BACKGROUND:The application of high-frequency ultrasound technology provides an effective tool for the precise assessment of skeletal muscle morphology in the elderly.However,the correlation between the morphological parameters of skeletal muscle obtained and physical activity capacity remains unclear. OBJECTIVE:To explore the correlation between morphological parameters of the gastrocnemius muscle and physical activity capacity in elderly females using high-frequency ultrasound imaging technology,thereby identifying effective predictive indicators for physical activity capacity in the elderly. METHODS:Fifty-nine elderly female subjects over the age of 60 with the ability to live independently were recruited in the communities surrounding Shanghai Sanda University.High-frequency ultrasound images of the subjects'gastrocnemius muscles were collected to obtain the relevant parameters,including muscle thickness,fiber length,pennation angle,and fiber length/muscle thickness(Lf/Tm)index.Physical activity capacity tests were also conducted and relevant indicators included the 10-meter walk test,timed up-and-go test,30-second chair stand test,and grip strength test.Correlation analyses were performed between various morphological parameters and physical activity capacity test indicators. RESULTS AND CONCLUSION:Significant correlations were found between various muscle morphological parameters(P<0.05).The pennation angle showed significant correlations with the 10-meter walking speed(r=-0.35,P<0.05)and timed up-and-go test results(r=0.32,P<0.05).The Lf/Tm index was positively correlated with 10-meter walking speed and grip strength test results(r=0.39,P<0.01;r=0.30,P<0.05),but was negatively correlated with timed up-and-go test results(r=-0.32,P<0.05).All these findings indicate that the pennation angle and Lf/Tm index of the gastrocnemius muscle show a good correlation with physical activity capacity in elderly females,which can serve as effective predictive indicators for physical activity capacity.

Background and purpose:The treatment of recurrent,metastatic,and treatment-na?ve advanced cervical cancer remains challenging.Immunotherapy in combination with chemotherapy and targeted therapy has shown preliminary clinical benefits,however,current evidence remains limited.This study aimed to evaluate the impact of camrelizumab combined with chemotherapy and targeted therapy on the prognosis of patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer.Methods:In this study,we conducted a retrospective analysis of the clinical data from 130 patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer admitted to Minhang Branch of Fudan University Shanghai Cancer Center from 2019 to 2025.The patients were categorized into the observation group(n=70),which included those who received camrelizumab with or without chemotherapy and targeted therapy,and the control group(n=60),including those who received chemotherapy and targeted therapy.Survival analysis was performed using the log-rank test,and univariate and multivariate Cox regression analyses were conducted to explore prognostic factors.This study was approved by the Ethics Committee of the Minhang Branch of Fudan University Shanghai Cancer Center[Approval number:(2024)Review No.(015)]and all informed consents were exempted.Results:The objective response rate(ORR)in the observation group was 72.9%,and the disease control rate(DCR)was 80.0%,which were significantly higher than those in the control group with an ORR of 20.0%(χ2=36.1,P＜0.001)and a DCR of 40.0%(χ2=21.8,P＜0.001).The median progression-free survival(PFS)in the observation group was not reached,significantly longer than that in the control group of 7.0 months(P＜0.001).Multivariate Cox regression analysis identified camrelizumab treatment as an independent protective factor for PFS(P＜0.001).Age,site of recurrence/metastasis,initial treatment approach,and histopathological type were not significantly associated with PFS.In the observation group,adverse events of grade 3 or higher were reported in 29 patients(41.4%),which primarily included vasculitis,hypothyroidism,hypersensitivity reactions,and diarrhea.Conclusion:The use of camrelizumab significantly improved treatment outcomes and prognosis for patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer,with significantly improved progression-free survival.Although a certain proportion of patients experienced adverse events of grade 3 or higher,the overall safety profile was acceptable.In clinical practice,immunotherapy offers a more effective treatment option for patients.

Objective:To summarize the clinical characteristics and treatment experience of patients with botulism after cosmetic botulinum toxin injection.Methods:A retrospective study was conducted on patients admitted to the Department of Medical Aesthetic and Plastic Surgery of the Fifth Affiliated Hospital of Zhengzhou University for botulism after cosmetic botulinum toxin injection between January 1, 2023, and October 31, 2024. Clinical data and treatment regimens were collected. Patients received botulinum antitoxin injection, neurotrophic therapy, nutrition supplementation, modulation and enhancement of cellular immune function, and systemic supportive care based on their condition. Prior to antitoxin administration, a skin test was performed. Patients with a negative test received intramuscular injections of 10 000 U of antitoxin serum every 12 hours, while those with a positive result underwent a desensitization protocol. The cessation criterion was significant improvement of toxic symptoms. Data collected included age, gender, region, time of presentation, injection location, brand and type of toxin, injection time, sites and dose of injection, time to onset of initial symptoms, main symptoms, skin test result for antitoxin, dosage of antitoxin administered, length of hospital stay, adverse reactions and prognosis. Data analysis was performed using GraphPad Prism Version 10.2.0.Results:A total of 179 patients were included, with 8 cases in 2023 and 171 cases in 2024. The majority were female (97.2%, 174 cases). The age range was 18-62 years, with a median age of 35 years; the highest proportion was in the 20-40 age group (71.5%, 128 cases). Patients were from 23 different provinces, autonomous regions, and municipalities directly under the central government in China. The injected product was mostly an unspecified brand of botulinum toxin (57.5%, 103 cases). Injections were primarily administered in non-medical institutions, with beauty salons or private studios accounting for 88.8% (159 cases). Injection sites included the platysma (92 cases), masseter muscle (82 cases), orbicularis oculi muscle (82 cases), frontalis muscle (67 cases), among others, with some patients receiving injections at multiple sites. 69 cases (38.5%) of patients were unaware of the injected dose; for the remaining cases, based on information provided, the injected doses were all within the safe range. The incubation period was mostly 1-7 days. The main symptoms included fatigue (171 cases), dysphagia (137 cases), dizziness (101 cases), blurred vision (76 cases), and difficulty opening eyes (66 cases). 176 patients received botulinum antitoxin treatment; 82 cases (46.6%) had a positive skin test and received desensitization injections, while 94 cases (53.4%) had a negative test. The total dosage of antitoxin used ranged from 10 000 U to 240 000 U. Three patients received only adjuvant therapy such as neurotrophic support. Adverse reactions during treatment primarily included induration at the injection site and serum sickness, all of which resolved after symptomatic treatment with antihistamines, steroids, etc. The hospital stay ranged from 1 to 24 d, with an average of 4.6 d. Upon discharge, symptoms in all patients had alleviated or resolved. At the 6-month follow-up after discharge, 14 patients were lost to follow-up; the remaining patients recovered well with no other complications.Conclusion:Poisoning incidents due to the illegal or improper use of botulinum toxin are increasing. Administration of botulinum antitoxin is an effective means to ameliorate intoxicating symptoms. Patients should seek timely medical intervention and receive antitoxin treatment as early as possible. Desensitization administration does not affect the efficacy of the antitoxin.

OBJECTIVE To explore the effect of fluconazole on proteomics of Trichosporon asahii so as to reveal the responding process of T.asahii to fluconazole stress and the resistance mechanisms to azoles on the protein level.METHODS T.asahii AS 2.2174 was chosen as the research subject,the minimum inhibitory concentration(MIC)of fluconazole was determined by broth microdilution assay.The protein abundance of T.asahii was detec-ted by means of tandem mass tag(TMT)technique combined with liquid chromatography-tandem mass spectrom-etry(LC-MS/MS)before and after the treatment with fluconazole(1× MIC).The differentially expressed pro-teins(DEPs)were identified based on the screening standards of fold change ≥1.20 or ≤0.83 and P＜0.05.Gene ontlogy(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis were performed for the DEPs so as to understand the biological property of the DEPs and the major biological pathways that the DEPs in-volved in.Finally,the targeted validation was carried out for the targeted differentially expressed proteins by using multiple reaction monitoring(MRM).RESULTS The MIC of fluconazole to T.asahii AS 2.2174 was 8 μg/ml.Totally 196 DEPs were identified,including 93 upregulated DEPs and 103 downregulated DEPs.The function en-richment analysis showed that the DEPs mainly participated in synthesis and metabolism of sterols,drug metabo-lism,stress response,energy metabolism and intertranslation.The targeted DEPs showed the consistent expres-sion trends in MRM target validation and TMT-LC-MS/MS.CONCLUSIONS The protein abundance of T.asahii has remarkable change under the fluconazole stress.The bioinformatics analysis reveals the complicated molecular mechanisms of T.asahii in response to the fluconazole stress,which may offer valuable ideas for understanding the drug resistance to azoles and developing new drug targets.

OBJECTIVE: To explore the genetic basis for a boy affected with Cohen syndrome. METHODS: A boy admitted to Children's Hospital of Nanjing Medical University in January 2021 was selected as the study subject. Genome DNA was extracted from peripheral blood samples from the child and his parents. Whole exome sequencing (WES) was carried out. And candidate variants were verified by Sanger sequencing. This study was approved by the Medical Ethics Committee of the hospital (Ethics No.: 202106060-1). RESULTS: WES revealed that the child has harbored compound heterozygous variants of the VPS13B gene, namely c.1563+1G>A and c.3007insC (p.A1003Afs*13), which were inherited from his mother and father, respectively. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were rates as pathogenic. The c.3007insC (p.A1003Afs*13) was unreported previously. CONCLUSION The compound heterozygous variants c.1563+1G>A and c.3007insC (p.A1003Afs*13) of the VPS13B gene probably underlay the pathogenesis of Cohen syndrome in this child. Above finding has enriched the mutational spectrum of VPS13B gene.
Humans ; Male ; Vesicular Transport Proteins/genetics* ; Intellectual Disability/genetics* ; Muscle Hypotonia/genetics* ; Microcephaly/genetics* ; Fingers/abnormalities* ; Myopia/genetics* ; Obesity/genetics* ; Developmental Disabilities/genetics* ; Mutation ; Exome Sequencing ; Child ; Heterozygote ; Retinal Degeneration

Objective:To summarize the clinical characteristics and treatment experience of patients with botulism after cosmetic botulinum toxin injection.Methods:A retrospective study was conducted on patients admitted to the Department of Medical Aesthetic and Plastic Surgery of the Fifth Affiliated Hospital of Zhengzhou University for botulism after cosmetic botulinum toxin injection between January 1, 2023, and October 31, 2024. Clinical data and treatment regimens were collected. Patients received botulinum antitoxin injection, neurotrophic therapy, nutrition supplementation, modulation and enhancement of cellular immune function, and systemic supportive care based on their condition. Prior to antitoxin administration, a skin test was performed. Patients with a negative test received intramuscular injections of 10 000 U of antitoxin serum every 12 hours, while those with a positive result underwent a desensitization protocol. The cessation criterion was significant improvement of toxic symptoms. Data collected included age, gender, region, time of presentation, injection location, brand and type of toxin, injection time, sites and dose of injection, time to onset of initial symptoms, main symptoms, skin test result for antitoxin, dosage of antitoxin administered, length of hospital stay, adverse reactions and prognosis. Data analysis was performed using GraphPad Prism Version 10.2.0.Results:A total of 179 patients were included, with 8 cases in 2023 and 171 cases in 2024. The majority were female (97.2%, 174 cases). The age range was 18-62 years, with a median age of 35 years; the highest proportion was in the 20-40 age group (71.5%, 128 cases). Patients were from 23 different provinces, autonomous regions, and municipalities directly under the central government in China. The injected product was mostly an unspecified brand of botulinum toxin (57.5%, 103 cases). Injections were primarily administered in non-medical institutions, with beauty salons or private studios accounting for 88.8% (159 cases). Injection sites included the platysma (92 cases), masseter muscle (82 cases), orbicularis oculi muscle (82 cases), frontalis muscle (67 cases), among others, with some patients receiving injections at multiple sites. 69 cases (38.5%) of patients were unaware of the injected dose; for the remaining cases, based on information provided, the injected doses were all within the safe range. The incubation period was mostly 1-7 days. The main symptoms included fatigue (171 cases), dysphagia (137 cases), dizziness (101 cases), blurred vision (76 cases), and difficulty opening eyes (66 cases). 176 patients received botulinum antitoxin treatment; 82 cases (46.6%) had a positive skin test and received desensitization injections, while 94 cases (53.4%) had a negative test. The total dosage of antitoxin used ranged from 10 000 U to 240 000 U. Three patients received only adjuvant therapy such as neurotrophic support. Adverse reactions during treatment primarily included induration at the injection site and serum sickness, all of which resolved after symptomatic treatment with antihistamines, steroids, etc. The hospital stay ranged from 1 to 24 d, with an average of 4.6 d. Upon discharge, symptoms in all patients had alleviated or resolved. At the 6-month follow-up after discharge, 14 patients were lost to follow-up; the remaining patients recovered well with no other complications.Conclusion:Poisoning incidents due to the illegal or improper use of botulinum toxin are increasing. Administration of botulinum antitoxin is an effective means to ameliorate intoxicating symptoms. Patients should seek timely medical intervention and receive antitoxin treatment as early as possible. Desensitization administration does not affect the efficacy of the antitoxin.

OBJECTIVE To explore the effect of fluconazole on proteomics of Trichosporon asahii so as to reveal the responding process of T.asahii to fluconazole stress and the resistance mechanisms to azoles on the protein level.METHODS T.asahii AS 2.2174 was chosen as the research subject,the minimum inhibitory concentration(MIC)of fluconazole was determined by broth microdilution assay.The protein abundance of T.asahii was detec-ted by means of tandem mass tag(TMT)technique combined with liquid chromatography-tandem mass spectrom-etry(LC-MS/MS)before and after the treatment with fluconazole(1× MIC).The differentially expressed pro-teins(DEPs)were identified based on the screening standards of fold change ≥1.20 or ≤0.83 and P＜0.05.Gene ontlogy(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis were performed for the DEPs so as to understand the biological property of the DEPs and the major biological pathways that the DEPs in-volved in.Finally,the targeted validation was carried out for the targeted differentially expressed proteins by using multiple reaction monitoring(MRM).RESULTS The MIC of fluconazole to T.asahii AS 2.2174 was 8 μg/ml.Totally 196 DEPs were identified,including 93 upregulated DEPs and 103 downregulated DEPs.The function en-richment analysis showed that the DEPs mainly participated in synthesis and metabolism of sterols,drug metabo-lism,stress response,energy metabolism and intertranslation.The targeted DEPs showed the consistent expres-sion trends in MRM target validation and TMT-LC-MS/MS.CONCLUSIONS The protein abundance of T.asahii has remarkable change under the fluconazole stress.The bioinformatics analysis reveals the complicated molecular mechanisms of T.asahii in response to the fluconazole stress,which may offer valuable ideas for understanding the drug resistance to azoles and developing new drug targets.

To explore the understanding of the target population regarding the Get Active Questionnaire for Pregnancy(GAQ-P)and the Companion Health Care Provider Consultation Form for Prenatal Physical Activity(cHCP-CF-PPA)in the Chinese context,and to verify the consistency of the Chinese version of the prenatal physical activity dual screening questionnaire with the original version in terms of language expression,27 pregnant women and 12 healthcare providers were selected from Obstetrics and Gynecology Hospital,Fudan University during Aug and Oct 2023,and were interviewed using purposive sampling.Two rounds of cognitive interviews were conducted.The first round revealed that some respondents experienced ambiguities in understanding the meanings of 5 items in the questionnaire.Following modifications,the second round indicated that the revised items were consistent in meaning with the original questionnaire.Cognitive interviews can facilitate the adaptation of the prenatal physical activity dual screening questionnaire to the Chinese cultural context,improve the understanding of the questionnaire items among the target population,and promote the localization of the screening tool.

Objective To analyze the correlation between right atrial strain at various stages and various influencing factors in patients with pulmonary hypertension,and to explore the role of right atrial strain in the assessment of pulmonary hypertension.Methods A total of 239 cases diagnosed with pulmonary hypertension who underwent echocardiography and complete right heart catheterization at hospital from October 2021 to December 2023 were included.Conventional ultrasound parameters such as right heart strain,right atrial area(RA area),inferior vena cava diameter(IVC diameter),and collapse rate of the inferior vena cava(IVC diameter changes)were measured.The heart rate(HR)corresponding to the ultrasound images were recorded.General information such as age and gender,as well as catheter data including mean right atrial pressure(mRAP),mean pulmonary artery pressure(mPAP),and pulmonary vascular resistance(PVR),were collected.The relationship between right atrial strain and its influencing factors was analyzed,and further analysis was conducted by dividing into shunt group and non-shunt group based on the presence or absence of left-to-right shunt disease.Results The correlation with RA reservoir strain(RASr)from high to low is RV global strain(RV4CSL),RV free wall strain(RVFWSL),RA area,IVC diameter,mRAP,age,HR,and PVR;the correlation with RAconduit strain(RAScd)from high to low is RV4CSL,RVFWSL,RA area,IVC diameter,mRAP,age,PVR,and HR;the correlation with RA contraction strain(RASct)from high to low is RA area,RV4CSL,RVFWSL,mRAP,IVC diameter,and HR.The collapse rate of the inferior vena cava is correlated with strain at various stages of the right atrium;gender is correlated with RASr and RASct.Conclusions Right atrial strain can reflect changes in right atrial function,with the highest correlation to right ventricular strain and right atrial area.Right atrial strain can indicate the severity of right ventricular function and right atrial remodeling,serving as an evaluative index for the condition and treatment outcomes of pulmonary arterial hypertension.

Background and Aims:Laparoscopic pancreaticoduodenectomy(LPD)has become a preferred approach for periampullary tumors,yet delayed gastric emptying(DGE)remains a frequent complication that hampers postoperative recovery.The nasojejunal feeding tube(NJT)is commonly used for early enteral nutrition,but its impact on DGE is controversial.This study aimed to evaluate whether intraoperative NJT placement increases the risk of DGE after LPD and to assess its influence on postoperative recovery outcomes.Methods:A retrospective cohort of 319 patients who underwent LPD at Provincial Hospital Affiliated to Shandong First Medical University from April 2017 to November 2023 was analyzed.Patients were divided into two groups based on intraoperative NJT placement(NJT group,n=200;non-NJT group,n=119).The incidence of DGE and postoperative outcomes were compared.Multivariate logistic regression and propensity score matching(PSM)were performed to identify independent risk factors for DGE.Results:The incidence of grade B/C DGE was significantly higher in the NJT group than in the non-NJT group(36.5%vs.21.8%,P=0.006).NJT placement was associated with longer postoperative hospital stay and higher hospitalization costs(both P<0.05).Multivariate analysis revealed intraoperative NJT placement(OR=1.960,95%CI=1.142-3.363,P=0.015)and intraoperative blood loss>400 mL(OR=1.921,95%CI=1.155-3.194,P=0.012)as independent risk factors for DGE.These findings were consistent after PSM.Conclusions:Prophylactic intraoperative NJT placement confers no additional benefit for postoperative recovery after LPD and is associated with a higher risk of DGE,prolonged hospitalization,and increased medical costs.Routine NJT placement should therefore be avoided,and individualized strategies should be adopted to minimize postoperative complications and enhance recovery.