Purpose: In this study, the neural communication patterns between hypothalamic structures and cortical areas in girls diagnosed with central precocious puberty (CPP) were explored. Endocrine profiles were incorporated to clarify the pathophysiological interactions between cerebral networks and hormonal regulation. The hypothalamus was designated as the key focus area for connectivity analysis. Methods: Fifty-seven girls (37 CPP, 20 non-CPP) were recruited from the Pediatric Development Clinic at the Second Affiliated Hospital of Anhui Medical University. The collected data included demographic information, gonadotropin-releasing hormone stimulation tests, and magnetic resonance imaging scans. Hypothalamic functional connectivity (FC) was analyzed using predefined region of interest coordinates, and correlations between hormone levels and FC values were assessed. Results: Compared to the non-CPP group, the CPP group exhibited elevated baseline follicle-stimulating hormone (FSH), baseline luteinizing hormone (LH), peak FSH, peak LH, and peak LH/FSH ratios. Patients with CPP exhibited enhanced neural synchronization linking the right lateral hypothalamic effector zone to the right superior frontal gyrus (displaying a borderline significant correlation with peak LH concentrations), concurrent with diminished functional coupling of the right lateral hypothalamic efferent to the right fusiform/supramarginal gyri. The left lateral hypothalamic projections demonstrated amplified connectivity with the right cuneus. No FC differences were observed in the medial hypothalamus. Conclusion Abnormal lateral hypothalamus FC patterns were identified in CPP girls and were particularly linked to peak LH levels. The findings offer novel insights into the neuroendocrine mechanisms underlying CPP.

Purpose: Our previous study showed that circulating tumor cell (CTC) count combined with gene mutation detection might help differentiate benign and malignant pulmonary nodules (PNs). Herein, we aimed to expand the study cohort and conduct further sequencing analysis. Materials and Methods: Patients with PNs were included, and CTCs were identified before operation. Low-coverage whole-genome sequencing (LC-WGS) and lung cancer-related targeted gene sequencing were performed on CTCs. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve. The differences in CTC counts among subgroups classified by demographic–clinical characteristics were analyzed. LC-WGS–based copy number variation (CNV) analysis and targeted gene mutation analysis were conducted. Results: A total of 172 patients were included. CTC count of 2.5 was identified by the ROC curves as the optimal diagnostic cutoff. The sensitivity and specificity of CTC count for differentiating benign and malignant PNs were 54.2% and 78.6%, respectively. The diagnostic sensitivity and specificity of combined CTC count, radiological nodule type, and any malignant imaging features were 84.7% and 71.4%, respectively. The CTC counts were significantly greater in patients with aggressive tumors, later stage, and spread through air spaces. CTCs from malignant cases had more CNVs than those from benign cases. Conclusion CTC count can be used in identifying malignant PNs. The diagnostic efficacy can be improved if combined with computed tomography imaging characteristics. Further CNV analysis might help differential diagnosis. Greater CTC count might suggest more aggressive tumors. CTC detection can provide important information and guidance for subsequent management of PNs.

This paper aims to summarize Professor ZHOU Shaohua's clinical experience in treating Parkinson's disease （PD） based on the "disease-symptom-syndrome integration" approach. It is believed that kidney essence deficiency is the root cause of the disease， and phlegm-stasis accumulating toxin is the key factor for its deterioration. PD could be divided into the prodromal stage， early stage and middle-late stage. In the prodromal stage， treatment focuses on tonifying the kidney and replenishing marrow， choosing Zuogui Pill （左归丸） or Yougui Pill （右归丸） to prescribe with modifications according to accompanying non-motor symptoms such as constipation and rapid eye movement sleep behavior disorder. For the early stage， the disease is differentiated into three syndromes， liver-kidney yin deficiency with stirring wind， spleen-kidney yang deficiency， and excessive phlegm turbidity， then following the principle of "calming wind by regulating blood first"， the basic prescriptions of Dading Fengzhu Pill （大定风珠）， Yougui Pill （右归丸） and Jinshui Liujun Decoction （金水六君煎） are applied respectively， combined with Siwu Decoction （四物汤） to nourish blood and extinguish wind. For the middle-late stage， therapies of tonifying the kidney and conso-lidating original qi are combined with detoxifying and resolving turbidity， prescribing fleshy and nourishing medicinals such as deer-horn glue （Cervus nippon Temminck） and turtle shell glue （Colla Carapacis et Plastri Testudinis）， together with Huanglian Jiedu Decoction （黄连解毒汤） to clear heat， detoxify and resolve turbidity， implementing simultaneous tonification and elimination. Integrated traditional Chinese and western medicine intervention is emphasized for non-motor symptoms including orthostatic hypotension and dysphagia.

Tuberculosis （TB） is a major infectious disease that seriously endangers public health. In traditional Chinese medicine （TCM）， TB is considered to be caused by "exogenous latent tuberculosis pathogens"， and whether the disease occurs depends on the strength of healthy Qi. The disease course is characterized by five features： Hidden latency， pathological accumulation， triggering due to deficiency of healthy Qi， depletion of healthy Qi， and prolonged progression with difficulty in recovery. The latent stage is based on the fundamental pathogenesis of "specific latent pathogens concealed in the lung collaterals and waiting for the appropriate time to manifest"， which exhibits the temporal and spatial characteristics of latent pathogens. During this stage， Mycobacterium tuberculosis remains in a dormant state and maintains a dynamic balance with the host immune system. The triggering and progression stages are characterized by the core pathogenesis of "deficiency of healthy Qi initiating pathogenic factors and excessive pathogenic factors triggering disease". Immune dysfunction may lead to severe pathological damage to the structure of the lung collaterals. The key pathogenesis of the latent-retention stage is "persistent latent pathogens consuming healthy Qi"， which is also the core reason for the difficulty in treating initial TB onset， prolonged disease progression， and recurrent attacks. Based on the theory of latent pathogens， this study establishes a four-stage prevention and treatment system "with pathogenesis as the guiding principle and disease stages as the criteria". The corresponding therapeutic principles include tonifying Qi and nourishing Yin， clearing and transforming latent phlegm， regulating and tonifying the spleen and kidney， strengthening healthy Qi and replenishing the primordial Qi， nourishing Yin and reducing fire， suppressing and eliminating tuberculosis pathogens， tonifying deficiency， restoring primordial Qi， clearing residual pathogens， and eliminating pathogenic factors. Guided by the theory of latent pathogens， this article systematically elucidates the TCM connotation of M. tuberculosis invasion of the lung collaterals and the staged syndrome differentiation and treatment approach， providing theoretical foundations and practical guidance for the prevention and treatment of TB through integrated Chinese and Western medicine and offering new perspectives for the prevention and control of infectious diseases using TCM.

ObjectiveTo investigate the effects of three-dimensional foot-ankle exercises (3DFAE) on mild-to-moderate hallux valgus in young women. MethodsFrom October to December, 2024, 45 female patients aged 18 to 26 years with hallux valgus were recruited from Capital University of Physical Education and Sports. They were randomly divided into control group (n = 15), toe-spread-out (TSO) group (n = 15) and 3DFAE group (n = 15). The control group only received foot health education, while the two intervention groups performed corresponding exercise training, for four weeks. Hallux valgus angle (HVA) was measured with photographic method, abductor hallucis activation was detected with surface electromyography, cross-sectional area of abductor hallucis was measured with Doppler ultrasound, and active ankle dorsiflexion range of motion (ROM) was assessed with a goniometer, before intervention, immediately after intervention, and four weeks after training cessation. A perceived difficulty scale was adopted to evaluate the training difficulty of TSO group and 3DFAE group at the first training session and upon completion of intervention. ResultsThe effects of time and interaction were significant for bilateral HVA, abductor hallucis activation, cross-sectional area of abductor hallucis and ankle dorsiflexion ROM (F > 2.728, P < 0.05), and the effect of group of left ankle dorsiflexion ROM was also significant (F = 4.995, P < 0.05). After intervention, bilateral HVA, abductor hallucis activation, cross-sectional area of abductor hallucis and ankle dorsiflexion ROM were all better than those before intervention (P < 0.05), and most indicators were superior to those measured at the 4-week follow-up (P < 0.05). The left ankle dorsiflexion ROM was better in 3DFAE group than in the control group and TSO group (P < 0.05). At the first intervention session, the perceived training difficulty was lower in 3DFAE group than in TSO group (t = 3.334, P = 0.002), and it decreased (t = 5.292, P < 0.001) after four weeks of training in TSO group, with no significant difference compared with 3DFAE group (P > 0.05). Conclusion3DFAE can improve ankle dorsiflexion ROM in young female patients with hallux valgus, with no more difficulty than TSO, and lower initial operation difficulty.

Modern cataract surgery has completely moved beyond the traditional vision-restoring model and has fully entered a new era of refractive cataract surgery(RCS)centered on precise refractive correction. Its core objective is to provide patients with personalized visual experiences characterized by full-range, clear, and comfortable vision. Currently, although diagnostic and therapeutic technologies for RCS are rapidly evolving, there remain many bottlenecks in the precise management of the entire perioperative process that urgently need to be addressed. Preoperatively, the measurement consistency among ocular biometry devices based on different detection principles remains poor, and systematic measurement errors cannot be completely eliminated. Moreover, the individualized selection of intraocular lenses(IOLs)relies heavily on surgeons' clinical experience, lacking a standardized quantitative decision-making framework, which makes it difficult to achieve precise personalized matching. Intraoperatively, the quality of continuous curvilinear capsulorhexis is affected by multiple factors such as ocular anatomical characteristics and surgical proficiency, and its stability cannot be reliably ensured. Various intelligent surgical navigation systems are compromised by intraoperative ocular conditions, and their clinical performance fails to meet theoretical expectations. At the postoperative stage, existing IOL optical designs and materials have inherent limitations. The longterm prevention and control of posterior capsule opacification(PCO)remains a core factor restricting patients' long-term high-quality visual outcomes. This article systematically reviews the precise diagnostic and therapeutic challenges and core bottlenecks across the preoperative, intraoperative, and postoperative stages of RCS. It further explores frontier technological directions—including cross-device error compensation models, artificial intelligence-assisted decision-making, preoperative VR-based visual simulation, and the construction of intelligent surgical ecosystem platforms—to delineate targeted solutions and optimization pathways. This review aims to provide references and insights for the standardized clinical implementation, technological innovation, and future research endeavors in precision diagnosis and treatment of RCS.

Phacoemulsification represents the mainstream, efficient, and safe surgical modality for cataract treatment, and continuous technological advances have further improved the safety profile of this procedure in ordinary patients. However, patients with high myopia feature inherent anatomical abnormalities of the eyeball, leading to a fundamental incompatibility with conventional phacoemulsification protocols. Such patients face a markedly elevated risk of both anterior and posterior segment perioperative complications, posing a persistent clinical challenge in cataract surgery. Focusing on the unique ocular anatomical characteristics associated with high myopia, this review systematically summarizes the distinct traumatic effects and pathological impacts of phacoemulsification on the anterior and posterior ocular segments of affected patients. Moving beyond generalized discussions of routine cataract management, it consolidates clinical evidence specific to this special-population patients, aiming to provide refined references for perioperative risk prevention and control in cataract patients complicated with high myopia.

Objective:To evaluate the prognosis of Hall technique and traditional performed metal crown (PMC) restoration technique, and to follow up the occlusal changes before and after treatment with Hall technique, providing references for the promotion of Hall technique.Methods:Children who visited the Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University from May 2021 to December 2022 were screened according to the inclusion and exclusion criteria. The therapeutic effects of the two groups were followed up at three time points: 1, 2 and 3 months after operation. The observation results were divided into three outcomes: success (crown in place, no symptoms of pulpitis or periapical periodontitis, no obvious abnormality in occlusion, no need for further treatment), partial failure (crown falling off or crown broken, tooth defect can be repaired, reversible pulpitis) and complete failure (irreversible pulpitis or periapical periodontitis, crown falling off and tooth defect irreparable), and statistical analysis was made. At the same time, the Hall technique group was followed up at five time points as before operation, immediately after operation, 2 weeks after operation, 4 weeks after operation and 8 weeks after operation respectively, in which the occlusion was analyzed by Dental Prescale Ⅱ system. The vertical dimension of occlusion (VDO), overbite and coverage, and canine relationship were recorded and compared. Three-dimensional finite element method was used to model and analyze the stress of the teeth treated with traditional PMC treatment and Hall technique, and the differences between them were compared.Results:Finally, 21 children were included in the Hall technique group, including 12 boys and 9 girls, with age of (5.0±1.4) years. Meanwhile, 22 children including 15 boys and 7 girls were in the traditional PMC group, with age of (5.1±1.3) years. There were 0 cases of complete failure and 0 cases of partial failure both in the Hall technique group and in the traditional PMC group within 1 month. There were 0 cases of complete failure and 1 case of partial failure in the Hall technique group, while 0 cases of complete failure and 0 cases of partial failure in the traditional PMC group within 2 months after operation. Hall technique group failed completely in 1 case and partially in 1 case, while the traditional pre-crown group failed completely in 0 cases and partially in 0 cases 3 months after operation. There was no significant difference in the incidence of primary index/complete failure and secondary index/partial failure between Hall technique group and traditional PMC group (all P>0.05). The occlusal area and occlusal force of children treated with Hall technique decreased immediately after operation compared with those before operation, but gradually recovered to the preoperative level at 2, 4 and 8 weeks after operation. To elaborate, the occlusal area decreased significantly from (14.79±3.55) mm 2 before operation to (10.15±3.17) mm 2 immediately after operation ( P=0.001), and recovered to (15.58±3.39) mm 2 at 8 weeks after operation ( P>0.05 compared with pre-operation). The occlusal force decreased significantly from (436.94±109.59) N before operation to (292.70±96.05) N immediately after operation ( P=0.001), and recovered to (441.86±104.31) N at 8 weeks after operation ( P>0.05 compared with pre-operation). Overbite decreased significantly from (2.54±1.05) mm before operation to (1.80±0.94) mm immediately after operation ( P=0.044) and then recovered to (2.35±1.02) mm ( P>0.05 compared with pre-operation). The coverage changed from (2.41±0.66) mm before operation to (2.27±0.61) mm immediately after operation ( P>0.05) and then recovered to (2.48±0.62) mm ( P>0.05 compared with pre-operation). The canine relationship was (3.12±0.54) mm before operation, and decreased significantly immediately after operation (2.17±0.89) mm ( P=0.001), and recovered to (3.05±0.61) mm after 8 weeks ( P>0.05 compared with pre-operation). In the three-dimensional finite element analysis, the maximum stress of all parts of the affected tooth increased immediately after Hall technique treatment, but with occlusal adjustment, the maximum stress of all parts of the affected tooth decreased, which was similar to that of the traditional metal pre-crown group. The vertical load and oblique load of pre-crown decreased from 180.11 and 496.16 MPa to 108.05 and 297.69 MPa, respectively. The vertical load and oblique load of enamel decreased from 94.83 and 255.94 MPa to 57.21 and 156.44 MPa, respectively. The vertical load and oblique load of dentin decreased from 55.19 and 124.77 MPa to 33.19 and 74.59 MPa, respectively. Conclusions:During the experimental observation period, there is no obvious difference between Hall technique and traditional PMC treatment technology in terms of post-treatment occlusion and clinical prognosis, which supports clinical application.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Aim To investigate whether protein inhibitor of activated STAT3(PIAS3)deficiency exacerbates the occurrence and development of atherosclerosis(As)in female ApoE knockout mice.Methods PIAS3 gene knockout mice with ApoE-/-background(PIAS3-/-/ApoE-/-)and their littermate PIAS3+/+/ApoE-/-mice were bred and fed with a high-fat/high-cholesterol diet for 12 weeks to induce As.Body weight(every week)and plasma lipid levels including to-tal cholesterol,triglyceride,high density lipoprotein cholesterol and non-high density lipoprotein cholesterol(every 4 weeks)of the mice were measured.Oil red O staining,HE staining,immunohistochemistry staining and immunofluores-cence staining were performed on mouse aortic tree and frozen sections of aortic root to evaluate the area,cellular composi-tion and stability of As plaques.Moreover,the expression of estrogen receptor α(ERα)and its co-localization with vas-cular smooth muscle cells(VSMC)in plaques were determined by immunofluorescence staining.Results Compared with PIAS3+/+/ApoE-/-mice,PIAS3-/-/ApoE-/-mice showed no significant differences in body weight,major organ weight(heart,liver,spleen,kidney and epididymal fat)and plasma lipid levels;however,PIAS3 deficiency promoted the forma-tion of As in female PIAS3-/-/ApoE-/-mice.Compared with PIAS3+/+/ApoE-/-mice,PIAS3-/-/ApoE-/-mice showed an increased lipid accumulation and a decreased VSMC content in As plaques(P＜0.05),leading to a decrease in plaque stability.In addition,the expression of ERα in the As plaques of PIAS3-/-/ApoE-/-mice was significantly downregulated(P＜0.05),and there was a obvious co-localization between ERα and VSMC.The reduction of VSMC content in PIAS3-/-/ApoE-/-mouse plaques might lead to a decrease of ERα expression,thereby weakening the anti-As effect of es-trogen.Conclusion PIAS3 deficiency exacerbates the formation of As plaques in female PIAS3-/-/ApoE-/-mice,which might be due to the regulatory effect of PIAS3 on ERα expression in plaques.