BACKGROUND: Meningeal metastasis (MM) is a form of malignant metastasis where tumor cells spread from the primary site to the pia mater, dura mater, arachnoid, subarachnoid space, and other cerebrospinal fluid compartments. Lung cancer is one of the most common malignant tumor types with MM. MM not only signifies that the lung cancer has progressed to an advanced stage but also leads to a range of severe clinical symptoms due to meningeal involvement. Currently, the risk factors associated with the development of MM are not fully elucidated. The aim of this study was to investigate the risk factors for MM in patients with lung adenocarcinoma (LUAD) who underwent non-surgical interventions, in order to identify LUAD patients at high risk for MM. METHODS: This retrospective study analyzed the clinical data of patients diagnosed with LUAD at the First Affiliated Hospital of Zhengzhou University from January 2020 to July 2024. Missing data were imputed using multiple imputation methods, and risk factors were identified through LASSO, univariate, and multivariate Logistic regression analyses. RESULTS: A total of 170 patients with LUAD were included in this study and divided into two groups: 87 patients with MM and 83 patients without MM. Univariate and multivariate Logistic regression analyses revealed that younger age at diagnosis (P=0.004), presence of the epidermal growth factor receptor (EGFR) L858R gene mutation (P=0.008), and concurrent liver metastasis at baseline (P=0.004) were independent risk factors for developing MM in LUAD patients who did not undergo surgical intervention. Conversely, higher baseline globulin levels (P=0.039) and the presence of the anaplastic lymphoma kinase (ALK) gene mutation (P=0.040) were associated with a reduced risk of MM development. CONCLUSIONS Age at diagnosis, EGFR L858R mutation status, ALK gene mutation status, concurrent liver metastasis, globulin levels at baseline were significantly associated with the risk of developing MM in patients with LUAD patients who did not undergo surgical intervention. For patients diagnosed at a younger age, carrying the EGFR L858R mutation, or presenting with baseline liver metastasis, early implementation of tertiary prevention strategies for MM is crucial. Regular monitoring of MM status should be conducted in these high-risk groups.
Humans ; Male ; Adenocarcinoma of Lung/therapy* ; Female ; Middle Aged ; Risk Factors ; Lung Neoplasms/therapy* ; Retrospective Studies ; Aged ; Meningeal Neoplasms/genetics* ; Adult

Sexual dimorphism in the brain underlies behavioral differences between sexes. The bed nucleus of the stria terminalis (BNST) is a complex nucleus that differs between males and females, but the sexual dimorphism in cytoarchitecture and the connectome of its oval subdivision (ovBNST) remains largely unexplored. By combining snRNA-seq and transgenic labeling, we found a higher density of ovBNST proenkephalin (ovBNST^PENK) neurons in male than female mice. Anatomically, we virally mapped the efferents and afferents of ovBNST^PENK neurons, finding reciprocally dimorphic connections with the hypothalamus and striatum. Gene enrichment analysis suggests that ovBNST^PENK neurons are modulated by the upstream dopamine pathway. Functionally, by applying caspase-3-mediated depletion of ovBNST^PENK neurons, we found that loss of these neurons enhanced locomotor activity in male but not female mice, without altering the anxiety-like phenotypes in either sex. Our study may pave the way for a better understanding of the anatomical and functional profiles of ovBNST^PENK neurons from a sexually dimorphic perspective.
Animals ; Male ; Female ; Septal Nuclei/physiology* ; Sex Characteristics ; Neurons/physiology* ; Enkephalins/metabolism* ; Mice ; Mice, Transgenic ; Protein Precursors/metabolism* ; Mice, Inbred C57BL ; Neural Pathways/physiology*

Objective:To evaluate the effect of remimazolam tosilate on postoperative delirium (POD) in elderly patients undergoing urological surgery.Methods:In this randomized controlled trial, 220 American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ elderly patients of either sex, aged≥65 yr, with body mass index of 18-28 kg/m 2, scheduled for elective urological surgery under general anesthesia, were divided into 2 groups ( n=110 each) using a random number table method: propofol group (group P) and remimazolam tosilate group (group R). Group P received propofol 1.0-1.5 mg/kg for induction and propofol 2-6 mg·kg -1·h -1 for maintenance, while group R received remimazolam tosilate 0.2-0.3 mg/kg for induction and remimazolam tosilate 0.5-1.2 mg·kg -1·h -1 for maintenance. The other drugs for induction and maintenance were the same in the two groups. POD was assessed using the Chinese version of the 3-minute diagnostic interview for Confusion Assessment Method within 3 days after surgery in the two groups. The intraoperative consumption of remifentanil and usage of vasoactive drugs, extubation time, 15-item Quality-of-Recovery scale scores at 24 h after operation, requirement for rescue analgesia within 24 h after operation, and postoperative adverse effects were recorded. Results:There were no significant differences in the incidence of POD within 3 days after operation, 15-item Quality-of-Recovery scale scores at 24 h after operation, or rate of rescue analgesia within 24 h after operation between two groups ( P>0.05). Compared with group P, the requirement for intraoperative vasoactive drugs was significantly reduced, the extubation time was shortened, and the incidence of hypoxemia was decreased within 24 h after operation in group R ( P<0.05 or 0.001). Conclusions:Remimazolam tosilate has no marked effect on the occurrence of POD in elderly patients undergoing urological surgery.

Objective To reveal the detailed histological characteristics of pyramidal neuron cell bodies and their axonal projections along the corticospinal tract in the primary motor cortex(M1)of the brain,by using the biotinylated dextran amine(BDA)neural tracing technique combined with panoramic and local microscopic imaging technologies.Methods A total of 100 nL of 10％BDA(10,000 molecular weight)was injected into M1 region using stereotaxic system.The distribution of BDA labeling along the corticospinal tract was continuously tracked with panoramic tissue scanning analysis system.Detailed observations of the histological characteristics of BDA labeling were carried out with laser confocal microscope.Results It is more convenient to observe the overall distribution of BDA neural labeling by using the panoramic tissue scanning analysis system.Around the injection site in M1,the BDA labeling was shown in the somas of pyramidal neurons in layer V.In the M1 region corresponding to the contralateral site of the injection site and ipsilateral primary sensory cortex,BDA showed predominantly the anterograde labeled nerve fibers accompanied by a few retrograde labeled neurons.Besides,BDA labeled nerve fibers-including bundles and terminals-projecting to regions such as the ipsilateral striatum,thalamus,internal capsule,cerebral peduncle,and pons,and further reaching the contralateral spinal cord via the brainstem pyramidal decussation.Confocal microscopy and its 3D reconstruction system facilitated detailed analysis of the local microscopic features of BDA labeling,revealing retrograde labeled neuron cell bodies,dendrites and their spines,as well as anterograde labeled nerve fibers and their terminals.Conclusions These findings demonstrated that the integration of traditional BDA neural tracing with panoramic tissue scanning analysis and confocal microscopy provided an effective approach to the observation and analysis of long-projection neural circuits from panoramic to local perspectives,with broad application prospects.

Objective:To evaluate the effect of remimazolam tosilate on postoperative delirium (POD) in elderly patients undergoing urological surgery.Methods:In this randomized controlled trial, 220 American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ elderly patients of either sex, aged≥65 yr, with body mass index of 18-28 kg/m 2, scheduled for elective urological surgery under general anesthesia, were divided into 2 groups ( n=110 each) using a random number table method: propofol group (group P) and remimazolam tosilate group (group R). Group P received propofol 1.0-1.5 mg/kg for induction and propofol 2-6 mg·kg -1·h -1 for maintenance, while group R received remimazolam tosilate 0.2-0.3 mg/kg for induction and remimazolam tosilate 0.5-1.2 mg·kg -1·h -1 for maintenance. The other drugs for induction and maintenance were the same in the two groups. POD was assessed using the Chinese version of the 3-minute diagnostic interview for Confusion Assessment Method within 3 days after surgery in the two groups. The intraoperative consumption of remifentanil and usage of vasoactive drugs, extubation time, 15-item Quality-of-Recovery scale scores at 24 h after operation, requirement for rescue analgesia within 24 h after operation, and postoperative adverse effects were recorded. Results:There were no significant differences in the incidence of POD within 3 days after operation, 15-item Quality-of-Recovery scale scores at 24 h after operation, or rate of rescue analgesia within 24 h after operation between two groups ( P>0.05). Compared with group P, the requirement for intraoperative vasoactive drugs was significantly reduced, the extubation time was shortened, and the incidence of hypoxemia was decreased within 24 h after operation in group R ( P<0.05 or 0.001). Conclusions:Remimazolam tosilate has no marked effect on the occurrence of POD in elderly patients undergoing urological surgery.

Objective To reveal the detailed histological characteristics of pyramidal neuron cell bodies and their axonal projections along the corticospinal tract in the primary motor cortex(M1)of the brain,by using the biotinylated dextran amine(BDA)neural tracing technique combined with panoramic and local microscopic imaging technologies.Methods A total of 100 nL of 10％BDA(10,000 molecular weight)was injected into M1 region using stereotaxic system.The distribution of BDA labeling along the corticospinal tract was continuously tracked with panoramic tissue scanning analysis system.Detailed observations of the histological characteristics of BDA labeling were carried out with laser confocal microscope.Results It is more convenient to observe the overall distribution of BDA neural labeling by using the panoramic tissue scanning analysis system.Around the injection site in M1,the BDA labeling was shown in the somas of pyramidal neurons in layer V.In the M1 region corresponding to the contralateral site of the injection site and ipsilateral primary sensory cortex,BDA showed predominantly the anterograde labeled nerve fibers accompanied by a few retrograde labeled neurons.Besides,BDA labeled nerve fibers-including bundles and terminals-projecting to regions such as the ipsilateral striatum,thalamus,internal capsule,cerebral peduncle,and pons,and further reaching the contralateral spinal cord via the brainstem pyramidal decussation.Confocal microscopy and its 3D reconstruction system facilitated detailed analysis of the local microscopic features of BDA labeling,revealing retrograde labeled neuron cell bodies,dendrites and their spines,as well as anterograde labeled nerve fibers and their terminals.Conclusions These findings demonstrated that the integration of traditional BDA neural tracing with panoramic tissue scanning analysis and confocal microscopy provided an effective approach to the observation and analysis of long-projection neural circuits from panoramic to local perspectives,with broad application prospects.

The bone-touching acupuncture method, as one of the five-body acupuncture techniques, is widely used and highly effective in the treatment of brain diseases, though its theoretical foundation has been lacking. This paper explores the close connection between bones and the brain in both physiological and pathological states, as described in traditional Chinese medicine (TCM) classics, and explains the "bone-brain axis" concept within the framework of TCM. It summarizes the effects and characteristics of the five-body acupuncture techniques, traces the origins and modern applications of the bone-touching acupuncture method, and discusses its theoretical basis for treating brain diseases. The aim is to provide a reference for future clinical and mechanistic research on bone-touching acupuncture in brain disease treatment and to offer new perspectives and approaches for acupuncture treatment of brain diseases.
Humans ; Acupuncture Therapy/methods* ; Brain/physiopathology* ; Brain Diseases/physiopathology* ; Bone and Bones/physiopathology* ; Medicine, Chinese Traditional/methods*

Objective To investigate the correlation between serum hepatitis B core anbody(anti-HBC),cholinesterase(CHE)and apolipoprotein AI(ApoAI)and the development of viral hepatitis.Methods 388 patients with viral hepatitis admitted to Nanjing Pukou District Hospital of Traditional Chinese Medicine from January 2021 to January 2024 were selected as the observation group,another 68 cases of health check-ups in medical check-up centre of Nanjing Pukou District Hospital of Traditional Chinese Medicine during the same period were selected as the control group.The serum levels of anti-HBC,CHE,and apolipoprotein AI between the observation group and the control group were compared.To compare the serum anti-HBC,CHE,ApoAI levels in patients with different disease severity of chronic hepatitis in the observation group.To compare the number of positive cases of serum anti-HBC,CHE,ApoAI in patients with different disease types in the observation group.To compare the serum anti-HBC,CHE,ApoAI levels in patients with different grades of cirrhosis in the observation group.Results Serum anti-HBC levels(4.52±0.63)log10PEIU/mL were higher in the observation group than in the control group(1.12±0.26)log10PEIU/mL,and the differences were statistically significant(t=-43.822,P＜0.001),while CHE(4.09±0.91)kU/L,ApoAI(102.54±5.95)mg/dL were lower than the control group(10.65±1.73)kU/L,(120.17±6.06)mg/dL,and the differences were statistically significant(t=46.580,22.477,P＜0.001);differences in serum anti-HBC,CHE,and ApoAI levels among patients with different severity of chronic hepatitis in the observation group were statistically significant(P＜0.05),and the serum levels of anti-HBC levels showed mild chronic hepatitis＜moderate chronic hepatitis＜severe chronic hepatitis,while the levels of CHE and ApoAI showed mild chronic hepatitis＞moderate chronic hepatitis＞severe chronic hepatitis the difference was statistically significant(P＜0.05);the number of positive cases of serum anti-HBC,CHE,ApoAI in acute jaundiced hepatitis,severe chronic hepatitis,cirrhosis and hepatocellular carcinoma were significantly higher than those of chronic hepatitis in mild and moderate forms and the difference was statistically significant(P＜0.05).The differences in serum anti-HBC,CHE,and ApoAI levels in patients with different grades of cirrhosis in the observation group were statistically significant(P＜0.05)and serum levels of anti-HBC levels increased continuously with the progression of the disease,whereas CHE and ApoAI decreased continuously with the difference being statistically significant(P＜0.05).Conclusion The levels of serum anti-HBC in patients with viral hepatitis are significantly increased,while the levels of CHE and apolipoprotein AI are significantly decreased,and the levels of serum anti-HBC,CHE and apolipoprotein AI are related to the development of the disease,which contributes to the development of the disease.

Objective:To develop a genotyping method for the Junior blood type and report on a rare blood type with Jr(a-).Methods:Healthy O-type RhD+ volunteer donors of the Shenzhen Blood Center from January to May 2021 ( n=1 568) and a pedigree with difficult cross-matching ( n=3) were selected as the study subjects. Serological methods were used for proband′s blood type identification, unexpected antibody identification, and antibody titer determination. Polymerase chain reaction-sequence specific primer (PCR-SSP) method was used for typing the proband′s RHD gene. ABCG2 gene coding region sequencing and a PCR-SSP genotyping method were established for determining the genotypes of the proband and his family members and screening of Jra antigen-negative rare blood type among the 1 568 blood donors. Results:The proband′s ABO and RhD blood types were respectively determined as B and partial D (RHDDVI.3/RHD01N.01), Junior blood type Jra antigen was negative, and plasma had contained anti-D and anti-Jra. Sequencing of the ABCG2 gene revealed that the proband′s genotype was ABGG201N.01/ABGG201N.01 [homozygous c. 376C>T (p.Gln126X) variants], which is the most common Jr(a-) blood type allele in the Asian population. Screening of the voluntary blood donors has detected no Jr(a-) rare blood type. Statistical analysis of the heterozygotes suggested that the allelic frequency for ABCG2*01N.01 (c.376T) was 0.45%, and the frequency of Jr(a-) rare blood type with this molecular background was about 0.2‰. Conclusion:A very rare case of partial DVI.3 type and Jr(a-) rare blood type has been identified. And a method for identifying the Junior blood type through sequencing the coding regions of the ABCG2 gene and PCR-SSP has been established.

Objective To analyze the correlation between the expression of soluble glycoprotein A(GPA)in plasma of healthy blood donors and anti-M and anti-"Mia"antibodies.Methods Plasma from healthy donors from February 9,2022 to February 15,2023 was collected:irregular antibody-negative NN type(group Ⅰ,n=118)and MM type(group Ⅱ,n=51),anti-M antibody positive NN type(group Ⅲ,n=145)and anti-"Mia"antibody positive companion type(group Ⅳ,n= 87),the GPA content in plasma of different individuals in 4 groups was detected,and the difference in GPA expression was analyzed by t-test.Results The average plasma GPA contents in groupsⅠ,Ⅱ,Ⅲ and Ⅳ were 9.941±0.252,10.97±0.256,5.139±0.129 and 4.28±0.139ng/ml,respectively.The average GPA content of groups Ⅰ and Ⅱ was higher,and the average GPA content of groups Ⅲ and Ⅳ was lower,and the differences were statistically significant(all P＜0.01).Conclusion The GPA content in plasma of healthy donors with anti-M and anti-"Mia"antibodies was significantly lower than that of the antibody-negative group.The results of this study lay a foundation for further investigation of whether GPA in plasma has the ability to neutralize anti-M and anti-"Mia"antibodies,improve disease diagnosis and safe blood transfusion.