Moyamoya disease is a cerebrovascular disease characterized by progressive stenosis of the distal end of the internal carotid artery, followed by the formation of an abnormal vascular network in the skull base. At present, the main treatment approach is to perform superficial temporal artery to middle cerebral artery bypass grafting to increase cerebral blood flow and improve the symptoms of patients. Cerebral hyperperfusion syndrome (CHS) is a common complication after revascularization, which can lead to more severe complications such as transient neurological events and intracranial hemorrhage. Therefore, predicting the occurrence of CHS through multimodal intraoperative monitoring is crucial for improving the outcomes of patients. This article reviews various common intraoperative monitoring techniques for predicting CHS.

Schistosomiasis was once hyper-endemic in Yunnan Province. Following concerted efforts for over 70 years, remarkable achievements have been made for schistosomiasis control in the province. In 2004, the Mid- and Long-term Plan for Schistosomiasis Prevention and Control in Yunnan Province was initiated in Yunnan Province, and the target for transmission control of schistosomiasis was achieved in the province in 2009. Following the subsequent implementation of the Outline for Key Projects in Integrated Schistosomiasis Control Program (2009—2015) and the 13th Five - year Plan for Schistosomiasis Control in Yunnan Province, no acute schistosomiasis had been identified in Yunnan Province for successive 12 years, and no local Schistosoma japonicum infections had been detected in humans, animals or Oncomelania hupensis snails for successive 6 years in the province by the end of 2020. The transmission of schistosomiasis was interrupted in Yunnan Province in 2020. This review summarizes the history of schistosomiasis, changes in schistosomiasis prevalence and progress of schistosomiasis control in Yunnan Province, and proposes the future priorities for schistosomiasis control in the province.

Objective To predict the potential geographic distribution of Oncomelania hupensis in Yunnan Province using random forest (RF) and maximum entropy (MaxEnt) models, so as to provide insights into O. hupensis surveillance and control in Yunnan Province. Methods The O. hupensis snail survey data in Yunnan Province from 2015 to 2016 were collected and converted into O. hupensis snail distribution site data. Data of 22 environmental variables in Yunnan Province were collected, including twelve climate variables (annual potential evapotranspiration, annual mean ground surface temperature, annual precipitation, annual mean air pressure, annual mean relative humidity, annual sunshine duration, annual mean air temperature, annual mean wind speed, ≥ 0 ℃ annual accumulated temperature, ≥ 10 ℃ annual accumulated temperature, aridity and index of moisture), eight geographical variables (normalized difference vegetation index, landform type, land use type, altitude, soil type, soil textureclay content, soil texture-sand content and soil texture-silt content) and two population and economic variables (gross domestic product and population). Variables were screened with Pearson correlation test and variance inflation factor (VIF) test. The RF and MaxEnt models and the ensemble model were created using the biomod2 package of the software R 4.2.1, and the potential distribution of O. hupensis snails after 2016 was predicted in Yunnan Province. The predictive effects of models were evaluated through cross-validation and independent tests, and the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS) and Kappa statistics were used for model evaluation. In addition, the importance of environmental variables was analyzed, the contribution of environmental variables output by the models with AUC values of > 0.950 and TSS values of > 0.850 were selected for normalization processing, and the importance percentage of environmental variables was obtained to analyze the importance of environmental variables. Results Data of 148 O. hupensis snail distribution sites and 15 environmental variables were included in training sets of RF and MaxEnt models, and both RF and MaxEnt models had high predictive performance, with both mean AUC values of > 0.900 and all mean TSS values and Kappa values of > 0.800, and significant differences in the AUC (t = 19.862, P < 0.05), TSS (t = 10.140, P < 0.05) and Kappa values (t = 10.237, P < 0.05) between two models. The AUC, TSS and Kappa values of the ensemble model were 0.996, 0.954 and 0.920, respectively. Independent data verification showed that the AUC, TSS and Kappa values of the RF model and the ensemble model were all 1, which still showed high performance in unknown data modeling, and the MaxEnt model showed poor performance, with TSS and Kappa values of 0 for 24%(24/100) of the modeling results. The modeling results of 79 RF models, 38 MaxEnt models and their ensemble models with AUC values of > 0.950 and TSS values of > 0.850 were included in the evaluation of importance of environmental variables. The importance of annual sunshine duration (SSD) was 32.989%, 37.847% and 46.315% in the RF model, the MaxEnt model and their ensemble model, while the importance of annual mean relative humidity (RHU) was 30.947%, 15.921% and 28.121%, respectively. Important environment variables were concentrated in modeling results of the RF model, dispersed in modeling results of the MaxEnt model, and most concentrated in modeling results of the ensemble model. The potential distribution of O. hupensis snails after 2016 was predicted to be relatively concentrated in Yunnan Province by the RF model and relatively large by the MaxEnt model, and the distribution of O. hupensis snails predicted by the ensemble model was mostly the joint distribution of O. hupensis snails predicted by RF and MaxEnt models. Conclusions Both RF and MaxEnt models are effective to predict the potential distribution of O. hupensis snails in Yunnan Province, which facilitates targeted O. hupensis snail control.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

The occurrence of obesity has increased across the whole world. Many epidemiological studies have indicated that obesity strongly contributes to the development of cancer, cardiovascular diseases, type 2 diabetes, liver diseases and other disorders, accounting for a heavy burden on the public and on health-care systems every year. Excess energy uptake induces adipocyte hypertrophy, hyperplasia and formation of visceral fat in other non-adipose tissues to evoke cardiovascular disease, liver diseases. Adipose tissue can also secrete adipokines and inflammatory cytokines to affect the local microenvironment, induce insulin resistance, hyperglycemia, and activate associated inflammatory signaling pathways. This further exacerbates the development and progression of obesity-associated diseases. Although some progress in the treatment of obesity has been achieved in preclinical and clinical studies, the progression and pathogenesis of obesity-induced diseases are complex and unclear. We still need to understand their links to better guide the treatment of obesity and associated diseases. In this review, we review the links between obesity and other diseases, with a view to improve the future management and treatment of obesity and its co-morbidities.

Objective To investigate the correlation between iron metabolism index and intelligence development of Dongxiang and Han students in Dongxiang county and Lanzhou city of Gansu province.Methods A total of 396 students aged from 6 to 11 years old were randomly selected for venous blood collection from two primary schools with Dongxiang and Han children in Dongxiang county and Lanzhou city.Blood routine and serum iron metabolism indicators were detected and iron metabolism indicators from different ethnic groups were analyzed.Students diagnosed with iron deficiency anemia(IDA) named as IDA group,and students without IDA who had similar background were enrolled in the control group.The correlation between iron metabolism index and intelligence quotient was analyzed.Results The ferritin level of Dongxiang students (51.81 μg/L)was lower than that of Han students(65.73 μg/L),and total iron binding capacity of students in Dongxiang county [(65.04 ± 6.68) μ mol/L] was higher than that of students in Lanzhou city [(59.92 ±5.91) μmol/L].The transferrinsaturation of students in Dongxiang county [0.23 (0.19 ～ 0.30)] was lower than that of students in Lanzhou city[0.26(0.20 ～0.32)].The differences were statistically significant(P ＜0.05).Analysis of multiple linear regression showed that ferritin and serum iron were correlated to intelligence quotient score of the IDA students (P ＜ 0.05).Conclusion Ferritin and serum iron are associated with primary school students' intelligence quotient.Religious practice,regional economic and cultural level have a certain influence on iron metabolism of local primary school students.It is very important to strengthen the supplement of dietary iron in primary school students in Dongxiang County and reduce the prevalence of iron deficiency.

Objective To analyze the clinical characteristics of connective tissue disease related interstitial lung disease (CTD-ILD).Methods The demographic data,clinical manifestations,blood gas analysis,lung function,chest high resolution CT (HRCT),histopathology of 186 patients with CTD-ILD admitted in Jinhua Central Hospital from January 2013 to December 2017 were retrospectively analyzed.Results In 186 patients with CTD-ILD,70 were males and 116 were females,with a mean age of 56.22± 12.27.Among them,61 cases were polymyositis/dermatomyositis (DM/PM)-ILD,44 cases were rheumatoid arthritis (RA)-ILD,26 cases were interstitial pneumonia with autoimmune features (IPAF),16 cases were systemic sclerosis (SSc)-ILD,14 cases were Sjogren syndrome (SS)-ILD,11 cases were overlap syndrome (OS)-ILD,7 cases were systemic lupus erythematosus (SLE)-ILD,5 cases were undifferentiated connective tissue disease (UCTD)-ILD,and 2 cases were mixed connective tissue disease (MCTD)-ILD.The incidence of respiratory symptoms was higher than that of systemic symptoms,and the incidence of systemic symptoms was higher than that of skin symptoms.Cough was the most common symptom of respiratory system,and arthralgia was the most common symptom of systemic symptoms,accounting for 54.9％(101/186) and 48.9％ (91/186)respectively.Blood gas analysis showed that hypoxemia accounted for 56.5％(83/147) and type Ⅰ respiratory failure accounted for 26.5％(39/147).The proportion of restrictive ventilation dysfunction in pulmonary function tests was 70.9％(105/148) and the diffuse dysfunction was 81.1％(120/148).The manifestations on HRCT were reticular linear shadow (44.1％),ground-glass opacity (54.3％),consolidation (23.1％),nodules shadow (20.9％) and cystic low density shadow(9.1％).The histopathological diagnosis mainly was non-specific interstitial pneumonia (NSIP,43.0％) and usual interstitial pneumonia (UIP,40.0％).Conclusion The arterial blood gas analysis,lung function and chest HRCT screening,and lung histopathological examination are important for early identification and diagnosis of CTD-ILD.

Objective To investigate the value of three dimensional time-of-flight (3D-TO)F) and three dimensional fast imaging employing steady state acquisition (3D-FIESTA)sequences in evaluation on spatial relationship among trigeminal nerve,facial nerve and peripheral vessels before microvascular decompression(MVD)with 3.0 T MR.Methods Data of MRI of 36 patients with trigeminal neuralgia (TN) and 31 with hemifacial spasm (HFS) before MVD were analyzed retrospectively.The intra-observer agreement for the spatial relationship among trigeminal nerve,facial nerve and adjacent blood vessels were observed.The differences of occurrence rates of neurovascular compression (NVC) of symptomatic side and asymptomatic side in TN and HFS patients were compared.Taking surgical results as the gold standards,the diagnostic efficacy for neurovascular relationships of symptomatic side with 3D-TOF and 3D-FIESTA sequences were calculated.Results The consistency between two observers in assessing relationship of trigeminal nerve,facial nerve and adjacent blood vessels of symptomatic and asymptomatic was good (all Kappa≥0.75,all P＜0.001).In both of TN and HFS patients,the occurrence rates of NVC of symptomatic side were significantly higher than those of asymptomatic side (x2=26.13,20.81,both P＜ 0.001).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of 3D-TOF and 3D-FIESTA sequences in displaying relationship of trigeminal nerve and vascular was 97.22％ (35/36),97.06％ (33/34),100％ (2/2),100％ (33/33)and 66.67％ (2/3),respectively,of relationship between facial nerve and vascular was 93.55％ (29/31),96.55％ (28/29),50.00％ (1/2),96.55％ (28/29) and 50.00％ (1/2),respectively.Conclusion 3D-TOF and 3D-FIESTA sequences can clearly display the spatial relationship of nerve and adjacent vessels,therefore providing imaging evidences for MVD.

Objective To investigate the value of MR diffusion tensor imaging(DTI)in assessment of the microstructural changes of the trigeminal nerve,and analyze it's correlation with the degree of vascular compression. Methods Thirty-four patients with trigeminal neuralgia from November 2015 to April 2017 were retrospectively analyzed in this study.And they were treated by microvascular decompression(MVD). There were 11 cases of gradeⅠ,16 cases of gradeⅡand 7 cases of gradeⅢaccording to the severity of the contact between nerves and vessels during the operation. All of them were scanned with three dimensional time-of-flight(3D-TOF)sequences, three dimensional fast imaging employing steady state acquisition(3D-FIESTA)sequences and DTI before undergoing surgical decompression. According to the preoperative MR scans,the trigeminal nerves were divided into the healthy side without neurovascular contact (25 cases) and the healthy side with a neurovascular contact (9 cases).The DTI parameters of the trigeminal nerve,including the anisotropic fraction(FA)and the ADC values were obtained.Comparison of the FA and ADC values of the trigeminal nerve between the different stages of the affected side was performed with single factor analysis of variance, and the paired samples t test was used to compare the difference of FA and ADC values of bilateral trigeminal nerve. The difference of FA and ADC values between the asymptomatic side with or without vascular contact was compared with independent sample t test. Spearman correlation analysis was used to evaluate the correlation between DTI parameters and the degree of compression. Results The FA values of patients with grades Ⅰ,ⅡandⅢwere 0.311±0.009, 0.308±0.007 and 0.299±0.009 respectively,and there was significant difference among different levels(F=5.269,P<0.05).The ADC values of the three grades were(2.298 ± 0.309)×10-3,(2.214 ± 0.175)×10-3and (2.259 ± 0.248)×10-3mm2/s respectively, showing no statistically significant difference(F=0.402,P>0.05). The FA values of bilateral trigeminal nerves in healthy side without neurovascular contact and in healthy side with neurovascular contact were statistically significant (t=-32.528,-25.178,P<0.05). There was significant difference in the ADC value of bilateral trigeminal nerves in the group without neurovascular contact(t=2.162,P<0.05).There was no statistically significant difference in the ADC values of bilateral trigeminal nerves in the healthy side of the neurovascular contact group(P>0.05).There were no statistically significant differences in the FA and ADC values between the two groups on the healthy side of the trigeminal nerve(P>0.05).The FA value was negatively correlated with the degree of vascular compression (r=-0.453,P<0.05),while the ADC value was not correlated with the degree of vascular compression(P>0.05). Conclusion DTI imaging can be used to evaluate the degree of trigeminal nerve injury. More obvious vascular compression leads to lower FA value.

Clinical data, imaging finding, laboratory and pathology results of 8 patients with eosinophilic granulomatous polyangiitis(EGPA)admitted in our hospital from April 2014 to September 2016 were retrospectively analyzed.There were 7 cases with sinus involvement;8 cases with increased eosinophil counts in peripheral blood, bronchoalveolar lavage fluid(BALF)and induced sputum, and with negative antineutrophil cytoplasmic antibodies(ANCA).Lung function tests showed mild obstructive ventilation dysfunction in 7 cases, positive relaxation test or excitation test in 4 cases, and mild dispersion function decline in 4 cases.Chest CT revealed multiple ground glass shadows and peripheral pulmonary nodules in both lungs in 4 cases,and bronchial wall thickening in 1 case.Transbrochial lung biopsy(TBLB)indicated extravascular infiltration of acidophilic granulocytes.Four cases were treated by glucocorticoid monotherapy, the other 4 cases were treated by glucocorticoids combined with cyclophosphamide.All patients achieved clinical relief after treatment,but 3 cases recurred.For suspicious EGPA patients in addition to paranasal sinus CT,ANCA vasculitis index, urine routine and renal function tests,it is necessary to perform nasal mucosa,bronchial mucosa,transbrochial lung biopsy and BLAF, induced sputum cytology to obtain timely diagnosis and treatment.