Climate change is altering the Earth's water cycle system. The resulting three extreme weather events—heatwaves, droughts, and extreme precipitation—impacts urban and rural water security through multi-layered mechanisms. A primary structural disparity exists between urban and rural systems: while urban areas benefit from comprehensive and standardized pipe networks that ensure terminal water quality, rural areas often suffer from "last mile" vulnerability due to inadequate infrastructure and outdated purification facilities. Extreme weather can directly alter the microbial community structure, concentrations of chemical pollutants and physicochemical properties of source water. These alterations interfere with the efficiency of water treatment processes and ultimately compromise the integrity of distribution systems. Because distribution networks often lack real-time monitoring and adaptive response capabilities, they have emerged as the most vulnerable link in the "water source-water treatment-distribution system" chain. Based on a systematic analysis of these chain-wide impacts, this paper proposed a series of control strategies, including security frameworks based on multi-model coupling and water source protection measures, improvement of water treatment technologies, optimization of distribution systems, and development of new water quality monitoring methods. These strategies aim to enhance the climate adaptability of urban and rural drinking water systems through multi-dimensional intervention, providing a theoretical basis for constructing climate-resilient water infrastructure.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with Neurofibromatosis-Noonan syndrome (NFNS). METHODS: A child with NFNS who was treated at the Department of Endocrinology of Hangzhou Children's Hospital in January 2024 was selected as the study subject. Clinical data of the child was collected by retrospective analysis. Peripheral venous blood samples (2 mL each) were collected from the child and his parents. Genomic DNA was extracted, and trio-whole exome sequencing (Trio-WES) of the family was carried out. Sanger sequencing was used to perform family verification on the candidate variants. The identified variants were classified for pathogenicity according to the Standards and Guidelines for the Interpretation of Sequence Variants established by the American College of Medical Genetics and Genomics (ACMG) (hereafter referred to as the "ACMG guidelines"). This study has been approved by the Medical Ethics Committee of Hangzhou Children's Hospital (Ethics No. 2021-06). RESULTS: The child was a 7-year and 4-month-old male. He has short stature, numerous café-au-lait spots on the neck and trunk, and special facial features such as a full forehead, wide interpupillary distance, a low nasal bridge, and low-set ears. The results of Trio-WES showed that the he had harbored the NF1 gene c.3773G>T (p.W1258L) mutation, which was verified by Sanger sequencing to be de novo in origin. The NF1 gene was associated with NFNS, which has an autosomal dominant inheritance. According to the ACMG guidelines, this variant was judged to be a likely pathogenic variant (PS2+PM2+PP3+PP2). No pathogenic variant in genes associated with Noonan syndrome, such as PTPN11, SOS1, RAF1, RIT1, and KRAS, was found. CONCLUSION The child with NFNS has clinical features such as short stature, special facial features, and café-au-lait spots. The c.3773G>T (p.W1258L) variation in the NF1 gene may be the genetic etiology of the NFNS child in this study. The results of this study has enriched the variation spectrum of the NF1 gene.
Child ; Humans ; Male ; Exome Sequencing ; Mutation ; Neurofibromatosis 1/genetics* ; Neurofibromin 1/genetics* ; Noonan Syndrome/genetics*

Objective To investigate the difference of facial soft tissue changes in patients with different vertical bone facial types after orthodontic treatment.Methods A total of 137 female patients with class Ⅱ malocclusion aged 18 to 30 years old were selected for retrospective analysis using facial soft tissue 3D model data.According to the mandibular plane angle(FH-MP)angle,they were divided into high angle group,average angle group and low angle group.The EinScan Pro 2X 2020 handheld high-precision 3D scanner was used to capture facial soft tissue images of patients before treatment(T0)and at 6 months during treatment(T1)and after treatment(T2).The patients'facial images were overlapped using reverse engineering software Geomagic Wrap 2021,and the differ-ences within and between groups were statistically analyzed using SPSS 26.0 statistical software.Results Before and after orthodontic treatment,the average overall facial changes in the high angle group were(-3.25±0.22)mm,in the average angle group was(-3.28±0.30)mm,and in the average low angle group was(-3.69±0.36)mm.Compared with the other two groups,the changes in the low angle group decreased more,and the difference was statistically significant(P＜0.05).The mandibular angle area and temporal area decreased the most in the low angle group,which were(-2.78±0.18)mm and(-2.27±0.35)mm,respectively,and the differ-ence was statistically significant compared with the other two groups(P＜0.05),while there was no statistically significant difference among the other groups(P＞0.05).Conclusion The whole face and all facial regions of the three groups had some negative changes,but the collapse in the mandibular angle area and the temporal muscle ar-ea of the low angle group was more obvious than that of the other two groups.

Platelet-aggregation receptor 1 (PEAR1) is a transmembrane receptor identified in 2005 and expressed mainly on platelets and endothelial cells. PEAR1 is a receptor protein that contacts platelets with each other and plays an important role in platelet activation and aggregation. Endothelial cells play an important role in maintaining vascular tone and vascular repair, and PEAR1 regulates the process of tumourigenesis and development by affecting their proliferation and associated neovascularisation. In recent years, PEAR1 has gradually been recognized as a potential target for antithrombotic drugs. This review focuses on elucidating the mechanisms of platelet endothelial aggregation receptor 1 and related signaling pathways in platelets and endothelial cells, and provides new ideas for the study of drug therapy for tumour-associated thrombosis.

OBJECTIVE：To study inhibitory activity of different extracts of Dracocephalum moldavica to clinical pathogenic bacteria，and to excavate its possible antibacterial mechanism. METHODS ：After extraction by 65％ ethanol and extraction by petroleum ether ，dichloromethane，ethyl acetate ，n-butanol，the different polar fractions of D. moldavica were obtained . Taking Klebsiella pneumoniae ，Staphylococcus aureus and other clinical multiple resistant pathogens as objects，the diameter of inhibition zone of different extraction fractions was measured by paper diffusion method ，and the antibacterial active fraction was screened. The minimal inhibitory concentration （MIC）of antibacterial active fraction to common clinical pathogens was determined by agar dilution method ；the growth curve of MRSA was drawn by turbidimetric method. The differentially expressed protein between antibacterial active fraction group and control group was screened by PEAK ® Q 8.5 software，and the gene ontology （GO）analysis and KEGG signaling pathway enrichment analysis were carried out by Blast 2 GO and KOBAS 3.0 online software. RESULTS ： Petroleum ether ，dichloromethane，ethyl acetate and n-butanol fraction of D. moldavica had no significant inhibitory effect on Gram-negative bacteria. The ethyl acetate fraction of D. moldavica had antibacterial activity in varying degrees against several kinds of Gram-positive bacteria as Staphylococcus aureus ，S. epidermidis；the diameter of inhibition zone was 10-16 mm，which was the active fraction. MICs of ethyl acetate fraction to S. aureus ，S. epidermidis and S. hominis were all 0.781 3 mg/mL；MIC to S. saprophyticus was 0.390 7 mg/mL；MICs to S. saprophyticus and standard strain of S. aureus were both 1.562 5 mg/mL. The 1， 2 times MIC of ethyl acetate could inhibit the growth of MRSA ，and the inhibitory activity increased with the increase of dose. A total of 300 differentially expressed proteins were screened （P＜0.01），of which 239 were up-regulated and 61 were down-regulated. The differentially expressed proteins were （No.81260478，No.816- mainly concentrated in cell sites such as cells ，cellular com- 60048） ponent，etc.，and in metabolic process such as cell process ， biological process and molecular functions such as catalytic activity，protein binding ，etc. They were mainly concentratedwang.zhanli@hotmail.com in microbial metabolism in different environments ，fructose and mannose metabolism signaling pathway （P＜0.05）. CONCLUSIONS ：The ethyl acetate fraction of D. Moldavica is the antibacterial active fraction ，and its activity may be related to the microbial metabolism and cell glycometablism.

Objective To investigate the drug resistance and the distribution situation of the related drug resistant genes in Staphylococcus aureus (SA), and to provide a basis for the clinical rational use of antibiotics and the hospital control of infection. Methods A total of 135 strains of SA were collected from the Second Affiliated Hospital of Baotou Medical College during January to December 2017. BD Phoenix TM-100 automatic microorganism identification and drug sensitivity systems and K-B agar diffusion method were used to identify SA colony and analyze its drug susceptibility; the related drug resistant genes were detected by polymerase chain reaction (PCR). Results Among 135 strains of SA, 16 (11.9%) methicillin-resistant SA (MRSA) and 119 (88.1%) methicillin-sensitive SA (MSSA) were detected. In the 14 strains of MRSA, the resistance rates to ampicillin, penicillin and erythromycin were high (91.9%, 91.1% and 64.4%, respectively), and no vancomycin, teicoplanin and linezolid-resistant strains were found. Additionally, the resistance rates of MRSA to ciprofloxacin were significantly higher than that of MSSA [31.3% (5/16) vs. 5.0% (6/119), P < 0.05]. Among 135 strains of SA, the detection rates of mecA, aac(6')/aph(2"), erm(A), erm(B), erm(C), and tetM were 4.4% (6/135), 10.4% (14/135), 0.7% (1/135), 27.4% (37/135), 31.4% (46/135) and 0.7% (1/135), respectively. In MRSA, the detection rates of mecA [37.5% (6/16) vs. 0 (0/119)], aac(6')/aph(2") [31.3% (5/16) vs. 7.6% (9/119)], and ermB [31.3% (5/16) vs. 26.9% (32/119)] were significantly higher than those in MSSA. It is noteworthy that the detection rate of mecA in MRSA was only 37.5% (6/16). Conclusions The MRSA detection rate of our hospital was below the national average level. The detection rates of resistance genes mecA, aac(6')/aph(2") and ermB were higher, which may be an important cause of drug resistance. Moreover, the detection of MRSA by mecA alone may lead to missed diagnosis, that should be paid attention to.

Objective To observe the metabolic changes of subcortical structures in children with intractable epilepsy using 18 F-FDG PET/CT,and to investigate the mechanism of subcortical structure involvement in epileptic seizures and its clinical significance.Methods Features of 18F-FDG PET/CT imaging in 611 intractable epilepsy children were analyzed.The metabolic changes of cortex and subcortical structures (basal ganglia,thalamus and cerebellum) were observed.The children were divided into three groups (young,middle and older groups) according to age,also mild group and severe group according to the number of involved lobar,respectively.The incidence of metabolic abnormalities in subcortical structures of different groups were analyzed.Results Among 611 children,unilateral cortical metabolic abnormality was found in 525,and bilateral cortical metabolic abnormalities were found in 86 children.The involvement of subcortical structures was detected in 190 children,including basal ganglia (n=64),thalamus (n=113) and cerebellum (n=105).The incidence of metabolic abnormality in subcortical structures under different age groups was not statistically different (all P＞ 0.05),while the incidence of metabolic abnormality in subcortical structures of severe group was significantly higher than that of mild group (all P＜0.001).Conclusion 18 F-FDG PET/CT might be able to detect the metabolic abnormalities of subcortical structures,therefore indicating the involvement of cerebral cortex.

Objective To investigate the characteristics of metabolic foci on 18F-fluorodeoxyglucose (FDG) PET/CT scan in pediatric patients with epilepsy.Methods Twenty-three pediatric patients (15 males,8 females,age range:0.5-13.3 years) with epilepsy were retrospectively reviewed from March 2014 to December 2016.All patients underwent 18F-FDG PET/CT and metabolic foci were found.The visual method and semi-quantitative analysis were used to analyze images.Fourteen of them underwent surgery and were followed up for 3-24 months.Results Glucose hypermetabolism were observed most frequently in the frontal and parietal lobes,with or without surrounding/remote hypometabolism.On the day of PET/CT imaging,8 patients had no seizures,14 patients had seizures,and 1 patient was uncertain.The sites of resection were consistent with the regions of hypermetabolism in 9 patients,among whom the pathological results showed 8 cortical malformations and 1 Rasmussen's syndrome.Follow-up results for the above 9 patients showed that there was 7 Engel class Ⅰ patients and 2 Engel class Ⅲ patients.Conclusion The hypermetabolism may mostly appear in the frontal and parietal lobes of pediatric patients with epilepsy,and malformations of cortical development seem to be the most common pathology results.

Objective: To characterize the gut microbial community structure of two-kidney-one-clip (2K1C) hypertensive rats, provide new evidences for prevention and treatment of hypertension. Methods: Adult male SD rats were divided into 2K1C hypertensive model group and sham operation group (n=8 each). Blood pressure was recorded by tail-cuff technique weekly for 4 weeks. Then, the total fecal DNA of rats in 2K1C model group and sham operation group were extracted. The structure and principal components of intestinal flora in 2K1C model rats and sham operated rats were analyzed using Hiseq3000 sequencing platform. Additionally, real time fluorescent quantitative polymerase chain reaction technology was used to detect the content of predominant bacteria, including Escherichia, Bifidobacterium, Lactobacillus and Bacteroides. Results: Compared with sham operation group, significant reduction in the relative abundance of Firmicutes (31.72 (30.06, 32.18) vs. 40.99 (38.78, 44.41), U=0.00, P<0.05) and increase in Bacteroidetes (48.13(41.16,50.25) vs. 27.81(25.84,31.38),U=0.00, P<0.05) were observed in the fecal samples from model group. The relative abundance of Escherichia coli (0.08(0.07,0.11) vs. 0.07(0.06,0.08),U=12.50, P<0.05) was increased and the short chain fatty acid producing strains such as Coprococcus, Roseburia, Blautia, Clostridium and Bacteroides was reduced in 2K1C model group than in sham operation group (all P<0.05). Moreover, the relative abundance of Prevotella (Bacteroidetes) was also significantly higher in 2K1C model group than in sham operation group (18.14(17.78,18.75) vs.1.83(1.50,5.19), U=0.00, P<0.05). Moreover, the relative abundance of Ruminococcus (Firmicutes) was significant higher in 2K1C model group than in sham operation group (7.73(6.04,9.34) vs. 3.68(2.46,4.67),U=0.00, P<0.05). Principal coordinate analysis showed that there was significant difference in the gut microbial community structure between 2K1C model group and sham operation group. Conclusion There are significant changes in the gut microbial community structure in 2K1C model group as compared to sham operation group, indicating renovascular hypertension might affect gut microbial community structure in this rat model.