Objective:To investigate the clinical manifestation, therapy, and prognosis of Susac syndrome and enhance the understanding of this disease.Methods:A case summary was made.The clinical data of two siblings with Susac syndrome treated at Children′s Medical Center, Peking University First Hospital in January 2024 were summarized.Reported cases of pediatric Susac syndrome were reviewed.Results:The onset of the disease in the two siblings was at the age of 3.00 and 6.75 years, with recurrent headaches, tinnitus, hearing loss and encephalopathy symptoms.Cranial magnetic resonance imaging showed multiple cerebral microbleeding and microinfarction lesions, " snowball like" in the corpus callosum and diffuse white matter edema in the brain.Audiometry revealed sensorineural hearing loss.In one case, ophthalmic fluorescein angiography revealed ischemic changes due to branch retinal artery occlusions.No pathogenic variants were detected in gene testing.This child was diagnosed with Susac syndrome, and the symptoms were improved after treatment with Corticosteroids and Rituximab.No relapse was observed during the 9-month follow-up.A total of 20 pediatric cases of Susac syndrome were retrieved, including 18 reported previously and 2 cases from this study.There were 2 boys and 18 girls, with the age of onset ranging from 2.5 to 17.0 years.The common initial symptoms included headache (19 cases), vertigo and tinnitus or hearing loss (9 cases), and vision impairment or visual field defect (4 cases). The symptoms were improved after immunotherapy.Conclusions:With a low incidence, Susac syndrome is rare in children and difficult to diagnose.There may be a genetic predisposition in such disease.Early diagnosis and immunotherapy can low the relapse and improve the prognosis.

Objective To observe the changes of invariant natural killer T(iNK T)cells in visceral adipose tissue and blood lipids of high-fat diet-fed mice,and to analyze the correlation between iNK T cells and lipid metabolism.Methods Fifty-two C57BL/6 mice were selected as the high-fat diet group,and 51 C57BL/6 mice as the normal control group.The high-fat diet intervention lasted for 12 weeks.At weeks 1,4,8,and 12,the epididymal and perirenal fats of mice in both groups were collected and weighed to record the visceral fat mass(VFM),and the changes in body fat content(BFC)were calculated.Flow cytometry and laser scanning confocal microscopy were used to detect the changes of invariant natural killer T(iNK T)cells in visceral adipose tissue.An automatic biochemical analyzer was used to measure the lipid levels in mice,and the correlations of iNKT cells in visceral adipose tissue with VFM,BFC,and serum lipid levels were analyzed.Results At 12 weeks after high-fat diet feeding,the body weight,VFM,BFC,serum total cholesterol(TC),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)increased significantly,while the content of invariant natural killer T(iNK T)cells in visceral adipose tissue decreased obviously in the high-fat diet group,as compared with the control group(P＜0.01).The iNKT cell number in visceral adipose tissue of mice was negatively correlated with VFM,BFC,serum HDL-C and serum TG(r=-0.293,-0.289,-0.337,-0.199,P＜0.05),and was not correlated with serum TC and LDL-C(r=-0.122,-0.082,P＞0.05).Conclution VFM is increased and iNK T cell number is decreased in in adipose tissue of high-fat diet-fed mice.The number of iNK T cells is negatively correlated with VFM,BFC,serum HDL-C and TG.

Objective To explore the associations among smoking behavior,cognitive function,and personality traits in first-episode male patients with schizophrenia,thereby providing theoretical underpinnings for individualized treatment strategies in clinical settings.Methods A total of 140 first-episode male inpatients with schizophrenia admitted to the hospital from January 2022 to December 2023 were recruited.According to their smoking behavior,they were categorized into a smoking group(n=80)and a non-smoking group(n=60).Moreover,healthy controls were recruited and classified into a healthy smoking group(n=62)and a healthy non-smoking group(n=67)based on their smoking status.The Positive and Negative Syndrome Scale(PANSS)was employed to evaluate psychiatric symptoms in the schizophrenia groups.Nicotine dependence was measured using the Fagerstr?m Test for Nicotine Dependence(FTND)in the two smoking groups.Cognitive function and personality traits were assessed in all participants using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Eysenck Personality Questionnaire(EPQ),respectively.Results Regarding cognitive function,the smoking group among schizophrenia patients demonstrated significantly higher scores than the non-smoking group in immediate memory,attention,and delayed memory(all P<0.05).Among schizophrenia patients,FTND scores were moderately negatively correlated with attention and delayed memory(r=-0.552 and-0.657 respectively;both P<0.001).Concerning personality traits,smokers had significantly higher scores in neuroticism and psychoticism compared to non-smokers(both P<0.001).Both patient groups had significantly lower lie scale scores when contrasted with healthy controls(P<0.01),while the healthy smoking group showed significantly higher extraversion scores than the other groups.Conclusions The smoking behavior of male patients during their first episode of schizophrenia exhibits specific characteristics in relation to cognitive performance and personality traits.Smokers demonstrate relatively superior performance in cognitive domains including attention,immediate memory,and delayed memory.However,higher degrees of nicotine dependence are associated with poorer cognitive function,especially in the aspects of attention and delayed memory.Regarding personality,smoking patients display elevated levels of neuroticism and psychoticism.These findings indicate that smoking behavior may be closely associated with cognitive functioning and personality traits,thus meriting clinical attention in the management of schizophrenia.

Purpose Based on multimodal imaging combined with a variety of histological techniques,to visually evaluate the changes of rats brain metabolic microenvironment after cerebral hypoxia and ischemia of prematurity,and to discuss the effects of abnormal lactate metabolism in the brain on oligodendrocyte precursor cells,so as to provide a basis for the early diagnosis and treatment of premature white matter injury(PWMI).Materials and Methods A total of 36 SPF-grade healthy 3-day-old Sprague-Dawley neonatal rats were randomly assigned to the sham surgery(Sham)group and the model(PWMI)group using a random number table method,with 18 rats in each group.A neonatal rat PWMI model was established by hypoxia-ischemia method.Twenty-four hours after modeling,laser speckle imaging was used to monitor cerebral blood flow and blood oxygen changes.Multimodal imaging was used to observe the changes in brain tissue microstructure and metabolism after PWMI.HE staining was used to observe the morphological changes of nerve cells in the white matter of the brain.Enzyme-linked immunosorbent assay was used to detect the changes of lactate content and lactate dehydrogenase activity in the white matter region of the brain after PWMI in neonatal rats.PDGFR-α immunofluorescence staining was used to observe the dynamic changes of the number of oligodendrocyte precursor cells in the subependymal zone after PWMI in neonatal rats.Results Twenty-four hours after modeling,the multimodal imaging results showed that the T2WI and diffusion-weighted imaging on the injured side of the PWMI group showed high intensity,and the relative cerebral blood flow,relative oxygen saturation,relative apparent diffusion coefficient and amide proton transfer(APT)Lorentzian difference value were lower than those in the Sham group(t=29.466,23.522,59.006,54.778,10.263,all P<0.001),and the lactate content was higher than that in the Sham group(t=-7.521,P<0.001).The results of HE staining and enzyme-linked immunosorbent assay showed that the arrangement of nerve cells in the white matter area of the injured side of the brain in the PWMI group was loose and disordered.The lactate content and lactate dehydrogenase activity were higher than those in the Sham group(t=-6.079,-10.548,both P<0.001).The results of immunofluorescence staining showed that the number of PDGFR-α+cells in the subependymal zone of the damaged side of the PWMI group was higher than that of the Sham group at 24 hours after modeling,and lower than that in the Sham group at 11 days after modeling(t=-8.386,6.676,both P<0.001).The correlation analysis between the lactate content and APT Lorentzian difference value in the brain and the number of oligodendrocyte precursor cells in the brain 11 days after modeling showed that the number of oligodendrocyte precursor cells in the subependymal zone was positively correlated with the APT Lorentzian difference value(r=0.821,P=0.001 1),and negatively correlated with the lactate content in the brain(r=-0.880,P=0.000 2).Conclusion Multimodal imaging can monitor the early brain metabolism changes of PWMI in neonatal rats,especially the changes of lactate,and provide a visual basis for their early diagnosis.The level of lactate in the brain increases after cerebral hypoxia and ischemia in prematurity,and oligodendrocyte precursor cells increase transiently and then decrease,resulting in PWMI.

This paper reports an early-onset diabetes patient combined with intrahepatic cholestasis and hepatocellular carcinoma caused by a mutation of ABCB11 gene.After surgery and drug treatment,the patient's digestive tract symptoms and diabetes were alleviated.Diabetes with primary intrahepatic cholestasis has not been reported in the literature.By introducing this case's clinical manifestations,genetic characteristics and clinical course,we hope to provide a reference for clinicians to understand the diagnosis,treatment and follow-up of this disease.

Objective To explore the current situation,research hotspots and development trend of acupuncture and moxibustion in the treatment of irritable bowel syndrome(IBS).Methods Literature on acupuncture and moxibustion for the treatment of IBS were retrieved by CNKI from the establishment of the database to February 2024.CiteSpace software was used to analyze the cooperative network of authors and institutions,keyword co-occurrence,clustering,and emergence and timeline analysis,and the corresponding knowledge graph was drawn.Results A total of 946 articles were included,and the overall number of publications showed an upward trend;63 authors published≥5 articles,forming a main collaborative team represented by Sun Jianhua,Chu Haoran,Ren Xiaoxuan,Shi Zhimin and others;41 institutions issued more than 5 papers,and the main institutions were Shanghai acupuncture and moxibustion Meridian Research Institute,Acupuncture-Moxibustion and Tuina,Beijing University of Traditional Chinese Medicine,and Shandong University of Traditional Chinese Medicine;High frequency keywords include"acupuncture","acupuncture and moxibustion","diarrhea","electroacupuncture","moxibustion",etc.,forming 9 main keyword clusters and 13 emerging keywords."intestinal flora"and"depression"are the most recent emerging keywords.Conclusion The research on acupuncture and moxibustion treatment of IBS is getting more and more attention.In recent years,the role of the bio-psycho-social model based on the brain gut axis in this field has received widespread attention,but the research lacks systematization.Research teams in different regions should increase exchanges and cooperation,carry out more high-quality related research,and promote the sustainable development of the characteristics and advantages of acupuncture and moxibustion treatment.

Objective To explore the current situation,research hotspots and development trend of acupuncture and moxibustion in the treatment of irritable bowel syndrome(IBS).Methods Literature on acupuncture and moxibustion for the treatment of IBS were retrieved by CNKI from the establishment of the database to February 2024.CiteSpace software was used to analyze the cooperative network of authors and institutions,keyword co-occurrence,clustering,and emergence and timeline analysis,and the corresponding knowledge graph was drawn.Results A total of 946 articles were included,and the overall number of publications showed an upward trend;63 authors published≥5 articles,forming a main collaborative team represented by Sun Jianhua,Chu Haoran,Ren Xiaoxuan,Shi Zhimin and others;41 institutions issued more than 5 papers,and the main institutions were Shanghai acupuncture and moxibustion Meridian Research Institute,Acupuncture-Moxibustion and Tuina,Beijing University of Traditional Chinese Medicine,and Shandong University of Traditional Chinese Medicine;High frequency keywords include"acupuncture","acupuncture and moxibustion","diarrhea","electroacupuncture","moxibustion",etc.,forming 9 main keyword clusters and 13 emerging keywords."intestinal flora"and"depression"are the most recent emerging keywords.Conclusion The research on acupuncture and moxibustion treatment of IBS is getting more and more attention.In recent years,the role of the bio-psycho-social model based on the brain gut axis in this field has received widespread attention,but the research lacks systematization.Research teams in different regions should increase exchanges and cooperation,carry out more high-quality related research,and promote the sustainable development of the characteristics and advantages of acupuncture and moxibustion treatment.

Objective To explore the associations among smoking behavior,cognitive function,and personality traits in first-episode male patients with schizophrenia,thereby providing theoretical underpinnings for individualized treatment strategies in clinical settings.Methods A total of 140 first-episode male inpatients with schizophrenia admitted to the hospital from January 2022 to December 2023 were recruited.According to their smoking behavior,they were categorized into a smoking group(n=80)and a non-smoking group(n=60).Moreover,healthy controls were recruited and classified into a healthy smoking group(n=62)and a healthy non-smoking group(n=67)based on their smoking status.The Positive and Negative Syndrome Scale(PANSS)was employed to evaluate psychiatric symptoms in the schizophrenia groups.Nicotine dependence was measured using the Fagerstr?m Test for Nicotine Dependence(FTND)in the two smoking groups.Cognitive function and personality traits were assessed in all participants using the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Eysenck Personality Questionnaire(EPQ),respectively.Results Regarding cognitive function,the smoking group among schizophrenia patients demonstrated significantly higher scores than the non-smoking group in immediate memory,attention,and delayed memory(all P<0.05).Among schizophrenia patients,FTND scores were moderately negatively correlated with attention and delayed memory(r=-0.552 and-0.657 respectively;both P<0.001).Concerning personality traits,smokers had significantly higher scores in neuroticism and psychoticism compared to non-smokers(both P<0.001).Both patient groups had significantly lower lie scale scores when contrasted with healthy controls(P<0.01),while the healthy smoking group showed significantly higher extraversion scores than the other groups.Conclusions The smoking behavior of male patients during their first episode of schizophrenia exhibits specific characteristics in relation to cognitive performance and personality traits.Smokers demonstrate relatively superior performance in cognitive domains including attention,immediate memory,and delayed memory.However,higher degrees of nicotine dependence are associated with poorer cognitive function,especially in the aspects of attention and delayed memory.Regarding personality,smoking patients display elevated levels of neuroticism and psychoticism.These findings indicate that smoking behavior may be closely associated with cognitive functioning and personality traits,thus meriting clinical attention in the management of schizophrenia.

Purpose Based on multimodal imaging combined with a variety of histological techniques,to visually evaluate the changes of rats brain metabolic microenvironment after cerebral hypoxia and ischemia of prematurity,and to discuss the effects of abnormal lactate metabolism in the brain on oligodendrocyte precursor cells,so as to provide a basis for the early diagnosis and treatment of premature white matter injury(PWMI).Materials and Methods A total of 36 SPF-grade healthy 3-day-old Sprague-Dawley neonatal rats were randomly assigned to the sham surgery(Sham)group and the model(PWMI)group using a random number table method,with 18 rats in each group.A neonatal rat PWMI model was established by hypoxia-ischemia method.Twenty-four hours after modeling,laser speckle imaging was used to monitor cerebral blood flow and blood oxygen changes.Multimodal imaging was used to observe the changes in brain tissue microstructure and metabolism after PWMI.HE staining was used to observe the morphological changes of nerve cells in the white matter of the brain.Enzyme-linked immunosorbent assay was used to detect the changes of lactate content and lactate dehydrogenase activity in the white matter region of the brain after PWMI in neonatal rats.PDGFR-α immunofluorescence staining was used to observe the dynamic changes of the number of oligodendrocyte precursor cells in the subependymal zone after PWMI in neonatal rats.Results Twenty-four hours after modeling,the multimodal imaging results showed that the T2WI and diffusion-weighted imaging on the injured side of the PWMI group showed high intensity,and the relative cerebral blood flow,relative oxygen saturation,relative apparent diffusion coefficient and amide proton transfer(APT)Lorentzian difference value were lower than those in the Sham group(t=29.466,23.522,59.006,54.778,10.263,all P<0.001),and the lactate content was higher than that in the Sham group(t=-7.521,P<0.001).The results of HE staining and enzyme-linked immunosorbent assay showed that the arrangement of nerve cells in the white matter area of the injured side of the brain in the PWMI group was loose and disordered.The lactate content and lactate dehydrogenase activity were higher than those in the Sham group(t=-6.079,-10.548,both P<0.001).The results of immunofluorescence staining showed that the number of PDGFR-α+cells in the subependymal zone of the damaged side of the PWMI group was higher than that of the Sham group at 24 hours after modeling,and lower than that in the Sham group at 11 days after modeling(t=-8.386,6.676,both P<0.001).The correlation analysis between the lactate content and APT Lorentzian difference value in the brain and the number of oligodendrocyte precursor cells in the brain 11 days after modeling showed that the number of oligodendrocyte precursor cells in the subependymal zone was positively correlated with the APT Lorentzian difference value(r=0.821,P=0.001 1),and negatively correlated with the lactate content in the brain(r=-0.880,P=0.000 2).Conclusion Multimodal imaging can monitor the early brain metabolism changes of PWMI in neonatal rats,especially the changes of lactate,and provide a visual basis for their early diagnosis.The level of lactate in the brain increases after cerebral hypoxia and ischemia in prematurity,and oligodendrocyte precursor cells increase transiently and then decrease,resulting in PWMI.