Abstract:Objective: To explore the effects of scalp cluster acupuncture on neuroinflammation and the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in amyloid precursor protein/presenilin 1 double transgenic (APP/PS1) mice. Methods: 18 male APP/PS1 transgenic mice were randomly divided into model group and scalp cluster acupuncture group, with 9 mice in each group, and 9 age-matched C57BL/6 mice were selected as the blank control group. Mice in the scalp cluster acupuncture group received acupuncture once daily at Baihui (GV20) and two points 2 mm lateral to the left and right of Baihui for 28 consecutive days. Morris water maze was used to evaluate learning and memory ability of mice. Nissl staining was used to observe the number of hippocampal neurons. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). Western blot was used to analyze the expression of JAK2, p-JAK2, STAT3 and p-STAT3 proteins in the hippocampus. Results: Compared with the blank control group, the escape latency of mice in the model group was prolonged, and the number of platform crossings and the time spent in the target quadrant were reduced (P<0.01), the number of hippocampal neurons was decreased (P<0.01), serum levels of IL-6, IL-1β and TNF-α were increased (P<0.01), and the protein expression levels of p-JAK2 and p-STAT3 were increased (P<0.01). Compared with the model group, cognitive function of mice in the scalp cluster acupuncture group was improved (P<0.05), the number of hippocampal neurons was increased (P<0.01), serum levels of IL-6, IL-1β and TNF-α were decreased (P<0.01), and the protein expression levels of p-JAK2 and p-STAT3 were decreased (P<0.01). Conclusion: Scalp cluster acupuncture may inhibit neuroinflammatory responses by regulating the JAK2/STAT3 signaling pathway, thereby improving cognitive function in APP/PS1 mice.

Abstract:Objective: To investigate the protective effect of Panax Notoginseng Saponins (PNS) on radiation-induced heart disease (RIHD) in rats and explore its underlying mechanism. Methods: A total of 50 rats were randomly divided into 5 groups using a random number table: normal control group, radiation-only group, and low-, medium-, and high-dose PNS intervention groups, with 10 rats in each group. Except for the normal control group, rats in the other four groups received a single 20 Gy cardiac irradiation. Rats in the low-, medium-, and high-dose PNS groups were intragastrically administered with 10 mg/kg, 30 mg/kg, and 60 mg/kg PNS, respectively, while those in the normal control and radiation-only groups received an equal volume of normal saline. The administration was initiated on the day of irradiation and continued daily for 4 weeks after radiotherapy. After irradiation, serum levels of cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), malondialdehyde (MDA), superoxide dismutase (SOD), intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and transforming growth factor-β1 (TGF-β1) were detected. Pathological changes of myocardial tissues were observed using hematoxylin-eosin (HE) staining. Western blot was performed to determine the protein expression levels of TGF-β1 and Smad3 in myocardial tissues. Results: Compared with the normal control group, the radiation-only group showed increased serum levels of cTnI, CK-MB, MDA, ICAM-1, TNF-α, IL-1β, and TGF-β1 (P<0.05), decreased serum SOD level (P<0.05), and elevated myocardial pathological score (P<0.05). Compared with the radiation-only group, all PNS intervention groups exhibited reduced serum levels of cTnI, CK-MB, MDA, ICAM-1, TNF-α, IL-1β, and TGF-β1 (P<0.05), increased serum SOD level (P<0.05), and decreased myocardial pathological score (P<0.05). The changes of these indexes were dose-dependent in the low, medium and high dose groups (P<0.05). Conclusion: PNS exerts a protective effect against RIHD in rats, and its mechanism may be associated with regulating oxidative stress, alleviating inflammatory response, and inhibiting the TGF-β1/Smad3 signaling pathway.

Abstract:Objective: To develop a lipid metabolism-associated gene signature to stratify sepsis patients for prognostic risk and evaluate their immune function. Methods: Based on the sepsis dataset GSE65682, lipid metabolism-related genes were screened. Univariate Cox regression, LASSO regression, and multivariate Cox regression analyses were integrated to identify hub genes. Patients were divided into high- and low-risk groups based on the median risk score. Kaplan-Meier and ROC curve analyses were used to evaluate predictive performance. Additionally, an independent external dataset, GSE95233, was introduced to further validate the robustness of the model. Immune function differences were analyzed using ssGSEA, CIBERSORT, and correlation network analysis. Results: A 9-gene prognostic signature was constructed, consisting of AHRR, CLN8, FASN, LSS, MED29, PAFAH1B1, PIP5K1C, TRIB3, and UGCG. Patients in the high-risk group showed poorer survival (KM test P=6.75×10??, area under the ROC curve AUC =0.951), with enrichment of chemokine receptor signaling and para-inflammatory responses. The low-risk group exhibited higher levels of tumor-infiltrating lymphocytes, type II interferon response, regulatory T cells, and macrophage infiltration. Immune network analysis revealed synergy between activated NK cells and M1 macrophages (r=0.44) and antagonism with resting NK cells (r=-0.62). CD86 and TNFSF4 were highly expressed in the low-risk group, while the enrichment score of CD200R1 was significantly reduced (P<0.05). The model maintained robust predictive performance in the independent external validation dataset GSE95233 (AUC=0.757). Conclusion: The established lipid metabolism-based 9-gene signature effectively predicts sepsis outcomes, revealing significant immune differences between risk groups. It provides a potential tool for risk stratification and personalized clinical intervention.

Abstract:Objective: To investigate the clinical characteristics of supernumerary teeth in children and their impact on the eruption of permanent teeth. Methods: A retrospective analysis was conducted on the clinical features of 132 pediatric patients (184 supernumerary teeth) and their effect on the eruption of permanent teeth. Results: The majority of patients were aged 7~9 years (53.03%), with a higher prevalence in males (approximately 4∶1). Most cases had a single supernumerary tooth (61.36%), with the teeth predominantly located on the palatal side (80.43%), inverted (47.28%), and conical in shape (62.50%). Most supernumerary teeth were unerupted (76.63%). 32 teeth (17.39%) caused delayed eruption/impaction, 43 teeth (23.37%) led to displacement, 18 teeth (9.78%) caused rotation, and 31 teeth (16.85%) resulted in midline diastema. Supernumerary teeth located within the dental arch were more likely to cause rotation of permanent teeth (25.00%) (P < 0.05). The tuberculate type was more frequently associated with displacement (44.23%) and rotation (21.15%) of permanent teeth (P<0.05). In contrast, orientation, eruption status, and distance from the permanent tooth germ showed no statistically significant association with eruption abnormalities (P>0.05). Conclusion: Supernumerary teeth can lead to eruption abnormalities of permanent teeth. Early imaging screening and intervention are crucial for preventing malocclusion.

Abstract:Objective: To explore the relationship between neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR) and injury in foveal avascular zone (FAZ), prognosis of patients with diabetic retinopathy (DR). Methods: A total of 123 patients with DR were enrolled, and all underwent optical coherence tomography angiography (OCTA). According to presence or absence of FAZ contour injury, patients were divided into injury group (n=60) and non-injury group (n=63), NLR, PLR and LMR levels in the two groups were compared. The relationship between FAZ contour injury and NLR, PLR, LMR were analyzed by Spearman correlation analysis. Taking whether there was visual disability after 1 year of follow-up as prognosis evaluation criteria, patients were divided into visual improvement group (n=86) and visual disability group (n=37), NLR, PLR and LMR levels in the two groups were compared. The predictive value of NLR, PLR and LMR levels for prognosis of DR was analyzed by ROC curves. Results: NLR and PLR in injury group were higher than those in non-injury group (P<0.05), while LMR was lower than that in non-injury group (P<0.05). NLR and PLR were positively correlated with FAZ contour injury (P<0.05), while LMR was negatively correlated with FAZ contour injury (P<0.05). NLR and PLR in visual disability group were higher than those in visual improvement group (P<0.05), while LMR was lower than that in visual improvement group (P<0.05). ROC curve analysis showed that area under the curve (AUC) values of NLR, PLR, LMR and combined detection for predicting prognosis of DR were 0.799, 0.807, 0.812 and 0.959, and their cut-off values were 2.82, 139.47 and 3.71, respectively. Conclusion: The levels of NLR, PLR and LMR are all related to FAZ contour injury in DR patients, which can also be applied as auxiliary detection indexes to clinically predict visual prognosis in DR patients.

Abstract:Objective: To analyze the influence of low-dose goserelin combined with dienogest on serum estrogen (E2), vascular endothelial growth factor (VEGF), membrane type 1 matrix metalloproteinase (MT1-MMP) and disease recurrence rate in patients with endometriosis (EMs) after hysteroscopy combined with laparoscopy, and to provide a basis for optimizing clinical postoperative treatment regimens. Methods: A total of 120 patients with EMs were prospectively enrolled. Following hysteroscopy combined with laparoscopy, they were divided into a combined group (n=60) and a single-drug group (n=60) according to different treatment protocols. The single-drug group received low-dose goserelin (1.8 mg per time, subcutaneous injection, once every 28 days); the combined group was additionally given dienogest (2 mg per time, oral administration, once daily) on the basis of the single-drug regimen, with both groups treated for 6 months. Serum hormone and cytokine levels, Endometriosis Health Profile-5 (EHP-5) scores, recurrence rate, ovarian reserve function and adverse reaction incidence were compared between the two groups. Results: After treatment, serum E2, progesterone (P), VEGF and MT1-MMP levels declined in both groups (P<0.05). The combined group had a higher E2 level (P<0.05) and lower VEGF and MT1-MMP levels (P<0.05). No significant intergroup difference was found in post-treatment P levels (P>0.05). Anti-Müllerian hormone levels and bilateral ovarian antral follicle counts decreased in both groups (P<0.05), yet the combined group maintained higher values than the single-drug group (P<0.05). EHP-5 scores dropped markedly in both groups (P<0.05), and the combined group achieved lower scores in pain and emotional domains relative to the single-drug group (P<0.05). The 12-month postoperative recurrence rate was significantly lower in the combined group (P<0.05). The total incidence of adverse reactions showed no statistical difference between the two groups (P>0.05). Conclusion: Low-dose goserelin combined with dienogest can downregulate serum E2, VEGF and MT1-MMP levels in post-surgical EMs patients and reduce recurrence risk, with acceptable safety.

Abstract:Objective: To investigate the effect of self-etching adhesive combined with composite resin filling on dental plaque control and restoration outcomes in children with dental caries. Methods: Totally 104 children with dental caries were enrolled. According to the treatment plan, they were divided into a control group (n=51) and an experimental group (n=52). The control group received total-etching adhesive combined with composite resin filling, while the experimental group received self-etching adhesive combined with composite resin filling. All children were followed up for 3 months. Periodontal health indicators and tooth sensitivity before and after treatment, restoration outcomes, and complications were compared between the two groups. Results: After treatment, periodontal probing depth (PD) and plaque index (PLI) decreased in both groups compared with baseline levels, and the values were lower in the experimental group (P < 0.05). Tactile values increased, while VAS scores and Schiff index decreased in the experimental group. All indices were better than those in the control group (P < 0.05). Compared to the control group, the experimental group reported a higher success rate of restoration (P < 0.05) and a lower total complication rate (P < 0.05). Conclusion: Compared with total-etching adhesive, self-etching adhesive combined with composite resin filling achieves better restoration outcomes in children with dental caries. It can effectively reduce dental plaque, decrease tooth sensitivity, and lower the complication rate. It is worthy of clinical application.

Abstract:Objective: To investigate the value of artificial intelligence (AI) in grading vascular stenosis on head and neck CT angiography (CTA) and to compare its diagnostic performance with that of frontline and second-line radiologists in a real-world clinical workflow. Methods: A total of 212 patients who underwent both head and neck CTA and digital subtraction angiography (DSA) were retrospectively enrolled. Using 3,816 vascular segments as the unit of analysis, DSA was used as the reference standard. The diagnostic performance of frontline radiologists, second-line radiologists, and the AI system was compared for three binary endpoints: ≥50% stenosis, ≥70% stenosis, and complete occlusion. McNemar tests, receiver operating characteristic (ROC) curve analyses, and DeLong tests were performed. Further analyses compared AI with frontline radiologists of different seniority levels and evaluated its performance in the anterior and posterior circulation. Results: Second-line radiologists achieved the best overall diagnostic performance across all three endpoints. The overall performance of the AI system was comparable to that of frontline radiologists but remained inferior to that of second-line radiologists (P < 0.001). For the three endpoints, the AUCs of frontline radiologists, second-line radiologists, and the AI system were 0.841, 0.910, and 0.838 for ≥50% stenosis, 0.893, 0.950, and 0.877 for ≥70% stenosis, and 0.931, 0.964, and 0.914 for complete occlusion, respectively. No significant differences in AUC were observed between AI and frontline radiologists (P > 0.05), whereas AI differed significantly from second-line radiologists for all endpoints (P < 0.001). After stratification, no significant AUC differences were found between AI and either residents or attending radiologists (P > 0.05). However, for the ≥50% and ≥70% stenosis endpoints, AI showed better paired classification performance than residents. AI performed relatively stable in the anterior circulation, while its sensitivity decreased in the posterior circulation. Conclusion: AI demonstrates adjunctive value in grading vascular stenosis on head and neck CTA. Its overall performance is comparable to that of frontline radiologists but remains inferior to that of second-line radiologists. At the current stage, AI is better suited as an assistive tool for frontline interpretation and as a prompt before second-line review.

Abstract:Objective: To explore the synergistic therapeutic effect and mechanism of narrow band ultraviolet B (NB-UVB) phototherapy combined with levocetirizine hydrochloride in the management of pruritus in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 136 T2DM patients complicated with pruritus were enrolled as research subjects. They were assigned into two groups according to different treatment options, with 68 cases in each group. The monotherapy group received oral levocetirizine hydrochloride alone, whereas the combination group was administered NB-UVB phototherapy plus levocetirizine hydrochloride. Both groups underwent a 4-week treatment course. Before and after the intervention, the pruritus symptom score, skin lesion score, and quality of life score were assessed for all patients. Meanwhile, the levels of peripheral blood T lymphocyte subsets in patients were detected. The overall therapeutic efficacy of the two groups was also compared and analyzed. Results: The total effective rate of the combination group was higher than that of the monotherapy group (P < 0.05). After 4 weeks of treatment, the pruritus symptom score and skin lesion score in the combination group were lower than those in the monotherapy group (P < 0.05), while the quality of life score was higher in the combination group (P < 0.05). In terms of immune indicators, the levels of CD3+, CD4+ T lymphocytes and the CD4+/CD8+ ratio in peripheral blood in the combination group were higher than those in the monotherapy group (P < 0.05). Conclusion: NB-UVB phototherapy combined with levocetirizine hydrochloride can effectively alleviate pruritus symptoms and ameliorate skin lesions in T2DM patients with pruritus. More importantly, this combined regimen can regulate the disordered peripheral blood T lymphocyte subsets, improve the body's immune regulation, and thus achieve a better clinical therapeutic effect than single levocetirizine hydrochloride treatment.

Abstract:Objective: To investigate the association between preoperative apolipoprotein B/apolipoprotein A1 ratio (ApoB/ApoA1) and the risk of developing acute kidney injury (AKI) following off pump coronary artery bypass grafting (OPCABG). Methods: A retrospective cohort study was conducted. Clinical data from 107 patients who underwent OPCABG were collected. Patients were divided into an AKI group (n = 34) and a non-AKI group (n = 73) based on postoperative occurrence of AKI defined by KDIGO criteria. Data, including gender, age, comorbidities, preoperative laboratory parameters (ApoB/ApoA1 ratio, albumin, hemoglobin, serum creatinine), and surgical approach, were collected and compared between the two groups. Univariate and multivariate Logistic regression analyses were performed to identify independent risk factors for postoperative AKI. Results: The preoperative ApoB/ApoA1 ratio was higher in the AKI group than in the non-AKI group (P < 0.05). Univariate analysis revealed that body weight and ApoB/ApoA1 ratio were influencing factors for AKI (P < 0.10). Multivariate Logistic regression analysis demonstrated that after adjusting for age, body weight, and preoperative serum creatinine, a higher preoperative ApoB/ApoA1 ratio remained an independent risk factor for AKI following OPCABG (P < 0.05). Conclusion: An elevated preoperative ApoB/ApoA1 ratio is independently associated with an increased risk of AKI after OPCABG. This ratio may serve as a potential biomarker for preoperative assessment of renal injury risk.

Abstract:Objective: To compare the efficacy of a fully oral intensive regimen versus the classic immunosuppressive regimen in patients with aplastic anemia (AA) who were unsuitable for antithymocyte globulin (ATG) therapy. Methods: 93 AA patients ineligible for ATG treatment were selected as the research subjects. They were divided into Group A (n=44) and Group B (n=49) based on their treatment regimens. Group A patients were treated with a full oral intensified regimen [cyclosporine + androgen + thrombopoietin receptor agonist (TPO-RA)], Group B patients were treated with a classic immunosuppressive regimen (cyclosporine + androgen), both group were treated for a duration of 6 months. The efficacy indicators (detachment from transfusion rate, overall hematological response rate, complete remission rate), blood routine index levels, and incidence of adverse reactions were compared between the two groups. Results: At the 3 month of treatment, the platelet and red blood cell transfusion rates in group A were higher than those in group B (P < 0.05). At the 6 month of treatment, the overall hematological response rate and complete remission rate in Group A were higher than those in Group B (P<0.05). The complete remission rate in Group A was higher than that in Group B (34.09% vs. 12.24%, P<0.05). The neutrophil, hemoglobin, platelet, and reticulocyte levels in Group A were higher than those in Group B (P<0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05). Conclusion: For AA patients unsuitable for ATG, the fully oral intensive triple therapy significantly improved hematologic responses, accelerated transfusion independence, and enhanced blood count recovery compared to the classic dual therapy, without increasing the risk of short-term severe adverse events.

Abstract:Objective: To evaluate the predictive value of serum vitamin D (VD), D-dimer, combined with uterine artery blood flow parameters and multimodal ultrasound score for pregnancy loss in patients with unexplained recurrent spontaneous abortion (URSA), from the perspective of imaging-based risk stratification. Methods: A retrospective analysis was conducted on 200 URSA patients. Based on pregnancy outcomes, they were divided into a normal pregnancy group (n=100) and a pregnancy loss group (n=100). Clinical characteristics, serological markers (VD, D-dimer), and ultrasound parameters, including the multimodal ultrasound score, uterine artery systolic/diastolic velocity ratio (S/D), resistance index (RI), and pulsatility index (PI), were compared between the two groups. Binary Logistic regression analysis was used to identify imaging and serological factors associated with pregnancy loss in URSA patients. The predictive performance of individual and combined indicators was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Compared with the normal pregnancy group, the pregnancy loss group had a higher number of previous miscarriages (P<0.001), lower serum VD levels and higher D-dimer levels (P<0.001). The multimodal ultrasound score was lower (P <0.001), while uterine artery S/D and RI were higher (P<0.05). Binary Logistic regression analysis revealed that decreased serum VD level (OR =0.955, 95% CI:0.931~0.980), increased D-dimer level (OR=5.585, 95% CI:2.066~15.098), decreased multimodal ultrasound score (OR=0.585, 95%CI:0.470~0.728), and increased uterine artery S/D ratio (OR=1.383, 95%CI:1.139~1.680) were independently associated with pregnancy loss in URSA patients. ROC curve analysis showed that the area under the curve (AUC) for the combined application of these indicators was 0.925 (95% CI:0.880~0.958), which was higher than that of any single indicator (P<0.001). Conclusion: Decreased serum VD, increased D-dimer, a lower multimodal ultrasound score, and an elevated uterine artery S/D ratio reflect high-risk imaging features associated with pregnancy loss in URSA patients. A comprehensive assessment centered on multimodal ultrasound, combined with serological markers, facilitates imaging-based risk stratification for pregnancy in URSA patients and provides a reference for pregnancy outcome evaluation.

Abstract:Objective: To investigate the dose-protective effects on cardiac substructures of Tomotherapy (TOMO) versus Intensity-Modulated Radiation Therapy (IMRT) with fixed fields during large-field radiotherapy following breast-conserving surgery for left-sided breast cancer, and to compare their short-term efficacy differences. Methods: A retrospective analysis of clinical data from 86 patients who underwent large-field radiotherapy after breast-conserving surgery for left-sided breast cancer. Patients were categorized by treatment modality into the TOMO group (n=43) and the IMRT group (n=43). The postoperative changes in the tumor bed region, target volume and organ at risk dose parameters, echocardiographic indicators, and the incidence of adverse reactions were compared between the two groups. Results: At 6 months post-radiotherapy, the TOMO group had a higher V95% coverage of the target volume than the IMRT group, a higher Conformity Index (CI) closer to 1, and a lower Homogeneity Index (HI) than the IMRT group (P<0.05). In the TOMO group, the dosimetric parameters for the heart and left ventricle [maximum dose (Dmax), mean dose (Dmean), V5Gy, and V20Gy] were all higher than those in the IMRT group, and the V30Gy for the heart was higher than that in the IMRT group (P<0.05). In the TOMO group, the Dmax, Dmean, and V20Gy of the left anterior descending artery (LAD) were lower than those in the IMRT group (P<0.05). In the TOMO group, the Dmean and V20Gy of the ipsilateral lung were lower than those in the IMRT group (P<0.05), while the Dmean and V5Gy of the contralateral lung and contralateral breast were higher than those in the IMRT group (P<0.05). The Dmean and V20Gy of the humeral head (affected side) were lower than those in the IMRT group (P< 0.05). The LVEF level in the TOMO group was higher than that in the IMRT group (P< 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compared with IMRT, TOMO delivers superior dose quality to the target volume in high-dose fractionation radiotherapy for left-sided breast cancer. It reduces doses to the left anterior descending artery, ipsilateral lung, and humeral head, but also increases overall cardiac dose and dose to contralateral structures to some extent.

Abstract:Objective: To investigate the diagnostic value of magnetic resonance imaging (MRI) in supraspinatus tendon tears. Methods: 105 patients with shoulder joint lesions were selected as the research subjects and divided into a control group (n=23) and a tear group (n=82) based on the presence of supraspinatus tendon injury. All patients underwent shoulder MRI examination. Using arthroscopy as the “gold standard”, the diagnostic efficacy of MRI was calculated. Patients in the tear group were divided into degeneration group (n=22), partial tear group (n=30), and complete tear group (n=30) according to the degree of injury. The quantitative MRI parameters [diffusion-weighted imaging (DWI) signal intensity, apparent diffusion coefficient (ADC) value, and tendon thickness] between the control group and patients with different degrees of injury were compared, and the correlation with the degree of supraspinatus tendon tear injury, and their diagnostic value for distinguishing tear from simple degeneration were analyzed. Results: The sensitivity, specificity, and accuracy of MRI in diagnosing supraspinatus tendon tears were 95.00%, 95.56%, and 95.24%, respectively. DWI signal intensity and ADC values increased with the aggravation of injury, while tendon thickness peaked in the partial tear group and then decreased (P<0.05). Both DWI signal intensity and ADC values showed a positive correlation with the degree of injury (r=0.891, 0.832, P<0.05). ROC curve analysis showed that the area under the curve (AUC) of ADC values and DWI signal intensity for distinguishing tears from simple degeneration was 0.812 and 0.899, respectively, and the AUC increased to 0.942 when combined. The AUC of tendon thickness was 0.630. Conclusion: MRI has a definite diagnostic effect on supraspinatus tendon tears. DWI signal intensity and ADC values can reflect the severity of injury, and their combination improves the differential diagnostic efficiency. As a morphological indicator, tendon thickness provides supplementary information for injury staging.

Abstract:Objective: To investigate the efficacy and safety of Xinqin Granules combined with cetirizine hydrochloride and mometasone furoate in treating children with adenoid hypertrophy. Methods: A total of 106 children with adenoid hypertrophy were enrolled as subjects. According to the different treatment medications, they were divided into a combination group (n=50) and a control group (n=56). The control group received cetirizine hydrochloride and mometasone furoate treatment, while the combination group received additional Xinqin Granules based on this regimen. After 3 months of treatment, the Adenoid/Nasopharynx ratio (A/N ratio), TCM syndrome efficacy, main TCM symptom scores, and immune function-related indicators were compared between the two groups, and their safety was assessed. Results: After treatment, the A/N ratio in the combination group was lower than that in the control group (P<0.05). The total effective rate of TCM syndrome efficacy in the combination group was higher than that in the control group (P<0.05). After treatment, the scores for nasal congestion and snoring symptoms in the combination group were lower than those in the control group (P<0.05), while there was no statistically significant difference in the mouth-breathing symptom score between the two groups (P >0.05). After treatment, the percentages of CD4? T cells, the CD4?/CD8? T cell ratio, and the levels of immunoglobulin (Ig)G and IgA in the combination group were higher than those in the control group(P<0.05), while the IgE level was lower than that in the control group(P<0.05). There was no statistically significant difference in the percentage of CD8? T cells between the two groups(P>0.05). No adverse reactions occurred in either group during the treatment period. Conclusion: The combination of Xinqin Granules with cetirizine hydrochloride and mometasone furoate is more conducive to improving clinical symptoms and reducing adenoid volume in children with adenoid hypertrophy, resulting in superior therapeutic effects. Its mechanism may be related to regulating the balance of T lymphocyte subsets, and its clinical application is safe and feasible.

Abstract:Objective: To explore the predictive value for fetal growth restriction (FGR) by combining early-pregnancy uterine artery Doppler indices [pulsatility index (PI), resistance index (RI), systolic-to-diastolic velocity ratio (S/D=PSV/EDV), and early diastolic notch] with serum placental growth factor (PLGF) levels. Methods: A retrospective analysis was conducted on the clinical data of pregnant women who received regular prenatal care from July 2024 to October 2025. Based on FGR diagnostic criteria, they were divided into an FGR group (n=39) and a non-FGR group (n=188). First-trimester uterine artery Doppler parameters (PI, RI, S/D), early diastolic notch presence, and serum PLGF levels were compared between the two groups. Independent predictors of FGR were determined through multivariate binary Logistic regression modeling, whereas the predictive accuracy of single and combined parameters was systematically assessed via ROC curve analysis with AUC quantification, enabling stratification of diagnostic performance. Results: Compared with the non-FGR group, pregnant women in the FGR group exhibited higher first-trimester right and left uterine artery PI and S/D values (P<0.001), a higher proportion of early diastolic notches (P=0.003), and lower serum PLGF levels (P=0.011). Although right and left RI values were slightly elevated in the FGR group (P>0.05). Multivariate Logistic regression identified right S/D (OR=1.619), left S/D (OR=1.411), PLGF (OR=0.985), and bilateral early diastolic notches (OR=0.302) as independent predictors of FGR. ROC curve analysis showed AUC values of 0.874, 0.826, 0.629, and 0.643 for right S/D, left S/D, PLGF, and early diastolic notches, respectively, when used individually. The combined model achieved an AUC of 0.918, with a sensitivity of 0.872 and specificity of 0.883, demonstrating superior predictive performance. Conclusion: First-trimester uterine artery Doppler flow spectra and PLGF serve as effective predictors for FGR. Notably, the combined predictive value of bilateral S/D, PLGF levels, and the presence of early diastolic notches is particularly high, with an AUC reaching 0.918.

Abstract:Objective: To explore the clinical efficacy of anti-infective therapy based on upper respiratory tract targeted pathogen sequencing in children with severe community-acquired pneumonia (CAP). Methods: A total of 160 children with severe CAP were selected as the research subjects. According to the treatment methods, all children were divided into control group (n=80) and observation group (n=80). The control group received conventional anti-infective treatment, and the observation group received anti-infective therapy based on upper respiratory tract targeted pathogen sequencing. The pathogen detection results, efficacy, treatment time, medical cost, and incidence of adverse reactions were compared between two groups. Results: The positive rate of the observation group was higher than that of the control group (88.75% vs. 76.25%, P<0.05). Compared with control group, the positive rate of viruses, mycoplasma, and two or more pathogens in the observation group were increased (P <0.05). In the main detected pathogens, the number of adenovirus and mycoplasma pneumoniae in observation group were higher than those of control group (P<0.05). The effective rate in the observation group was higher than that in the control group (P<0.05). The number of cases with treatment regimen adjustment in the observation group was higher than that in the control group (P<0.05). Compared with control group, the duration of antibiotic usage, length of hospital stay, and medical costs in the observation group were reduced (P <0.05). There was no statistically significant difference in adverse reactions between the two groups (P>0.05). Conclusion: Upper respiratory tract targeted pathogen sequencing could quickly and accurately identify the pathogen of children with severe CAP, the anti-infective treatment based on its guidance can effectively improve clinical efficacy, shorten hospitalization time and antibiotic use time, and reduce medical costs.

Abstract:Objective: To explore the therapeutic effect of Yangyin Qingmai Decoction (YQMD) in combination with conventional Western medicine for patients with early to middle stages of diabetic nephropathy (DN) presenting with Qi-Yin deficiency. Methods: A total of 100 individuals diagnosed with type 2 DN accompanied by Qi-Yin deficiency syndrome were recruited. They were divided into the combined therapy group (n=50) and the Western medicine group (n=50) according to different treatment methods. The Western medicine group received routine therapy with dapagliflozin and insulin, while the combined therapy group received additional YQMD on the basis of the same Western regimen. Both groups were treated for 12 weeks. Changes in traditional Chinese medicine (TCM) syndrome scores, urinary albumin-to-creatinine ratio (UACR), 24-hour urinary protein excretion, glycated hemoglobin (HbA1c) levels, and the incidence of adverse reactions were compared between the two groups. Results: After 12 weeks of treatment, the overall effective rate of TCM syndrome improvement was higher in the combined therapy group than in the Western medicine group (92.0% vs. 78.0%, P <0.05). UACR levels, 24-hour urinary protein excretion, HbA1c level, fatigue and lassitude score, polydipsia score, and lumbar and knee soreness and weakness score in the combined therapy group were lower than those in the Western medicine group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: YQMD combined with Western medicine shows marked benefits for patients with Qi-Yin deficiency syndrome at the early to middle stages of diabetic nephropathy. It can effectively improve TCM syndrome manifestations, reduce urinary protein levels, improve glycemic control, and is well tolerated. This integrated approach has promising clinical application value.

Abstract:Objective: To explore the correlation between heart rate variability (HRV), electrocardiogram (ECG) features, and the severity of coronary artery lesions in patients with coronary artery disease (CAD). Methods: A total of 72 elderly patients diagnosed with CAD by coronary angiography were selected as the CAD group. Based on the median Gensini score, they were divided into a mild lesion group (n=40) and a severe lesion group (n=32). Additionally, 30 healthy individuals undergoing physical examination during the same period were selected as the control group. All subjects underwent 24-hour ambulatory ECG monitoring using the Medex ECG system. Time-domain [standard deviation of all NN intervals (SDNN), root mean square difference of adjacent NN intervals (RMSSD)] and frequency-domain [low-frequency power (LF), high-frequency power (HF), LF/HF] HRV indices, as well as conventional ECG characteristics, were analyzed. Differences in these parameters among the groups were compared. Pearson or Spearman correlation analysis was used to examine the correlations between HRV indices, ECG characteristics, and the Gensini score. Results: Compared with the control group, patients in the CAD group showed reductions in SDNN, RMSSD, and HF (P<0.05), while the LF/HF ratio was increased (P<0.05). Moreover, the severe lesion subgroup exhibited lower SDNN, RMSSD, and HF compared to the mild lesion subgroup (P<0.05), and a higher LF/HF ratio than the mild lesion subgroup (P<0.05). The incidences of ST-T changes and complex ventricular premature beats were higher in the CAD group than in the control group (P<0.05), and were more frequent in the severe lesion subgroup than in the mild lesion subgroup (P<0.05). No significant difference was observed in the incidence of atrial premature beats among the three groups (P>0.05). Pearson correlation analysis showed that SDNN, RMSSD, and HF were all negatively correlated with the Gensini score (P <0.05), while the LF/HF ratio was positively correlated with the Gensini score (P<0.05). Spearman rank correlation analysis indicated that both ST-T changes and complex ventricular premature beats were positively correlated with the Gensini score (P<0.05), while atrial premature beats showed no significant correlation with the Gensini score (P>0.05). Conclusion: The HRV and ECG features in CAD patients correlate with the severity of coronary artery lesions and can serve as non-invasive reference indices for assessing the condition.

Abstract:Objective:To investigate the value of peripheral blood eosinophil(EOS)count and fractional exhaled nitric oxide(FeNO)in the diagnosis and management of children with cough variant asthma(CVA). Methods:60 children with CVA were included in the CVA group,and 60 children with non-CVA chronic cough treated in the hospital during the same period were selected as the cough group.After 4 weeks of treatment,the children with CVA were divided into well-controlled group(n=30),partially controlled group (n=18)and uncontrolled group (n=12)according to the control status of children’s asthma control test.The baseline data,FeNO and EOS count were compared in children with CVA group,cough group,and different asthma control groups.The value of EOS count and FeNO in the diagnosis and management of CVA in children was analyzed by receiver operating characteristic (ROC)curve. Results:The percentage of predicted value for forced expiratory volume in one second(FEV1%Pred),percentage of predicted value for peak expiratory flow (PEF%pred)and percentage of predicted value for forced expiratory flow at 50% (FEF50%pred)in the CVA group were lower than those in the cough group(P<0.05),while the FeNO,EOS count and immunoglobulin E (IgE)were higher compared to the cough group(P<0.05). ROC curve revealed that the areas under the curves of FeNO and EOS count in the diagnosis of CVA children were 0.912(95% CI:0.853~0.970)and 0.876(95% CI:0.810~0.942),and the sensitivities were 90.00%and 83.30%,and the specificities were 90.00% and 88.30%,respectively. FeNO,EOS count and IgE were lower in the well-controlled group than those in the partially controlled group and the uncontrolled group (P<0.05),and were also lower in the partially controlled group than those in the uncontrolled group(P<0.05). ROC curve suggested that the areas under the curves of FeNO and EOS count were 0.898(95% CI:0.786~1.000)and 0.806(95% CI:0.667~0.944)in the evaluation of good control of CVA in children,and the sensitivities were 83.30% and 77.80%,and the specificities were 96.70% and 73.30%,respectively. Conclusion:EOS count and FeNO level in children with CVA are increased,and EOS count and FeNO have high value in the diagnosis and management of CVA in children.

Abstract:Objective: To explore the predictive value of prenatal ultrasound characteristics of fetal constriction of the aorta (CoA) in postpartum neonatal outcomes. Methods: A total of 128 pregnant women with fetal CoA indicated by prenatal ultrasound who underwent regular prenatal examinations were enrolled, and all were followed up till 0~2 years old after fetal birth. According to echocardiographic diagnosis and surgical confirmation after birth, neonatal outcomes were divided into group A (significant constriction) and group B (mild constriction + normal). The maternal and neonatal general data and prenatal ultrasonogram characteristics [ascending aortic diameter (AAO), distal transverse aortic arch (DTAA), flow velocity at the stenosis site] in the two groups were compared. The relationship between AAO, DTAA, flow velocity at the stenosis site and significant CoA was analyzed by Logistic regression analysis, and predictive value of AAO, DTAA, flow velocity at the stenosis site and combined detection in significant CoA was analyzed by ROC curves. Results: Among 128 pregnant women after follow-up, there were 11 cases with normal neonates, 31 cases with mild constriction and 86 cases with significant constriction. The age of puerperae, gestational weeks detected by ultrasound, BMI and proportion of gestational diabetes mellitus in group A were higher than those in group B(P<0.05). AAO and DTAA in group A were lower than those in group B, and flow velocity at the stenosis site was faster than that in group B(P<0.05). After correcting the influences of age, gestational age detected by ultrasound, BMI and the proportion of gestational diabetes mellitus, Logistic regression analysis showed that low AAO, low DTAA and high flow velocity at the stenosis site were risk factors of significant CoA (P<0.05). The results of ROC curves analysis showed that AUC values of AAO combined with DTAA and flow velocity at the stenosis site, and DTAA alone for predicting significant CoA were greater, showed good predictive value. Conclusion: Prenatal AAO, DTAA and flow velocity at the stenosis site have significant clinical predictive value in CoA. Among them, DTAA has the highest predictive value. In clinical practice, DTAA can be the first choice for prediction, while AAO and flow velocity at the stenosis site can be applied as auxiliary predictive indexes

Abstract:Objective: To explore the correlation between the severity of coronary artery lesions and serum biomarkers in patients with coronary heart disease(CHD). Methods: A total of 453 patients with CHD were selected as the observation group, while 213 patients without CHD were included as the control group. According to the severity of coronary artery lesions, CHD patients were divided into mild group(n=147), moderate group(n=132)and severe group(n=174). The general information and serum biomarker levels of patients with different severity of coronary artery disease between the observation group and the control group were compared, the correlation between serum biomarker levels and the severity of coronary artery disease were analyzed by Pearson correlation analysis. The influence factors of severity of coronary artery disease in CHD patients were analyzed by Ordered Logistic regression analysis. Results: The comparisons of high-density lipoprotein(HDL), lipoprotein-associated phospholipase A2(Lp-PLA2), D-dimer, B-type natriuretic peptide(BNP), cardiac troponin I(cTnI), fibrinogen(FIB), and C-reactive protein (CRP)in observation group were higher than those in the control group (P <0.05). There were significant differences in the levels of D-dimer, BNP, cTnI, FIB, CRP, and lymphocytes(LYM)among patients with different severity levels of coronary heart disease (P <0.05), with severe group > moderate group > mild group. The correlation analysis results showed that the levels of serum Lp-PLA2, D-dimer, BNP, cTnI, FIB, CRP were correlated with the severity of coronary artery disease in CHD patients (P <0.05). The regression analysis results showed that cTnI and FIB levels were independent risk factors affecting the severity of coronary artery disease in CHD patients(P<0.05). Conclusion: The severity of coronary artery lesions in patients with CHD is associated with the levels of Lp-PLA2, D-dimer, BNP, cTnI, FIB and CRP. Among them, cTnI and FIB are independent risk factors and can assist in clinical assessment.

Abstract:Objective: To explore the efficacy and safety of methylprednisolone combined with dupilumab in the treatment of bullous pemphigoid(BP). Methods: 106 patients with BP admitted to department of dermatology were selected and divided into the conventional group and the dupilumab group based on their treatment regimens. Propensity score was used to match 53 patients in each group. The conventional group received intravenous methylprednisolone treatment, the dupilumab group received methylprednisolone (administered identically to the conventional group) combined with dupilumab treatment. Both groups were evaluated for efficacy at the 16 weeks treatment time point. The clinical efficacy, complete regression time of skin lesion, pruritus symptoms[pruritus number rating scale(NRS)score], skin lesion severity[BP disease area index(BPDAI)], serum anti-BP180 antibody, anti-BP230 antibody level, peripheral blood eosinophil (EOS) absolute value before and after treatment were compared between the two groups. The recurrence and adverse reactions of the two groups were counted after 6 months of follow-up. Results: The overall response rate in the dupilumab group was higher than that in the conventional group (P<0.05), the complete regression time of skin lesion was shorter than that in the conventional group (P <0.05). After treatment, the dupilumab group exhibited lower NRS scores, BPDAI scores, serum anti-BP180 antibody levels, anti-BP230 antibody levels, and absolute peripheral blood eosinophil count compared to the conventional group(P<0.05). At 6 months of follow-up, the recurrence rate in the dupilumab group with 11.32% was lower than 30.19% in the conventional group (P<0.05). There were no statistical differences in the incidence rates of adverse reactions between the dupilumab group and the conventional group (P >0.05). Conclusion: Methylprednisolone combined with dupilumab has significant efficacy in the treatment of BP, and it can effectively alleviate the severity of skin lesion, shorten the complete regression time of skin lesion, reduce the levels of autoantibodies and EOS and lower the risk of recurrence, with good safety.

Abstract:Objective: To explore the effect of a family-centred, information-motivation-behavioural skills (IMB)-based intervention on breastfeeding attitudes among women with gestational diabetes mellitus (GDM). Methods: 84 GDM patients were divided into two groups according to different nursing methods. The observation group(n=42)received usual care plus the IMB family-centred programme, and the control group (n =42)received usual care only. Breastfeeding knowledge, motivation, attitude and glycaemic indices were compared, together with exclusive breastfeeding rates on postpartum day3 and at1,3and6months. Results: After the intervention, scores on the breastfeeding knowledge, motivation and attitude scales were higher in the observation group than those in the control group (P <0.05). Fasting glucose, 2-h postprandial glucose and HbA1c were lower in the observation group(P<0.05). Exclusive breastfeeding rates at all four timepoints were higher in the observation group (P <0.05). Conclusion: The IMB-based family-centred intervention improves breastfeeding knowledge, motivation and attitudes, facilitates glycaemic control and increases exclusive breastfeeding rates in women with GDM.

Abstract:Objective: To explore the application effect of evidence-based nursing model based on risk defense mechanism on reducing risks during laparoscopic hysterectomy. Methods: A total of 92 patients undergoing laparoscopic hysterectomy were enrolled. Patients were divided into a conventional intervention group and an evidence-based intervention group based on different intervention methods, with 46 cases in each group. The perioperative indicators, negative emotions and quality of life (GQOLI-74) before and after nursing, incidence rates of perioperative adverse events and complaints, and patient satisfaction were compared between the two groups. Results: The gastrointestinal function recovery time, ambulation time and hospitalization time in evidence-based intervention group were shorter than those in conventional intervention group (P < 0.05). After nursing, the SAS score and SDS score in the two groups were decreased (P<0.05), and the scores in evidence-based intervention group were lower than those in conventional intervention group(P<0.05). The scores of GQOLI-74 items in evidence-based intervention group were higher than those in conventional intervention group(P<0.05). The incidence rates of adverse events were lower in evidence-based intervention group than those in conventional intervention group(P<0.05), and the nursing complaint rate was also lower than that in conventional intervention group(P<0.05). The nursing satisfaction in evidence-based intervention group was higher compared to conventional intervention group (P<0.05). Conclusion: Evidence-based intervention model based on risk defense mechanism can effectively promote the postoperative rehabilitation of patients with laparoscopic hysterectomy, improve the negative emotions and living standards, and reduce perioperative adverse events and complaint rate. It has high patient satisfaction and is worthy of clinical promotion and use.

Abstract:Objective: To understand the current status and equity of resource allocation in immunization clinics in Chengdu, and to provide a basis for health administrative departments to further optimize the allocation of immunization program resources. Methods: A questionnaire survey was conducted to assess the current status of human resource allocation. The Gini coefficient, agglomeration degree, and spatial autocorrelation analysis were employed to evaluate the equity of resource allocation. Results: In 2024, the number of vaccination personnel per 10,000 population in Chengdu was 1.07. The staff were predominantly female, with an age distribution of (36.60±7.62) years old. The proportions of personnel with official establishment, high academic qualifications, and senior professional titles were relatively low. Overall, the equity of immunization resource allocation based on population was superior to that based on geographical area. The resources in the first and second urban circles were well allocated or even surplus in terms of geographical distribution, while the third circle showed better allocation efficiency when measured by population. In terms of spatial distribution, the high-high clustering mainly radiated to surrounding areas with Qionglai City and Jianyang City in the third circle as the core. And the low-low clustering was primarily concentrated in the first urban circle and the northwestern part of the second circle. Conclusion: The resource allocation in vaccination clinics in Chengdu is irrational and unevenly distributed, necessitating further optimization.