Objective To evaluate the clinical efficacy and security of therapeutic endoscopy in colorectal polyps. Methods This study was retrospectively analyzed the clinical characteristics of 259 cases with colorectal polyps which were treated by APC, EMR, ESD,high-frequency electroblationt. Results Of 259 patients, 258 cases were successfully removed. One case can not completely stanch bleeding and turned surgical operation. Four cases were early postopera-tive bleeding, and the bleeding stopped under endoscopic hemostasis. There was one case of perforation which was im-proved after conservative treatment. There was no delayed bleeding, burns, subcutaneous emphysema and other compli-cations. Concludion The endoscopic treatment of colorectal polyps is a simple, cheap, safe, reliable and is suitable for a wide range treatment, which is worthy of clinical application.

Objective:To understand the early clinical characteristics and drug sensitivity results of children died of invasive pneumococcal disease (IPD) in Pediatric Intensive Care Unit (PICU) so as to guide the early clinical identification and treatment.Methods:The early clinical data and drug sensitivity result of children died of IPD in PICU of the Children′s Hospital, Zhengzhou University and Beijing Children′s Hospital, Capital Medical University from May 2015 to May 2019 were retrospectively analyzed.Results:A total of 18 children meeting the criteria were enrolled, including 6 males and 12 females.The median age was 1 year and 9 months (ranged from 2 months and 20 days to 6 years and 7 months), there were 2 cases(11.1%) > 5 years old, and 16 cases(88.9%)≤ 5 years old.There were 17(94.4%) children related to community acquired infection.Among 18 cases, the first symptom was intracranial infection in 10 cases (55.6%), bloodstream infection in 4 cases (22.2%), and pulmonary infection in 3 cases (16.7%). There were 5 cases complicated with virus infection at the same time.Auxiliary examination: all of the 18 cases had anemia and hypoalbuminemia, and 15 cases(93.8%) had HCO 3- reduction.White blood cells(WBC), platelets(PLT) and natural killer (NK) cell decreased in 7 cases (7/18 cases), 12 cases (12/18 cases) and 6 cases (5/16 cases), respectively, but C-reactive protein(CRP), procalcitonin (PCT), lactic acid concentration(LAC), D-dimer (D-Di), international normalized ratio (INR) and B-type natriuretic peptide (BNP) were increased in 12 cases (12/18 cases), 14 cases (14/18 cases), 7 cases (7/17 cases), 14 cases (14/17 cases) and 9 cases (9/9 cases), respectively.Six children(33.3%) did not receive the treatment of sensitive antibiotics before admission.According to the drug sensitivity results: all the 18 strains had multiple-drug resistance(MDR), and the resistance rates of Penicillin, Erythromycin, Tetracycline, Clindamycin and Sulfamethoxazole were 22.2%, 100.0%, 100.0%, 100.0% and 94.4%, respectively, all the strains were sensitive to Vancomycin, Linezolid and Levofloxacin. Conclusions:Most of the children died of IPD in PICU are of community-acquired infection and less than 5 years old.Anemia and hypoalbuminemia are common in the dead children.The decreased in HCO 3- and increased PCT, LAC and D-Di in the early stage might be related to poor prognosis of patients.Most of the children died of IPD are infected with MDR strains.

Objective:To investigate the clinical efficacy and safety of amlodipine besylate and benazepril hydrochloride tablets (II) in the treatment of primary hypertension.Methods:A total of 280 patients with primary hypertension who were treated at Shougang Shuigang Hospital between June 2022 and June 2023 were selected as study subjects. A clinical case-control study was conducted, and the RAND function method was utilized to randomly allocate the subjects into four groups, each receiving a different treatment: amlodipine besylate group (Group A, n = 70), benazepril hydrochloride group (Group B, n = 70), compound formulation amlodipine besylate and benazepril hydrochloride tablets group (Group C, n = 71), and amlodipine besylate plus benazepril hydrochloride group (Group D, n = 69). Relevant therapeutic indicators (blood pressure compliance rate, changes in blood pressure values) and safety indicators (adverse reactions, medication adherence) were observed. Results:The blood pressure compliance rates of Group C and Group D were 91.5% (65/71) and 89.9% (62/69), respectively. There was no statistically significant difference between the two groups ( χ2 = 1.24, P = 0.143), but both were higher than the rates of 77.1% (54/70) and 74.3% (52/70) in Group A and Group B, respectively ( χ2 = 5.68, 4.86, P = 0.004, 0.012). Before treatment, there was no statistically significant difference in systolic and diastolic blood pressure among the four groups of patients (all P > 0.05). After treatment, there was a statistically significant decrease in both systolic and diastolic blood pressure among the four groups compared with their pre-treatment levels (all P < 0.05). Specifically, Group C and Group D exhibited significant reductions in blood pressure following treatment ( t = 4.35, 5.12, 7.25, 5.86, all P < 0.05). Meanwhile, there was no statistically significant difference in systolic blood pressure between Group C and Group D after treatment ( P > 0.05), while diastolic blood pressure was lower in Group C than Group D after treatment ( t = 6.01, P < 0.05). There was a significant downward trend observed in total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels (all P < 0.05). Notably, Group B and Group D reported higher incidences of dry cough, with 15 and 10 cases, respectively, compared with Group A and Group C, which had 1 and 3 cases, respectively. These differences were statistically significant ( χ2 = 4.25, 5.04, both P < 0.05). Furthermore, the treatment compliance rates for Group A, Group B, and Group C were 72.9% (51/70), 71.4% (50/70), and 74.6% (53/71), respectively, all exceeding the 46.4% (32/69) compliance rate of Group D. These differences were also statistically significant ( χ2 = 4.68, 5.24, 4.98, all P < 0.05). Conclusion:The clinical efficacy and safety of the compound formulation amlodipine besylate and benazepril hydrochloride tablets (II) in the treatment of primary hypertension are superior to those of single tablets and combination therapy.

Objective:To analyze the predictive value of serum Nesfatin-1 combined with the Status Epilepticus Severity Scale (STESS) score on the short-term prognosis of children with status epilepticus (SE).Methods:A clinical data of 145 children with SE who were admitted to the Children′s Hospital Affiliated to Zhengzhou University, Henan Children′s Hospital, Zhengzhou Children′s Hospital, from January 2016 to January 2020 were analyzed retrospectively.After admission, the serum levels of Nesfatin-1 and the STESS score were measured.According to the Glasgow Outcome Scale (GOS) score at discharge, children with SE were divided into poor prognosis group (<5 scores) and good prognosis group (5 scores). Univariate and multivariate Logisitc regression analyses were performed to analyze influence of the serum Nesfatin-1 level and STESS score on the short-term prognosis of children with SE.Receiver operating characteristic (ROC) curve was depicted to evaluate the predictive value of serum Nesfatin-1 level combined with STESS score in the short-term prognosis of children with SE. Results:Twenty-five cases out of 145 (17.24%) children with SE were discharged with a GOS score of <5 (poor prognosis group), 120 cases were in the good prognosis group.In the poor prognosis group, the overall attack (88.00% vs.66.67%), attack time of SE > 1 h (76.00% vs.27.50%), admission to child intensive care unit(PICU) (76.00% vs.37.50%), implementation of endotracheal intubation (16.00% vs.5.00%), abnormal electroencephalogram(EEG) results (73.91% vs.41.03%), abnormal proportion of head imaging results (82.61% vs.29.49%), serum Nesfatin-1 level[(3.65±1.45) μg/L vs.(2.20±0.77) μg/L] and STESS score[(3.01±0.75) points vs.(1.80±0.60) points] were significantly higher than those in the good prognosis group (all P<0.05). Logistic regression analysis showed that the attack time of SE > 1 h, admission to PICU, abnormal EEG, abnormal proportion of head imaging results, serum Nesfatin-1 level and STESS score were independent risk factors for the poor short-term prognosis of children with SE ( OR=4.217, 3.456, 2.626, 4.109, 3.040 and 2.012, respectively, all P<0.001). The cut-off value of serum Nesfatin-1 level and STESS score was 3.01 μg/L and 2.38 points, respectively.The Youden index and AUC of the combination of serum Nesfatin-1 level and STESS scores were 0.736 and 0.921 (95% CI: 0.861-0.959), respectively, which were better than those of single detection of either serum Nesfatin-1 level [Youden index 0.447; AUC 0.795(95% CI: 0.720-0.858)] or STESS scores [Youden index 0.562; AUC 0.859(95% CI: 0.792-0.911)]. Conclusions:The abnormal increases in serum Nesfatin-1 level and STESS score are risk factors for poor prognosis of SE in children, and their combination has a high predictive value for the poor short-term prognosis.

Objective:To investigate the relationship between intra-abdominal pressure (IAP) and respiratory function in mechanically ventilated children with severe pneumonia and its prognostic value.Methods:A case-series study.Ninety-two children with severe pneumonia who were treated with mechanical ventilation in the Intensive Care Unit of Children′s Hospital Affiliated to Zhengzhou University from May 2019 to May 2021 were taken as the study subjects.The IAP and respiratory function-related indexes of the children were monitored.Those with IAP ≥12 mmHg(1 mmHg=0.133 kPa) were divided into the study group, and those with IAP <12 mmHg were divided into the control group.The difference in respiratory function related indexes between the 2 groups was compared, and the relationship between IAP and respiratory function indexes was analyzed by Pearson correlation.The children were divided into a good prognosis group and a poor prognosis group according to their prognosis.The relevant clinical data of the children in the 2 groups were collected for univariate analysis, and multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of children with mechanical ventilation for severe pneumonia.A receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of IAP on the prognosis of mechanically ventilated children with severe pneumonia.Results:The arterial partial pressure of oxygen (PaO 2) [(80.15±8.23) mmHg], arterial blood oxygen saturation (SaO 2) [(91.32±2.13)%], and oxygenation index (PaO 2/FiO 2) [(198.29±20.25) mmHg] in the study group were lower than those in the control group [(85.74±8.42) mmHg, (97.05±2.47)%, and (234.84±25.24) mmHg], while the respiratory rate (RR) [(56.23±2.16) breaths/min vs. (50.41±2.24) breaths/min], partial pressure of carbon dioxide (PaCO 2) [(36.48±3.72) mmHg vs.(33.29±3.46) mmHg], fraction of inspired oxygen (FiO 2) [(40.42±4.25)% vs.(36.51±3.72)%], mean arterial pressure (MAP) [(55.98±5.69) mmHg vs.(52.79±5.43) mmHg], and positive end expiratory pressure (PEEP) [(5.03±0.52) cmH 2O vs.(4.52±0.47) cmH 2O, 1 cmH 2O=0.098 kPa] were higher than those in the control group, and the differences were all statistically significant (all P<0.05).The IAP of the children in the study group was (14.25±1.83) mmHg, and that in the control group was (10.38±1.14) mmHg.Pearson correlation analysis showed that IAP was negatively correlated with PaO 2, SaO 2, and PaO 2/FiO 2 ( r=-0.615, -0.587, and -0.647, all P<0.05), and was positively correlated with RR, PaCO 2, FiO 2, MAP, and PEEP ( r=0.618, 0.634, 0.579, 0.578, 0.593, all P<0.05).IAP [(14.76±1.58) mmHg], PaCO 2 [(39.95±4.21) mmHg], FiO 2 [(50.29±5.12)%], alanine aminotransferase[(42.08±4.15) U/L], and total bilirubin [(17.92±1.87) μmol/L] in the poor prognosis group were greater than those [(10.75±1.19) mmHg, (35.37±3.64) mmHg, (45.38±4.47)%, (39.87±4.06) U/L, and (17.09±1.75) μmol/L] in the good prognosis group, while PaO 2 [(65.42±7.86) mmHg vs.(76.42±7.51) mmHg], SaO 2 [(90.65±9.26)% vs.(96.21±2.19)%], and PaO 2/FiO 2 [(130.09±15.15) mmHg vs.(168.40±20.17) mmHg] were smaller than those in the good prognosis group, and the differences were statistically significant (all P<0.05).Logistic regression analysis showed that IAP, PaO 2, PaCO 2, and SaO 2 were risk factors affecting the prognosis of mechanically ventilated children with severe pneumonia (all P<0.05).The optimal cut-off point of IAP for predicting a poor prognosis in mechanically ventilated children with severe pneumonia was 14.55 mmHg, and the area under the ROC curve was 0.873, with a sensitivity of 88.10% and a specificity of 76.00%. Conclusions:IAP has a certain relationship with the respiratory function of mechanically ventilated children with severe pneumonia, and has a good predictive value for the prognosis of the children.

Mitochondrial and peroxisome fission deficiency-related encephalopathy caused by DNM1L gene mutation is a rare and fatal epileptic encephalopathy, with clinical phenotype and genetic heterogeneity. The acute stage is drug-resistant epilepsy with poor prognosis and serious neurological sequelae. A case of genetically confirmed encephalopathy related to mitochondrial and peroxisome fission defects is reported, the clinical data, treatment process are summarized, and the previous literature is reviewed to improve the understanding of the rare disease.

As the "star product" of Shanghai, Shanghai herbal paste has played an irreplaceable role both in the treatment of diseases and nurturing health. The concept of Shanghai regional culture, Shanghai style Chinese medicine and Shanghai herbal paste were introduced by the combination of literature search and practical experience. The historical developments of Shanghai herbal paste were summarized in order to understand Shanghai herbal paste comprehensively and provide a historical and empirical basis for the inheritance and innovation of Shanghai herbal paste.