD4+T cell count ≥200 cells/μL(88.9％)and 100-199 cells/μL(81.5％),differences were both statistically significant(both P＜0.05).In HIV/TB co-infected patients with CD4+T lymphocyte count ≥100 cells/μL,the general sensi-tivity and the specificity of dual factor combined detection were 85.2％(46/54)and 82.0％(91/111),respectively.Multivariate analysis showed that CD4+T lymphocyte count was an independent influencing factor for the underdia-gnosis in HIV/TB patients conducting dual factor combined detection(P＜0.05),while age,gender,pathogen re-sults,and the presence or absence of TB had no statistically significant impact on the results of dual factor combined detection(all P＞0.05).Conclusion Dual factor combined detection using tuberculosis-specific cytokines IFN-γand IL-2 has a high diagnostic value in the diagnosis of TB in HIV-infected patients,especially in those with CD4+T lymphocyte count ≥100/μL,which can provide auxiliary diagnostic value for the clinical diagnosis of HIV infection combined with TB.

Alzheimer disease(AD)and Parkinson disease(PD)are both common neurodegenerative disorders,which can manifest as cognitive impairments.AD and PD have overlapping and distinct features in cognition-related metabolic pathways,potentially reflecting different underlying mechanisms.MRI can indirectly assess structural and functional changes in metabolic pathways,while PET can evaluate cerebral metabolic activity and functional connectivity.Integration of MRI and PET may provide complementary insights into neural structure and function.This review summarized research progresses in the application of MRI and PET for neuroimaging studies of cognitive impairment in neurodegenerative diseases.

Alzheimer disease(AD)and Parkinson disease(PD)are both common neurodegenerative disorders,which can manifest as cognitive impairments.AD and PD have overlapping and distinct features in cognition-related metabolic pathways,potentially reflecting different underlying mechanisms.MRI can indirectly assess structural and functional changes in metabolic pathways,while PET can evaluate cerebral metabolic activity and functional connectivity.Integration of MRI and PET may provide complementary insights into neural structure and function.This review summarized research progresses in the application of MRI and PET for neuroimaging studies of cognitive impairment in neurodegenerative diseases.

Freezing of gait(FOG)is a confirmed disabling gait disorder in Parkinson disease(PD).Resting-state functional MRI(rs-fMRI)can reflect brain functional connectivity(FC)under resting-state,hence being helpful to reveal the pathophysiological mechanisms of FOG.The processes of rs-MRI brain networks for PD complicated with FOG were reviewed in this article.

With the encouragement of policies and the rapid development of the biopharmaceutical industry,the number of software as medical device(SaMD)registration applications in Shanghai has continued to increase in recent years,and this paper summarizes the GMP nonconformities found in the field inspection of SaMD in Shanghai from 2020 to 2023,and the results show that nearly 70%of the problems were found in the software development process.Through in-depth analysis,this paper proposes the corresponding countermeasures for the problems found in the five most common stages such as software requirements,software design,software testing,software defect management and software configuration management,combined with the characteristics of software development.These suggested measures have certain reference significance for medical device software development and quality control personnel,and technical reviewer and inspectors.

Objective:To construct an anticipatory grief intervention scheme for family caregivers of advanced cancer patients based on narrative theory, and to provide reference for anticipatory grief nursing intervention.Methods:From October 2022 to May 2023, through literature research, semi-structured interview and brainstorming method, the first draft of nursing intervention plan was constructed, the Delphi method was used to conduct 2 rounds of correspondence consultation with 15 experts, and the indicators at all levels were modified according to the opinions of experts, and the final draft of intervention plan was formed.Results:The experts were all female, aged (49.67 ± 5.83) years old. The authority coefficient of the two rounds of experts was 0.87. The Kendall coordination coefficients of the first, second, and third level indicators after the first round of expert inquiry were 0.195, 0.113, and 0.093, respectively. The Kendall coordination coefficients of the first, second, and third level indicators after the second round of expert inquiry were 0.200, 0.119, and 0.101, respectively. The differences were statistically significant ( χ2 values were 8.76-107.21, all P<0.05).Finally, a nursing intervention plan based on narrative theory was formed, which included 4 primary indicators, 19 secondary indicators and 72 tertiary indicators. Conclusions:The anticipatory grief intervention scheme for family caregivers of advanced cancer patients is scientific, practical and feasible, and can be used for psychological nursing of family caregivers.