Objective To compare the capture performance differences between TruSeq? Exome and NimbleGen SeqCap EZ Human Exome kits in children with cerebral palsy(CP),and to provide a technical selection basis for clinical genetic research and diagnosis.Methods Peripheral blood samples from 48 sporadic CP patients were included.Exome libraries were constructed using TruSeq(DNA probes)and NimbleGen(RNA probes),followed by sequencing on the Illumina HiSeq 2000 platform.Bioinformatics analysis was applied to evaluate mapping rate,target region coverage,variant concordance,and clinical relevance based on a CP-related gene set(2 293 genes).The statistical analysis was performed using a paired t-test with a significance threshold of α=0.05.Results The results showed no significant differences between NimbleGen and TruSeq exome capture kits in basic data quality(alignment rate,insert size)and GC content.However,they exhibited complementary characteristics in key performance metrics:NimbleGen demonstrated superior performance in specific depth coverage(1×coverage rate,P=1.84×10-5;20×coverage rate,P=1.49×10-20).TruSeq,on the other hand,showed higher sensitivity in Indel detection(TruSeq vs.NimbleGen:11 371±1 689 vs.11 274±1 670,P=3.24×10-7)and rare variant capture(TruSeq vs.NimbleGen:3 164±766 vs.3 072±774,P=1.20×10-4),successfully identifying all 11 pathogenic variants(including 2 missed by NimbleGen).Conclusion TruSeq,with its superior variant detection rate,is more suitable for clinical diagnostic applications,while NimbleGen's coverage stability may be advantageous for research-oriented projects.

Objective:To investigate the correlation between insulin resistance surrogate indicators and early-stage kidney injury in type 2 diabetes mellitus(T2DM).Methods:A total of 918 T2DM patients hospitalized in the Endocrinology Department of Xinhua Hospital from January 2018 to December 2020 were selected, including 313 patients with early-stage kidney injury and 605 without. Differences in insulin resistance surrogate indicators, including triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C), triglyceride glucose(TyG) index, and triglyceride glucose-body mass index(TyG-BMI), were compared between the two groups. Factors associated with early-stage kidney injury in T2DM were analyzed, and the impact of TG/HDL-C, TyG index, and TyG-BMI on early-stage kidney injury in T2DM were explored.Results:Compared with T2DM patients without early-stage kidney injury, those with early-stage kidney injury exhibited significantly elevated levels of TG/HDL-C, TyG index, and TyG-BMI( P< 0.001). TG/HDL-C, TyG index, TyG-BMI, age, duration of diabetes, systolic blood pressure, fasting insulin, and HbA 1C were identified as independent risk factors for early-stage kidney injury in T2DM. Compared to the Q1 quartile, the risk in the Q4 quartile was 3.168 times(95% CI 1.993-5.036) for TG/HDL-C, 2.714 times(95% CI 1.710-4.306) for TyG index, and 2.893 times(95% CI 1.820-5.598) for TyG-BMI. Conclusion:Insulin resistance surrogate indicators TG/HDL-C, TyG index, and TyG-BMI are significantly elevated in T2DM patients with early-stage kidney injury, serving as independent risk factors for early-stage renal impairment in T2DM.

Objective:To investigate the clinical characteristics of patients with hepatitis B virus（HBV）-related primary hepatocellular carcinoma（HCC）who were treated in a multidisciplinary team（MDT）for liver cancer，so as to provide a basis for clinical optimization of the diagnosis and treatment of patients with chronic hepatitis B（CHB）.Methods:A retrospective analysis was performed for 482 HBV-related HCC patients who were treated with HCC-MDT every Thursday afternoon in The First Affiliated Hospital of the Army Medical University from January 2022 to May 2024，aged 18-87（55.54±10.84）years，86.93%（419/482）males and 13.07%（63/482）females. According to the different underlying liver diseases at the time of initial medical treatment and the different prognostic outcomes at the later follow-up，the differences in clinical characteristics between groups under different conditions were compared and analyzed，and the influencing factors of HCC prognosis were understood by Logistic regression analysis. Results:At the time of MDT presentation，the differences in HBeAg status（ χ2=6.311 ，P=0.043），γ-glutamyl traspeptidase（GGT）（ Z=6.277， P=0.043），alkaline phosphatase（ALP）（ Z=7.236 ，P=0.027），and model for end-stage liver disease（MELD）scores（ Z=6.111， P=0.047）among patients with different underlying liver diseases were statistically significant. At follow-up，6.75%（11/163）of HBV-related HCC patients who presented to MDT had a family history of HCC，and their cumulative mortality rate was as high as 60.8%（205/337）at least for 1 year. Mulitivariate Logistic regression analysis showed that different underlying liver disease at the time of initial medical treatment，HBV DNA replication level，MELD score and choice of anti-cancer treatment regimen were the influencing factors for the prognosis of HCC（all P<0.05）. The worse the degree of cirrhosis at the initial presentation，the higher the level of HBV DNA replication，and the higher the MELD score，the worse the prognosis for HCC. Conclusion:Advancing the diagnosis and treatment of CHB，maximizing the inhibition of HBV DNA replication，reducing the MELD score，and optimizing the anti-cancer treatment regimen can reduce the mortality rate of HBV-related HCC.

Objective:To analyze the efficacy of combination of peginterferon α-2b（Peg-IFN α-2b）with nucleos（t）ide analogues（NAs）on antiviral therapy in children with chronic hepatitis B（CHB）and to provide an optimized clinical treatment strategies for CHB children.Methods:A retrospective analysis was conducted on 30 CHB children treated in The First Affiliated Hospital of the Army Medical University（Southwest Hospital）from January 2022 to January 2025 with treatment duration at least 48 weeks. The enrolled children were aged between 2 and 17 years and divided into the NAs combined with Peg-IFN α-2b（NPI）group（n=13）and NAs group（n=17）by their therapy regimens. The characteristics of baseline，week 12，week 24，week 48 and week 96 were compared between groups，as well as the differences in response to biochemical，immune and viral indicators at each observation point. Logistic regression analysis and receiver operating characteristic（ROC）curve analysis were performed to identify factors influencing the HBsAg seroclearance. Results:At baseline of treatment，the proportion of HBeAg positivity in the NPI group and the NAs group was high（76.9% vs 86.6%， χ2=0.679， P=0.628），and the alanine aminotransferase（ALT）and aspartate aminotransferase（AST）in the NPI group were significantly lower than those in the NAs group（ P<0.001）. At 24 weeks，the decrease in HBsAg in the NPI group was also significantly higher than that in the NAs group（ Z=-3.161， P=0.002）. Finally，the cumulative seroclearance rate of HBsAg at 96 weeks in the NPI group was significantly higher than that in the NAs group（46.15% vs 5.88%， χ2=0.679， P=0.025）. Mulitivariate Logistic regression analysis showed that treatment regimen and gender were risk factors affecting the outcome of HBsAg（ P<0.05）. ROC curve analysis showed that the increase in ALT at 12 weeks compared with baseline（AUC=0.857，Cutoff value=3.615 IU/L），the decrease in ALT at 24 weeks（AUC=0.870，Cutoff value=47.85 IU/L），and the decrease in HBsAg at 12 weeks and especially at 24 weeks（AUC=0.885，Cutoff value=0.97log IU/ml）were effective predictors of HBsAg prognosis at 96 weeks. Conclusion:In CHB children，antiviral regimen Peg-IFN α-2b combined with NAs was more effective than NAs alone in improving the HBsAg seroclearance rate of CHB，and the effects in female were better than in male. The decline of HBsAg and the fluctuation of ALT in the early treatment period are valid predictors of HBsAg clearance.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To analyze the medication pattern of traditional chinese medicine for pediatric mesenteric lymphadenitis,and to provide medication reference for clinical treatment of this disease.Methods:A total of 159 traditional chinese medicine prescriptions who were diagnosed with pediatric mesenteric lymphadenitis in the outpatient department of the Traditional Chinese Medicine Department of Chongqing Medical University Affiliated Children's Hospital from January 2020 to March 2024 were collected.A medication database was created by Excel software,and the high-frequency application of traditional chinese medicine,four qi of traditional chinese medicine,five flavors,meridian tropism,correlation analysis,and cluster analysis were analyzed by ancient and modern medical case cloud platform and SPSS software.Results:The top 10 drugs in terms of frequency were licorice,hawthorn,tangerine peel,corydalis yanhusuo,malt,white peony,magnolia officinalis,poria cocos,atractylodes macrocephala,and forsythia suspensa.The top three medicinal properties were warm,calm,and cold.The top three medicinal flavors were sweet,spicy,and bitter.The top three drugs classified by meridian were spleen,lung,and stomach.Association rule analysis identified four groups of core drugs.Cluster analysis divides high-frequency traditional Chinese medicine into four effective prescription groups.Conclusion:Traditional chinese medicine treatment for pediatric mesenteric lymphadenitis,association rule analysis has identified core drug combinations,including licorice,hawthorn,tangerine peel,etc;Cluster analysis divides high-frequency traditional chinese medicine into four groups of prescriptions,with the treatment methods of regulating qi and strengthening spleen,strengthening spleen and eliminating dampness,clearing heat and detoxifying,and promoting qi and blood circulation,providing reference for the rational application of traditional chinese medicine in the treatment of pediatric mesenteric lymphadenitis in clinical practice.