Objective:To analyze the risk factors for children with severe community-acquired pneumonia (CAP) being admitted to the pediatric intensive care unit (PICU),and establish a clinical prediction model,then evaluate the clinical application value of this model.Methods:A retrospective analysis was performed on children diagnosed with severe CAP at the Children's Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University from January to June 2023.The children were divided into the PICU group and the non-PICU group based on whether they were admitted to PICU at admission.The differences in pediatric early warning score（PEWS），clinical characteristics，and laboratory test results between the two groups at their last visit before admission were compared. The independent risk factors for children with severe CAP admitted to PICU were analyzed,and a clinical prediction model was established,which was validated through the receiver operating characteristic (ROC) curve.Results:A total of 274 children were included,including 141 males and 133 females,with a median age of 50 (24,81) months. There were 43 cases in PICU group and 231 cases in non-PICU group.There were no statistically significant differences in gender and age between the two groups of children ( P>0.05). The PEWS score,white blood cell count,neutrophil count,neutrophil/lymphocyte ratio,procalcitonin (PCT),and lactate levels of children in the PICU group were significantly higher than those of children in the non-PICU group.While the duration of fever,peak temperature,and percutaneous arterial oxygen saturation (SpO 2) were significantly lower in the PICU group than those in the non-PICU group. All these differences were statistically significant ( P<0.05).Binary Logistic regression analysis showed that PEWS>4 points（ OR=6.583，95% CI 1.763 - 24.588， P<0.05），PCT>0.42 μg/L（ OR=19.046，95% CI 4.362-83.159， P<0.05），and SpO 2<93%（ OR=21.670，95% CI 3.843-122.184， P<0.05）were independent risk factors for children with severe CAP to be admitted to PICU.A clinical prediction model was constructed based on the above three independent risk factors.The area under ROC curve of the clinical prediction model was 0.941（95% CI 0.913-0.968， P<0.05），the sensitivity was 95.3%，the specificity was 80.5%，the positive predictive value was 83.0%，and the negative predictive value was 94.5%. Conclusion:For children with severe CAP，if they have PEWS > 4,an elevated PCT level，and a decreased SpO 2，it is recommended that they be admitted to PICU for further monitoring and treatment.The clinical prediction model for admission to the PICU for children with severe CAP，constructed by combining PEWS with commonly used clinical information in pediatric emergency，has a relatively high predictive efficacy and can provide a reference for the stratified diagnosis and treatment of children with severe CAP in the future.

Objective To investigate the serum levels of long non-coding RNA(lncRNA)HOX transcript antisense RNA(HOTAIR)and homeobox A11 antisense RNA(LncRNA HOXA11-AS)in patients with traumatic brain injury(TBI),and their relationship with cognitive function.Methods From January 2022 to December 2023,106 TBI patients who visited Fuling Hospital Affiliated to Chongqing University were regarded as the TBI group.They were separated into a cognitive impairment group(n=44)and a non-cognitive impairment group(n=62)based on whether they experienced cognitive impairment.78 healthy individuals who underwent physical examinations in Fuling Hospital Affiliated to Chongqing University were regarded as the control group.Real-time fluorescence quantitative PCR(qRT-DCR)method was applied to detect serum LncRNA HOTAIR and LncRNA HOXA11-AS levels.Spearman and Pearson methods were used to analyze the correlation between serum LncRNA HOTAIR and LncRNA HOXA11-AS levels,cognitive function,and inflammatory factors in TBI patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum LncRNA HOTAIR and LncRNA HOXA11-AS for cognitive impairment in TBI patients.Logistic regression was applied to analyze the impacts of serum LncRNA HOTAIR and LncRNA HOXA11-AS expression on cognitive impairment after TBI.Results Compared with the control group,the expression levels of serum LncRNA HOTAIR(1.75±0.29 vs 1.03±0.15)and LncRNA HOXA11-AS(1.59±0.35 vs 0.99±0.18)in the TBI group were significantly increased,and the differences were statistically significant(t=20.034,13.846,all P<0.05).The cognitively impaired group had significantly higher serum LncRNA HOTAIR,LncRNA HOXA11-AS,tumor necrosis factor-α(TNF-α),interleukin 1β(IL-1β)and interleukin 6(IL-6)levels were significantly higher in the cognitive impairment group than in the group without cognitive impairment(t=3.011～9.615),and Montreal Cognitive Assessment(MoCA)scale was considerably lower than that of the no cognitive impairment group(t=17.633),and the differences were statistical significance(all P<0.05).Spearman correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS in TBI patients were negatively correlated with MoCA scores(r=-0.515,-0.430,all P<0.001),Pearson correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were positively correlated with TNF-α,IL-1βand IL-6 levels(r=0.423,0.397,0.452,0.437,0.512,0.390,all P<0.001).The AUC(95%CI)of serum LncRNA HOTAIR and LncRNA HOXA11-AS alone and in combination predicted cognitive impairment after TBI was 0.896(0.822～0.947),0.864(0.784～0.923)and 0.960(0.903～0.988),respectively,the combined predictive value of the two was better than that of individual prediction(Z=2.457,2.998,all P<0.05).Logistic regression analysis showed that elevated expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were risk factors for cognitive impairment in TBII patients,while MoCA score was a protective factor(all P<0.05).Conclusion The levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS have certain value in the functional impairment of TBI patients,and they may participate in the occurrence and progression of cognitive impairment in TBI patients by regulating the levels of inflammatory factors in the body.

AIM:This study aims to investigate the expression and prognostic value of ubiquitin-conjugating enzyme E2C(UBE2C)in hepatocellular carcinoma(HCC),and to explore its impact on cancer stemness and the regulato-ry mechanisms.METHODS:(1)The TCGA and GEO databases were used to analyze UBE2C mRNA expression levels in HCC tissues and their correlation with prognosis using bioinformatics techniques,and these findings were further vali-dated in postoperative specimens from 107 HCC patients.The GEPIA database was used to analyze the correlation be-tween UBE2C and steroid receptor coactivator(SRC).(2)The CCK8,colony formation,wound healing,and spheroid formation assays were used to assess the effects of UBE2C on HCC cell proliferation,migration,and stemness.The inter-action between UBE2C and signal transducer and activator of transcription 3(STAT3),as well as its regulatory mecha-nism,was examined by Western blot and co-immunoprecipitation assays.(3)The subcutaneous xenograft model in nude mice was employed to validate the role of UBE2C in tumor growth in vivo.RESULTS:(1)Bioinformatics analysis re-vealed that UBE2C expression was significantly up-regulated in HCC tissues compared with adjacent normal tissues(P<0.05 in TCGA,and P<0.01 in GEO).Consistently,analysis of HCC specimens confirmed that high UBE2C expression was associated with shortened overall survival and disease-free survival of HCC patients(P<0.05).Furthermore,analysis using the GEPIA database revealed a positive correlation between UBE2C and SRC(P<0.01).(2)In vitro experiments demonstrated that UBE2C significantly promotes the proliferation and migration of HCC cells.Based on these findings,we presumed that UBE2C may regulate the phosphorylation of STAT3 at the Y705 site by modulating SRC activity,thereby in-fluencing the stemness characteristics of tumor cells.(3)In vivo experiments further confirmed that UBE2C inhibition sig-nificantly suppressed tumor growth.CONCLUSION:The UBE2C promoted proliferation and migration of HCC cells and regulated the stemness of HCC cells by interacting with STAT3.

There is a large gap between production and demand of plant oil in China, which leads to the heavy reliance on imports. Diacylglycerol acyltransferase (DGAT) and phospholipid: diacylglycerol acyltransferase (PDAT) are two key enzymes responsible for the synthesis of triacylglycerol, thereby affecting the yield and quality of plant oil. This paper comprehensively reviews the research progress in DGAT and PDAT in terms of their biological functions in plant oil synthesis, the molecular mechanisms of regulating plant lipid metabolism, growth, and development under stress, and their roles in driving oil synthesis under the background of synthetic biology. Furthermore, future research and application of DGAT and PDAT are prospected. This review aims to provide a basis for deeply understanding the molecular mechanism of plant oil synthesis and improving the quality and productivity of oil crops by the utilization of DGAT and PDAT genes.
Diacylglycerol O-Acyltransferase/physiology* ; Plant Oils/metabolism* ; Acyltransferases/metabolism* ; Lipid Metabolism/genetics* ; Gene Expression Regulation, Plant ; Triglycerides/biosynthesis*

Objective:To investigate the clinical effect of indocyanine green angiography (ICGA)-assisted design and harvest of expanded flaps for scar reconstruction.Methods:This study was a retrospective observational study. From April 2019 to August 2023, 19 patients with scars (8 males, 11 females; aged 3-38 years) treated at the Plastic Surgery Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences met the inclusion criteria. The scars were distributed on the head, face, trunk, and extremities. In stage Ⅰ surgery, skin soft tissue expanders were implanted in suitable areas around the scars for skin soft tissue expansion. In stage Ⅱ surgery, the scar tissue was excised, resulting in wound areas ranging from 100 to 210 cm 2, and expanded flaps were designed. ICGA was used to identify target perforators and their accompanying veins, and the flap design was adjusted to ensure the inclusion of complete arterial and venous axes. The expanded flap with an area of 120 to 240 cm2 was harvested using unilateral back-cut technique and transferred to the recipient site, and the donor site wound was sutured directly. The durations of the arterial and venous phases of ICGA during flap design were recorded. The length-to-width ratios of the back-cut flaps were calculated for different regions. After stage Ⅱ surgery, the blood perfusion and survival of the flap, the wound healing at the donor site, and the occurrence of complications were observed. During follow-up, the appearance, color, and texture of the patient's flap were observed. Results:The arterial phase of ICGA lasted 10-27 (18±5) s, and the venous phase lasted 78-116 (100±10) s. The length-to-width ratios of the back-cut flaps were 1.22±0.32, 1.63±0.12, and 1.15±0.21 for the head and neck, trunk, and limb regions, respectively. After stage Ⅱ surgery, one patient had a large area of insufficient blood perfusion in the flap. By comparing ICGA images before and after flap transfer, the sutures at the oral commissure were loosened, the blood flow of the flap was restored. The blood perfusion of the flaps in other patients was good. All flaps survived completely, with well-healed donor site wounds and no complications. During 0.5-14.0 months of follow-up, all flaps of patients demonstrated excellent appearance, with color and texture matching the surrounding skin.Conclusions:As a means of superficial blood flow visualization, ICGA can not only clearly show the microvascular distribution of the expanded flap before operation, assist in optimizing the design of the flap, but also evaluate the blood perfusion of the flap after operation, reduce the occurrence of complications, and provide a full-process navigation for the harvesting of expanded flaps, thereby improving the safety of flap transfer for scar reconstruction.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

AIM:This study aims to investigate the expression and prognostic value of ubiquitin-conjugating enzyme E2C(UBE2C)in hepatocellular carcinoma(HCC),and to explore its impact on cancer stemness and the regulato-ry mechanisms.METHODS:(1)The TCGA and GEO databases were used to analyze UBE2C mRNA expression levels in HCC tissues and their correlation with prognosis using bioinformatics techniques,and these findings were further vali-dated in postoperative specimens from 107 HCC patients.The GEPIA database was used to analyze the correlation be-tween UBE2C and steroid receptor coactivator(SRC).(2)The CCK8,colony formation,wound healing,and spheroid formation assays were used to assess the effects of UBE2C on HCC cell proliferation,migration,and stemness.The inter-action between UBE2C and signal transducer and activator of transcription 3(STAT3),as well as its regulatory mecha-nism,was examined by Western blot and co-immunoprecipitation assays.(3)The subcutaneous xenograft model in nude mice was employed to validate the role of UBE2C in tumor growth in vivo.RESULTS:(1)Bioinformatics analysis re-vealed that UBE2C expression was significantly up-regulated in HCC tissues compared with adjacent normal tissues(P<0.05 in TCGA,and P<0.01 in GEO).Consistently,analysis of HCC specimens confirmed that high UBE2C expression was associated with shortened overall survival and disease-free survival of HCC patients(P<0.05).Furthermore,analysis using the GEPIA database revealed a positive correlation between UBE2C and SRC(P<0.01).(2)In vitro experiments demonstrated that UBE2C significantly promotes the proliferation and migration of HCC cells.Based on these findings,we presumed that UBE2C may regulate the phosphorylation of STAT3 at the Y705 site by modulating SRC activity,thereby in-fluencing the stemness characteristics of tumor cells.(3)In vivo experiments further confirmed that UBE2C inhibition sig-nificantly suppressed tumor growth.CONCLUSION:The UBE2C promoted proliferation and migration of HCC cells and regulated the stemness of HCC cells by interacting with STAT3.

Objective To investigate the serum levels of long non-coding RNA(lncRNA)HOX transcript antisense RNA(HOTAIR)and homeobox A11 antisense RNA(LncRNA HOXA11-AS)in patients with traumatic brain injury(TBI),and their relationship with cognitive function.Methods From January 2022 to December 2023,106 TBI patients who visited Fuling Hospital Affiliated to Chongqing University were regarded as the TBI group.They were separated into a cognitive impairment group(n=44)and a non-cognitive impairment group(n=62)based on whether they experienced cognitive impairment.78 healthy individuals who underwent physical examinations in Fuling Hospital Affiliated to Chongqing University were regarded as the control group.Real-time fluorescence quantitative PCR(qRT-DCR)method was applied to detect serum LncRNA HOTAIR and LncRNA HOXA11-AS levels.Spearman and Pearson methods were used to analyze the correlation between serum LncRNA HOTAIR and LncRNA HOXA11-AS levels,cognitive function,and inflammatory factors in TBI patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum LncRNA HOTAIR and LncRNA HOXA11-AS for cognitive impairment in TBI patients.Logistic regression was applied to analyze the impacts of serum LncRNA HOTAIR and LncRNA HOXA11-AS expression on cognitive impairment after TBI.Results Compared with the control group,the expression levels of serum LncRNA HOTAIR(1.75±0.29 vs 1.03±0.15)and LncRNA HOXA11-AS(1.59±0.35 vs 0.99±0.18)in the TBI group were significantly increased,and the differences were statistically significant(t=20.034,13.846,all P<0.05).The cognitively impaired group had significantly higher serum LncRNA HOTAIR,LncRNA HOXA11-AS,tumor necrosis factor-α(TNF-α),interleukin 1β(IL-1β)and interleukin 6(IL-6)levels were significantly higher in the cognitive impairment group than in the group without cognitive impairment(t=3.011～9.615),and Montreal Cognitive Assessment(MoCA)scale was considerably lower than that of the no cognitive impairment group(t=17.633),and the differences were statistical significance(all P<0.05).Spearman correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS in TBI patients were negatively correlated with MoCA scores(r=-0.515,-0.430,all P<0.001),Pearson correlation analysis showed that the expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were positively correlated with TNF-α,IL-1βand IL-6 levels(r=0.423,0.397,0.452,0.437,0.512,0.390,all P<0.001).The AUC(95%CI)of serum LncRNA HOTAIR and LncRNA HOXA11-AS alone and in combination predicted cognitive impairment after TBI was 0.896(0.822～0.947),0.864(0.784～0.923)and 0.960(0.903～0.988),respectively,the combined predictive value of the two was better than that of individual prediction(Z=2.457,2.998,all P<0.05).Logistic regression analysis showed that elevated expression levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS were risk factors for cognitive impairment in TBII patients,while MoCA score was a protective factor(all P<0.05).Conclusion The levels of serum LncRNA HOTAIR and LncRNA HOXA11-AS have certain value in the functional impairment of TBI patients,and they may participate in the occurrence and progression of cognitive impairment in TBI patients by regulating the levels of inflammatory factors in the body.

Objective:To explore and compare the clinical application value of 8-channel head phased-array coil, an 8-channel temporomandibular joint (TMJ)-specific surface coil, and a single-channel surface coil in TMJ MRI examinations.Methods:A total of 600 temporomandibular disorders (TMD) patients (1 200 joints) who underwent TMJ MRI examination in the First People′s Hospital of Jinzhong from June 2020 to January 2025 were retrospectively screened. Based on inclusion/exclusion criteria, 120 TMD patients (240 joints) with closed-mouth oblique sagittal proton density weighted imaging (OSag PDWI), coronal T2 fat-suppression weighted imaging (OCor fs T2WI) and open-mouth oblique sagittal proton density weighted imaging (OSag PDWI) were included. Patients were divided into groups A, B, and C, with 40 cases in each group. Group A (31female, 9male, median age 24 years old), underwent 8-channel head phased-array coil imaging. Group B (29 female, 11male, median age 23.5 years old) underwent TMJ imaging with an 8-channel surface coil. Group C (29 female, 11male, median age 22.5 years old) underwent single-channel surface coil imaging. There were no significant differences in age, gender, type or disease types among groups ( P>0.05). Six healthy volunteers without TMD (4 female, 2 male, range 19 to 45 years old) underwent imaging with all three coils as self-control. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality were compared for five regions of interest (ROI) in both patients and volunteers. Results:Under the same sequence and the same parameters, SNR and CNR in group B were higher than those in group A, and SNR and CNR in group C were also higher than those in group A, the differences were statistically significant ( P<0.05). However, there were significant differences in SNR and CNR between group B and group C in the closed and open positions of ROI1, the open positions of ROI3 and the open positions of ROI5 ( P<0.05), and there were no significant differences in other positions ( P>0.05). Group B had the best image quality, followed by group C and group A had the worst image quality. There were significant differences in the visualization of OSag PDWI in the closed mouth position, OCor T2WI in the coronal position, and OSag PDWI in the open mouth position, such as condyle, anterior attachment, joint disc, double lamina area, joint cavity and lateral pterygoid muscle ( P<0.05). There were significant differences between group B and group C in showing the joint cavity in the closed mouth position and showing the structure of the bilaminar area in the open mouth position ( P<0.05). There was no significant difference in other regions of interest ( P>0.05). The subjective scores of condyle, anterior attachment, articular disc, bilaminar area, articular cavity, lateral pterygos muscle and other structures were medium to high in group A, high in group B, and high or high in group C by two radiologists independently. In the five rois, the 8-channel TMJ surface coil showed more details, especially in the articular disc, condyle and lateral pterygoid muscle regions, and had more advantages in both volunteers and patients. Conclusions:The 8-channel TMJ-specific surface coil provides significantly clearer visualization of critical anatomical details within the ROIs, demonstrating the highest clinical application value and is recommended as the preferred choice.

Objective:To analyze the risk factors for children with severe community-acquired pneumonia (CAP) being admitted to the pediatric intensive care unit (PICU),and establish a clinical prediction model,then evaluate the clinical application value of this model.Methods:A retrospective analysis was performed on children diagnosed with severe CAP at the Children's Hospital Affiliated to School of Medicine of Shanghai Jiao Tong University from January to June 2023.The children were divided into the PICU group and the non-PICU group based on whether they were admitted to PICU at admission.The differences in pediatric early warning score（PEWS），clinical characteristics，and laboratory test results between the two groups at their last visit before admission were compared. The independent risk factors for children with severe CAP admitted to PICU were analyzed,and a clinical prediction model was established,which was validated through the receiver operating characteristic (ROC) curve.Results:A total of 274 children were included,including 141 males and 133 females,with a median age of 50 (24,81) months. There were 43 cases in PICU group and 231 cases in non-PICU group.There were no statistically significant differences in gender and age between the two groups of children ( P>0.05). The PEWS score,white blood cell count,neutrophil count,neutrophil/lymphocyte ratio,procalcitonin (PCT),and lactate levels of children in the PICU group were significantly higher than those of children in the non-PICU group.While the duration of fever,peak temperature,and percutaneous arterial oxygen saturation (SpO 2) were significantly lower in the PICU group than those in the non-PICU group. All these differences were statistically significant ( P<0.05).Binary Logistic regression analysis showed that PEWS>4 points（ OR=6.583，95% CI 1.763 - 24.588， P<0.05），PCT>0.42 μg/L（ OR=19.046，95% CI 4.362-83.159， P<0.05），and SpO 2<93%（ OR=21.670，95% CI 3.843-122.184， P<0.05）were independent risk factors for children with severe CAP to be admitted to PICU.A clinical prediction model was constructed based on the above three independent risk factors.The area under ROC curve of the clinical prediction model was 0.941（95% CI 0.913-0.968， P<0.05），the sensitivity was 95.3%，the specificity was 80.5%，the positive predictive value was 83.0%，and the negative predictive value was 94.5%. Conclusion:For children with severe CAP，if they have PEWS > 4,an elevated PCT level，and a decreased SpO 2，it is recommended that they be admitted to PICU for further monitoring and treatment.The clinical prediction model for admission to the PICU for children with severe CAP，constructed by combining PEWS with commonly used clinical information in pediatric emergency，has a relatively high predictive efficacy and can provide a reference for the stratified diagnosis and treatment of children with severe CAP in the future.