ObjectiveThe study explores the influence of voluntary wheel running on the behavioral abnormalities and the activation state of the hypothalamic-pituitary-adrenal (HPA) axis in autism spectrum disorder (ASD) rats through gut microbiota. MethodsSD female rats were selected and administered either400 mg/kg of valproic acid (VPA) solution or an equivalent volume of saline via intraperitoneal injection on day 12.5 of pregnancy. The resulting offspring were divided into 2 groups: the ASD model group (PASD, n=35) and the normal control group (PCON, n=16). Behavioral assessments, including the three-chamber social test, open field test, and Morris water maze, were conducted on postnatal day 23. After behavioral testing, 8 rats from each group (PCON, PASD) were randomly selected for serum analysis using enzyme-linked immunosorbent assay (ELISA) to measure corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT) concentration, to evaluate the functional state of the HPA axis in rats. On postnatal day 28, the remaining 8 rats in the PCON group were designated as the control group (CON, n=8), and the remaining 27 rats in the PASD group were randomly divided into 4 groups: ASD non-intervention group (ASD, n=6), ASD exercise group (ASDE, n=8), ASD fecal microbiota transplantation group (FMT, n=8), and ASD sham fecal microbiota transplantation group (sFMT, n=5). The rats in the ASD group and the CON group were kept under standard conditions, while the rats in the ASDE group performed 6 weeks of voluntary wheel running intervention starting on postnatal day 28. The rats in the FMT group were gavaged daily from postnatal day 42 with 1 ml/100 g fresh fecal suspension from ASDE rats which had undergone exercise for 2 weeks, 5 d per week, continuing for 4 weeks. The sFMT group received an equivalent volume of saline. After the interventions were completed, behavioral assessments and HPA axis markers were measured for all groups. ResultsBefore the intervention, the ASD model group exhibited significantly reduced social ability, social novelty preference, spontaneous activity, and exploratory interest, as well as impaired spatial learning, memory, and navigation abilities compared to the normal control group (P<0.05). Serum concentration of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosterone (CORT) in the PASD group were significantly higher than those in the PCON group (P<0.05). Following 6 weeks of voluntary wheel running, the ASDE group showed significant improvements in social ability, social novelty preference, spontaneous activity, exploratory interest, spatial learning, memory, and navigation skills compared to the ASD group (P<0.05), with a significant decrease in serum CORT concentration (P<0.05), and a downward trend in CRH and ACTH concentration. After 4 weeks of fecal microbiota transplantation in the exercise group, the FMT group showed marked improvements in social ability, social novelty preference, spontaneous activity, exploratory interest, as well as spatial learning, memory, and navigation abilities compared to both the ASD and sFMT groups (P<0.05). In addition, serum ACTH and CORT concentration were significantly reduced (P<0.05), and CRH concentration also showed a decreasing trend. ConclusionExercise may improve ASD-related behaviors by suppressing the activation of the HPA axis, with the gut microbiota likely playing a crucial role in this process.

ObjectiveRecent studies have highlighted the critical role of NUDT19 in the initiation, progression, and prognosis of specific cancer types. However, its involvement in pan-cancer analysis has not been fully characterized. This study aims to systematically explore the expression patterns, clinical significance, and immune-related functions of NUDT19 in various cancer types through multi-omics analysis, further revealing its potential role in cancer, particularly its functional and therapeutic target value in leukemia. MethodsTo achieve this goal, various bioinformatics approaches were employed to evaluate the expression patterns, clinical significance, and immune-related functions of NUDT19 in tumors and normal tissues. Additionally, we analyzed the mutation characteristics of NUDT19 and its relationship with epigenetic modifications. Using the single-cell analysis tool SingleCellBase, we explored the distribution of NUDT19 across different cell subpopulations in tumors. To validate these findings, qRT-PCR was used to measure NUDT19 expression levels in specific tumor cell lines, and we established acute myeloid leukemia (AML) cell lines (HL-60 and THP-1) to conduct NUDT19 knockdown and overexpression experiments, assessing its effects on leukemia cell proliferation, apoptosis, and invasion. ResultsPan-cancer analysis revealed the dysregulated expression of NUDT19 across multiple cancer types, which was closely associated with poor prognosis, clinical staging, and diagnostic markers. Furthermore, NUDT19 was significantly correlated with tumor biomarkers, immune-related genes, and immune cell infiltration in different cancers. Mutation analysis showed that multiple mutations in NUDT19 were significantly associated with epigenetic changes. Single-cell analysis revealed the heterogeneity of NUDT19 expression in cancer cells, suggesting its potentially diverse functional roles in different cell subpopulations. qRT-PCR experiments confirmed the significant upregulation of NUDT19 in various tumor cell lines. In AML cell lines, NUDT19 knockdown led to reduced cell proliferation and invasion, with increased apoptosis, while NUDT19 overexpression significantly enhanced cell proliferation and invasion while reducing apoptosis. ConclusionThis study demonstrates the diverse roles of NUDT19 in various cancer types, with a particularly prominent functional role in leukemia. NUDT19 is not only associated with tumor initiation and progression but may also influence cancer progression through the regulation of immune microenvironment and epigenetic mechanisms. Our research highlights the potential of NUDT19 as a therapeutic target, particularly for targeted therapies in malignancies such as leukemia, with significant clinical application prospects.

Cerebrovascular ultrasound includes transcranial color coded Doppler(TCCD)and transcranial Doppler(TCD).The clinical application of TCCD and TCD has gone through a clinical application process over 30,40 years,respectively.Cerebrovascular ultrasound is increasingly receiving clinical attention for early screening,diagnosis,treatment,and follow-up of intracranial and extracranial artery(especially intracranial artery)lesions,especially for the evaluation of neurological function,ischemic stroke,subarachnoid hemorrhage,right-to-left shunting,cerebral blood flow autoregulation,sickle cell anemia,and other diseases.This review focused on reviewing the progress of clinical applications of cerebrovascular ultrasound both domestically and internationally.

Objective To investigate the current status,diagnostic difficulties,and the necessity of formulating a consensus on several issues of cerebrovascular ultrasound examination in China.Methods A network questionnaire survey was conducted to investigate several problems of cerebrovascular ultrasound and the needs of expert consensus among practitioners of transcranial Doppler(TCD)ultrasound and transcranial color coded Doppler(TCCD)ultrasound in medical institutions.The questionnaire covered the basic information of the respondent group,including the region where the medical institution was located(Q1),the level of the medical institution(Q2),the scope of practice of TCD or TCCD practitioners(Q3),title(Q4);the assessment mode of cerebrovascular and cervical vascular(Q5);the general demand for expert consensus(Q6)and TCD diagnosis-related issues(Q7-Q17).There were three dimensions of TCD diagnosis-related issues(diagnostic criteria,multi-dimensional comprehensive assessment,and dynamic monitoring during the perioperative period of angioplasty),with a total of 11 items(Q7-Q17:intracranial artery stenosis or occlusion,vascular development anomalies,side branch circulation judgment,ultrasound dynamic monitoring after angioplasty,cerebral vasospasm,contrast-enhanced TCD examination,etc.).At the same time,open-ended questions were also set up:the most important content to be improved in cerebrovascular ultrasound(Q18).The reliability analysis of the questionnaire was used to assess the reliability,with Cronbach's α coefficient ≥0.7 considered as good reliability.The validity evaluation was conducted by factor analysis.The comparison of the demand for each item under different conditions was conducted by x2 test,and the Kruskal-Wallis H test was used to compare ranked data among different groups.Results A total of 1 395 complete and valid questionnaires were collected,involving TCD or TCCD practitioners from 31 provinces,autonomous regions,and municipalities(there was no response from the Xizang Autonomous Region),which had a certain representativeness.Survey reliability evaluation:Cronbach's α coefficient=0.917(F=132.702,P＜0.01).Factor analysis,KOM=0.930(x2=8 478.844,P＜0.01),the cumulative contribution rate was 70.600％when taking into account three factors.Among the respondents,the proportion of those from tertiary-level grade A hospitals was the highest(64.2％[896/1 395]);the distribution of titles was dominated by those of attending physicians(48.5％[676/1 395]),followed by senior titles(37.2％[519/1 395]);among the respondents,66.6％(929/1 395)said they urgently needed expert consensus,while 32.7％(456/1 395)said they needed to improve existing standards.There were significant differences in the needs for expert consensus and each item across different regions,professional titles and evaluation models(all P＜0.05).Conclusions The questionnaire have high reliability and validity.There is an urgent need for expert consensus on several issues related to cerebrovascular ultrasound among the respondents.The establishment of expert consensus would contribute to standardized and precise evaluation system,thereby promoting quality control management and standardization of cerebrovascular ultrasound practices.

Objective:This study aims to assess the status of catastrophic health expenditure(CHE)among elderly households in China,analyze the evolving inequality trends of CHE,and identify the contributing factors.Methods:Utilizing data from the China Family Panel Studies(2012-2020),we employed Logit regression and multiple linear regression to estimate the factors influencing CHE,Furthermore,we utilized the concentration index and its decomposition method to examine the disparities in CHE and the respective impacts of associated factors.Results:The findings reveal a heightened vulnerability among elderly households,with discernible income-related inequalities and a rising trend.Economic factors.Household savings,per capita income,and net worth,as well as the health status of the elderly and their membership in elderly-oriented organizations,positively contribute to the inequality in catastrophic health expenditure.Conversely,the presence of a partner exhibits a negative influence.Conclusion:These results underscore the need for policy interventions that address these contributing factors and effectively provide economic risk mitigation for the elderly population.

Objective:To develop a deep learning model based on multimodal data for glaucoma diagnosis and severity assessment.Methods:A diagnostic test was conducted.A total of 145 normal eyes from 86 participants and 507 eyes with primary open-angle glaucoma from 314 participants were collected at the First Affiliated Hospital of Kunming Medical University from June to December in 2023.Fundus photographs and visual field data were obtained, and glaucoma eyes were divided into three groups based on the mean deviation value of the visual field, namely mild group (154 eyes), moderate group (113 eyes), and severe group (240 eyes).Three convolutional neural network (CNN) models, including DenseNet 121, ResNet 50 and VGG 19, were used to build an artificial intelligence (AI) model.The impact of single-modal and multimodal data on the classification results was evaluated, and the most appropriate CNN network architecture for multimodal data was identified.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of The First Affiliated Hospital of Kunming Medical University (No.2023L93).Written informed consent was obtained from each subject.Results:A total of 652 eyes had both fundus photographs and visual field test results.Images were randomly assigned to training and test datasets in a 4∶1 ratio by using computer random number method.AI models built with different CNN models showed high accuracy, with DenseNet 121 outperforming ResNet 50 and VGG 19 on various effectiveness measures.In the single-modal algorithm using fundus photographs, single-modal algorithm using visual field tests, and multimodal algorithm combining fundus photographs and visual field data, the area under the curve for early glaucoma detection was 0.87, 0.93 and 0.95, respectively.Conclusions:The use of multimodal data enables the development of a highly accurate tool for the glaucoma diagnosis and severity grading.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Immmunosuppressants are mainly used to reduce rejection after solid organ transplantation,so as to improve the success rate of organ transplantation.However,long-term use of immunosuppressants can also serious-ly impair the immune function of patients,thereby increasing the risk of viral infection and postoperative complica-tions,leading to transplant failure.Therefore,patients need to use both immunosuppressants and antiviral agents.If some immunosuppressants with antiviral effects are found,the patient's burden of taking medicines will be greatly reduced.Currently,the immunosuppressants with antiviral effect have been focused by researchers.The gradual re-vealing of the antiviral mechanism of these immunosuppressants will help to optimize the treatment plan of postope-rative rehabilitation of organ transplant recipients.Based on the mechanism of rejection of transplanted organ,this paper systematically describes the types of viruses which closely related to infection of organ transplant patients and the molecular mechanism of some immunosuppressants in antiviral aspects,which further provides a new idea for clinical prevention and treatment of viral infection due to organ transplantation.

The gene GeDRP1E encoding dynamin-related protein 1E in Gastrodia elata was cloned by specific primers which were designed based on the transcriptome data of G. elata. Bioinformatics analysis on GeDRP1E gene was carried out by using ExPASy, ClustalW, MEGA, etc. Positive transgenic Arabidopsis plant and potato minituber were obtained with the genetic transformation system of Arabidopsis and potato. The plant height and seed setting rate of transgenic Arabidopsis, and agronomic characters, such as size, weight and starch content of potato minituber of transgenic potato were tested and analyzed. And GeDRP1E gene function was preliminarily investigated. The results showed that the open reading frame of GeDRP1E gene was 1 899 bp in length and 632 amino acids residues were encoded, with a relative molecular weight of 69.90 kDa and a molecular formula of C₃₀₇₉H₄₉₇₃N₈₈₃O₉₃₃S₁₉. It was predicted that the theoretical isoelectric point was 7.27, the instability coefficient was 43.34, and the average hydrophilicity index was -0.259, which was indicative of an unstable hydrophilic protein. GeDRP1E has no transmembrane structure and signal peptide, and was localized in the cytoplasm. The phylogenetic tree showed that GeDRP1E was highly homologous with DRP1E proteins of other plant species, among which GeDRP1E had the highest homology with DcDRP1E (XP_020689662.1) in Dendrobium candidum, reaching 90.05%. GeDRP1E plant expression vector pCambia1300-35Spro-GeDRP1E was constructed by double digests, and Arabidopsis complementary mutant and potato overexpression strain of GeDRP1E gene were obtained by Agrobacterium-mediated gene transformation. Compared with the Arabidopsis AtDRP1E mutant, the height and seed setting rate of the GeDRP1E complementation mutant were rescued. The minituber of GeDRP1E overexpression potato had larger size, heavier weight and higher starch content, comparing to wild-type potato. It was preliminarily induced that GeDRP1E was involved in mitochondrial morphology regulation, which related to the growth and development of Arabidopsis plants and potato miniature. The research results laid a foundation for further elucidating the molecular mechanisms underlying the growth and development of G. elata tuber development.

Objective To observe the clinical efficacy of abdominal acupuncture with acupuncture method of Zuosheng Youjiang(left ascending and right descending)Qi-Regulation Microneedling in the treatment of depression.Methods Sixty cases of depression were randomly divided into observation group and control group,30 cases in each group.The observation group was given Zuosheng Youjiang Qi-Regulation Microneedling therapy,and the control group was given oral use of Sertraline Hydrochloride Tablets.A total of 6 weeks of treatment was given.After 6 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in Hamilton Depression Scale(HAMD)scores and Self-rating Anxiety Scale of Depression(SAS)scores of the two groups were observed before and after treatment.The safety and the occurrence of adverse reactions in the two groups were evaluated.Results(1)After treatment,the HAMD scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the HAMD scores,and the differences were statistically significant(P＜0.05).The difference between the HAMD scores of patients in the two groups was statistically significant before and after treatment(P＜0.05).(2)After treatment,the SDS scores of the two groups of patients were significantly improved,and the observation group was significantly superior to the control group in improving the SDS scores,and the difference was statistically significant(P＜0.05).The difference between the pre-treatment and post-treatment differences in the SDS scores of the two groups of patients was statistically significant(P＜0.05).(3)The total effective rate of the observation group was 100.00%(30/30),and the control group was 83.33%(25/30).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(4)There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P＞0.05).Conclusion Abdominal acupuncture combined with Zuosheng Youjiang Qi-Regulation Microneedling for the treatment of depression can significantly improve the clinical symptoms of the patients,and the therapeutic effect is remarkable.