Antibody-negative autoimmune encephalitis （AE） in children poses certain challenges for clinical diagnosis and treatment due to the lack of characteristic autoantibodies. This study conducts a retrospective analysis of the clinical data of a boy， aged 7 years， who had the main manifestations of “irritability， vomiting， pyrexia， and lethargy”. Video electroencephalography showed diffuse slow waves， with the presence of type 2 cerebrospinal fluid oligoclonal bands， and the boy was tested negative for related autoantibodies in blood and cerebrospinal fluid. Finally the boy was diagnosed with antibody-negative AE. After admission， the boy received first-line immunotherapy with methylprednisolone and intravenous immunoglobulin， combined with tocilizumab for intensive treatment， and the symptoms were rapidly relieved. At 1 week after discharge， the boy experienced memory loss， and head MRI suggested cerebral atrophy. After 1 month of adjuvant hyperbaric oxygen therapy， the boy’s memory recovered to the level before disease onset， and reexaminations of MRI and video electroencephalography obtained normal results.No recurrence was observed during follow-up for 6 months， and the boy achieved satisfactory academic performance.This case suggests that for children with antibody-negative AE， first-line immunotherapy combined with tocilizumab can rapidly control inflammation， and the addition of hyperbaric oxygen therapy can effectively improve subsequent cerebral structural and cognitive abnormalities， with few adverse reactions， which provides a new clinical approach for the treatment of this type of disease.

Objective:To investigate the CT image characteristics of anterior ethmoidal artery（AEA） through CT scan and its significance in nasal endoscopic surgery. Methods:A retrospective study of 82 patients（164 sides） with chronic sinusitis was conducted. All patients underwent CT scan and the images were reconstructed. The AEA classification was used and calculate the rate of AEA suspension. The AEA was classified, and the suspension rate of the AEA was calculated. The height of the lateral lamella of the cribriform plate （LLCP） was measured, and Keros classification was performed. The relationship between Keros classification and AEA suspension was analyzed. The supraorbital ethmoidal cell （SOEC） was identified, and its relationship with AEA suspension was analyzed. Results:Type Ⅰ AEA accounted for 42.07%（69/164）. Type Ⅱ AEA accounted for 22.56%（37/164）. Type Ⅲ AEA accounted for 35.37%（58/164）. The suspension rate was 35.37%. The average height of the LLCP was （3.7±1.8） mm. In the Keros classification, type Ⅰaccounted for 53.05%（87/164）, Type Ⅱaccounted for 37.80%（62/164）. Type Ⅲ accounted for 9.15%（15/164）. The results of the Spearman analysis showed that there was a moderate positive correlation between the Keros classification and the suspension of the AEA（r=0.526, P<0.01）. Among 164 sides, SOEC was present in 15 sides. The suspension rate of AEA in the group with SOEC was significantly higher than that in the group without SOEC（P<0.01）. Conclusion:Sinus CT and multiplanar reconstruction can clarify the image characteristics of AEA and its relationship with surrounding structures. When the level of Keros classification is higher or SOEC is present, the suspension rate of AEA increases significantly. It is of great significance to clarify the characteristics of AEA before surgery in order to avoid injury during surgery.
Humans ; Retrospective Studies ; Endoscopy ; Ethmoid Sinus/diagnostic imaging* ; Tomography, X-Ray Computed ; Arteries/diagnostic imaging* ; Sinusitis/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Aged

Objective To evaluate the application value of dermatoscope combined with rapid frozen section examination in the treatment of head and facial skin tumors.Methods A retrospective analysis was performed on 123 patients with head and facial skin masses admitted to Affiliated Jinhua Hospital,Zhejiang University School of Medicine from June 2019 to December 2023.Patients were divided into two groups according to their wishes.Patients in group A underwent preoperative dermoscopy combined with intraoperative rapid frozen section examination,and patients in group B underwent preoperative skin biopsy combined with intraoperative rapid frozen section examination.The diagnostic accuracy of two methods was compared.Results There were 81 patients in group A,including 39 basal cell carcinoma,25 squamous cell carcinoma,8 solar keratosis,5 seborrheic keratosis and 4 verrucous nevus.There were 42 patients in group B,including 25 basal cell carcinoma,13 squamous cell carcinoma and 4 solar keratosis.Both groups of patients successfully completed the operation,postoperative follow-up 6 months no recurrence.The accuracy of dermoscopy in the diagnosis of head and facial skin masses was 91.36％,and the accuracy of skin biopsy was 100％.There was no statistical significance between them(x2=2.407,P=0.121).Conclusion In surgical treatment of head and facial skin tumors,the diagnostic accuracy of preoperative dermoscopy combined with intraoperative rapid frozen section examination is high,and it is worthy of clinical promotion.

Objective:To analyze the epidemiological characteristics of active pulmonary tuberculosis (pulmonary tuberculosis) in Xi'an from 2013 to 2023 and predict the incidence trend of pulmonary tuberculosis in Xi'an by using autoregressive integrated moving average (ARIMA) product seasonal models to provide a decision-making basis for tuberculosis prevention and control.Methods:The incidence data of pulmonary tuberculosis reported in Xi'an from 2013 to 2023 were collected through the Tuberculosis Information Management System of the Chinese Center for Disease Control and Prevention. The Excel 2016 software was used for descriptive statistical analysis of pulmonary tuberculosis incidence data reported in Xi'an from 2013 to 2023. The SPSS 20.0 software was used to establish an ARIMA product seasonal model to predict the incidence of pulmonary tuberculosis in Xi'an.Results:A total of 49 860 cases of pulmonary tuberculosis were reported in Xi'an from 2013 to 2023, with an annual average incidence of 45.60/100 000. The incidence showed a downward trend in the past decade. The incidence was high in spring, with a peak from March to May, a small peak from November to January, and a low incidence in February and October. The annual average incidence of pulmonary tuberculosis in 2 suburban counties (52.80/100 000) was higher than that in 14 urban areas (43.21/100 000) ( χ2=20.19, P<0.001). With the increase of age, the incidence of pulmonary tuberculosis was higher, and the incidence of the males was higher than that of female ( χ2=378.34, P<0.001), the ratio of male to female incidence was 1.73∶1. The most occupation of the population was farmers, accounting for 46.54%. The established ARIMA (0, 1, 1) (1, 1, 1) 12 product seasonal model exhibited a good prediction effect, with the Bayesian Information Criterion being -1.567, the root mean square error being 0.42, and the mean absolute percentage error being 9.62. The average relative error between the actual value and the predicted value was 6.63%, and the 95% CI of the predicted value included the actual value. Conclusions:2013-2023, the incidence of pulmonary tuberculosis in Xi'an has been on the decline as a whole. Special attention should be paid to the prevention and control of tuberculosis in districts (counties) adjacent to mountainous areas in the south, people aged 60 years and above, and farmers and other vulnerable groups. The established ARIMA (0, 1, 1) (1, 1, 1) 12 product seasonal model exhibited a good predictive effect and can be applied to the short-term prediction of tuberculosis incidence.

Objective:To identify the change trajectory of intrinsic capacity in people aged ≥50 years in Shanghai and explore the impact of intrinsic capacity trajectory change on overall function and dalily life activities in this population.Methods:The longitudinal data from round 1 to 3 Study of Global Ageing and Adult Health in Shanghai were used. The total intrinsic ability scores from five dimensions of cognition, psychology, sensory, vitality and locomotion were calculated. The censored normal model of group-based trajectory was used to identify the trajectory of intrinsic capacity change over time. Linear regression model and multivariate logistic regression model were used to analyse the effects of different levels intrinsic capacity trajectory on the scores of the WHO Disability Assessment Schedule (WHODAS), the activity of daily living (ADL) and the instrumental activities of daily living (IADL).Results:A total of 2 302 study participants aged ≥50 years with 3 round complete data were included in this study, and 3 levels of intrinsic capacity trajectory were identified, low-level trajectory (9.3%), medium-level trajectory (41.7%), and high-level trajectory (49.0%). Compared with the high-level group, the medium-level and low-level groups had higher WHODAS scores, which increased by 3.578 (95% CI: 2.028-5.129) and 12.620 (95% CI: 9.951-15.289), respectively, and those with more severe disability and those in the low-level group were at higher risk for severe difficulty in ADLs ( OR=12.450, 95% CI: 4.310-35.966) and IADLs ( OR=5.479, 95% CI: 1.311-22.904). Conclusions:Heterogeneity in trajectory of intrinsic capacity exists in people aged ≥50 years in Shanghai. Middle-aged and elderly people with low initial level and rapid decline trajectory of intrinsic capacity are at greater risk for the decline of daily life ability and the increase of disability. It is necessary to strengthen the long-term dynamic monitoring and evaluation of the change trajectory of intrinsic capacity in this population.

[Purpose]To analyze the incidence and mortality of colorectal cancer in Zhejiang can-cer registration areas in 2021 and its temporal trends from 2000 to 2021.[Methods]Data from 22 cancer registries in Zhejiang Province in 2021 that met the quality standards were included.The crude incidence/mortality rate,age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC)and by world standard population(ASIRW/ASMRW),and cumulative incidence(mortality)rate for 0～74 years old were calculated.Trends from 2000 to 2021 were ana-lyzed using the Joinpoint regression model by calculating the annual percentage change(APC)and average annual percentage change(AAPC).[Results]In 2021,the number of new colorectal cancer cases in Zhejiang cancer registration areas was 12 265,with 4 323 deaths.ASIRC and ASMRC were significantly higher in men(32.74/105 and 10.11/105)than those in women(20.78/105 and 5.99/105).Urban areas showed higher ASIRC and ASMRC(28.27/105 and 8.06/105)than rural areas(24.12/105 and 7.85/105).The age-specific incidence and mortality rates of colorectal cancer in Zhejiang Province showed an increasing trend with age,with a peak of 219.63/105 in the age group of 80～84 years old.The age-specific mortality rate peaked in the age group of 85 years old and above,with a peak of 199.65/105.From 2000 to 2021,ASIRC in Zhejiang Province showed an upward trend(AAPC=2.23％,P＜0.001),ASMRC showed a marginal increase(AAPC=0.78％,P=0.067).[Conclusion]The incidence of colorectal cancer in Zhejiang Province had been on a continuous rise in the past 22 years,and health education and early screening should be empha-sized.

Objective This study aimed to investigate the effects of sleep interruption(SI)cycles on emotional behavior in ICR mice,and to establish a mouse model of comorbid anxiety and depression induced by SI.Methods Seventy-two male ICR mice(4～5 weeks old)were divided randomly into a blank group and a model group.Mice in the model group were subjected to SI stress modeling for 1,2,and 3 weeks,respectively.After modeling,emotional behaviors were evaluated using open-field,elevated plus maze,light-dark box,marble-burying,and forced-swimming tests.Serum corticosterone levels were detected by enzyme-linked immunosorbent assay.Results Mice in the model group buried significantly more marbles after 1 week of SI stress,compared with the blank group(P＜0.05).After 2 weeks of stress,mice in the model group also showed a significant decrease in the number of crossings in the light-dark box(P＜0.05)and a significant increase in the number of marbles buried(P＜0.01)compared with the control group.After 3 weeks of stress,mice in the model group showed a significant increase in the number of marbles buried(P＜0.05),a significant decrease in the number of crossings in the light-dark box(P＜0.05),and a significant increase in immobility time in the forced-swim test(P＜0.01).Conclusions ICR mice exhibited significant anxiety-related behaviors after 2 weeks of SI modeling and significant anxiety-and depressive-related behavioral changes after 3 weeks.Three weeks of SI stress can be used to establish a model of comorbid anxiety and depression.

Objective To compare of the efficacy of two distinct debridement techniques in membrane induction therapy for chronic tibial osteomyelitis.Methods A retrospective study was conducted on 52 patients with Cierny-Mader type IV A/B chronic tibial osteomyelitis who were treated at the Third Affiliated Hospital of Zunyi Medical University between July 2016 and December 2023.Five patients were diagnosed and treated before 2020,while 47 were managed from 2020 onward.Patients were divided into two groups:a local debridement group(n=28)and an en bloc osteotomy group(n=24).Perioperative outcomes—including operative time,incision length,intraoperative blood loss,and length of hospital stay—were assessed,along with clinical efficacy at 6 months,12 months,and final follow-up.Clinical outcomes were evaluated using the Hospital for Special Surgery(HSS)knee score,the American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score,joint range of motion(knee flexion-extension and ankle plantarflexion-dorsiflexion),recurrence rate,and the Paley classification for infectious bone defects.Results The local debridement group exhibited significantly less intraoperative blood loss(P<0.05),shorter operative time(P<0.05),and reduced hospital stay(P<0.05),as well as higher AOFAS and HSS scores at both 6 and 12 months postoperatively(P<0.05).In contrast,the osteotomy group demonstrated superior Paley classification outcomes at 6 months,12 months,and final follow-up(P<0.05),along with lower rates of infection recurrence.Longitudinal analysis indicated significant improvements in AOFAS scores,HSS scores,and joint mobility over time in both groups(P<0.05).However,no statistically significant differences were observed between groups in terms of functional scores or joint mobility parameters at final follow-up(P>0.05).Conclusion En bloc osteotomy combined with the induced membrane technique(Masquelet technique)enables more comprehensive debridement,minimizes the necessity for repeated surgical interventions,reduces postoperative complications,lowers the risk of recurrence,and promotes enhanced bone healing.

Objective This study investigates the force distributions and movement patterns of the maxillary dentition during molar intrusion with clear aligners,aiming to provide a theoretical basis for optimizing clinical orthodontic treatment strategies.Methods A three-dimensional(3D)finite element model of the periodontal ligament-teeth-clear aligners complex was established to simulate different intrusion modes,including bilateral first molar intrusion,bilateral second molar intrusion,and simultaneous intrusion of bilateral first and second molars.The von Mises stress distribution characteristics and displacement patterns of each tooth under different intrusion conditions were systematically analyzed.Results Compared with simultaneous molar intrusion,the individual intrusion design resulted in greater intrusive movement(4.260-10.500 μm)accompanied by distal-lingual crown inclination(distal displacement:-7.690--5.100 μm;buccal displacement:-20.500--6.750 μm).Anchorage teeth displayed a displacement trend opposite to that of the intruded molars.The anterior teeth demonstrated minimal displacement and low stress levels.During maxillary molar intrusion with clear aligners,the maximum equivalent stress in the periodontal ligaments occurred at the anchorage teeth mesial to the intruded molars,primarily concentrated in the apical region and the mesial aspect of the buccal cervical area.Conclusions A sequential intrusion strategy enhances vertical control efficiency compared to simultaneous intrusion.Unanticipated mesiodistal and buccolingual displacements in the posterior region necessitate the implementation of counteracting mechanisms in aligner design.In clinical practice,priority should be given to monitoring the risks of root resorption and bone remodeling effects in stress-concentrated zones(apical and buccal cervical regions)of anchorage teeth.

AIM:To investigate whether total alkaloids of Cocculus orbiculatus(COTA)attenuate ulcerative colitis(UC)in mice via PINK1/parkin mitophagy pathway.METHODS:Sixty C57BL/6 mice were randomly divided into normal control group,model group,positive drug mesalazine group,and low-,medium-and high-dose(0.162,0.324 and 0.486 g/kg)COTA groups,with 10 mice in each group.Except for normal control group,the mice in all groups were given free access to 3%dextran sulfate sodium(DSS)solution for 7 consecutive days to establish a UC model in mice,and were then treated with COTA or mesalazine via oral gavage.The general condition of the mice was observed,and the colon length and disease activity index(DAI)score were determined.Colon histopathological damage was observed by HE staining.The serum levels of interleukin-1β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)were detected by ELISA.The pro-tein levels of PINK1,parkin,microtubule-associated protein 1 light chain 3(LC3),P62 and beclin-1 in colon tissues were determined by Western blot.The protein expression of LC3 and parkin was detected by immunofluorescence.RE-SULTS:Compared with normal control group,the mice in model group showed varying degrees of soft stools or bloody stools,decreased body weight(P<0.05),increased DAI score,shortened colon length(P<0.05),and obvious pathologi-cal damage in the colon tissue.The serum levels of IL-1β,IL-6 and TNF-α were elevated(P<0.05).The protein levels of parkin,PINK1,LC3-II and beclin-1 were significantly decreased(P<0.05),while P62 protein expression was in-creased(P<0.05).Immunofluorescence showed a small number of autophagosomes in the colon tissue.In contrast,com-pared with model group,the mice in total alkaloids of Cocculus orbiculatus groups exhibited increased body weight(P<0.05),decreased DAI score,increased colon length(P<0.05),and reduced levels of IL-1β,IL-6 and TNF-α(P<0.05).The protein levels of parkin,PINK1,LC3 and beclin-1 were elevated(P<0.05),while P62 expression was re-duced(P<0.05),with numerous autophagosomes visible in the colon tissue via immunofluorescence.CONCLUSION:Total alkaloids of Cocculus orbiculatus can enhance the expression of mitophagy-related proteins PINK1,parkin,LC3 and beclin-1,activate mitophagy,and reduce the expression of inflammatory factors,thereby attenuating the inflammatory re-sponse in the colon mucosa of DSS-induced UC mice.