This report describes the clinical course， diagnosi and treatment of a patient with neuromyelitis optica spectrum disorder （NMOSD） who presented initially with depression and delusion. The patient was a 38-year-old woman who initially presented with low mood， accompanied by nausea and vomiting. Mental examination revealed delusions of jealousy and psychomotor retardation. Subsequently， she developed fever and decreased muscle strength. Magnetic resonance imaging (MRI） revealed lesions involving pons and upper cervical spinal cord. Cerebrospinal fluid testing was positive for aquaporin 4 （AQP4） antibodies， and metagenomic sequencing of cerebrospinal fluid detected DNA fragments of Escherichia coli and Klebsiella pneumoniae. Following treatment with glucocorticoid pulse therapy combined with anti-infective therapy， the patient's mood， psychiatric symtoms， and neurological symptoms improved. This case suggests that psychiatric symptoms including depression and delusion may be the presenting features of NMOSD， and that infectious factors might play a role in triggering autoimmune responses. These observations offer valuable clinical clues for the early identification of NMOSD.

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.

CT is a commonly examination method in pediatric clinical practice.Formulating and popularizing low-dose pediatric CT scanning protocols and constructing a standard image quality evaluation system are the key directions of low-dose pediatric CT imaging.In recent years,domestic CT equipment achieved technological breakthroughs in hardware performance and image reconstruction algorithms,which could provide new paths for pediatric low-dose CT imaging in children combining with artificial intelligence technology.The current status of scanning protocols,the establishment of imaging quality evaluation system and the clinical promotion,as well as challenges of domestic CT in pediatric low-dose CT imaging were reviewed in this article.

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.

CT is a commonly examination method in pediatric clinical practice.Formulating and popularizing low-dose pediatric CT scanning protocols and constructing a standard image quality evaluation system are the key directions of low-dose pediatric CT imaging.In recent years,domestic CT equipment achieved technological breakthroughs in hardware performance and image reconstruction algorithms,which could provide new paths for pediatric low-dose CT imaging in children combining with artificial intelligence technology.The current status of scanning protocols,the establishment of imaging quality evaluation system and the clinical promotion,as well as challenges of domestic CT in pediatric low-dose CT imaging were reviewed in this article.

CRISPR-Associated Protein 9 ; Gene Editing ; CRISPR-Cas Systems/genetics*

A fundamental challenge that arises in biomedicine is the need to characterize compounds in a relevant cellular context in order to reveal potential on-target or off-target effects. Recently, the fast accumulation of gene transcriptional profiling data provides us an unprecedented opportunity to explore the protein targets of chemical compounds from the perspective of cell transcriptomics and RNA biology. Here, we propose a novel Siamese spectral-based graph convolutional network (SSGCN) model for inferring the protein targets of chemical compounds from gene transcriptional profiles. Although the gene signature of a compound perturbation only provides indirect clues of the interacting targets, and the biological networks under different experiment conditions further complicate the situation, the SSGCN model was successfully trained to learn from known compound-target pairs by uncovering the hidden correlations between compound perturbation profiles and gene knockdown profiles. On a benchmark set and a large time-split validation dataset, the model achieved higher target inference accuracy as compared to previous methods such as Connectivity Map. Further experimental validations of prediction results highlight the practical usefulness of SSGCN in either inferring the interacting targets of compound, or reversely, in finding novel inhibitors of a given target of interest.
Drug Delivery Systems ; Proteins ; Transcriptome

Objective To investigate whether the population pharmacokinetics (PPK)models can optimize the initial dosage of individualized Valproic acid (VPA)in children with epilepsy. Methods The epileptic children without taking VPA previously were recruited from October 2015 to May 2017 at the Department of Pediatrics,Peking University First Hospital,and they were divided into the PPK model group and the traditional empirical method group by randomized method. The initial VPA dosages for the PPK model group were calculated by PPK model,whereas those of the traditional empirical method group were dosed at 20-25 mg/(kg·d)regularly. The steady-state serum trough concentrations of VPA were extracted,and then the number and percentage of the patients whose serum trough concen-trations of VPA were 50-100 mg/L in the 2 groups were analyzed and compared with prospectively randomized me-thod. Results Totally 65 epileptic children were recruited and they were randomly divided into the traditional empirical method group (32 cases)and the PPK model group (33 cases). Twenty-seven children in the traditional empirical method group were observed,and 12 children had local epilepsy attack and 15 had generalized seizures;whereas among 29 cases in the PPK model group,there were 12 local attack of epilepsy and 17 had generalized seizures. VPA add-on therapy was administrated in 9 cases and 15 cases in the traditional empirical method group and the PPK model group, respectively. There were 5 cases,21 cases and 1 case with VPA serum concentrations of ＜50 mg/L,50-100 mg/L and＞100 mg/L in the traditional empirical group;while there were 9 cases,20 cases and 0 case in the PPK model group. The VPA serum concentrations of 21 cases (77. 8%,21/27 cases)in the traditional empirical method group and 20 ca-ses (69. 0%,20/29 cases)in the PPK model group were 50-100 mg/L,respectively,and the difference was not sta-tistically significant(P＞0. 05). Conclusion Although the study doesn't suggest that the established PPK model of VPA in Chinese epileptic children is superior to the traditional empirical method,the PPK model might be potentially valuable for optimized individualized dosage adjustment for those with serum trough concentrations not in the reasonable range by the traditional empirical method and with clinical seizure or brain firing activities.

Objective To observe the effect of Shengxian Decoction (Decoction for lifting the depressed organs) in the treatment of 38 patients with obstructive sleep apnea hypopnea syndrome (OSAHS) in the TCM syndrome of qi deficiency of the lung and spleen. Methods Totally 68 patients were randomized into a control group (30 cases) treated by Duxil for oral taking and a treatment group (38 cases) treated by Duxil and Shengxian Decoction for 10 days. The changes in the symptom scores of both groups after treatment were observed. The polysomnogram (PSG) was applied before and after treatment to record the total sleep time,hypopnea total time,and average heart rate to calculate the times when oxygen saturation was less than 90% in each hour sleep time,the total continuous time when oxygen saturation was less than 90% in the whole night,apnea-hypopnea index (AHI),and hypopnea index (HI). Results After treatment,the main symptoms in the treatment group were significantly improved (P