Anshan Hospital

To prospectively compare the diagnostic value of 18 F-meta-fluorobenzylguanidine ([ 18 F]MFBG) and [ 68 Ga]Ga-DOTA-TATE PET/CT in pediatric patients with suspected recurrent/refractory neuroblastoma. Between December 2024 and March 2025, 28 children (18 boys, 10 girls; mean age ± SD 4.8 ± 2.5y) underwent both tracers within 1 week at a single institution. Physiological biodistribution, image quality, lesion conspicuity, semiquantitative uptake (SUVmax), Curie score, and response classification were analyzed side-by-side. [ 18 F]MFBG showed higher background than [ 68 Ga]Ga-DOTA-TATE in skeletal muscle but lower activity in articular metaphyses, pituitary, and kidneys. Heterogeneous distribution of [ 18 F]MFBG was more common in the liver, while notable uptake differences were observed in the pancreas with [ 68 Ga]Ga-DOTA-TATE. Patient-level concordance was high (both scans positive in 15, negative in 7); discordance occurred in 6 patients (2 MFBG+/DOTA-TATE-, 4 MFBG-/DOTA-TATE+). Region-level analysis encompassed 86 relapsed or metastatic regions in 17 patients. [ 18 F]MFBG detected 80 regions (sensitivity 93.0%, specificity 96.4%, AUC 0.947), whereas [ 68 Ga]Ga-DOTA-TATE detected 82 (sensitivity 95.4%, specificity 86.6%, AUC 0.910). Superior specificity of [ 18 F]MFBG stemmed largely from its higher uptake in bone/marrow metastases compared with [ 68 Ga]Ga-DOTA-TATE (median SUVmax 5.21 vs. 2.90, P <0.0001). Region-level concordance revealed 78 concordant positive sites and 39 discordant sites (9 MFBG+/DOTA-TATE-, 30 MFBG-/DOTA-TATE+). Aggregate Curie scores were identical (155 each). Because uptake patterns were complementary, combining both tracers improved visual confidence in heterogeneous tumors and refined treatment-response categorization. [ 18 F]MFBG and [ 68 Ga]Ga-DOTA-TATE PET/CT imaging are effective for evaluating relapsed or metastatic neuroblastoma because they show lower uptake in normal organs and benign lesions. The 2 imaging modalities offer complementary value in tumor detection and assessment of treatment response due to tumor spatial heterogeneity.

This study aimed to investigate the relationship between anemia, stroke severity, short-term prognosis, and imaging features of infarction. The clinical features and imaging data of patients with anemia and acute ischemic stroke were retrospectively analyzed. All patients were divided into anemia and non-anemia groups, and according to the degree of anemia, they were divided into mild anemia group and moderate and severe anemia group. Stroke severity, short-term prognosis, and infarct lesion characteristics were compared between all groups. Among the 238 AIS patients, we found that the prevalence of anemia was 25.6%. There was significant correlation between the severity of anemia and NIHSS at admission (P = 0.01); The severity of anemia affected 90-day mRS (P = 0.01), and increased the length of hospital (P < 0.01). In the moderate and severe anemia group, there were 16 cases of watershed infarction, 15 of cerebral infarction, and 14 of corona radiata and centrum semiovale infarction. Multiple infarcts were more significantly common in the moderate and severe anemia group (P < 0.01). The degree of anemia correlated with the severity of acute ischemic stroke. Furthermore, the severity of anemia was closely related to patient prognosis. The infarct sites of moderate and severe anemia were mostly in the cerebral lobe, corona radiata, and centrum semiovale, and the watershed area was prone to infarction with multiple infarction lesions, which may be related to tissue hypoperfusion. By analyzing the clinical features and imaging of patients with anemia combined with acute ischemic stroke, we found: The anemia group had higher NIHSS at admission than the non-anemia group; The short-term prognosis of moderate and severe anemia group was worse than mild anemia group and non-anemia group; Imaging findings illustrated the infarct sites of the moderate and severe anemia group were mostly in the cerebral lobe, corona radiata, and centrum semiovale, and the watershed area was prone to infarction with multiple infarction lesions.

When patients report a penicillin allergy (self-reported penicillin allergy, SRPA), clinicians alter their antibiotic management of the patient. However, fewer than 5% of SRPA have life-threatening reactions, and receiving narrower spectrum antibiotics may result in under treatment. Reports from community studies suggest that patients with SRPA are more likely to come to harm, but as SRPA implies exposure to healthcare, it is unclear whether additional harm is as a result of co-morbidities and the need to receive healthcare, rather than a harm in itself. This raises the question of how great an impact SRPA has on hospital and ICU mortality for patients admitted to hospital. A literature search will be performed using MEDLINE, Embase and CINAHL (via OVID) in October 2024. The eligible studies will be of adult hospitalised patients with penicillin allergy compared with their non-allergic counterparts. We will extract demographic and outcome data including whether the patients were treated in ICU and mortality (28-days, in-ICU or in-hospital). If possible, the results will be pooled for a meta-analysis by combining the all-cause mortality of patients at 28 days, in-ICU or in-hospital. Heterogeneity will be assessed using the I2 or H2 statistics if the number of included studies is less than 10. Previous reports of poor outcomes from SRPA are often based around increased risk of increased antibiotic use and antibiotic resistance. The requirement of SRPA to develop where there is exposure to healthcare and co-morbidities may mean that these outcomes are derived from poorer health rather than from SRPA perse. The impact of SRPA on hospitalised patients is less understood, with outcomes that are well-defined, such as mortality. This review will outline the differences that exist, and a meta-analysis may define the size of any differences. PROSPERO CRD42024537658.

This study aimed to characterize pediatric nasal button battery impactions and evaluate, in an in vitro septum model, the efficacy of household reagents in mitigating alkaline-induced injury. We retrospectively reviewed 230 pediatric cases over ten years. Demographic characteristics, presentation times, and complications were recorded. In vitro, sheep septal cartilage segments (2-3mm thick) were immersed in saline at 36°C and exposed to a 3V button battery for 15, 30, 45, or 60min to determine the critical injury window. In the 30min group, interventions with honey, MOH (a honey-olive oil mixture), vinegar, vitamin D, glycerin, and saline were applied, and the tissue pH, residual battery voltage, and injury depth were measured. A retrospective analysis of 230 children revealed that 61.7% were male, 97.8% were aged 1-5years, and 87.4% presented within 24h of battery impaction; the incidence of nasal septal perforation was 16.5%. In vitro experiments identified 30min as the critical window for rapid tissue injury progression, with a mean injury depth of 2160 ± 43.8μm. Intervention assays demonstrated that honey (685.3 ± 92.2μm), MOH (1038 ± 145.1μm), and glycerin (1275 ± 39.6μm) significantly reduced injury depth without breaching the perichondrial layer. Honey and MOH best neutralized the pH, whereas glycerin and vitamin D inhibited battery discharge the most. Saline, vinegar, or vitamin D alone had no protective effect on depth. Alkaline burns from nasal button batteries progress rapidly within 30min. Household reagents-especially honey, MOH, or glycerin-neutralize pH, inhibit discharge, and attenuate tissue damage. In prehospital settings where immediate care is delayed, early application of honey, MOH, or glycerin is recommended to minimize severe complications.

This study aimed to identify metabolic signatures reflecting air pollution and further explore their associations with gout risk. We retrieved 207,908 gout-free participants from a large cohort study. Annual average concentrations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx) were estimated using bilinear interpolation based on the residential address. Elastic net regression was used to identify air pollutant-related metabolites and construct metabolic signatures. Cox regression models were performed to evaluate the association between air pollutants, related metabolic signatures, and the risk of gout. Mediation analyses were performed to explore how metabolites mediate the relationships linking air pollutants to gout. During a median follow-up of 12.56 years, 2,474 incident gout cases were identified. We identified metabolite biomarkers reflecting air pollutants, including 87 metabolites for PM2.5, 76 for PM10, 68 for NO2, and 71 for NOx. Air pollution-related metabolic signatures were associated with elevated gout risk, with hazard ratios of 1.10 (95% confidence interval [CI] 1.05-1.14) for PM2.5, 1.12 (95% CI 1.08-1.17) for PM10, 1.09 (95% CI 1.04-1.13) for NO2, and 1.11 (95% CI 1.06-1.15) for NOx. Consistently, per-interquartile rangeincrease in PM2.5, PM10, NO2, and NOx was associated with 17%, 15%, 6%, and 6% increased gout risk, respectively. Additionally, metabolic signatures mediated the air pollutants-gout associations, with the mediation proportions varying from 2.36% for PM2.5 to 4.30% for NOx. Our study indicated that air pollutants and metabolic signatures were associated with elevated gout risk, with metabolomic signatures playing a mediating role in the air pollutants-gout relationship.

Abstract Objective Despite the central role of deep brain structures such as the striatum in motor learning, existing noninvasive stimulation methods are hindered by limited depth and precision. Temporal interference (TI) stimulation presents the potential for precise, individualized modulation of deep regions. However, how TI stimulation influences deep brain activity and large-scale network reorganization to facilitate motor learning is still unclear. Therefore, this study aimed to clarify these mechanisms by investigating how personalized, high-intensity TI targeting the striatum modulates neural activity and enhances motor learning. Methods Twenty-six healthy right-handed male participants were enrolled in a randomized, double-blind, sham-controlled crossover study. Each participant received both TI and sham stimulation targeting the right striatum (10 mA, Δf = 20 Hz) through an individualized electrode montage. Resting-state functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), and serial reaction time (SRT) task performance were assessed before and after each intervention. Neural analyses included static and dynamic fractional amplitude of low-frequency fluctuation (fALFF) in the target region, structural connectivity (SC)–functional connectivity (FC) coupling and topological metrics across six major brain networks, as well as brain-behavior correlations related to learning performance. Results (1) Target region activity: TI stimulation significantly increased both static and dynamic fALFF in the right striatum (Cohen’s d = 0.49, p = 0.016; Cohen’s d = 0.39, p = 0.035). (2) Brain network reorganization: Compared with the Sham group, the TI group exhibited significantly reduced SC-FC coupling in the cerebellar network (CN) (t = – 2.279, Cohen’s d = -0.82, p = 0.027, FDR corrected). TI stimulation significantly enhanced nodal degree in the cerebellar network (CN) and nodal efficiency the cingulo-opercular network (CON) (FDR corrected with Bonferroni correction, p < 0.0083) following the stimulation. Behavioral performance: The TI stimulation significantly improved performance in second implicit learning (SIL) after stimulation (Cohen’s d = 0.47, p = 0.043). Brain-behavior correlation: Changes in SC-FC coupling in the CN were significantly negatively correlated with improvement in SIL (r = – 0.372, p = 0.040). Conclusion Personalized high-intensity TI of the striatum enhances deep target activity and promotes selective network reorganization, particularly by reducing SC-FC coupling and strengthening intra-network connectivity in the CN. These network-level modulations underlie improved implicit learning performance, highlighting the potential of TI neuromodulation as a precise and effective approach for promoting motor learning by targeting deep nuclei and large-scale brain networks. Trial registration number ChiCTR2500098699.