Objective To assess the accuracy of pN staging prediction in papillary thyroid carcinoma (PTC) using ultrasound radiomics and deep neural networks (DNN). Methods A retrospective analysis was conducted on 375 patients with pathologically confirmed PTC, comprising 261 cases in the training set and 114 in the test set. Staging was categorized as pN0 (no cervical lymph node metastasis), pN1a (central neck lymph node metastasis), and pN1b (lateral neck lymph node metastasis). An ultrasound physician manually segmented the regions of interest (ROIs) for PTC, extracting 1899 radiomic features. Dimensionality reduction was performed using the least absolute shrinkage and selection operator (LASSO) regression. A DNN model for predicting PTC pN staging was developed using the H2O deep learning platform, trained on the training set, and validated on the test set to assess the accuracy of the optimal model. Results A total of 153 patients were in the pN0 stage, 131 patients in the pN1a stage, and 91 patients in the pN1b stage. LASSO regression selected 15 radiomic features for each PTC. The optimal DNN model, constructed using these 15 features, achieved accuracies of 85.82% on the training set and 81.57% on the test set. Conclusion Ultrasound radiomics of PTC demonstrates high accuracy in predicting pN staging and shows potential for automating N staging in patients.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

OBJECTIVE To develop a storage device for portable sterile surgical instrument kits that enables intelli-gent management of surgical instruments in field and disaster relief environments.METHODS Based on various in-telligent monitoring modules such as temperature sensors,humidity sensors and oxygen sensors,environmental state parameters of the surgical instrument kits at different locations were obtained.An intelligent storage manage-ment device for portable sterile surgical instrument kits was designed,which employed neural network technology to predict the expiration date of the surgical instrument kits in real-time.RESULTS The production and technical parameters,design renderings and production processes for the intelligent storage management device for portable sterile surgical instrument kits were initially completed,providing a reference for the effective application of nu-merically controlled storage devices for mobile surgical instruments in field environments in the future.CONCLUSIONS The intelligent storage management device for portable sterile surgical instrument kits meets the requirements for managing surgical instruments in field environments,achieving real-time data monitoring and management of surgical instrument kits in special environments.

The glymphatic system is a recently discovered essential waste-clearance pathway in the central nervous system that plays a pivotal role in maintaining brain homeostasis.Growing evidence suggests that dysfunction of this system is closely associated with the pathogenesis of various neurodegenerative disorders;however,its precise mechanistic involvement in Parkinson's disease is poorly understood.This review systematically summarizes the structural and functional characteristics of the glymphatic system,provides an in-depth exploration of its potential role in Parkinson's disease pathophysiology,and synthesizes current research evidence on glymphatic system-targeted therapeutic strategies,with the aim of establishing a theoretical foundation for advancing the understanding of PD pathogenesis and developing novel diagnostic and therapeutic approaches.

OBJECTIVE To optimize the optimum processing technology of vinegar-processed Artemisiae Argyi Folium(AAF),and analyze the difference of index components and analgesic activity before and after processing.METHODS The method for the determination of total flavonoids and total terpenes in AAF was established with eupatilin and Santamarine as control substances,re-spectively.The HPLC-VWD method was established for the simultaneous determination of 6-Methoxytricin,Santamarine,eupatilin and Artemisolide in AAF.Box-Behnken design-response surface method was used to optimize the processing technology of vinegar-processed AAF,with the content of total flavonoids,total terpenes and four active ingredients as the index,and the amount of rice vin-egar,moistening time,processing temperature and processing time as the factors.The quantitative analysis was combined with hierar-chical cluster analysis(HCA),principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)to evaluate the difference of index components before and after processing.The analgesic activity before and after processing was investigated using pain mice induced by formalin.RESULTS The optimum processing parameters of vinegar-processed AAF were 16%rice vinegar dosage,moistening time 50 min,processing temperature 160℃and processing time 12 min.There were significant differences in the content of index components before and after processing.The analgesic activity of vinegar-processed AAF was signifi-cantly better than that of AAF.CONCLUSION The optimized processing technology is stable and feasible,which can provide scien-tific basis for standardizing production of vinegar-processed AAF.

The glymphatic system is a recently discovered essential waste-clearance pathway in the central nervous system that plays a pivotal role in maintaining brain homeostasis.Growing evidence suggests that dysfunction of this system is closely associated with the pathogenesis of various neurodegenerative disorders;however,its precise mechanistic involvement in Parkinson's disease is poorly understood.This review systematically summarizes the structural and functional characteristics of the glymphatic system,provides an in-depth exploration of its potential role in Parkinson's disease pathophysiology,and synthesizes current research evidence on glymphatic system-targeted therapeutic strategies,with the aim of establishing a theoretical foundation for advancing the understanding of PD pathogenesis and developing novel diagnostic and therapeutic approaches.

OBJECTIVE To develop a storage device for portable sterile surgical instrument kits that enables intelli-gent management of surgical instruments in field and disaster relief environments.METHODS Based on various in-telligent monitoring modules such as temperature sensors,humidity sensors and oxygen sensors,environmental state parameters of the surgical instrument kits at different locations were obtained.An intelligent storage manage-ment device for portable sterile surgical instrument kits was designed,which employed neural network technology to predict the expiration date of the surgical instrument kits in real-time.RESULTS The production and technical parameters,design renderings and production processes for the intelligent storage management device for portable sterile surgical instrument kits were initially completed,providing a reference for the effective application of nu-merically controlled storage devices for mobile surgical instruments in field environments in the future.CONCLUSIONS The intelligent storage management device for portable sterile surgical instrument kits meets the requirements for managing surgical instruments in field environments,achieving real-time data monitoring and management of surgical instrument kits in special environments.

OBJECTIVE To optimize the optimum processing technology of vinegar-processed Artemisiae Argyi Folium(AAF),and analyze the difference of index components and analgesic activity before and after processing.METHODS The method for the determination of total flavonoids and total terpenes in AAF was established with eupatilin and Santamarine as control substances,re-spectively.The HPLC-VWD method was established for the simultaneous determination of 6-Methoxytricin,Santamarine,eupatilin and Artemisolide in AAF.Box-Behnken design-response surface method was used to optimize the processing technology of vinegar-processed AAF,with the content of total flavonoids,total terpenes and four active ingredients as the index,and the amount of rice vin-egar,moistening time,processing temperature and processing time as the factors.The quantitative analysis was combined with hierar-chical cluster analysis(HCA),principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)to evaluate the difference of index components before and after processing.The analgesic activity before and after processing was investigated using pain mice induced by formalin.RESULTS The optimum processing parameters of vinegar-processed AAF were 16%rice vinegar dosage,moistening time 50 min,processing temperature 160℃and processing time 12 min.There were significant differences in the content of index components before and after processing.The analgesic activity of vinegar-processed AAF was signifi-cantly better than that of AAF.CONCLUSION The optimized processing technology is stable and feasible,which can provide scien-tific basis for standardizing production of vinegar-processed AAF.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.