Abstract:Objective To observe the clinical efficacy of cyclosporin A combined with Huaiqihuang granules in the integrated Chinese and western medicine treatment of children with aplastic anemia(AA).Methods The clinical data of 62 children with AA admitted to the First Affiliated Hospital of Xinjiang Medical University from October 2020 to October 2023 were collected for retrospective analysis.According to different treatment regimens,the patients were divided into the control group(32 cases,treated with oral cyclosporin capsules combined with stanozolol tablets)and the observation group(30 cases,treated with oral Huaiqihuang granules on the basis of the control group).The clinical efficacy,recovery indicators,traditional Chinese medicine(TCM)syndrome scores,blood routine indicators,T lymphocyte subsets,interferon-γ levels before and after treatment,and the incidence of adverse reactions were compared between the two groups.Results The total remission rate of the observation group was higher than that of the control group[96.7％(29/30)vs 68.8％(22/32)],the number of medical visits and severe infections,the length of each hospitalization were significantly less than those of the control group(all P＜0.05).After treatment,the TCM syndrome scores,CD4+,interferon-γ and T helper 17 cell levels in the observation group were lower than those in the control group,while the platelet count,hemoglobin and neutrophil levels were higher than those in the control group(all P＜0.05).There were no statistically significant differences in the incidence of various adverse reactions and the total incidence of adverse reactions between the two groups(all P＞0.05).Conclusion Huaiqihuang granules combined with cyclosporin A has high application value in the clinical treatment of children with AA,which can improve the clinical symptoms and immune function of patients with good safety and reliability.

Abstract:Objective To investigate the efficacy of Qingre Lifei oral liquid combined with recombinant human interferon α1b in the treatment of bronchiolitis in children and its effect on hemorheology.Methods A total of 296 children with bronchiolitis admitted to Beijing University of Chinese Medicine Third Affiliated Hospital from December 2022 to December 2023 were selected and randomly divided into the observation group and the control group with 148 cases in each group by computer random number method.The control group was treated with nebulized inhalation of recombinant human interferon α1b via oral or nasal route on the basis of supportive therapy,and the observation group was treated with oral Qingre Lifei oral liquid on the basis of the control group.Both groups were treated continuously for 7 d.The disappearance time of symptoms and signs,lung function,inflammatory factors,hemorheological indexes,therapeutic efficacy and adverse reactions were compared between the two groups.Results The disappearance time of cough,paroxysmal dyspnea,nasal flaring and three concave signs in the observation group was shorter than that in the control group(all P＜0.05).After treatment,the inspiratory to expiratory time ratio,time to peak tidal volume ratio and interferon-γ in the observation group were significantly higher than those in the control group,while respiratory resistance,interleukin-33,eosinophils,plasma viscosity,erythrocyte aggregation index and fibrinogen were significantly lower than those in the control group(all P＜0.05).The total effective rate of the observation group was higher than that of the control group[96.6％(143/148)vs 89.2％(132/148)](P=0.013).No severe adverse reactions were observed in both groups during the treatment period.Conclusion Qingre Lifei oral liquid combined with recombinant human interferon α1b in the treatment of bronchiolitis in children is helpful to alleviate respiratory symptoms,inhibit airway inflammation and regulate hemorheology,with good efficacy and safety.

Abstract:Chronic obstructive pulmonary disease(COPD)is a highly prevalent respiratory disease world-wide,and its treatment is faced with challenges such as a long course of disease and recurrent attacks.In recent years,improving the clinical efficacy of COPD patients by regulating intestinal function has become a research hotspot.As one of the traditional Chinese medicine(TCM)Zang-Fu organ theories,"the lung and large intestine are interior-exterior related"proposes a unique idea of"simultaneous treatment of lung and intestine".Modern medicine has put forward the"lung-gut axis"theory based on the crosstalk relationship between microorganisms and their metabolites between the lung and large intestine,which provides a scientific basis and research direction for the TCM treatment of COPD.Based on the theory of"simultaneous treatment of lung and intestine"and with the modern research on the"lung-gut axis"as the key,this paper intends to systematically sort out the application progress from"simultaneous treatment of lung and intestine"to the"lung-gut axis".It expounds the treatment of COPD by TCM compound prescriptions,TCM enema,acupoint application and other methods,which can regulate intestinal flora imbalance,restore immune balance and exert a synergistic therapeutic effect.This study aims to give full play to the advantages of classic TCM theories in the research field of respiratory diseases and provide new ideas for the TCM treatment of COPD.

Abstract:Objective To evaluate the effect of the monitoring and early warning system for acute flaccid paralysis(AFP)cases in a tertiary general hospital in Beijing,and to provide a reference for similar medical institutions.Methods Taking Beijing Anzhen Hospital,Capital Medical University as an example,the baseline data before optimization were the AFP monitoring and early warning data from January to June 2024,and the outcome data after optimization were the AFP monitoring and early warning data from January to June 2025.The differences in the number of monitoring and early warning pop-ups,disease types,early warning trigger rate and management process of the AFP case monitoring and early warning system before and after optimization were compared.Results After the system optimization,real-time pop-ups could be triggered when clinical doctors included 14 AFP disease keywords such as"nerve,paralysis,spinal cord"in the diagnosed disease types.A total of 113 pop-ups were triggered by clinical doctors from January to June 2025,an increase of 16.49％compared with the same period in 2024,involving an increase in disease types from 2 to 7.The number of visits by patients under 15 years old from January to June 2025 decreased by 22.92％compared with the same period in 2024,and the pop-up early warning trigger rate was 2.97‰,which was significantly higher than 1.96‰ in the same period in 2024(U=2.991,P＜0.01).In addition,the pop-up interface of the functional management department added the functions of recording the cause of early warning trigger,disposal basis and results,and simultaneously added the retrieval function of fuzzy diagnosis fields,supporting real-time retrieval of any diagnosis keywords in all departments of the hospital.Conclusion After the system optimization,the sensitivity of AFP case pop-up trigger is significantly improved,which helps to enhance clinicians' awareness of AFP case identification and reporting;the functional management department can realize permanent traceability of disposal records.The fuzzy diagnosis field retrieval function can not only reduce irrelevant pop-ups for clinicians and lighten their workload,but also improve retrieval efficiency,and provide a flexible keyword retrieval channel for the monitoring of various infectious diseases.

Abstract:Objective To analyze the epidemiological characteristics of inpatients with ocular trauma admitted to a Grade A tertiary hospital in Beijing from 2015 to 2019.Methods A total of 621 patients with traumatic ocular diseases admitted to the Third Medical Center,Chinese PLA General Hospital from January 2015 to December 2019 were retrospectively enrolled.Data including gender,age,type of admission diagnosis and surgical treatment were recorded.Multivariate Logistic regression model was used to analyze the risk factors for traumatic ocular diseases.Result Among the 621 patients,483 were male and 138 were female.In terms of age distribution,there were 64 cases under 13 years old,221 cases aged 13-30 years,295 cases aged＞30-60 years and 41 cases over 60 years old.Regarding occupational distribution,172 were construction workers,105 were manufacturing workers and 89 were students.There were significant differences in the proportion of patients among different genders,ages and occupations(all P＜0.001).The top three admission diagnoses were orbital wall fracture(294 cases,47.3％,including 271 cases caused by blunt trauma),canaliculus laceration(142 cases,22.9％,including 96 cases caused by blunt instrument cutting)and lens dislocation(44 cases,7.1％,including 38 cases caused by high-velocity impact).There was a significant difference in the proportion of ocular trauma types among patients receiving different surgical methods(P＜0.001).Multivariate Logistic regression analysis showed that male sex(odds ratio=1.83,95％confidence interval:1.29-2.60),construction worker occupation(odds ratio=2.45,95％confidence interval:1.78-3.38)and blunt instrument injury(odds ratio=4.12,95％confidence interval:2.96-5.73)were independent risk factors for orbital wall fracture(all P＜0.05).The age of＞30-60 years old(odds ratio=4.21,95％confidence interval:2.89-6.13)and sharp instrument cutting(odds ratio=3.87,95％confidence interval:2.64-5.67)were independent risk factors for canaliculus laceration(both P＜0.001).Conclusions Young and middle-aged laborers are high-risk groups for ocular trauma,with occupa-tional exposure and daily activities as the main inducing factors,indicating that occupational protection and safety education on sports activities are urgently needed to be strengthened.Orbital wall fracture should be taken as a key direction for prevention and treatment,and surgical strategies should be individually designed based on age and injury type.

Abstract:Objective To investigate the clinical efficacy of Shengmai Qiangxin granules in the treatment of senile chronic heart failure(CHF)and its regulatory effect on the renin-angiotensin-aldosterone system(RAAS).Methods A prospective randomized controlled trial was designed,and 94 elderly CHF patients with Qi-Yin deficiency complicated with blood stasis admitted to the Second Affiliated Hospital,Heilongjiang University of Chinese Medicine from January 2022 to January 2025 were enrolled.They were divided into the control group and the observation group with 47 cases in each group by the stratified block randomization method.The control group received conventional western medicine and Chinese medicine placebo treatment,while the observation group was given Shengmai Qiangxin granules on the basis of conventional western medicine treatment,with a course of 8 weeks.The curative effect,traditional Chinese medicine(TCM)syndrome score,6 min walk test distance,quality of life,cardiac function indexes,N-terminal pro-brain natriuretic peptide(NT-proBNP),troponin I(TnI),creatine kinase isoenzyme MB(CK-MB)and RAAS indexes including plasma renin activity(PRA),angiotensin Ⅱ(Ang Ⅱ)and aldosterone levels were compared between the two groups.The incidence of adverse reactions was also compared between the two groups.Results The total effective rate of the observation group after treatment was higher than that of the control group[93.6％(44/47)vs 74.5％(35/47)](P=0.011).After treatment,the TCM syndrome score,Minnesota living with heart failure questionnaire(MLHFQ)score,and serum levels of NT-proBNP,TnI,CK-MB,PRA,Ang Ⅱ and aldosterone in both groups were lower than those before treatment,while the 6 min walk test distance and left ventricular ejection fraction(LVEF)were longer/higher than those before treatment(all P＜0.05).After treatment,the TCM syndrome score,MLHFQ score,and serum levels of NT-proBNP,TnI,CK-MB,PRA,AngⅡ and aldosterone in the observation group were lower than those in the control group,while the 6 min walk test distance and LVEF were longer/higher than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Shengmai Qiangxin granules combined with conventional western medicine treatment can significantly inhibit the RAAS,and improve cardiac function and quality of life in elderly patients with CHF.

Abstract:Objective To evaluate the application value of ultra-tension-relieving suture in incision repair after excision of benign skin tumors.Methods Clinical data of 54 patients who underwent excision of benign skin tumors and completed follow-up in the outpatient department of Beijing Anzhen Hospital,Capital Medical University from September 2023 to December 2024 were retrospectively analyzed.According to the suture method after skin tumor resection,patients were divided into control group(25 cases)receiving traditional tension-relieving suture and observation group(29 cases)receiving ultra-tension-relieving suture.Incision healing at 2 weeks after operation,incidence of complications,and scar appearance and texture at 6 months after operation were compared between the two groups.The Vancouver Scar Scale(VSS),Patient Scar Assessment Scale(PSAS)and Observer Scar Assessment Scale(OSAS)were used for scoring.Results There was no significant difference in delayed healing rate between the two groups(P=0.463).The incidence of infection and hematoma in the observation group was lower than that in the control group,and the pigmentation rate was similar to that in the control group,but the differences were not statistically significant(all P＞0.05).In each subscore of VSS,the scores of pigmentation,vascularity,pliability and total score in the observation group were significantly lower than those in the control group[1.0(1.0,1.0)vs 2.0(1.0,2.0),1.0(0.0,1.0)vs 1.0(1.0,2.0),1.0(1.0,1.0)vs 2.0(1.0,2.0),and(3.3±1.4)vs(5.4±2.5)](all P＜0.05).The scores of color,pliability,patient satisfaction,pain,itching and overall impression in PSAS of the observation group were significantly lower than those of the control group,and the scores of vascularity,pigmentation,pliability,surface roughness,area and overall impression in OSAS of the observation group were significantly lower than those of the control group(all P＜0.05).Conclusion Ultra-tension-relieving suture can effectively disperse incision tension,reduce scar formation and improve postoperative aesthetic effect.

Abstract:Sepsis is one of the diseases leading to high mortality worldwide,and microcirculation dysfunc-tion is the key pathological link in the development of sepsis to septic shock.Anisodamine hydrobromide is an alkaloid extracted from natural plants with multiple pharmacological effects of anti-inflammatory,anti-oxidative and microcirculation improvement.This article reviews the pathophysiological mechanism of microcirculation dysfunction in septic shock,discusses the protective effect and potential mechanism of anisodamine hydrobromide on microcirculation dysfunction in septic shock,and summarizes its research progress in clinical application.Studies have shown that anisodamine hydrobromide can improve microcirculation function,reduce organ damage and improve the survival rate of patients with septic shock through multi-target mechanisms,which has important clinical application prospects.

Abstract:Sepsis,as one of the most common clinical critical diseases,leads to the death of a large number of patients every year and consumes a large number of medical resources.The core of the progression of sepsis is the immune system response.In recent years,a series of new immune-inflammatory markers derived from blood routine indicators play an important role in the diagnosis,treatment and prognosis evaluation of sepsis,which are crucial for timely guidance of accurate treatment of sepsis,improvement of clinical efficacy of patients with sepsis,and early warning of organ failure.This article reviews the research progress on the correlation between new immune-inflammatory markers in blood routine and sepsis.

Abstract:In China,body mass index over 28 kg/m2 is usually defined as obesity.Obesity is the fifth leading cause of death in the world,and its prevention and treatment effects directly affect the national health level.Recent studies have shown that metabolic adaptation is closely related to weight regain after weight loss in obese people.This article reviews the multiple difficulties and comprehensive intervention strategies in obesity management,such as metabolic adaptation,adipocyte memory effect,gene regulation,psychological factors,and environmental obesity-inducing effect,in order to provide reference for the prevention and treatment of obesity in the grassroots.

Abstract:The incidence of gastric cancer is high in China(especially in western China).Although the early diagnosis of gastric cancer has been improved,the current situation is still not satisfied.MicroRNA(miR)can regulate gene expression after transcription and participate in the occurrence and development of tumors and other biological processes.As important messengers of intercellular communication,exosomes can regulate the communi-cation between local cells and distant cells by transporting specific contents(such as miR),and then affect the proliferation,invasion,metastasis and drug resistance of tumor cells.They have significant advantages over conventional diagnostic markers in clinical practice,and may become potential biomarkers for the diagnosis of gastric cancer.At present,the accuracy and effectiveness of the treatment of gastric cancer are insufficient.This article reviews the mechanism of exosomal miR in the occurrence and development of gastric cancer and its research progress as diagnostic markers and therapeutic targets of gastric cancer,in order to provide new ideas and strategies for the early diagnosis and treatment of gastric cancer.

Abstract:In recent years,clinical statistics have shown that acute respiratory distress syndrome(ARDS)is associated with an extremely high mortality rate.In current clinical practice,the lungs of patients with severe ARDS mostly present as"baby lung"or"white lung",resulting in severe respiratory failure.Extracorporeal membrane oxygenation(ECMO)is a life-support technique that has shown important value in supporting patients with severe respiratory failure in recent years.Its core mechanism is to replace or partially replace lung function through extracorporeal circulation,effectively maintaining the patient's respiratory function and ultimately buying valuable time for the treatment of the primary disease of ARDS.Based on the relevant advances,clinical efficacy and prognostic factors of ECMO in the treatment of ARDS,this article systematically reviews and analyzes the relevant research progress at home and abroad,aiming to provide a theoretical basis and practical guidance for further optimizing the application of ECMO in ARDS.

Abstract:Objective To explore the clinical characteristics of rare hemolytic disease of newborn(HDN),and improve the understanding of rare HDN.Methods The clinical data of 8 children diagnosed with rare HDN in the Department of Pediatrics,Beijing Anzhen Hospital,Capital Medical University from July 2021 to July 2025 were retrospectively analyzed,including 4 cases of Rh blood group incompatibility hemolysis caused by combined anti-c and anti-E antibodies,3 cases of MN blood group incompatibility hemolysis including 1 case complicated with ABO blood group incompatibility hemolysis,and 1 case of Duffy blood group incompatibility hemolysis.Their clinical manifestations,laboratory examinations,treatments and outcomes were analyzed.Results All 4 children with Rh incompatibility hemolytic disease induced by combined anti-c and anti-E antibodies presented with hyperbilirubinemia and anemia,among whom 2 suffered from severe anemia and 1 was complicated with circulatory disturbance,with positive direct and indirect antiglobulin tests in all 4 cases.Hyperbilirubinemia and anemia occurred in all 3 children with MN hemolytic disease,and severe anemia and circulatory disturbance were found in the case complicated with ABO blood group incompatibility hemolysis.All 3 cases showed negative direct antiglobulin test and positive indirect antiglobulin test.Pathological jaundice and mild anemia occurred in the child with Duffy blood group incompatibility hemolytic disease.None of the 8 children received exchange transfusion,and all were discharged with improved conditions.Delayed hemolysis occurred one month after birth in the child complicated with MN and ABO blood group incompatibility hemolysis.Serum cardiac injury biomarkers including cardiac troponin I,creatine kinase isoenzyme,creatine kinase and lactate dehydrogenase were elevated at the onset of HDN in all 8 children.Except cardiac troponin I,the other three indicators decreased significantly during recovery period(P＜0.05).All cardiac troponin I levels returned to normal within 2 weeks to 1.5 months during follow-up.Conclusions Active screening of maternal and neonatal serum antibodies should be performed for neonates with high hemolytic risk and hemolytic manifestations to reduce missed diagnosis.Delayed hemolysis may occur in neonates with MN blood group incompatibility hemolytic disease,so regular follow-up is necessary.Symptoms of Duffy blood group incompatibility hemolysis are generally mild.Myocardial injury induced by HDN is mainly manifested as elevated serum myocardial enzymes,and cardiac troponin I takes the longest time to recover.

Abstract:With the rapid development of science and technology society,artificial intelligence has been deeply involved in daily life,becoming an important achievement of modern science and technology,and one of the hottest topics in the 21st century.In the medical field,artificial intelligence has been involved in all aspects,such as disease diagnosis,drug development,patient management,and so on.Through deep learning and big data analysis,artificial intelligence can improve the safety,accuracy and efficiency of medical services.Artificial intel-ligence is widely used in clinical anesthesia,including intelligent drug delivery system,prediction of perioperative adverse events,evaluation of anesthesia depth,perioperative ultrasound,establishment of electronic data case database,intelligent teaching and so on.This allows anesthesiologists to greatly improve their work efficiency.Of course,the development of artificial intelligence still has some limitations,such as the protection of personal data privacy is not perfect,and the mechanism of artificial intelligence is complex and difficult to understand.This article will summarize the latest application progress of artificial intelligence in the field of anesthesiology and the challenges still facing.

Abstract:Endometriosis(EMs)is a common gynecological disease in which endometrial tissue(glands and stroma)occurs outside the body of the uterus.EMs has a wide range of lesions and benign morphology,but it cannot be denied that it has clinical behavior properties similar to malignant tumors such as adhesion,invasion and metastasis,and is prone to recurrence,which seriously affects the daily life and physical and mental health of female patients.So far,the specific pathogenesis of EMs has not been completely clear,but in recent years,more and more studies have shown that intestinal flora may be closely related to the occurrence and development of EMs.The effect of intestinal flora diversity imbalance on EMs may be related to the mechanism of participating in immune response,affecting the release of inflammatory factors,and participating in estrogen metabolism.EMs can be improved by regulating intestinal flora,such as intestinal microbiota preparations,fecal microbiota transplantation,and diet regulation.This article reviews the correlation between intestinal flora and EMs,the possible pathogenic mechanism of intestinal flora on EMs,and the possible methods of treating EMs by regulating intestinal flora.

Abstract:Objective To investigate the predictive value of triglyceride glucose-body mass index(TyG-BMI),a composite index of triglyceride-glucose index(TyG)and body mass index,for severe acute hypertriglyceridemic pancreatitis(HTG-AP).Methods Clinical data of 84 patients with HTG-AP hospitalized in the Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from February 2015 to April 2025 were retrospectively collected.Patients were divided into severe group(27 cases)and non-severe group(57 cases)according to disease severity,and TyG-BMI of each patient was calculated.General data,TyG,TyG-BMI and laboratory indicators were compared between the two groups by univariate analysis.Binary multivariate Logistic regression was used to analyze independent influencing factors of severe HTG-AP,and receiver operating characteristic curve was used to evaluate the predictive value of each index for severe HTG-AP.Results Age in the severe group was significantly younger than that in the non-severe group,and body mass index,proportion of diabetes mellitus,TyG,TyG-BMI,triglyceride,blood glucose,C-reactive protein and D-dimer levels were signifi-cantly higher than those in the non-severe group(all P＜0.05).Binary multivariate Logistic regression analysis showed that TyG,TyG-BMI,body mass index and C-reactive protein were independent risk factors for predicting severe HTG-AP(all P＜0.05).The area under the curve of TyG-BMI for predicting severe HTG-AP was 0.956,with 95％confidence interval:0.919-0.994.The AUC of TyG-BMI combined with C-reactive protein for predicting severe HTG-AP was 0.991,with 95％confidence interval:0.976-1.000.Conclusion TyG-BMI can be used as an effective biomarker for predicting the severity of severe HTG-AP.

Abstract:Objective To construct a therapeutic effect evaluation model for patients with patent foramen ovale(PFO)-related migraine based on imaging features and verify its efficacy.Methods A total of 60 patients with PFO-related migraine treated at the Second Affiliated Hospital of Xinjiang Medical University from January 2023 to June 2025 were enrolled.According to therapeutic effect,patients were divided into good effect group(35 cases)and poor effect group(25 cases).Baseline characteristics,biochemical and imaging indicators were collected and compared between the two groups.Cox proportional-hazards model and multivariate Logistic regression analysis were used to identify independent risk factors affecting the prognosis of patients with PFO-related migraine.A therapeutic effect evaluation model was established.The accuracy of the model was evaluated by Nomogram and calibration curve.Results There were significant differences in age,gender,visual aura,proportion of hyperhomocys-teinemia,risk of paradoxical embolism(RoPE)score,headache impact test score,international normalized ratio,homocysteine,number of white matter lesions,mean volume of white matter lesions,location of white matter lesions,demyelinating lesions,number of subcortical infarcts and right-to-left shunt grade between the two groups(all P＜0.05).Multivariate Cox regression analysis showed that age,visual aura,number of white matter lesions,mean volume of white matter lesions,location of white matter lesions,number of subcortical infarcts and RoPE score were independent risk factors for therapeutic effect in patients with PFO-related migraine.Harrell's C-index was 0.821(95％confidence interval:0.734-0.876).Nomogram and calibration curve showed good consistency between actual risk and model prediction.Conclusion The therapeutic effect evaluation model for patients with PFO-related migraine constructed based on neuroimaging features has high accuracy.

Abstract:Objective To develop and validate a multidimensional neuromotor function evaluation system suitable for clinical application in Chinese patients with spinal cord injury.Methods An initial item pool was established through systematic literature review and semi-structured interviews.The modified Delphi method with two rounds involving 24 experts was adopted for item screening.Item analysis,reliability and validity tests,and predictive validity evaluation were performed in 225,125 and 368 patients respectively.Results Item analysis showed satisfactory discriminatory ability of all items.Reliability analysis presented that the overall Cronbach's αcoefficient was 0.872,the intraclass correlation coefficient(ICC)for inter-rater reliability was 0.963,and the ICC for test-retest reliability was 0.945.Validity analysis revealed good construct validity with a cumulative variance contribution rate of 71.3％.The total score was highly correlated with the American Spinal Injury Association motor score and the spinal cord independence measure Ⅲ total score(r=0.784,0.853,respectively).Predictive validity analysis showed that the area under the curve of the system total score for predicting functional household ambulation at 6 months was 0.934,with an optimal cut-off value of 68 points(sensitivity 89.5％,specificity 86.1％).Patients stratified into low,medium and high rehabilitation potential groups according to the cut-off value showed a significant gradient in functional achievement rate(8.7％,47.1％,89.5％,P＜0.001).Conclusion The newly constructed evaluation system has favorable psychometric properties and excellent clinical predictive performance.It realizes the transition from"injury diagnosis"to"functional profiling",and can serve as a standardized tool for clinical rehabilitation assessment and decision-making.

Abstract:Objective To investigate the pregnancy outcomes of puerperae with pulmonary arterial hypertension(PAH)after congenital heart disease(CHD)surgery.Methods A retrospective cohort study was conducted on 83 puerperae with PAH after CHD surgery admitted to the Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University from June 2012 to June 2022.According to the systolic pulmonary artery pressure estimated by echocardiography,the patients were divided into mild-moderate PAH group(＜80 mmHg,66 cases)and severe PAH group(≥80 mmHg,17 cases).Differences in gestational week at delivery,mode of delivery,neonatal outcomes and adverse cardiovascular events were analyzed between groups.Patients were further divided into non-adverse cardiovascular event group(54 cases)and adverse cardiovascular event group(29 cases)based on the occurrence of adverse cardiovascular events during pregnancy and puerperium.Univariate and multivariate Logistic regression analyses were used to identify risk factors for adverse cardiovascular events during pregnancy and puerperium.Results All 66 patients with mild-moderate PAH terminated pregnancy in the third trimester(after 28 gestational weeks)under multidisciplinary management.Among 17 patients with severe PAH,2 underwent cesarean termination of pregnancy due to deteriorated cardiac function in the second trimester,and the rest delivered live births after 28 gestational weeks.The mean gestational week of all live births was(36.5±2.5)weeks,ranging from 31 to 40 weeks.Compared with the mild-moderate PAH group,the severe PAH group had earlier gestational week at delivery,lower neonatal birth weight,and higher incidences of preterm birth and adverse cardiovascular events(all P＜0.05).A total of 3 maternal deaths occurred,all in the severe PAH group,with PAH crisis as the main cause of death.Multivariate Logistic regression analysis showed that cardiac function grade Ⅲ-Ⅳ(odds ratio=3.156,95％confidence interval:1.419-7.017,P=0.005)and brain natriuretic peptide ≥ 100 ng/L(odds ratio=11.221,95％confidence interval:2.418-12.659,P＜0.001)were risk factors for adverse cardiovascular events during pregnancy and puerperium in patients with PAH after CHD surgery.Conclusions Standardized multidisciplinary management during pregnancy yields favorable pregnancy outcomes in patients with mild-moderate PAH after CHD surgery.Increased pulmonary artery pressure significantly raises the incidences of preterm birth,small-for-gestational-age infants and adverse cardiovascular events.Cardiac evaluation is recommended for patients with PAH after CHD surgery before pregnancy.

Abstract:Candida albicans is the main pathogen causing invasive fungal infections in humans.Invasive fungal infections are of great clinical concern because of their high mortality.Fluconazole is the most commonly used antifungal drug in clinical practice.However,with the widespread use of fluconazole,the resistance to fluconazole has increased year by year,and the resistance mechanism shows diversity and complexity.Traditional Chinese medicine has the characteristics of low toxicity,broad spectrum,multi-target,low price and difficult to induce drug resistance.A large number of studies have shown that traditional Chinese medicine can regulate multiple fluconazole resistance targets to play a potential role in the treatment of Candida albicans resistant strains,and can also enhance the antibacterial effect of existing azole antifungal drugs and reverse drug resistance.This article reviews the mechanism of natural traditional Chinese medicine targeting fluconazole resistance in Candida albicans,in order to provide theoretical basis for the development of azole antifungal sensitization therapy based on the monomer components of traditional Chinese medicine.