General Hospital of Jinan Military Command

Neural stem cells (NSCs) have been experimentally used in multiple models and patients, offering great potential for the treatment of neurological disorders such as ischaemic stroke. However, the proliferative and differentiative limitations of NSCs transplants must be overcome to further exploit the clinical potential of NSCs-based therapies. This study aimed to elucidate the regulatory role of Nrf2 in NSCs proliferation and neuronal differentiation in vitro, to evaluate the therapeutic potential of transplanting Nrf2-overexpressed NSCs for functional recovery in the MCAO mouse model, and to further explore the synergistic benefits of combining this cell therapy with the pharmacological Nrf2 agonist PTE. The study design encompassed in vitro NSC cultures and a mouse MCAO model, involving Nrf2 modulation, transplantation of engineered NSCs, pharmacological activation with PTE, and comprehensive assessment of cellular, molecular, and functional outcomes. Specifically, Nrf2 expression was manipulated using AAV-9. Nrf2-overexpressed NSCs were generated via AAV-9 transduction and stereotaxically transplanted into the lateral ventricle of mice with MCAO, with a subset of these animals additionally receiving the Nrf2 agonist PTE. Nestin, Dcx, BrdU, NeuN, and GFAP expression were evaluated using immunofluorescence; GFAP-positive and NeuN-positive cell proportions were quantified by flow cytometry. Oxidative stress was monitored using DCF fluorescence and MDA ELISA kits. Inflammation was measured with IL-6 and TNF-α ELISA kits. The expression levels of Nrf2, HO-1, NQO1, p65, and NLRP3 were evaluated using western blotting. Neurological deficits were assessed using Clark scores, rotarod test, Morris water maze, grip strength test, cerebral water content measurement, and TTC staining for infarction volume. Overexpression or knockdown of Nrf2 in vitro (in NSCs) and in vivo (in mouse hippocampus) correspondingly regulated the expression of its downstream effectors, HO-1 and NQO1. In vitro, Nrf2 regulated the proliferation and neuronal differentiation of NSCs. In the MCAO mouse model, Nrf2 ameliorated cerebral oxidative stress and inflammation, and improved functional recovery, as evidenced by improved neurological scores, enhanced performance in behavioural tests, reduced infarction volume, and attenuated cerebral oedema. Transplantation of Nrf2-overexpressed NSCs promoted the proliferation and neuronal differentiation of the grafts, enhanced their neuroprotective effects, and led to superior recovery compared to standard NSCs transplantation. Furthermore, administration of the Nrf2 agonist PTE synergized with Nrf2-overexpressed NSCs transplantation, resulting in augmented anti-inflammatory, antioxidant, and functional benefits. This study demonstrates that Nrf2 is a key regulator of NSCs proliferation and neuronal fate, both intrinsically and following transplantation. Furthermore, the combination of Nrf2-overexpressed NSCs transplantation and PTE administration synergistically amplified therapeutic outcomes, offering a promising combinatorial strategy to enhance neurorepair after ischemic stroke.

To address the challenges of high computational complexity and poor real-time performance in UAV path planning within complex environments, this paper proposes a multi-resolution algorithm based on Markov Decision Processes. By defining the state space, action space, state transition probability function, and multi-objective reward function, the algorithm dynamically partitions the mission's environmental map into units of varying resolutions under communication-constrained conditions, thereby reducing computational overhead. The optimal policy is then derived through value iteration, which balances computational efficiency with navigation safety. Simulation results demonstrate that the proposed approach not only maintains the quality of path planning and satisfies communication constraints, but also significantly reduces computation time while keeping the collision probability close to zero.

Superficial dermal fibroblastic/myofibroblastic proliferation comprises a spectrum of tumours, most of which present as solitary lesions. Generalized forms are exceptionally rare. To describe and analyse a novel entity clinically manifested as disseminated firm papules and histologically characterized by fibroblastic/myofibroblastic proliferation. We conducted a retrospective analysis of eight patients diagnosed between 2010 and 2024, collected from four medical centres. Histopathological review of haematoxylin and eosin-stained sections was performed, alongside available immunohistochemical studies. Whole-exome sequencing was carried out on genomic DNA from three patients, to explore potential genetic causes. The cohort consisted of five female and three male individuals (median age 18 years; range 14-26) presenting with multiple skin-coloured to dark-red papules predominantly on the extremities, buttocks and chest. Histopathology revealed fascicular proliferations of bland spindle cells in the superficial dermis. Immunohistochemically, the lesions were weakly positive for smooth muscle actin and negative for CD68, CD34, desmin and S100 protein, with loss of elastic fibres. No relevant germline driver mutations were detected in peripheral blood DNA. Spontaneous regression occurred in five patients during follow-up. We propose the term 'disseminated myofibroblastic papulosis' for this newly recognized, probably underdiagnosed entity. Given its benign behaviour and frequent self-resolution, a watchful waiting approach after diagnosis is recommended.

Patient: Male, 21-year-oldFinal Diagnosis: Cerebral venous sinus thromboembolism • pulmonary thromboembolismSymptoms: Cough • diarrhea • sore throat • vomitingClinical Procedure: Anti-infection • anticoagulant • symptomatic and supportive careSpecialty: Neurology • PulmonologyObjective: Rare diseaseBackgroundAt high altitude, reduced oxygen pressure and compensatory physiological mechanisms lead to increased blood viscosity and edema. This report describes the case of a 21-year-old man working at high altitude for 3 days who developed cerebral venous sinus thrombosis, pulmonary thromboembolism, and right ventricular thrombosis.Case ReportA 21-year-old man developed sore throat, cough, vomiting, and diarrhea on the 3rd day after rapidly ascending to a high altitude. After 3 days of anti-infective treatment with minimal effect, he experienced headache, seizures, dizziness, and blurred vision on the 7th day. He was ultimately diagnosed with cerebral venous sinus thrombosis (CVST) complicated by pulmonary thromboembolism (PTE) and right ventricular thrombosis. After 6 months of treatment with low-molecular-weight heparin and warfarin, his prognosis was good.ConclusionsThis report shows the rapid progression of multiple thrombotic events at high altitude and the approaches to diagnosis and management.

The ECHS1 (short-chain enoyl-CoA hydratase 1) gene is critical for mitochondrial fatty acid β-oxidation and branched-chain amino acid metabolism. Mutations in ECHS1 lead to severe mitochondrial dysfunction and are implicated in rare metabolic and neurodegenerative disorders. This review summarizes current understanding of how ECHS1 participates in key molecular processes, including energy metabolism, oxidative stress regulation, and apoptosis, and discusses its influence on mitochondrial function. It also highlights advances in experimental models, including mouse, Drosophila, and induced pluripotent stem cell (iPSC) -based systems, which have illuminated the gene’s physiological roles while revealing model-specific limitations. Therapeutic approaches, such as dietary interventions, gene therapy, enzyme replacement therapy, and stem cell therapy, are critically evaluated, emphasizing their potential and current challenges. Despite significant progress, gaps remain in understanding ECHS1’s tissue-specific and developmental-stage-specific functions. This review underscores the need for advanced human-relevant models and integrative technologies to address these gaps and foster the development of personalized treatments for ECHS1-related disorders.

<p>In the online version of the article titled “High-Altitude Pulmonary Edema Combined with Spontaneous Pneumomediastinum: A Case Report”, a change was made under the heading of funding as per the authors request and has been updated in “Current Medical Imaging”, 2024; 20: e15734056234694 [1]. </p> <p> The original article can be found online at: https://www.eurekaselect.com/article/135263. </p> <p> Original: </p> <p> FUNDING </p> <p> This study was funded by Natural Science Foundation of Xinjiang Province (No: 2021D01C471). </p> <p> Corrected: </p> <p> FUNDING </p> <p> None.</p>

Acute mountain sickness (AMS) is a common condition following rapid exposure to high altitude, though severe complications such as acute gastrointestinal bleeding, systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) are rare. Herein, we report a case of SIRS and MODS in a young traveler who visited Lhasa, Tibet (elevation 3,650 m). Three days after arrival, the patient developed headache, abdominal pain, significant hematemesis, and persistent hypotension. Gastroscopy revealed diffuse bleeding of the gastric mucosa. Laboratory tests indicated multi-organ dysfunction involving the lungs, liver, and kidneys. The patient responded well to conservative treatment of continuous oxygen supplementation. This case represents one of the first reported instances of acute gastric mucosal injury and MODS induced by AMS, underscoring the significant medical risks associated with high-altitude environments.

Individuals residing in plateau regions are susceptible to pulmonary hypertension (PH) and there is an urgent need for a prediction nomogram to assess the risk of PH in this population. A total of 6603 subjects were randomly divided into a derivation set and a validation set at a ratio of 7:3. Optimal predictive features were identified through the least absolute shrinkage and selection operator regression technique, and nomograms were constructed using multivariate logistic regression. The performance of these nomograms was evaluated and validated using the area under the curve (AUC), calibration curves, the Hosmer–Lemeshow test, and decision curve analysis. Comparisons between nomograms were conducted using the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices. NomogramI was established based on independent risk factors, including gender, Tibetan ethnicity, age, incomplete right bundle branch block (IRBBB), atrial fibrillation (AF), sinus tachycardia (ST), and T wave changes (TC). The AUCs for NomogramI were 0.716 in the derivation set and 0.718 in the validation set. NomogramII was established based on independent risk factors, including Tibetan ethnicity, age, right axis deviation, high voltage in the right ventricle, IRBBB, AF, pulmonary P waves, ST, and TC. The AUCs for NomogramII were 0.844 in the derivation set and 0.801 in the validation set. Both nomograms demonstrated satisfactory clinical consistency. The IDI and NRI indices confirmed that NomogramII outperformed NomogramI. Therefore, the online dynamic NomogramII was established to predict the risks of PH in the plateau population.

Due to exposure to hypoxic environments, individuals residing in plateau regions are susceptible to pulmonary hypertension (PH). Consequently, there is an urgent need for a simple and efficient nomogram to assess the risk of PH in this population.This study included a total of 6,603 subjects, who were randomly divided into a validation set and a derivation set at a ratio of 7:3. Optimal predictive features were identified through the least absolute shrinkage and selection operator regression technique, and nomograms were constructed using multivariate logistic regression. The performance of these nomograms was evaluated and validated using the area under the curve (AUC), calibration curves, the Hosmer-Lemeshow test, and decision curve analysis. Comparisons between nomograms were conducted using the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices.Nomogram I was established based on independent risk factors, including gender, Tibetan ethnicity, age, incomplete right bundle branch block (IRBBB), atrial fibrillation (AF), sinus tachycardia (ST), and T wave changes (TC). The AUCs for Nomogram I were 0.716 in the derivation set and 0.718 in the validation set. Nomogram II was established based on independent risk factors, including Tibetan ethnicity, age, right axis deviation (RAD), high voltage in the right ventricle (HVRV), IRBBB, AF, pulmonary P waves, ST, and TC. The AUCs for Nomogram II were 0.844 in the derivation set and 0.801 in the validation set. Both nomograms demonstrated satisfactory clinical consistency. The IDI and NRI indices confirmed that Nomogram II outperformed Nomogram I . Therefore, the online dynamic Nomogram II was established.A reliable and straightforward nomogram was developed to predict the risks of PH in the plateau population.

BackgroundChronic osteomyelitis is a highly prevalent and severe orthopaedic complication, representing a critical unresolved issue. The clinical symptoms of osteomyelitis are influenced by various factors, including geography, lifestyle, and pre-existing medical conditions.This study aims to provide theoretical basis for treatment and prevention of osteomyelitis by investigating and analyzing clinical features and pathogen distribution among 282 patients with chronic tibial osteomyelitis in xinjiang.MethodsA total of 282 patients with chronic tibial osteomyelitis from January 1, 2012 to January 1, 2022 in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. All data were collected from electronic medical record (EMR) system including demographics, etiology, risk factors, osteomyelitis location and clinical classification.ResultsFarmers, students, unemployed and retirees accounted for a relatively large proportion of the 282 patients. There were 233 males and 49 females with a gender ratio of 4.75:1. The average age was 40.21 ± 15.68 years and was mainly concentrated in 41–50 years, specifically, the mean age of females was slightly older than that of males. Education level was mostly primary and secondary school education, and illiteracy. Risk factors of chronic tibial osteomyelitis included history of smoking and drinking, history of multiple repeated surgeries, and impaired immunity. Frequent clinical symptoms were in the order of pain, local swelling, pus discharge and skin ulceration. Among all inflammatory markers, proportion of positive results were 30.85%, 59.93% and 53.90% for white blood cell (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), respectively. Positive rate of pathogenic microorganism culture was low and the three most common bacteria were Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa) and Escherichia coli (E. coli). The most frequent site of infection was middle tibia. According to Cierny-Mader osteomyelitis classification, the most common types were type IIIA, IVA and IIA.ConclusionNumber of visits due to chronic osteomyelitis increased year by year, with young and middle-aged male farmers and low education level as the main groups. Smoking and drinking were two considerable risk factors that should be attached to a great importance. No significant increase was found in inflammatory markers and lower positive rate of pathogenic microorganism culture was observed. Multi-drug resistant bacteria were common and S. aureus remained the most frequent pathogen. Elevated ESR had certain diagnostic value for osteomyelitis. Type III and type IV osteomyelitis accounted for a large proportion which posed great challenges for clinical diagnosis and treatment.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12891-024-07928-7.