People 's Liberation Army 451 Hospital

Repetitive transcranial magnetic stimulation (rTMS) is widely used in the treatment of major depressive disorder (MDD). Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is currently the latest effective treatment option that can rapidly antidepressant and alleviate suicidal ideation. However, its mechanism of action is unclear. In this study, we applied regional homogeneity (ReHo) and dynamic functional connectivity (DFC) analyses to investigate the temporal similarity of signal fluctuations and dynamic properties of functional connectivity in 26 MDD patients. ReHo analysis revealed alterations of synchronicity of neuronal oscillations after treatment in the default mode network, subcutaneous nucleus network, frontoparietal network, etc. DFC analysis showed that there were two different states of connectivity. In addition, SAINT also induced increased number of state transitions and enhanced DFC variability in the default mode network, subcutaneous nucleus network, frontoparietal network, etc. Furthermore, correlation analysis revealed a significant negative correlation between DFC variability and baseline scale scores. Finally, we built a machine learning model to predict treatment efficacy based on baseline characteristics and demonstrated that neural activity and brain functional connectivity features at baseline effectively predicted outcomes following SAINT treatment. These findings enhance our understanding of the neurological changes in MDD patients undergoing SAINT, offering potential imaging markers for predicting rTMS treatment efficacy.

Neurofibromas are benign peripheral nerve sheath tumors. It is more common in neurofibromatosis type Ⅰ. However, isolated vagal nerve neurofibroma（VNN） of the neck is extremely rare, and only a few case reports have been reported. Its etiology and pathogenesis are not clear. The diagnosis is mainly based on pathological examination and immunohistochemistry, and surgical resection is the main treatment. This study reports a rare case of giant solitary vagus neurofibroma in the neck. The patient was a 29-year-old female who was found to have a mass on the right side of the neck by physical examination, which was considered to be a vagus nerve tumor by neck ultrasound and imaging examination. The tumor was completely removed during the operation, with the size of about 10.0 cm×2.5 cm, and the patient had no special discomfort. Postoperative pathology and immunohistochemistry confirmed neurofibroma. After surgery, the patient had right vocal cord paralysis, hoarseness, choking and paroxysmal cough. After swallowing function training and voice rehabilitation treatment in the department, the patient recovered satisfactorily. There was no complication and recurrence during the follow-up of 1 year. This article reviews the literature to improve the diagnosis and treatment of solitary vagus neurofibroma in the neck by combining its medical history, imaging features, pathology and immunohistochemistry, and surgical treatment.

ObjectivesTo analyze the prevalence and risk factors of plasma transfusions during resuscitation after burns in children.MethodsA retrospective study was carried out at the Burn Treatment Center of the Central Theatre Air Force Hospital of the People's Liberation Army in Datong City, China. The study included pediatric patients (between the ages of two months and 14 years) who were admitted for burns between January 2010 and December 2021. Details of plasma transfusions during the burn resuscitation process for each child were recorded. The association between risk factors and plasma transfusions was evaluated using non-conditional logistic regression.ResultsOf the children who suffered from burns, 12.89% (n = 174/1,350) received plasma transfusions during burn resuscitation. The median amount of plasma transfusions administered was 2.5 units (interquartile range, 1.4). Among the pediatric burn patients who received plasma transfusion, 67.24% did not receive any treatments before being admitted to the hospital, while 14.94% were admitted 6 h or more after the burns occurred. The total body surface area (TBSA) of pediatric burn patients who received plasma transfusion ranged from 10% to 55%, with a median burn area of 20% of the TBSA and a mean burn area of 22% of the TBSA. Non-conditional logistic regression analysis identified TBSA, white blood cell count (WBC), heart rate, and pre-hospital remedies as significant predictors of plasma transfusion.ConclusionTBSA (total body surface area), WBC (white blood cell count), heart rate, and pre-hospital interventions can serve as reliable predictors for determining the necessity of plasma transfusions during burn resuscitation. Utilizing these factors can assist blood banks and clinicians in preparing and administering targeted plasma treatments, as well as potentially reducing the overall need for plasma transfusions in pediatric burn patients.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects approximately one-third of the global population. Meanwhile, the development of MASLD is related to dysbiosis of the gut microbiota (GM). Our previous studies have shown that Vitamin K2 (VK2) has considerable potential to ameliorate mitochondrial dysfunction in mice fed a high-fat diet (HFD); however, the mechanism through which VK2 improves mitochondrial function and mitigates MASLD remains unclear. This study aimed to elucidate the mechanism through which VK2 modulates MASLD. A total of 80 C57BL/6J mice (4-5 weeks old) were fed a HFD for 16 weeks to establish the MASLD animal model. Additionally, VK2 was administered at a dose of 120 mg/kg/day for the last 8 weeks; 30 mice were fed a normal diet for the entire 24-week period. Mice were randomly divided into groups according to different experimental protocols. Hematoxylin and Eosin (H&E) staining, Oil Red O staining, and Cluster of Differentiation 11b (CD11b) immunofluorescence staining were used to detect liver histology and inflammatory cell infiltration in the mouse liver tissues. Moreover, 16S rRNA gene sequencing, antibiotic treatment, and fecal microbiota transplantation (FMT) were employed to investigate the microbiota-mediated anti-MASLD effects of VK2. Adeno-associated virus 9 (AAV9) was used to elucidate the mechanism through which VK2 regulates MASLD severity. VK2 significantly reduced hepatic lipid (triacylglycerol (TG) and total cholesterol (TC)) levels, as well as serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in HFD-fed mice (p < 0.05). VK2 also significantly suppressed inflammatory responses (p < 0.05), oxidative stress (p < 0.05), and improved mitochondrial dysfunction (p < 0.05) in a GM-dependent manner. Furthermore, VK2 restored the balance in the intestinal microbiota primarily through regulating Lactobacillus spp. abundance, and markedly alleviated MASLD via a GM-dependent manner. VK2 notably upregulated the expression of SIRT3 signaling pathway proteins (p < 0.05), thereby reducing MASLD-associated mitochondrial dysfunction (p < 0.05). VK2 exerts promising therapeutic effects mainly through enhancing intestinal Lactobacillus abundance and ameliorating mitochondrial dysfunction.