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 application effect of comprehensive intervention measures combined with photodynamic therapy on children with condyloma acuminatum (CA).

Clinical data of 30 children with CA who received aminolaevulinic acid-photodynamic therapy (ALA-PDT) at the Department of Dermatology and Venereology, Beijing Ditan Hospital, Capital Medical University from January 2018 to December 2024 were analyzed, retrospectively. Based on conventional PDT, a series of comprehensive intervention measures such as targeted psychological intervention, full-process pain management, postoperative wound skin management, and health knowledge education were implemented for CA children and their families. After the treatment was completed, regular follow-up were conducted for 6 months to collect statistics on the treatment efficacy, treatment compliance, and related adverse reactions of the children.

Among the 30 children with CA, 18 cases were boys and 12 cases were girls, aged from 2 to 14 years old [(6.3±2.4) years old], the disease duration was 1 to 6 months [(4.2±1.2) months], the diameter of the lesions was 0.2 to 1.8 cm [(1.22±0.10) cm], and the number of lesions was 1 to 8 [(4.43±0.8)]; 20 cases (66.67%) had lesions involving the external genitalia, 8 cases (26.67%) involved the perianal, and 2 cases (6.66%) had external genitalia and perianal lesions. After PDT combined with comprehensive interventions, 22 cases (73.33%) were cured, 7 cases (23.33%) were markedly effective, and 1 case (3.33%) was ineffective. The total treatment effective rate was 96.67% (29/30). No case recurred during the follow-up for 6 months. All children completed the full course of treatment, and 25 cases (83.33%) were fully compliant, 5 cases (16.67%) were partially compliant. No serious systemic adverse reactions occurred during the treatment, and local adverse reactions were all mild to moderate, and may occur concomitantly on the same child. A total of 11 children (36.67%) had at least one local adverse reaction, 6 cases (20.00%) had pain, 6 cases (20.00%) had local erythema, 2 cases had blister erosion (6.67%), 1 case had itching with burning sensation (3.33%), and 3 cases had pigmentation (10.00%); All adverse reactions were completely relieved after local symptomatic treatment and did not affect the ALA-PDT treatment process.

After the comprehensive intervention measures combined with ALA-PDT, CA children showed good treatment compliance, and the adverse reactions can be effectively alleviated.

To investigate the role and potential mechanisms of oropharyngeal microbiota dysbiosis in the development and progression of post-coronavirus disease 2019 (COVID-19) pulmonary fibrosis (PCPF).

A cross-sectional case-control study was conducted, enrolling recovered patients who had been hospitalized for COVID-19 in Xuanwu Hospital Capital Medical University, from December 2022 to May 2023, and had completed a 2-year follow-up after discharge. According to high-resolution computed tomography findings during follow-up, patients were classified into fibrosis group and non-fibrosis group. The α-diversity of the oropharyngeal microbiota between the two groups were compared by Mann-Whitney U test; β-diversity was assessed by non-metric multidimensional scaling (NMDS) and principal coordinates analysis (PCoA). Differences in taxonomic abundance at the phylum, genus and species levels were analyzed by Benjamini-Hochberg method with false discovery rate (FDR) correction. Spearman’s rank correlation was applied to evaluate the associations between microbial taxa and clinical symptoms as well as exercise capacity.

Total of 83 patients were enrolled, 43 cases in fibrosis group and 40 cases in non-fibrosis group. During the 2-year follow-up, patients in fibrosis group had more respiratory symptoms and anxiety. Patients in fibrosis group showed significantly higher scores than non-fibrosis group in mMRC scale (U=676.0, P=0.008), BCSS score (U=625.0, P=0.029), CAT score (t=2.127, P=0.036), CET score (U=538.5, P=0.002) and Hamilton Anxiety Rating Scale score (U=634.0, P=0.039); The 6-minute walking distance of patients in fibrosis group was shorter (U=598.5, P=0.017), all with significant differences. Microbiome analysis revealed significantly elevated α-diversity of oropharyngeal microbiota in fibrosis group (Chao1 index: U=580.5, P=0.010; Shannon index: U=557.0, P=0.005; Simpson index: U=513.0, P=0.001; Faith’s phylogenetic diversity: U=579.0, P=0.010; Simpson’s evenness index: U=577.0, P=0.010; Heip’s evenness index: U=529.0, P=0.035), with significant differences. β-diversity analysis showed distinct separation of microbial community structure between the two groups. Taxonomic analysis demonstrated that the relative abundances of potential pro-inflammatory taxa, including Prevotella (U=358.0, P<0.001), Veillonella (U=418.0, P<0.001) and Streptococcus (U=538.0, P=0.003), were significantly increased in fibrosis group, whereas Neisseria (U=226.0, P<0.001) was significantly decreased. Correlation analysis indicated that the abundance of Streptococcus parasanguinis was positively associated with mMRC (r=0.24, P=0.04) and CAT (r=0.27, P=0.02). In contrast, Fusobacterium periodonticum abundance was negatively correlated with CAT (r=－0.30, P<0.01) and Warrick score (r=－0.26, P=0.02), but positively correlated with 6MWD (r=0.26, P=0.02). Furthermore, Veillonella rogosae and Streptococcus infantis were both significantly and negatively correlated with Warrick score (r=－0.30, P<0.01; r=－0.28, P=0.01).

Patients with post-COVID-19 pulmonary fibrosis exhibited persistent oropharyngeal microbial dysbiosis, which is closely associated with clinical symptoms and functional impairment. The oropharyngeal microbiome might serve as a potential non-invasive biomarker for risk assessment and a novel therapeutic target for post-COVID-19 pulmonary fibrosis.

To investigate the independent predictive factors for diagnosis of tuberculous meningitis (TBM) based on regional characteristics in Qinghai, China, and to construct and validate a diagnostic prediction model.

The clinical data of 931 patients with infectious meningitis, including 739 cases with TBM and 192 cases with non-tuberculous infectious meningitis (non-TBM) treated at Qinghai Provincial Fourth People’s Hospital from January 2019 to January 2024 were collected, retrospectively. They were divided into a training set (651 cases, including 522 cases of TBM and 129 cases of non-TBM) and a validation set (280 cases, including 217 cases of TBM and 63 cases of non-TBM) with a ratio of 7∶3. The influencing factors of TBM diagnosis were screened by Lasso regression and multivariate Logistic regression, and a nomogram prediction model was constructed. The diagnostic efficiency of five machine learning models (decision tree, Logistic regression, random forest, support vector machine and extreme gradient boosting) were evaluated and compared by the receiver operating characteristic (ROC) curve.

The general demographic data and biochemical parameters between patients in training set and validation set were without significant differences (all P>0.05); the baseline characteristics between patients in TBM group and non-TBM group across both the training set and validation set were also without significant differences (all P>0.05). By Lasso dimensionality reduction screening of predictive variables and multivariate regression analysis, a total of 6 independent predictors for TBM were identified: consciousness disorder (OR=2.988, 95%CI: 1.242-7.555, P=0.017), gamma interferon release assay (IGRA) (OR=4.279, 95%CI: 2.074-9.120, P<0.001), CSF monocyte ratio≥50% (OR=4.061, 95%CI: 1.88-9.174, P<0.001), magnetic resonance imaging (MRI) suggesting tuberculoma (OR=7.080, 95%CI: 2.019-34.77, P=0.006), MRI suggesting cranial base meningeal enhancement (OR=3.022, 95%CI: 1.429-6.519, P=0.004) and computerized tomography (CT) showing pulmonary lesions (blood disseminated tuberculosis: OR=46.140, 95%CI: 8.765-856.9, P<0.001). AUC of the Logistic regression model in training set and validation set were both 0.948 (95%CI: 0.927-0.969, 0.920-0.975), with sensitivities of 87.16% and 85.71%, and specificities of 89.92% and 90.48%. The Extreme Gradient Boosting (XGB) model performed the best in diagnosing TBM (AUC=0.954).

The Logistic regression model based on clinical and imaging features exhibits excellent diagnostic accuracy for TBM and is suitable for clinical application.

To investigate the expression profile of novel immunomodulatory factor interleukin (IL)-41 in pediatric patients with Mycoplasma pneumoniae pneumonia (MPP), and to analyze its correlation with disease severity, diagnostic efficacy and value for predicting severe progression.

Total of 32 children with MPP under 18 years old, admitted to Beijing Friendship Hospital, Capital Medical University and Hebei Yiling Hospital throughout 2024 were enrolled for retrospective cohort study, including 17 cases of mild disease (mild group) and 15 cases of severe disease (severe group), while 8 healthy children undergoing physical examinations were selected as the control group. Serum IL-41 level was detected in enrolled children by enzyme-linked immunosorbent assay (ELISA), and parameters such as gender, age, C-reactive protein (CRP), procalcitoninand (PCT) and IL-6 levels were compared, respectively. The diagnostic efficacy of these markers for severe MPP was evaluated by receiver operating characteristic (ROC) curve, the relationships between serum IL-41 level and clinical indicators were analyzed by correlation heatmaps.

Among the 32 enrolled ediatric patients with MPP, there were 11 males (34.4%) and 21 females (65.6%), with a mean age of (8.60±2.89) years old. There was no statistically significant difference in age between mild group and severe group [(9.06±3.45) years old vs. (8.07±2.09) years old] (t=0.393, P=0.697). IL-41 level of MPP children in mild group was significantly higher than that of healthy control group [(182.191±65.364) pg/ml vs. (137.628±2.914) pg/ml], with significant difference (t=2.805, P=0.013). But there were no significant difference of IL-41 level between severe group and healthy control group, or between mild group and severe group (all P>0.05). The area under the ROC curve (AUC) for diagnostic differentiation between mild group and severe group by individual biomarkers IL-41, CRP and IL-6 were 0.652, 0.590 and 0.522, respectively, all showing suboptimal performance. However, the three idicators combined AUC significantly improved to 0.768 (95%CI: 0.598-0.938, P=0.013), with the sensitivity and specificity of 93.8% and 57.1%, respectively. In mild group, the IL-41/CRP ratio [24.47 (7.4, 41.1)] and IL-41/IL-6 ratio [26.88 (9.1, 34.6)] were significantly higher than those of severe group [10.81 (1.3, 18.9) and 9.85 (1.7, 15.1)], with significant differences (Z=－3.946 and －1.957, both P<0.001). Spearman correlation analysis demonstrated a significant positive correlation between serum IL-41 and IL-6 levels of patients with MPP (r=0.64, P=0.020).

Serum IL-41 level is significantly elevated in children with mild MPP, which was elevated but without significance in severe MPP cases, suggesting that IL-41 may exert a protective effect against severe disease as an anti-inflammatory factor. Combined detection of IL-41, CRP and IL-6 enhances the diagnostic accuracy for severe MPP, and dynamic monitoring of IL-41 level may aid in disease progression assessment of patients with MPP.

To investigate the correlation between the expression levels of CXC chemokine receptor 3 (CXCR3), the ligands (CXCL10, CXCL11) and the clinical characteristics and disease severity of patients with tuberculosis.

Clinical data from 81 tuberculosis patients treated in Hebei Chest Hospital between December 2022 and October 2023 were collected and baseline characteristics among tuberculosis patients with different disease severities were compared; the correlation between the positive expression rates of chemokine CXCR3, CXCL10 and CXCL11 and tuberculosis lesion severity were analyzed by a generalized mixed-effects model; the associations between immune microenvironment indicators and the positive expression rates of chemokine CXCR3, CXCL10 and CXCL11 were analyzed by Pearson correlation analysis; the predictive accuracy of the positive expression rates of chemokine CXCR3, CXCL10 and CXCL11 for tuberculosis lesion severity were evaluated; the predictive performance of these chemokine expression rates were assessed by DeLong test and receiver operating characteristic (ROC) curves.

Among the 81 pulmonary tuberculosis patients, 52 cases were male and 29 cases were female, with a mean age of (42.95±6.83) years old. Tuberculosis patients with a history of smoking, no BCG vaccination and poor ventilation showed significantly higher positive expression rates of CXCR3, CXCL10 and CXCL11 (all P<0.05). The tuberculosis patients with B cells<16%, CD4⁺ T lymphocytes<30%, CD8⁺ T lymphocytes<31%, natural killer (NK) cells<15% and macrophages≥66% showed significantly elevated positive expression rates of CXCR3, CXCL10 and CXCL11 (all P<0.05). Hierarchical regression analysis showed that smoking history had a significantly positive impact on the positive expression rates of CXCR3 (t=1.574, P=0.002), CXCL10 (t=1.638, P=0.015) and CXCL11 (t=3.175, P=0.025) of patients with pulmonary tuberculosis. BCG vaccination history and poor ventilation had significantly negative effects on the positive expression rates of CXCR3, CXCL10 and CXCL11, with significant differences (BCG vaccination history: t=－0.809, P=0.008; t=－1.975, P=0.019; t=－4.546, P=0.022; poor ventilation: t=－1.503, P=0.015; t=－1.335, P=0.007; t=－2.324, P=0.008). As the severity of pulmonary tuberculosis progressed, smoking history (χ²=31.867, P<0.001), ventilation condition (χ²=15.178, P=0.001), macrophage ratio (F=9.921, P<0.001), CXCR3 positivity (χ²=18.277, P<0.001), CXCL10 positivity (χ²=15.178, P=0.001) and CXCL11 positivity (χ²=19.708, P<0.001) increased gradually among patients with pulmonary tuberculosis. BCG vaccination history (χ²=15.178, P=0.001), B cells (F=10.947, P<0.001), CD4⁺ T lymphocytes (F=11.471, P<0.001), CD8⁺ T lymphocytes (F=10.911, P<0.001) and NK cells (F=11.124, P<0.001) levels decreased gradually, with significant differences. The results of the generalized linear mixed-effects model analysis showed that compared with patients who were negative for CXCR3, CXCL10 and CXCL11, the risk of mild lesion severity of patients with positive CXCR3, positive CXCL10 and positive CXCL11 in pulmonary tuberculosis were 2.125, 2.080 and 2.153, respectively; OR for moderate lesion severity were 2.723, 3.294 and 1.934, respectively; and OR for severe lesion severity were 2.832, 2.501 and 2.271, respectively. Pearson correlation analysis results showed that B cells, CD4⁺ T lymphocytes, CD8⁺ T lymphocytes and NK cells were significantly and negatively correlated with the positive expression rates of CXCR3, CXCL10 and CXCL11 (all P<0.001), while macrophages were significantly and positively correlated with the positive expression rates of CXCR3, CXCL10 and CXCL11 (r=0.463, 0.489, 0.677, all P<0.001). The prediction of three combined indicators for the severity of pulmonary tuberculosis lesions (moderate-severe and severe) had a significantly higher accuracy rate than any single indicator alone (all P<0.05). The results of ROC curve analysis showed that the optimal cut-off values for combined prediction on the severity of pulmonary tuberculosis lesions as moderate-severe or severe were 82.75% and 95.71%, respectively. DeLong test indicated that the combined prediction of three factors had a higher efficacy (AUC) than individual factor (all P<0.05).

The positive expression rates of CXCR3, CXCL10 and CXCL11 are closely related to the clinical characteristics and lesion severity of patients with pulmonary tuberculosis, which may be involved in local immune regulation of pulmonary tuberculosis.

To investigate the effect of acupoint application of Xiaoluosan on cytokines and T lymphocyte subsets in children with Mycoplasma pneumoniae pneumonia (MPP).

Clinical data of 102 children with MPP in the Department of Pediatrics, Taihe Traditional Chinese Medicine Hospital affiliated to Anhui University of Traditional Chinese Medicine from October 2023 to October 2024 were collected. Total of 102 random numbers were generated and sorted either in ascending order or according to an odd-even criterion; odd-numbered numbers were assigned to the experimental group (51 cases) and even-numbered numbers to control group (51 cases). Children in control group received treatment with azithromycin, while those in experimental group additionally received Xialuosan patch application. Clinical efficacy, improvement of signs and symptoms, lung function indicators, serum cytokine levels, distribution of T lymphocyte subsets and incidence of adverse reactions of MPP cases between experimental group and control group were compared by Mann-Whitney U test or Pearson χ² test.

Compared with baseline levels before treatment, the forced vital capacity (FVC), peak flow velocity (PEF) and the ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC) increased significantly in both groups; but the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) reduced significantly, all with significant differences (all P<0.05). The clinical total effective rate (98.04%, 50/51), FVC (2.70±0.43) L, PEF (6.54±0.82) L/s and FEV1/FVC (76.59±6.88) of cases in experimental group were significantly higher than those of control group [clinical total effective rate: 76.47%, 39/51, FVC: (2.18±0.31) L, PEF: (5.27±0.70), FEV1/FVC: (70.92±6.14)] (χ²=10.667, t=7.005, t=8.412, t=4.391; all P<0.001). The recovery time of routine blood test indices (t=7.223, P<0.001), disappearance time of cough (t=6.631, P<0.001), disappearance time of wheezing and dyspnea (t=4.856, P<0.001), disappearance time of pulmonary rales (t=8.788, P<0.001) and defervescence time (t=12.097, P<0.001) were all significantly shortened in the experimental group. Serum levels of IL-6 [(6.44±0.78) pg/ml vs. (9.55±1.21) pg/ml: t=15.428, P<0.001], TNF-α [(8.24±0.93) pg/ml vs. (10.93±1.32) pg/ml: t=11.897, P<0.001] and CRP [(1.21±0.21) mg/L vs. (2.09±0.34) mg/L: t=15.726, P<0.001] of cases in experimental group were significantly lower than those of control group, all with significant differences. After treatment, the levels of CD3⁺ T and CD4⁺ T lymphocytes of children in both groups were significantly higher than those of pre-treatment levels, while the level of CD8⁺ T lymphocytes was significantly decreased (all P<0.05). After treatment, the levels of CD3⁺ T lymphocytes [(71.02±7.83)%] and CD4⁺ T lymphocytes [(43.28±5.24)%] of cases in experimental group were significantly higher than those of control group [(67.55±6.42)% and (38.99±4.65)%], whereas the CD8⁺ T lymphocyte level [(18.24±1.34)% vs. (21.11±1.99)%] was significantly lower than that of control group (t=2.447, 4.373, 8.543; all P<0.001), with significant differences. The incidence of adverse reactions was 7.84% of cases in control group and 1.96% in experimental group, but without significant difference (χ²=1.950, P=0.161).

Xiaoluosan acupoint application to MPP children can effectively reduce the levels of IL-6, TNF-α and CRP, inhibit inflammatory response, regulate T lymphocyte subsets and enhance the clinical efficacy.

To investigate the clinical characteristics of anti-tuberculosis drug-induced liver injury (AT-DILI) and identify the influencing factors of nonrecovery outcomes, so as to provide evidence for risk identification and follow-up the management during anti-tuberculosis therapy.

Clinical data of 136 patients with AT-DILI admitted to the Fourth People’s Hospital of Qinghai Province from January 2020 to May 2024 were collected, retrospectively, including demographic characteristics, underlying liver disease, time to liver injury onset, clinical pattern of AT-DILI, severity grade, laboratory indicators, treatment and outcomes. Patients were divided into improved group (112 cases) and unresolved group (24 cases) according to the clinical outcomes, and clinical characteristics were compared between the two groups by a unified set of variables. The influencing factors for unrecovery outcomes in patients with AT-DILI were analyzed by Univariate and multivariate Logistic regression analyses. Receiver operating characteristic (ROC) curves were established based on the predicted probabilities from the final Logistic regression model, which contained hepatitis B and gamma-glutamyl transferase (GGT) level, and to evaluate the discriminative performance of this model for nonrecovery outcomes in patients with AT-DILI.

Among the 136 patients, 86 (63.2%) were male and 50 (36.8%) were female; 69 (50.7%) patients were complicated with hepatitis B, and 18 (13.2%) patients received artificial liver support therapy. Overall, 112 patients (82.4%) recovered or improved, whereas 24 (17.6%) patients had nonrecovery outcomes. AT-DILI mainly occurred during 60 days after initiation of anti-tuberculosis therapy (118 cases, 86.8%). Cholestatic pattern was the most common (96 cases, 70.6%), and grade 4 liver injury was the most common severity grade (49 cases, 36.0%). Age distribution, whether complicated with hepatitis B, severity of liver injury, drug resistance status, GGT, serum sodium (Na), procalcitonin (PCT) and hemoglobin (Hb) between the improved group and unresolved group of patients with AT-DILI were significantly different (all P<0.05). Multivariate Logistic regression analysis showed that hepatitis B (OR=7.838, 95%CI: 2.039-30.130, P=0.003) and GGT level (OR=1.012, 95%CI: 1.001-1.024, P=0.046) were both influencing factors of unresolved outcomes for patients with AT-DILI. The combined model based on hepatitis B and GGT level showed certain discriminative performance for nonrecovery (AUC=0.886, 95%CI: 0.819-0.953, P<0.001).

AT-DILI often occurs in early stage of anti-tuberculosis treatment, so liver function monitoring within the first two months after medication administration should be emphasized. Concomitant hepatitis B and elevated GGT level are risk factors for unresolved outcomes in patients with AT-DILI, which can serve as reference indicators for early identification of high-risk patients and the follow-up management.

To investigate the clinical characteristics of pediatric patients with pertussis across different age groups.

Clinical data of 567 pediatric patients with pertussis diagnosed at Chengdu Public Health Clinical Medical Center from January 2022 to December 2024 were analyzed, retrospectively. Patients were grouped into≤3 months group (118 cases), 3-36 months group (180 cases), 36 months-6 years old group (115 cases) and>6 years old group (154 cases). General information, vaccination history, epidemiological characteristics, clinical manifestations, and laboratory test results [white blood cell (WBC) count, absolute lymphocyte count (ALC) and platelet (PLT) count] were collected, respectively. Intergroup comparisons were performed by Chi-square test or Kruskal-Wallis H test.

Among the 567 enrolled children, the incidence rates were higher in 36 month-6 years old [20.3% (115/567)] and>6 years old groups [27.2% (154/567)] , respectively; Cases occurred throughout the year, with a peak incidence in summer (61.2%, 347/567), followed by spring (22.4%, 127/567); while 262 children (46.2%) were unvaccinated or not fully immunized. The main clinical symptoms included paroxysmal spasmodic cough (84.7%, 480/567), vomiting (35.8%, 203/567) and crowing-like stridor (29.6%, 168/567). The incidence of paroxysmal spasmodic cough (χ²=38.36, P<0.001), crowing stridor (χ²=47.44, P<0.001), wet rales or wheezing (χ²=92.22, P<0.001) and pneumonia (χ²=47.49, P<0.001) were significantly different among children with pertussis of all age groups; moreover, the incidence decreases with age increasing in pediatric patients, both≤3 month old group and 3-36 month old group exhibiting significantly higher rates of these clinical manifestations compared with>6 years old group (all P<0.001). White blood cell (WBC) count (H=68.65, P<0.001), absolute lymphocyte count (ALC) (H=163.25, P<0.001) and platelet (PLT) count (H=190.72, P<0.001) were significantly different among children with pertussis of all age groups; the above mentioned indicators were significantly higher in≤3 month old group and 3-36 month-old group compared with 36 month to 6 years old group and>6 years old group, all with significant differences (all P<0.001).

Clinical manifestations of pertussis in young children are typical, particularly evident in infants aged≤3 months. WBC, ALC and PLT levels are generally elevated in young pediatric patients, which provides valuable reference for early diagnosis of pertussis when combined with clinical presentations.

To conduct a bibliometric visualization analysis of research on liquid chromatography-tandem mass spectrometry (LC-MS/MS) in blood concentration detection using Chinese databases, aiming to reveal its research status, evolution trajectory and frontier hotspots.

Relevant literature was systematically retrieved from the CNKI, the VIP Chinese Journal Service Platform, and Wan fang Database. Visualization analysis was performed using CiteSpace 6.3.R1 software.

A total of 2743 articles were included, with annual publication volume showing a phased characteristic of slow growth, rapid increase and subsequent stabilization. The top three institutions by publication volume were China Pharmaceutical University, the Second Xiangya Hospital of Central South University, and Central South University. The main contributing authors were research teams led by Wen Yuguan and Wen Aidong as core members. Keywords with high frequency included "pharmacokinetics", "LC-MS/MS" and "blood drug concentration". Keyword evolution analysis indicated that the research has progressed through three stages: Methodology establishment, application expansion and clinical precision. Current hotspots focus on therapeutic drug monitoring, ultra-performance liquid chromatography-tandem mass spectrometry and personalized medication research targeting specific drugs and populations.

LC-MS/MS technology has become an indispensable core analytical platform for blood drug concentration detection. The research system is mature and continuously deepening its integration into clinical practice. Future efforts should strengthen collaboration among institutions and authors, continuously improve techniques, refine methodological standardization, and expand application scenarios to further promote the development of individualized drug therapy.

To explore the current landscape of artificial intelligence (AI) models built on clinical laboratory data for predicting chronic kidney disease (CKD)-related outcomes.

Following the PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Web of Science, Scopus, China National Knowledge Infrastructure(CNKI), and Wanfang Databases to identify studies employing AI algorithms with clinical laboratory data to predict CKD outcomes.

16 studies were ultimately included, spanning data from 6 countries, with sample sizes ranging from 308 to 4.8 million participants. Random forest and gradient boosting algorithms are the most widely adopted modeling algorithms. Beyond estimated glomerular filtration rate and serum creatinine, several auxiliary biomarkers demonstrated independent predictive value including urine albumin-to-creatinine ratio, serum albumin, hemoglobin, cystatin C, and glycosylated hemoglobin spanning the domains of renal function, metabolism, nutrition, and hematology. The best-performing models across included studies achieved area under curve values ranging from 0.689 to 0.993.

AI predictive models built on clinical laboratory data demonstrate promising performance across multiple CKD outcome categories, with the integration of multidimensional laboratory biomarkers offering a clear advantage over conventional single-marker assessment frameworks.

Hematology analyzers serve as the most fundamental and widely used disease screening tool in clinical practice, offering a multidimensional detection system that provides numerical results such as complete blood count, white blood cell differential count and cell population data (CPD), alongside graphical data including scattergrams and histograms. However, universal review criteria based on cell counts and instrument flags fail to adapt to the specimen characteristics of different medical institutions, thus resulting in high false-negative risks and a heavy review burden. In recent years, artificial intelligence (AI) has achieved breakthrough advances in medical image recognition, providing a novel approach for the intelligent analysis of hematological graphical data. This paper systematically examines the feasibility of integrating multidimensional signal features from hematology analyzers with traditional review criteria, and divides the development of AI-assisted re-examination workflow into 4 stages: Traditional rule implementation, feature-parameter modeling, intelligent graphical data analysis, and multimodal data fusion. It elaborates on CPD-based machine learning screening methods, the strengths of deep learning in graphical analysis, and the clinical efficacy of multimodal fusion, while analyzing core challenges including the scarcity of high-quality datasets, the algorithmic "black box" issue, and the lack of standardized evaluation frameworks. Looking ahead, the construction of an integrated intelligent review system incorporating numerical parameters, graphical features and clinical information will enhance the detection capacity for abnormal specimens via human-machine collaboration, thereby reducing unnecessary manual reviews.

The development of smart clinical laboratories has gradually evolved from isolated functional applications toward integrated, end-to-end process collaboration. However, three core challenges remain: weak data governance infrastructure, inadequate organizational coordination, and limited data sharing and reuse. These factors collectively constrain the substantive transition from "informatization" to "intelligentization". This article, grounded in the ISO 15189 quality management framework, conducts a systematic analysis across 4 dimensions: Connotative characteristics, current development status, challenges faced, and implementation strategies. Accordingly, it proposes a phased construction pathway based on a "unified data foundation plus scenario-based applications" an organizational collaboration mechanism characterized by "laboratory-led, IT-coordinated, and management-involved" governance, and a data governance framework that ensures security, compliance, and trusted sharing. The value of this article lies in advancing the emerging concept of smart clinical laboratories from vague understanding to actionable strategic design, offering practical references for medical institutions pursuing intelligent transformation.