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.

Ferroptosis is a type of programmed cell death characterized by iron-dependent lipid peroxidation accumulation, playing a significant role in the development of ischemic stroke (IS) and cerebral ischemia-reperfusion injury. Traditional Chinese medicine can intervene in the ferroptosis process by regulating key mechanisms such as iron metabolism imbalance, abnormal lipid peroxidation accumulation, and the antioxidant defense system, thereby exerting neuroprotective effects. This article reviews the primary mechanisms of ferroptosis in IS and the research progress of traditional Chinese medicine interventions, aiming to provide new research insights for the prevention and treatment of IS.

This article systematically reviews the concept of brain-heart health managers and explores their practice in the health management of stroke patients. Through in-depth analysis of the workflow and mode of the brain-heart health manager, it aims to provide theoretical basis and practical experience for establishing the specific work responsibilities of the profession and constructing effective management strategies, thus providing optimized solutions for the prevention and treatment of stroke in China.

To compare the symptoms, laboratory indicators and prognostic outcomes between patients of fever with thrombocytopenia syndrome (SFTS) and scrub typhus.

The demographic and clinical characteristics (gender, age, occupation, clinical manifestations, laboratory test results and imaging examination results) of 33 patients with SFTS and 17 patients with scrub typhus admitted to the Department of Infectious Diseases, Zhongnan Hospital of Wuhan University from April to June 2025 were collected. The condition changes and outcomes of the patients from admission to day 28 were observed, while the survival time from onset to death of deceased patients were recorded. The cases were diagnosed by the nucleic acid of Dabie bandavirus and targeted next-generation sequencing detection methods. Patients with SFTS and scrub typhus were treated with favipiravir and omalizumab, respectively. Comparisons of quantitative data were performed by the independent samples t-test or rank sum test, while count data was analyzed by Fisher’s exact probability method. Survival period was analyzed by the Kaplan-Meier method, and survival processes were compared by log-rank test.

All patients with SFTS and scrub typhus were farmers, with no statistically significant differences in gender (P=0.327) or age at onset (t=1.673, P=0.101). Clinical manifestations: patients of both groups exhibited fever, but without statistically significant difference (P=1.000). Compared with patients of scrub typhus, the proportions of bleeding (39.4% vs. 0.0%: P=0.002) and neurological involvement (51.5% vs. 0.0%: P<0.001) of patients with SFTS were significantly higher, while the proportions of patients with rash (9.1% vs. 88.2%: P<0.001), eschar (0% vs. 29.4%: P=0.003) and muscle pain (33.3% vs. 64.7%: P=0.042) were significantly lower, all with significant differences. The differences of imaging examinations revealed pulmonary infection (P=0.129), hepatosplenomegaly (P=0.597) and lymphadenopathy (P=0.099) between the two groups were not statistically significant (by Fisher’s exact test). Among the 33 patients with SFTS, 22 were discharged after improvement and 11 died; 15 patients (45.5%) were admitted to ICU, and 6 of them underwent tracheal intubation after admission to ICU, all of whom died. All 17 patients with scrub typhus were clinically cured and discharged, and none were admitted to ICU. Log-rank test showed that the survival rate of patients with scrub typhus was higher than that of patients with SFTS, with significant difference (χ²=6.79, P=0.009). Compared with patients with scrub typhus, the counts of white blood cells (Z=4.07, P<0.001) and platelet (Z=5.04, P<0.001) were significantly decreased in patients with SFTS, while alanine aminotransferase, aspartate aminotransferase, creatine kinase isoenzyme, lactate dehydrogenase, amylase and troponin levels were significantly elevated (all P<0.05), the activated partial thromboplastin time (Z=4.62, P<0.001) and thrombin time (Z=4.92, P<0.001) were prolonged, all with significant differences.

Patients with SFTS often present hemorrhage and neurological involvement, and a high mortality rate. Laboratory tests of patients with scrub typhus mostly show mild abnormalities, with relatively minor organ damage. For patients with epidemiological history presenting rash + eschar + myalgia and suspected SFTS, empirical administration of tetracyclines is prioritized, which facilitates rapid disease control, reducing complications and improving the prognosis.

To investigate the awareness of hepatitis C prevention, treatment knowledge and the status of antiviral therapy (ART) among former hepatitis C patients in Fengtai District, Beijing, and to analyze the influencing factors.

A cross-sectional survey design was adopted to conduct on-site questionnaire surveys among hepatitis C cases whose current residential addresses were in Fengtai District, Beijing, and were reported in China Disease Prevention and Control Information System from January 2004 to December 2024. The awareness of prevention and treatment knowledge and antiretroviral therapy (ART) status of hepatitis C patients with different characteristics were analyzed by Chi-square test, and the influencing factors were analyzed by multivariate Logistic regression.

Total of 737 patients with hepatitis C were included. The highest proportion of patients were identified through screening before blood transfusion, surgery or invasive procedures (including hemodialysis), accounting for 33.8% (249/737); followed by patients identified through routine health check-ups, accounting for 32.3% (238/737); 24.2% (178/737) of participants were detected due to clinical symptoms or abnormal liver function. Among the risk behavioral factors for possible infection in epidemiological history, 32.8% (242/737) of patients had a history of invasive medical behaviors such as visits to private clinics or street-side unlicensed shops. The overall awareness rate of hepatitis C prevention and treatment knowledge in enrolled cases was 72.3% (533/737). Multivariate Logistic regression analysis showed that affordable out-of-pocket cost (>2 000 RMB: aOR=1.473, 95%CI: 1.030-2.108, P=0.034) and employment status (not retired: aOR=1.616, 95%CI: 1.022-2.557, P=0.040) were both influencing factors for the awareness rate of hepatitis C prevention and treatment knowledge among hepatitis C patients; while employment status (retired: aOR=0.556, 95%CI: 0.337-0.918, P=0.022), medical insurance type (urban employee medical insurance: aOR=3.476, 95%CI: 1.234-9.791, P=0.018; urban resident medical insurance: aOR=3.683, 95%CI: 1.295-10.473, P=0.014) and affordable out-of-pocket cost (≤2 000 RMB: aOR=0.474, 95%CI: 0.323-0.694, P<0.001) were all influencing factors for receiving ART among hepatitis C patients. Total of 657 blood samples were collected, among which, 199 were positive for HCV RNA, with a positive rate of 30.3% (199/657). Six genotypes were identified in the 199 cases with successful genotyping, and genotype 1b was the predominant strain (66.3%, 132/199).

The awareness rate of hepatitis C prevention and treatment knowledge among previously reported hepatitis C patients in Fengtai District is relatively high, but the ART treatment rate remains low. Targeted health education, treatment initiation mobilization interventions and supplementary special subsidies for low-income populations should be implemented to improve the patients’ willingness to receive ART. Continuous supervision and standardization of invasive medical practices in private clinics and unregulated medical institutions should be strengthened to cut off iatrogenic transmission routes. Hepatitis C virus antibody screening should be promoted as part of routine health check-up programs for high-risk populations, and individuals with a history of high-risk behaviors should be encouraged to proactively undergo screening, so as to achieve early detection and early diagnosis.

To investigate the clinical characteristics of patients with concurrent gastric and colonic polyps and their relationship with different subtypes of Helicobacter pylori (Hp) infection.

Total of 300 patients who underwent gastroscopy and colonoscopy in the Department of Gastroenterology, Shanghai Shibei Hospital from October 2018 to October 2023 were enrolled. According to the results of gastrointestinal endoscopy, the patients were divided into concurrent gastric and colonic polyp group (92 cases), isolated gastric polyp group (106 cases) and isolated colonic polyp group (102 cases). The clinical data, gastrointestinal endoscopy findings, Hp infection rate and subtype distribution were compared among the three groups. The independent influencing factors for gastric polyps combined with colorectal polyps of different pathological types, as well as for Hp infection in these patients were analyzed by multivariate Logistic regression analysis. The multiplicative interaction between clinical factors and Hp infection in patients with concurrent gastric and colonic polyps were analyzed by an unconditional Logistic regression model, and additive interaction was analyzed by an interaction calculation table.

Gender (χ²=7.133, P=0.028), age (F=65.696, P=0.015), body mass index (BMI) (F=27.501, P=0.036), smoking history (χ²=6.765, P=0.034), drinking history (χ²=7.797, P=0.020), Hp infection (χ²=10.460, P=0.005), fatty liver (χ²=6.031, P=0.049), diabetes mellitus (χ²=6.427, P=0.040), interleukin-6 (IL-6) (F=12.675, P=0.023) and transforming growth factor-α (TGF-α) (F=33.368, P=0.030) among the three groups were all with significant differences. Results of multivariate Logistic regression analysis showed that age (OR=2.503, 95%CI: 2.121-3.689, P=0.023), drinking history (OR=3.553, 95%CI: 2.868-4.712, P=0.009), Hp infection (OR=3.217, 95%CI: 2.614-4.386, P=0.014), fatty liver (OR=1.631, 95%CI: 1.328-2.512, P=0.036) and diabetes mellitus (OR=2.612, 95%CI: 2.181-3.711, P=0.021) were independent influencing factors for different pathological types of gastrointestinal polyps. The distribution of Hp subtypes was significantly different among the three groups (χ²=14.700, P=0.001). The infection rate of type Ⅰ Hp was significantly higher in concurrent gastric and colonic polyp group (68.52%) than that of isolated gastric polyp group (41.03%) and isolated colonic polyp group (30.95%) (χ²=6.983, P=0.008; χ²=13.359, P=0.001). Results of Logistic regression analysis revealed that age (OR=2.411, 95%CI: 1.866-3.598, P=0.012), drinking history (OR=2.315, 95%CI: 1.645-3.487, P=0.016), fatty liver (OR=2.132, 95%CI: 1.431-3.065, P=0.031) and diabetes mellitus (OR=2.268, 95%CI: 1.513-3.251, P=0.024) were all independent risk factors for Hp infection in patients with concurrent gastric and colonic polyps. Interaction analysis indicated that age (OR_{multiplicative}=5.136, 95%CI_{multiplicative}: 1.358-15.842, P_{multiplicative}=0.007; OR_additive=8.624, 95%CI_additive: 3.499-13.652, P_additive=0.003), drinking history (OR_{multiplicative}=4.954, 95%CI_{multiplicative}: 1.006-12.834, P_{multiplicative}=0.008; OR_additive=8.239, 95%CI_additive: 3.289-15.421, P_additive=0.004), fatty liver (OR_{multiplicative}=4.536, 95%CI_{multiplicative}: 1.123-10.348, P_{multiplicative}=0.009; OR_additive=8.892, 95%C_additive : 1.869-17.212, P_additive=0.002), diabetes mellitus (OR_{multiplicative}=5.360, 95%CI_{multiplicative}: 1.286-16.532, P_{multiplicative}=0.006; OR_additive=8.627, 95%CI_additive: 1.217-15.964, P_additive=0.003) and type Ⅰ Hp infection exhibited multiplicative and additive interactions in the development of concurrent gastric and colonic polyp.

Age, drinking history, fatty liver and diabetes mellitus are independent influencing factors of Hp infection in patients with gastric polyp and colonic polyp, and there is a synergistic interaction between the above factors and type Ⅰ Hp infection in the occurrence of the disease. In clinical practice, colonoscopy is recommended for patients with such gastric polyp to early detect and intervene possible coexisting colonic lesions.

Viral infectious diseases are highly diverse, with some viruses exhibiting high transmissibility or high variability, posing a persistent threat to global public health. Lipidomics, a crucial branch of metabolomics, provides unique insights into virus-host interaction mechanisms and facilitates the development of novel diagnostic and therapeutic approaches. This review systematically summarizes key applications of lipidomics in research on influenza viruses, severe acute respiratory syndrome coronavirus 2, human immunodeficiency virus, hepatitis viruses, and other viral pathogens. Studies demonstrate that these viruses exploit the host lipid metabolic network to facilitate entry, replication and immune evasion. Concurrently, dysregulation of lipid metabolites, such as eicosanoids, sphingolipids and lysophospholipids are closely associated with pathological processes including cytokine storms, tissue damage and disease progression. This review underscores the pivotal role of lipid metabolism in antiviral therapy and evaluates its translational potential, thereby offering innovative perspectives for the prevention and control of viral infectious diseases.

Helicobacter pylori is one of the most important pathogens causing human gastrointestinal diseases and has been classified as a Group 1 carcinogen by the World Health Organization (WHO). Accurate detection of Helicobacter pylori is of great significance for clinical diagnosis and treatment. Currently, a variety of routine clinical diagnostic methods are available, with serological antibody detection, ¹³C/¹⁴C urea breath test (UBT), microaerophilic culture and histological staining being the most commonly used. However, due to the overuse of antibacterial agents, Helicobacter pylori drug resistance has become increasingly prevalent, rendering traditional detection methods inadequate to fully meet the demands of personalized medicine. Molecular detection technologies, which target drug resistance and virulence genes, have emerged as crucial tools urgently required for clinical practice and scientific research, providing novel solutions for clinical management. This review summarizes the research progress of molecular detection methods for Helicobacter pylori, discusses their clinical application value and technical limitations, and aims to provide a theoretical basis for the selection of individualized and precise diagnosis and treatment strategies for Helicobacter pylori infection.

To investigate the short-term efficacy of anisodamine hydrobromide (654-1) combined with blood purification therapy in patients with septic shock.

The clinical data of 76 patients with septic shock admitted to Linfen People’s Hospital between December 2023 and March 2025 were analyzed, retrospectively. According to different treatment strategies, patients were divided into blood purification group (41 cases), who received conventional anti-infection therapy, fluid resuscitation and blood purification; and patients in 654-1+blood purification group (35 cases) received additional 654-1 on the basis of conventional treatment and blood purification. The baseline characteristics, inflammatory markers, markers related to multiple organ function and prognostic outcomes between the two groups were compared, respectively. Baseline data was analyzed by Chi-square test and Mann-Whitney U test. Longitudinal data were analyzed by repeated-measures analysis of variance and generalized estimating equations.

The baseline characteristics between patients of blood purification group and 654-1+blood purification group at admission were without significant differences (all P>0.05). At 24 h, 48 h and 72 h after blood purification therapy, inflammatory markers, including C-reactive protein, procalcitonin, interleukin-6 and interleukin-10 were significantly lower in patients of 654-1+blood purification group than those of blood purification group (all P<0.001). Compared with patients in blood purification group, at 2 h after blood purification therapy, markers related to multiple organ function in 654-1+blood purification group showed significantly lower levels of serum creatinine (Z=2.871, P=0.004), blood urea nitrogen (Z=3.074, P<0.001) and blood lactate (Z=2.666, P=0.008), as well as higher urine output (Z=3.111, P=0.002) and lower alanine aminotransferase (Z=3.007, P=0.003) and aspartate aminotransferase levels (Z=3.590, P<0.001). However, no significant difference in SOFA scores was observed between the two groups (Z=1.165, P=0.244). The counts of red blood cell (RBC) and platelets in both groups showed a declining trend within the first 48 h after treatment. From 72 h onward, RBC counts of patients in 654-1+blood purification group gradually increased and were significantly higher than those of blood purification group at 72 h, 96 h, 120 h, 144 h and 168 h after blood purification therapy (all P<0.001). Meanwhile, platelet counts in 654-1+blood purification group exhibited a sustained upward trend and were significantly higher than those of blood purification group at the same time points (all P<0.001). Short-term prognostic outcomes were significantly better in 654-1+blood purification group, including shorter duration of vasoactive drug use (Z=2.456, P=0.014), shorter duration of blood purification therapy (Z=3.131, P=0.002), shorter ICU length of stay (Z=2.540, P=0.011) and shorter total hospital duration (Z=3.482, P<0.001).

The addition of 654-1 to blood purification therapy is associated with improved short-term clinical outcomes in patients with septic shock. During blood purification therapy for patients with septic shock, the combined use of 654-1 can improve short-term clinical prognosis.

To investigate the distribution characteristics of pathogens in children with respiratory tract infection in Nanjing and surrounding areas in 2024.

The clinical data of pediatric patients (≤18 years old) who underwent nucleic acid testing for 11 respiratory pathogens due to upper respiratory tract infection or complicated with upper respiratory tract infection at Nanjing Children’s Hospital affiliated to Nanjing Medical University from January to December 2024 were analyzed, retrospectively. Total of 5 973 clinical samples were collected, and the positive detection rates of 11 respiratory pathogens were analyzed by Chi-square test based on different genders, ages and specific periods (such as winter and summer vacations, as well as spring and autumn semesters).

The top five pathogens ranked by detection rate were: human rhinovirus (HRV) (1 150 cases, 31.27%), Mycoplasma pneumoniae (957 cases, 26.01%), adenovirus (672 cases, 18.27%), parainfluenza virus (525 cases, 14.27%) and respiratory syncytial virus (349 cases, 9.49%). The highest positive detection rates were observed in 1 to 3-year-old child group (68.9%) and during winter vacation (73.7%). Statistically significant differences in respiratory pathogen distribution were noted across different age groups (χ²=140.393, P<0.001) and different semesters and holidays (χ²=21.648, P<0.001). The positive rates of HRV (25.7%), parainfluenza virus (15.2%), adenovirus (17.0%) and Mycoplasma pneumoniae (22.7%) were high and peaked between May and July. The prevalence of paramyxovirus, respiratory syncytial virus (RSV), influenza A virus and its H1N1 subtype began to rise from November to December. In contrast, the positive rate of influenza B virus gradually declined after the peak infection in January, showing a fluctuating trend with the gradual increase of influenza A virus. Mixed infections were not uncommon (accounting for 13.93% of the total samples), with two-virus mixed infection being the most (12.47% of the total samples). HRV (367/745, 49.26%) and Mycoplasma pneumoniae (238/745, 31.95%) exhibited the highest proportions of mixed infections.

During 2024, HRV accounted for the highest proportion of positive cases among pediatric respiratory pathogen infection in Nanjing and surrounding areas, with mixed infections commonly involving HRV and Mycoplasma pneumoniae. Infections were more prevalent in children aged 1-3 years old, necessitating enhanced infant protection and parental health education. The winter vacation and spring semester represent peak periods for high incidence of respiratory tract infections, during which child health protection and pathogen surveillance should be strengthened.

To investigate the correlation between nuclear factor-κB (NF-κB) expression in bronchoalveolar lavage fluid (BALF) and computed tomography (CT) imaging features, and its predictive value for prognosis of patients with severe pneumonia.

Total of 128 patients with severe pneumonia admitted to the Emergency Department and Emergency Intensive Care Unit (EICU) of 3201 Hospital from February 2022 to January 2024 were enrolled, according to the clinical outcomes after treatment, they were divided into improved group (86 cases) and deterioration group (42 cases). Clinical data including age, maximum body temperature, hypertension, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and CT imaging features were compared between the two groups, respectively. The dynamic changes of NF-κB levels during treatment were analyzed by repeated-measuressis of variance. The relationship between CT imaging features and NF-κB level were analyzed by multiple linear regression. The probability curve of NF-κB level associated with clinical deterioration was ploted by the Logistic regression model, and the correlation between NF-κB level and disease deterioration were analyzed by generalized mixed-effects model. The predictive efficacy of NF-κB level for disease deterioration was evaluated by receiver operating characteristic (ROC) curve analysis. The association between NF-κB expression and survival prognosis was assessed by Kaplan-Meier analysis.

Age [(63.58±8.07) years old vs. (59.26±7.73) years old: t=2.926, P=0.004], maximum body temperature [(38.64±2.58) ℃ vs. (37.26±2.14) ℃: t=3.198, P=0.002], proportion of hypertension (30.95% vs. 13.95% : χ²=5.188, P=0.023), TNF-α [(2.15±0.46) pg/ml vs. (1.68±0.32) pg/ml: t=6.723, P<0.001], CRP [(35.67±6.85) mg/L vs. (25.48±5.19) mg/L: t=9.361, P<0.001], IL-6 [(15.64±2.09) pg/ml vs. (11.75±1.36) pg/ml: t=12.648, P<0.001] and PCT [(7.89±1.43) µg/L vs. (6.84±1.26) µg/L: t=4.233, P<0.001] of patients in deterioration group were significantly higher than those of improved group, all with significant differences. The deterioration group also showed significantly higher frequencies of CT imaging features: patchy opacities (78.57% vs. 60.47%: χ²=4.147, P=0.042), lung consolidation (61.90% vs. 41.86%: χ²=4.539, P=0.033), ground-glass like changes (64.29% vs. 39.53%: χ²=6.930, P=0.008), involvement of≥2 lung lobes (69.05% vs. 40.70%: χ²=9.072, P=0.003), bronchial wall thickening (66.67% vs. 36.05%: χ²=10.648, P=0.001), patellar consolidation shadow (42.86% vs. 24.42%: χ²=4.529, P=0.033), hilar lymph node enlargement (33.33% vs. 12.79%: χ²=7.577, P=0.006), pleural effusion (59.52% vs. 31.40%: χ²=9.256, P=0.002) and atelectasis (45.24% vs. 18.60%: χ²=10.075, P=0.002) than those of improved group, all with significant differences. The results of repeated measurement ANOVA showed that the time effect, intergroup effect and interaction effect of NF-κB level in both groups were statistically significant (all P<0.001). The results of multiple linear regression analysis showed that NF-κB level was independently correlated with patchy opacities (OR=1.614, P=0.033), lung consolidation (OR=1.846, P=0.009), ground glass change (OR=1.889, P=0.012), involvement of≥2 lung lobes (OR=1.436, P=0.007), bronchial wall thickening (OR=1.428, P=0.008), lamella consolidation shadow (OR=2.106, P=0.020), hilar lymph node enlargement (OR=1.862, P=0.001), pleural effusion (OR=1.731, P=0.005) and atelectasis (OR=1.895、P=0.014), all with significant differences. Logistic regression analysis indicated that distinct NF-κB values corresponded to specific probabilities of disease deterioration, and vice versa. Elevated NF-κB level (NF-κB: 14.57-17.14 ng/L: OR=1.171, 95%CI: 1.024-1.579, P=0.014; NF-κB>17.14 ng/L: OR=1.162, 95%CI: 1.059-2.857, P=0.005) was risk factor for increased deterioration in patients with severe pneumonia (P=0.014, 0.005). ROC analysis demonstrated that NF-κB expression had a certain predictive value for the deterioration of patients with severe pneumonia (AUC=0.896, sensitivity and specificity were 84.25% and 80.79%, respectively). The one-year overall survival of patients with NF-κB low expression was higher than that of patients with NF-κB high expression (89.06% vs. 48.44%: Log-rank χ²=24.582, P<0.001).

NF-κB high expression in BALF is associated with an increased risk of clinical deterioration of patients with severe pneumonia, and NF-κB expression is closely correlated with CT imaging features.

Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, leading to numerous adverse clinical consequences. It is particularly prevalent among ICU patients, often resulting in various poor prognoses, which has gradually garnered the attention of ICU physicians. The assessment methods for sarcopenia include muscle strength measurement, physical performance evaluation, and the measurement of muscle quantity or quality. Given the limited feasibility of muscle strength measurement and physical performance in critically ill patients, the assessment of sarcopenia in critically ill patients primarily focuses on measuring muscle mass or quantity. Various methods can be employed, including dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), sarcopenia index (SI), and other techniques. Each method has its own characteristics, advantages and disadvantages for critically ill patients. We aims to provide necessary references for the clinical evaluation and scientific research of sarcopenia in critically ill patients.

The decline of skeletal muscle mass is one of the serious complications of sepsis. It is characterized by the weakend muscle strength, reduced fiber cross-sectional area and dismished muscle quantity. It manifests as flaccid weakness in the limbs, particularly in the proximal limb muscles. Meanwhile, it will affect the prognosis of patients, especially elderly patients, leading to their reduced quality of life and life safety risk. The anabolic resistance in sepsis patients leads to the disruption of the balance between protein synthesis and breakdown, manifested as increased protein catabolism and decreased anabolism, which is one of the main reasons for the decline of skeletal muscle mass. At present, the relevant research on skeletal muscle catabolism in sepsis is relatively well estabished, and protein-anabolic resistance has become an issue of increasing concern. Therefore, we review the correlative mechanisms between protein-anabolic resistance and the decline of skeletal muscle mass in sepsis, aiming to provide theoretical basis and solutions for the clinical prevention and treatment of the skeletal muscle loss in sepsis patients.