Early-stage diagnosis of liver cancer is challenging, with an overall poor prognosis. The tumor microenvironment of primary liver cancer is complex, exhibiting significant heterogeneity both interpersonally and intratumorally. Therefore, it is of paramount importance to dynamically analyze biological markers in the tumor microenvironment of primary liver cancer in vivo. In recent years, significant progress has been made in the imaging diagnosis and treatment of liver cancer with the development of molecular imaging. Molecular imaging techniques utilize specific nano-imaging probes to evaluate pathological changes of liver cancer at the molecular and cellular levels in real-time. These techniques enable precise imaging to reveal key molecular biomarkers involved in the occurrence and progression of liver cancer, exploring their associations with cancer progression and outcomes. This article focuses on molecular imaging, emphasizing the current research status and latest advancements in the field of liver cancer diagnosis and therapy using techniques such as CT, MRI, optical imaging, PET imaging, and multimodal imaging. It also identifies important future directions and significant challenges for further development.

Objective:The emergence of polymyxin-resistant Klebsiella pneumoniae(KPN)in clinical settings necessitates an analysis of its antibiotic resistance characteristics,epidemiological features,and risk factors for its development.This study aims to provide insights for the prevention and control of polymyxin-resistant KPN infections. Methods:Thirty clinical isolates of polymyxin-resistant KPN were collected from the Third Xiangya Hospital of Central South University.Their antibiotic resistance profiles were analyzed.The presence of carbapenemase KPC,OXA-48,VIM,IMP,and NDM was detected using colloidal gold immunochromatography.Hypervirulent KPN was initially screened using the string test.Biofilm formation capacity was assessed using crystal violet staining.Combination drug susceptibility tests(polymyxin B with meropenem,tigecycline,cefoperazone/sulbactam)were conducted using the checkerboard method.Polymyxin-related resistance genes were detected by PCR.Multi-locus sequence typing(MLST)was performed for genotyping and phylogenetic tree construction.The study also involved collecting data from carbapenem-resistant(CR)-KPN polymyxin-resistant strains(23 strains,experimental group)and CR-KPN polymyxin-sensitive strains(57 strains,control group)to analyze potential risk factors for polymyxin-resistant KPN infection through univariate analysis and multivariate Logistic regression.The induction of resistance by continuous exposure to polymyxin B and colistin E was also tested. Results:Among the 30 polymyxin-resistant KPN isolates,28 were CR-KPN,all producing KPC enzyme.Four isolates were positive in the string test.Most isolates showed strong biofilm formation capabilities.Combination therapy showed additive or synergistic effects.All isolates carried the pmrA and phoP genes,while no mcr-1 or mcr-2 genes were detected.MLST results indicated that ST11 was the predominant type.The phylogenetic tree suggested that polymyxin-resistant KPN had not caused a hospital outbreak in the institution.The use of two or more different classes of antibiotics and the use of polymyxin were identified as independent risk factors for the development of polymyxin-resistant strains.Continuous use of polymyxin induced drug resistance. Conclusion:Polymyxin-resistant KPN is resistant to nearly all commonly used antibiotics,making polymyxin-based combination therapy a viable option.No plasmid-mediated polymyxin-resistant KPN has been isolated in the hospital.Polymyxin can induce resistance in KPN,highlighting the need for rational antibiotic use in clinical settings to delay the emergence of resistance.

Sugar-sugar glycosyltransferases play important roles in constructing complex and bioactive saponins. Here, we characterized a series of UDP-glycosyltransferases responsible for biosynthesizing the branched sugar chain of bioactive steroidal saponins from a widely known medicinal plant Paris polyphylla var. yunnanensis. Among them, a 2'-O-rhamnosyltransferase and three 6'-O-glucosyltrasferases catalyzed a cascade of glycosylation to produce steroidal diglycosides and triglycosides, respectively. These UDP-glycosyltransferases showed astonishing substrate promiscuity, resulting in the generation of a panel of 24 terpenoid glycosides including 15 previously undescribed compounds. A mutant library containing 44 variants was constructed based on the identification of critical residues by molecular docking simulations and protein model alignments, and a mutant UGT91AH1^Y187A with increased catalytic efficiency was obtained. The steroidal saponins exhibited remarkable antifungal activity against four widespread strains of human pathogenic fungi attributed to ergosterol-dependent damage of fungal cell membranes, and 2'-O-rhamnosylation appeared to correlate with strong antifungal effects. The findings elucidated the biosynthetic machinery for their production of steroidal saponins and revealed their potential as new antifungal agents.

Objective:To clarify the evidences of hippocampal injury after radiotherapy avoiding hippocampus and explore its relationships with cognition.Methods:A prospective design was adopted in this study.A total of 183 patients with nasopharyngeal carcinoma treated by intensity modulated radiation therapy (IMRT group) and 30 matched healthy control (HC group)were collected in the Affiliated Hospital of Jiangsu University and Southeast University Affiliated Zhongda Hospital from January 2017 to December 2019. All subjects were assessed by Montreal Cognitive Assessment (MoCA-B) at baseline and 6 months after radiotherapy, then the patients with nasopharyngeal carcinoma were divided into cognitive impairment group and non-cognitive impairment group. Subjects were scanned with Siemens 3.0 T MR, and T 1WI was used as analysis sequence.The individual standardized hippocampus ROIs were extracted based on Montreal Neurological Institute(MNI) brain template.All texture features were calculated using the Radiomics developed by C++and Delphi, and the intra group correlation coefficients (ICC), average direction, machine learning (random forest) and autocorrelation matrix were used for reducing the features dimension. One-way ANOVA and generalized linear models were used to compare the differences among different groups. Pearson correlations analyses were used to evaluate the relationships between important texture features and clinical data. Logistic regressions were used to calculate the abilities of texture features to predict cognitive impairment. Results:After 9 patients who lost follow-up were excluded, a total of 164 patients with nasopharyngeal carcinoma were included as IMRT group.Texture features of ROIs were extracted and dimensionally reduced successfully. Five differences features (Variance, Entropy, GlevNonU, RLNonUni and Contrast)were found among HC group, cognitive impairment group and non-cognitive impairment group, and the last three further showed significant differences within IMRT group (GlevNonU, P=0.011;RLNonUni, P<0.001;Contrast, P<0.001). Hippocampal doses were positively correlated with Variance ( r=0.448, P<0.05), and negatively correlated with Entropy ( r=-0.461, P<0.05). There was a positive correlation between MoCA-B scores with GlevNonU, RLNonUniand Contrast ( r=0.503, P<0.05; r=0.587, P<0.05; r=0.531, P<0.05). GlevNonU and Contrast were independent predictors of cognitive impairment in hippocampal avoidance of radiotherapy (OR=0.731, 95%CI 0.610-0.857; OR=0.651, 95%CI 0.496-0.853). Conclusion:Results of texture analysis could be used as micro imaging evidences of hippocampal injury in radiotherapy avoiding hippocampus, and could also effectively predict the occurrences of cognitive impairment.

Background/Aims: Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD. Methods: This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay. Results: The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. Conclusions Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

Objective To explore the clinical effect of SaO2and heart rate(HR)for the diagnosis of acute mountain sickness (AMS).Methods A total of 1 062 male soldiers on garrison duty in rapidly entering to high altitude at 3 700-5 400 m from May 2013 to August 2015 were included as the research subjects.The demography data were collected and the AMS symptoms investiga-tion was performed.SaO2and HR were detected and the relationship between SaO2and HR at different altitudes with AMS symp-tom score was analyzed.Results The cut-off value of SaO2for diagnosing AMS in rapidly entering to high altitude at 3 700-<4 300 m was 84.5%(AUC=0.781)with the screening sensitivity of 78.31% and specificity of 72.02%;which of HR for diag-nosing AMS was 89.5 times/min(AUC=0.640)with the screening sensitivity of 71.27% and specificity of 54.63%.When SaO2 was serially connected with HR,its sensitivity was 58.87% and the specificity was 89.23%,while the parallel connection yielded a sensitivity of 90.70% and a specificity of 37.43%.In rapidly entering the altitude at above 5000 m,the cut-off value of SaO2for di-agnosing AMS was 80.5%(AUC=0.825)with the screening sensitivity of 84.62% and specificity of 68.85%;which of HR for di-agnosing AMS was 93.5 times/min(AUC= 0.718)with the screening sensitivity of 53.00% and specificity of 85.25%;when SaO2was serially connected with HR,its sensitivity for diagnosing AMS was 47.01% and specificity was 93.44%,while the paral-lel connection yielded a sensitivity of 90.60% and a specificity of 60.66%.Conclusion SaO2combined with HR can serve as an ob-jective index for the on-site diagnosis of AMS and is convenient for the AMS preliminary screening of large populations.

By sorting out 2005-2015's literature on the mechanism of acupuncture and moxibustuion treatment for lumbar intervertebral disc herniation, this article concludes that the studies focused mainly on six aspects: improvement in nail fold microcirculation, improvement in neural ultrastructure, regulation of bodily autoimmunity, improvement in hemorheological indicators, regulation of neuroelectrophysiology and regulation of chemical neuroinflamma- tory mediators. A summary is made from the six aspects.

OBJECTIVE:To investigate the effectiveness and economics of 10 mg/d rosuvastatin and 20 mg/d atorvastatin in the treatment of hyperlipidemia (HLP). METHODS:The information of 180 HLP patients selected from Tianmen Municipal First People's Hospital during Mar. 2015-Feb. 2016 were divided into group A and B according to medication regimen,with 90 cases in each group. Group A was given Atorvastatin calcium tablet 20 mg,qd;group B was given Rosuvastatin calcium tablet 10 mg,qd. Treatment course of 2 groups lasted for 8 weeks. Blood lipid indexes before and after treatment,lipid-lowering efficacy,the rate of qualified blood lipid and the occurrence of ADR after treatment were compared between 2 groups. Cost-effectiveness analysis was adopted for economic evaluation. RESULTS:Before treatment,there was no statistical significance in the levels of blood lipid in-dexes between 2 groups (P>0.05). After treatment,TC and LDL-C levels of 2 groups were significantly lower than before treat-ment,and those of group B were significantly lower than those of group A,with statistical significance(P<0.05). Total response rate of lipid-lowering in group B(97.78％)was significantly higher than group A(86.67％),and the rate of qualified blood lipid (66.67％)was also significantly higher than group A(51.11％),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). The costs of group A and B were 488.32,436.24 yuan,and cost-effectiveness ratios were 5.63,4.46;incremental cost-effectiveness ratio was -4.69. The plan of group B had cost-effective-ness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:In the view of short-term efficacy,10 mg/d rosuvastatin plan is better than 20 mg/d atorvastatin plan in lowering lipid and has cost-effectiveness advantage,and both have similar safety.

Objective To analyze health status and characters of health service demand and utilization among farmers and herdsmen in Kangxiwa and Saitula border areas from the altitude of 3700m to 4300m for offered scientific advices to the health management institutions for optimizing the allocation of health resources.Methods A total of 51 families in the Kangxiwa and Saitula areas in Karakorum-Kunlun Mountains were randomly chosen with stratified sampling method for the family health survey.Physical and biochemical examination were carried out for each herdsman.Results Among the participants,the most disease the two-week medical consultation rate was 1.74％.the hospitalization rate was 0.98％.The two-week medical consultation and hospitalization rate of herds were lower than the national and Xinjiang level for rural area.Herdsmen's doctor poor accessibility and low-income may be the main reasons for the underutilization of health services ;The difficult situation of herdsmen has been initially improved after participating in the new rural cooperative medical care.Conclusion The health status of native herdsmen in Kara Kunlun mountains was poor,and the provision of health services cannot meet the demand for health service of native herdsmen.It's necessary to improve efficiency of utilization of health service and optimize the allocation of health resources.