Objective:To explore the effects of imperatorin(IMP)on airway remodeling in the bronchial asthma mice,and to elucidate the possible mechanisms.Methods:Forty SFP male BALB/c mice were randomly divided into control group,model group,low dose of IMP group(IMP-L group),high dose of IMP group(IMP-H group)and dexamethasone group,with 8 mice in each group.Except for contol group,the mice in the other groups were injected with an ovalbumin(OVA)suspension intraperitoneally to induce the asthma models.After one week,the daily asthma symptoms of the mice were observed and scored.After 8 weeks,the enhanced pause(Penh)values of the mice in various groups were detected to evaluate the airway reactivities.The percentages of eosinophils in the bronchoalveolar lavage fluid(BALF)of the mice in various groups were detected by flow cytometry.The levels of serum IgE,interleukin interferon-gamma(IL)-13,IL-5,IL-4 and interferon-gamma(IFN-γ)in BALF of the mice in various groups were measured by enzyme-linked immunosorbent assay(ELISA)method.HE,PAS and Masson staining were applied to observe the pathomorphology,the number of goblet cells and collagen deposition of the lung tissue of the mice in various groups.Immunohisto chemistry method was applied to detect the expressions of α-smooth muscle actin(α-SMA)and mouse mammary tumor virus(MMTV)wingless type MMTV intergration site family member 5A(Wnt5A)proteins in lung tissue of the mice in various groups.The expression levels of Wnt5A,cellular myelocytomatosis oncogene(c-Myc),β-catenin and α-SMA in lung tissue of the mice in various groups were detected by Western blotting method.The expression levels of α-SMA protein in lung tissue of the mice in various groups were detected by immunofluorescence method.Results:Compared with control group,the score of asthma symptoms of the mice in model group was increased(P<0.01);the Penh value was significantly increased(P<0.01);the serum IgE levels and the levels of IL-13,IL-5,IL-4 in BALF,as well as the percentage of eosinophils(EOS)in BALF were significantly increased(P<0.05 or P<0.01),and the level of IFN-γ was reduced(P<0.05);the expression levels of α-SMA and Wnt5A proteins in lung tissue were markedly increased(P<0.01);the expression levels of proteins associated with the Wnt/β-catenin signaling pathway in the lung tissue were significantly increased(P<0.01);the immofluorescence method results showed the expression level of α-SMA protein in lung tissue was significantly increased(P<0.01).Compared with model group,the scores of asthma symphtoms of the mice in IMP-L group,IMP-H group,and dexamethasone group were decereased(P<0.01),and the Penh values of the mice in IMP-H group were decreased(P<0.05);the serum IgE levels and the levels of IL-13,IL-5,IL-4 in BALF,as well as the percentages of EOS in BALF of the mice in IMP-L group,IMP-H group,and dexamethasone group were decreased(P<0.05 or P<0.01),and the levels of IFN-γ were increased(P<0.05);the expression levels α-SMA and Wnt5A proteins in lung tissue were decreased(P<0.05 or P<0.01);the expression levels of proteins related to the Wnt/β-catenin signaling pathway in the lung tissue were decreased(P<0.05 or P<0.01);the immunofluorescence method results showed that expression levels of the α-SMA protein in the lung tissue were reduced(P<0.05 or P<0.01).Conclusion:IMP has an improving effect on airway remodeling in the asthmatic mice and can inhibit the expression levels of Wnt/β-catenin pathway-related proteins.

Objective:To understand the incidence and epidemiological characteristics of enteritis due to norovirus infection in Guizhou Province from 2016 to 2023, and provide reference for the prevention and control of enteritis caused by norovirus.Methods:The data were from National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. To collect the data of other infectious diarrhea cards in Guizhou from 2016 to 2023, which were annotated as enteritis due to norovirus and food-borne disease surveillance sentinel report in Guizhou, which were positive for norovirus detection. The data of cluster/outbreaks were from the Public Health Emergency Event Surveillance System and the field investigation reports of CDC at all levels. Descriptive epidemiological method was used to describe the characteristics of its three-dimension distribution, epidemic situation and pathogen spectrum. R 4.2.2 software was used for statistical analysis.Results:A total of 2 340 cases of enteritis due to norovirus were reported in Guizhou Province during this period, with an average annual reported incidence of 0.79/100 000, and the incidence showed an upward trend (trend χ2=1 723.80, P<0.001). The high incidence season is from October to March (winter and spring). The male to female ratio of the cases was 1.39∶1 (1 362∶978). A total 1 382 cases occurred in age group under 5 years old (59.06%) and 1 249 cases occurred in children living scatteredly (53.38%). The average annual reported incidence in 6 prefectures (muniipality)(1.15/100 000 in Qiandongnan Miao and Dong Autonomous Prefecture, 1.08/100 000 in Guiyang, 1.07/100 000 in Liupanshui, 1.06/100 000 in Qianxinan Buyi and Miao Autonomous Prefecture, 0.91/100 000 in Qiannan Buyi and Miao Autonomous Prefecture and 0.89/100 000 in Tongren) in Guizhou Province was higher than provincial level, and the affected areas gradually expanded from southeastern counties (districts) to western and northern counties (districts). The average annual reported incidence rate was higher in urban area (1.12/100 000) than in rural area (0.39/100 000). A total of 31 cluster/outbreaks of enteritis due to norovirus were reported, in which 83.87% (26/31) occurred in child care settings, primary and secondary schools, in which 74.19% (23/31) were caused by human-to-human transmission. In the 2 340 cases, 2 147 were laboratory diagnosed (91.75%), and 193 were clinically diagnosed (8.25%). In the laboratory diagnosed cases, 2 026 (94.36%) were caused by single norovirus infection and 121 (5.64 %) were caused by mixed infection. Conclusions:On the whole, the incidence of enteritis due to norovirus in Guizhou Province was on the rise from 2016 to 2023, and winter and spring were the high incidence seasons. Effective prevention and control measures should be taken for key populations, key regions and key places, and multi-channel and multi-pathogen surveillance and health education should be strengthened.

Melatonin is widely used as an over-the-counter medication to treat insomnia in children with autism spectrum disorder (ASD) and neurogenetic disorders (NGD). However, there is still a lack of research on its efficacy and safety, and clinical practice standards are to be established. In response, the International Pediatric Sleep Association (IPSA) convened an expert panel and developed a consensus statement:"Melatonin Use in Managing Insomnia in Children with Autism and Other Neurogenetic Disorders-an Assessment by the International Pediatric Sleep Association (IPSA)", which was published in Sleep Medicine, April 2024. The consensus focused on the efficacy and adverse effects of melatonin treatment for insomnia in children with ASD and NGD-including Smith-Magenis syndrome, Rett syndrome, Angelman syndrome, and tuberous sclerosis complex. It systematically reviews randomized controlled trials (RCTs) conducted between 2012 and 2022, and integrates current best clinical practices to formulate 10 consensus recommendations. Despite these contributions, the consensus has limitations: a small number of included RCTs, a lack of grading for evidence quality, and recommendation strength. Furthermore, the study population is primarily composed of children from Western countries. This article seeks to interpret the consensus to improve standardized use of melatonin for insomnia in Chinese children with ASD and NGD, and to provide a reference for the future development of localized evidence-based guidelines.

Objective:To understand the incidence and epidemiological characteristics of enteritis due to norovirus infection in Guizhou Province from 2016 to 2023, and provide reference for the prevention and control of enteritis caused by norovirus.Methods:The data were from National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. To collect the data of other infectious diarrhea cards in Guizhou from 2016 to 2023, which were annotated as enteritis due to norovirus and food-borne disease surveillance sentinel report in Guizhou, which were positive for norovirus detection. The data of cluster/outbreaks were from the Public Health Emergency Event Surveillance System and the field investigation reports of CDC at all levels. Descriptive epidemiological method was used to describe the characteristics of its three-dimension distribution, epidemic situation and pathogen spectrum. R 4.2.2 software was used for statistical analysis.Results:A total of 2 340 cases of enteritis due to norovirus were reported in Guizhou Province during this period, with an average annual reported incidence of 0.79/100 000, and the incidence showed an upward trend (trend χ2=1 723.80, P<0.001). The high incidence season is from October to March (winter and spring). The male to female ratio of the cases was 1.39∶1 (1 362∶978). A total 1 382 cases occurred in age group under 5 years old (59.06%) and 1 249 cases occurred in children living scatteredly (53.38%). The average annual reported incidence in 6 prefectures (muniipality)(1.15/100 000 in Qiandongnan Miao and Dong Autonomous Prefecture, 1.08/100 000 in Guiyang, 1.07/100 000 in Liupanshui, 1.06/100 000 in Qianxinan Buyi and Miao Autonomous Prefecture, 0.91/100 000 in Qiannan Buyi and Miao Autonomous Prefecture and 0.89/100 000 in Tongren) in Guizhou Province was higher than provincial level, and the affected areas gradually expanded from southeastern counties (districts) to western and northern counties (districts). The average annual reported incidence rate was higher in urban area (1.12/100 000) than in rural area (0.39/100 000). A total of 31 cluster/outbreaks of enteritis due to norovirus were reported, in which 83.87% (26/31) occurred in child care settings, primary and secondary schools, in which 74.19% (23/31) were caused by human-to-human transmission. In the 2 340 cases, 2 147 were laboratory diagnosed (91.75%), and 193 were clinically diagnosed (8.25%). In the laboratory diagnosed cases, 2 026 (94.36%) were caused by single norovirus infection and 121 (5.64 %) were caused by mixed infection. Conclusions:On the whole, the incidence of enteritis due to norovirus in Guizhou Province was on the rise from 2016 to 2023, and winter and spring were the high incidence seasons. Effective prevention and control measures should be taken for key populations, key regions and key places, and multi-channel and multi-pathogen surveillance and health education should be strengthened.

Melatonin is widely used as an over-the-counter medication to treat insomnia in children with autism spectrum disorder (ASD) and neurogenetic disorders (NGD). However, there is still a lack of research on its efficacy and safety, and clinical practice standards are to be established. In response, the International Pediatric Sleep Association (IPSA) convened an expert panel and developed a consensus statement:"Melatonin Use in Managing Insomnia in Children with Autism and Other Neurogenetic Disorders-an Assessment by the International Pediatric Sleep Association (IPSA)", which was published in Sleep Medicine, April 2024. The consensus focused on the efficacy and adverse effects of melatonin treatment for insomnia in children with ASD and NGD-including Smith-Magenis syndrome, Rett syndrome, Angelman syndrome, and tuberous sclerosis complex. It systematically reviews randomized controlled trials (RCTs) conducted between 2012 and 2022, and integrates current best clinical practices to formulate 10 consensus recommendations. Despite these contributions, the consensus has limitations: a small number of included RCTs, a lack of grading for evidence quality, and recommendation strength. Furthermore, the study population is primarily composed of children from Western countries. This article seeks to interpret the consensus to improve standardized use of melatonin for insomnia in Chinese children with ASD and NGD, and to provide a reference for the future development of localized evidence-based guidelines.

ObjectiveTo explore the effects of after-school tutoring for school-age children on their emotions and behaviors， and to provide a basis for developing after-school tutoring and psychological support strategies for school-age children. MethodsFour elementary schools in a district of Shanghai were selected by simple random sampling method. Whole group sampling was conducted by class， and parents of students were surveyed by general questionnaire and the scale of strengths and difficulties. Information was collected on the basic conditions of children and families and the results were compared and analyzed. ResultsThis study showed that 88.26% of children attended extracurricular classes， of which 26.16% attended 3 or more classes， 42.5% attended cultural classes， 28.3% attended sports classes， and 59.8% attended art classes. Children who did not attend classes had higher pro-social scores. Children who attended reading class had lower scores for emotional problems that was a protective factor for emotional problems. Children who chose extracurricular programs in sports and reading also had lower overall scores for difficulties. Excessive use of electronic devices by school-age children on weekdays or weekends had a negative effect on emotional and conduct problem scores regardless of whether they chose extracurricular programs. It appeared that the choice of cultural programs， art programs and different levels of exercise intensity had no effect on children's emotions and behaviors. ConclusionFor children with low pro-social level， extracurricular classes should be carefully selected. For extracurricular classes， more reading and sports-related courses can be considered， which have positive effects on school-age children’s emotions and behaviors. Regardless of the choice of extracurricular classes， try to avoid excessive online classes.

Objective:To investigate the effect of modified holmium laser enucleation of the prostate (HoLEP) in patients with large-volume benign prostatic hyperplasia (BPH), and the effect on urethral function, pain mediators, epidermal growth factor (EGF) and prostate specific antigen (PSA).Methods:The clinical data of 83 patients with large-volume BPH in Dalian Central Hospital from October 2019 to April 2021 were retrospectively analyzed. Among them, 42 patients were treated with modified HoLEP (modified HoLEP group), and 41 patients were treated with transurethral resection of the prostate (TURP; TURP group). The procedure-related indexes (operative time, hospital stay, duration of urinary catheter retention, bladder flushing time and hemoglobin loss) were compared between 2 groups; the serum levels of pain mediators including substance P (SP), prostaglandin E 2 (PGE 2), calcitonin gene-related peptide (CGRP) before surgery and 1, 3 days after surgery were measured; the serum levels of EGF and PSA before surgery and 1, 2 weeks after surgery were measured; postoperative complications were counted; the maximum urinary flow rate, residual urine volume and bladder compliance before surgery and 3, 6 months after surgery were measured to assess urethral function; the improvement of symptoms before surgery and 3, 6 months after surgery were assessed by the overactive bladder symptom score scale, the international prostate symptom score scale and the quality of life index scale. Results:There was no statistical difference in operative time between 2 groups ( P>0.05); the hospital stay, duration of urinary catheter retention and bladder flushing time in modified HoLEP group were significantly shorter than those in TURP group: (4.52 ± 1.07) d vs. (5.74 ± 1.46) d, (2.87 ± 0.72) d vs. (4.84 ± 0.93) d, (18.29 ± 6.75) d vs. (28.54 ± 10.68) d, the hemoglobin loss was significantly lower than that in TURP group: (2.96 ± 0.84) g vs. (13.17 ± 5.69) g, and there were statistical differences ( P<0.01). There were no statistical differences in SP, PGE 2 and CGRP before surgery between 2 groups ( P>0.05); the SP, PGE 2 and CGRP 1 and 3 d after surgery in modified HoLEP group were significantly lower than those in TURP group, and there were statistical differences ( P<0.01). There were no statistical differences in EGF, PSA, urethral function and symptoms improvement before and after surgery ( P>0.05). The incidence of postoperative complications in modified HoLEP group was significantly lower than that in TURP group: 9.52% (4/42) vs. 29.27% (12/41), and there was statistical difference ( P<0.05). Conclusions:Modified HoLEP for the treatment of large-volume BPH patients can effectively reduce the incidence of postoperative complications, further reduce the level of pain mediators, and effectively shorten the postoperative recovery process.

Objective To summarize the preliminary clinical outcomes of combination therapy with molecular targeted agents/immunological agents and to explore the potential value of multidisciplinary therapy in the treatment of postoperative refractory recurrent hepatobiliary tumor.Methods 52 cases of postoperative refractory recurrent hepatobiliary tumor during June 2016 to January 2019 from outpatient and inpatient departments at the First Medical Center of PLA General Hospital were prospectively collected,including 37 males and 15 females,with a mean age of (56.2 ± 8.5) years.Referring to the results of next-generation sequencing (NGS) and other-omics,we designed individualized therapy options for each patient.Follow-ups were done regularly and tumor responses were assessed by modified response evaluation criteria in solid tumors (mRECIST).Results Of 52 patients,median follow-up was 10 months (range 3-31 months).14 (26.9％) patients achieved a complete response (CR).8 (15.3％) patients achieved a partial response (PR).14 (26.9％) patients had stable disease (SD).16 (30.8％,including 4 deaths) had progressive disease (PD).Objective response rate and disease control rate were 42.3％ (22/52) and 69.2％ (36/52),respectively.The median progression-free survival (PFS) was 7 months.6-and 12-month overall survival rates were 100％ (48/48),87.5％ (21/24),respectively.Conclusions Precision medicine has good guidance on the treatment of refractory recurrence of hepatobiliary tumors.The combination therapy of multi-target tyrosine kinase inhibitors and immune checkpoint inhibitors may achieve better disease control and deserve further promotion in clinical application.

Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1％) cases,Ta in 20(18.9％) cases and carcinoma in situ in 6 (5.7％) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5％) patients experienced tumor recurrence and 2 (1.9％) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5％.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95％CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1％ (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 ％),9 cases (3.3 ％) with economic reasons and 11 cases (4.0％) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.

Objective To study the efficacy and security of solifenacin in prevention of cystospasm after radical prostatectomy. Methods The clinical data of 93 localized prostate cancer patients who had underwent laparoscopic radical prostatectomy were retrospectively analyzed. The patients were divided into solifenacin group (52 cases) and control group (41 cases) based on the condition of taking solifenacin after operation. The day and night frequency and duration of cystospasm from the first day to the third day after operation, incidence of urine extravasation, duration of bloody urine, time of pelvic cavity drainage and ureter retention, untoward reaction (dry mouth, headache and abdominal distention) was compared between two groups. Results The day and night frequency and duration of cystospasm at second day and third day after operation in solifenacin group were significantly lower than those in control group. Day frequency of cystospasm: (1.54 ± 0.42) times vs. (3.35 ± 0.43) times and (1.38 ± 0.58) times vs. (2.86 ± 0.66) times, night frequency of cystospasm:(1.66 ± 0.63) times vs. (3.58 ± 0.72) times and (1.47 ± 0.33) times vs. (3.27 ± 0.68) times, duration of cystospasm:(0.18 ± 0.11) h vs. (0.33 ± 0.18) h and (0.21 ± 0.09) h vs. (0.29 ± 0.21) h, and the incidence of urine extravasation at the third day after operation in solifenacin group was significantly lower than that in control group: 1.92% (1/52) vs. 17.07% (7/41), and there were statistical differences (P<0.05). The duration of bloody urine, time of pelvic cavity drainage and ureter retention after operation in solifenacin group were significantly shorter than those in control group:(30.2 ± 5.6) h vs. (48.3 ± 4.7) h, (50.6 ± 5.9) h vs. (70.3 ± 6.2) h and (7.6 ± 1.4) d vs. (10.4 ± 0.9) d, and there were statistical differences (P<0.05). There was no statistical difference in untoward reaction between 2 groups (P>0.05). Conclusions Solifenacin can reduce the frequency of cystospasm and shorten the duration of cystospasm effectively after radical prostatectomy. It has a positive effect on reducing the incidence of urinary extravasation and shorting the extubation time. It is helpful to improve the quality of life and the recovery of the patients.