Abstract:Objective To investigate the clinical efficacy of Xiao'er Xuanfei Zhike granules combined with ceftazidime in the treatment of children with bronchopneumonia.Methods A total of 126 children with bronchopneumonia who were treated in Wuhan Hospital of Traditional Chinese Medicine from April 2021 to September 2023 were enrolled and divided into the control group and the observation group according to the random number table method,with 63 cases in each group.The control group was given intravenous drip of ceftazidime for injection at a dose of 50 mg/kg,twice a day.On the basis of the control group's regimen,the observation group was additionally treated with Xiao'er Xuanfei Zhike granules,1 bag each time for children aged 5-7 years old and 1.5 bags each time for children aged 8-11 years old,taken orally three times a day.Both groups were treated continuously for 7 d.The clinical efficacy,symptom relief time,pulmonary function indexes before and after treatment,serum inflammatory markers and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The relief times of asthma,cough,fever and disappearance time of pulmonary rales in the observation group were significantly shorter than those in the control group[(3.3±0.5)d vs(4.5±0.5)d,(4.1±0.7)d vs(5.1±0.8)d,(2.1±0.4)d vs(3.2±0.6)d,(4.2±0.6)d vs(5.4±0.8)d](all P<0.001).After treatment,the pulmonary function indexes of both groups were significantly higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group(all P<0.05).After treatment,the serum inflammatory markers of both groups were significantly lower than those before treatment,and the markers in the observation group were significantly lower than those in the control group(all P<0.05).In the control group,1 case of nausea and vomiting and 1 case of abdominal pain occurred,with the incidence of adverse reactions being 3.2％(2/63).In the observation group,1 case of diarrhea and 2 cases of nausea and vomiting occurred,with the incidence of adverse reactions being 4.8％(3/63).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Xiao'er Xuanfei Zhike granules combined with ceftazidime has a reliable therapeutic effect in the treatment of children with bronchopneumonia,which is helpful to relieve clinical symptoms,improve pulmonary function,reduce inflammatory response,and has good safety.

Abstract:Objective To analyze the different clinical characteristics and laboratory indicators of respiratory tract infections in children caused by influenza B,adenovirus,and respiratory syncytial virus.Methods A total of 668 children who visited the outpatient department or were hospitalized in Beijing Friendship Hospital,Capital Medical University from December 2023 to March 2024 were selected as the research subjects.According to the results of etiological nucleic acid detection,they were divided into influenza B group(259 cases),adenovirus group(216 cases),and respiratory syncytial virus group(193 cases).The clinical symptoms,laboratory indicators,and lymphocyte subset indicators of the three groups were compared.Results There were statistically significant differences in the proportions of moderate fever,high fever,sore throat,wheezing,vomiting,abdominal pain,headache,and concurrent Mycoplasma infection among the three groups(all P<0.05).There were statistically significant differences in white blood cell count,neutrophil count,lymphocyte count,monocyte count,and platelet count among the three groups(all P<0.05).There were statistically significant differences in CD+3,CD+8,CD+4,and CD+16 levels among the influenza B group,adenovirus group,and respiratory syncytial virus group[(1.86±0.25)vs(2.09±0.53),(2.14±0.46);(0.47±0.11)vs(1.02±0.26),(1.07±0.19);(1.25±0.38)vs(0.67±0.19),(1.18±0.35);(0.51±0.13)vs(0.54±0.07),(0.30±0.06)](all P<0.05).Conclusion After infection with the three viruses,children have common clinical manifestations and laboratory indicators of viral infection,as well as distinct manifestations and characteristics specific to each virus.

Abstract:Objective To compare the postoperative safety,recovery quality,and economic burden of tracheal intubation general anesthesia for pediatric oral surgery between outpatient and inpatient settings.Methods A total of 426 children(213 cases in the outpatient group and 213 cases in the inpatient group)admitted to Hospital of Stomatology,Fujian Medical University from November 2022 to August 2025 were retrospectively enrolled.The outpatient group consisted of children who met the ambulatory surgery criteria and were discharged on the same day,while the inpatient group was observed for≥24 h.The primary endpoint was the unplanned medical interven-tion rate within 24 h after surgery(unplanned revisit rate in the outpatient group;unplanned intervention escalation rate in the inpatient group).Secondary endpoints included perioperative complications,pain scores,parental satisfaction,and economic costs,compared between groups;while,multivariate regression analysis was used to adjust for confounding factors such as surgical type.Results No unplanned medical interventions occurred within 24 h after surgery in either group.There were no statistically significant differences between the two groups in the incidence of intraoperative hypoxemia,airway spasm,postoperative complications,parental satisfaction with pain control,or overall satisfaction(all P>0.05).The out-of-pocket anesthesia cost in the outpatient group was significantly higher than that in the inpatient group[(1 668±224)yuan vs(837±79)yuan](P<0.001).Conclusion The outpatient setting is comparable to the inpatient setting in terms of safety for tracheal intubation general anesthesia in pediatric oral surgery,and equivalent family satisfaction with pain management can be achieved.However,due to restrictions in medical insurance policies,the proportion of out-of-pocket expenses in the outpatient setting is significantly higher,which may restrict its clinical promotion.

Abstract:With the aging of the population in China,the standardized training of geriatricians is required.Geriatric medical education is characterized by interdisciplinary,multiple medications,and complex assessment methods for geriatric syndromes.The traditional"academic"teaching method is difficult to form a complete knowledge chain for geriatric medical students,which is inconsistent with the"holism"and"integration thought"in modern medical education.The medical training model organ of system-based curriculum(OSBC)can integrate the knowledge of various disciplines horizontally and vertically,strengthen the correlation between basic disciplines and clinical courses,which is beneficial to the training of interdisciplinary composite talents and the improvement of humanistic quality.The application of OSBC in geriatric physician training conforms to the current reform direction of clinical medical education,which is of great significance to promote the progress of medical and health care.This article expounds the development status of OSBC education,the existing geriatric education model and the development prospect of OSBC in geriatric education.

Abstract:Objective To explore the effect of Kangfuxin liquid combined with linezolid in the treatment of pulmonary tuberculosis in children.Methods A total of 188 children with pulmonary tuberculosis admitted to Qinghai Women and Children's Hospital from October 2023 to October 2024 were selected.According to the random number table method,they were divided into control group and combined group,with 94 cases in each group.On the basis of standardized treatment,the control group was treated with linezolid,and the combined group was treated with Kangfuxin liquid on the basis of the control group.The clinical efficacy,remission time,inflammatory factors,immune function and adverse reactions were compared between the two groups.Results The total effective rate of the combined group was higher than that of the control group[95.7％(90/94)vs 87.2％(82/94)](P=0.037).The cavity closure time,lesion absorption time,sputum culture negative time and acid-fast staining smear negative time of the combined group were shorter than those of the control group(all P＜0.05).After treatment,the levels of interferon-γ,interleukin-10 and high-sensitivity C-reactive protein in the combined group were lower than those in the control group(all P＜0.05).After treatment,the CD4+and CD4+/CD8+ratios in the combined group were higher than those in the control group,and CD8+was lower than that in the control group(all P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.194).Conclusion Kangfuxin liquid combined with linezolid is effective in the treatment of pulmonary tuberculosis in children,which can effectively shorten the remission time,reduce the expression of inflammatory factors,improve immune function,and has good safety.

Abstract:Objective To investigate the effects of different doses of recombinant human growth hormone(rhGH)on children with idiopathic short stature(ISS).Methods A total of 95 children with ISS admitted to the Affiliated Hospital of Hebei University from March 2022 to March 2023 were selected,and they were divided into low-dose group[31 cases,0.26 mg/(kg·d)],medium-dose group[32 cases,0.35 mg/(kg·d)]and high-dose group[32 cases,0.41 mg/(kg·d)]according to the random number table method.The growth status,growth factor levels,thyroid function,glucose and lipid metabolism indexes,bone metabolism indexes,and adverse reactions were compared among the three groups.Results After treatment,the height,growth rate,height standard deviation score,and levels of insulin-like growth factor binding protein 3(IGFBP-3)and insulin-like growth factor 1 of the three groups were higher than those before treatment,and those in the high-dose group were higher than those in the medium-dose group and the low-dose group(all P＜0.05).After treatment,there was no significant difference in thyroid function indexes of the three groups and before treatment,and there was no significant difference among the three groups(all P＞0.05).After treatment,the levels of fasting insulin,triglyceride,and low-density lipoprotein cholesterol of the three groups were lower than those before treatment(all P＜0.05),and there were no statistically significant differences in the glucose and lipid metabolism indexes among the three groups(all P＞0.05).After treatment,the levels of omentin-1 and bone alkaline phosphatase of the three groups were higher than those before treatment,and those of the high-dose group were higher than those of the middle-dose group and the low-dose group[(64±7)mg/L vs(57±7),(57±8)mg/L;(161±18)U/L vs(132±16),(130±17)U/L](all P＜0.05).There was no statistically significant difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion High-dose rhGH has a better effect in the treatment of children with ISS,which has a great effect on serum IGFBP-3 and omentin-1 levels,and the three doses have similar effects on glucose and lipid metabolism and thyroid function in children.

Abstract:Immune checkpoint inhibitors(ICIs)represent a major breakthrough in modern medical cancer therapy,pioneering a new paradigm for tumor treatment.However,immune-related adverse events(irAEs)are critical constraints affecting patients' ability to sustain immunotherapy and also one of the important limiting factors for expanding the application scope of immunotherapy.The onset time of irAEs is unpredictable,with variable symptoms ranging in severity.Their unique pathogenic mechanisms render the management of these adverse events particularly complex.Traditional Chinese medicine(TCM)serves as a vital cornerstone in the prevention and treatment of drug-induced adverse reactions.From the perspective and theory of TCM,enhancing the understanding and management of irAEs,as well as researching and constructing optimal prediction models and TCM intervention strategies for irAEs,are topics worthy of exploration at present.

Abstract:With the continuous improvement of people's requirements for health management,rational drug use monitoring and adverse reaction risk early warning have become important links to ensure patient safety.In recent years,the application of artificial intelligence technology in this field has attracted wide attention.The application of technologies such as machine learning,natural language processing,decision support systems and data mining can timely issue early warnings for irrational drug use and potential adverse reactions during clinical treatment through the analysis of large amounts of data,thereby significantly improving the effectiveness and safety of patient treatment.However,there are still various problems and challenges in the current application of artificial intelligence,such as algorithm bias,data security,privacy protection and ethics.This paper aims to review the application of artificial intelligence in clinical rational drug use monitoring and adverse reaction risk early warning,explore the role of artificial intelligence in improving the safety and effectiveness of clinical drug therapy for patients,and provide a reference basis for the popularization and application of artificial intelligence in the field of medical health.

Abstract:Objective To investigate the prescription status of long-term prescriptions containing may heart failure-exacerbating medications(HFEM)in outpatients with heart failure in cardiology department and analyze its influencing factors.Methods A retrospective analysis was conducted on the prescription data of 1 559 outpatients with heart failure who visited the cardiology department of Beijing Tongren Hospital,Capital Medical University from January to December 2022.Prescriptions containing HFEM were screened according to the HFEM catalog released by the American Heart Association in 2016.The patients were divided into the HFEM group and non-HFEM group according to the presence or absence of HFEM in the prescriptions.The clinical characteristics,number of complicated diseases,main comorbidities,number of medications used and professional titles of prescribing physicians were compared between the two groups,and the influencing factors for prescribing HFEM-containing prescriptions were analyzed.Results A total of 1 559 patients with heart failure or cardiac insufficiency in the diagnosis of long-term prescriptions were included in this study,among whom 168 patients(10.8％)were prescribed HFEM(HFEM group).The number of complicated diseases in the HFEM group was higher than that in the non-HFEM group.The proportions of comorbid hypertension,diabetes mellitus,anxiety-depressive state and medication use≥5 kinds in the HFEM group were higher than those in the non-HFEM group,while the proportion of comorbid arrhythmia was lower than that in the non-HFEM group(all P<0.05).Multivariate Logistic regression analysis showed that the number of complicated diseases,comorbid diabetes mellitus,comorbid anxiety-depressive state and number of medications used were independent influencing factors for prescribing HFEM-containing prescriptions(odds ratio=0.848,6.343,5.502,1.372)(all P<0.05).Conclusions HFEM are present in 10.8％of long-term prescriptions for outpatients with heart failure in cardiology department.The number of complicated diseases,comorbid diabetes mellitus,anxiety-depressive state and number of medications used are independent influencing factors for prescribing HFEM-containing prescriptions.

Abstract:This study adopted a method combining literature review and theoretical analysis.Firstly,it systematically reviewed the evolution of the concept of homeostatic medicine,covering its various stages from germination,establishment to in-depth development.Secondly,it focused on interpreting the theoretical framework of homeostatic medicine proposed by Professor Liu Chengyuan in the early 21st century,and further explored the intrinsic connection between this framework and traditional Chinese medicine(TCM)theory.According to the theory of homeostatic medicine,homeostasis is the core characteristic for the healthy survival of living organisms,which is a complex system collaboratively composed of three states:material state,energy state and information state.These three states are interrelated and indispensable,maintaining the dynamic balance of the life system through nonlinear interaction.The theory of homeostatic medicine has formed a holistic cognitive framework for the life system.Under this framework,modern medicine(focusing on the material state)and TCM(focusing on the energy state and information state)have achieved complementary unification.As a core concept at the level of life sciences,the theory of homeostatic medicine not only provides strong theoretical support for the modern construction of the TCM theoretical system,but also profoundly influences the future medical health concepts,medical research directions and clinical medical practice.From the perspective of homeostatic medicine theory,it is expected to truly establish a"new medicine"integrating traditional Chinese and Western medicine.

Abstract:Objective To investigate the correlation of serum long non-coding RNA(lncRNA)PSMB8-AS1 and myokine 53(MG53)levels with coronary lesion severity and prognosis in patients with acute coronary syndrome(ACS).Methods A prospective cohort study was conducted,enrolling 352 ACS patients admitted to People's Hospital of Shigatse City,Tibet Autonomous Region and Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2021 to April 2023(ACS group)and 100 healthy volunteers who underwent physical examination during the same period(control group)in People's Hospital of Shigatse City,Tiet Autonomous Region.According to the Gensini score of coronary angiography,ACS patients were divided into mild group(Gensini score≤40,120 cases),moderate group(Gensini score 41-79,162 cases)and severe group(Gensini score≥80,70 cases).The occurrence of major adverse cardiovascular events(MACEs)was followed up for 1 year.Serum lncRNA PSMB8-AS1 expression and MG53 levels were detected in all subjects within 24 h of enroll-ment.Multivariate Logistic regression was used to analyze the influencing factors of prognosis in ACS patients.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of lncRNA PSMB8-AS1 and MG53 for prognosis in ACS patients.Results The serum lncRNA PSMB8-AS1 expression and MG53 levels in the ACS group were significantly higher than those in the control group[(2.96±0.71)vs(1.36±0.33),(456±96)ng/L vs(108±20)ng/L](both P<0.05).The serum lncRNA PSMB8-AS1 expression and MG53 levels in the severe group were significantly higher than those in the moderate and mild groups(all P<0.05).During the 1-year follow-up,2 patients were lost to follow-up and 63 patients developed MACEs.The serum lncRNA PSMB8-AS1 expression and MG53 levels in the poor prognosis group were significantly higher than those in the good prognosis group(all P<0.05).High N-terminal pro-brain natriuretic peptide(NT-proBNP),high lncRNA PSMB8-AS1 expression and high MG53 level were risk factors for poor prognosis in ACS patients(all P<0.05),while high left ventricular ejection fraction(LVEF)was a protective factor(P<0.05).The areas under the curve(AUC)of lncRNA PSMB8-AS1 and MG53 for predicting prognosis in ACS patients were 0.806 and 0.862,respectively,which were higher than that of LVEF(both P<0.05),and showed no significant difference compared with that of NT-proBNP(P>0.05).The AUC of combined detection of lncRNA PSMB8-AS1 and MG53 for predicting prognosis in ACS patients was 0.953,which was higher than that of each single index(both P<0.05).Conclusion The increased serum lncRNA PSMB8-AS1 expression and MG53 levels in ACS patients are associated with severe coronary lesions and poor prognosis.Combined detection of lncRNA PSMB8-AS1 and MG53 is helpful for predicting the risk of poor prognosis in ACS patients.

Abstract:Objective To compare the efficacy and safety of moxifloxacin and omadacycline in the treatment of adult Mycoplasma pneumoniae pneumonia(MPP).Methods The clinical data of 139 adult MPP patients admitted to Beijing Ditan Hospital,Capital Medical University,from August to December 2024 were retrospectively collected.Among them,73 cases were treated with omadacycline(observation group)and 66 cases with moxifloxacin(control group).The clinical indicators,antipyretic time,symptom remission rate,improvement of pulmonary imaging and safety of the two groups were analyzed.Results After treatment,the levels of white blood cell count,neutrophil/lymphocyte ratio,C-reactive protein,procalcitonin,serum amyloid A and interleukin-6 in both groups were significantly better than those before treatment(all P<0.05),while there were no statistically significant differences between the two groups(all P>0.05).The antipyretic time in the observation group was shorter than that in the control group[(1.3±0.5)d vs(2.1±0.8)d](P=0.02).There was no significant difference in the total effective rate between the observation group and the control group[91.8％(67/73)vs 90.9％(60/66)](P=0.85).After 1 and 4 weeks of treatment,there were no significant differences in the imaging absorption rate between the two groups(both P>0.05).During the treatment period,the incidence of adverse reactions in the observation group was lower than that in the control group[2.7％(2/73)vs 12.1％(8/66)](χ2=7.93,P<0.01).Conclusion Omadacycline has comparable efficacy to moxifloxacin in the treatment of adult MPP,with the advantage of better safety.

Abstract:Objective To explore the correlation and predictive value of the aggregate index of systemic inflammation(AISI)with hypertension in non-overweight or non-obese population.Methods A total of 8 920 non-overweight or non-obese adults who underwent health checkups at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 1,2021 to September 30,2024 were enrolled.They were divided into hypertension group and control group(non-hypertensive population)according to the presence of hypertension.Due to the skewed distribution of AISI,logarithmic transformation(Log2)was performed for subsequent analysis,and baseline characteristics were observed with hypertension status as the grouping basis.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of AISI for hypertension in non-overweight or non-obese population.Results Among 8 920 non-overweight or non-obese subjects,1 289 were hypertensive patients(hypertension group)and the rest were non-hypertensive(control group).The hypertension group had significantly higher levels of age,body mass index,total cholesterol,triglycerides,low-density lipoprotein cholesterol,fasting blood glucose,serum creatinine,serum uric acid,and Log2 AISI(all P<0.05).In addition,there were statistically significant differences between the two groups in the proportions of drinking history,diabetes mellitus,kidney disease history,other cardio-cerebrovascular disease history,and family history of hypertension(all P<0.05).In the continuous variable analysis,Model 1 without covariate adjustment showed that for each 1-unit increase in Log2 AISI in non-overweight or non-obese individuals,the risk of hypertension increased by 24％.This association remained significant even after full adjustment for covariates(both P<0.001).In the categorical variable analysis,Model 1 without covariate adjustment revealed that individuals in the highest quartile of Log2 AISI had a significantly higher risk of hypertension than those in the lowest quartile,and this association persisted in the fully adjusted Model 3(both P<0.001).ROC curve analysis showed that the area under the curve of Log2 AISI for predicting the risk of hypertension in non-overweight or non-obese population was 0.615(95％confidence interval:0.599-0.629).Conclusion In the non-overweight or non-obese population,AISI is significantly non-linearly and positively correlated with the risk of hypertension and has good predictive efficacy,which can be used for the early diagnosis of hypertension in non-overweight or non-obese individuals.

Abstract:Objective To analyze the diagnostic value of combined detection of serum interleukin-33(IL-33),leukotriene B4(LTB4)and a disintegrin and metalloproteinase 17(ADAM17)in elderly patients with chronic atrophic gastritis(CAG).Methods A retrospective study was conducted on 219 elderly patients who underwent gastroscopy due to abdominal discomfort at the 904th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from September 2022 to September 2024.According to the pathological biopsy results,the patients were divided into CAG group(122 cases)and non-CAG group(97 cases).The CAG group was further subdivided into mild group(36 cases),moderate group(41 cases)and severe group(45 cases)based on the histological grading of gastric mucosal atrophy.Serum levels of IL-33,LTB4 and ADAM17 were detected.Pearson correlation analysis was used to evaluate the correlations between serum IL-33,LTB4 and ADAM17 in CAG patients.The relationships between serum IL-33,LTB4,ADAM17 levels and clinicopathological characteristics of CAG patients were analyzed.Receiver operating characteristic(ROC)curve was used to assess the diagnostic value of single and combined detection of serum IL-33,LTB4 and ADAM17 for elderly CAG.Results Serum levels of IL-33,LTB4,and ADAM17 in the CAGgroup were significantly higher than those in the non-CAG group(all P<0.001).Serum levels of IL-33,LTB4,and ADAM17 showed a gradual upward trend in the mild,moderate,and severe groups(all P<0.05).Pearson correlation analysis revealed that IL-33 was positively correlated with LTB4(r=0.551,P<0.001),IL-33 with ADAM17(r=0.581,P<0.001),and LTB4 with ADAM17(r=0.443,P<0.001).The expressions of serum IL-33,LTB4,and ADAM17 were associated with gastric mucosal atrophy,intestinal metaplasia,chronic inflammation,and dysplasia in CAG patients(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)for the diagnosis of CAG by single detection of serum IL-33,LTB4,ADAM17,and their combined detection was 0.868,0.829,0.758,and 0.908,respectively.The AUC of the combined detection was higher than that of each single indicator(all P<0.05).Conclusion The serum expressions of IL-33,LTB4,and ADAM17 in elderly CAG patients increase with the aggravation of the disease.The combined detection of these three indicators can effectively diagnose elderly CAG patients with different disease severity,providing effective guidance for their early diagnosis,timely treatment,and prevention of further gastric mucosal atrophy.

Abstract:Objective To investigate the impact of radiotherapy on cardiovascular disease mortality in patients with different gastrointestinal malignant tumors.Methods A total of 621 324 patients with gastrointestinal malignant tumors were screened from the large cohort of the Surveillance,Epidemiology,and End Results database of the National Cancer Institute.Poisson regression analysis and Fine-Gray competing risk regression analysis were used to evaluate the impact of radiotherapy on cardiovascular disease mortality in patients with different gastrointestinal malignant tumors.Subgroup analysis was conducted simultaneously to identify the predictive factors of radiotherapy-related cardiovascular disease mortality.Results A total of 621 324 patients with gastrointestinal malignant tumors were enrolled,including 30 453 cases(4.9％)of esophageal cancer,53 282 cases(8.6％)of gastric cancer,452 464 cases(72.8％)of colorectal cancer,37 630 cases(6.1％)of hepatocellular carcinoma,7 979 cases(1.3％)of gallbladder cancer,and 39 516 cases(6.3％)of pancreatic cancer.Among the 106 110 patients with gastrointestinal tumors who received radiotherapy,the risk of cardiovascular disease mortality was significantly increased in patients with esophageal cancer and gastric cancer[relative risk(RR)=1.15,95％confidence interval(CI)=1.03-1.28,adjusted hazard ratio(HR)=1.15,95％CI=1.06-1.29;RR=1.19,95％CI=1.08-1.31,adjusted HR=1.11,95％CI=1.02-1.21].Compared with the general population in the United States,patients with esophageal cancer who received radiotherapy had the highest standardized mortality ratio of cardiovas-cular disease mortality.Advanced age,long disease course,male gender,and concurrent chemotherapy were associated with a higher risk of cardiovascular mortality.Conclusions Among patients with gastrointestinal malignant tumors,those with esophageal cancer and gastric cancer who receive radiotherapy have an increased risk of cardiovascular disease mortality.Advanced age,long disease course,male gender,and concurrent chemotherapy may be potential predictive factors for radiotherapy-related cardiovascular disease mortality in patients with gastroin-testinal malignant tumors.

Abstract:Objective To analyze the etiological distribution and prognosis of pulmonary hypertension(PH)in children without congenital heart disease.Methods A total of 34 children with PH unrelated to congenital heart disease,aged<14 years,who were admitted to the Department of Cardiology,Hebei Children's Hospital from November 2017 to May 2024 were enrolled.According to the etiologies,the patients were divided into three groups:Group A(Group 1 pulmonary arterial hypertension),Group B(Group 3 PH due to lung diseases and/or hypoxia),and Group C(Group 5 PH due to unclear or multifactorial causes).Clinical data of the children were collected,the etiological distribution was described,and survival curves were plotted to analyze the differences in survival rates.Results A total of 34 children were enrolled in this study,including 15 cases of arterial PH(Group A),14 cases of lung disease and/or hypoxia-related PH(Group B),and 5 cases in Group C,all of whom were diagnosed with methylmalonic acidemia.In Group B,the age,transcutaneous oxygen saturation,and pulmo-nary artery systolic pressure were lower than those in Group A,while the proportion of preterm infants and arterial partial pressure of carbon dioxide level were higher than those in Group A(all P<0.05).Twenty-one children were admitted to the intensive care unit for treatment due to critical conditions at admission,while the remaining children with relatively stable conditions were treated in general wards.The 1-year,3-year,and 5-year survival rates were 72.7％,72.7％,and 54.5％in Group A,49.0％,39.2％,and 39.2％in Group B,and 100.0％,75.0％,and 75.0％in Group C,respectively.The 1-year,3-year,and 5-year survival rates of children admitted to the intensive care unit were 55.7％,50.1％,and 37.6％,respectively,while those of children not admitted to the intensive care unit were 100.0％,75.0％,and 56.3％,with a statistically significant difference between the two groups(Log-rank χ2=4.700,P=0.030).For children aged 2 years and above,the 1-year,3-year,and 5-year survival rates were 87.4％,77.7％,and 64.7％,respectively,compared with 58.2％,41.4％,and 41.4％for children under 2 years of age,and the difference between the groups was statistically significant(Log-rank χ2=4.793,P=0.029).Conclusions The etiologies of PH in children are widely distributed.Children with PH often present with poor cardiac function at admission;some are critically ill and require intensive care,with an unfavorable prognosis.Lung disease or hypoxia-related PH,critical condition requiring intensive care unit admission at presentation,and young age at diagnosis are associated with poor prognosis.

Abstract:The incidence of sarcopenia in maintenance hemodialysis(MHD)patients is significantly higher than that in the general population,which has a negative impact on the quality of life and prognosis of MHD patients.This article reviews the epidemiology,influencing factors,pathogenesis and intervention of sarcopenia in MHD patients,and points out that the influencing factors include insufficient exercise,malnutrition,intestinal flora imbalance,electrolyte imbalance,age and gender,and its pathogenesis involves protein metabolism disorder,inflammatory state,insulin resistance and neuromuscular junction dysfunction.Exercise training,nutritional support and drug therapy can be used for intervention.

Abstract:Rheumatoid arthritis(RA)is a chronic systemic autoimmune disease characterized by joint inflammation,which often leads to joint pain,limited movement,deformity and even loss of function,seriously affecting the quality of life and mental health of patients.This article reviews the main factors affecting the quality of life and mental health of RA patients,and summarizes the interventions for RA patients in recent years,aiming to provide theoretical basis and reference for clinical practice to improve the quality of life and mental health of RA patients.

Abstract:Diabetes,as a common chronic metabolic disease in clinical practice,is characterized by a high incidence rate,a long treatment cycle and many complications.The low cure rate of diabetic wounds is the main reason for the high disability and mortality rate of patients,which has a serious impact on the physical and mental health and quality of life of patients.Therefore,how to improve the cure rate of diabetic wounds has become an urgent problem to be solved.Cell necrotizing apoptosis is one of the research hotspots in recent years.As a novel programmed cell death pathway,it is involved in various inflammatory responses.Studies have shown that necrotizing apoptosis of cells is involved in the pathogenesis of diabetes and plays an extremely important role in the healing of diabetic wounds.Factors such as tumor necrosis factor-α,receptor-interacting serine-threonine protein 1/3,and mixed lineage kinase ligands are the main proteins regulating the signaling pathway of cell necrotizing apoptosis and also affect the healing of diabetes and its complications.This article elaborates on the research of cell necrotizing apoptosis and surface-related proteins and their mechanism of action in diabetic wounds,providing a reference for the clinical treatment of diabetic wounds.

Abstract:Lymph node calcification in the parotid gland region is a rare chronic secondary disease with potential clinical significance.This article reports a case of a 41-year-old female patient with left parotid gland region lymph node calcification,who presented with a mass in the left preauricular area for 30 years.The patient had no obvious symptoms in the early stage and sought medical attention recently due to occasional pain.Imaging examinations suggested a calcified nodule in the left parotid gland,and intraoperative and postoperative pathology further confirmed lymph node calcification in the parotid gland region.Open surgical treatment was performed,and the patient recovered well postoperatively.The uniqueness of this case lies in its long disease course and rare anatomical location.The diagnosis and treatment of such diseases require a comprehensive consideration of patient symptoms,lesion characteristics,and pathological results.This report aims to provide a therapeutic reference for clinicians when encountering similar rare cases.