ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Four novel β-galactoside prodrugs were designed and synthesized from anthraquinones HAQ-OH and AQ-OH in an attempt to use the prodrugs to selectively release superoxide anion (O2−) in cancer cells and to achieve selected anticancer activity by utilizing the Warburg effect and the elevated level of β-galactosidase in certain cancer cells. Cellular assays showed that the prodrugs Gal-HAQ and Gal-AQ selectively inhibited the proliferation and induced apoptosis of ovarian cancer OVCAR-3 cells overexpressing β-galactosidase. Using O2− fluorescent probe, it was found that in OVCAR-3 cells Gal-HAQ and Gal-AQ could time-dependently release O2−, which was essential for their anticancer activity. Furthermore, it was found that Gal-HAQ and Gal-AQ were effective senolytics toward senescent cells overexpressing β-galactosidase without affecting the viability of corresponding non-senescent cells, further confirming the β-galactosidase-dependent cytotoxicity of the prodrugs. In conclusion, Gal-HAQ and Gal-AQ, which release O2− in response to β-galactosidase, are expected to serve as candidate prodrugs targeting cancer cells.

Objective: To investigate the mechanism by which serum amyloid P component (SAP) alleviates periodontitis in mice, providing an experimental basis to establish SAP as a novel therapeutic agent for periodontitis. Methods: Ethical approval was obtained from the Institutional Animal Ethics Committee. Periodontitis models were established in wild-type (WT) mice and SAP-transgenic (SAP-Tg) mice, divided into four groups: WT control (WT group), WT periodontitis (WT+P group), SAP-Tg control (Tg group), and SAP-Tg periodontitis (Tg+P group). On day 7, the mice were euthanized, and periodontal tissues, teeth, and alveolar bone were collected. SAP protein expression was detected by enzyme-linked immunosorbent assay (ELISA). Micro-CT and HE staining were used to measure alveolar bone resorption (distance from the cementoenamel junction to the alveolar bone crest). Tartrate-resistant acid phosphatase (TRAP) staining was performed to assess osteoclast number, and immunohistochemistry (IHC) was employed to evaluate macrophage infiltration. The expression levels of inflammatory cytokines including interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were measured by qRT-PCR. Oral microorganism composition was analyzed using 16S ribosomal RNA (16S rRNA) gene sequencing. Additionally, macrophages from WT and SAP-Tg mice were isolated to establish an in vitro inflammation model, divided into WT+LPS and Tg+LPS groups. The expression of macrophage polarization-related genes including inducible nitric oxide synthase (iNOS), CD86, CD163, and CD206) were assessed by qRT-PCR. After the induction of osteoclast differentiation, TRAP staining was performed. Results: ELISA results demonstrated that periodontal tissues from Tg+P group mice exhibited higher levels of SAP expression compared to the WT+P group. Micro-CT and HE staining analyses revealed that the Tg+P group showed reduced alveolar bone resorption, indicated by a shorter distance between the cementoenamel junction and alveolar bone crest, compared to the WT+P group. Furthermore, TRAP staining results indicated a decrease in osteoclast numbers in the Tg+P group compared to the WT+P group. IHC and qRT-PCR results indicated reduced macrophage infiltration and decreased expression of IL-1β, IL-6, and TNF-α in the Tg+P group. Oral microorganism sequencing showed no significant difference in periodontitis-associated pathogenic bacteria between WT+P and Tg+P groups. In vitro experiments demonstrated that compared to the WT+LPS group, the Tg+LPS group exhibited downregulated M1 macrophage markers (iNOS and CD86) and upregulated M2 macrophage markers (CD163 and CD206). TRAP staining confirmed fewer osteoclasts in the Tg+LPS group. Conclusion SAP overexpression effectively alleviates periodontitis severity in mice by inhibiting M1 macrophage polarization, reducing pro-inflammatory cytokine expression, and suppressing osteoclast differentiation, thereby attenuating alveolar bone resorption.

AIM: To compare the visual quality in patients with low-to-moderate myopia after 0.05 D interval spherical lens optometry-guided small-incision lenticule extraction(SMILE)and conventional 0.25 D interval spherical lens optometry-guided SMILE.METHODS: Retrospective study. A total of 400 cases(400 eyes)with low-to-moderate myopia that underwent SMILE in the ophthalmology department of 989th Hospital of Joint Logistic Support Force from August 2021 to August 2023 were enrolled and the data from the right eyes were collected for analysis. According to the method of optometry test modality, they were divided into 0.05 D group and 0.25 D group, with 200 eyes in each group. The differences were compared between the two groups of patients in intraoperative corneal ablation thickness, uncorrected distance visual acuity(UDVA), high-order corneal aberrations(HOA), spherical aberrations, vertical coma, horizontal coma and trefoil aberrations before and at 1, 3 and 6 mo after surgery. Additionally, the percentage of eyes with residual spherical equivalent(SE)≤±0.25 D, postoperative visual symptoms and scores on the quality of visual(Qov)were compared between the two groups at 6 mo after surgery.RESULTS: The corneal ablation thickness in the 0.05 D group was 92.78±16.56 μm, which was slightly higher than that in the 0.25 D group(83.24±17.33 μm; P<0.001). The UDVA at each postoperative time point in the 0.05 D group was superior to that in the 0.25 D group(all P<0.001). The HOA, spherical aberration, horizontal coma and vertical coma in the two groups at 1, 3 and 6 mo after operation were higher than those before operation(all P<0.05). The spherical aberration in the 0.05 D group at each time point after surgery were higher than those in the 0.25 D group, and vertical coma were lower than those in the 0.25 D group(all P<0.05). At 6 mo postoperatively, the percentage of eyes with residual SE ≤±0.25 D in the 0.05 D group was 97.5%(195 eyes), which was higher than 87.5%(175 eyes)in the 0.25 D group(P<0.05). The most common adverse visual symptoms after SMILE in both groups were hazy vision and glare. The total Qov score in the 0.05 D group was 0.35(0.24, 0.55), which was lower than [0.62(0.32, 0.89)] in the 0.25 D group(P<0.05).CONCLUSION: Compared with conventional 0.25 D interval spherical lens optometry-guided SMILE, the 0.05 D interval spherical lens optometry-guided SMILE for the correction of low-to-moderate myopia has better predictability and can achieve better vision and visual quality.

Pituitary stalk interrupt syndrome is characterized by pituitary stalk thinning or disappearance, anterior pituitary hypoplasia and posterior pituitary ectopic, this article reviewed and analyzed a case of PSIS presenting with bilateral lower limb edema, abnormal liver and kidney function, and significantly above-normal height. We explore the clinical manifestations, laboratory tests, diagnosis, and treatment of this case, as well as the potential underlying mechanisms of non-alcoholic fatty liver disease(NAFLD) and its related complications. The findings suggest that PSIS should be considered in patients with abnormal liver and kidney function. Early identification and timely intervention may improve patient prognosis.

Objective:To investigate the disease-modifying effect of long-course use of Omalizumab (OMZ) on children and adolescents with allergic asthma.Methods:Retrospective cohort study.The clinical data of 66 children with moderate to severe allergic asthma treated with OMZ in the Department of Pediatrics, the Second Hospital of Tianjin Medical University from April 2019 to June 2024 were analyzed.According to the course of OMZ, the patients were divided into a short course group (33 cases), a medium course group (21 cases), and a long course group (12 cases).The courses of treatment of the 3 groups were 6-<12, 12-<24 and 24 months or more, respectively.Pulmonary ventilation functions [including the percentage of forced expiratory volume in the first second to the expected value (FEV 1%pred), the peak expiratory flow rate to the expected value (PEF%pred), and the maximum mid-expiratory flow to the expected value (MMEF%pred)], fractional exhaled nitric oxide (FeNO) and the absolute value of peripheral blood eosinophils (EOS) were analyzed before and after OMZ treatment.Moreover, whether allergic asthma and comorbidities such as allergic rhinitis (AR), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU) were controlled was explored.Changes in inhaled corticosteroids (ICS) and serum total immunoglobulin E (TIgE) levels were measured.The paired t-test was used for testing measurement data with normal distribution, and the rank sum test for testing non-normally distributed data. Results:(1)Changes of pulmonary ventilation function, FeNO and EOS: the pulmonary ventilation function in the short course group, the FEV 1%pred and MMEF%pred in the medium course group, and the PEF%pred and MMEF%pred in the long course group were improved compared with those at baseline (all P<0.05).FeNO levels in all the 3 groups decreased, compared with those at baseline (all P<0.05).There was no significant difference in peripheral blood EOS between the 3 groups compared with those at baseline (all P>0.05).(2)Control status of allergic asthma and comorbidities: the Asthma Control Test/Childhood Asthma Control Test (ACT/C-ACT), Asthma Control Questionnaire (ACQ) scores and the visual analogue scores (VAS) of rhinitis improved in all 3 groups, compared with those at baseline (all P<0.05).Among 4 patients complicated with AD, 3(75.0%) showed decreased Scoring Atopic Dermatitis Index(SCORAD) scores, compared with those at baseline.Of the 6 children complicated with CSU, 5(83.3%) did not develop rash after injection.(3)Frequency of acute exacerbations of asthma: the number of acute exacerbations of asthma after treatment was lower than that before treatment in all the 3 groups (all P<0.05).The number of attacks in the long course group was decreased in the third year, compared with that in the first year ( P<0.05).(4)The ICS consumption: the ICS consumption in all the 3 groups was significantly decreased, compared with that at baseline (all P<0.05).Six patients (28.6%) in the medium course group had no recurrence within 1 year after stopping ICS therapy.One of the 7 patients (14.3%) in the long course group had stopped ICS for more than 2 years, and 3 patients (42.9%) had stopped ICS for more than 1 year.These 4 children had no recurrence.(5)The change of TIgE: in the short and medium course groups, serum TIgE levels at the end of treatment were higher than those at baseline (all P<0.05).The serum TIgE level in the second year of treatment was higher than that at baseline in the long course group ( P<0.05).The serum TIgE level in the third year of treatment was decreased, compared with that in the second year ( P<0.05). Conclusions:OMZ can improve lung function and FeNO levels, reduce the incidence of acute exacerbations of asthma, and lower ICS usage in children.At the same time, it can also improve the allergic diseases AR, AD and CSU.The prolonged treatment of OMZ can bring long-term sustained benefits to children.The changes in serum TIgE and FeNO levels may suggest that the long-term application of OMZ plays a disease-modifying role in allergic asthma.

Objective:To explore the feasibility of high-level deep learning image reconstruction (DLIR-H) algorithm in dynamic myocardial perfusion (CTP) and coronary CT angiography (CCTA) extraction.Methods:From October 2021 to October 2022, 41 patients with confirmed or suspected coronary heart disease who underwent traditional CCTA and dynamic CTP examinations on GE Apex CT were prospectively collected. Traditional CCTA used 100 kVp tube voltage scan and DLIR-H to reconstruct the original image, while dynamic CTP used 80 kVp tube voltage scan to reconstruct the original image with ASiR-V 100% and DLIR-H, respectively. Comparing subjective and objective scores and myocardial blood flow (MBF) values?of rest and stress CTP between ASiR-V100% and DLIR-H. Subjective and objective scores, as well as stenosis degree and coronary CT blood flow reserve fraction (CT-FFR) value were analyzed on a vessel basis, and the image quality and diagnostic performance of traditional CCTA and single-phase CCTA (SP-CCTA) extracted under DLIR-H CTP were compared. Statistical analysis were performed using paired t test, Wilcoxon signed-rank test and χ2 test. Results:In the subjective image quality analysis of resting and stress CTP, DLIR-H was improved compared with ASiR-V100%, and the difference was statistically significant (all P<0.05). There was no significant difference in MBF values obtained by the two reconstruction methods in the assessment of quantitative myocardial perfusion ( P>0.05). Compared with traditional CCTA, the vascular CT value of SP-CCTA increased by 15.12%, the noise value increased by 32.27%, and the subjective score was also slightly lower (4.23±0.05). However, there were no statistically significant differences in total plaque volume, maximum stenosis degree, and number of CT-FFR positive vessels between SP-CCTA and traditional CCTA (all P>0.05). Conclusion:The deep learning reconstruction algorithm can not only improve the quality of the original image to a certain extent on dynamic CTP, but also extract high-quality single-phase CCTA to meet clinical diagnosis and realize a “one-stop” dynamic myocardial perfusion examination, which will help simplify the examination process, reduce contrast agent and radiation doses in the future.

Objective To investigate the effects and underlying mechanisms of Shexiang Baoxin pill(SBP)on wire injury-induced valvular dysfunction in rats.Methods A rat model of aortic valve injury was established using a standardized wire injury method.Animals were randomly divided into control,sham,model,and SBP low-,medium-,and high-dose(SBP-L,SBP-M,SBP-H)intervention groups.Aortic valve function was evaluated using echocardiography.Histopathological changes were assessed using hematoxylin-eosin(HE)and Masson's staining.Serum levels of lipid peroxides(LPO),malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH),and total iron were measured using biochemical assays.Expression levels of ferroptosis-related proteins(ACSL4,SLC7A11,and GPX4)and osteogenic markers(RUNX2 and BMP2)in valve tissues were detected through Western blot and RT-qPCR.Results The SBP-M and SBP-H groups showed significantly higher aortic valve orifice areas((3.70±0.04)mm2 and(3.90±0.11)mm2 vs(2.25±0.37)mm2,P＜0.0001),lower transvalvular pressure gradients((0.52±0.09)mmHg and(0.49±0.13)mmHg vs(0.90±0.17)mmHg,P＜0.01),and lower aortic valve peak flow velocities((68.83±4.98)cm/s and(63.61±11.43)cm/s vs(87.14±11.22)cm/s,P＜0.05,P＜0.01)than those in the model group.HE and Masson's staining result demonstrated that SBP alleviates valve thickening and fibrosis(fibrotic area:(35.98±5.2)5％vs(53.01±2.44)％,P＜0.01).Biochemical tests showed that SBP reduces serum levels of lipid peroxidation products(LPO and MDA)and total iron ions while increasing SOD and GSH levels(P＜0.001,P＜0.0001).SBP downregulated the ferroptosis-related protein ACSL4(P＜0.01),upregulated the anti-ferroptosis proteins SLC7A11 and GPX4(P＜0.05,P＜0.01),and inhibited the expression of the osteogenic molecules RUNX2 and BMP2(P＜0.05,P＜0.01,P＜0.0001).Conclusions SBP may alleviate mechanical injury-induced valve dysfunction in rats through the modulation of oxidative stress and restoration of iron homeostasis.These findings provide experimental evidence for the role of SBP in the early intervention of valvular disease.The precise active components,molecular targets,and clinical translation of SBP require further investigation.

Objective:To explore the incidence of delirium in patients of advanced age hospitalized in internal medicine departments and analyze its influencing factors.Methods:A retrospective analysis was conducted on the medical records of 586 patients of advanced age hospitalized in internal medicine departments at the Beijing University of Chinese Medicine Third Affiliated Hospital from May 2023 to May 2024. Patients were divided into a delirium group and a non-delirium group based on whether delirium occurred. Univariate analysis and binary Logistic regression analysis were used to explore the factors influencing delirium in patients of advanced age hospitalized in internal medicine departments.Results:Among 586 patients of advanced age hospitalized in internal medicine departments, the incidence of delirium was 21.2% (124/586). Binary Logistic regression analysis showed that age, activities of daily living (Barthel Index), folate deficiency, sleep disorders, and indwelling catheters were factors influencing delirium in patients of advanced age hospitalized in internal medicine departments ( P<0.05) . Conclusions:The incidence of delirium is high among patients of advanced age hospitalized in internal medicine departments. Healthcare professionals should pay particular attention to elderly patients with advanced age, limited activities of daily living, folate deficiency, sleep disorders, and indwelling catheters, and should implement targeted preventive strategies as early as possible.

Objective To develop and validate a deep learning model based on chest CT images to accurately distinguish between drug-resistant(DR-TB)and-sensitive tuberculosis(DS-TB).Methods A retrospective study was conducted on 722 cases of confirmed secondary tuberculosis admitted in our center from January 2019 to December 2022.According to the results of antimicrobial susceptibility test,they were divided into 357 DS-TB cases and 365 DR-TB cases.Pre-existing U-Net segmentation model was employed to segment the lung parenchyma regions in CT images.The dataset was randomly partitioned into a training set and a testing set in an 8:2 ratio.Six 3D deep learning architectures(3D Swin Transformer,3D ShuffleNet v2,3D ViT,3D MobileNet v2,3D DenseNet,and 3D ResNet18)were employed to evaluate the discriminative efficiency between DS-TB and DR-TB.Hyperparameters were optimized by five-fold cross-validation on the training set to construct the optimal model.The performance of the constructed model was assessed using area under the curve(AUC),sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and F1-score.Six radiologists independently evaluated DR-TB identification on the test set,and their performance was compared with the best-performing deep learning model.Results The AUC value in DR-TB prediction was 0.583,0.704,0.698,0.758,0.736,and 0.841,respectively,for 3D Swin Transformer,3D ShuffleNet v2,3D ViT,3D MobileNet v2,3D DenseNet,and 3D ResNet18.The 3D ResNet18 model demonstrated optimal performance,achieving a sensitivity of 0.935(95%CI:0.880～0.987),a specificity of 0.642(95%CI:0.492～0.757),a PPV of 0.750(95%CI:0.663～0.835),an NPV of 0.896(95%CI:0.809～0.976),an AUC value of 0.841,and a F1-score of 0.832.The radiologists got a F1-score of 0.571,0.450,0.675,0.623,0.617 and 0.635,respectively,and the F1-score of the 3D ResNet18 model is all higher than that of the radiologists.The highest-performing radiologist achieved sensitivity,specificity,PPV and NPV of 0.701(95%CI:0.605～0.802),0.567(95%CI:0.447～0.684),0.651(95%CI:0.549～0.757),and 0.623(95%CI:0.500～0.754),with all these values lower than those of the 3D ResNet18 model(P<0.05).Class activation mapping showed that the 3D ResNet18 model could focus on key lesion areas.The class activation mapping demonstrated that the 3D ResNet18 model could effectively focus on critical lesion regions.Conclusion Our 3D ResNet18 model shows the best predictive performance in identifying DR-TB,and is expected to assist clinical diagnosis for DR-TB.