Objective To establish a simultaneous detection approach for 34 emerging contaminants(ECs)in tap water by liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).Human health risk assessment was performed according to the detection results from 43 tap water samples.Methods Tap water samples were concentrated and extracted by solid phase extraction,and then blown to near dry by nitrogen at 40℃.The sample extracts were dissolved in methanol-water solution(95:5,VN)to 0.5 mL for analyzing.Agilent Jet Stream Electrospray Ionization(AJS ESI)and the multiple reaction monitoring(MRM)mode were performed for MS to acquire the data of 34 ECs.A database including precursor ion,product ion and retention times was established accordingly.Results The average linear correlation coefficients(r)of 34 kinds of ECs was 0.995 9.The limits of detection were 0.01～0.60 ng/L and the recoveries were between 60.7％and 119.8％.The intra-group precisions were between 0.05％～9.89％and the intra-day precisions were between 0.20％～14.40％for the spiked samples.The method was applied to analyze 43 tap water samples and a total of 15 ECs were detected.According to the results,the detection rate of caffeine was the highest(84％),and the concentration range was ND～74.42 ng/L.Among all the ECs detected,1,2,3-benzotriazole had the highest concentration(ND～361.15 ng/L),where detection rate was 44％.Humans may be exposed to these ECs by drinking the tap water.The human health risk assessments of 12 kinds of ECs were carried out,however,the estimated risk was negligible(risk quotient＜0.01).Conclusion The method is simple,highly sensitive and selective,and could meet the detection needs of ECs at trace level in tap water.There was no human health risk posed for ECs identified in 43 tap water samples analyzed by this method.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal hematopoietic stem cell disease caused by abnormal expression of glycosylphosphatidylinositol (GPI) on the cell membrane due to mutations in the phosphatidylinositol glycan class A(PIGA) gene. It is commonly characterized by intravascular hemolysis, repeated thrombosis, and bone marrow failure, as well as multiple systemic involvement symptoms such as renal dysfunction, pulmonary hypertension, swallowing difficulties, chest pain, abdominal pain, and erectile dysfunction. Due to the rarity of PNH and its strong heterogeneity in clinical manifestations, multidisciplinary collaboration is often required for diagnosis and treatment. Peking Union Medical College Hospital, relying on the rare disease diagnosis and treatment platform, has invited multidisciplinary clinical experts to form a unified opinion on the diagnosis and treatment of PNH, and formulated the Expert Consensus of Multidisciplinary Diagnosis and Treatment for Paroxysmal Nocturnal Hemoglobinuria (2024), with the hope of promoting the standardization of PNH diagnosis and treatment.

Objective:To develop and evaluate a nomogram prediction model for poor outcome in patients with minor acute ischemic stroke (MIS) at 90 days after onset.Methods:Patients with MIS admitted to the Second People's Hospital of Hefei from January 2022 to June 2023 were retrospectively enrolled. At 90 days after onset, the modified Rankin Scale was used for outcome evaluation. <2 points were defined as good outcome and ≥2 points were defined as poor outcome. Multivariate logistic regression analysis was used to identify independent risk factors for poor outcome, and a nomogram prediction model was developed based on these factors. Results:A total of 177 patients with MIS were included, of which 61 (34.46%) had poor outcome. Multivariate logistic regression analysis showed that hypertension (odds ratio [ OR] 3.484, 95% confidence interval [ CI] 1.378-8.810; P=0.008), diabetes ( OR 2.936, 95% CI 1.301-6.625; P=0.009), National Institutes of Health Stroke Scale (NIHSS) score at admission ( OR 2.936, 95% CI 1.027-1.709; P=0.031) and systolic blood pressure at admission ( OR 1.083, 95% CI 1.053-1.115; P<0.001) were the independent risk factors for poor outcome. The established nomogram prediction model had a C-index of 0.828 and the area under the curve was 0.841 (95% CI 0.778-0.891). The calibration curve fitted well with the ideal curve. The clinical decision curve showed that the model had stronger clinical applicability. Conclusions:Hypertension, diabetes, NIHSS score and systolic blood pressure at admission are independent risk factors for poor outcome of patients with MIS. The nomogram based on the above factors has higher discriminative power and clinical value for predicting poor outcome in patients with MIS.

Post-stroke depression (PSD) is an important mental complication of stroke, affecting nearly 1/3 of stroke patients, seriously affecting patients' functional recovery and quality of life, and is associated with increased mortality of stroke patients. Traditional antidepressant treatments include medication and psychotherapy, but there may be problems with adverse reactions, tolerance, or limited effectiveness. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive neuroregulatory technique, offers a new treatment option for patients with PSD. This article reviews the application of rTMS in the treatment of PSD and its possible mechanism.

Objective : To develop a prediction model for live birth based on the basic characters of patients after transcervical resection of adhesions (TCRA) undergoing frozen⁃thawed embryo transfer (F⁃ET) . Methods : A total of 491 cycles who went F ⁃ET after TCRA were included. The cycles were randomly divided into training (n = 347) and validation (n = 144) cohorts at 7 ∶ 3 ratio. Relevant factors of live birth were selected via logistic regression analysis based on the data from patients in the training cohort. Multivariate logistic regression analysis was used to establish a nomogram , and then this predict model was calibrated and verified. Results : Age , body mass index (BMI) , miscarriages and endometrial thickness were significantly related to the live birth. The statistical nomogram was built with the area under the ROC cu2rve for the training cohort was 0. 713 (95% CI: 0. 519 - 0. 815) , Hosmer⁃Lemeshow goodness of fit test were χ = 7. 062 , P = 0. 530 , and the slope of calibration curve was close to 1. AUC of validation cohort was 0. 609 (95% CI: 0. 660 - 0. 561) , presenting a well⁃pleasing goodness⁃of⁃fit and stability in this model. Conclusion Age , BMI , miscarriages and endometrial thickness can better predict the probability of live birth undergoing F ⁃ET after TCRA.

Humans ; Tenofovir/therapeutic use* ; Emtricitabine/therapeutic use* ; HIV Infections/drug therapy* ; Anti-HIV Agents/therapeutic use*

OBJECTIVE: To investigate the consistency and diagnostic performance of magnetic resonance imaging (MRI) for detecting microvascular invasion (MVI) of hepatocellular carcinoma (HCC) and the validity of deep learning attention mechanisms and clinical features for MVI grade prediction. METHODS: This retrospective study was conducted among 158 patients with HCC treated in Shunde Hospital Affiliated to Southern Medical University between January, 2017 and February, 2020. The imaging data and clinical data of the patients were collected to establish single sequence deep learning models and fusion models based on the EfficientNetB0 and attention modules. The imaging data included conventional MRI sequences (T₁WI, T₂WI, and DWI), enhanced MRI sequences (AP, PP, EP, and HBP) and synthesized MRI sequences (T1mapping-pre and T1mapping-20 min), and the high-risk areas of MVI were visualized using deep learning visualization techniques. RESULTS: The fusion model based on T1mapping-20min sequence and clinical features outperformed other fusion models with an accuracy of 0.8376, a sensitivity of 0.8378, a specificity of 0.8702, and an AUC of 0.8501 for detecting MVI. The deep fusion models were also capable of displaying the high-risk areas of MVI. CONCLUSION The fusion models based on multiple MRI sequences can effectively detect MVI in patients with HCC, demonstrating the validity of deep learning algorithm that combines attention mechanism and clinical features for MVI grade prediction.
Humans ; Carcinoma, Hepatocellular ; Retrospective Studies ; Liver Neoplasms ; Magnetic Resonance Imaging ; Algorithms

Exosomes (EXOs) are formed by intracellular multivesicular bodies and carry a variety of biomacromolecules such as lipids, proteins, encoding and non-coding RNAs, and mitochondrial DNA. EXOs can be released in vivo by different cell types, including hepatocytes, hepatic stellate cells, and immune cells and play the role of intercellular communication. More and more studies have shown that EXOs are involved in the development, progression, and prognosis of chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC) caused by hepatitis B virus (HBV) infection and are expected to become potential biomarkers for the early diagnosis and prognostic evaluation of HBV-related HCC. This article reviews the role of EXOs in the host infection process of HBV and the importance of EXOs in the development, progression, and prognosis of CHB and HCC, in order to provide new ideas for the basic and clinical research in this field.

Worster-Drought syndrome (WDS) is a special and rare type of cerebral palsy, which is characte-rized by pseudobulbar palsy, selective weakness of the muscles of the lips, tongue, and soft palate, dysarthria, dysphagia, salivation, and jaw spasm.The onset of WDS is linked with a variety of prenatal, intrapartum and postnatal factors.The report of family cases of WDS suggested the genetic predisposition.Although there is no cure at present, early genetic counseling, early diagnosis and intervention can reduce the morbidity of offspring and improve the symptoms of children with WDS, which will greatly reduce the burden on the family and society in the future.In the present study, this paper aims to explore the etiology, pathogenesis, clinical manifestation, imaging examination, diagnosis, disease spectrum and current treatment of WDS, thus improving the diagnostic and therapeutic efficacy.

Objective To investigate the effects of salvianolic acids(SA) on improving cerebral ischemic damage through silencing information regulator protein 1 (SIRT1)/high-mobility group box 1 (HMGB1) signal pathway in rat. Methods 132 male general-grade healthy SD rats were randomly divided into four groups:sham operation group(Sham),ischemia model group(IS),SA group and inhibitor group(EX527). Focal cerebral ischemia was induced by occlusion of right MCA for 2 h. The neurological deficits were assessed by modified Neurological Severity Scores (mNSS) at 1,3,and 7 days after reperfusion. The concentrations of SIRT1,HMGB1 mRNA in peri-ischemic brain tissues were detected by RT-PCR at 1,3 and 7 days after reperfusion. SIRT1,HMGB1,P-53 and NF-κB protein expression were detected by Western blot. Serum P-53,NF-κB levels were measured by ELISA. The histomorphology in peri-ischemic brain tissues was observed by HE staining first day after reperfusion. The terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) method was used to detect the neuronal apoptosis index. Results (1)Compared with IS and EX527 group,the mNSS score in SA group was significantly lower at 1 d,3 d and 7 d after reperfusion. (2)The expressions of HMGB1,P-53 and NF-κB in SA group were significantly lower than those in IS and EX527 group 7 d after reperfusion. The expression of HMGB1,P-53 and NF-κB protein in EX527 group was lower than that in IS group while it was significantly higher than the sham group 7 d after reperfusion. The expression of SIRT1 protein in SA group was significantly higher than that in IS and EX527 group,while the expression of SIRT1 protein in EX527 group was significantly higher than the sham group and IS group. (3)The expression of HMGB1 mRNA in SA group was significantly lower than that in sham group,IS group and EX527 group in the 7 d. The expression of HMGB1 mRNA in EX527 group was significantly higher than that in IS group and lower than that in sham group. The expression of SIRT1 mRNA in SA group was significantly higher than that in IS group,EX527 group and sham group. The expression of SIRT1 mRNA in EX527 group was significantly higher than that in sham operation and IS group. (4)The expressions of P-53 and NF-κB in peripheral blood of rats in SA group were significantly lower than those in IS group and EX527 group while the expression of P-53 and NF-κB protein in EX527 group was significantly lower than that in IS group and was higher than that in sham group at different time points. (5)The neuronal apoptosis index in SA group was significantly lower than that of IS group and EX527 group (P<0.05),while the neuronal apoptosis index of EX527group was significantly lower than that of IS group (P<0.05). Conclusion SA alleviate cerebral ischemc injury in rat by promoting SIRT1 transcription,inhibiting HMGB1 migration and expression,reducing the release of inflammatory factors P-53 and NF-κB in downstream pathways,and inhibiting neuronal apoptosis.