OBJECTIVE To explore the risk factors for severe influenza patients in Fuzhou,and to provide reference for the prevention and control of severe influenza.METHODS Information on 412 patients with severe influenza in Fuzhou City with onset dates from Jan.2023 to Jan.2025 was collected from the China Influenza Surveillance In-formation System and the China Disease Prevention and Control Information System.The severe patients were matched 1∶1 with non-severe patients based on gender and age±3 years of the severe patients.Basic infor-mation,vaccination history,clinical symptoms,types of infecting viruses and medical history of both groups of patients were collected to summarize the risk factors for severe illness progression in influenza patients.RESULTS The proportions of obesity,retired personnel,children or students,unemployed individuals and smokers in the se-vere group were all higher than those in the non-severe group,while the vaccination rate(6.07％)was lower than that of the non-severe group(16.50％)(P＜0.001).The proportions of typical symptoms of shortness of breath/dyspnea and altered mental status/convulsions in the severe group were 23.30％and 21.60％,respectively,which were higher than those in the non-severe group(P＜0.001).The proportions of individuals with a history of chro-nic respiratory diseases and cancer/tumors in the severe group were 26.70％and 19.90％,respectively,which were higher than those in the non-severe group(P＜0.001).The proportion of influenza A(H1 N1)in the severe group(58.50％)was higher than that in the non-severe group(39.32％)(P＜0.001).Retired personnel,children or students and unemployed individuals were high-risk groups for the severe influenza,while farmers were a low-risk group.Obesity(OR=1.966),unvaccination(OR=3.738),smoking(OR=1.787),typical symptoms of shortness of breath/dyspnea(OR=3.305),altered mental status/convulsions(OR=4.099),history of chronic respiratory diseases(OR=4.820)and history of cancer/tumors(OR=3.269)and infection with influenza A(H1N1)(OR=6.422)and influenza A(H3N2)(OR=4.441)were risk factors for the severe influenza(P＜0.05).The recovery time in the severe group was 21(6,33)days,which was longer than that in the non-severe group(P＜0.001).CONCLUSIONS Obesity,unvaccination,smoking,typical symptoms of shortness of breath/dyspnea,altered mental status/convulsions,history of chronic respiratory diseases and history of cancer/tumors and infection with influenza A(H1N1)and influenza A(H3N2)are risk factors for severe influenza patients.It is necessary to strengthen influenza prevention and control among the elderly and children,enhance health edu-cation,and continuously promote influenza vaccination among key populations.

This paper summarized the current status of infection and quality control of medical flexible endoscope (abbreviation:endoscope),which can identify that defect of the quality control of endoscopic forceps channels was a major cause of nosocomial infections of endoscopy. Based on this,a multifunctional quality control workstation with forceps channel of detecting flexible endoscope,and precision components included top ends for medical endoscopes has been developed,which can clearly display residual contaminants and damages in the forceps channels and precision components after the endoscope was reprocessed. It is contribute to enhance the quality control of reprocessing endoscope,and reduce cross-infection of endoscope.

Objective:To observe the impact of upper limb resistance exercise on the exercise tolerance, muscle strength and life quality of patients with chronic obstructive pulmonary disease (COPD) so as to provide a reference for optimizing their rehabilitation plans.Methods:Fifty-eight COPD patients were randomly divided into an observation group and a control group, each of 29. Both groups were given routine pulmonary rehabilitation training (including lip retraction and abdominal breathing) for 12 weeks, while the observation group also performed upper limb resistance exercises. Before and after the intervention, both groups were evaluated using the 6-minute walk test (6MWT), St. George′s Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea Scale (mMRC). Lung function, respiratory muscle strength and upper limb muscle strength were also measured.Results:After the intervention there was a significant increase in the average 6MWT distance, maximum inspiration pressure, maximum expiratory pressure, and upper limb muscle strength among the observation group. In the control group, maximum inspiration pressure and the average the dyspnea mMRC score had improved. The observation group showed a significant decrease in the average heart rate after the 6MWT, and in average dyspnea mMRC and SGRQ scores. So after the intervention there were significant differences between the groups in terms of 6MWT distance (312.3±50.2m), maximum inspiratory pressure (96.8±11.3cmH 2O), maximum expiratory pressure (88.6±11.3cmH 2O), heart rate after the 6MWT (113.8±4.9beats/min) and SGRQ score. Conclusions:Adding upper limb resistance exercise to routine pulmonary rehabilitation can further improve the exercise tolerance, respiratory muscle strength, upper limb muscle strength and life quality of COPD patients. Therefore, such therapy is worthy of clinical promotion and application.

Purpose To investigate the independent risk factors for early recurrence of solitary hepatocellular carcinoma after radiofrequency ablation based on gadoxetic acid disodium(Gd-EOB-DTPA)-enhanced MRI combined with clinical features.Materials and Methods Clinical and imaging data of hepatocellular carcinoma patients who underwent radiofrequency ablation at the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to June 2022 were retrospectively collected.All patients underwent preoperative Gd-EOB-DTPA-enhanced MRI and were followed up for up to two years post-surgery.Univariate and multivariate Cox proportional hazards regression were performed to identify independent risk factors for recurrence after radiofrequency ablation.Results A total of 58 patients were finally included,including early recurrence group(n=22)and non-early recurrence group(n=36).Multivariate Cox regression analysis revealed that preoperative alpha-fetoprotein(AFP)levels(HR=1.103,95%CI 1.008-1.206,P=0.033),arterial-phase irregular margin enhancement(HR=4.647,95%CI 1.527-14.110,P=0.007),peritumoral arterial-phase enhancement(HR=11.575,95%CI 3.575-37.478,P=0.001)and peritumoral hepatobiliary phase hypointensity(HR=5.058,95%CI 1.129-22.668,P=0.034)were independent risk factors for early recurrence.The area under the curve for AFP combined with arterial-phase irregular margin enhancement,peritumoral arterial-phase enhancement and peritumoral hepatobiliary phase hypointensity were 0.896,0.842 and 0.860,with accuracy rates of 81.0%,84.5%and 82.8%,respectively.Conclusion Preoperative serum AFP levels,arterial-phase irregular margin enhancement,peritumoral arterial-phase enhancement and peritumoral hepatobiliary phase hypointensity are independent risk factors for early recurrence after radiofrequency ablation in hepatocellular carcinoma patients.The combination of AFP and any of these MRI features significantly improves predictive efficacy.

Purpose To investigate the independent risk factors for early recurrence of solitary hepatocellular carcinoma after radiofrequency ablation based on gadoxetic acid disodium(Gd-EOB-DTPA)-enhanced MRI combined with clinical features.Materials and Methods Clinical and imaging data of hepatocellular carcinoma patients who underwent radiofrequency ablation at the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to June 2022 were retrospectively collected.All patients underwent preoperative Gd-EOB-DTPA-enhanced MRI and were followed up for up to two years post-surgery.Univariate and multivariate Cox proportional hazards regression were performed to identify independent risk factors for recurrence after radiofrequency ablation.Results A total of 58 patients were finally included,including early recurrence group(n=22)and non-early recurrence group(n=36).Multivariate Cox regression analysis revealed that preoperative alpha-fetoprotein(AFP)levels(HR=1.103,95%CI 1.008-1.206,P=0.033),arterial-phase irregular margin enhancement(HR=4.647,95%CI 1.527-14.110,P=0.007),peritumoral arterial-phase enhancement(HR=11.575,95%CI 3.575-37.478,P=0.001)and peritumoral hepatobiliary phase hypointensity(HR=5.058,95%CI 1.129-22.668,P=0.034)were independent risk factors for early recurrence.The area under the curve for AFP combined with arterial-phase irregular margin enhancement,peritumoral arterial-phase enhancement and peritumoral hepatobiliary phase hypointensity were 0.896,0.842 and 0.860,with accuracy rates of 81.0%,84.5%and 82.8%,respectively.Conclusion Preoperative serum AFP levels,arterial-phase irregular margin enhancement,peritumoral arterial-phase enhancement and peritumoral hepatobiliary phase hypointensity are independent risk factors for early recurrence after radiofrequency ablation in hepatocellular carcinoma patients.The combination of AFP and any of these MRI features significantly improves predictive efficacy.

Objective:To observe the impact of upper limb resistance exercise on the exercise tolerance, muscle strength and life quality of patients with chronic obstructive pulmonary disease (COPD) so as to provide a reference for optimizing their rehabilitation plans.Methods:Fifty-eight COPD patients were randomly divided into an observation group and a control group, each of 29. Both groups were given routine pulmonary rehabilitation training (including lip retraction and abdominal breathing) for 12 weeks, while the observation group also performed upper limb resistance exercises. Before and after the intervention, both groups were evaluated using the 6-minute walk test (6MWT), St. George′s Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea Scale (mMRC). Lung function, respiratory muscle strength and upper limb muscle strength were also measured.Results:After the intervention there was a significant increase in the average 6MWT distance, maximum inspiration pressure, maximum expiratory pressure, and upper limb muscle strength among the observation group. In the control group, maximum inspiration pressure and the average the dyspnea mMRC score had improved. The observation group showed a significant decrease in the average heart rate after the 6MWT, and in average dyspnea mMRC and SGRQ scores. So after the intervention there were significant differences between the groups in terms of 6MWT distance (312.3±50.2m), maximum inspiratory pressure (96.8±11.3cmH 2O), maximum expiratory pressure (88.6±11.3cmH 2O), heart rate after the 6MWT (113.8±4.9beats/min) and SGRQ score. Conclusions:Adding upper limb resistance exercise to routine pulmonary rehabilitation can further improve the exercise tolerance, respiratory muscle strength, upper limb muscle strength and life quality of COPD patients. Therefore, such therapy is worthy of clinical promotion and application.

Huangqintang， with its accurate efficacy， is a classic formula specialized in treating dysentery recommended and promoted by medical experts from successive generations， and it was included in the Catalogue of Ancient Classic Prescriptions （the Second Batch， Han Chinese medicine prescriptions） published by the National Administration of Traditional Chinses Medicine （TCM） in 2023. The method of bibliometrics was applied in this study to conduct textual research on the classic formula Huangqintang and provide a literature reference for the development of modern preparations of Huangqintang. A total of 2 026 pieces of ancient literature were searched with "Huangqintang" as the key word， and 23 pieces of effective data were selected， involving 15 ancient TCM books. The historic evolution， composition， dosage， origin， processing methods， preparation and decocting methods， efficiency， and application of Huangqintang were carefully reviewed. The results showed that Huangqintang was first recorded in the Treatise on Febrile Diseases written by ZHANG Zhongjing. It has the effect of clearing heat， stopping dysentery， regulating the middle， and downbearing counterflow and has become one of the classic formulas widely used in clinical practice. Because of its accurate efficacy， medical experts from later generations have modified it from its original composition. Though many prescriptions have different names， it is the manifestation of physicians' inheritance and development of the thought of ZHANG Zhongjing. Ancient literature showed this prescription had wide indications yet centered on digestive system diseases such as dysentery and abdominal pain. Modern applications of Huangqintang involve digestive， respiratory， ophthalmology and otolaryngology， gynecological， skin， musculoskeletal system， and connective tissue， and this prescription has great potential in treating ulcerative colitis， diarrhea， acute enteritis， and damp-heat dysentery. Through a systematic textual excavation and review of the ancient literature about Huangqintang， the paper has confirmed its key information， so as to provide a scientific basis for the clinical application and new drug development of classic formulas.

Objective To observe the value of machine learning(ML)models based on brain functional network features combining clinical indicators for predicting postoperative outcomes of patients with drug-resistant mesial temporal lobe epilepsy(DR-mTLE).Methods Totally 84 patients with unilateral DR-mTLE who underwent surgery were retrospectively enrolled and classified into seizure free(SF)group(n=55)and non-seizure free(NSF)group(n=29)according to one-year postoperative follow-up.Clinical data were analyzed to screen independent predictors of postoperative outcomes.Based on brain preoperative resting-state functional MRI,brain functional networks were constructed using graph theory analysis,and 587 features were extracted.Five-fold cross validation was used to divide the data into training set and test set,then the optimal brain functional network features related to postoperative outcomes of DR-mTLE patients were selected.Combining with clinically relevant independent predictors,ML models were constructed using classifiers including Gaussian process(GP),logistic regression(LR),support vector machine(SVM)and quadratic discriminant analysis(QDA),respectively,and the prediction efficacy,calibration and clinical value of each ML model were evaluated.Results Both course of disease and lesion location were clinically relevant independent predictors of postoperative outcome of DR-mTLE patients(OR=0.928,5.710,P=0.010,0.016).Four optimal brain function network features were selected,including betweenness centrality of the third zone of cerebellar vermis,degree centrality of right globus pallidus,nodal efficiency of temporal left inferior temporal gyrus and nodal clustering coefficient of left inferior parietal lobule.The average area under the curve(AUC)of GP,LR,SVM and QDA models in test set was 0.868,0.864,0.875 and 0.870,respectively.Calibration curves and decision curve analysis indicated that each ML model had good calibration and high clinical net benefit.Conclusion ML models based on brain functional network features combining with clinical indicators could be used to effectively predict postoperative outcomes in DR-mTLE patients.

Objective:To evaluate the safety and efficacy of secondary transport on extracorporeal membrane oxygenation (ECMO) for critically ill children.Methods:This was a retrospective cohort study. Data from 222 pediatric patients who underwent ECMO transport from May 2019 to May 2024 at 5 ECMO centers and Chinese Database of Pediatric Extracorporeal Life Support Organization were collected. The cases were divided into primary and secondary transport groups by nature of transport. The clinical data, including demographics, ECMO indications, transport distance, pre-transport lab results, prognosis and complications were analyzed. Two independent samples t-test, Wilcoxon test, and χ2 test or Fisher′s exact probability method were used to compare the differences between 2 groups and evaluate the safety and efficacy of secondary transport. Results:Among the 222 children transported with ECMO, there were 135 males and 87 females, with an age of 3.0 (0.2, 7.0) years. There were 202 cases in the primary transport group and 20 cases in the secondary transport group. All secondary transport patients had failed attempts at weaning ECMO before transfer. The patients in the secondary transport group were older, had higher rates of surgical cannulation, circulatory support, and pre-ECMO lactate levels compared to the primary transport group (7.0 (2.8, 10.0) vs. 3.0 (0.2, 6.0) years old, 55.0% (11/20) vs. 3.6% (7/202), 80.0% (16/20) vs. 41.6% (84/202), (10±4) vs. (7±6) mmol/L, Z=3.41, χ 2=66.31, 10.99, t=2.24, all P<0.05). In the secondary transport group, the vasoactive-inotropic scores of patients on circulatory support and the oxygenation index for patients requiring respiratory support were higher than those in the primary transport group (83±33 vs. 82±68, 51.0±1.8 vs. 37.4±10.2, t=2.36, 2.63, respectively; both P<0.05). There were no statistically significant differences between the 2 groups in sex, transport distance, pre-ECMO creatinine, arterial blood gas BE values, and ECMO duration (all P>0.05). No life-threatening complications occurred during the transport in either group. Two patients in the secondary transport group underwent heart transplantation, and 1 patient underwent radiofrequency ablation. The overall survival rate between the 2 groups showed no statistically significant difference (45.0% (9/20) vs. 55.4% (112/202), χ2=1.15, P>0.05). Conclusions:Secondary ECMO transport for critically ill children don't increase mortality or life-threatening complications during transport. ECMO patients who cannot receive effective treatment locally can benefit from secondary transport to an advanced ECMO center provides further treatment opportunities.

This paper summarized the current status of infection and quality control of medical flexible endoscope (abbreviation:endoscope),which can identify that defect of the quality control of endoscopic forceps channels was a major cause of nosocomial infections of endoscopy. Based on this,a multifunctional quality control workstation with forceps channel of detecting flexible endoscope,and precision components included top ends for medical endoscopes has been developed,which can clearly display residual contaminants and damages in the forceps channels and precision components after the endoscope was reprocessed. It is contribute to enhance the quality control of reprocessing endoscope,and reduce cross-infection of endoscope.