Objective:To analyze the clinical value of 18F-FDG PET/MR for precise localization of epileptogenic foci in patients with refractory epilepsy. Methods:From February 2019 to December 2021, 81 patients (52 males, 29 females; age (30.0±10.9) years) with refractory epilepsy confirmed in Ruijin Hospital Shanghai Jiao Tong University School of Medicine were retrospectively enrolled. All patients underwent preoperative PET/MR exam, and the possible position of the epileptogenic foci were determined by PET/MR imaging and pre-surgical evaluation, then the stereoelectroencephalography (SEEG) electrodes were implanted. Surgery was performed, and outcome was assessed by using a modified Engel classification two years after surgery. χ2 test was used to compare the detection rates of MRI and PET/MR fusion imaging in localizing epileptogenic foci and the detection rates of epileptogenic foci in temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE) by PET/MR. Results:MRI correctly localized seizure foci in 38 patients, with the detection rate of 46.91%(38/81), while PET/MR detected seizure foci in 73 patients, with the detection rate of 90.12%(73/81; χ2=35.05, P<0.001). There were 63 TLE and 18 ETLE patients. The detection rate of PET/MR in localizing seizure foci in TLE patients was 95.24%(60/63), which was significantly higher than that in ETLE patients (13/18; χ2=5.94, P=0.015). After 2 years follow-up, the postoperative efficacy rate of TLE patients with Engel grades Ⅰ-Ⅱ was 76.19%(48/63), which was 13/18 of ETLE patients ( χ2=0.12, P=0.731). Conclusion:Hybrid PET/MR imaging can accurately locate epileptogenic foci, especially for MRI negative lesions, which provides precision imaging information for surgical planning and improves surgical success rate.

Objective:To explore the prevalence, clinical features, genetic characteristics and prognosis of Citrin deficiency in Henan province of China.Methods:A total of 986 565 neonates screened by tandem mass spectrometry at the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2021 were retrospectively analyzed. Analysis of SLC25A13 gene variants and parental verification were carried out for neonates suspected for Citrin deficiency by next-generation sequencing. The clinical, biochemical and genetic characteristics of Citrin deficiency patients were integrated to guide the diet treatment and follow up the growth and development. Paired- t test was used to compare the amino acid levels in the peripheral blood samples before and after the treatment. Results:Nine cases of Citrin deficiency were diagnosed among the 986 565 neonates. Specific elevation of citrulline was observed in all of the 9 cases. Six variants were detected by genetic sequencing, among which c. 852_855delTATG, c. 615+ 5G>A, c. 550C>T and IVS16ins3kb were known pathogenic variants, whilst c. 1111_1112delAT and c. 837T>A were unreported previously. The detection rate for c. 852_855delTATG was the highest (61.6%, 11/18), followed by IVS16ins3kb (16.7%, 3/18). The clinical symptoms of all patients were relieved after the treatment, and the blood amino acid profile and biochemical parameters were significantly improved by gradually falling within the normal range. By June 2022, all patients had shown a good prognosis.Conclusion:The prevalence of Citrin deficiency among neonates from Henan Province by tandem mass spectrometry is 1/109 618, and the carrier rate for the pathogenic variants of the SLC25A13 gene was 1/166. The c. 852_855delTATG may be a hot spot variant among the patients. Discovery of the novel variants has enriched the mutational spectrum of the SLC25A13 gene. Above results have provided a basis for the early diagnosis, treatment, prognosis and genetic counseling for the affected families.

Introduction::The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, a novel biomarker for metabolic syndrome (MetS), has been validated in the general population as being significantly correlated with cardiovascular disease (CVD) risk. However, its capabilities to predict CVD in people living with human immunodeficiency virus (HIV; PLWH) remain underexplored.Methods::We conducted a retrospective cohort study of 16,081 PLWH who initiated antiretroviral therapy (ART) at the Third People’s Hospital of Shenzhen (China) from 2005 to 2022. The baseline TG/HDL-C ratio was calculated as TG (mmol/L) divided by HDL-C (mmol/L). We employed a multivariate Cox proportional hazards model to assess the association between the TG/HDL-C ratio and CVD occurrence, using Kaplan-Meier curves and log-rank tests to compare survival distributions. The increase in prediction risk upon the addition of the biomarker to the conventional risk model was examined through the assessment of changes in net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Nonlinear relationships were investigated using a restricted cubic spline plot, complemented by a two-piecewise Cox proportional hazards model to analyze threshold effects.Results::At the median follow-up of 70 months, 213 PLWH developed CVD. Kaplan-Meier curves demonstrated a significant association between the increased risk of CVD and a higher TG/HDL-C ratio (log-rank P <0.001). The multivariate-adjusted Cox proportional hazards regression model indicated that the CVD hazard ratios (HR) (95% confidence intervals [95% CIs]) for Q2, Q3, and Q4 versus Q1 of the TG/HDL-C ratio were 2.07 (1.24, 3.45), 2.17 (1.32, 3.57), and 2.20 (1.35, 3.58), respectively ( P <0.05). The consideration of the TG/HDL-C ratio in the model, which included all significant factors for CVD incidence, improved the predictive risk, as indicated by the reclassification metrics (NRI 16.43%, 95% CI 3.35%-29.52%, P = 0.014). The restriction cubic spline plot demonstrated an upward trend between the TG/HDL-C ratio and the CVD occurrence ( P for nonlinear association = 0.027, P for overall significance = 0.009), with the threshold at 1.013. Significantly positive correlations between the TG/HDL-C ratio and CVD were observed below the TG/HDL-C ratio threshold with HR 5.88 (95% CI 1.58-21.88, P = 0.008), but not above the threshold with HR 1.01 (95% CI 0.88-1.15, P = 0.880). Conclusion::Our study confirms the effectiveness of the TG/HDL-C ratio as a predictor of CVD risk in PLWH, which demonstrates a significant nonlinear association. These findings indicate the potential of the TG/HDL-C ratio in facilitating early prevention and treatment strategies for CVD among PLWH.

Objective To evaluate the clinical effect of using a new cross buccal tube(XBT)to close the extraction gap of the maxillary second premolar and control the anchorage.Methods Fifteen adolescent patients with moderate to severe crowding,skeletal Class Ⅰ,missing maxillary second premolars or difficult to retain during clinical examination were selected.PASS orthodontic technique was used to reduce the number of maxillary second premolars to relieve crowding and retract the anterior teeth.Before and after treatment,head lateral images were taken and cephalometric measurements were taken.Changes of bone and dental indexes related to molar anchorage and anterior adduction were observed.Results After treatment,teeth of all patients were arranged neatly,the occlusion relationship was good and the profile was improved.Before and after treatment,there were no significant changes in bone indicators such as ∠SNA,∠SNB and ∠ANB(P＞0.05).There was no significant change in vertical height ∠MP-SN(P＞0.05).The angle of the upper and lower central incisors,∠U1-SN,∠U1-NA,∠ L1-MP and ∠L1-NB decreased significantly,while ∠U1-L1 increased significantly(P＜0.05).The upper incisor margin point moving towards the distal(P＜0.05),and there was no significant change in the position of the upper incisor root apex and first molar(P＞0.05).Conclusion The application of the new cross buccal tube is beneficial for adolescent patients to control the occlusion of the extraction gap of the maxillary second premolar.

Objective To analyze the radionuclide levels in food and the committed effective dose due to food intake in residents around the Shidaowan Nuclear Power Plant (SNPP). Methods Daily food samples were collected within 30 km radius around the nuclear power plant in 2019—2022. The radioactivity levels before and after the operation of SNPP were determined. The data were combined with the dietary consumption of residents in Shandong province, China to estimate the committed effective dose. Results The radionuclides ²³⁸U, ²³²Th, ²²⁶Ra, and ⁴⁰K in food were at normal background levels, and the average radioactivity was (0.062 ± 0.004), (0.121 ± 0.007), (0.162 ± 0.010), and (92.4 ± 5.5) Bq/kg fresh weight. Trace ¹³⁷Cs and ⁹⁰Sr were detected in some food samples and the average radioactivity was (0.047 ± 0.003) and (0.193 ± 0.200) Bq/kg fresh weight. The levels of radionuclides did not increase after the operation of SNPP compared with that before operation. The estimated committed effective dose in residents due to food intake was 0.205 mSv. Conclusion The radioactivity of food in the area around SNPP shows no difference before and after operation, and the dose burden is low in local residents.

{L-End}Objective To understand the prevalence of work-related musculoskeletal disorders (WMSDs) and sickness absence due to WMSDs among key industry workers in Shenzhen City. {L-End}Methods A total of 14 949 workers exposed to dust, noise, chemical and radiation (hereinafter referred to as "traditional occupational groups") in some key industries in Shenzhen City, as well as bus drivers, teachers, medical staff, policemen, courier, sanitation workers and video operators were selected as the research subjects using stratified cluster sampling. The Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of WMSDs and sickness absence due to WMSDs in the past year. {L-End}Results The overall prevalence of WMSDs among the study subjects was 56.3% (8 423/14 949). The prevalence of WMSDs in different body parts from high to low was neck, waist, shoulder, back, knee, wrist, ankle, hip, and elbow, which was 37.6%, 35.7%, 31.7%, 25.2%, 18.3%, 15.4%, 14.9%, 12.4%, and 11.6%, respectively (P<0.01). The overall prevalence of WMSDs among different occupational groups from high to low was teachers, video operators, bus drivers, couriers, medical staff, policemen, traditional occupational groups, and sanitation workers, which was 82.2%, 75.7%, 74.9%, 73.9%, 67.9%, 64.3%, 43.3%, and 31.9%, respectively (P<0.01). The overall rate of sickness absence due to WMSDs was 18.3% (2 736/14 949). The overall rate of sickness absence among different occupational groups from high to low was bus drivers, couriers, teachers, traditional occupational groups, policemen, video operators, medical staff, and sanitation workers, which was 31.6%, 24.5%, 20.9%, 20.2%, 15.2%, 12.4%, 9.3%, and 6.7%, respectively (P<0.01). Among different parts of the body, the highest correlation coefficient of WMSDs was found between neck and shoulder ［correlatioon cofficient (r)=0.648, P<0.01］, while the lowest was between neck and ankle (r=0.303, P<0.01). {L-End}Conclusion The prevalence of WMSDs and sickness absence due to WMSDs among key industry workers in Shenzhen City is relatively high. Comprehensive prevention and control measures should be taken according to the characteristics of occupational population to reduce the impact of WMSDs on the health of occupational population.

Objective:To observe the effects of acupuncture at Houxi(SI3)and Huantiao(GB30)on the expression levels of nuclear factor kappa B(NF-κB),inducible nitric oxide synthase(iNOS),and nitric oxide(NO)of NF-κB inflammatory signaling pathway in L5 spinal nerve root of lumbar disc herniation(LDH)model rats and explore the mechanism of acupuncture in LDH treatment.Methods:Forty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into a sham operation group,a model group,acupuncture group 1,and acupuncture group 2,with 10 rats in each group.The non-compression nucleus protrusion model was made by puncturing L4-L5 spinous process space and injecting autologous nucleus suspension.Acupuncture at bilateral Shenshu(BL23),Dachangshu(BL25),and Weizhong(BL40)was carried out in acupuncture group 1,and acupuncture at bilateral Houxi(SI3)and Huantiao(GB30)in acupuncture group 2.All rats were treated with balanced reinforcing and reducing needling manipulations,and the needles were retained for 30 min/time with one episode of needling manipulation every 10 min,once a day,14 times in total.The threshold value of paw withdrawal pain was measured by a thermal stimulation pain instrument;the serum NF-κB,iNOS,and NO levels were measured by enzyme-linked immunosorbent assay.The pathomorphological changes of spinal nerve roots were observed by hematoxylin-eosin(HE)staining;quantitative reverse transcription polymerase chain reaction was used to detect iNOS mRNA expression in spinal nerve roots;the NF-κB and iNOS protein expression in spinal nerve roots was detected by the immunofluorescence method.Results:Compared with the sham operation group,the threshold of paw withdrawal pain in the model group was decreased,and the expression levels of serum NF-κB,iNOS,and NO were increased;HE staining showed many degenerated and dissolved Schwann cells in spinal nerve roots with vacuolar changes;meanwhile,the expression levels of NF-κB and iNOS proteins,and the iNOS mRNA in spinal nerve roots were increased.Compared with the model group,the paw withdrawal pain thresholds in acupuncture group 1 and acupuncture group 2 were increased,and the increase in acupuncture group 2 was greater(P<0.05);the expression levels of serum NF-κB,iNOS,and NO in acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01);the vacuolar changes of spinal nerve roots,and the degeneration and lysis of Schwann cells in acupuncture group 1 and acupuncture group 2 were decreased,which were more obvious in acupuncture group 2;the NF-κB and iNOS protein expression and the iNOS mRNA expression levels in spinal nerve roots of acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01).Conclusion:Acupuncture at Houxi(SI3)and Huantiao(GB30)can improve the morphology of spinal nerve roots,inhibit the NF-κB and iNOS protein expression levels in spinal nerve roots and the serum NO level,and relieve the pain caused by inflammation of spinal nerve roots,which may be one of the mechanisms of acupuncture in LDH treatment.

Objective To analyze the main active components and potential molecular mechanism of Sophora flavescens against breast cancer based on network pharmacology and molecular docking. Methods The chemical constituents were collected and screened by TCMSP, ETCM database and literature review. The targets of active ingredients were predicted by Swiss Target Prediction database. Breast cancer-related targets were collected by GeneCards, TTD, Drugbank and OMIM. The anti-breast cancer targets of Sophora flavescens were screened by Venny 2.1.0 software. Cytoscape software was used to construct the network diagram of Sophora flavescens-key active ingredients-targets. STRING database was used to analyze the common targets, and PPI network diagram was constructed. GO function enrichment analysis and KEGG pathway enrichment analysis of key target proteins were performed by DAVID database and Hiplot online platform. Schrodinger software was used to calculate the molecular docking between the active ingredients and targets. Molecular biological methods were used to verify the key targets. Results A total of 36 active components with clear structures were screened from Sophora flavescens. 70 anti-breast cancer targets of Sophora flavescens were screened out. 12 core targets including EGFR, AKT1, ESR1, SRC, CYP19A1, AR and ABCB1 participate in endocrine resistance, EGFR tyrosine kinase inhibitors and estrogen signaling pathways in breast cancer. Moreover, the docking score between the core component and the key target AR is the highest. In vitro experiments showed that the extract of Sophora flavescens can inhibit the proliferation of breast cancer cells, induce cell apoptosis and up-regulate AR protein expression. Conclusion It was revealed that Sophora flavescens plays an anti-breast cancer role by regulating complex biological processes through multiple components acting on multiple targets and signaling pathways. The upregulation of AR protein by Sophora flavescens may become a new therapeutic strategy for the treatment of breast cancer.

Objective To compare the clinicopathological characteristics between primary and contralateral cancers in patients with metachronous bilateral breast cancer (MBBC) who carried a BRCA1/2 germline pathogenic variant. Methods A total of 496 BRCA1/2 carriers with primary unilateral breast cancer were included (196 with BRCA1 and 300 with BRCA2). Clinicopathological information of patients was collected, and the median follow-up for the entire cohort was 10.4 years (0.4-20.8 years). Results Among all patients, 31 (15.8%) of the 196 BRCA1 carriers and 49 (16.3%) of the 300 BRCA2 carriers had MBBC, respectively. Among the 31 BRCA1 carriers who developed MBBC, the proportion of triple-negative breast cancer (TNBC) in primary cancer and contralateral cancer was 61.3% and 67.7%, respectively. If the primary cancer of BRCA1-mutated MBBC was TNBC, the probability of the contralateral breast cancer with TNBC was 89.5% (17/19), which was significantly higher than that if the primary cancer was non-TNBC (33.3%, 4/12) (P=0.004). Among the 49 BRCA2 carriers who developed MBBC, the predominant molecular phenotype of the primary and contralateral cancers was HR+ & HER2- (77.6% and 67.3%, respectively; P=0.53). Conclusion Approximately 60% of BRCA1 carriers exhibit TNBC. If a BRCA1 carrier with a TNBC primary breast cancer had an MBBC, the probability of the contralateral breast cancer being TNBC phenotype is almost 89.5%.

Objective To investigate the gross alpha and gross beta radioactivity levels in drinking water around Shidao Bay Nuclear Power Plant before its operation. Methods Ten sampling sites were set up within 30 km of Shidao Bay Nuclear Power Plant. From 2018 to 2021, samples were collected during the dry season and wet season each year and were tested in a laboratory according to Standard examination methods for drinking water—radiological parameters (GB/T 5750.13—2006). Results From 2018 to 2021, the gross alpha radioactivity in drinking water within 30 km of Shidao Bay Nuclear Power Plant was within the range of about 0.004-0.420 Bq/L, which does not exceed the guided gross alpha radioactivity specified in the National Standard; from 2018 to 2021, the gross beta radioactivity level was about 0.008-1.050 Bq/L. In 2018, the gross beta radioactivity at the sampling site 4.7 km from the Nuclear Power Plant exceeded the guided level specified in the National Standards for Drinking Water Quality (GB 5749—2006), but it fell within the guided level in a repeat laboratory test after deducting the effect of ⁴⁰K on the gross beta radioactivity. Conclusion After deducting the effect of ⁴⁰K on the gross beta radioactivity, the gross alpha and gross beta radioactivity levels in drinking water within 30 km of Shidao Bay Nuclear Power Plant are within the guided levels specified in the National Standards.