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 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.

To explore the clinical efficacy of non-hormonal therapy (HT) regimens in patients with genitourinary syndrome of menopause (GSM).

A total of 150 patients diagnosed with GSM who received treatment at Shanghai Fifth People′s Hospital, Fudan University from January 2023 to December 2024 were enrolled as research subjects. A prospective randomized controlled clinical trial was conducted. Subjects were divided into three groups via the random number table method with distinct therapeutic interventions: study group 1 [n=50, treated with pelvic floor muscle training (PFMT), the non-HT], study group 2 (n=50, treated with vaginal moisturizer, the non-HT), and control group (n=50, treated with topical estrogen application, the HT). All patients received 12 weeks of treatment. Before and after intervention, the vaginal atrophy status was assessed using the Vaginal Health Index Score (VHIS); the severity of GSM symptoms was evaluated by the GSM symptom scale; the incidence of urinary incontinence and its impact on patients′ daily lives were measured using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF); and the severity of menopause-related symptoms was determined via the Kupperman Index. Intra-group and inter-group comparisons of the four aforementioned scoring indicators before and after intervention among the three groups were performed using the chi-square test, Mann-Whitney U test, Kruskal-Wallis H test and Dunn′s test. This study was approved by the Ethics Committee of Shanghai Fifth People′s Hospital, Fudan University(Approval No. Ethics Review [2022] No. 141). All participants signed written informed consent prior to enrollment.

① There were no significant differences among three groups of GSM patients in general clinical data including age and height etc., as well as the total scores and individual item scores of VHIS, GSM symptom scale, ICIQ-UI SF and Kupperman Index before intervention (P>0.05). ② Intra-group comparisons of VHIS indicators revealed that the vaginal elasticity scores after intervention in study group 1 and the control group were significantly higher than that before intervention; the vaginal secretion volume scores after intervention in study group 1 and study group 2 were significantly higher than that before intervention; the vaginal pH scores after intervention in study group 2 and the control group were significantly higher than that before intervention; the vaginal epithelial integrity score after intervention in control group was significantly higher than that before intervention; the vaginal lubrication score and total VHIS score after intervention in all three groups were significantly higher than those before intervention, respectively; the proportion of patients with vaginal pH>5.0 after intervention in study group 2 and the control group was significantly lower than that before intervention; and all above differences were statistically significant (P<0.05). Inter-group comparisons demonstrated that vaginal elasticity scores after intervention in study group 1 and the control group were significantly higher than that in study group 2, and the total VHIS score after intervention in control group was higher than that in study group 1, and the differences were statistically significant (P<0.05). ③ Intra-group comparisons of GSM symptom scores showed that vaginal dryness scores and total GSM scores after intervention in all three groups were lower than those before intervention; the dyspareunia scores after intervention in study group 2 and the control group were lower than that before intervention; and all the above differences were statistically significant (P<0.05). Inter-group comparisons indicated that the vaginal dryness score after intervention in study group 1 was higher than that in control group; the dysuria score after intervention in study group 2 was higher than that in study group 1 and the control group; the dyspareunia score after intervention in study group 1 was higher than that in study group 2, and the differences were statistically significant (P<0.05). ④ Intra-group comparisons of ICIQ-UI SF showed that the urinary incontinence frequency score after intervention in study group 1 was 1 (0, 1), which was lower than that of 1 (0, 2) before intervention, and the difference was statistically significant (Z=2.24, P=0.017). ⑤ Intra-group comparisons of Kupperman index demonstrated that the proportion of patients with Kupperman index ≥16 after intervention in study group 1 and the control group were lower than that before intervention, respectively; the total Kupperman index scores after intervention in study group 1 and study group 2 were lower than that before intervention, respectively; and all the differences were statistically significant (P<0.05).

PFMT and vaginal moisturizer (non-HT), as well as topical estrogen application (HT), can alleviate genitourinary symptoms in patients with GSM to varying degrees with respective advantages, providing diversified and individualized options for clinical management of GSM.

To explore the application of extracorporeal membrane oxygenation (ECMO) technology in the treatment of critically ill obstetric patients.

Six critically ill pregnant women treated with ECMO at Shenzhen People′s Hospital from January 1, 2020, to May 31, 2025, were selected as the study subjects. A retrospective analysis was conducted on the clinical data of the six cases to summarize ECMO indications, complications, and maternal and fetal outcomes. This study was approved by the Medical Ethics Committee of Shenzhen People′s Hospital (Approval No. LL-KY-2026273-01).

The indications for ECMO in this study included one case of cardiogenic shock, one case of severe pneumonia caused by aspiration during cesarean section, three cases of pulmonary hypertension crisis, and one case of cardiac arrest. Five cases used venoarterial (VA)-ECMO, while one case used venovenous (VV)-ECMO. The ECMO initiation times were 2 cases before delivery, 1 case during delivery, and 3 cases after delivery. Complications during ECMO treatment included three cases of pneumonia, one case of amputation due to ischemic necrosis in the left lower limb, two cases of pulmonary hemorrhage, one case of gastrointestinal bleeding accompanied by airway bleeding, and one case of arteriovenous fistula (superficial femoral artery and great saphenous vein on the right side) with incision infection at the puncture site, and decreased muscle strength in both lower limbs.Among the six patients, one case was with a twin pregnancy, and the other five were singleton pregnancy. The hospitalization duration for the six patients ranged from 28 to 126 days, with a median of 71.5 days. Regarding maternal outcomes, five patients recovered and were discharged, while one died due to pulmonary hypertension crisis. The neonatal outcomes were one stillbirth, and the remaining six were live births, all of whom recovered well with active neonatal treatments.

ECMO helps to reduce the mortality rate of critically ill pregnant women and provides a foundation for further treatment.

To evaluate the efficacy and safety of telitacicept in children with refractory IgA vasculitis with nephritis(IgAVN).

Four children with refractory IgAVN who were hospitalized and treated with telitacicept in the Department of Nephrology, Xi′an Children′s Hospital from August 1, 2024 to March 1, 2025 were enrolled, including 1 boy (case 2) and 3 girls (cases 1, 3, and 4). All 4 children received telitacicept as add-on therapy on the basis of conventional treatment with glucocorticoids and/or immunosuppressants, as well as angiotensin-converting enzyme inhibitors or angiotensin Ⅱ receptor blockers. Telitacicept was administered by subcutaneous injection once weekly at a weight-based dose of 80 mg or 160 mg per dose, with a treatment duration of no less than 24 weeks. Clinical data before and after treatment were retrospectively analyzed, including 24-hour urinary protein excretion, urine protein-to-creatinine ratio (UPCR), routine urinalysis, serum albumin, estimated glomerular filtration rate (eGFR), blood lipid levels, immunoglobulin levels, and B lymphocyte counts. Changes in the doses of glucocorticoids and other immunosuppressants were also recorded. China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese Medical Journal Full-text Database, and PubMed were searched using" IgAVN" " IgA vasculitis nephritis" and " telitacicept" as search keywords to identify studies on telitacicept in the treatment of pediatric IgAVN. The retrieval period was from March 2021 to March 2025. This study was approved by the Ethics Committee of Xi′an Children′s Hospital (Approval No. 2025-019-01), and written informed consent was obtained from the guardians of all children.

① Among these 4 cases, 1 was male (case 2) and 3 were female (cases 1, 3, and 4). The age at first administration of telitacicept ranged from 10 years and 9 months to 16 years and 3 months. At 24 weeks of follow-up, 24-hour urinary protein excretion decreased from baseline in cases 1, 2, and 4, and the changing trend of urine protein-to-creatinine ratio (UPCR) was generally consistent with that of 24-hour urinary protein excretion. In case 3, proteinuria-related indicators fluctuated markedly, without a sustained decreasing trend. During treatment, estimated glomerular filtration rate (eGFR) remained generally stable in all 4 cases, and serum albumin levels increased from baseline, with an increase ranging from 2.7% to 12.7%. Cases 1, 2, and 4 had hypercholesterolemia before treatment, and their serum total cholesterol levels decreased from baseline after treatment, with a decrease ranging from 8.5% to 43.1%. Case 3 had no obvious abnormality in serum total cholesterol level before treatment, and no obvious change was observed after treatment. At 24 weeks of treatment, serum IgG, IgM, and IgA levels decreased to varying degrees from baseline in all 4 cases, with decreases of 23.5%-45.5%, 53.8%-83.4%, and 35.9%-56.0%, respectively. B lymphocyte counts showed an overall decreasing trend. The median glucocorticoid dose at first administration of telitacicept was 0.29 mg/(kg·d), which decreased to 0.215 mg/(kg·d) at the last follow-up, representing a 25.9% reduction from baseline. Case 2 discontinued glucocorticoids after 24 weeks of treatment. During follow-up, all 4 cases developed infectious events. Cases 1-3 developed upper respiratory tract infections, and case 4 developed gastrointestinal infection. All infections resolved after oral medication and symptomatic treatment. No injection-site reactions or serious adverse events were observed. ② The literature review identified 5 relevant studies involving 24 children. Together with the 4 cases in this study, a total of 28 children were included in the summary analysis. All 28 children received subcutaneous telitacicept once weekly. Among them, 17 children had 24-hour urinary protein excretion reduced to the normal range, gross hematuria improved after treatment in 7 children who had gross hematuria before treatment, and microscopic hematuria was alleviated to varying degrees in 21 children. Immunoglobulin levels decreased after treatment in 16 children, with IgG reduction being the most common. In terms of safety, no serious adverse events or discontinuation of telitacicept due to adverse reactions were reported. The main adverse reactions included upper respiratory tract infection, gastrointestinal infection, and hypogammaglobulinemia.

Telitacicept can improve proteinuria and reduce glucocorticoid dosage in children with refractory IgAVN, with no serious adverse events were observed during short-term follow-up. However, its long-term efficacy and safety need to be further confirmed by large-sample studies with long-term follow-up.

To explore the clinical characteristics, treatment and prognosis of patients with acquired aplastic anemia (AA) secondary to brucellosis in pregnancy.

A case of patient with brucellosis in full-term pregnancy leading to secondary acquired AA (patient 1) admitted to the Second Affiliated Hospital of Dalian Medical University in February 2020 was selected as the study subject. A retrospective analysis method was employed to analyze her clinical data. Using " pregnancy" " brucellosis" " acquired aplastic anemia" as Chinese and English keywords, the search results of relevant literature on acquired AA secondary to brucellosis in pregnancy in CNKI database, Wanfang Data Knowledge Service Platform and PubMed database showed that there were no relevant reports on acquired AA secondary to brucellosis in pregnancy. Therefore, " pregnancy" " brucellosis" and " case report" were used as Chinese and English keywords to search the above databases. The literature retrieval time was set from the establishment of each database to March 2026. The clinical data of patients with brucellosis in pregnancy reported at home and abroad were comprehensively analyzed. The procedures followed in this study was complied with the requirements of the Helsinki Declaration of the World Medical Association revised in 2013.

① Patient 1 was a 33-year-old female, who was treated in our hospital due to " 37^{+ 2} weeks of amenorrhea and a small amount of vaginal bloody secretions for 1 day". Patient 1 had lived in a brucellosis-endemic area for a long time and had a history of contact with cattle and sheep. She was treated for fever and fatigue 10 years ago, and blood culture and bone marrow examination indicated brucellosis infection. Serological examination before and during this pregnancy indicated positive Brucella antibody. During this pregnancy, she experienced fatigue, profuse sweating, nausea, joint pain and skin ecchymosis, and gradually developed severe cytopenia. The platelet count (PLT) during pregnancy was (5-20)×10⁹/L (abnormally lower than the normal reference value), and the hemoglobin (Hb) level was 52-70 g/L (abnormally lower than the normal reference value). She received intermittent platelet and red blood cell transfusions, with transient effects. After treatment with rifampicin, the PLT transiently increased to 100×10⁹/L, but the full course of treatment was not completed due to gastrointestinal adverse reactions. Laboratory examination after this admission showed white blood cell count (WBC) was 4.05×10⁹/L, PLT was 5×10⁹/L, Hb was 52 g/L, and positive Brucella immunoglobulin (Ig)G antibody. After multidisciplinary team consultation, she was treated with intravenous immunoglobulin (20 g/d) and dexamethasone (6 mg/12 h), along with supportive treatment of 2 U platelets and 4 U red blood cells. After the PLT rose to 59×10⁹/L and Hb rose to 58 g/L, an emergency cesarean section was performed under subarachnoid block anesthesia. The newborn was in good condition at birth, with an Apgar score of 10 points at 1 minute after birth, a birth weight of 2 750 g, a normal umbilical cord blood complete blood cell count, and positive umbilical cord blood Brucella IgG antibody. Placental pathological examination showed congestion of placental villous capillaries, small focal infarction and a small amount of inflammatory cell infiltration. The PLT of patient 1 decreased again after cesarean section. After further hematological evaluation, bone marrow examination was rechecked at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences. Combined with the bone marrow examination results, clinical manifestations and exclusion of other secondary factors, she was diagnosed as acquired AA secondary to brucellosis. And after treatment with recombinant erythropoietin, immunosuppressants and glucocorticoids, the above parameters improved, and she was discharged. Follow-up results at 42 days and 6 months postoperatively for patient 1 showed that the PLT remained at approximately 20×10⁹/L, with no obvious bleeding manifestations. ② According to the literature search strategy set in this study, a total of 6 articles related to patients with brucellosis in pregnancy were retrieved, involving 6 patients with brucellosis in pregnancy (patients 2-7). Together with patient 1, a total of 7 patients were included for comprehensive analysis. The average age of these 7 patients was 28 years, including 5 primiparas and 2 multiparas. The main clinical manifestations were joint pain (5 cases), fatigue (4 cases), hyperhidrosis (3 cases), and fever (2 cases). One case underwent misoprostol induction at 6⁺ months of gestation, and 6 cases delivered live newborns, including 4 cases of premature delivery and 2 cases of full-term delivery.

Acquired AA secondary to brucellosis in pregnancy is extremely rare, and its pathogenesis is complex. Brucellosis in pregnancy can pose a serious threat to both the pregnant mother and the fetus, and early diagnosis and timely intervention are crucial. For the treatment of brucellosis in pregnancy, multidisciplinary team collaboration is required, and comprehensive consideration of anti-infection, supportive treatment and hematological management is needed to reduce the risk of secondary AA.

To investigate the relationship between the interval between two deliveries and postpartum pelvic floor function indicators in women with different modes of delivery.

A total of 345 women who delivered at Shanghai First Maternity and Infant Hospital from January 2022 to December 2023 were enrolled in this retrospective study. According to the modes of the two deliveries, the women were divided into the cesarean delivery group (n=152) and the natural childbirth group (n=193). Based on the interval between the two deliveries, women in both groups were stratified into three categories: <3 years, 3-10 years, and >10 years. All participants underwent pelvic floor muscle function and pelvic floor structure examinations at 45-60 days after the second delivery. Postpartum pelvic floor dysfunction-related symptoms were assessed using the Pelvic Floor Distress Inventory-20 (PFDI-20). The differences in type Ⅰ muscle fiber mean electromyographic value and variability, type Ⅱ muscle fiber maximum electromyographic value and rise time, levator hiatus circumference and area, and PFDI-20 scores were compared between the two groups at different delivery intervals. Spearman rank correlation analysis was performed to evaluate the correlation between the interval between two deliveries and postpartum pelvic floor function indicators. The procedures of this study complied with the standards established by the Ethics Committee of Shanghai First Maternity and Infant Hospital, and the study was approved by the ethics committee (Approval No.20220109).

① There were no statistically significant differences between the cesarean delivery group and the natural childbirth group in maternal age, interval between two deliveries, body mass index, neonatal birth weight at the first and current deliveries, or gestational age at the first and current deliveries (P>0.05). ② At different delivery intervals, the type Ⅰ muscle fiber mean electromyographic value and type Ⅱ muscle fiber maximum electromyographic value in the cesarean delivery group were generally higher than those in the natural childbirth group, whereas the type Ⅰ muscle fiber variability and type Ⅱ muscle fiber rise time were generally lower than those in the natural childbirth group; these differences were statistically significant (P<0.05). The levator hiatus circumference and area in the natural childbirth group were greater than those in the cesarean delivery group, and the PFDI-20 subscale scores and total score were higher than those in the cesarean delivery group, with statistically significant differences (P<0.05). ③ In both the cesarean delivery group and the natural childbirth group, pelvic floor muscle electromyographic indicators, pelvic floor structure indicators, and PFDI-20 scores differed significantly among women with different delivery intervals (P<0.05). Overall, women with an interval of 3-10 years between the two deliveries had relatively better pelvic floor function indicators, whereas those with an interval of <3 years had relatively poorer pelvic floor function indicators. ④ Correlation analysis showed that, among women with delivery intervals of <3 years and 3-10 years, the type Ⅰ muscle fiber mean electromyographic value and type Ⅱ muscle fiber maximum electromyographic value were positively correlated with the specific delivery interval in both the cesarean delivery group and the natural childbirth group (P<0.05), whereas no correlation was observed for the other indicators (P>0.05).

Mode of delivery and the interval between two deliveries may be associated with postpartum pelvic floor function recovery. Compared with women who underwent natural childbirth, those who underwent cesarean delivery had generally better postpartum pelvic floor function indicators. Women with an interval of 3-10 years between two deliveries had relatively better pelvic floor function indicators. Clinical attention should be paid to postpartum pelvic floor function screening and rehabilitation guidance for women who undergo natural childbirth and those with a short interval before a subsequent pregnancy.

To explore the characteristics of swallowing disorders and their influencing factors in Parkinson disease (PD) patients, aiming to provide a reference for the early detection, diagnosis, and intervention of swallowing disorders in this population.

Thirty-four PD patients admitted to The Eighth People's Hospital of Longgang District in Shenzhen from June 2023 to April 2025 were consecutively enrolled. Their general data, characteristics of swallowing disorders, and the relationship with disease duration and cognitive function were analyzed. The characteristics of swallowing disorders were analyzed using the incidence rates of various manifestations, and influencing factors were analyzed using binary Logistic regression.

Among the 34 PD patients, swallowing delay had the highest incidence (88.2%), followed by premature spillage and residue (both 55.9%). As the intake volume increased, the incidence rates of all three swallowing disorder manifestations showed a significant upward trend (P<0.05). Binary Logistic regression analysis revealed that disease duration was not an independent influencing factor for swallowing delay, premature spillage or residue (P>0.05). The MoCA score was an independent protective factor for premature spillage with 10 mL low-thickened and 5 mL high-thickened boluses, and an independent risk factor for residue with 5 mL high-thickened boluses (all P<0.05).

Swallowing delay was a common feature of dysphagia in PD patients, with the risk of swallowing impairments rising as bolus volume increased. MoCA-evaluated cognitive function was associated with premature spillage and residue, whereas disease duration had no significant impact on these three swallowing outcomes.

To evaluate the timeliness and safety of domestically produced 16-slice mobile CT systems in neurosurgical intensive care units (ICUs).

Head CT examination data were collected from hospitalized patients in the Neurosurgery ICU of Sichuan Provincial People's Hospital from January 2023 to October 2024. Patients underwent single or multiple head CT scans according to clinical indications (e.g., disease progression monitoring or routine follow-up). Examination data were categorized into mobile CT group and fixed large-scale CT group according to device type. Comparison was conducted regarding scanning procedures, examination duration, incidence of adverse events, and the substitution rate of mobile CT.

A total of 2274 patients underwent 8661 scans, including 5214 fixed large-scale CT scans and 3447 mobile CT scans, yielding a substitution rate of 39.8% (3447/8661). The mobile CT group required fewer procedural steps than the fixed large-scale CT group; its examination duration [7.4 (6.0, 9.2) min] was significantly shorter than that of the fixed large-scale CT group [18.3 (16.6, 21.1) min] (P<0.05). No severe adverse events such as bed falls, catheter dislodgement, or shock occurred in the mobile CT group.

The 16-slice mobile CT system revolutionizes head imaging examinations in critical care settings, demonstrating significant timeliness advantages in ICU monitoring.

Cerebral hemorrhage has a high incidence, disability, and mortality rate, making it a common and critical neurological disease. Surgical treatment is the primary method for treating cerebral hemorrhage and can significantly improve patient prognosis. Neuroelectrophysiological monitoring technology provides precise functional assessment for cerebral hemorrhage surgery by monitoring neuroelectrical activity in real time, reducing surgery-related nerve injury, and improving surgical safety and effectiveness. This article reviews the monitoring methods, clinical value, and existing challenges of neuroelectrophysiological monitoring in cerebral hemorrhage surgery, summarizes the current application status of the technology and looks ahead to future development directions, aiming to provide clinicians with theoretical reference for related surgical diagnosis and treatment and promote further application and development of this technology in cerebral hemorrhage surgery.

To investigate the application value of donor-site perfusion via turbocharging in immediate deep inferior epigastric perforator (DIEP) flap breast reconstruction following breast cancer surgery.

A retrospective analysis was conducted on the clinical data of 12 female patients with breast cancer who underwent nipple-sparing mastectomy followed by immediate DIEP flap breast reconstruction perfused by turbocharging (turbocharged DIEP) in the Shenzhen Hospital of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2024 and December 2025. There were 3 cases of stage Ⅰ, 8 cases of stage Ⅱ and 1 case of stage Ⅲ. Preoperative computed tomography angiography (CTA) was performed in all patients to accurately locate the number and anatomical positions of DIEP. The number of donor perforator vessels, the diameters of arteries and veins, and the number of vessels used for turbocharging anastomosis were systematically recorded during surgery. Postoperative follow-up was conducted to assess flap survival rate and the incidence of complications, and the BREAST-Q Questionnaire was used to quantitatively evaluate patient satisfaction with reconstructed breast appearance and functional recovery of the donor and recipient sites.

Double-pedicle DIEP flap transplantation was successfully performed in all 12 patients. The flap harvest area ranged from 12.0 cm×24.0 cm to 14.0 cm×30.0 cm, with an average weight of (759.17±99.91) g and operative time of (487.67±97.21) min. Intraoperative anatomical dissection identified 3 perforator vessels in 8 cases and 4 perforator vessels in 4 cases; among them, single-artery turbocharging was used in 8 cases and double-artery turbocharging in 4 cases. The diameter of turbocharged arteries was (0.75±0.19) mm, and the venous diameter was (0.94±0.12) mm. All patients were followed up for 3.0-14.5 months with a median follow-up of 6.3 months. All transplanted flaps survived completely, with no perioperative complications such as flap necrosis, hematoma or infection. The mean BREAST-Q score was (91.83±2.52), indicating high patient satisfaction with the appearance of reconstructed breasts and the functional recovery of donor and recipient sites. No local recurrence or distant metastasis occurred during the follow-up period.

Under strict patient selection, turbocharged-DIEP breast reconstruction has good safety, feasibility and aesthetic effects, which can be used for immediate breast reconstruction after breast cancer surgery.