Objective To observe the clinical efficacy of thumb-tack needling for subcutaneous embedding combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of post-stroke dysphagia.Methods A total of 120 cases of patients with post-stroke dysphagia admitted to the 908th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from February 2022 to February 2024 were randomly divided into the observation group and the control group according to random number table method,with 60 cases in each group.Both groups of patients were given conventional symptomatic supportive treatment,such as trophic nerve,improving circulation,etc.,and the control group was given high-frequency rTMS treatment,while the observation group was treated with thumb-tack needling for subcutaneous embedding therapy on the basis of the treatment in the control group.The course of treatment covered four weeks continuously.After one month of treatment,the clinical efficacy of the two groups was evaluated,and the changes in scores of traditional Chinese medicine(TCM)syndrome,Functional Oral Intake Scale(FOIS)and Standardized Swallowing Assessment(SSA),as well as levels of serum total protein(TP),serum albumin(ALB),and hemoglobin(Hb)before and after treatment were observed in the patients of the two groups.The changes in swallowing wave amplitude and swallowing duration before and after treatment were compared between the two groups of patients.Results(1)During the study,there were none in the observation group and eight cases in the control group were failed to follow-up.Finally,64 cases in the observation group and 56 cases in the control group were included in the efficacy statistics.(2)The total effective rate was 92.19%(59/64)in the observation group and 76.79%(43/56)in the control group,and the efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(3)After treatment,the TCM syndrome scores of the patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically significant differences(P<0.05).(4)After treatment,the FOIS score and SSA score of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)After treatment,the swallowing wave amplitude and swallowing duration of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(6)After treatment,the TP,ALB and Hb levels of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically significant differences(P<0.05).Conclusion Thumb-tack needling for subcutaneous embedding combined with rTMS in the treatment of post-stroke dysphagia can significantly shorten the patients'swallowing duration and enlarge the swallowing wave amplitude,thus improving their swallowing function and improving their quality of life.

Objective:To understand the learning interest of college students majoring in Bioinformatics in Shenyang Medical College and its influencing factors,so as to provide a strong basis for future teaching reform and curriculum setting.Method:After the actual teaching,a self-made questionnaire was used to conduct a quantitative survey on the first-year students majoring in Bioinformatics of Shenyang Medical College to understand their learning interest and analyze its influencing factors.Results:The questionnaire survey found that students majoring in Bioinformatics had different interest points for all 9 courses,different teaching links and different teaching methods in the second semester of freshman.Students had a general high interest in Introduction to Bioinformatics and Introduction to Biometrics.In the Introduction to Bioinformatics course,students were more interested in the history of bioinformatics,but less interested in algorithm-related knowledge points.In the Introduction to Biometrics course,students were more interested in the application cases of biometric recognition,but less interested in laws and regulations of biometrics.The interest of students in learning mainly lied in whether it is conducive to the postgraduate entrance examination.Conclusion:Through strengthen the education of bioinformatics related courses,enhance students'understanding of bioinformatics knowledge and improve their interest in Bioinformatics by analyzing the results of students'questionnaire.

Objective:Chronic urticaria presents a chronic process of recurrent attacks,and its first-line treatment is second-generation antihistamine with limited treatment options.The efficacy of antihistamine varies among individuals and cannot meet the needs of all patients.This study aims to explore the clinical efficacy and safety of Zhiyang Xiaozhen granules combined with antihistamine in the treatment of chronic urticaria patients. Methods:We retrospectively analyzed the clinical data of patients with chronic urticaria who visited the Xiangya Hospital of Central South University from April 2020 to March 2021.The patients who received conventional second-generation antihistamine treatment were selected as a control group,while the patients who received combined treatment with Zhiyang Xiaozhen granules on the basis of conventional second-generation antihistamine treatment were selected as an observation group.The differences in the Weekly Urticaria Activity Score(UAS7)and Dermatology Life Quality Index(DLQI)between the 2 groups before and 4 weeks after treatment were compared.The Symptom Score Reduce Index(SSRI)was used to evaluate and compare the efficacy of the 2 treatment regimens. Results:After 4 weeks of treatment,the UAS7 levels in both groups were significantly reduced(P=0.001 and P<0.001,respectively).The effective rates of the control group and the observation group were 61.11%and 59.38%,respectively when converting UAS7 to SSRI for efficacy evaluation,and there was no statistically significant difference in efficacy between the 2 groups(P>0.05);however,when converting DLQI to SSRI for efficacy evaluation,the effective rates of the control group and the observation group were 33.33%and 46.88%,respectively,and the difference in efficacy between the 2 groups was statistically significant(P<0.001).There were 3 patients with adverse drug reactions related to drowsiness in both groups. Conclusion:The combination of Zhiyang Xiaozhen granules and second-generation antihistamine can effectively improve disease activity in patients with chronic urticaria,and the improvement in quality of life is better than that with the second-generation antihistamine alone.

This study searched the clinical researches on traditional Chinese medicine （TCM） for cardiovascular diseases registered in Chinese Clinical Trial Registry and the US Clinical Trial Registry， the cardiovascular disease-related studies funded by the National Natural Science Foundation of China， as well as those published in China National Knowledge Infrastructure （CNKI）， Wanfang database， VIP.com， China Biology Medicine disc （CBMdisc）， Embase， Medline， Cochrane Library， and other databases published cardiovascular disease-related studies from 1 January 2021 to 30 June 2023. In order to analyse and evaluate the research progress of TCM treatment for coronary heart disease， hypertension， heart failure， and arrhythmia， this study aimed at recent research hotspots and research direction. It is found that the research on TCM for cardiovascular diseases was gradually deepening and the high-quality evidence continued to emerge. It is believed that studies related to the prevention and treatment of common cardiovascular diseases by TCM reflected the multi-angle integration of modern technology and pattern differentiation and treatment， closer integration of clinical and basic research， and further optimisation of pattern identification and interventions. On this basis， the research programme and implementation process should be further standardized， and the translation of research results should be emphasized to promote the standardized application and promotion of TCM diagnosis and treatment of cardiovascular diseases.

Objective:To evaluate the efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in children, and to analyze its influencing factors.Methods:A retrospective analysis was carried out on the demographic and clinical data collected from children with moderate to severe AD, who were treated with dupilumab in the Department of Dermatology, Xiangya Hospital, Central South University from October 2020 to October 2022. The initial dose (200 - 600 mg) of dupilumab was administered based on children's age and weight, followed by 200 - 300 mg every 2 - 3 weeks. The curative efficacy and quality of life were evaluated using the Investigator's Global Assessment (IGA), Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Peak Pruritus Numerical Rating Scale (PP-NRS), Patient-Oriented Eczema Measure (POEM), and the Children's Dermatology Life Quality Index (CDLQI) /Infants' Dermatitis Quality of Life Index (IDQoL) before treatment, and at weeks 4, 12, and 16 after treatment. Adverse events during the treatment period were also recorded. The main outcome indicators were the proportion of patients achieving IGA0/1 and EASI75 (≥ 75% improvement from baseline in EASI score) at week 16. Changes in the clinical scores and laboratory parameters at different time points after the treatment with dupilumab were analyzed using generalized estimating equations, and a logistic regression model was used to identify the influencing factors for EASI75 response at week 16.Results:A total of 136 children aged 2 - 11 years met the diagnosis of moderate to severe AD and received at least one dose of dupilumab, among whom 123 children met the inclusion criteria for this analysis. IGA, EASI, SCORAD, POEM, CDLQI/IDQoL, and PP-NRS scores were significantly improved at weeks 4, 12, and 16 after dupilumab therapy compared with baseline scores (all P < 0.01). At week 16, the proportions of patients achieving IGA0/1, EASI50, EASI75, EASI90, CDLQI/IDQoL improvement ≥ 4 points, and PP-NRS improvement ≥ 4 points were 44.6% (33/74), 86.5% (64/74), 70.3% (52/74), 48.7% (36/74), 56.8% (42/74), and 77.0% (57/74), respectively; the eosinophil counts significantly decreased compared with the baseline level ( P = 0.001). The total IgE levels at different time points after treatment did not differ from the baseline level ( P > 0.01). At week 16, the related factors for the response to dupilumab were relatively low ages (compared with the children aged 6 - 11 years, those aged 2 - 5 years showed lower EASI75 response rates: OR = 0.148, 95% CI: 0.027 - 0.823, P = 0.029) and having a family history of urticaria ( OR = 0.033, 95% CI: 0.002 - 0.601, P = 0.021), while gender, AD duration, subtypes and main clinical phenotypes of AD, allergic history, family history of atopic diseases, presence of serum allergen-specific IgE antibodies, serum total IgE levels, or eosinophil counts did not affect the efficacy of dupilumab (all P > 0.05). During the 16-week treatment, 3 children discontinued the dupilumab treatment due to disease exacerbation, and 1 child developed conjunctivitis. Conclusions:Dupilumab could effectively improve the symptoms and signs of children with moderate to severe AD whose condition was poorly controlled by conventional treatments, with a low incidence rate of adverse reactions. Relatively low ages and having a family history of urticaria may be negative factors influencing the efficacy of dupilumab in children with moderate to severe AD at week 16.

Objective:To evaluate the efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in children, and to analyze its influencing factors.Methods:A retrospective analysis was carried out on the demographic and clinical data collected from children with moderate to severe AD, who were treated with dupilumab in the Department of Dermatology, Xiangya Hospital, Central South University from October 2020 to October 2022. The initial dose (200 - 600 mg) of dupilumab was administered based on children's age and weight, followed by 200 - 300 mg every 2 - 3 weeks. The curative efficacy and quality of life were evaluated using the Investigator's Global Assessment (IGA), Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Peak Pruritus Numerical Rating Scale (PP-NRS), Patient-Oriented Eczema Measure (POEM), and the Children's Dermatology Life Quality Index (CDLQI) /Infants' Dermatitis Quality of Life Index (IDQoL) before treatment, and at weeks 4, 12, and 16 after treatment. Adverse events during the treatment period were also recorded. The main outcome indicators were the proportion of patients achieving IGA0/1 and EASI75 (≥ 75% improvement from baseline in EASI score) at week 16. Changes in the clinical scores and laboratory parameters at different time points after the treatment with dupilumab were analyzed using generalized estimating equations, and a logistic regression model was used to identify the influencing factors for EASI75 response at week 16.Results:A total of 136 children aged 2 - 11 years met the diagnosis of moderate to severe AD and received at least one dose of dupilumab, among whom 123 children met the inclusion criteria for this analysis. IGA, EASI, SCORAD, POEM, CDLQI/IDQoL, and PP-NRS scores were significantly improved at weeks 4, 12, and 16 after dupilumab therapy compared with baseline scores (all P < 0.01). At week 16, the proportions of patients achieving IGA0/1, EASI50, EASI75, EASI90, CDLQI/IDQoL improvement ≥ 4 points, and PP-NRS improvement ≥ 4 points were 44.6% (33/74), 86.5% (64/74), 70.3% (52/74), 48.7% (36/74), 56.8% (42/74), and 77.0% (57/74), respectively; the eosinophil counts significantly decreased compared with the baseline level ( P = 0.001). The total IgE levels at different time points after treatment did not differ from the baseline level ( P > 0.01). At week 16, the related factors for the response to dupilumab were relatively low ages (compared with the children aged 6 - 11 years, those aged 2 - 5 years showed lower EASI75 response rates: OR = 0.148, 95% CI: 0.027 - 0.823, P = 0.029) and having a family history of urticaria ( OR = 0.033, 95% CI: 0.002 - 0.601, P = 0.021), while gender, AD duration, subtypes and main clinical phenotypes of AD, allergic history, family history of atopic diseases, presence of serum allergen-specific IgE antibodies, serum total IgE levels, or eosinophil counts did not affect the efficacy of dupilumab (all P > 0.05). During the 16-week treatment, 3 children discontinued the dupilumab treatment due to disease exacerbation, and 1 child developed conjunctivitis. Conclusions:Dupilumab could effectively improve the symptoms and signs of children with moderate to severe AD whose condition was poorly controlled by conventional treatments, with a low incidence rate of adverse reactions. Relatively low ages and having a family history of urticaria may be negative factors influencing the efficacy of dupilumab in children with moderate to severe AD at week 16.

Objective:To investigate the clinical features, characteristics under white-light endoscopy and endoscopic ultrasonography, and treatment strategies of gastritis cystica profunda (GCP) accompanied with or without neoplastic lesions.Methods:Clinical data of 35 patients, who were pathologically diagnosed as having GCP after endoscopic or surgical resection in Beijing Friendship Hospital, Capital Medical University from January 2015 to February 2021, were retrospectively collected, including 27 patients with neoplastic lesions. The demographic information, clinical manifestations, endoscopic features, treatment methods, and pathological results of GCP were summarized.Results:Thirty-five patients with GCP were 68.26±8.08 years old, and mostly male (80.00%, 28/35). The most common symptom was upper abdominal pain, accounting for 31.43% (11/35), and 25.71% (9/35) had no symptoms. Other symptoms included acid reflux, heartburn, abdominal distension, anemia, and choking sensation after eating. The most common site of GCP was cardia (51.43%, 18/35), and the main endoscopic manifestations of GCP were flat mucosal lesions (68.57%, 24/35), mainly 0-Ⅱa and 0-Ⅱa+Ⅱc type lesions, accounting for 66.67% (16/24). The second common endoscopic manifestation was polypoid eminence (20.00%, 7/35). Endoscopic ultrasonography was performed in 15 patients, with main manifestations of uniform hypoechoic with or without cystic echo (73.33%, 11/15). Among the GCP cases, 33 patients received endoscopic resection, and 2 received surgical treatment. The treatment processes were all successfully completed, and en-bloc resection was accomplished for all lesions receiving endoscopy, with the mean endoscopic operation time of 86.13 min. One patient suffered postoperative delayed bleeding after ESD which was stopped by endoscopic hemostasis. Final pathological results showed that the proportion of GCP complicated with neoplastic lesions was 77.14% (27/35), 68.57% (24/35) with early gastric cancer or precursor. Twenty-three cases achieved R0 resection. One case showed positive basal resection margin and vascular invasion, and recurrence happened in situ at the 5th month of follow-up, surgical resection was then performed. The endoscopic complete resection rate was 95.83% (23/24).Conclusion:GCP usually occurs in middle-aged and elderly male, often located in cardia, manifested mainly as flat mucosal lesions and polypoid changes. Endoscopic ultrasonography shows a high diagnostic value for GCP, and endoscopic treatment is safe and effective minimally invasive treatment for GCP.

Objective: To explore the relative risks of rotavirus diarrhea after exposure to different levels of atmospheric pressure in children in Guangzhou City, so as to provide reference for improving public awareness of high atmospheric pressure exposure. Methods: The study used the China Notifiable Communicable Diseases Network System and China Meteorological Science Data Sharing Service Network to collect meteorological data and data relating to daily cases of rotavirus diarrhea in children at Guangzhou Women and Children s Medical Center from 2012 to 2020. The association between rotavirus diarrhea and atmospheric pressure was analyzed using distributed lag non linear models (DLNM). The relative risks of different sex and age sub groups exposed to different atmospheric pressures were also evaluated. Results: A total of 18 587 cases of rotavirus diarrhea were reported from 2012 to 2020, among which 11 662 cases (62.7%) were boys, and 12 582 cases (67.7%) were children aged 6 to 24 months old, which represented the highest proportion. The results of the DLNM showed that the relative risk of rotavirus diarrhea was the highest on the day of exposure to extreme high atmospheric pressure ( RR =1.50, 95% CI =1.24-1.82, P <0.05) and the effect could last for 28 days. Risk of rotavirus diarrhea was low for exposure to low pressure within 2 weeks ( P <0.05). During extremely high atmospheric pressure weather, RR was higher in girls ( RR =3.31, 95% CI =1.46-7.49， P <0.05) than that in boys ( RR =1.98, 95% CI =0.96-4.07， P >0.05). Among different age sub groups, RR was the highest in children aged 24 to 60 months after exposure to the highest level of atmospheric pressure exposure ( RR =3.36, 95% CI =1.27-8.89, P <0.05). Conclusion In Guangzhou, exposure to high pressure increases the risk of rotavirus diarrhea in children. In the future, public awareness should be raised regarding the risk after exposure to high atmospheric pressure.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.

The aim of this study was to investigate the preventive effect of pancreatic duct stent on acute pancreatitis after endoscopic retrograde cholangiopancreatography. A retrospective analysis of the case data of patients who first underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis in the Beijing Friendship Hospital from January 2015 to December 2019 for 5 years. According to whether the pancreatic duct stent was indwelled during the operation, they were divided into pancreatic duct stent group (147 cases) and non-indwelling pancreatic duct stent group (192 cases). The incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography was compared between the two groups according to COTTON criteria. Independent sample t test, Pearson Chi-square test (χ 2) and Fisher′s exact test were used to compare groups′ differences. There were 2 cases of acute pancreatitis in the pancreatic duct stent group, all of which improved after 48 hours. There were 22 cases of acute pancreatitis in the non-indwelling pancreatic duct stent group, of which 20 cases improved within 48 hours, and the other 2 cases had severe pancreatitis, which improved and discharged after 30 days of treatment. There was significant difference in the incidence of acute pancreatitis between the pancreatic duct stenting group (1.4%) and the group without placement of pancreatic duct stents (11.5%) (χ2=12.905, P<0.001). In conclusion, Pancreatic duct stent may be an effective method to prevent PEP.