Objective : To analyze the epidemiological characteristics of pertussis among the population aged ≤18 years in Zhejiang Province from 2016 to 2023, so as to provide a basis for optimizing pertussis prevention and control measures as well as immunization strategies. Methods: Data on pertussis cases among individuals aged ≤18 years in Zhejiang Province from 2016 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Vaccination records were obtained from the specialized pertussis epidemiological survey conducted in Zhejiang Province. The descriptive epidemiological method was employed to analyze the epidemiological characteristics of pertussis among the population aged ≤18 years, as well as the interval between disease onset and the last immunization among breakthrough cases. Results: A total of 7 431 pertussis cases aged ≤18 years were reported in Zhejiang Province from 2016 to 2023, with an average annual reported incidence of 8.68/105. The overall trend showed no statistical significance (P>0.05). The reported incidence remained relatively low from 2016 to 2021, consistently below 10.00/105. In contrast, the incidence rose to 33.98/105 in 2022 and 13.39/105 in 2023. The peak incidence period was from April to August, during which 4 024 cases were reported, accounting for 54.15%. Hangzhou City, Wenzhou City, and Ningbo City reported the highest number of cases, with 3 844, 1 581, and 646 cases, representing 51.73%, 21.28%, and 8.69%, respectively. In terms of average annual incidence, Hangzhou City, Wenzhou City, and Huzhou City ranked the highest, with rates of 33.98/105, 12.38/105, and 12.27/105, respectively. Among age groups, the highest reported incidence was observed in children aged 0-<1 years, at 48.87/105. From 2016 to 2023, the incidence in the 5-<10 years and 10-18 years age groups showed upward trends (AAPC=108.193%, 106.709%, both P<0.05). The proportion of cases in the 5-<10 years age group also increased during this period (P<0.05). A total of 109 breakthrough pertussis cases were identified. The median interval between disease onset and the last immunization was 4.00 (interquartile range, 4.00) years. The numbers of cases with intervals of 1-<2 years and ≥6 years were both relatively high, comprising 25 cases and 37 cases, which accounted for 22.94% and 33.94%, respectively. Conclusions From 2016 to 2021, the reported incidence of pertussis in Zhejiang Province remained relatively stable. However, a sharp increase was observed in 2022. The disease peaked during spring and summer. Key populations for targeted prevention and control included children aged 0-<1 year, 5-<10 years, and 10-18 years. The interval between disease onset and the last immunization among breakthrough pertussis cases exhibited a bimodal distribution.

Objective To analyze the correlations between the thoracic electrical impedance tomography(EIT)-derived parameters global inhomogeneity(GI),center of ventilation(COV),regional ventilation delay(RVD),and atelectasis in hospitalized patients,and to explore their effectiveness in evaluating atelectasis.Methods The clinical data of 140 hospitalized patients monitored by thoracic EIT between Sep.2024 and Jan.2025 were retrospectively analyzed.Patients were assigned to 2 groups based on chest computed tomography confirmation of atelectasis within the preceding short-term period during EIT monitoring:non-atelectasis group or atelectasis group.The algorithm software designed with MATLAB was used to acquire GI and COV.RVD was obtained through analysis with the Dr?ger EIT Data Analysis Tool 6.3 software,and patients'general data were concurrently documented.Comparative analysis of EIT-derived parameters between groups was conducted.Multivariate logistic regression analysis was employed to investigate the correlations of GI,COV,and RVD with atelectasis,while receiver operating characteristic curve analysis was performed to assess the efficacy of EIT-derived parameters in evaluating atelectasis.Results A total of 140 patients were enrolled,with 19(13.6%)cases presenting atelectasis.Compared to the non-atelectasis group,the atelectasis group demonstrated significantly higher proportions of male patients and cardiovascular disease and thoracic surgery(non-pulmonary)histories,lower body mass index(BMI),and alongside elevated GI and RVD values with reduced COV(all P＜0.05).Multivariate logistic regression analysis revealed that GI,COV,and RVD maintained independent associations with atelectasis after adjusting for age,gender,BMI,pleural effusion,and emphysema(odds ratio[OR]=1.39,95%confidence interval[CI]1.20-1.67;OR=0.85,95%CI 0.75-0.96;OR=1.22,95%CI 1.09-1.39;all P＜0.05).The area under curve(AUC)values of GI,COV,and RVD for evaluating atelectasis in hospitalized patients were 0.82,0.80,and 0.82,respectively(while RVD demonstrated a higher AUC,its clinical applicability was influenced by respiratory patterns).Conclusion Thoracic EIT-derived parameters GI and COV demonstrate significant correlations with atelectasis and may serve as valuable indicators for evaluating atelectasis in hospitalized patients.

Chronic glomerulonephritis （CGN） is a common clinical chronic glomerular disease caused by autoimmune reaction， the pathogenesis of which is complex and has not been fully elucidated. There is no specific treatment method in modern medicine. The establishment of an animal model of CGN in accordance with its characteristics in western medicine and traditional Chinese medicine will help to reveal the pathogenesis of CGN， rate drugs， and improve the treatment plan. Based on the clinical diagnostic criteria of CGN， the paper establishes the syndrome differentiation criteria of CGN for Chinese and western medicine. Through summarizing the literature on animal models of CGN and making a further analysis， it is found that the CGN models are mainly modeled using rats with the methods of single-factor induction or two-factor induction， and the main manifestation of the disease characteristics is nephritis-related symptoms. The single-factor-induced or two-factor-induced CGN rat models have a high fitting degree with the clinical characteristics in western medicine， but the fitting degree is insufficient with the clinical characteristics in traditional Chinese medicine. In addition， the CGN models with syndromes of traditional Chinese medicine are dominated by Qi deficiency in the spleen and kidney and Qi deficiency in the lung and kidney， while models for Yang deficiency in the spleen and kidney， Yin deficiency in the liver and kidney， and deficiency of both Qi and Yin are slightly insufficient. Therefore， it is important to prepare a new and improved animal model of CGN， so that a preclinical model can be provided for the exploration of the pathogenesis of CGN in western medicine and traditional Chinese medicine and its therapeutic research.

Hypertrophic scar is a fibrous hyperplastic disorder that arises from skin injuries. The current therapeutic modalities are constrained by the dense and rigid scar tissue which impedes effective drug delivery. Additionally, insufficient autophagic activity in fibroblasts hinders their apoptosis, leading to excessive matrix deposition. Here, we developed an active microneedle (MN) system to overcome these challenges by integrating micromotor-driven drug delivery with autophagy regulation to remodel the scar microenvironment. Specifically, sodium bicarbonate and citric acid were introduced into the MNs as a built-in engine to generate CO₂ bubbles, thereby enabling enhanced lateral and vertical drug diffusion into dense scar tissue. The system concurrently encapsulated curcumin (Cur), an autophagy activator, and triamcinolone acetonide (TA), synergistically inducing fibroblast apoptosis by upregulating autophagic activity. In vitro studies demonstrated that active MNs achieved efficient drug penetration within isolated scar tissue. The rabbit hypertrophic scar model revealed that TA-Cur MNs significantly reduced the scar elevation index, suppressed collagen I and transforming growth factor-β1 (TGF-β1) expression, and elevated LC3 protein levels. These findings highlight the potential of the active MN system as an efficacious platform for autonomous augmented drug delivery and autophagy-targeted therapy in fibrotic disorder treatments.

Objective To investigate the impacts of intervertebral foramen endoscopic surgery combined with silver needle hyperthermia therapy on lumbar spine function and local tenderness in patients with lumbar disc herniation(LDH).Methods From April 2020 to March 2023,100 LDH patients were randomly devided into a control group(50 cases)and an observation group(50 cases)through random number table method.The control group was treated with intervertebral foramen endoscopic surgery combined with conventional lumbar and dorsal muscle training,while observed group was treated with intervertebral foramen endoscopic surgery combined with silver needle warm therapy.The lumbar function,local tenderness,laboratory indicators,and adverse reactions were compared.Results The Japanese Orthopaedic Association(JOA)score increased in both groups after treatment,and observed group had obviously higher scores,the differences were statistically significant(P<0.05);After treatment,both groups showed a decrease in pain visual analogue scale(VAS)score,and observed group had obviously lower scores,the differences were statistically significant(P<0.05);The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2),and 5-hydroxytryptamine(5-HT)in both groups decreased after treatment,and the observed group showed a more obvious decrease in all indicators,the differences were statistically significant(P<0.05);The incidence of adverse reactions was 4.00%(2/50)in observed group and 20.00%(10/50)in the control group,adverse reactions in observed group were obviously fewer,the difference was statistically significant(P<0.05).Conclusion The combination of intervertebral foramen endoscopic surgery and silver needle hyperthermia therapy can effectively improve lumbar spine function and alleviate local tenderness symptoms in patients with LDH.It is worthy clinical application.

During the progression of ischemic stroke,cells experience oxidative stress and intracellular energy depletion,triggering the dynamic assembly and disassembly of stress granules.Stress granules may have a dual role in ischemic stroke.In the ultra-early reperfusion period(6-36 h),under acute stress,the stress granules may inhibit neuronal apoptosis and exert neuroprotective effects through reversible liquid-liquid phase separation.In contrast,in the acute reperfusion period(36 h to 2 weeks),under prolonged stress,pathological stress granules may accumulate through liquid-solid phase transition,leading to neuronal dysfunction and inducing ischemic stroke sequelae such as motor and cognitive impairments.This article reviewed the mechanisms of stress granules dynamic phase transitions during ischemic stroke and their effects on neurons,aiming to provide references and insights for future stress granule-targeted interventions for ischemic stroke and its sequelae.

Objective:To explore the relationship between parenting styles of toddlers aged 30 months and attention deficit hyperactivity disorder (ADHD) symptom trajectories in preschool children.Methods:The subjects were 2 111 children and their parents in Ma'anshan Birth Cohort. Parenting styles were assessed at 30 months of age using the Brief Toddler Parenting Style Questionnaire, which defines parenting styles on four dimensions: warmth and interaction, attention and acceptance, outdoor and social activities, and neglect and restrictions. The Chinese version of the Conners Abbreviated Symptom Questionnaire was used to examine preschooler's ADHD symptoms aged 3, 5, and 6 years. ADHD symptom trajectories were fitted using group-based trajectory modeling. The multinomial logistic regression model was used to evaluate the relationship between parenting styles at 30 months of age and ADHD symptom trajectories in children. The additive and multiplicative models were applied to analyze the interaction effect of negative parenting styles in children's ADHD symptom trajectories.Results:ADHD symptom trajectories in children included the low-score (48.3%), moderate-score (47.7%), and high-score groups (4.0%). After adjusting for the confounding factors, the results of the multinomial logistic regression analysis showed that negative parenting styles of the father/mother were associated with ADHD symptom trajectories in children ( P<0.05). The father/mother's low warmth and interaction (father: OR=2.07,95% CI:1.68-2.54; mother: OR=2.02,95% CI:1.64-2.48), low attention and acceptance (father: OR=1.94,95% CI:1.57-2.39; mother: OR=1.47,95% CI:1.20-1.81), low outdoor and social (father: OR=1.74,95% CI:1.43-2.13; mother: OR=1.60,95% CI:1.32-1.94), and high neglect and restriction (father: OR=2.09,95% CI:1.67-2.62; mother: OR=2.06,95% CI:1.65-2.56) were associated with ADHD symptom moderate-score trajectories compared to the low-score trajectory group, mother's low warmth and interaction, low outdoor and social, and high neglect and restrictions. Statistically significant association was seen in negative parenting styles of fathers with the high-score group. There was a multiplicative interaction for hostile parenting ( P<0.05). The additive interaction results showed that there was a synergistic effect of hostile parenting, which increased the risk of the high-score trajectories of ADHD symptoms in children. Conclusions:Both parents' parenting styles influenced ADHD symptom change the trajectories in preschoolers. Negative parenting styles of the father/mother increase the risk of the moderate-score and high-score trajectories of ADHD symptoms in children. Hostile parenting by both parents has a synergistic impact on the risk of ADHD symptom trajectories in children, and the simultaneous presence of both increases the risk of the high-score trajectory of ADHD symptoms.

Objective:To standardize the management of Investigator-Initiated Trials(IITs) and improve the quality of research projects, this study takes a tertiary hospital in Beijing as an example to analyze the key risk points in the implementation process of IITs and proposes countermeasures based on the issues identified during the management process.Methods:The study analyzed the IITs conducted at in the hospital from 2022 to 2023, focusing on 4 aspects: project classification evaluation and management (risk management), project implementation quality (process management), collaboration and support conditions(contract review and execution), and participant protection (medical ethics). It examined the key points and difficulties in project process management to standardize the quality management of IITs.Results:The implementation process management of IITs in medical institutions was an essential component for standardized clinical research management and an effective means to ensure the scientific nature of clinical research and the quality of data.Conclusions:Medical institutions should establish an effective and feasible IIT quality management system to comprehensively enhance the quality of IIT project, aiming to produce high-quality clinical research outcomes.

Objective:To investigate the incidence of osteoporosis (OP) in maintenance hemodialysis (MHD) patients at the blood purification center in Gaochun district, and analyze its influencing factors.Methods:A retrospective study was conducted on 3 622 patients who received regular MHD treatment at Nanjing Gaochun People′s Hospital and Nanjing Gaochun Traditional Chinese Medicine Hospital from January 2019 to December 2023. The demographic characteristics, comorbidities, and clinical data such as blood calcium and creatinine of patients were collected. The ultivariate Logistic regression model was applied to analyze the influencing factors of OP in MHD patients.Results:The survey revealed that 33.63% of MHD patients had decreased bone mass, and 37.24% of MHD patients experienced osteoporosis. According to the occurrence of OP, 3 622 patients were separated into the OP group (1 349 cases) and the non-OP group (2 273 cases). Univariate analysis showed that compared with the non-OP group, the albumin (ALB) level in the OP group was lower: (38.95 ± 5.17) g/L vs. (40.32 ± 5.84) g/L, there was statistical difference( P<0.05). Compared with the non-OP group, the levels of immunoreactive parathyroid hormone (iPTH) and alkaline phosphatase (ALP) in the OP group were higher: (262.29 ± 36.76) ng/L vs. (249.55 ± 32.73) ng/L, (114.74 ± 18.01) U/L vs. (109.63 ± 17.25) U/L, the proportion of patients aged≥60 years old, female and dialysis duration≥5 years was higher: 61.75%(833/1 349) vs. 47.87%(1 088/2 273), 66.35%(895/1 349) vs. 54.86%(1 247/2 273), 52.34%(706/1 349) vs. 34.36%(781/2 273), there were statistical differences( P<0.05). Multivariate Logistic regression revealed ALB ( OR = 0.724, 95% CI 0.568 - 0.920), iPTH ( OR = 1.374, 95% CI 1.095 - 1.725), ALP ( OR = 1.325, 95% CI 1.070 - 1.641), age ( OR = 2.753, 95% CI 1.664 - 4.556), gender ( OR = 2.993, 95% CI 1.611 - 5.560), and dialysis time ( OR = 4.216, 95% CI 2.365 - 7.516) were all influencing factors for the occurrence of OP in MHD patients ( P<0.05). Conclusions:The incidence of OP in MHD patients in Gaochun district is high, and its occurrence is closely related to ALB, iPTH, ALP, age, gender and dialysis time. Clinical attention should be focused on this.

OBJECTIVE: To observe the clinical effect of needle cauterization on vitiligo with deficiency cold and blood stasis. METHODS: A total of 62 patients of vitiligo with deficiency cold and blood stasis were randomly divided into an observation group and a control group, 31 cases each group.On the basis of 308 nm excimer light irradiation combined with ironing with Chinese medicine, the control group was treated with tacrolimus ointment for external use, twice a day; the observation group was treated with needle cauterization at vitiligo spots, once a week.Both groups were treated for 10 weeks. Before and after treatment, the area of vitiligo spot, TCM syndrome score, serum levels of inflammatory indexes (interleukin[IL]-6 and IL-17) were observed in the two groups, and the clinical effect was evaluated. RESULTS: After treatment, the areas of vitiligo spot, TCM syndrome scores and serum levels of IL-6, IL-17 were decreased compared with those before treatment in both groups (P<0.05), and the above indexes in the observation group were lower than those in the control group (P<0.05). The total effective rate in the observation group was 93.5% (29/31), which was higher than 77.4% (24/31) in the control group (P<0.05). CONCLUSION Needle cauterization could reduce the areas of vitiligo spot in patients of vitiligo with deficiency cold and blood stasis, improve the clinical symptoms, its mechanism may be related to the reduction of serum levels of inflammatory indexes.
Humans ; Vitiligo/physiopathology* ; Male ; Female ; Adult ; Young Adult ; Middle Aged ; Adolescent ; Interleukin-6/blood* ; Interleukin-17/blood* ; Cautery ; Acupuncture Therapy/instrumentation* ; Needles ; Cold Temperature ; Treatment Outcome