Comparison of children and adults in deep brain stimulation for Tourette Syndrome: a large-scale multicenter study of 102 cases with long-term follow-up.

BACKGROUND: Deep brain stimulation (DBS) is a promising therapy for refractory Gilles de la Tourette syndrome (GTS). However, its long-term efficacy, safety, and recommended surgical age remain controversial, requiring evidence to compare different age categories. METHODS: This retrospective cohort study recruited 102 GTS patients who underwent DBS between October 2006 and April 2022 at two national centers. Patients were divided into two age categories: children (aged < 18 years; n = 34) and adults (aged ≥ 18 years; n = 68). The longitudinal outcomes as tic symptoms were assessed by the YGTSS, and the YBOCS, BDI, and GTS-QOL were evaluated for symptoms of obsessive-compulsive disorder (OCD), depression, and quality of life, respectively. RESULTS: Overall, these included patients who finished a median 60-month follow-up, with no significant difference between children and adults (p = 0.44). Overall, the YGTSS total score showed significant postoperative improvements and further improved with time (improved 45.2%, 51.6%, 55.5%, 55.6%, 57.8%, 61.4% after 6, 12, 24, 36, 48, and ≥ 60 months of follow-up compared to baseline, respectively) in all included patients (all p < 0.05). A significantly higher improvement was revealed in children than adults at ≥ 60 months of follow-up in the YGTSS scores (70.1% vs 55.9%, p = 0.043), and the time to achieve 60% improvement was significantly shorter in the children group (median 6 months vs 12 months, p = 0.013). At the last follow-up, the mean improvements were 45.4%, 48.9%, and 55.9% and 40.3%, 45.4%, and 47.9% in YBOCS, BDI, and GTS-QOL scores for children and adults, respectively, which all significantly improved compared to baseline (all p < 0.05) but without significant differences between these two groups (all p > 0.05), and the children group received significantly higher improvement in GTS-QOL scores than adults (55.9% vs. 47.9%, p = 0.049). CONCLUSIONS: DBS showed acceptable long-term efficacy and safety for both children and adults with GTS. Surgeries performed for patients younger than 18 years seemed to show acceptable long-term efficacy and safety and were not associated with increased risks of loss of benefit compared to patients older than 18 at the time of surgery. However, surgeries for children should also be performed cautiously to ensure their refractoriness and safety.

Exploring barriers to influenza vaccine uptake and recommendation among healthcare providers in the community in China: A qualitative study.

Healthcare providers (HCPs) are recommended for priority influenza vaccination due to their high risk of contracting influenza. HCPs greatly aid in targeted population immunization campaigns. Therefore, understanding the factors that influence HCPs' decisions to get vaccinated and to recommend influenza vaccination is essential. However, there currently needs to be more evidence on this topic in China. Qualitative interviews using a semi-structured interview method were conducted with 180 HCPs from urban community hospitals and town hospitals in four cities in Shandong Province during August 2023. The interview content was analyzed using thematic analysis to identify the variables impacting the vaccination and recommendation practices of HCPs, as well as their suggestions for improving vaccination services. The results will help support the future development of precise intervention measures as well as focused education and training.

Defect identification of bare printed circuit boards based on Bayesian fusion of multi-scale features.

The aim of this article is to propose a defect identification method for bare printed circuit boards (PCB) based on multi-feature fusion. This article establishes a description method for various features of grayscale, texture, and deep semantics of bare PCB images. First, the multi-scale directional projection feature, the multi-scale grey scale co-occurrence matrix feature, and the multi-scale gradient directional information entropy feature of PCB were extracted to build the shallow features of defect images. Then, based on migration learning, the feature extraction network of the pre-trained Visual Geometry Group16 (VGG-16) convolutional neural network model was used to extract the deep semantic feature of the bare PCB images. A multi-feature fusion method based on principal component analysis and Bayesian theory was established. The shallow image feature was then fused with the deep semantic feature, which improved the ability of feature vectors to characterize defects. Finally, the feature vectors were input as feature sequences to support vector machines for training, which completed the classification and recognition of bare PCB defects. Experimental results show that the algorithm integrating deep features and multi-scale shallow features had a high recognition rate for bare PCB defects, with an accuracy rate of over 99%.

Morphological variation of gubernacular tracts for permanent mandibular canines in eruption: a three-dimensional analysis.

OBJECTIVES: This study aims to evaluate the morphological features of gubernacular tract (GT) for erupting permanent mandibular canines at different ages from 5 to 9 years old with a three-dimensional (3D) measurement method. METHODS: The cone-beam CT images of 50 patients were divided into five age groups. The 3D models of the GT for mandibular canines were reconstructed and analysed. The characteristics of the GT, including length, diameter, ellipticity, tortuosity, superficial area, volume, and the angle between the canine and GT, were evaluated using a centreline fitting algorithm. RESULTS: Among the 100 GTs that were examined, the length of the GT for mandibular canines decreased between the ages of 5 and 9 years, while the diameter increased until the age of 7 years. Additionally, the ellipticity and tortuosity of the GT decreased as age advanced. The superficial area and volume exhibited a trend of initially increasing and then decreasing. The morphological variations of the GT displayed heterogeneous changes during different periods. CONCLUSIONS: The 3D measurement method effectively portrayed the morphological attributes of the GT for mandibular canines. The morphological characteristics of the GT during the eruption process exhibited significant variations. The variations in morphological changes may indicate different stages of mandibular canine eruption.

Neurosurgical robots in China: State of the art and future prospect.

Neurosurgical robots have developed for decades and can effectively assist surgeons to carry out a variety of surgical operations, such as biopsy, stereo-electroencephalography (SEEG), deep brain stimulation (DBS), and so forth. In recent years, neurosurgical robots in China have developed rapidly. This article will focus on several key skills in neurosurgical robots, such as medical imaging systems, automatic manipulator, lesion localization techniques, multimodal image fusion technology, registration method, and vascular imaging technology; introduce the clinical application of neurosurgical robots in China, and look forward to the potential improvement points in the future based on our experience and research in the field.

The NONRATT023402.2/rno-miR-3065-5p/NGFR axis affects levodopa-induced dyskinesia in a rat model of Parkinson's disease.

Levodopa-induced dyskinesia (LID) is a common motor complication in Parkinson's disease. However, few studies have focused on the pathogenesis of LID at the transcriptional level. NONRATT023402.2, a long non-coding RNA (lncRNA) that may be related to LID was discovered in our previous study and characterized in rat models of LID. In the present study, NONRATT023402.2 was overexpressed by injection of adeno-associated virus (AAV) in striatum of LID rats, and 48 potential target genes, including nerve growth factor receptor (NGFR) were screened using next-generation sequencing and target gene predictions. The NONRATT023402.2/rno-miR-3065-5p/NGFR axis was verified using a dual luciferase reporter gene. Overexpression of NONRATT023402.2 significantly increased the abnormal involuntary movements (AIM) score of LID rats, activated the PI3K/Akt signaling pathway, and up-regulated c-Fos in the striatum. NGFR knockdown by injection of ShNGFR-AAV into the striatum of LID rats resulted in a significant decrease in the PI3K/Akt signaling pathway and c-Fos expression. The AIM score of LID rats was positively correlated with the expressions of NONRATT023402.2 and NGFR. A dual luciferase reporter assay showed that c-Fos, as a transcription factor, bound to the NONRATT023402.2 promoter and activated its expression. Together, the results showed that NONRATT023402.2 regulated NGFR expression via a competing endogenous RNA mechanism, which then activated the PI3K/Akt pathway and promoted c-Fos expression. This suggested that c-Fos acted as a transcription factor to activate NONRATT023402.2 expression, and form a positive feedback regulation loop in LID rats, thus, aggravating LID symptoms. NONRATT023402.2 is therefore a possible novel therapeutic target for LID.

Identification of Cuproptosis Clusters and Integrative Analyses in Parkinson's Disease.

Parkinson's disease (PD) is the second most common neurodegenerative disease; it mainly occurs in the elderly population. Cuproptosis is a newly discovered form of regulated cell death involved in the progression of various diseases. Combining multiple GEO datasets, we analyzed the expression profile and immunity of cuproptosis-related genes (CRGs) in PD. Dysregulated CRGs and differential immune responses were identified between PD and non-PD substantia nigra. Two CRG clusters were defined in PD. Immune analysis suggested that CRG cluster 1 was characterized by a high immune response. The enrichment analysis showed that CRG cluster 1 was significantly enriched in immune activation pathways, such as the Notch pathway and the JAK-STAT pathway. KIAA0319, AGTR1, and SLC18A2 were selected as core genes based on the LASSO analysis. We built a nomogram that can predict the occurrence of PD based on the core genes. Further analysis found that the core genes were significantly correlated with tyrosine hydroxylase activity. This study systematically evaluated the relationship between cuproptosis and PD and established a predictive model for assessing the risk of cuproptosis subtypes and the outcome of PD patients. This study provides a new understanding of PD-related molecular mechanisms and provides new insights into the treatment of PD.

Astrocyte-derived SerpinA3N promotes neuroinflammation and epileptic seizures by activating the NF-κB signaling pathway in mice with temporal lobe epilepsy.

Impaired activation and regulation of the extinction of inflammatory cells and molecules in injured neuronal tissues are key factors in the development of epilepsy. SerpinA3N is mainly associated with the acute phase response and inflammatory response. In our current study, transcriptomics analysis, proteomics analysis, and Western blotting showed that the expression level of Serpin clade A member 3N (SerpinA3N) is significantly increased in the hippocampus of mice with kainic acid (KA)-induced temporal lobe epilepsy, and this molecule is mainly expressed in astrocytes. Notably, in vivo studies using gain- and loss-of-function approaches revealed that SerpinA3N in astrocytes promoted the release of proinflammatory factors and aggravated seizures. Mechanistically, RNA sequencing and Western blotting showed that SerpinA3N promoted KA-induced neuroinflammation by activating the NF-κB signaling pathway. In addition, co-immunoprecipitation revealed that SerpinA3N interacts with ryanodine receptor type 2 (RYR2) and promotes RYR2 phosphorylation. Overall, our study reveals a novel SerpinA3N-mediated mechanism in seizure-induced neuroinflammation and provides a new target for developing neuroinflammation-based strategies to reduce seizure-induced brain injury.

Case report: One human Streptococcus suis infection in Shandong Province, China.

BACKGROUND: Streptococcus suis is an emerging zoonotic pathogen. Human infections with S suis have been identified in Europe, North America, South America, Oceania, Africa and Asia. As the most common clinical symptom of human S suis, meningitis develops in 50% to 60% of infected patients, and approximately 60% of the patients with meningitis symptoms have neurologic sequelae. The cost of infection with S suis imposes a tremendous burden on patients' families. CASE PRESENTATION: A 56-year-old woman was infected with S suis. The patient reared pigs in her backyard. At admission, her blood examination showed a leukocyte count of 27.28 × 109/L with 94.20% neutrophils. Cerebrospinal fluid was cloudy with a leukocyte count of 2700 × 106/L. Cerebrospinal fluid cultures revealed gram-positive cocci identified as S suis type II. Ceftriaxone was then administered. CONCLUSION: Human infections with S suis highlights the need for health education, prevention and surveillance it.

Emotional symptoms and cognitive function outcomes of subthalamic stimulation in Parkinson's disease depend on location of active contacts and the volume of tissue activated.

BACKGROUND: Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD), that can improve patients' motor and non-motor symptoms. However, there are differences in the improvement of patients' emotional symptoms and cognitive function. OBJECTIVE: To investigate the impact of active contact location and the volume of tissue activated (VTA) on patients' emotional symptoms and cognitive function in STN-DBS in PD. METHODS: A total of 185 PD patients were included in this study. We evaluated them using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale, Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE) scales at the preoperative, 1- and 12-month postoperative time points. Leads were positioned in standard space using the Lead-DBS toolbox, and VTA was calculated for analysis. RESULTS: When the lead active contact was closer to the ventral side of the STN, the patients' HAM-A improvement rate was higher, and when the active contact was closer to the anterior and dorsal sides of the STN, the patients' MoCA improvement rate was higher. Stimulation of the sensorimotor zone was more favorable to the improvement of HAM-A and HAM-D in patients. And, the stimulation of the associative zone was more favorable to the improvement of MoCA in patients. CONCLUSION: Our results provide evidence that the 12-month outcomes of cognitive function and emotional symptoms in PD patients with STN-DBS were closely related to the specific location of the active contacts in the STN and influenced by the VTA.

Epidemiology of human papillomavirus on condyloma acuminatum in Shandong Province，China.

Condyloma acuminatum (CA) is a sexually transmitted disease (STD) caused by human papillomavirus (HPV) infection. It is important to study the prevalence and distribution of HPV genotypes before implementing the HPV vaccination program. Therefore, the aim of this study was to evaluate the epidemiological characteristics of CA cases and the distribution of HPV genotypes in Shandong Province, China. One-to-one questionnaire surveys were conducted on all patients diagnosed with CA in sentinel hospitals from Shandong Province, China. HPV genotypes were determined using the polymerase chain reaction (PCR)-reverse dot blot hybridization method. The study enrolled 1185 patients (870 males and 315 females) and found that CA patients are mainly males and sexually active people between the ages of 20 and 40. Recurrence occurred in 34.7% patients. Among the 880 CA patients who underwent HPV typing, the HPV test positivity rate was 91.4%. In these cases, low-risk (LR) HPV infection was predominant, with an infection rate of 91.3%, while high-risk (HR) HPV genotypes were found in 53.5% patients. The most frequent HPV genotypes encountered were HPV6 (57.8%), HPV11 (37.2%), HPV16 (13.7%), and HPV42 (10.3%). HPV6 and/or HPV11 are the main infections in all patients, and more than half of the patients are coinfected with HR-HPV. However, unlike other regions, HPV42 has a higher prevalence rate among CA patients in Shandong Province and is a nonvaccine HPV genotype. Therefore, regular HPV typing helps to understand the characteristics of specific genotypes and the choice of the best type for vaccine coverage.

Vanillin enhances the antibacterial and antioxidant properties of polyvinyl alcohol-chitosan hydrogel dressings.

Wound management requires the preparation of controllable, safe and effective dressings to isolate the wound from the external environment. Currently, widely used commercial dressings focus on the isolation effect rather than an environment conducive to wound healing. To provide the dressing with beneficial properties such as wetting and antioxidant and antibacterial activity, this study used polyvinyl alcohol (PVA) hydrogel as the base material and introduced chitosan (CS) and vanillin (V) to design a PVA/CS/V three-phase hydrogel dressing. The dressings were prepared using a freeze-thaw cycle to achieve properties. We conducted a comparative analysis of PVA/V and PVA/CS two-phase hydrogels. The PVA/CS/V (PCV) hydrogel dressing maintaining an elastic modulus at >5 kPa at 15-40 °C. An in vitro antibacterial assay showed the potent antibacterial ability of hydrogels against gram-positive and -negative bacteria, and cells in some PCV groups showed higher activity. The antioxidant results showed that PCV hydrogel had a potent scavenging effect on DPPH, ABTS+, and PTIO free radical. The antibacterial and antioxidant properties of three-phase hydrogel showed the best performance in all experimental groups. These results suggest that PCV hydrogel has value in commercial applications due to its simple preparation process and excellent biological properties.

Structural Elucidation and genetic identification of the O-antigen from a novel serogroup of Escherichia coli strain 2017LL031.

The O-antigen is an important virulence factor involved in the survival, virulence and invasion of bacteria. The bacterial serological types are highly dependent on these surface-exposed and structurally unique O-antigen structures. In this work, the structure of O-antigen from an Escherichia coli strain 2017LL031 was elucidated as a hexasaccharide repeating unit: →3)-[ß-D-Glcp-(1 â†’ 2)]-α-L-Rhap-(1 â†’ 3)-[α-D-Quip-(1 â†’ 3)-α-D-GlcpA-(1 â†’ 2)]-ß-L-Fucp-(1 â†’ 3)-ß-D-GlcpNAc-(1→, which is completely different from all known E. coli serogroups. The O-antigen gene cluster (O-AGC) of 2017LL031 was also analyzed and correlates well to its O-Ag. Moreover, the O-AGC of 2017LL031 was deleted and its role in O-Ag biosynthesis was confirmed experimentally. Taken together, our results present that a novel E.coli serotype 2017LL031 is identified.

A simple, safe and easily accessible polyvinyl alcohol hydrogel for wound cleaning.

Acute wounds are often contaminated by some kind of filth, and fluids are usually used to wash away the dirt, but the force of the fluid may cause secondary injury at the wound site or even increase the risk of infection. Hydrogels have several advantages over liquid scouring since they are less intense, more portable, and easier to control. In this study, poly(vinyl alcohol) was used to prepared a series of hydrogels, which were tested in terms of their properties and abilities to clean simulated dirty wounds. Simulated dirt and bacterial (Serratia marcescens) adhesion experiments demonstrated that they could effectively adhere to a certain amount of dirt or bacteria to achieve the purpose of wound cleaning. In addition to the bacterial adhesion, the antibacterial experiments also proved that the hydrogels have a certain inhibitory effect on the proliferation of E.coli and S.aureus. The hydrogels could change shape freely and exhibited excellent biocompatibility, ductility, and self-healing capabilities, which increase their service life and make them more suitable for treating wounds or acting as protection buffers. Based on all these characteristics, the developed hydrogel may be a potentially valuable material for wound cleaning.

An MRI radiomics approach to predict survival and tumour-infiltrating macrophages in gliomas.

Preoperative MRI is one of the most important clinical results for the diagnosis and treatment of glioma patients. The objective of this study was to construct a stable and validatable preoperative T2-weighted MRI-based radiomics model for predicting the survival of gliomas. A total of 652 glioma patients across three independent cohorts were covered in this study including their preoperative T2-weighted MRI images, RNA-seq and clinical data. Radiomic features (1731) were extracted from preoperative T2-weighted MRI images of 167 gliomas (discovery cohort) collected from Beijing Tiantan Hospital and then used to develop a radiomics prediction model through a machine learning-based method. The performance of the radiomics prediction model was validated in two independent cohorts including 261 gliomas from the The Cancer Genomae Atlas database (external validation cohort) and 224 gliomas collected in the prospective study from Beijing Tiantan Hospital (prospective validation cohort). RNA-seq data of gliomas from discovery and external validation cohorts were applied to establish the relationship between biological function and the key radiomics features, which were further validated by single-cell sequencing and immunohistochemical staining. The 14 radiomic features-based prediction model was constructed from preoperative T2-weighted MRI images in the discovery cohort, and showed highly robust predictive power for overall survival of gliomas in external and prospective validation cohorts. The radiomic features in the prediction model were associated with immune response, especially tumour macrophage infiltration. The preoperative T2-weighted MRI radiomics prediction model can stably predict the survival of glioma patients and assist in preoperatively assessing the extent of macrophage infiltration in glioma tumours.

Case report: One human Streptococcus suis occurred in Shandong Province, China.

BACKGROUND: Streptococcus suis (S suis) is a major pathogen of bacterial infectious diseases, which can be transmitted to human beings through close contact with sick pigs or carriers, and can cause toxic shock, meningitis, septicemia, pneumonia, and other complications, with an extremely high mortality and disability rate. S suis is also an emerging zoonotic agent, mainly occurring in China, Thailand, and the Netherlands. This seriously threatens the health and family economy of patients. CASE PRESENTATION: A 75-year-old man presented with a 1-day history of fever, vomiting, coughing, chills, and unconsciousness. He was admitted with the diagnosis sepsis and intracranial infection. At admission, hematologic studies showed a leukocyte count of 23.45 × 109/L with 91% neutrophils. Chest computed tomography revealed double pneumonia. Blood cultures grew small colonies, which were identified as S suis. Antibiotic susceptibility testing revealed that the pathogen was susceptible to levofloxacin. And then, treatment with levofloxacin was implemented. Epidemiological investigations showed that the patient had eaten pork from a sick pig. When a patient with bacterial infection has a history of eating pork from sick pigs, human S suis infection should be taken seriously. CONCLUSION: Although human S suis infection generally presents as a sporadic disease, its high burden highlights the importance of epidemiological surveillance and health education regarding human S suis infection.

Genomic diversity of human papillomavirus type 6 from patients with condyloma acuminatum in Eastern China.

OBJECTIVE: Human papillomavirus type 6 (HPV6) is the major etiological agent of anogenital warts both men and women. However, there is limited data on its genomic characterization in mainland China. The aim of this study was to understand the complete genomic diversity of HPV6 from patients with condyloma acuminatum (CA) and to explore the prevalence of different variant lineages/sublineages in eastern China. METHODS: CA samples were collected in 3 hospitals in Shandong Province, China from January 2020 to March 2021. DNA extraction, PCR amplification, Sanger sequencing and sequence assembly were performed on HPV6-positive samples. The complete genomes obtained in this study were analyzed phylogenetically with global HPV6 sequences in GenBank database using MEGA 11. RESULTS: A total of 55 complete genomic sequences of HPV6 were obtained in this study. They were classified as HPV6 variant lineage A (n = 20), sublineage B1 (n = 34) and sublineage B3 (n = 1) by phylogenetic analysis. Sequence alignment showed E1, E5A, E5B, L1, L2, LCR were relatively highly variable regions for sublineage B1 whereas E1, E5A, L2 for lineage A. Both phylogenetic trees of lineage A and sublineage B1 composed of two main branches. Chinese sequences of lineage A segregated into the major branch while those in sublineage B1 belonged to both branches. Genomic divergence between sequences from China and other countries was 0.00% - 0.33% in lineage A and 0.00% - 0.40% in sublineage B1. CONCLUSIONS: This is the first study on HPV variant lineages circulating in mainland China. The results revealed that lineage A and sublineage B1 were prevalent and they had different highly variable regions. Further surveillance is needed to understand the dynamic change of different variants in the population.

Chitosan thermosensitive hydrogels based on lyophilizate powders demonstrate significant potential for clinical use in endoscopic submucosal dissection procedures.

The goal of this study was to develop intraoperative biomaterials for use in endoscopic submucosal dissection (ESD) procedures that are stable during storage, easy to use, and effective in clinical practice. Therefore, injectable thermosensitive hydrogels were developed based on lactobionic acid-modified chitosan/chitosan/ß-glycerophosphate (CSLA/CS/GP) hydrogel lyophilizate powders, and their properties were compared with original hydrogels that had not been freeze-dried. The results indicated that the lyophilizate powders retained their thermosensitive properties, and gels could be formed within 5 min at 37 °C. Compared to the original hydrogels, the injectability of the hydrogels derived from lyophilizate powders increased significantly. These novel materials maintained their original porous network lamellar structure but exhibited improved mechanical strength and tissue adhesion. Their application with L929 and GES-1 cells revealed that the lyophilizate powder hydrogels demonstrated good cytocompatibility and clearly protected the cells in an acidic environment. The results of submucosal injection experiments involving porcine stomach tissue indicated that the heights of the cushions created by CSLA/CS/GP lyophilizate powder hydrogels lasted longer than those generated with normal saline. The thermosensitive hydrogels based on lyophilizate powders may contribute to practical clinical applications involving ESD, and may also have potential value for other applications in the digestive tract.