Objective This study aimed to investigate the genetic diversity, differentiation, and population structure of Aedes albopictus across different geographical regions in Shandong Province, and to explore the relationship between genetic diversity and geographical distribution. Methods Between July and August 2024, ten Ae. albopictus populations were sampled from seven cities in Shandong Province. Genomic DNA was extracted from individual mosquitoes, and the mitochondrial cytochrome c oxidase subunit I(COⅠ)gene was amplified using PCR and sequenced. The obtained sequences were verified using BLAST and analyzed with MAFFT, MEGA 11, DnaSP v6.12, Arlequin 3.5, PopART 1.7, STRUCTURE 2.3.4 and the R packages adegenet and vegan to assess genetic diversity and population structure. Results A total of 229 COⅠ sequences(662 bp) was obtained, revealing ten variable sites with no insertions or deletions. The overall base composition showed an AT bias of 67.7%. Haplotype analysis identified 11 haplotypes, with Hap2 being the dominant and most widely distributed haplotype across all populations. Neutrality tests showed significant population expansion only in the Rizhao population. Mantel testing result revealed that geographical distance does not significantly impede gene flow. Overall, genetic differentiation among populations was low, indicating frequent gene flow. When combined with additional samples from Shanghai, Fujian, Guangdong, Yunnan, Hainan and Guangxi, STRUCTURE, UPGMA and DAPC analyses revealed two primary genetic clusters of Ae. albopictus. Conclusions Ae. albopictus populations in Shandong Province exhibit frequent gene flow, low genetic differentiation, and relatively low overall genetic diversity. However, the Rizhao population showed signs of recent expansion, highlighting the need for enhanced surveillance and targeted control measures in this area.

Objective To analyze the monitoring data of ¹³¹I internal exposure in Guangdong Province over the past 3 years, study the thyroid ¹³¹I contamination levels among nuclear medicine staff, and provide a basis for optimizing the monitoring plan. Methods Using a convenience sampling method, 574 detections of nuclear medicine staff from 28 hospitals in Guangdong Province were included in the study. The thyroid ¹³¹I activity was measured directly in vivo. Differences in detection rates were analyzed, and committed effective doses were estimated. Results Over the past 3 years in Guangdong Province, ¹³¹I accumulation was found in the thyroids of staff from 14 hospitals for 62 (10.8%) detections, with an average activity of 154.8 (13.2-8730.6) Bq. The adjusted annual intake was 50.7 (4.5-820.6) kBq. The committed effective dose was 0.56 (0.05-9.03) mSv/a, and the values were ≥ 2 mSv for 8 persons. Among different positions, nurses showed the highest detection rate (19.6%), followed by cleaners (14.7%), with significant differences (P<0.05). Among different exposure types, the detection rate was highest for loading medication into automatic dispenser (23.3%), and the mean activity was highest for entering thyroid cancer patient ward (495.4 Bq), with significant differences (P<0.05). Conclusion Monitoring of ¹³¹I internal exposure in Guangdong Province found that the radiation doses of some staff members had exceeded the threshold specified in other investigations. Routine personal ¹³¹I internal exposure monitoring should be conducted, with increased monitoring frequency. Priority should be given to nurses and cleaners, with monitoring extended to cleaners and outsourced dispensing staff.

Introduction: Cushing’s disease in adolescents is rare and frequently difficult to diagnose due to overlapping features with common pubertal and metabolic conditions. We present an adolescent who underwent inferior petrosal sinus sampling (IPSS) with possible cyclical Cushing’s disease, highlighting the diagnostic challenges and the interpretive value of IPSS. Case: A 16-year-old female presented with progressive weight gain, acne, hirsutism, secondary amenorrhea, proximal myopathy, violaceous striae, and facial plethora over 1 year. Her 24-hour urinary cortisol was >3,310 nmol/L with failure of suppression following a 1-mg overnight dexamethasone suppression test (701 nmol/L). Her adrenocorticotropic hormone (ACTH) was raised (77.9 pg/mL), consistent with ACTH-dependent Cushing syndrome. Her hemoglobin A1c was 5.9%, and she has low bone mass for age with a Z score of -2.9 at the Lumbar spine. Pituitary magnetic resonance imaging identified a rightsided microadenoma measuring 0.6 × 0.5 cm, while computed tomography of the thorax, abdomen, and pelvis showed no ectopic source. IPSS with desmopressin stimulation was performed to confirm the ACTH source. No steroidogenesis inhibitors were administered prior to testing. Notably, cortisol levels during IPSS were relatively low, with midnight cortisol of 91 nmol/L and morning cortisol of 200 nmol/L, suggesting testing during a trough phase of possible cyclical hypercortisolism. Despite this, IPSS demonstrated a significant central-to-peripheral ACTH gradient supporting a pituitary source. Conclusion This case highlights the diagnostic dilemma of interpreting IPSS in suspected cyclical Cushing’s disease. Fluctuating cortisol secretion may result in discordant biochemical findings and complicate localization studies. IPSS findings should be interpreted cautiously and integrated with clinical features, imaging, and serial biochemical monitoring. Recognition of cyclical disease patterns is essential to ensure appropriate management in adolescent patients.
Adolescent ; Humans ; Petrosal Sinus Sampling

Introduction: Therapeutic plasma exchange (TPE) has emerged as a rescue therapy in thyroid storm. Multiple cycles are often required to achieve adequate reduction in circulating thyroid hormone levels. We report a case of thyroid storm with multiorgan failure successfully managed with only two cycles of TPE, followed by carbimazole. : A 43-year-old female with no significant past medical history presented with a 5-month history of altered bowel habits. She has a small goiter, which was not investigated before. She underwent elective esophagogastroduodenoscopy and colonoscopy at a private centre, both of which were unremarkable. Post-procedure, she developed unstable tachyarrhythmia and cardiac arrest. Return of spontaneous circulation was achieved after three cycles of cardiopulmonary resuscitation, and she was transferred to the intensive care unit. Biochemical evaluation revealed severe thyrotoxicosis (thyroid-stimulating hormone [TSH] <0.008 mIU/L, free thyroxine 4 [FT4] >100 pmol/L). BurchWartofsky Point Scale was 90. Her clinical course was complicated by multiorgan failure, including ischemic hepatitis with coagulopathy and oliguric acute kidney injury requiring continuous venovenous hemodialysis. Lugol’s iodine and corticosteroids were initiated as thionamides were contraindicated due to severe hepatic dysfunction. She developed refractory tachyarrhythmia despite electrical cardioversion. Following a multidisciplinary discussion, TPE was initiated due to the limited choice of antithyroid medication. After two TPE sessions, thyroid function improved markedly (TSH 0.01 mIU/L, FT4 26.2 pmol/L), accompanied by improvement in hepatic and renal function, allowing safe commencement of carbimazole. Thyroid function remained stable with FT4 of 19.3 pmol/L 1 week post TPE. Echocardiography demonstrated mildly reduced left ventricular ejection fraction (45–50%) with bi-atrial dilatation. Conclusion This case highlights the role of limited-cycle TPE as an effective rescue therapy and bridging strategy to definitive treatment in severe thyroid storm with multiorgan failure. Timely TPE initiation may improve biochemical control and clinical outcomes in critically ill patients.
Plasma Exchange ; Thyroid Crisis

BACKGROUND : The prevalence of rs5186 (AGTR1 A1166C) in the Mekong Delta remains largely unexplored. This study aimed to determine the prevalence of rs5186 in patients with primary hypertension at Xuyen A Vinh Long hospital and to investigate its association with some risk factors for hypertension. METHODS : A case-control study was conducted including 65 hypertensive and 65 non-hypertensive patients. Genotype analysis of rs5186 was performed using tetra-primer amplification refractory mutation system-polymerase chain reaction, and glucose level and lipid profiles were measured. Associations between single-nucleotide polymorphisms, biochemical indicators, and hypertension risk were evaluated using multivariate logistic regression. A dominant genetic model (AC + CC) versus AA was applied for rs5186, and false discovery rate correction was used to account for multiple testing. RESULTS : The genotypes of rs5186 in the hypertension group were 55.4% AA, 43.1% AC, and 1.5% CC, whereas in the control group, they were 64.6% AA, 35.4% AC, and 0% CC. The differences in the genotype distribution were not statistically significant (p = 0.7). The AC + CC genotypes showed no significant association with hypertension after adjustment for confounders. Among biochemical factors, elevated blood glucose (>6.5 mmol/l) was strongly associated with hypertension, with a 6-fold increased risk compared to individuals with normal glucose levels (p<0.001). CONCLUSIONS The rs5186 was not significantly associated with hypertension in this cohort, whereas metabolic factors, particularly hyperglycemia and obesity, were strongly associated with increased hypertension risk. Larger studies are needed to confirm the role of rs5186 and to examine the consistency of effect sizes across different populations.
glucose ; hypertension ; PCR ; SNPs ; Vietnam

In this work,four salicylhydrazone compounds(L1?L4)were designed and synthesized by using vanillin derivatives as raw material.The structures were confirmed by nuclear magnetic resonance(NMR)and high-resolution mass spectrometry(HRMS).The optical experiments showed that probe L1 and probe L3 could be used as aluminium ion(Al3+)fluorescence probes.The fluorescence color of probe L1 solution changed from colorless to blue after adding Al3+,and the limit of detection was 25.1 nmol/L.Compared with probe L1,the fluorescence color of probe L3 solution changed from colorless to green after complexing with Al3+,and the limit of detection was 17.3 nmol/L.Probe L1 and probe L3 showed the advantages of fast response speed,high selectivity and good anti-interference.The mechanism of Al3+recognition was further demonstrated by HRMS and 1H NMR.Cell imaging experiments showed that probe L1 and L3 had low cytotoxicity and had great application potential in detection of Al3+in vivo.

Objectives: Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults. Methods: This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction. Results: During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96. Conclusions Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.

Objective:To investigate the influence of the complexity metrics of the multi-leaf collimator (MLC) on the γ-pass rate of volumetric modulated arc therapy (VMAT) plans for nasopharyngeal carcinoma (NPC).Methods:A total of 60 VMAT plans for NPC were selected to measure the γ-pass rate. The MLC data across all control points (CPs) in each VMAT plan were analyzed to calculate the mean field area (MFA), average leaf gap (ALG), small aperture score (SAS), and their corresponding weighted metrics including MFAW, ALGW, and SASW, considering dose weight (W). Pearson′s bivariate correlation analysis was conducted to examine the correlations between MLC complexity metrics and the γ-pass rate. Moreover, the receiver operating characteristic (ROC) analysis was employed to assess the predictive efficacy of MLC complexity metrics on dose verification result.Results:Under the 3%/3 mm, 3%/2 mm, and 2%/2 mm criteria, the MFA in the 60 VMAT plans exhibited a positive correlation with the γ-pass rate ( r=0.82, 0.79, 0.72, P<0.05), and the MFAW was also positively correlated with the γ-pass rate ( r=0.83, 0.81, 0.75, P<0.05). The ALG manifested a positive correlation with the γ-pass rate ( r=0.82, 0.79, 0.74, P<0.05), as did the ALGW ( r=0.83, 0.81, 0.77, P<0.05). The SAS(0-1 cm), SAS(1-2 cm), SAS(2-3 cm), and SAS(3-4 cm) displayed negative correlations with the γ-pass rate ( r= -0.86, -0.82, -0.71, -0.84, -0.82, -0.72, -0.79, -0.79, -0.73, -0.30, -0.35, -0.42, P<0.05), whereas the SAS(4-5 cm), SAS(5-6 cm), and SAS(6-40 cm) showed positive correlations with the γ-pass rate ( r=0.49, 0.45, 0.33, 0.73, 0.71, 0.59, 0.79, 0.79, 0.76, P<0.05). The outcomes of SASW reveal slightly stronger correlations than those of SAS. In terms of correlations among complexity metrics, a positive correlation was observed between MFA and ALG ( r=0.98, P<0.05). ALG was negatively correlated with SAS(0-1 cm), SAS(1-2 cm), SAS(2-3 cm), and SAS(3-4 cm) ( r= -0.95, -0.94, -0.89, -0.39, P<0.05), and positively correlated with SAS(4-5 cm), SAS(5-6 cm), and SAS(6-40 cm) ( r=0.51, 0.77, 0.92, P<0.05). The weighted result mirrored these correlations. The ROC-derived analytical result indicate that MFA, MFAW, ALG, ALGW, SAS(0-1 cm), SAS(1-2 cm), SAS(2-3 cm), SAS(6-40 cm), SASW(0-1 cm), SASW(1-2 cm), SASW(2-3 cm), and SASW(6-40 cm) demonstrated exceptional predictive efficacy for dose verification result [Area under the curve (AUC) > 0.9, P<0.05]. Conclusions:The γ-pass rate of VMAT plans for NPC is strongly correlated with MLC complexity metrics, which demonstrate excellent predictive efficacy for dose verification result. The increased uncertainty in dose calculations and measurements caused by narrow fields generated by the MLC is a significant factor contributing to the reduced γ-pass rate of VMAT plans. This finding is associated with discrepancies in the precision of treatment planning system (TPS) modeling and the accuracy of dose verification tools, providing a reference for similar challenges.

Objective:To investigate the differences in dosimetric parameters for target volumes and organs at risk (OARs), radiation doses to reconstructed tissues, and beam-on time in radiotherapy among helical tomotherapy (HT), volumetric modulated arc therapy (VMAT), and fixed-field intensity-modulated radiotherapy (F_IMRT) following immediate breast reconstruction for breast cancer, thereby providing a reference for the selection of clinical radiotherapy techniques.Methods:This study retrospectively investigated 15 breast cancer patients who underwent radiotherapy following modified radical mastectomy and immediate breast reconstruction at the Liuzhou Worker′s Hospital from August 2018 to July 2023. During target volume delineation, precautions were taken to avoid the reconstructed tissues, which were delineated separately. Customized HT, VMAT, and F_IMRT treatment plans were designed for each patient. The plans were categorized into the HT, VMAT, and F_IMRT groups based on different radiotherapy techniques employed. They were comparatively analyzed through one-way analysis of variance (ANOVA), with multiple comparisons further conducted in the case of significant differences.Results:Statistical analyses reveal significant differences in various parameters of target volumes among the three groups of plans ( F = 38.73, 14.95, 37.01, 48.05, 35.55, 22.56, 34.30, P < 0.05). Pairwise comparisons indicate that the maximum dose ( D2%), minimum dose ( D98%), mean dose ( Dmean), and the proportion of high-dose volumes within the target volume ( V107%and V110%) in both the HT and VMAT groups were significantly better than those in the F_IMRT group. The HT group demonstrated the optimal conformity index (CI), while the VMAT group displayed the superior homogeneity index (HI) compared to the other two groups. In terms of OAR, the V20 of the ipsilateral lung was the lowest in the HT group ( F = 14.31, P < 0.05) and the highest in the F_IMRT group ( F = 14.31, P < 0.05). However, the V5 and Dmean for both the ipsilateral and contralateral lungs in the HT group significantly surpassed those of the other groups ( F = 39.16, 31.91, P < 0.05). The mean dose Dmean ( F = 5.57, P < 0.05) of the contralateral breast was significantly reduced in the VMAT group compared to the other two groups. No statistically significant differences were observed for other OARs, including the heart, spinal cord PRV, thyroid, and humeral head ( P > 0.05). The radiation doses to reconstructed tissues ( Dmax, V53.5, Dmean) ascended in the order of HT, VMAT, and F_IMRT groups ( F = 17.69, 17.53, 15.11, P < 0.05). The HT and F_IMRT groups showed similar beam-on times ( P > 0.05), both exceeding that of the VMAT group by several folds ( F = 28.72, P < 0.05). Conclusions:The comparative analysis indicates that the three radiotherapy techniques exhibit distinct advantages and limitations, with F_IMRT demonstrating the least comprehensive advantage. HT can enhance the conformity of target volumes while reducing the overall radiation doses to reconstructed tissues and the crucial indicator V20 in the ipsilateral lung. VMAT demonstrates the highest treatment efficiency, yielding improved dose uniformity in the target volume and reduced radiation doses to the contralateral breast. It is advisable to prioritize HT or VMAT based on actual clinical conditions.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by hallmark pathological features, including β-amyloid deposition, neurofibrillary tangles formed by hyperphosphorylated tau protein, and chronic neuroinflammation. Recent studies have revealed that the glymphatic-meningeal-cervical lymphatic system plays a pivotal role in intracranial metabolic waste clearance, and its dysfunction may impair the clearance efficiency of β-amyloid and tau proteins. Based on this mechanism, domestic scholars have innovatively proposed lympho-microsurgical reconstruction of the brain-cervical lymphatic drainage pathway, aiming to ameliorate AD pathological progression and cognitive function by enhancing intracranial waste clearance. Through a comprehensive literature review, this article focuses on the theoretical rationale for lympho-microsurgical intervention in AD. While critically evaluating existing surgical approaches and efficacy assessment systems, it further examines the fundamental scientific challenges and clinical translation barriers in directly applying this technique to AD treatment, with the goal of providing theoretical insights and methodological guidance for future research.