OBJECTIVE To conduct a systematic review concerning the safety of using glucagon-like peptide-1 receptor agonists （GLP-1RA） before gastrointestinal endoscopy. METHODS Chinese and English databases including CNKI， Wanfang Data， VIP， CBM， and PubMed were searched to collect systematic reviews and meta-analyses on the safety of using GLP-1RA before gastrointestinal endoscopy， with a search period from the inception to September 30， 2025. Report quality， methodological quality， risk of bias， and evidence quality were assessed using the PRISMA 2020 statement， AMSTAR 2 scale， ROBIS tool， and GRADE tool， respectively. Corrected covered area （CCA） was used to quantitatively evaluate the degree of outcome overlap， and a comprehensive quality analysis was performed on the quantitative results of systematic reviews/meta-analyses. RESULTS Ten studies were included. All 10 stu dies had some information deficiencies （15.5-19.5 points）， and were at high risk of bias； 9 studies were extremely low methodological quality， while 1 study was low. In terms of evidence quality， among 88 outcome indexes， there was 1 moderate-level index， 28 low-level indexes， and 59 extremely low-level indexes. The CCA values of the incidence of residual gastric contents， aspiration， endoscopy interruption， repeated endoscopy， inadequate bowel preparation and Boston Bowel Preparation Scale scores were 37.30%， 35.00%， 35.00%， 50.00%， 29.60% and 20.00%， respectively. Results of comprehensive quality analysis showed that compared with the control group， the incidence of residual gastric contents， endoscopy interruption and repeated endoscopy were increased significantly in the intervention group， along with a notably prolonged gastric emptying time and a significantly lower score of Boston Bowel Preparation Scale （ P ＜0.05）. However， the study results regarding the effects of GLP-1RA on the incidence of aspiration and inadequate bowel preparation were inconsistent. CONCLUSIONS The use of GLP-1RA before gastrointestinal endoscopy can increase certain safety risks， including residual gastric contents， endoscopy interruption and repeated endoscopy， prolong gastric emptying time， and reduce the quality of bowel preparation. However， the effects on aspiration and inadequate bowel preparation remain controversial. The reports included in systematic reviews/meta-analyses exhibited low quality in reporting， methodology and evidence， with high risk of bias. Therefore， conclusions should be interpreted with caution.

Objective To explore the diagnostic value of lung ultrasound(LUS)score,computed tomo-graphy(CT)combined with serum CXC chemokine ligand 8(CXCL8)and soluble co stimulatory molecule B7-H3(sB7-H3)for severe Mycoplasma pneumoniae pneumonia(MPP)in children.Methods From April 2022 to April 2024,a total of 210 children with MPP who visited Maternal and Child Health Hospital of Zhan-gqiu District were included as research subjects,and they were separated into severe MPP group and non se-vere MPP group according to the severity of the disease.Enzyme-linked immunosorbent assay was applied to detect serum levels of CXCL8 and sB7-H3.LUS score and CT diagnosis were conducted.The value of LUS score,CT and serum CXCL8,sB7-H3 in the diagnosis of severe MPP was analyzed using the receiver operating characteristic curve.Results There were no statistically significant differences in height,age,fever days,weight,hospital stay,and gender between the severe MPP group and the non severe MPP group(P>0.05).Compared with the non severe MPP group,the serum levels of CXCL8,sB7-H3,and LUS score were all in-creased in the severe MPP group(P<0.05).The area under the curve(AUC)of LUS score,serum CXCL8,and sB7-H3 for diagnosing severe MPP was 0.865,0.785,and 0.750,respectively.The CT diagnosis results showed 35 false positives and 22 false negatives,with Kappa value of 0.459 compared to clinical examination results(P<0.05).The diagnostic results of LUS score,CT combined with serum CXCL8 and sB7-H3 showed 3 false positives and 15 false negatives,with Kappa vale of 0.828 compared to clinical examination results(P<0.05).The diagnosis of LUS score,CT combined with serum CXCL8,and sB7-H3 had higher specificity and accuracy than those of single detection of the four(P<0.05),and the sensitivity of the combined diagno-sis of the four was increased(P<0.05)and the missed diagnosis rate was reduced compared to the single de-tection of CXCL8 and sB7-H3(P<0.05).Conclusion The serum levels of CXCL8,sB7-H3,and LUS score in children with MPP increase.The specificity and accuracy of LUS score,CT combined with serum CXCL8,sB7-H3 in diagnosing severe MPP increase.

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.

Objective:Analysis of the composition of pathogen spectrum and prevalence characteristics in throat swabs of patients with acute respiratory infections (ARI) in Yucheng city, Henan province, from March to June 2023.Methods:After 1 153 throat swabs were collected from ARI patients in Yucheng, 18 respiratory pathogens were tested using a real-time fluorescence quantitative polymerase chain reaction (qPCR) method. The characterization of pathogens spectrum was analyzed.Results:A total of 1 153 throat swabs from ARI patients were collected from March to June 2023 in Yucheng, including 171 outpatients and 982 hospitalized patients. A total of 244 positive samples for common respiratory pathogens were detected (at least one pathogen per sample was detected). The total detection rate of respiratory pathogens was 21.16%, and the top three detection rates were, in descending order, human bocavirus (HBoV), enterovirus (EV), and human parainfluenza virus (HPIV). The main detection month for pathogens was May, with a detection rate of 42.3% (60/142). The main respiratory pathogens detected are HBoV, EV, and HPIV. The detection rate of the age group under 1 year old was the highest, at 25.1% (49/195), mainly consisting of HBoV, respiratory syncytial virus (RSV), and HPIV. The main clinical manifestations of respiratory pathogen-positive patients were fever and cough, and the clinical diagnosis was mainly lower respiratory tract infection, all of which were hospitalized patients.Conclusions:The respiratory pathogens in ARI patients were mainly HBoV, EV, and HPIV from March to June, 2023 in Yucheng. The peak of the epidemic was in May, mainly infecting children under 5 years of age.

Objective:To evaluate the effect of preoperative oral carbohydrate intake on postoperative nausea and vomiting (PONV) in elderly patients undergoing gynecological laparoscopic surgery.Methods:This study was a randomized controlled trial. One hundred elderly patients, aged≥65 yr, with a body mass index of 18-30 kg/m 2, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent gynecological laparoscopic surgery at the Baoding First Central Hospital from March 2023 to June 2024, were selected. Stratification was conducted by age (65-74 yr/≥75 yr) using an online randomization tool, and the patients were randomly divided into conventional fasting group (group C) and oral carbohydrate group (group P), with 50 cases in each group. Patients took oral carbohydrate drinks of 4 ml/kg at 2 h before operation, with total amount ≤400 ml in group P, while patients received conventional preoperative fasting protocols in group C. The occurrence and severity of PONV within 48 h postoperatively were observed. The visual analogue scale scores for hunger and thirst, State-Trait Anxiety Inventory scale scores, length of stay in the postanesthesia care unit, duration of hospital stay, time to first flatus, time to first ambulation, and patient′s satisfaction were recorded in the two groups. Results:Compared with group C, the incidence and severity of PONV were significantly decreased within 48 h after surgery, the visual analogue scale scores for hunger and thirst and State-Trait Anxiety Inventory scale scores were significantly decreased after entering the operating room, the length of stay in the postanesthesia care unit, time to first flatus and time to first ambulation were significantly shortened, and the patient′s satisfaction was significantly increased in group P ( P<0.05). Conclusions:Oral carbohydrate intake before operation can effectively reduce the occurrence and severity of PONV and improve the quality of postoperative recovery in elderly patients undergoing gynecological laparoscopic surgery.

Objective:To investigate the relationship between artificial radionuclide 137Cs and stable cesium (Cs) in wild edible fungi and seek potential correlations. Methods:A total of 30 samples, including the caps (with gills) and stipes of wild edible fungi, were collected from the northeastern region of China. The measurement and analysis of 137Cs were conducted following recommended procedures in GB/T 16145-2022, and stable Cs was determined using inductively coupled plasma mass spectrometry (ICP-MS). Then, the correlation analysis of data on 137Cs and stable Cs was performed using SPSS 11.5 software, and scatter plots were prepared using the Origin 21.0 software. Results:The fungi caps exhibited a specific activity of 137Cs ranging from 0.52 to 55.9 Bq/kg (dry weight) and a stable Cs content from 0.069 mg/kg to 16.2 mg/kg (dry weight). The stipes showed a specific activity of 137Cs ranging from 0.53 Bq/kg to 101 Bq/kg (dry weight) and a stable Cs content from 0.075 to 11.5 mg/kg (dry weight). These data revealed a significant correlation between the specific activity of 137Cs and the stable cesium content in all samples including caps and stipes, with correlation coefficients r of 0.956, 0.912, and 0.931, respectively, and all significant levels P < 0.01. The ratios of the specific activity of 137Cs to stable Cs content varied from 2.09 Bq/kg to 20.1 Bq/kg (dry weight), with an average of 10.7 Bq/kg (dry weight). Conclusions:Wild edible fungi fail to distinguish between 137Cs and stable cesium when absorbing Cs elements from their growing substrates. Furthermore, there is a strong correlation between the specific activity of 137Cs and stable Cs content. In the case of exogenous 137Cs contamination, the ratio of the specific activity of 137Cs and stable Cs content will significantly change. Therefore, an increase in the ratio can be used as a reference for identifying 137Cs contamination events.

Objective:To explore the applicability of critical statistical measures Z, Z′, Zeta ( ζ), and En value in comparative capability assessments by analyzing the data from nationwide radiological health technology institutions from 2020 to 2023, aiming to provide a reference for further improving China′s comparative assessment method for verifying the γ-ray spectroscopy capability of radionuclides. Methods:Based on the nationwide analysis and comparison of γ-ray spectroscopy of radionuclides conducted annually by the National Institute for Radiological Protection, China CDC, the deviations between laboratory result and reference values were determined using the above-mentioned four statistical measures. Finally, the qualification rates of the γ-ray spectroscopy result from relevant institutions were assessed and analyzed.Results:The result indicate that the qualification rates of the Z value exceeded 85%, which might be inaccurate in some cases since it ignored the limitation of uncertainty. In contrast, the Z′ value yielded more scientific and representative result because it considered the uncertainty of reference values, and the inter-laboratory comparison qualification rate is above 95%. In the case of low uncertainty of the γ-ray spectroscopy result, the Zeta ( ζ) or En ratio exhibited relatively high sensitivity and, accordingly, relatively low qualification rates, indicating that this ratio may not comprehensively reflect the interlaboratory comparison result. Conclusions:The Z, Z′, Zeta ( ζ), and En values demonstrate their own advantages and limitations in assessing the capability of the γ-ray spectroscopy of radionuclides. For comparison projects involving multiple laboratories and complex measurement conditions, such as the nationwide verification of the capabilities of the γ-ray spectroscopy of radionuclides, it is feasible to combine the Z′ value with the Zeta ( ζ) or En ratio, with the former and the latter used to determine the qualified and excellent capability result, respectively. This enables the comprehensive assessment of the measurement and analysis capabilities of the γ-ray spectroscopy laboratories of radiological health technology institutions in China.

Objective:To investigate the relationship between alterations in dynamic functional connectivity (dFC) and spatial navigation abilities in individuals with subjective cognitive decline (SCD) across different Traditional Chinese Medicine (TCM) constitutions.Methods:Seventy-five participants with SCD, comprising 34 individuals with balanced constitutions and 41 individuals with biased constitutions, were recruited from the Affiliated Drum Tower Hospital of Nanjing University Medical School between August 2022 and January 2025. The participants underwent TCM constitution assessment, spatial navigation ability testing, and neuropsychological scale evaluation. Additionally, each participant was assessed using 3.0 T resting-state functional magnetic resonance imaging (rs-fMRI) and high-resolution T1-weighted imaging scans. Based on prior research, 20 spatial navigation-related regions of interest (ROIs) were defined. Afterwards, rs-fMRI time series were segmented using a sliding time window approach before calculating the dFC within the spatial navigation brain network.Results:Compared to the balanced constitution group, the biased constitution SCD group showed significantly lower scores on the Mini-Mental State Examination (MMSE) ( z=-3.05, P=0.002) and the Auditory Verbal Learning Test (AVLT) measures: immediate recall ( z=-2.12, P=0.035), short-delay recall ( z=-2.22, P=0.026), long-delay recall ( z=-2.88, P=0.004), cued recall ( z=-2.91, P=0.004), and recognition ( z=-2.20, P=0.028). They also exhibited significantly higher average error distances in ego-allocentric navigation ( z=-2.28, P=0.023), egocentric navigation ( z=-2.31, P=0.021), and delayed navigation ( z=-2.02, P=0.043). Participants with SCD who had a biased constitution also demonstrated significantly reduced dFC between the left parahippocampal gyrus (PHG) and left prefrontal cortex (PFC) ( t=2.43), right precuneus and right retrosplenial cortex (RSC) ( t=2.96), and left inferior parietal lobule (IPL) and left hippocampus ( t=2.42) (all P<0.05, Bonferroni-corrected). Conversely, the dFC was significantly increased between the right PHG and left PFC ( t=-2.29, P<0.05, Bonferroni-corrected). Significant correlations were also found in participants with SCD who had biased constitutions: the dFC between the left PHG and left PFC positively correlated with the egocentric navigation average total error ( r=0.34, P=0.030) and negatively correlated with the visuospatial memory cognitive domain ( r=-0.35, P=0.026); the dFC between the left IPL and left hippocampus negatively correlated with the egocentric navigation average total error ( r=-0.32, P=0.043); and the dFC between the right PHG and left PFC positively correlated with the delayed navigation average total error ( r=0.33, P=0.037). The area under the ROC curve for the combined differences in cognitive assessments, spatial navigation behavior, and navigation-related brain network dFC was 0.966 in predicting biased constitution versus balanced constitution in participants with SCD. Conclusions:Individuals with SCD and biased constitutions demonstrated poorer spatial navigation ability, possibly due to altered dFC within the spatial navigation brain network. Furthermore, the integrated model based on spatial navigation behaviors and dFC exhibited a high predictive value in distinguishing between individuals with SCD who had balanced and biased constitutions.

Chronic atrophic gastritis(CAG)is a chronic gastric disorder characterized by recurrent damage to the gastric mucosal epithelium,resulting in the reduction of intrinsic glands,with or without concurrent intestinal metaplasia.The"hyperactive stomach qi"theory,derived from Huang Di Nei Jing Su Wen Ji Zhu,proposes that the core pathogenesis of CAG lies in excessive stomach qi activity,grounded in the physiological principle of"strong yang qi in earth and weak yin qi in earth".This theory synthesizes the clinical manifestations and pathological progression of CAG,asserting that its development often involves intertwined pathological factors such as stagnation,dryness-heat,phlegm-dampness and stasis-toxicity.A triphasic therapeutic framework is proposed:the spleen qi deficiency phase,marked by impaired spleen transport function and dysregulated qi-fluid distribution,requiring spleen fortification and qi-fluid regulation;the hyperactive stomach qi phase,characterized by intensified stomach qi activity coupled with dryness-damp stagnation,necessitating stagnation resolution,dampness elimination and yin nourishment;the decline and disorder of middle qi phase,characterized by the deficiency of the middle qi,with phlegm,blood stasis and toxins forming the terminal stage.Treatment should focus on reinforcing the middle and restoring balance,detoxifying and dissipating accumulation.By exploring CAG pathogenesis and treatment through the lens of"hyperactive stomach qi",this study aimed to provide novel theoretical insights and therapeutic strategies for TCM in the prevention and treatment of CAG.

Intravascular large B cell lymphoma (IVLBCL) is a rare, aggressive subtype of diffuse large B cell lymphoma, with nasal turbinate involvement being uncommon. We report a 51-year-old woman with a 1-month history of fever of unknown origin. Laboratory findings showed cytopenia, hypertriglyceridemia, elevated ferritin, increased soluble CD25, and bone marrow hemophagocytosis. No infectious cause was identified. PET-CT revealed abnormal 18F-fluorodeoxyglucose (FDG) uptake in the nasal turbinates. Turbinate biopsy revealed tumor cells localized predominantly within vascular lumens, positive for CD20, BCL6, PAX5, and MUM1, with a Ki-67 index >60%, confirming a diagnosis of IVLBCL with hemophagocytic lymphohistiocytosis (HLH). The patient received one cycle of the DEP regimen (liposomal doxorubicin, etoposide, and methylprednisolone) for HLH, followed by five cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and consolidation with auto-HSCT, achieving sustained complete remission. IVLBCL outcomes are heterogeneous; early diagnosis and prompt treatment improve survival, and R-CHOP plus auto-HSCT may be an effective strategy.