Neurovascular coupling (NVC) reflects the coordination between brain activity and cerebral blood flow, while glymphatic function indicates the capacity to clear metabolic waste from the brain. However, differences in these two factors between patients on peritoneal dialysis (PD) and hemodialysis (HD), as well as their interrelationship, remain unclear. Functional magnetic resonance imaging, three-dimensional pseudo-continuous arterial spin labeling, and diffusion tensor imaging were prospectively performed in 56 patients on PD, 54 patients on HD, and 52 healthy controls (HC). The study calculated the amplitude of low frequency fluctuation-cerebral blood flow (ALFF-CBF) coupling coefficient and the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, which respectively represent the overall NVC level and the glymphatic function. Compared to HC, patients on PD and HD exhibited lower ALFF-CBF coupling coefficients and DTI-ALPS indices, but there were no significant differences between the PD and HD groups. Additionally, positive correlations were observed between ALFF-CBF coupling coefficients and DTI-ALPS indices across all three groups. he degrees of neurovascular decoupling and altered glymphatic function are comparable between patients on PD and HD. Importantly, neurovascular decoupling may be associated with altered glymphatic function in patients on dialysis. The degrees of neurovascular decoupling and altered glymphatic function are comparable between patients on PD and HD. Importantly, neurovascular decoupling may be associated with altered glymphatic function in patients on dialysis.

Objective: To analyze the mutation status of the PIK3CA gene and the clinicopathological characteristics in lung adenocarcinoma. Methods: Lung adenocarcinoma cases that underwent next-generation sequencing (NGS) for the PIK3CA gene at the Department of Pathology, the Third People's Hospital of Henan Province and the Henan Provincial People's Hospital from January 1, 2020 to December 31, 2024 were collected. Clinicopathological indicators were recorded for statistical analysis, and follow-up was conducted. Results: A total of 127 lung adenocarcinoma patients with PIK3CA mutations were detected. There was a slight female predominance (75/127, 59.1%), the majority were non-smokers (95/127, 74.8%), and age was 65.0(57.0, 71.0)years old. Most lung adenocarcinomas were moderately differentiated (56/127, 44.1%) or poorly differentiated (44/127, 34.6%), with clinical stage Ⅳ being the most common (60/127, 47.2%). Hotspot mutations in the PIK3CA gene were present in 77 cases (77/127, 60.6%), specifically manifesting as mutations in exon 9 (E9, p.E545K/Q, p.E542K) and exon 20 (E20, p.H1047R/L/Y). Compared with E9 mutations, E20 mutations were more frequently associated with lymph node metastasis, visceral pleural invasion, airspace dissemination, poorer differentiation, and higher staging, and had a worse prognosis. Multivariate Cox analysis showed that PIK3CA hotspot mutations did not significantly affect prognosis (HR=0.586,95%CI=0.343-1.002,P=0.051). Co-existing mutations in other genes were found in 105 cases (105/127, 82.7%), with 72 cases (72/105, 56.7%) harboring concomitant EGFR mutations. Of the 62 cases receiving targeted therapy, 11 developed drug resistance, primarily due to secondary EGFR exon 20 mutations (9/11). Conclusions: Lung adenocarcinomas with PIK3CA mutations exhibit distinct clinicopathological characteristics in terms of gender, age, smoking history, differentiation degree, and clinical stage. Acquired drug resistance in lung adenocarcinoma may be accompanied by PIK3CA mutations, but PIK3CA mutation is not the main mechanism of targeted therapy resistance in lung adenocarcinoma patients.

Oxidative stress and inflammation are interconnected drivers of cellular damage in pathologies ranging from neurodegenerative disorders to sensorineural hearing loss. We aimed to develop a chitosan-Prussian blue nanozyme (CS-PB) to target these processes in sensorineural hearing loss. CS-PB (35 μg/mL) pretreatment of H2O2-injured HEI-OC1 cochlear cells for 4 h markedly decreased the levels of reactive oxygen species (ROS) inside cells (from 3.8 to 2.4 relative fluorescence intensity) by approximately 37% (P < 0.001)-and concomitantly significantly decreased expression of the oxidative damage markers 4-HNE and 3-NT (both P < 0.001). The rate of apoptosis decreased from 27.5% in the H2O2-treated group to 14.1% following CS-PB treatment (P < 0.01). This reduction was accompanied by a significant downregulation of the pro-apoptotic proteins Bax (P < 0.05) and Cleaved-caspase-3 (P < 0.001), as well as an upregulation of the anti-apoptotic protein Bcl-XL (P < 0.01).Western blot analysis confirmed that CS-PB significantly downregulated TLR4 expression and inhibited downstream phosphorylation of p-P65/P65, while upregulating p-IκBα/IκBα protein (all P < 0.01) associated with reduction in the production of inflammatory cytokines like TNF-α, IL-1β, and IL-6. Treatment with the specific TLR4 antagonist TAK-242 (2 μM) mimicked the effect of CS-PB, with coadministration showing no additional ant-inflammatory effect (although HEI-OC1 viability was additionally increased), indicating that the anti-inflammatory properties of CS-PB were facilitated via the TLR4/NF-κB signaling pathway. In vivo, CS-PB pretreatment (2 mg/mL, 2 μL) was administered by carefully applying the solution to the round window membrane (RWM) using a microsyringe in a noise-induced hearing loss rat model, which significantly curtailed the noise-induced activation of the TLR4/NF-κB pathway in the cochlea. After 24 hours, the levels of p-P65/P65 and TLR4 decreased by 54% and 50%, respectively. (P < 0.001), and levels of the inflammatory cytokines IL-6, TNF-α and IL-1β were decreased by 53%, 48%, and 51% (P < 0.001). Furthermore, the degree of pathway inhibition showed a strong correlation with cytokine reduction (r = 0.87-0.89, all P < 0.001). CS-PB showed no significant cytotoxicity in vitro or in vivo, suggesting that its combined ROS-scavenging and TLR4/NF-κB-modulating properties may represent a potential therapeutic strategy, pending further mechanistic and translational validation.

Pediatric osteomyelitis of the jaw is predominantly non-odontogenic in origin, typically arising from hematogenous spread. This case report presents a rare case of mandibular marginal osteomyelitis secondary to second molar pericoronitis in a child, clinically manifesting as facial swelling, induration, and trismus. The pediatric patient was treated with a combined regimen of systemic antimicrobial therapy and localized surgical intervention. At the 12-month follow-up, near-anatomical remodeling of the affected mandible was achieved, accompanied by restoration of mouth opening to physiological limits. This case report indicates that early diagnosis and intervention of pediatric mandibular marginal osteomyelitis arising from second molar pericoronitis are critical to prevent mandibular deformities, pathological fractures, and facial asymmetry. Furthermore, prophylactic extraction of third molar tooth germs and contralateral pericoronal pocket excision during surgery may reduce recurrence.

Stroke is characterized by high morbidity, disability, and mortality, and has become the third leading cause of death worldwide. In China, stroke accounts for 39.9% of all cerebrovascular diseases, with young and middle-aged survivors (aged 40-60 years) comprising 33% of global stroke survivors in this age group and over 51.51% of all stroke cases in China. Despite significant improvements in treatment, 70-80% of survivors still lose the ability to live independently, and social participation declines to varying degrees. Social participation plays an important role in rehabilitation outcome indicators, which can reflect the overall recovery of survivors and is closely related to quality of life. Guided by the International Classification of Functioning, Disability and Health (ICF) framework, this review aims to examine the current status, assessment tools, and influencing factors of social participation among young and middle-aged stroke survivors, with the goal of informing future research and guiding clinical practice.

The industrial cultivation of tomato seedlings requires a high degree ofuniformity and consistency in grading. However, traditional grading methods based on phenotypictraits such as leaf area and canopy width are susceptible to environmental conditions, therebylimiting the accuracy and efficiency of grading. Since cumulative internode length is relativelystable and closely correlated with seedling vigor, this study aims to develop an accurate methodfor measuring and grading the cumulative internode length of tomato seedlings.