Tetrodotoxin（TTX）is a potent neurotoxin known for its specific sodium channel blocking effects, widely used in biomedical research. While TTX has been identified in various marine organisms, its true origin remains unclear, and the specific biosynthetic pathways are yet to be elucidated. The reported sources of TTX and the progress in research on TTX biosynthesis were summarized, with a focus on potential microbial sources of TTX, which could provide scientific reference for the production and biosynthesis studies of TTX.

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC. Methods: TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays. Results: TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression. Conclusion TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.

ObjectiveTo establish an adjusted Serfling regression model to estimate the excess cases and the excess epidemic period of hand-foot-mouth disease (HFMD) in Beijing from 2011 to 2019, so as to provide data support and decision-making basis for HFMD prevention and control. MethodsThe weekly number of HFMD cases in Beijing from 2011 to 2019 was utilized for adjusted the Serfling regression model. Then the adjusted model was used to fit the baseline and epidemic threshold of HFMD in Beijing from 2011 to 2019, calculating the excess cases and determining the excess epidemic period. ResultsA total of 279 306 cases of HFMD were reported in Beijing from 2011 to 2019, with the climax of the disease occurring in summer and autumn. After adjusting the fitting R² of the Serfling regression model to 0.773, a total of 10 excess epidemic periods totaling 92 weeks were estimated, mainly occurring in summer. The highest number of excess cases during an excess epidemic period was found in 2014 (1 272 cases, 95%CI: 990‒1 554), accounting for 65.04% of the actual cases (95%CI: 50.62%‒79.46%). ConclusionThe adjusted Serfling regression model fits well and can be utilized for early warning of HFMD and estimating the disease burden caused by HFMD.

Skull segmentation in magnetic resonance image(MRI)provides realistic skull models for MEG and EEG positive problems.An MRI skull segmentation method based on bi-stream pyramid decoder and deep supervision(BiNETR)is proposed to solve the problem of difficult segmentation due to the blurred and complex structure of MRI skull imaging.The method uses a bi-stream pyramid decoder as the main decoder in the network structure of encoding-decoding,including serial dual decoders for edge information oriented and precise feature merging.Specifically,edge information oriented pyramid decoder effectively enhances the edge information based on feature sharpening to improve the edge segmentation accuracy,and the precise feature merging pyramid decoder further refines and reuses the edge-enhanced features to promote the fusion of deep and shallow features.In addition,deep supervised computation of intermediate feature loss is introduced to implant the gradient into the deep network for enhancing network training.The segmentation algorithm is validated on the skull dataset,achieving a Dice similarity coefficient of 0.880±0.039 and an average symmetric surface distance of(0.931±0.286)mm,outperforming other state-of-the-art methods.The experimental results demonstrate the effectiveness and accuracy of the proposed algorithm in MRI skull segmentation.

Objective:To apply data mining and bibliometric methods to collect and analyze literatures related to the uPMR 790 integrated positron emission tomography/magnetic resonance imaging(PET/MRI)of the United Imaging Healthcare(UIH)and assess its output effects in clinical research and application,continued research and development,performance improvement,technology assessment,healthcare technology management,and other aspects.Methods:To conduct literature searches on data platforms such as China National Knowledge Infrastructure(CNKI),WanFang Data Knowledge Service Platform(WANFANG DATA),Wanfang Medical Network(WANFANG MED ONLINE),Chinese Medical Association Journal Database(Yiigle),NIH/PubMed,etc.Based on literature review,to implement bibliometric analysis and evaluate from several technological output dimensions.Results:134 sample literatures were obtained.Among them,there are 121 journal articles,10 dissertations(1 doctoral dissertation and 9 master's theses),3 case reports from the Chinese Medical Case Repository,59 of foreign language journals,and 101 articles sourced from uPMR 790 users as the first author affiliation.Engineering and technical personnel from UIH participated in 58 journal articles;89 clinical research articles,accounting for 66.42%of the sample literatures,15 engineering research and artificial intelligence(AI)research articles,accounting for 11.19%,15 technology assessment articles,accounting for 11.19%,4 healthcare technology management articles,1 experimental research article,and 10 reviews.In addition,33 related patent technologies were retrieved from UIH and its cooperative institutions,as well as UIH PET/MRI equipment users,including 20 invention patents,13 utility model patents.Conclusion:The research results show that the innovative medical equipment,the uPMR 790 PET/MRI,has definite technological outputs in clinical research and application,providing important and widely data of evidence-based medicine for clinical application promotion.It also map out the effective support of this innovative medical equipment for multidisciplinary clinical research such as medical imaging,neurology,cardiovascular and cerebrovascular diseases,geriatrics,pediatrics,etc.Driven by the model of medical-engineering integration and synergy mechanism,display multidimensional output effects such as continuous research and development,quality improvement,technology assessment,configuration management,and healthcare technology management.UIH actively participates in researchs and follows up on innovative practices in medical-engineering integration,demonstrating a positive attitude as a leading medical equipment enterprise.Real world research will provide evidence support for the application demonstration and promotion for equipment manufactured by Chinese medical equipment enterprises.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To explore the clinical treatment principles for tibial plateau fracture related infection (TPFRI).Methods:A retrospective study was used to analyze the clinical data of 47 patients with TPFRI who had been admitted to The Third Hospital of Hebei Medical University from May 2015 to May 2022. There were 33 males and 14 females, with an age of (49.3±9.5) years. By admission, 32 tibial plateau fractures got healed while 15 ones remained unhealed. According to the site of infection, TPFRI was classified into 3 categories: arthritic type (9 cases), adjacent articular type (28 cases), and distal articular type (10 cases). Individualized reconstruction plans were made according to fracture union, bone and soft tissue defects, and infection involvement of the knee joint. The knee function was assessed by the modified Hospital for Special Surgery (HSS) criteria at the final follow-up. The fracture union and complications were recorded.Results:All patients were followed up for (37.4±11.7) months. The infection was controlled and the fractures got united after (4.6±1.4) months in the 15 patients whose tibial plateau fractures remained unhealed by admission. In the 32 cases whose tibial plateau fractures got healed by admission (except for the 7 cases without bone defects, 1 case undergoing femoral condyle amputation and 1 case undergoing tibial flip amputation), respectively, Masquelet technique was used in 5 cases, Ilizarov bone transport in 3 cases, filling with an astrocnemius muscle flap or a myocutaneous flap in 5 cases, semi-open bone grafting in 1 case, open bone cement rod technique in 1 case, platelet-rich plasma combined with negative pressure drainage in 1 case, and knee arthrodesis in 7 cases to reconstruct their bone and soft tissue defects. At the final follow-up, the knee function was evaluated based on the modified HSS scoring as excellent in 28 cases, as good in 15 cases, as moderate in 3 cases and as poor in 1 case. The number of the patients with excellent or good knee function was significantly larger in the adjacent articular type and distal articular type than in the arthritic type ( P<0.05). The number of the patients with excellent or good knee function was significantly larger in those whose tibial plateau fractures remained unhealed by admission than in those whose tibial plateau fractures got healed by admission ( P<0.05). All patients did not experience such complications as open fat liquefaction, bone nonunion, lower limb deep vein thrombosis, or pulmonary embolism. Conclusions:In the treatment of TPFRI, individualized treatment plans should be made to improve infection control, accelerate functional recovery of the knee joint, and reduce incidence of complications, taking into consideration such factors as fracture union, bone and soft tissue defects, and infection involvement of the knee joint.

A self-supervised super-resolution reconstruction method based on scale adaptive and coordinate encoding is proposed to realize super-resolution reconstruction of anisotropic brain magnetic resonance images with different slice thicknesses even in the absence of paired isotropic brain magnetic resonance images.Firstly,an image encoding module that integrates super-resolution scale information is used to learn the specific features of images with different slice thicknesses.Subsequently,a coordinate encoding module is employed to facilitate the deep fusion of coordinate information and image features.Finally,an overall loss function comprising reconstruction loss and brain tissue edge perception loss is adopted to optimize the recovery of edge high-frequency information,while global residual learning is introduced to enhance network training.Experimental results on the HCP-1200 and OASIS-1 datasets demonstrate that the proposed method outperforms other self-supervised super-resolution reconstruction methods.

Clinically,the incidence of chronic musculoskeletal pain is relatively high,and it is one of the main causes of disability in Chinese residents,causing a heavy health and economic burden to the society.There are limited treatments available for patients who are ineffective to conservative treatment and whose disorders are inoperable.Recently,transcatheter embolization(TCE)has become a potential treatment method for such patients.Chronic musculoskeletal pain,such as knee osteoarthritis,adhesive capsulitis of the shoulder(frozen shoulder),tendinopathy,and neck/back muscle pain,can induce pathological neovascularization and inflammatory reactions.TCE of abnormal neovasculature can improve patient's pain and limb function.So far,there are relatively few studies on the TCE of chronic musculoskeletal pain in China,and there are no large-scale high-quality clinical studies abroad.This paper aims to make a comprehensive review about the TCE for chronic musculoskeletal pain,focusing on its basic principles,operative techniques,and latest clinical achievements.