To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To explore the clinical characteristics and maternal and fetal outcomes of pregnant women with malignant tumors.

A total of 30 455 women with singleton pregnancies who delivered at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School between January 2020 and December 2024 were enrolled in this study, including 385 cases complicated by malignancy. According to the presence or absence of malignancy, participants were divided into a malignancy group (n=385) and a control group (n=30 070). Propensity score matching (PSM) was performed at a ratio of 1∶4 using age, gravidity, parity, chronic hypertension, pregestational diabetes mellitus, pre-pregnancy body mass index(BMI) ≥ 28 kg/m², and history of assisted reproductive technology as covariates. The malignancy group was further stratified by the timing of cancer diagnosis into a pre-pregnancy subgroup (n=367, malignancy diagnosed before pregnancy) and a pregnancy-associated subgroup (n=18, malignancy diagnosed during pregnancy or the puerperium). The clinical characteristics and maternal–fetal outcomes were retrospectively analyzed for all groups. This study was approved by the Medical Ethics Committee of Drum Tower Hospital, the Affiliated of Hospital Nanjing University Medical School (Approval No. 2025-0873-01). As this was a retrospective single-center cohort study, the requirement for informed consent was waived.

①The incidence of pregnancy complicated by malignancy was 1.26% (385/30 455) and showed a significant increasing trend over the study period (χ²_trend=33.61, P<0.001), with thyroid cancer being the most common type (77.9%, 300/385). After propensity score matching, 384 women were included in the malignancy group and 1 533 in the control group. ②Compared with the control group, women in the malignancy group had a significantly lower gestational age at delivery and a lower incidence of premature rupture of membranes (PROM), but significantly higher rates of intensive care unit (ICU) admission and postpartum blood transfusion (P<0.05); no significant differences were observed in other maternal or neonatal outcomes (P>0.05). ③Within the malignancy group, women diagnosed during pregnancy had a lower gestational age at delivery, higher proportions of pre-delivery hemoglobin levels <110 g/L, higher ICU admission and transfusion rates, and lower neonatal birth weight than those diagnosed before pregnancy (P<0.001). ④Among the 18 women diagnosed with malignancy during pregnancy, six received chemotherapy or surgical treatment during pregnancy, one maternal death occurred, and all neonates survived.

The incidence of pregnancy complicated by malignancy has shown an increasing trend over recent years. Women who were diagnosed before pregnancy and conceived after completing standard treatment with stable disease generally had favorable maternal and neonatal outcomes, whereas those diagnosed during pregnancy tended to have poorer outcomes. Early identification and multidisciplinary standardized management are therefore essential for improving maternal and neonatal prognosis in women with pregnancy complicated by malignancy.

To investigate the early growth and development pattern of small for gestational age (SGA) infants born to mothers with gestational diabetes mellitus (GDM).

A total of 358 pregnant women and their live singleton SGA infants delivered at Wuhan Children′s Hospital from 2012 to 2014 were selected for this study. Based on whether the mothers were diagnosed with GDM before 32 weeks of gestation, the subjects were divided into GDM group (n=44, GDM mothers and their SGA infants) and non-GDM group (n=314, mothers without GDM and their SGA infants). A prospective, birth cohort study was designed, the regular follow-ups were conducted on SGA infants of two groups and to monitor their physical development indicators. The weight for age Z-score (WAZ) and length for age Z-score (LAZ) at age of 0 (birth), 6, 12, 18, and 24 months of SGA infants, as well as the velocity of weight increments Z-score (V-WIZ) and length of increments Z-score (V-LIZ) every 6 months after birth (defined in this study as age brackets 1, 2, 3, and 4, corresponding to 0-6 months, 6-12 months, 12-18 months, and 18-24 months of age, respectively) of SGA infants, were compared between two groups and stratified by gender by Mann-Whitney U test. This study was approved by the Medical Ethics Committee of Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology (Approval No. 2010R009-F04). Informed consent forms was obtained from all participating pregnant women.

① The gestational age at delivery of pregnant women in GDM group was lower, and the incidence of hypertensive disorders of pregnancy (HDP) was higher than those in non-GDM group, and the differences were statistically significant (P<0.05). ② The V-LIZ for SGA infants at age bracket 1 in GDM group was 0.31 (-0.36, 0.92), which was lower than that of 0.80 (0.08, 1.53) in non-GDM group; meanwhile, the V-WIZ and V-LIZ for female SGA infants at age bracket 1 in GDM group were 0.90 (0.25, 1.94) and 0.01 (-0.61, 0.92), respectively, which were higher and lower than those of 0.63 (-0.18, 1.34) and 0.92 (0.01, 1.53), respectively in non-GDM group, and above differences were statistically significant (Z=-2.28, -2.27, -2.69; P=0.022, 0.028, 0.007). ③ A comparison of WAZ and LAZ curves for SGA infants in GDM group at various months of age (0, 6, 12, 18, 24 months) showed that WAZ increased rapidly before 6 months of age and LAZ increased rapidly before 12 months of age for both male and female SGA infants. Furthermore, the LAZ curve of aged 0-6 months for female SGA infants was flatter compared to male SGA infants. ④ There were no significant differences between male and female SGA infants in GDM group in V-WIZ and V-LIZ of the four age brackets, respectively (P>0.05).

The early growth patterns of SGA infants born to GDM mothers are different from those in the non-GDM group. There is a significant gender difference, which is that female SGA infants present a pattern of faster weight gain but lagging length growth before 6 months of age.

To explore the diagnostic value of multimodal functional magnetic resonance imaging (fMRI) indicators combined with clinical features for delayed brain function development in children.

A total of 241 children with delayed brain function development admitted to the Children′s Hospital of Soochow University from January 2022 to December 2024 were retrospectively selected as the study group. Another 200 healthy children who underwent physical examination during the same period in the same hospital were selected as the control group. All the children underwent multimodal fMRI to obtain the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in the subcortical white matter of the frontal, parietal, and occipital lobes (SWM-FPOL), as well as the ratios of N-acetylaspartate (NAA) to creatine (Cr) (NAA/Cr) and glutamate/glutamine complex (Glx) to Cr (Glx/Cr). Clinical data of all subjects were collected retrospectively. Univariate and multivariate analyses were performed using independent-samples t test, chi-square test, and multivariate unconditional logistic regression to identify influencing factors (multimodal fMRI indicators and clinical features) of delayed brain function development in children. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of multivariate unconditional logistic regression results based on multimodal fMRI indicators combined with clinical features for delayed brain function development in children. There were no statistically significant differences in general clinical data such as age and gender ratio between two groups (P>0.05). This study was approved by the Ethics Committee of the Children′s Hospital of Soochow University (Approval No. 2025cs129).

①The proportion of neonatal asphyxia, maternal complications during pregnancy and perinatal period, premature birth, infant diseases, parental mental retardation, ADC values and Glx/sCr of SWM-FPOL in study group were higher than those in control group, while the parents′ education level, birth weight, and FA values and NAA/Cr level of SWM-FPOL were significantly lower than those in control group, and all the differences were statistically significant (P<0.05). ②Multivariate unconditional logistic regression analysis showed that maternal complications during pregnancy and perinatal period (OR=2.635, 95%CI: 1.388-5.002), preterm birth (OR=3.047, 95%CI: 1.712-5.422), parental mental retardation (OR=4.533, 95%CI: 2.323-8.844), high ADC value of SWM-FPOL (OR=3.642, 95%CI: 2.253-5.887), high Glx/Cr of SWM-FPOL (OR=6.487, 95%CI: 3.430-12.265) were independent risk factors for delayed brain function development in children, while high NAA/Cr of SWM-FPOL (OR=0.152, 95%CI: 0.084-0.275) was its independent protective factor (P<0.05). ③The ROC curve analysis results showed that the area under the curve (AUC) of maternal complications during pregnancy and perinatal period, preterm birth, parental mental retardation, and ADC value, NAA/Cr, Glx/Cr of SWM-FPOL alone and these six indicators combined diagnoses of delayed brain function development in children were 0.617, 0.636, 0.616, 0.731, 0.803, 0.787 and 0.919 respectively (all P<0.05).

The combination of clinical features of child such as maternal complications during pregnancy and perinatal period, preterm birth, and parental mental retardation with fMRI indicators of child (ADC value, Glx/Cr, and NAA/Cr of SWM-FPOL) has a relatively high value in the diagnosis of delayed brain function development in children.

To analyze the clinical features of Chlamydia pneumoniae pneumonia in children (CPP).

A total of 174 children with CPP admitted to the Suzhou University Affiliated Children′s Hospital from July 2023 to April 2025 were selected as research subjects. Based on the type of infection, they were divided into two groups, group A (n=96) and group B (n=78). The group B was further categorized into three subgroups according to the types of pathogens: subgroup B1 (n=40, mixed viral/mycoplasma pneumoniae infections), subgroup B2 (n=25, mixed bacterial infections), and subgroup B3 (n=13, mixed viral/mycoplasma pneumoniae and bacterial infections). The clinical manifestations, laboratory test results, and imaging characteristics were compared retrospectively. The study followed the standards set by the Medical Ethics Committee of the Suzhou University Affiliated Children′s Hospital and got the committee′s approval (Approval No. 2025CS134), and informed consent from the children′s guardians were obtained.

①Among 174 children with CPP, 96 cases (55.2%) had isolated CP infection, while 78 cases (44.8%) had mixed infections; the majority were male (64.9%, 113/174) and over 6 years old (90.8%, 158/174), averaging 14 days of illness. All children had cough symptoms, 76 cases (43.7%) had fever, and 138 cases (79.3%) had sputum production. Among children with mixed infections, rhinovirus (HRV) had the highest detection rate (27/78, 34.6%), followed by Staphylococcus aureus (12/78, 15.4%). ②The incidence of wheezing in group A was significantly lower than that in subgroup B1, with the difference reaching statistical significance (P<0.05). In group A, the incidence of moderate fever was significantly higher, whereas the incidence of high fever was significantly lower than that in subgroup B2, and both differences were statistically significant (P<0.05). In addition, the incidence of vomiting in group A was significantly lower than that in subgroup B3, and the difference was also statistically significant (P<0.05). ③Comparisons of white blood cell count (WBC), neutrophil percentage (NEUT%), hs-CRP, alpha-hydroxybutyrate dehydrogenase(α-HBDH), alanine aminotransferase (ALT), and creatine kinase-MB isoenzyme (CK-MB) levels between group A and groups B1, B2, and B3 showed no significant differences (P>0.05). ④Imaging examination results showed that unilateral lung involvement was more common (71.8%, 125/174), with the right lower lobe being the most commonly affected area (19.5%, 34/174), and lesions involving ≥2 lung lobes were observed in 74 cases (42.5%).

The incidence of mixed infections in children with CPP is high. The younger they are, the more likely they are to have mixed infections, which come with more severe symptoms. For children with CPP, we should actively test for pathogens to quickly identify mixed infections and offer targeted treatments.

To investigate the clinical characteristics, genetic features, and follow-up outcomes of children with MECP2 gene mutations.

A retrospective analysis was conducted on the clinical data of 15 children with MECP2 gene mutations diagnosed by molecular testing at the First Affiliated Hospital of Anhui Medical University from October 2017 to March 2025. Data collected included general information, clinical phenotypes, auxiliary examination results, treatment, and follow-up records. Whole-exome sequencing (WES) was performed to detect gene mutations in the children and their parents, with Sanger sequencing for verification and pedigree co-segregation analysis. Pathogenicity grading was performed according to the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) guidelines, combined with RTT diagnostic criteria and clinical staging for comprehensive evaluation. This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Approval No. PJ-2024-12-62), and all legal guardians of the subjects provided written informed consent.

① Among the 15 children, 11 were female and 4 were male. Ten cases met the diagnostic criteria for typical RTT, three were atypical RTT, and two did not meet the RTT diagnostic threshold (one case with pervasive developmental delay and regression, and one with autism spectrum disorder). All typical RTT cases exhibited developmental regression, loss of hand function and language ability, and associated with hand stereotyped movements. Male children showed significant clinical phenotypic heterogeneity. ②At initial diagnosis, six cases had coexisting epilepsy, two had only abnormal electroencephalogram (EEG), and three of the seven with normal EEG developed epilepsy during the course of the disease. At initial diagnosis, 2 cases exhibited abnormal cranial MRI findings. Among the 15 pediatric patients, 5 cases had nonsense mutations, 4 cases had missense mutations, 4 cases had frameshift/splicing site mutations, and 2 cases had copy number variations (CNV). Of these, 12 cases presented with novel mutations, and 3 cases were maternally inherited. According to the ACMG/AMP guidelines, all identified mutations were classified as pathogenic (L) or potentially pathogenic (LP), including a frameshift mutation (p.L383Profs*5) reported for the first time in this study. Among the 13 RTT patients, 10 were in stage Ⅱ at initial diagnosis, and 3 were in stage Ⅰ. Follow-up ranged from 2 to 96 months. Three male patients died, all exhibiting rapid disease progression with severe complications. The disease progression in 9 RTT patients was observed over time, with 1 case showing no progression and 2 cases with stable conditions (non-RTT). Among the 9 cases finally diagnosed with epilepsy, 3 cases were refractory epilepsy with poor prognosis, 4 cases had well-controlled epilepsy, and 2 cases had controlled epilepsy after short-term follow-up.

MECP2 gene mutations are associated with significant clinical phenotypic heterogeneity. Female patients predominantly present with classic RTT phenotypes, while male patients exhibit rapid disease progression and poor prognosis, manifesting as developmental delay or severe fatal encephalopathy. Epilepsy control is correlated with the degree of functional preservation.

To explore the effects of the double-lumen water balloon combined with oxytocin on cervical ripening and impact on pregnancy outcomes in term pregnant women with borderline oligohydramnios.

A total of 88 term borderline oligohydramnios pregnant women who delivered at the Chaohu Hospital Affiliated to Anhui Medical University between March 2021 and March 2024 were selected as the study subjects. They were randomly divided using a random number table method into study group (n=44, inducing labor with double-lumen water balloon combined with oxytocin) and control group (n=44, inducing labor with oxytocin). The cervical ripeness before and after induced labor, induction outcomes, neonatal outcomes, and adverse pregnancy outcomes were compared between two groups using the independent-samples t test or chi-square test, as appropriate. This study was approved by the Medical Ethics Committee of Chaohu Hospital Affiliated to Anhui Medical University (Approval No. KYXM202103-053). There were no significant differences in baseline characteristics, including maternal age, gestational age, and gravidity between the two groups (P> 0.05).

①After labor induction, the scores of cervical position, cervical consistency, cervical dilation, cervical effacement, and fetal station and the total Bishop score were all significantly better in the study group than those in control group (t=11.58, 9.51, 11.03, 11.07, 9.98, 6.24; all P<0.001). The proportion of vaginal delivery in study group was 93.2% (41/44), which was significantly higher than that in control group (77.3%, 34/44) (χ²=5.57, P=0.018). The induction bleeding volume and postpartum blood loss in study group were significantly lower than those in control group, and the durations of the first and third stages of labor were significantly shorter in the study group (t=2.37, P=0.020; t=2.85, P=0.005; t=3.23, P=0.002; t=8.80, P<0.001). ②There were no significant differences between two groups in neonatal birth weight and Apgar score at 5 min after delivery (P>0.05). ③The overall incidence of adverse pregnancy outcomes was significantly lower in study group than that in control group [2.3% (1/44) vs 13.6% (6/44), χ²=3.88, P=0.049].

The combination of a double-lumen water balloon with oxytocin has certain value in promoting cervical ripening and increasing vaginal delivery rates in full-term pregnant women with borderline oligohydramnios.

To explore the value of early (within 24 hours after birth) platelet parameters combined with serum granulocyte colony-stimulating factor (G-CSF) level in predicting 72 hours withdrawal failure in extremely preterm infants with broncho-pulmonary dysplasia (BPD).

A total of 106 cases of extremely preterm infants with BPD who received invasive mechanical ventilation treatment at Changzhou Maternal and Child Health Care Hospital from July 2020 to July 2023 were selected as research subjects. Based on the weaning outcome within 72 hours after the first extubation, the infants were divided into failure group (n=32, those who needed reintubation within 72 hours after the first extubation due to respiratory failure or other reasons) and success group (n=74, those who did not need reintubation within 72 hours after the first extubation). The platelet parameters [platelet count (PLT), platelet distribution width (PDW), and mean platelet volume (MPV)] and serum G-CSF level within 24 hours after birth, as well as perinatal and general information of infants in two groups were collected by prospective study method and were compared using independent-samples t tests and chi-square test. Multivariate unconditional logistic regression analysis was used to analyze the influencing factors of weaning failure within 72 hours after the first extubation in extremely preterm infants with BPD. Receiver operating characteristic (ROC) curve was used to assess the predictive value of early platelet parameters and serum G-CSF level for weaning failure within 72 hours after the first extubation in extremely preterm infants with BPD. The procedures followed in this study complied with the standards of the Medical Ethics Committee of Changzhou Maternal and Child Health Care Hospital and were approved by the committee (Approval No. 202070).

①Among 106 extremely premature infants with BPD who underwent invasive mechanical ventilation, 32 cases required reintubation within 72 hours after after first extubation, and the failure rate was 30.2%. ②The intrauterine infection rate was higher in failure group than that in success group, and the duration of invasive mechanical ventilation before the first extubation was longer than that in success group, and the early MPV and serum G-CSF were higher than those in success group, and all the differences were statistically significant (χ²=4.66, P=0.031; t=3.66, P=0.001; t=4.43, P=0.001; t=2.07, P=0.041). ③Multivariate unconditional logistic regression analysis showed that the duration of invasive mechanical ventilation before the first extubation (OR=4.495, 95%CI: 2.588-7.806), early MPV (OR=3.086, 95%CI: 1.777-5.359), and early serum G-CSF level (OR=3.747, 95%CI: 2.158-6.507) were all independent factors influencing weaning failure within 72 hours after the first extubation in extremely preterm infants with BPD (P<0.05). ④ROC curve analysis showed that the sensitivities of early MPV and serum G-CSF level alone and in combination for predicting weaning failure within 72 hours after the first extubation in extremely preterm infants with BPD were 73.9% (95%CI: 64.2%-85.2%), 75.1% (95%CI: 67.1%-89.4%), and 84.2% (95%CI: 75.6%-93.5%), respectively; the specificities were 77.4% (95%CI: 69.1%-86.3%), 68.2% (95%CI: 60.2%-76.5%), and 83.9% (95%CI: 74.2%-91.3%), respectively; and the area under the curve (AUC) were 0.737, 0.712, and 0.879, respectively.

Early MPV and serum G-CSF level are associated with weaning failure within 72 hours after the first extubation in extremely preterm infants with BPD, and can be used to assist in predicting the risk of weaning failure within 72 hours after the first extubation in these infants.

To explore the influencing factors of postoperative infection in patients with gynecological malignant tumors.

A total of 234 patients with gynecological malignancies who underwent surgical treatment at the Department of Gynecology, Chongqing General Hospital, Chongqing University from April 2020 to March 2023 were selected as the study subjects. Among them, 80 cases were cervical cancer, 107 cases were ovarian cancer, and 47 cases were endometrial cancer. Patients were divided into infection group (n=55) and non-infection group (n=179) based on whether they developed postoperative infection. A retrospective analysis was conducted to collect general clinical data and preoperative, surgical, and postoperative data from both groups, and comparative analyses were performed using independent-samples t test and chi-square test. Multivariate unconditional logistic regression analysis was used to analyze the independent influencing factors of postoperative infection in gynecological malignant tumor patients. There were no statistically significant differences in age, body mass index (BMI), or other general clinical data between two groups (P>0.05). The procedures followed in this study were approved by the Medical Ethics Committee of Chongqing General Hospital, Chongqing University (Approval No. KYS2022-012-01).

①Among 234 patients with gynecological malignancies, 55 cases (23.5%) developed postoperative infections. Of the 55 infected patients, 60 strains of pathogens were cultured, with Escherichia coli having the highest incidence (32/55, 58.2%), followed by Pseudomonas aeruginosa (5/55, 9.1%), Enterobacter cloacae subsp. cloacae (4/55, 7.3%), and Klebsiella pneumoniae (4/55, 7.3%); 8 cases (14.5%) had dual bacterial infections. ②Univariate analysis revealed that there were statistically significant differences between two groups in 13 factors, including tumor type, American Society of Anesthesiologists (ASA) classification, operation duration, type of vaginal stump suture, use of drainage tube, drainage tube placement location, duration of indwelling drainage tube, number of urinary catheter insertions, duration of indwelling urinary catheter, ≥1 central venous catheterization, duration of central venous catheterization, types of postoperative use of antibiotics, and duration of antibiotic use (P<0.05). ③Multivariate unconditional logistic regression analysis showed that ASA classification Ⅲ+ Ⅳ and conventional suture for vaginal stump closure were independent risk factors for postoperative infection in patients with gynecological tumors (OR=3.266, 3.632, 95%CI: 1.361-7.645, 1.454-9.072, P=0.008, 0.006). Compared to postoperative cephalosporin antibiotics alone, postoperative use of non-cephalosporin antibiotics was an independent protective factor against postoperative infection in patients with gynecological malignancies (OR=0.298, 95%CI: 0.127-0.702, P=0.006). Compared to postoperative antibiotic use for 1-3 days, postoperative antibiotic use for 4-7 days and ≥8 days were also independent protective factors against postoperative infection in patients with gynecological malignancies (OR=0.103, 0.073, 95%CI: 0.031-0.340, 0.019-0.277, both P<0.001).

ASA classification, vaginal suture type, type of postoperative antibiotics used, and duration of postoperative antibiotic use are all independent influencing factors for postoperative infection in patients with gynecological malignancies. Postoperative nutritional intervention, intraoperative antimicrobial suture utilization, proper postoperative use of antibiotics and standardized postoperative antibiotic protocols may effectively reduce the risk of postoperative infection in patients with gynecological malignancies.

To explore the therapeutic effects of surgical treatment for patients with refractory postpartum hemorrhage (IPPH) after cesarean sections.

Clinical research literature on the efficacy of surgical treatment for patients with IPPH after cesarean section was selected from databases including China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, China Biomedical Literature Database, PubMed, Embase, and Web of Science using computer-based retrieval. Key words in both Chinese and English, such as ＂cesarean section＂ ＂refractory postpartum hemorrhage＂ etc., were employed to screen clinical studies that met the inclusion and exclusion criteria of this research and had acceptable literature quality. The retrieval time frame was from January 1, 2000, to June 1, 2024. RevMan 5.3 software was used to analyze the obtained data. First, the Cochrane-Q test was applied to detect the heterogeneity among the included literature, and a random effects model or a fixed effects model was used for Meta-analysis based on the results. For the efficacy evaluation index postpartum hemorrhage(PPH) volume adopted in this study, the standardized mean difference (SMD) was used as the effect size, and its 95%CI was calculated. A funnel plot was used to evaluate the publication bias of the included literature.

According to the literature retrieval strategy set in this study, a total of 17 pieces of literature on the efficacy of surgical treatment for patients with IPPH after cesarean section were included, all of which were of grade B quality. There was significant heterogeneity among the literature. The studies involved 775 patients with IPPH after cesarean section treated surgically, and a total of eight surgical treatment methods were adopted. The SMD with PPH volume as the efficacy index for 8 methods were as follows, respectively. The SMD for the efficacy of modified B-Lynch suture combined with bilateral ascending uterine artery ligation was -2.07 (95%CI: -3.14--1.00, P<0.001); the SMD for the efficacy of modified B-Lynch suture was -0.59 (95%CI: -0.84--0.34, P<0.001); the SMD for the efficacy of bilateral ascending uterine artery ligation was -2.77 (95%CI: -4.91--0.64, P<0.001); the SMD for the efficacy of uterine artery ligation combined with intrauterine water balloon compression was -1.27 (95%CI: -1.76--0.77, P<0.001); the SMD for the efficacy of uterine artery ligation combined with Hayman suture was -5.24 (95%CI: -6.01--4.48, P<0.001); the SMD for the efficacy of Bakri balloon intrauterine packing was -3.71 (95%CI: -4.77--2.65, P<0.001); the SMD for the efficacy of pelvic vascular interventional embolization was -1.63 (95%CI: -1.92--1.34, P<0.001); and the SMD for the efficacy of uterine cross-ligature was -4.52 (95%CI: -11.26--2.22, P=0.190). The pooled effect size for the efficacy of the eight surgical treatment methods, that is, the overall SMD for efficacy was -2.46 (95%CI: -3.09--1.82, P<0.001). The efficacy of the study group (use one of the eight methods) was superior to that of the control group, and the differences were all statistically significant (P<0.05).

The existing eight surgical treatment methods, such as modified B-Lynch suture etc., have definite clinical efficacy in treating patients with IPPH after cesarean section and can be selected for individual or combined application according to the actual conditions of patients.

In recent years, against the backdrop of widespread administration of acellular pertussis (aP) vaccines, the incidence of pertussis has exhibited a resurgent trend in numerous countries across the globe. Molecular epidemiological studies have revealed that population-level variations have occurred in multiple virulence genes encoding vaccine-associated antigens of Bordetella pertussis (Bp), accompanied by the replacement of dominant clonal lineages, which may be implicated in the phenomenon of "pertussis resurgence". This review summarizes the variation characteristics of major vaccine-associated antigen genes of Bp in recent years, including pertussis toxin promoter (ptxP), pertussis toxin subunit A (ptxA), pertactin gene (prn), filamentous hemagglutinin gene (fhaB), and fimbriae gene (fim), with a focus on the analysis of their evolutionary trends in circulating strains in China and the discrepancies from the antigen components of currently used co-purified acellular pertussis vaccines (cp-ACVs). Available evidence demonstrates that vaccine immune pressure may drive the expansion of non-vaccine-type alleles such as prn deficiency, ptxP3, and ptxA1, while antimicrobial selective pressure facilitates the formation of dominant clonal clusters harboring multiple phenotypic characteristics. The aforementioned structural alterations of antigens may elevate the potential risks of vaccine antigen mismatch and immune escape. Accordingly, sustainable implementation of whole-genome sequencing-based molecular epidemiological surveillance, combined with optimization of vaccine antigen design by integrating host immune response mechanisms, constitutes a crucial strategy to counteract the continuous evolution of Bp and enhance the efficacy of pertussis prevention and control.

Acupuncture has achieved favorable clinical efficacy in the treatment of essential hypertension (EH), but the central nervous system mechanism underlying its antihypertensive effect remains to be further elucidated. Magnetic resonance imaging (MRI) technology provides objective neuroimaging evidence, facilitating the exploration of hypertension-related cerebral mechanisms and the central action pathways of acupuncture intervention. This article systematically combs and summarizes three core aspects: abnormal changes in brain function and structure in patients with EH, advances in MRI-based imaging research on acupuncture for EH, and the mechanism of action of brain regions associated with the autonomic nervous system in acupuncture-induced blood pressure reduction. Based on existing neuroimaging evidence, this review further concludes the key brain regions correlated with the antihypertensive effect of acupuncture, and analyzes the limitations of current studies—such as small sample sizes, inconsistent acupuncture protocols, and short-term follow-up duration. It aims to provide a reference for in-depth revelation of the central mechanism of acupuncture in treating EH and optimization of future research designs.

Acupuncture therapy has garnered growing attention and recognition in the clinical management of neurological disorders, attributed to its notable efficacy, favorable safety profile, and minimal adverse reactions. Over the past decade, the research paradigm of acupuncture for neurological diseases has shifted from verifying universal therapeutic effects to in-depth exploration of its action rules and underlying mechanisms, with continuous advancements toward a more profound understanding. Acupuncture has been extensively applied in major neurological conditions such as stroke, Parkinson's disease and Alzheimer's disease—two common neurodegenerative disorders—and substantial progress has been achieved in elucidating its mechanisms of action. Studies have demonstrated that acupuncture exerts unique advantages in improving motor dysfunction, cognitive impairment, and neural repair through multi-targeted, holistic regulation, with abundant and reliable evidence-based medical evidence accumulated particularly in post-stroke rehabilitation and primary insomnia. However, while advancing the standardization and normalization of acupuncture protocols, full consideration must be given to individual patient differences (e.g., age, disease stage, and constitution). Currently, high-quality evidence-based research on this therapy remains relatively insufficient, and its complex neurophysiological mechanisms urgently await further in-depth interpretation. This review summarizes the clinical research progress of acupuncture in treating neurological diseases over the past decade, aiming to provide a more practically instructive reference for the standardized application of acupuncture in the clinical diagnosis and treatment of neurological disorders.