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 address the growing pathogenicity and biofilm-mediated drug resistance of Pseudomonas putida (P. putida) in root canal therapy failure and refractory apical periodontitis, and to overcome the bottleneck of "extremely low sample quantity" that hinders the systemic activity evaluation of natural products. This study aims to establish a micro-scale, visual, and high-throughput drug screening platform based on microfluidic chips.

P. putida KT2440 was selected as the model strain, and a green fluorescent protein (GFP) -labeled strain was constructed to establish a microfluidic biofilm model. To accommodate rare natural products, a "qualitative rapid screening" strategy with a fixed threshold of 200 μg/mL was established. Using the length of the fluorescent line segment as a quantitative metric, 40 natural products derived from myxobacteria and plants were blindly screened for anti-biofilm activity. Calcium hydroxide and Ciprofloxacin served as the lower and upper limits of efficacy, respectively, to define the effective screening range. A t-test was used to compare results with the traditional 96-well plate micro-broth dilution method; consistency between the two methods was verified, and sample consumption was compared.

The microfluidic screening platform successfully categorized the 40 compounds into three tiers: Strong, moderate, and ineffective. Ultimately, 6 lead compounds with significant anti-P. putida biofilm activity were identified (positive detection rate of 15%), including novel macrocyclic peptides and certain monoterpenoids. Methodological validation showed high qualitative consistency between the microfluidic chip screening and traditional methods. regarding sample consumption, the platform required only nanoliter (nL) -level volumes per test, with a single compound consumption as low as 8 ng. This represented a sample saving of approximately 15 000-fold compared to the traditional 96-well plate method, significantly reducing the demand for fermentation products.

The microfluidic high-throughput screening platform constructed in this study effectively overcame the technical challenge of sample scarcity in natural product mining through a fixed-concentration qualitative screening strategy. The platform featured extremely low sample consumption, high analytical throughput, and accurate results, providing strong technical support for rapidly locking onto active lead compounds against drug-resistant bacterial biofilms.

To evaluate the in vitro antibacterial effect of freshly-prepared slightly acidic electrolyzed water (SAEW) against Enterococcus faecalis (E. faecalis), a common and persistent pathogen in root-canal therapy, and to preliminarily explore its underlying mechanism.

Freshly-prepared SAEW was produced by on-site electrolysis. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of SAEW against planktonic E. faecalis were determined. An ex-vivo infected single-rooted tooth model was established. Infected teeth were assigned into four groups by simple randomization, and root canals were irrigated with 0.9% sodium chloride solution, low-concentration SAEW (MIC), high-concentration SAEW (2×MIC), and 5.25% sodium hypochlorite solution, respectively. Immediate antibacterial efficacy was assessed by bacterial sampling and colony counting before and after irrigation. Root-canal irrigants were collected. Scanning electron microscopy (SEM) was used to observe bacterial ultrastructural alterations. Confocal laser scanning microscopy combined with SYTO 9/PI fluorescent staining was performed to quantitatively analyze the effect of SAEW on bacterial membrane integrity. The cytotoxicity of SAEW toward human gingival fibroblast cells (HGFCs) was detected using the CCK-8 assay. Statistical analyses were conducted with SPSS 26.0. Normality and homogeneity-of-variance tests were performed for quantitative data. Normally distributed data with homogeneous variances were presented as mean ± standard deviation (SD). One-way analysis of variance (ANOVA) followed by the least-significant-difference (LSD) post-hoc test was applied for multi-group comparisons. A two-sided P<0.05 was considered statistically significant.

Freshly-prepared SAEW exhibited distinct concentration-dependent antibacterial activity against both planktonic and intracanal E. faecalis. The MIC and MBC values of SAEW for planktonic E. faecalis were 6.25 and 12.50 mg/L, respectively. The overall difference in the colony reduction rates of Enterococcus faecalis among the four groups was statistically significant (F = 306.46, P<0.001). The colony reduction rates of groups A, B, C, and D were (25.69 ± 7.41) %, (73.38 ± 1.69) %, (85.89 ± 2.09) %, and (96.60 ± 1.33) %, respectively. Compared with group A, groups B, C, and D exhibited significantly higher colony reduction rates. Moreover, group C showed a significantly higher antibacterial effect than group B but a lower bactericidal efficacy than group D (all P<0.001). These results indicated that SAEW exerts a concentration-dependent antibacterial effect, while its immediate bactericidal potency is inferior to 5.25% sodium hypochlorite. Scanning electron microscopy revealed varying degrees of bacterial ultrastructural damage in each group. Quantitative confocal laser scanning microscopy with SYTO 9/PI staining showed bacterial membrane-damage rates of 0.84% for the 0.9% sodium-chloride group, 74.39% for the low-concentration-SAEW group, 87.38% for the high-concentration-SAEW group, and 92.62% for the 5.25% sodium-hypochlorite group, with significant inter-group differences (F = 2 056.72, P<0.001). These findings indicated that SAEW exerted antibacterial effects by disrupting bacterial membrane integrity in a concentration-dependent manner. At effective antibacterial concentrations, the viability of HGFCs remained above 90% in SAEW-treated groups, whereas cell viability was below 10% in the sodium-hypochlorite-treated group.

This study demonstrated that SAEW could effectively inhibit and kill E. faecalis. Although its immediate in vitro bactericidal potency may be lower than that of high-concentration sodium hypochlorite, SAEW showed promising potential as a supplementary or alternative root-canal irrigant owing to its favorable antibacterial performance and biocompatibility. Further validation using complex biofilm and in vivo models is required.

Dental caries is a highly prevalent chronic infectious disease worldwide. However, traditional preventive agents, such as antimicrobials and fluorides, face limitations including the induction of bacterial resistance and disruption of oral microecological balance. Emerging as a novel strategy, microecological regulation using probiotics to "combat bacteria with bacteria" offers a promising alternative for caries prevention. Nevertheless, current clinical probiotic products generally suffer from short retention times in the oral cavity, susceptibility to saliva rinsing, and difficulty in achieving effective colonization on dental surfaces. As an innovative delivery system, hydrogels can efficiently encapsulate probiotics, achieve lesion-targeted colonization, and significantly prolong retention time. These hydrogel systems exert anti-caries effects through competitive exclusion of cariogenic bacteria, pH regulation, secretion of antimicrobial substances, and immune modulation. This article reviews recent research progress on probiotic-loaded anti-caries hydrogels, with a particular focus on the anti-caries mechanisms, principles of strain selection, hydrogel design mechanisms, and the regulatory roles of degradation kinetics in probiotic delivery and therapy. Overall, this review aims to provide a theoretical reference for the microecological prevention and clinical translation of dental caries.

To explore the factors influencing the failure of root canal treatment in apical periodontitis, and to construct and validate a nomogram prediction model for the efficacy of root canal treatment in apical periodontitis based on these factors.

A prospective study was conducted involving 150 patients with apical periodontitis treated at Huizhou First People's Hospital from April 2024 to June 2025. All patients underwent root canal treatment and were followed up for 6 months. They were divided into the treatment failure group and the treatment success group according to the efficacy criteria of root canal treatment. Clinical data of the patients were collected. Logistic regression analysis was used to identify the factors influencing the failure of root canal treatment in apical periodontitis. A nomogram prediction model for the failure of root canal treatment in apical periodontitis was constructed, and the performance of this risk prediction model was validated.

The follow-up results showed that among the 150 patients with apical periodontitis, 35 (23.33%) had treatment failure and 115 (76.67%) had treatment success. Logistic regression analysis revealed that tooth position (posterior teeth), the number of root canal treatments (≥2 times), crown sealing effect (crown leakage), root canal filling length (underfilling/overfilling), and instrument fracture (present) were independent risk factors for the failure of root canal treatment in apical periodontitis, with odds ratios (ORs) of 2.002, 2.079, 2.255, 2.063, and 1.950, respectively. The corresponding 95% confidence intervals (CIs) were 1.080-3.711, 1.159-3.729, 1.111-4.575, 1.076-3.954, and 1.113-3.416, with P-values of 0.028, 0.014, 0.025, 0.030, and 0.020, respectively. The nomogram model developed using these five risk factors demonstrated an area under the ROC curve (AUC) of 0.836 (95% CI: 0.781-0.892), indicating good discrimination. The slope of the calibration curve was close to 1, and the Hosmer and Lemeshow test showed that the model had good fit (χ² = 7.568, P = 0.268) .

Tooth position, the number of root canal treatments, crown sealing effect, root canal filling length, and instrument fracture are risk factors affecting root canal treatment in apical periodontitis. The nomogram model constructed based on these factors has good accuracy and clinical application value, and may serve as a reference for clinical treatment of apical periodontitis.

Based on a review of relevant literature published between 2004 and 2025 in PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure, together with current guidelines, expert consensus statements, and representative clinical studies, this article proposes a four-domain integrated framework for oral and maxillofacial multispace infection (OMSI) centered on the physiology-inflammation axis. The framework is intended to support risk stratification and pathway-oriented management of severe OMSI by integrating evidence across four domains: Physiological decompensation, infection extent and anatomical involvement, inflammatory response, and host reserve. Risk assessment of severe OMSI should not depend on any single indicator. The proposed physiology-inflammation axis-based framework applies weighted integration of clinical information, in which physiological decompensation and infection extent with anatomical involvement directly determine the urgency of early intervention, whereas inflammatory response and host reserve are used to assess infection activity, treatment response, and the patient's tolerance of infection, anesthesia, surgery, and other interventions. Pathway-oriented management is organized around key time windows: Airway assessment and initial resuscitation at 0 h<t≤1 h, incision and drainage with source control at 1 h<t≤6 h, intensified multisystem monitoring at 6 h<t≤24 h, the first systematic reassessment at 24 h<t≤48 h, and de-escalation, rehabilitation, and follow-up at t>48 h according to the patient's clinical condition. By incorporating risk-factor identification, bedside assessment, risk stratification, and multidisciplinary collaboration into a unified decision-making pathway, the framework may facilitate the early identification of high-risk patients and the organization of structured clinical management. At present, the framework remains exploratory, and the weighting of individual indicators, threshold settings, and boundaries of clinical applicability require further validation and refinement through multicenter prospective studies.

To investigate the effects of renal tubular epithelial cell-specific c-kit gene knockout on macrophage infiltration and renal interstitial fibrosis following unilateral ischemia-reperfusion injury (uIRI) in mice.

Eight-week-old male renal tubular epithelial cell-specific c-kit knockout mice (Ggt1-Cre c-kit^-/-), c-kit^loxp/loxp mice, and wild-type (WT) C57BL/6J mice were used to establish the uIRI model. Experimental mice were divided into six groups (n= 12 per group): Ggt1-Cre c-kit^-/- uIRI group, c-kit^loxp/loxp uIRI group, C57BL/6J uIRI group (WT uIRI group), Ggt1-Cre c-kit^-/- sham group, c-kit^loxp/loxp sham group, and C57BL/6J sham group (WT sham group). Kidney tissue and blood samples were collected at 1, 3, 14, and 28 days post-operation. Serum creatinine (SCr) and blood urea nitrogen (BUN) levels were measured, and renal histopathological changes were evaluated. Sirius red staining was used to assess renal interstitial fibrosis. Macrophage infiltration was examined by immunohistochemistry. The protein and mRNA expression levels of α-smooth muscle actin (α-SMA), vimentin, and collagen I were detected by Western blotting and RT-qPCR, respectively. ANOVA software was used for statistical analysis.

Compared with the WT uIRI group and c-kit^loxp/loxp uIRI group, the Ggt1-Cre c-kit^-/- uIRI group exhibited significantly lower SCr and BUN levels at all time points after uIRI operation (all P<0.05). On 3 and 14 days post-operation, the number of infiltrating macrophages in the Ggt1-Cre c-kit^-/- uIRI group was significantly reduced compared with the other two uIRI groups. On postoperative day 28, the renal interstitial fibrosis score and the mRNA and protein expression levels of fibrosis markers (α-SMA, vimentin, and collagen I) in the Ggt1-Cre c-kit^-/- uIRI group were significantly lower than those in the other two uIRI groups (all P<0.05).

Renal tubular epithelial cell-specific c-kit gene knockout significantly attenuates renal interstitial fibrosis and inhibits macrophage infiltration, suggesting that c-kit gene may serve as a new therapeutic target for kidney diseases.

To explore the correlation between dynamic changes of serum complement C3 and C4 and renal function progression as well as prognosis in patients with lupus nephritis.

Patients with lupus nephritis diagnosed by renal biopsy between January 2022 and January 2025 were retrospectively enrolled. Clinical, pathological, and serum complement C3 and C4 data at baseline (Day 0) and all time points within the 0-180-day follow-up period were collected. The relative change amplitude and time-weighted mean of complement levels from Day 0 to Day 180 were calculated. Patients were classified into the persistently normal group, the recovered group, the persistently reduced group, and the newly reduced group according to complement levels at baseline and Day 180. Landmark analysis was performed with Day 180 as the landmark time point. The Kaplan-Meier method and multivariate Cox regression model were used, and LASSO-Cox regression was adopted for sensitivity analysis to assess the association between longitudinal changes in complement levels and the composite endpoint of renal function progression.

A total of 148 patients with lupus nephritis were enrolled in this study, with a median follow-up of 19.80 months. Among them, 32 patients (21.62%) developed renal function progression and were assigned to the progression group, and the remaining 116 patients were included in the non-progression group. Compared with the non-progression group, the progression group had lower baseline levels of complement C3 and C4 (all P<0.05). The proportion of patients with persistently reduced C3 and C4 in the progression group was higher than that in the non-progression group (all P<0.05). Patients with persistently reduced C3 and C4 exhibited the lowest renal progression-free rate (P<0.05). After adjustment for confounding factors, the persistently reduced C3 phenotype was independently associated with renal function progression (HR=3.120, 95%CI: 1.051-9.270, P=0.040). Indicators related to C4 showed no significant association with renal function progression (all P>0.05). LASSO-Cox sensitivity analysis verified the robustness of the findings in this study.

Dynamic change in serum complement C3, especially the persistently reduced phenotype, is independently associated with the long-term risk of renal function progression in patients with lupus nephritis. Dynamic monitoring of complement C3 level contributes to risk stratification and prognostic evaluation of lupus nephritis.

Abnormal activation of programmed cell death (PCD) plays a key regulatory role in the progression of kidney injury and fibrosis, and different modes of PCD can participate in the occurrence and development of chronic kidney disease (CKD) through diverse pathological mechanisms. Autophagy has a "double-edged sword" effect. Its moderate activation can maintain cellular homeostasis and retard renal fibrosis by clearing damaged organelles and misfolded proteins. However, its excessive activation or impaired function leads to the accumulation of harmful substances and mitochondrial dysfunction, thereby accelerating the progression of kidney diseases. Necroptosis mediates inflammatory responses and promotes renal fibrosis via the receptor-interacting protein kinases 1/3 (RIPK1/RIPK3)-mixed lineage kinase domain-like protein (MLKL) signaling pathway. Pyroptosis relies on the activation of the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) inflammasome, which promotes the release of pro-inflammatory factors and aggravates renal injury. Ferroptosis participates in the pathological process of CKD through lipid peroxidation and iron-dependent mechanisms. Targeted therapeutic strategies for the aforementioned PCD have exhibited potential renal-protective effects in various preclinical models, including diabetic kidney disease, unilateral ureteral obstruction, 5/6 nephrectomy, and acute kidney injury. This paper reviews the roles, mechanisms and interactions of the four PCD modalities in CKD. In the future, machine learning can be leveraged to optimize multi-target combination therapies (e.g., quercetin derivatives synergistically regulating ferroptosis and necroptosis), realize patients stratification and therapeutic effect prediction, and provide a new paradigm for precise intervention of CKD.

Immunoglobulin A (IgA) nephropathy is the most common primary glomerular disease and one of the leading causes of end-stage kidney disease. In recent years, the gut-kidney axis has become a research hotspot in the pathogenesis of IgA nephropathy. Accumulating studies have demonstrated that the onset of IgA nephropathy is closely associated with gut microbiota dysbiosis, disruption of the intestinal mucosal barrier, aberrant mucosal immune activation, and disturbed gut microbial metabolites. This review systematically summarizes the latest research progress regarding the gut-kidney axis in the pathogenesis of IgA nephropathy, and outlines novel intervention strategies based on the gut-kidney axis, including dietary modulation, gut microbiota intervention, mucosal immune regulation, and biologic agents targeting B-cells/plasma cells. Conventional therapeutic approaches that may exert benefits via modulating the gut-kidney axis are also summarized, so as to provide theoretical evidence and new research insights for individualized prevention and treatment of IgA nephropathy.

To explore the value of combined high-risk human papillomavirus (HR-HPV) testing and abnormal p16 gene methylation detection for the early diagnosis of patients with cervical cancer.

From June 2019 to June 2021, a total of 182 participants undergoing cervical biopsy at the Nantong Maternal and Child Health Care Hospital were selected for this study.All participants were tested for HR-HPV typing and abnormal p16 gene methylation.This study analyzed 14 HR-HPV types, including HPV-16, -18, -31, and -33, from the participants.The HR-HPV positivity rates and abnormal p16 gene methylation positivity rates among different cervical lesion grades were compared by chi-square test for linear trend.The positivity rates of abnormal p16 gene methylation across different HR-HPV types were compared by chi-square test.The diagnostic value of HR-HPV typing, abnormal p16 gene methylation testing, and their combination was assessed using the receiver operating characteristic (ROC) curve.The procedures followed in this study met the standards of the Medical Ethics Committee of Nantong Maternal and Child Health Care Hospital and were approved by the committee (Approval No.Y2020090).

①Among the 182 participants, the cervical biopsy results showed 19 cases with a normal cervix or cervical inflammation, 30 cases with cervical intraepithelial neoplasia (CIN)1, 55 cases with CIN2, 61 cases with CIN3, and 17 cases with cervical squamous cell carcinoma (SCC); the HR-HPV positivity rate was 87.4% (159/182), and the abnormal p16 gene methylation positivity rate was 25.3% (46/182).②With increasing severity of cervical lesions, the positive rates of HPV-16/-18 and abnormal p16 gene methylation showed increasing trends (χ²=7.07, P=0.008; χ²=19.51, P<0.001).The positive rate of abnormal p16 gene methylation was higher in HPV-16/-18-positive participants than in those positive for the other 12 HR-HPV types (χ²=10.55, P=0.001).③ROC curve analysis showed that the area under the curve (AUC) of HR-HPV testing combined with abnormal p16 gene methylation detection for the diagnosis of cervical cancer was 0.746 (95%CI: 0.637-0.855), with a sensitivity of 58.8% and a specificity of 84.8%.The DeLong test showed significant differences in AUC between the combined testing and HPV testing alone, as well as between the combined testing and abnormal p16 gene methylation testing alone (Z=-3.24, P=0.001; Z=-3.74, P<0.001).

Combined HR-HPV testing and abnormal p16 gene methylation detection can improve the overall diagnostic performance and specificity for cervical cancer, although its sensitivity remains limited.

To explore the incidence of various inborn errors of metabolism (IEM) in newborns in Hainan Province.

A total of 86 543 newborns born in Hainan Province from January 1 to December 31, 2024, whose guardians agreed to undergo neonatal IEM screening, were selected as the study subjects. Using tandem mass spectrometry detection technology, initial and re-screening of various IEM were conducted on dried blood spot specimens collected from the heels of newborn infants. For some newborns who tested positive in the rescreening, peripheral blood was collected, and the type of IEM and gene mutations were confirmed by whole exome sequencing (WES) detection technology. The positive rates of initial IEM screening among newborns of different genders, gestational ages, birth weights, ethnicities, and registered residences were compared by chi-square test, and further pairwise comparisons were performed using the chi-square splitting method, and the Bonferroni method was used to adjust the significance level. This study was conducted in accordance with the ethical standards of Hainan Women and Children′s Medical Center, and was approved by its Ethics Committee (Approval No.HNWCMC-2026-151).

①In 2024, there were 92 170 live births in Hainan Province, and 86 543 of them underwent IEM screening, with an IEM screening rate of 93.89%. Among these 86 543 newborns, the positive rate of initial IEM screening was 3.58% (3 094/86 543). And 2 591 cases underwent IEM rescreening, with an IEM rescreening rate of 83.74% (2 591/3 094). Among them, 245 cases were positive for IEM rescreening, the positive rate of IEM rescreening was 9.46% (245/2 591), and 136 (55.51%, 136/245) newborns underwent genetic testing, and 38 were finally diagnosed with IEM. The incidence rate of IEM in newborns was about 4.39×10^-4 (38/86 543). ②The positive rate of initial IEM screening in newborns with gestational age <37 weeks was higher than that in newborns with gestational age ≥37 to 42 weeks, and the difference was statistically significant (χ²=361.64, P<0.001). The overall comparison of the positive rate of initial IEM screening among newborns with different birth weights also showed a statistically significant difference (χ²=291.65, P<0.001). Further pairwise comparisons revealed that the positive rate of initial IEM screening in newborns with birth weight <2 500 g, ≥2 500 to 4 000 g, and >4 000 g differed significantly in any pairwise comparison (P≤0.001). The overall comparison of the positive rate of initial IEM screening among newborns of different ethnic groups showed a statistically significant difference (χ²=36.12, P<0.001). Further pairwise comparisons revealed that the positive rate of initial IEM screening in Li ethnic group newborns was higher than that in Han and Miao ethnic group newborns, and both the differences were statistically significant (P<0.001, P=0.006). The comparison of the positive rate of initial IEM screening among newborns with different registered residence also showed a statistically significant difference (χ²=80.62, P<0.001). Further pairwise comparisons revealed that the positive rate of initial IEM screening in newborns from ethnic minority cities and counties in Hainan Province was higher than that in newborns from Han ethnic group cities and counties in Hainan Province, and the difference was statistically significant (P<0.001). ③Among the 86 543 newborns, the detection rate of IEM-related gene mutation was 7.16×10^-4 (62/86 543). The top four detected gene mutations were SLC22A5, SLC25A13, ACADS, and ASS1 gene mutations. The top three detected gene mutation sites were c. 51C>G, c. 852_855del, and c.322G>A, respectively. ④Among the 38 newborns with IEM confirmed by genetic testing, 4 cases were amino acid metabolism disorders, 7 cases were organic acidemia, 5 cases were urea cycle disorders, and 22 cases were fatty acid oxidation metabolism disorders. The top three IEM diseases in terms of confirmed cases were primary carnitine deficiency (13 cases), short-chain acyl-CoA dehydrogenase deficiency (6 cases), and citrullinemia type Ⅱ (5 cases).

The incidence of IEM among newborns in Hainan Province is relatively high, with a diverse range of types. It is recommended to initiate early screening for various IEM in newborns and to enhance the management of infants with positive IEM screening results in Hainan Province.

To analyze clinical features of pertussis in infants of aged 0-2 months and to identify risk factors for progression to severe disease.

Clinical data of 78 infants with pertussis aged 0-2 months who were hospitalized in Xi′an Children′s Hospital from January to December 2024 were retrospectively analyzed.They were divided into study group (n=18, severe pertussis) and control group (n=60, mild pertussis) according to the diagnostic criteria for severe pertussis. General clinical data, clinical manifestations, and laboratory results were collected and compared between the two groups by statistical methods. Multivariate unconditional logistic regression was used to identify factors influencing the development of severe pertussis, and a predictive model was constructed based on these factors. Receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each individual factor and the combined model for severe pertussis. This study followed the standards set by the Ethics Committee of Xi′an Children′s Hospital and was approved by the committee (Approval No. 2024-010-01).

① All 78 children presented with paroxysmal spasmodic cough (100.0%), followed by facial flushing during coughing (43.6%, 34/78) and cyanosis during coughing (39.7%, 31/78), while inspiratory whooping and post-tussive vomiting occurred in only 15.4% (12/78) and 10.3% (8/78), respectively. ② The study group had lower admission body weight than the control group [4.0 kg(3.6, 4.5 kg) vs 5.0 kg(4.5, 5.5 kg), P<0.001], and a higher incidence of cyanosis during coughing (66.7% vs 31.7%), with statistically significant differences between two groups (P<0.05). Additionally, study group had a longer hospital stay than control group [11.0 d (8.0, 16.5 d) vs 8.0 d(6.3, 10.0 d)], and the difference was also statistically significant (P=0.001).③ Multivariate unconditional logistic regression analysis showed that admission body weight (OR=0.169, 95%CI: 0.059-0.485, P=0.001) and cyanosis during coughing (OR=3.719, 95%CI: 1.046-13.220, P=0.042) were factors influencing the progression to severe pertussis. A combined predictive model was established based on cyanosis during coughing and admission body weight, and the Hosmer-Lemeshow goodness-of-fit test indicated good model calibration (χ²=6.27, P=0.508). ④ ROC curve analysis showed that the area under the curve (AUC) of admission body weight, cyanosis during coughing, and the combined model for predicting severe pertussis were 0.810 (95%CI: 0.697-0.924), 0.675 (95%CI: 0.531-0.819), and 0.841 (95%CI: 0.721-0.961), respectively.

The most common clinical manifestations of infants with pertussis aged 0-2 months were paroxysmal spasmodic cough, facial flushing during coughing, and cyanosis during coughing. The combination of admission body weight and cyanosis during coughing showed good early predictive value for progressing to severe pertussis.