Objective:To compare the efficacy of 18F-AlF-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-octreotide (OC) PET/CT and MRI in detecting liver metastases (LM) of neuroendocrine neoplasm (NENLM). Methods:18F-AlF-NOTA-OC PET/CT and MRI findings (dynamic contrast enhanced MRI and diffusion weighted imaging) of 44 patients (26 males, 18 females, age (53.8±13.4) years) with neuroendocrine neoplasm (NEN) confirmed by pathological or clinical follow-up in the First Affiliated Hospital of Zhengzhou University from July 2021 to December 2023 were retrospectively analyzed. According to the size of LM, patients were divided into 3 groups with long diameter ≤1 cm, 1 cm< long diameter ≤2 cm and long diameter >2 cm. According to the 2019 WHO pathological grade, patients were divided into G1, G2, G3 and neuroendocrine carcinoma groups. McNemar χ2 test was used to compare the difference in detecting LM and lesions between the two methods. Results:The detection rate of 18F-AlF-NOTA-OC PET/CT and MRI in patients with NENLM was 95.45%(42/44). Among 44 patients, 227 lesions were detected by PET/CT and 303 were detected by MRI. Based on lesion analysis ( n=307), the detection rate of 18F-AlF-NOTA-OC PET/CT for NENLM was lower than that of MRI (73.94%(227/307) vs 98.70%(303/307); χ2=66.96, P<0.001). For NENLM with long diameter ≤1 cm, 1 cm < long diameter ≤2 cm, long diameter >2 cm, the detection rates of MRI were higher than those of 18F-AlF-NOTA-OC PET/CT (98.72%(77/78), 93.55%(116/124), 97.35%(110/113) vs 47.44%(37/78), 73.39%(91/124), 87.61%(99/113); χ2 values: 5.88-36.21, all P<0.05). Conclusions:Compared with 18F-AlF-NOTA-OC PET/CT, MRI has a higher detection rate for NENLM with different long diameters of NEN, especially for lesions with long diameter≤1 cm.

Objective:To compare the efficacy of 18F-AlF-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-octreotide (OC) PET/CT and MRI in detecting liver metastases (LM) of neuroendocrine neoplasm (NENLM). Methods:18F-AlF-NOTA-OC PET/CT and MRI findings (dynamic contrast enhanced MRI and diffusion weighted imaging) of 44 patients (26 males, 18 females, age (53.8±13.4) years) with neuroendocrine neoplasm (NEN) confirmed by pathological or clinical follow-up in the First Affiliated Hospital of Zhengzhou University from July 2021 to December 2023 were retrospectively analyzed. According to the size of LM, patients were divided into 3 groups with long diameter ≤1 cm, 1 cm< long diameter ≤2 cm and long diameter >2 cm. According to the 2019 WHO pathological grade, patients were divided into G1, G2, G3 and neuroendocrine carcinoma groups. McNemar χ2 test was used to compare the difference in detecting LM and lesions between the two methods. Results:The detection rate of 18F-AlF-NOTA-OC PET/CT and MRI in patients with NENLM was 95.45%(42/44). Among 44 patients, 227 lesions were detected by PET/CT and 303 were detected by MRI. Based on lesion analysis ( n=307), the detection rate of 18F-AlF-NOTA-OC PET/CT for NENLM was lower than that of MRI (73.94%(227/307) vs 98.70%(303/307); χ2=66.96, P<0.001). For NENLM with long diameter ≤1 cm, 1 cm < long diameter ≤2 cm, long diameter >2 cm, the detection rates of MRI were higher than those of 18F-AlF-NOTA-OC PET/CT (98.72%(77/78), 93.55%(116/124), 97.35%(110/113) vs 47.44%(37/78), 73.39%(91/124), 87.61%(99/113); χ2 values: 5.88-36.21, all P<0.05). Conclusions:Compared with 18F-AlF-NOTA-OC PET/CT, MRI has a higher detection rate for NENLM with different long diameters of NEN, especially for lesions with long diameter≤1 cm.

Objective:To explore the effects of dopamine receptor D2(DRD2)on astrocytic dedifferentiation based on SOX2-regulated genes in neural stem cells(NSCs)and astrocytes.Methods:Immunofluorescence staining and SOX2-GFP mice were used to examine the lineage differentiation of SOX2-positive cells during the development of cere-bral cortex.Primary NSCs/astrocytes culture,ChIP-seq and Western Blot were adopted to analyze and verify the expres-sion of candidate genes.Pharmacological manipulation,neurosphere formation,photochemical ischemia,immunofluo-rescence staining and behavior tests were adopted to evaluate the effects of activating DRD2 signaling on astrocytic dedif-ferentiation.Results:Immunofluorescence staining demonstrated the NSC-astrocyte switch of SOX2-expression in the normal development of cerebral cortex.ChIP-seq revealed enrichment of DRD2 signaling by SOX2-bound enhancers in NSCs and SOX2-bound promoters in astrocytes.Western Blot and immunofluorescence staining verified the expression of DRD2 in NSCs and reactive astrocytes.Application of quinagolide hydrocholoride(QH),an agonist of DRD2,signifi-cantly promoted astrocytic dedifferentiation both in vitro and in vivo following ischemia.In addition,quinagolide hydro-choloride treatment improved locomotion recovery.Conclusion:Activating DRD2 signaling facilitates astrocytic dedif-ferentiation and may be used to treat ischemic stroke.

BACKGROUND:At present,open reduction and internal fixation and minimally invasive needle aspiration are commonly used in patients with Sanders types Ⅱ and Ⅲ calcaneal fractures.However,there is little comparison between the clinical efficacy of the two methods and high-level clinical evidence is still available. OBJECTIVE:To compare the curative effect of Sanders types Ⅱ and Ⅲ calcaneal fractures treated by three-dimensional digital model-assisted minimally invasive needle penetration and tarsal sinus incision and manual reduction and internal fixation with steel plate. METHODS:From January 2021 to October 2022,80 patients with Sanders types Ⅱ and Ⅲ calcaneal fractures who were treated in the Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with manual reduction and internal fixation with steel plate through the traditional tarsal sinus incision,while the observation group was treated with a three-dimensional digital model assisted with minimally invasive needle penetration fixation.The operation time,blood loss,hospitalization time and fracture healing time of the two groups were recorded.The changes in Maryland score,AO-FAS score,pain visual analog scale score,quality of life score(SF-36 score),and imaging parameters(B?hler angle,Gissane angle,calcaneal length,width and height)were observed before and 12 months after operation in the two groups.The complications during the follow-up were recorded. RESULTS AND CONCLUSION:(1)Operation time,blood loss,hospitalization time and fracture healing time in the observation group were lower than those in the control group(all P<0.05).(2)The Maryland score,AO-FAS score,SF-36 score,B?hler angle,Gissane angle,calcaneal length and height of the two groups after treatment were significantly higher than those before treatment(all P<0.05).Visual analog scale score and calcaneal width were significantly lower than those before treatment(all P<0.05).(3)After 12 months of follow-up,the incidence of complications in the observation group was lower than that in the control group(all P<0.05).(4)In conclusion,the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures with three-dimensional digital model-assisted minimally invasive needle penetration fixation can significantly improve the operation time,bleeding volume and other perioperative indicators,and can reduce the occurrence of multiple complications.The recovery of ankle function,relief of pain symptoms,and improvement of quality of life are equivalent to traditional therapy.

The cognitive impairment of diabetes mellitus type 2(T2DM)is closely related to neurovascular coupling(NVC)changes,but the exact mechanism remains unclear.Functional MRI(fMRI)technology were able to jointly analyze NVC changes of T2DM,providing new ideas for revealing the mechanism of cognitive dysfunction caused by T2DM.The progresses of fMRI for exploring NVC changes in T2DM were reviewed in this article.

Objective:To explore the clinical characteristics and risk factors of abnormal urinary albumin/creatinine ratio(UACR) in obese population.Methods:Baseline data from 2011 to 2012 in Henan Sub-center of"Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal(REACTION) study"were utilized and those of body mass index≥28 kg/m 2 were screened. The patients were divided into UACR normal group and UACR abnormal group(101 pairs) upon being matched on a 1∶1 basis by age and gender. Multivariate logistic regression analysis, receiver operating characteristic(ROC) curve, and restricted cubic spline(RCS)analysis were performed to explore the risk factors for abnormal UACR. Results:Compared with the normal UACR group, the UACR abnormal group had a higher number of alcohol consumers, a higher prevalence of hypertension, elevated systolic blood pressure, and triglyceride(all P<0.05). Multivariate logistic regression analysis showed that alcohol consumption( P=0.008), systolic blood pressure( P<0.001), triglyceride( P=0.049), and homeostasis model assessment for insulin resistance(HOMA-IR, P=0.033) were independent risk factors for abnormal UACR in obese people. The ROC curve analysis indicated that systolic blood pressure had the strongest diagnostic performance as a single factor(ROC curve area=0.801), and there was no significant difference in diagnostic performance compared to multiple factors combination. RCS analysis results showed that the probability of abnormal UACR increased monotonically with the increase of systolic blood pressure when the systolic blood pressure was between 130 and 158 mmHg(1 mmHg=0.133 kPa). When systolic blood pressure was not in the interval, the probability of abnormal UACR did not change significantly. The results of regression analysis of triglyceride subgroup showed that when triglyceride level was greater than or equal to 5.6 mmol/L, the risk of abnormal UACR level was significantly increased( P=0.029). Conclusion:Systolic blood pressure, triglyceride, HOMA-IR, and alcohol drinking history are independent risk factors for abnormal UACR in obese people. When systolic blood pressure is≥130 mmHg or triglyceride is≥5.6 mmol/L, the risk of abnormal UACR is significantly increased.

Objective: To explore the intervention effect of group counseling integrating teadrinking on depression, social avoidance and distress, coping styles and selfesteem among college students, so as to provide references for promoting the psychological health of students. Methods: From March to June 2021, a convenience sampling method was used to recruit 46 college students from a university in Nanjing for intervention project. There were 23 students in intervention group and control group, respectively. The intervention was conducted for 2.5 hours per week across a 6 week period. The intervention group received two sessions of group counseling that incorporated teadrinking experience, and the sessions involved tea knowledge explanation, observation and learning, embodied experience, emotional expression, interpersonal assistance and emotional support, cultural customs and life integration. After the intervention was completed, the control group received onetime group counseling that integrated teadrinking. The Wilcoxon difference test and Mann-Whitney U test were performed to compare the scores of each scale within and between the groups, and the χ2 test was used to compare the detection rates. Results: There were no statistically significant differences in the scores of positive coping, negative coping, selfesteem, social avoidance and distress between the intervention group and the control group (Z=-1.20, -0.33, -0.35, 1.31,P>0.05). There were statistically significant differences in positive coping styles, selfesteem, social avoidance and distress between the intervention group and the control group after the intervention(27.70±5.60，22.05±4.30；30.52±3.63，28.27±4.06；7.43±7.38，13.64±6.79) (Z=-3.31, -2.10, 3.22, P<0.05). The intervention group showed statistically significant differences in social avoidance and distress scores before and after the intervention(11.96±7.47,7.43±7.38) (Z=-2.88), and the depression detection rate decreased(60.9%，30.4%) (χ2=4.29) (P<0.05). There were no statistically significant differences in positive coping, negative coping, selfesteem, social avoidance and distress scores, and depression detection rate between the control group before and after the intervention (Z/χ2=-0.28, -0.42, -1.24, -1.25；1.39, P>0.05). The followup results 1year later showed that there was a statistically significant difference in social avoidance and distress(6.57±6.21,14.16±9.22), and in the detection rates of depression(21.7%,52.2%) between the intervention group and the control group (Z/χ2=2.70,4.57,P<0.05). Conclusions Group counseling integrating teadrinking could improve interpersonal relationships, emotional states, selfesteem levels and coping strategies among college students. Group psychological counseling that incorporates teadrinking can be adopted to improve the mental health status of college students.

Objective:To analyze Helicobacter pylori（Hp）infection and drug resistance in outpatient children in Wuxi，Jiangsu Province，China，and guide the rational use of drugs.Methods:The clinical data of children who were treated in the outpatient clinic of the Gastroenterology Department at Wuxi Children's Hospital for upper gastrointestinal symptoms and underwent gastroscopy from January 2020 to February 2024 were collected.The Hp infection and drug resistance status were analyzed.Results:A total of 2 119 children with upper gastrointestinal symptoms underwent gastroscopy，of which 669 children（31.6%）had positive gastric mucosal Hp isolation and culture，including 363 males and 306 females，and there was no significant difference in Hp positivity rate between different genders（ P>0.05）.There were 41（6.1%）cases aged <8 years，300（44.8%）casesa ged 8~12 years，and 328（49.0%）cases aged 13~18 years，respectively，and the positive rate of Hp in the age group of 13~18 years was higher than those in 8~12 years and <8 years old，respectively，and the difference was statistically significant（ χ2=236.174， P<0.001）.The results of the antimicrobial susceptibility test showed that the resistance rates of 669 strains of Hp to metronidazole,clarithromycin,and levofloxacin were 72.2%(483/669),33.5%(224/669),and 16.3%(109/669),respectively.No strains resistant to furazolidone，amoxicillin，or tetracycline were found.There were 314(46.9%) strains with dual drug resistance,and the drug resistance rates to metronidazole+clarithromycin,metronidazole+levofloxacin,and clarithromycin+levofloxacin were 23.5%(157/669),14.2%(95/669),and 9.3%(62/669),respectively.There were 48(7.2%) triple drug-resistant strains,all of which were resistant to metronidazole+clarithromycin+levofloxacin.There were no significant differences in the resistance rates of Hp to metronidazole，clarithromycin，and levofloxacin across different genders and among age groups（ P>0.05）. Conclusion:Children with Hp infection in Wuxi area are mainly older children.The resistance rates of Hp to metronidazole and clarithromycin are high,so it is not recommended to use them for empirical Hp eradication treatment.It is suggested that individualized eradication treatment should be carried out according to the results of drug sensitivity test.

Objective:To analyze Helicobacter pylori（Hp）infection and drug resistance in outpatient children in Wuxi，Jiangsu Province，China，and guide the rational use of drugs.Methods:The clinical data of children who were treated in the outpatient clinic of the Gastroenterology Department at Wuxi Children's Hospital for upper gastrointestinal symptoms and underwent gastroscopy from January 2020 to February 2024 were collected.The Hp infection and drug resistance status were analyzed.Results:A total of 2 119 children with upper gastrointestinal symptoms underwent gastroscopy，of which 669 children（31.6%）had positive gastric mucosal Hp isolation and culture，including 363 males and 306 females，and there was no significant difference in Hp positivity rate between different genders（ P>0.05）.There were 41（6.1%）cases aged <8 years，300（44.8%）casesa ged 8~12 years，and 328（49.0%）cases aged 13~18 years，respectively，and the positive rate of Hp in the age group of 13~18 years was higher than those in 8~12 years and <8 years old，respectively，and the difference was statistically significant（ χ2=236.174， P<0.001）.The results of the antimicrobial susceptibility test showed that the resistance rates of 669 strains of Hp to metronidazole,clarithromycin,and levofloxacin were 72.2%(483/669),33.5%(224/669),and 16.3%(109/669),respectively.No strains resistant to furazolidone，amoxicillin，or tetracycline were found.There were 314(46.9%) strains with dual drug resistance,and the drug resistance rates to metronidazole+clarithromycin,metronidazole+levofloxacin,and clarithromycin+levofloxacin were 23.5%(157/669),14.2%(95/669),and 9.3%(62/669),respectively.There were 48(7.2%) triple drug-resistant strains,all of which were resistant to metronidazole+clarithromycin+levofloxacin.There were no significant differences in the resistance rates of Hp to metronidazole，clarithromycin，and levofloxacin across different genders and among age groups（ P>0.05）. Conclusion:Children with Hp infection in Wuxi area are mainly older children.The resistance rates of Hp to metronidazole and clarithromycin are high,so it is not recommended to use them for empirical Hp eradication treatment.It is suggested that individualized eradication treatment should be carried out according to the results of drug sensitivity test.

Pulmonary hypertension (PH) is an insidious pulmonary vasculopathy with high mortality and morbidity and its underlying pathogenesis is still poorly delineated. The hyperproliferation and apoptosis resistance of pulmonary artery smooth muscle cells (PASMCs) contributes to pulmonary vascular remodeling in pulmonary hypertension, which is closely linked to the downregulation of fork-head box transcriptional factor O1 (FoxO1) and apoptotic protein caspase 3 (Cas-3). Here, PA-targeted co-delivery of a FoxO1 stimulus (paclitaxel, PTX) and Cas-3 was exploited to alleviate monocrotaline-induced pulmonary hypertension. The co-delivery system is prepared by loading the active protein on paclitaxel-crystal nanoparticles, followed by a glucuronic acid coating to target the glucose transporter-1 on the PASMCs. The co-loaded system (170 nm) circulates in the blood over time, accumulates in the lung, effectively targets the PAs, and profoundly regresses the remodeling of pulmonary arteries and improves hemodynamics, leading to a decrease in pulmonary arterial pressure and Fulton's index. Our mechanistic studies suggest that the targeted co-delivery system alleviates experimental pulmonary hypertension primarily via the regression of PASMC proliferation by inhibiting cell cycle progression and promoting apoptosis. Taken together, this targeted co-delivery approach offers a promising avenue to target PAs and cure the intractable vasculopathy in pulmonary hypertension.