Objective To explore the risk factors for ischemic stroke in patients with atrial fibrilla-tion(AF)and construct a prediction model.Methods A retrospective study was conducted on 253 AF patients treated at our hospital from January 2021 to December 2024.They were randomly divided into a modeling group(n=177)and a validation group(n=76)in a 7∶3 ratio.The model-ing group was further divided into a simple AF subgroup(96 cases)and a stroke subgroup(81 cases)based on the occurrence of ischemic stroke.Clinical data were collected,including low-density lipoprotein cholesterol,red cell distribution width(RDW),D-dimer,fibrinogen,N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-sensitivity cardiac troponin I(hs-cTnI),etc.Univariate and multivariate logistic regression analyses were performed to identify risk factors for ischemic stroke,and a nomogram model was constructed.The predictive performance of the model was evaluated using ROC curve analysis,calibration curve analysis,and decision curve analysis(DCA).Results Multivariate logistic regression analysis indicated that left atrial diameter(OR=1.205,95％CI:1.046-1.388,P=0.010),RDW(OR=1.605,95％CI:1.138-2.263,P=0.007),D-dimer(OR=2.633,95％CI:1.229-5.640,P=0.013),fibrinogen(OR=3.053,95％CI:1.312-7.108,P=0.010),NT-proBNP(OR=1.005,95％CI:1.003-1.007,P=0.001),and hs-cTnI(OR=1.129,95％CI:1.046-1.218,P=0.002)were independent risk factors for ischemic stroke in AF patients.ROC curve analysis showed an AUC value of 0.926(95％CI:0.885-0.967)for the modeling group and 0.912(95％CI:0.847-0.978)for the validation group.H-L test showed Chi-square=8.005,P=0.433 for the modeling group and Chi-square=2.590,P=0.957 for the validation group.DC A demonstrated high practical value for the model.Conclusion The nomo-gram model constructed in the study has good predictive performance and clinical utility.

Objective:To investigate changes of CD4+T/CD8+T ratio in children with mycoplasma pneumoniae pneumonia(MPP)at different ages and to predict outcome.Methods:A total of 150 children aged 1～12 with MPP admitted to The Second People's Hospital of Hefei from March 2021 to September 2023 were selected as study group,and were divided into improved group(n=112)and deteriorated group(n=38)according to clinical outcomes after treatment.According to age,patients were divided into in-fant group(≤3 years old)38 cases,preschool group(4～6 years old)57 cases,school age group(>6 years old)55 cases.General information,biochemical test indicators and other related data were collected,CD4+T/CD8+T was calculated,and statistical analysis was performed by SPSS23.0 software.Through univariate and multifactor Logistics regression analysis,changes of CD4+T/CD8+T and other indicators in MPP children of different ages were compared,and independent factors affecting outcome of MPP children were screened.ROC curve was used to analyze efficacy of selected independent influencing factors in predicting outcome of MPP children of different ages.Log-binomial model was used to analyze risk effect of age on CD4+T/CD8+T and different outcomes in MPP children.Dose-response relationship between CD4+T/CD8+T and risk of disease progression in MPP children was analyzed by Logistic regression model combined with restricted cubic spline(RCS)model.P<0.05 was statistically significant.Results:CRP,IgA,IgG,IgM and CD8+T were the highest in infant group,followed by preschool group,the lowest in school-age group(P<0.05),CD4+T and CD4+T/CD8+T were the lowest in infant group,followed by preschool group,and the highest in school-age group(P<0.05).MPP children with≤3 years old accounted for the lowest proportion of improvement(18.76%)and the worst improvement,followed by MPP children with 4～6 years old,MPP children with>6 years old accounted for the highest proportion of improvement(43.75%),and the best im-provement(P<0.001).Improvement of children with disease course≤7 days was significantly better than disease course>7 days(P<0.001).CRP,DD,ESR,LDH,IgA,IgG,IgM and CD8+T levels in children with MPP deterioration were significantly higher than children with MPP improvement(P<0.001),and CD4+T and CD4+T/CD8+T levels were significantly lower than children with MPP im-provement(P<0.001).Multi-factor Logistics regression analysis showed that age,IgA,IgG,IgM and CD4+T/CD8+T were independent influencing factors for outcome of MPP children(P<0.05).ROC curve analysis showed that when cut-off value was 1.50,AUC of CD4+T/CD8+T to predict outcome of MPP children was 0.86(95%CI:0.75～0.94),sensitivity and specificity were 83.76%and 84.60%,respectively.Log-binomial model showed that MPP children with CD4+T/CD8+T≤1.50%had the highest risk of worsening out-come.Risk scores before and after adjustment were 2.05(1.41～3.75),2.07(1.46～3.88)and 2.14(1.50～4.02)times of those in im-provement group.School-age children with CD4+T/CD8+T>1.50%had the lowest risk of worsening,and risk before and after adjust-ment was 1.07(1.00～1.87),1.13(1.04～1.98),1.18(1.07～2.01)times higher than improved group.RCS model analysis of relation-ship between CD4+T/CD8+T and different outcomes in MPP children showed that regardless of whether confounders were adjusted,CD4+T/CD8+T was negatively correlated with outcome of MPP children.Conclusion:CD4+T/CD8+T in MPP children of different ages is significantly different.CD4+T/CD8+T is the lowest in infant group,followed by preschool group,and the highest in school-age group.CD4+T/CD8+T in children with worsening MPP is significantly lower than improved MPP,and CD4+T/CD8+T is negatively correlated with outcome of MPP children,which has certain value in predicting outcome of MPP children.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.

Objective:To utilize single-cell RNA sequencing (scRNA-seq) to untangle the temporal expression profiles of molecules associated with congenital tooth agenesis and dental hard tissue formation during mouse molar development, and to construct a comprehensive cell atlas spanning the entire developmental period from E13.5 to P7.5, thereby providing new insights into the molecular mechanisms underlying abnormal tooth development.Methods:scRNA-seq data of murine mandibular molar tooth germs at five developmental stages (E13.5, E14.5, E16.5, P3.5, P7.5) were obtained from the GEO database (accession: GSE189381). The Seurat pipeline was employed for quality control, data normalization, dimensionality reduction, and Harmony-based batch effect correction. Cellular subpopulations were identified through uniform manifold approximation and projection dimensionality reduction, while developmental trajectories were reconstructed using Monocle for pseudotime analysis.Results:scRNA-seq analysis profiling identified 27 distinct cellular clusters, which were annotated into twelve major cell types including epithelial cells, mesenchymal cells, and endothelial cells. Msx1 exhibited a bimodal expression pattern. Pax9 reached its peak at E14.5 and then gradually decreased. Eda had a low expression level with a diffuse distribution. In contrast, Amelx and Enam were barely expressed during the embryonic stage and were activated at P3.5. Dspp was ectopically highly expressed in epithelial cells from P3.5 to P7.5, while Dmp1 was specifically upregulated in mesenchymal cells at P7.5.Conclusions:The temporal expression patterns of key regulatory genes for tooth agenesis (Msx1, Pax9, Eda), ameloblast differentiation (Amelx, Enam), and odontoblast development (Dspp, Dmp1) during mouse molar development. These findings provide a theoretical foundation and potential therapeutic targets for deciphering the molecular mechanisms underlying tooth agenesis and other developmental dental anomalies, paving the way for targeted clinical interventions.

In China,lung cancer ranks first in the incidence and death of malignant tumors.Early diagnosis and timely treatment can significantly improve the survival rate of lung cancer.However,75％of patients are already in the advanced stage at the time of initial diagnosis,missing the best treatment opportunity.Lung nodules are the manifestations of early lung cancer.How to accurately distinguish benign and malignant pul-monary nodules and avoid missing diagnosis of malignant lung nodules and over-treatment of benign lung nod-ules are important clinical problems.Liquid biopsy has the advantages of non-invasiveness,high reproducibili-ty,operability,easy dynamic monitoring and overcoming tumor heterogeneity,which can realize early detection and diagnosis of malignant tumors.Besides,it is the most potential precision tumor detection technology,which is expected to become a breakthrough in the diagnosis of benign and malignant lung nodules.This arti-cle reviews the research and application of liquid biopsy in the diagnosis of lung nodules in recent years,in or-der to provide ideas for clinical application and future research.

Objective:To investigate the contents of natural radionuclides in agricultural soils in some of Gansu Hexi area to accumulate the relevant basic data.Methods:A stratified sampling method was used to collect 146 soil samples in the area. ORTEC P-type HPGE gamma spectrometry system was used to measure radionuclides. The measurement data were collated and analyzed.Results:The activity concentrations measured were 232Th 18.94-108.39 Bq/kg, 226Ra 14.37-79.20 Bq/kg and 40K 440.03-1 358.18 Bq/kg, in turn with the mean values of (68.22±16.32), (47.90±11.12) and (763.90±133.93) Bq/kg, respectively. The difference in activity concentrations of 232Th, 226Ra and 40K in agricultural soils in different areas was statistically significant( H=50.87, 45.14, 40.28, P<0.05). Conclusions:The study on the activity concentrations of natural radionuclides in agricultural soils provides basic information for the transfer of radionuclides to crops, which needs further investigation, monitoring and analysis.

Objective:To evaluate the effect of ciprofol on intraoperative hypotension in patients undergoing bronchoscopy procedures.Methods:In this randomized controlled study, 112 adult patients of either sex, aged 18-64 yr, with a body mass index of 19.8-28.3 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with estimated operation time of ≥1 h, undergoing elective bronchoscopy procedures, were assigned to one of two groups ( n=56 each) using a random number table method: ciprofol group (C group) and propofol group (P group). All the patients received total intravenous anesthesia. The induction dose of ciprofol was 0.1-0.3 mg/kg, and the maintenance dose was 0.4-1.2 mg·kg -1·h -1 in group C. The induction dose of propofol was 1-3 mg/kg, and the maintenance dose was 4-12 mg·kg -1·h -1 in group P. The primary outcome was the incidence of intraoperative hypotension, and the secondary outcomes were the time of emergence from anesthesia, sleep quality, patients′ and surgeons′ satisfaction with anesthesia, and the incidence of complications within 30 days after surgery. Results:Compared with group P, the incidence of intraoperative hypotension was significantly decreased, and the time of emergence from anesthesia was shortened in group C ( P<0.05). There was no statistically significant difference in secondary outcomes between the two groups ( P>0.05). Conclusions:Ciprofol is superior to propofol in reducing the risk of intraoperative hypotension and facilitates a more rapid emergence from anesthesia in patients undergoing bronchoscopy procedures.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.