Patent foramen ovale(PFO)demonstrates significant comorbidity with migraine,but its causal relationship and the efficacy of transcatheter closure remain controversial.This systematic review examines potential biomarkers and relevant imaging assessments for PFO-associated migraine,aiming to provide a theoretical foundation for clinical diagnosis and treatment.Key biomarkers include platelet activation markers,calcitonin gene-related peptide,homocysteine,and platelet-to-lymphocyte ratio.Imaging evaluations encompass right-to-left shunt grading(transthoracic echocardiography,transcranial Doppler ultrasound),cerebrovascular breath-holding index,characteristics of white matter hyperintensities,alterations in resting-state functional magnetic resonance imaging(rs-f-MRI)brain networks,in-situ thrombi detected by optical coherence tomography,and electroencephalogram(EEG)power spectral features.Research indicates that integrating biomarkers with imaging technologies enhances diagnostic discrimination and treatment outcome prediction.Current challenges include unclear causal relationships and insufficient standardization of detection methods.Future efforts require multidisciplinary collaboration to establish personalized diagnostic and therapeutic frameworks through multimodal indicators,thereby advancing precise prevention and treatment strategies for PFO-related migraine.

Objective To explore the predictive value of serum high-mobility group box protein B1(HMGB1)and soluble receptor for advanced glycation end-products(sRAGE)in the occurrence and short-term prognosis of sepsis-associated encephalopathy(SAE).Methods Clinical data of 228 patients with sepsis were retrospectively analyzed.According to the presence of SAE,patients were divided into the SAE group(96 cases)and the non-SAE group(132 cases).General clinical data,laboratory test results,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores,Sequential Organ Failure Assessment(SOFA)scores and serum HMGB1 and sRAGE levels were compared between the two groups.Multivariate Logistic regression analysis was performed to determine factors influencing SAE occurrence.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive ability of HMGB1,sRAGE and the HMGB1/sRAGE ratio to predict the occurrence and short-term prognosis of SAE.Kaplan-Meier survival curves were used to compare the 28-day mortality rates of SAE patients with different HMGB1 and sRAGE expression levels.Results Compared to the non-SAE group,patients in the SAE group exhibited elevated serum HMGB1 levels,decreased sRAGE levels and an increased HMGB1/sRAGE ratio(P＜0.05).The areas under the curve(AUC)for predicting SAE using HMGB1,sRAGE and the HMGB1/sRAGE ratio were 0.826(95%CI:0.770-0.872),0.682(95%CI:0.617-0.742)and 0.895(95%CI:0.848-0.932),respectively,indicating predictive value.Among the 96 SAE patients,52(54.2%)died within 28 days.There were no statistically significant differences in HMGB1,sRAGE and the HMGB1/sRAGE ratio between surviving and deceased patients(P＞0.05).Similarly,there were no significant differences in 28-day mortality rates between SAE patients with different HMGB1 or sRAGE expression levels.Conclusion Elevated serum HMGB1 and reduced sRAGE are of significant value in the auxiliary diagnosis of SAE,but have limited clinical predictive value for short-term prognosis.

Abdominal war trauma is a common and high-risk type of injury in the modern battlefield,with rapid changes in condition and a high mortality rate.There is an urgent need for emerging medical technologies to improve the efficiency and success rate of first aid for military casualties.With the development of artificial intelligence(AI),5G,and other emerging technologies,the concept of intelligent medical treatment is gradually forming and can assist in the diagnosis and treatment of abdominal trauma.This paper reviews the characteristics of abdominal war trauma in modern wars,discusses the application of intelligent medical treatment for abdominal war trauma and its drawbacks to be solved,aiming to provide reference for research related to abdominal war trauma.

ObjectiveTo obtain the gene sequences of major histocompatibility complex (MHC ) Ⅱgenes of Wuzhishan pigs, analyze their genetic information, and explore the biological functions of their MHC system. MethodsSpleen samples were collected from 3 adult male Wuzhishan pigs. Primers were designed according to MHCⅡ gene sequences, and the coding sequences of Wuzhishan pig MHCⅡ genes were amplified by RT-PCR. Sanger sequencing was performed to determine the full-length sequences. Bioinformatics tools were employed to analyze the physicochemical properties, phylogenetic relationships, conserved motifs, structural domains, chromosomal localization, and syntenic relationships of these genes. ResultsEight MHCⅡ genes were identified in Wuzhishan pigs, designated as SLA-DRA, SLA-DQA, SLA-DQB, SLA-DRB, SLA-DOB, SLA-DMB, SLA-DMA and SLA-DOA. The full-length sequences of these genes were determined by Sanger sequencing and subsequently deposited in GenBank under accession numbers PQ182796, PQ182797, PQ182798, PQ182799, PQ182800, PQ182801, PQ182802, and PQ164779. Phylogenetic analysis showed that the six MHCⅡ genes of Wuzhishan pigs clustered separately from their counterparts in Duroc, Meishan, Large White, and Bama pigs, indicating distinct evolutionary trajectories. Bioinformatics analysis demonstrated that most MHC Ⅱ proteins were hydrophobic, with molecular weights ranging from 27 700 to 30 000 Da. Genes within the same subregion shared conserved motifs. Specifically, four MHCⅡ proteins encoded by SLA-DQB, SLA-DRB, SLA-DOB, and SLA-DMB contained the MHCⅡβ conserved domain, while those encoded by the genes SLA-DRA, SLA-DQA, SLA-DMA, and SLA-DOA contained the MHCⅡα conserved domain. The eight MHCⅡ genes were scattered along the long arm of chromosome 7 in the Wuzhishan pigs, exhibiting syntenic relationships with three human genes and five Duroc pig genes. ConclusionThe MHCⅡ genes of Wuzhishan pigs may possess a unique evolutionary origin.

ObjectiveTo obtain the gene sequences of major histocompatibility complex (MHC ) Ⅱgenes of Wuzhishan pigs, analyze their genetic information, and explore the biological functions of their MHC system. MethodsSpleen samples were collected from 3 adult male Wuzhishan pigs. Primers were designed according to MHCⅡ gene sequences, and the coding sequences of Wuzhishan pig MHCⅡ genes were amplified by RT-PCR. Sanger sequencing was performed to determine the full-length sequences. Bioinformatics tools were employed to analyze the physicochemical properties, phylogenetic relationships, conserved motifs, structural domains, chromosomal localization, and syntenic relationships of these genes. ResultsEight MHCⅡ genes were identified in Wuzhishan pigs, designated as SLA-DRA, SLA-DQA, SLA-DQB, SLA-DRB, SLA-DOB, SLA-DMB, SLA-DMA and SLA-DOA. The full-length sequences of these genes were determined by Sanger sequencing and subsequently deposited in GenBank under accession numbers PQ182796, PQ182797, PQ182798, PQ182799, PQ182800, PQ182801, PQ182802, and PQ164779. Phylogenetic analysis showed that the six MHCⅡ genes of Wuzhishan pigs clustered separately from their counterparts in Duroc, Meishan, Large White, and Bama pigs, indicating distinct evolutionary trajectories. Bioinformatics analysis demonstrated that most MHC Ⅱ proteins were hydrophobic, with molecular weights ranging from 27 700 to 30 000 Da. Genes within the same subregion shared conserved motifs. Specifically, four MHCⅡ proteins encoded by SLA-DQB, SLA-DRB, SLA-DOB, and SLA-DMB contained the MHCⅡβ conserved domain, while those encoded by the genes SLA-DRA, SLA-DQA, SLA-DMA, and SLA-DOA contained the MHCⅡα conserved domain. The eight MHCⅡ genes were scattered along the long arm of chromosome 7 in the Wuzhishan pigs, exhibiting syntenic relationships with three human genes and five Duroc pig genes. ConclusionThe MHCⅡ genes of Wuzhishan pigs may possess a unique evolutionary origin.

The European Association for Cardio-Thoracic Surgery (EACTS) has recently updated and published the "2024 EACTS guidelines on perioperative medication in adult cardiac surgery". Based on the latest evidence, the guidelines have been updated in multiple aspects including underlying disease management, antithrombotic medication, arrhythmia treatment and other supportive care, etc. This paper aims to summarize and interpret the guidelines, in order to promote clinicians’ understanding and optimize perioperative medical treatment in adult cardiac surgery.

Objective:To evaluate the clinical efficacy of botulinum toxin type A (BTX-A) combined with sodium hyaluronate solution for facial microdroplet injection in improving facial skin photoaging.Methods:A prospective randomized controlled trial was conducted. From January to July 2024, patients with facial photoaging problems were recruited from the Plastic Surgery Department of the Affiliated Hospital of Xuzhou Medical University and randomly divided into a monotherapy group (sodium hyaluronate solution droplet injection) and a combination therapy group (BTX-A + sodium hyaluronate solution droplet injection) by hierarchical block randomization method. The treatment regimen was 3 months, with one treatment for each month, with a total of 3 treatment. The combination therapy group only used a combination therapy of two drugs (BTX-A 25 U+ 5 ml sodium hyaluronate solution) during the first injection. During the three treatments of the monotherapy group and the second and third treatments of the combination therapy group, 5 ml of sodium hyaluronate solution was injected as the solo ingredient. Follow up was conducted at 1, 2, and 4 months after the last treatment. Serum superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were detected by test kit. Five skin texture indicators (moisture content, transepidermal water loss rate, elasticity, glossiness, and pH) were evaluated using the German CK skin tester. VISIA skin detector was used for facial two-dimensional photography and skin condition analysis. Clinical efficacy (significant improvement, obvious improvement, improvement, no improvement) and global aesthetic improvement scale (GAIS) scores on a 5-point scale were recorded. Patient satisfaction levels (very satisfied, satisfied, and dissatisfied) were investigated. The data were analyzed using SPSS 27.0 software. Count data was presented as examples and(or) percentages, and analyzed using a chi-square test. Normal distribution measurement data was represented by Mean±SD and analyzed using t-test. Results:A total of 100 patients were included, with 50 cases in each group. There were 17 males and 33 females in the monotherapy group, with an age of (31.3±7.1) years, and there were 5, 14, 29 and 2 patients in the Ⅰ to Ⅳ types of Glogau skin photoaging classification, respectively. There were 15 males and 35 females in the combination therapy group, with an age of (32.1±8.4) years old, and there were 4, 15, 27 and 4 patients in the Ⅰ to Ⅳ types of Glogau skin photoaging classification, respectively. There was no statistically significant difference in gender composition, age, and Glogau skin photoaging classification between the two groups (all P>0.05). One month after the first treatment, both groups showed an increase in SOD activity and a decrease in MDA levels, with more significant changes observed in the combination therapy group ( P<0.01 for both). At the follow-up of 1, 2, and 4 months after the last treatment, the combination therapy group outperformed the monotherapy group in all 5 skin texture indicators (all P<0.05). One month after the last treatment, the total effective rate of the combination therapy group was 76.0% (38/50), which were significantly higher than that of the monotherapy group’s 50.0% (25/50) ( P<0.05); in addition, the combination therapy group showed significant advantages in facial aesthetic GAIS scores, as well as patient satisfaction, with a satisfaction rate of up to 98.0% (49/50), which was higher than the 88.0% (44/50) of the monotherapy group ( P<0.01). Throughout the entire treatment process, neither group experienced serious adverse reactions. Conclusion:Facial microdroplet injection of BTX-A combined with sodium hyaluronate solution effectively improves symptoms of facial skin photoaging, enhancing skin hydration and elasticity, reducing transepidermal water loss, improving skin gloss, regulating skin pH, and enhancing skin antioxidant capacity, ultimately achieving facial skin rejuvenation. This method is safe, effective and holds high clinical relevence and patient satisfaction.

Radiomics provides quantitative support for the diagnosis,treatment strategy and prognosis evaluation of brain arteriovenous malformation(bAVM)through high-throughput analysis of imaging data,and it also shows significant advantages in clinical symptom prediction,personalized treatment and clinical outcome prediction.Emerging imaging techniques,such as blood oxygen level-dependent cerebrovascular reactivity imaging and ultrasound technology,provide a new perspective for evaluating the hemodynamic changes and epilepsy susceptibility associated with bAVM.In addition,advances in deep learning algorithms in automatic segmentation of bAVM lesions have greatly improved the accuracy and efficiency of segmentation.With the continuous progress of imaging technology,data analysis algorithms and software,radiomics is expected to play a greater role in precision medicine and individualized treatment,bringing better diagnosis and treatment services and better treatment effects for bAVM patients.

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.