Objective:To identify factors influencing treatment-free remission (TFR) outcomes in children and adolescent patients with chronic myeloid leukemia (CML) after imatinib (IM) discontinuation.Methods:This multicenter retrospective study analyzed 36 children and adolescent patients with CML from eight hematology centers in China (December 1, 2016, to September 27, 2024) who discontinued IM therapy with documented post-cessation outcomes. Clinical characteristics and molecular response dynamics were assessed. Univariate analysis and multivariate Cox proportional hazards regression models were employed to assess factors associated with TFR outcomes.Results:A total of 36 patients were documented, comprising 17 males and 19 females. The median ages at CML diagnosis and IM discontinuation were 11 years ( IQR: 5,16) and 20 years ( IQR: 14,25), respectively. The median time from IM initiation to first deep molecular response (DMR) was 21 months ( IQR: 13, 38). Pre-discontinuation, patients received IM for a median duration of 96 months ( IQR: 84, 121) and maintained DMR for 74 months ( IQR: 63, 89). With a median post-discontinuation follow-up of 38 months ( IQR: 15, 68), cumulative TFR rates at 6, 12, 24, and 36 months were 74.1%, 60.7%, 60.7%, and 56.0%, respectively, generating an overall TFR rate of 58.3%. Fifteen patients lost major molecular response at a median of 5 months post-discontinuation ( IQR: 3, 11). All 15 patients resumed tyrosine kinase inhibitor therapy, comprising 13 who restarted IM and 2 who switched to dasatinib. By the last follow-up, 13 (86.7% ) patients regained DMR after a median treatment duration of 5 months ( IQR: 3, 17), and no disease progression occurred in any patient. Withdrawal syndrome occurred in 2 (5.6% ) patients. Univariate analysis revealed significantly higher TFR rates in patients with pre-discontinuation IM duration of ≥100 months vs <100 months (82.4% vs 36.8%, P=0.017) and pre-discontinuation DMR duration of ≥72 months vs <72 months (84.2% vs 29.4%, P=0.003). Multivariate Cox analysis identified pre-discontinuation DMR duration as an independent protective factor for TFR ( HR=5.419, 95% CI: 1.524–19.272, P=0.009) . Conclusion:DMR duration was identified as an independent protective factor influencing TFR outcomes in children and adolescent patients with CML after IM discontinuation. Patients who maintained DMR for ≥72 months before IM discontinuation demonstrated a significantly higher TFR rate.

Traditional four examinations of traditional Chinese medicine （TCM） are based on the symptoms and signs of patients， which are the advantages of TCM but also have shortcomings. Chronic kidney disease has the characteristics of insidiousness， long-term， deficiency and variability during its onset， which are difficult to be intervened in time based on only symptoms， therefore it is necessary to extend the application of the four examinations in the diagnosis and treatment process of chronic kidney disease. Based on the background of the continuous development of TCM syndrome differentiation techniques， this article proposed the extension and application strategies of the traditional four examinations in chronic kidney disease， including the incorporation of microscopic syndrome differentiation to identify the causes of kidney disease and prevent symptom deterioration； the utilization of accurate examination information enhanced by artificial intelligence for controlling development of existing disease； the integration of disease differentiation and syndrome differentiation to summarize clinical rules towards using constant to measure variation； and the establishment of a kidney disease database for the storage of four examinations information to prevent recurrence after recovery. The four above extension and application strategies can be used to achieve the long-term management and treatment effects of timely and early diagnosis， dynamic observation of the condition， accurate application of intervention， and strengthened prognosis assessment in the diagnosis and treatment of chronic kidney disease， and expand the advantages of TCM in the prevention and treatment of chronic kidney disease.

Over the past decade, pathology technology in China has undergone rapid development. Through continuous efforts to strengthen normative foundations and quality control, the three-tiered quality control network (national, provincial, and municipal) has been consolidated. These efforts have effectively driven the homogenization of pathology technical quality nationwide. Concurrently, the standardization of laboratory quality management systems and the advancement of automated pathological equipment have laid a solid foundation for the evolution of pathological diagnosis. Breakthroughs in cutting-edge technologies, including digital pathology, artificial intelligence, and molecular pathology, are further catalyzing a paradigm shift from traditional morphological analysis toward next-generation diagnostic pathology. Marking the 70th anniversary of this journal, the field's evolution over the past decade and chart its future course were reviwed systematically, aiming to provide an insightful roadmap for the ongoing progress of the discipline.

Over the past decade, pathology technology in China has undergone rapid development. Through continuous efforts to strengthen normative foundations and quality control, the three-tiered quality control network (national, provincial, and municipal) has been consolidated. These efforts have effectively driven the homogenization of pathology technical quality nationwide. Concurrently, the standardization of laboratory quality management systems and the advancement of automated pathological equipment have laid a solid foundation for the evolution of pathological diagnosis. Breakthroughs in cutting-edge technologies, including digital pathology, artificial intelligence, and molecular pathology, are further catalyzing a paradigm shift from traditional morphological analysis toward next-generation diagnostic pathology. Marking the 70th anniversary of this journal, the field's evolution over the past decade and chart its future course were reviwed systematically, aiming to provide an insightful roadmap for the ongoing progress of the discipline.

Objective:To identify factors influencing treatment-free remission (TFR) outcomes in children and adolescent patients with chronic myeloid leukemia (CML) after imatinib (IM) discontinuation.Methods:This multicenter retrospective study analyzed 36 children and adolescent patients with CML from eight hematology centers in China (December 1, 2016, to September 27, 2024) who discontinued IM therapy with documented post-cessation outcomes. Clinical characteristics and molecular response dynamics were assessed. Univariate analysis and multivariate Cox proportional hazards regression models were employed to assess factors associated with TFR outcomes.Results:A total of 36 patients were documented, comprising 17 males and 19 females. The median ages at CML diagnosis and IM discontinuation were 11 years ( IQR: 5,16) and 20 years ( IQR: 14,25), respectively. The median time from IM initiation to first deep molecular response (DMR) was 21 months ( IQR: 13, 38). Pre-discontinuation, patients received IM for a median duration of 96 months ( IQR: 84, 121) and maintained DMR for 74 months ( IQR: 63, 89). With a median post-discontinuation follow-up of 38 months ( IQR: 15, 68), cumulative TFR rates at 6, 12, 24, and 36 months were 74.1%, 60.7%, 60.7%, and 56.0%, respectively, generating an overall TFR rate of 58.3%. Fifteen patients lost major molecular response at a median of 5 months post-discontinuation ( IQR: 3, 11). All 15 patients resumed tyrosine kinase inhibitor therapy, comprising 13 who restarted IM and 2 who switched to dasatinib. By the last follow-up, 13 (86.7% ) patients regained DMR after a median treatment duration of 5 months ( IQR: 3, 17), and no disease progression occurred in any patient. Withdrawal syndrome occurred in 2 (5.6% ) patients. Univariate analysis revealed significantly higher TFR rates in patients with pre-discontinuation IM duration of ≥100 months vs <100 months (82.4% vs 36.8%, P=0.017) and pre-discontinuation DMR duration of ≥72 months vs <72 months (84.2% vs 29.4%, P=0.003). Multivariate Cox analysis identified pre-discontinuation DMR duration as an independent protective factor for TFR ( HR=5.419, 95% CI: 1.524–19.272, P=0.009) . Conclusion:DMR duration was identified as an independent protective factor influencing TFR outcomes in children and adolescent patients with CML after IM discontinuation. Patients who maintained DMR for ≥72 months before IM discontinuation demonstrated a significantly higher TFR rate.

Xiaoxuming decoction is one of the classical prescriptions in ancient times,mainly used for treating stroke syndrome,with significant therapeutic effects.Recent studies have found that it is also effective for other neurological diseases besides stroke,such as facial paralysis and vertigo,but there are few reports on related achievements,lacking systematic organization and summary.This article systematically summarizes the application practice and mechanism of Xiaoxuming decoction in the above-mentioned diseases,aiming to provide a solid foundation and scientific reference for deepening the exploration of Xiaoxuming decoction in the field of nervous system disease.

Objective:To analyze the risk factors leading to the failure of enhanced recovery after surgery (ERAS) in inflammatory bowel disease (IBD) patients with colorectal resection.Methods:A retrospective case-control study was conducted. Clinical data of consecutive IBD patients who received colorectal resection under ERAS protocol in Jingling Hospital from January 2019 to February 2021 were analyzed. ERAS failure was defined as prolonged postoperative length of hospital stay, or unplanned reoperation, accidental readmission or death within 30 days after operation. The patients were divided into failed ERAS group and successful ERAS group according to whether the ERAS failed. Univariate and Logistic multivariate analyses were performed to identify the risk factors of ERAS failure in IBD patients with colorectal resection.Results:A total of 216 patients were enrolled. There were 65 patients in failed ERAS group and 151 in successful ERAS group. Univariate analysis showed that compared with successful ERAS group, the ratio of body mass index (BMI) <18.5 kg/m 2 (61.5% vs.46.4%, P = 0.041) , the ratio of preoperative nutritional risk screening tools 2002 (NRS-2002) score ≥3 points (69.2% vs. 48.3%, P = 0.005) , the ratio of preoperative modified Glasgow prognostic score (mGPS) = 2 points (30.8% vs. 10.6%, P<0.001) , the ratio of preoperative steroids use within 4 weeks before operation (44.6% vs. 23.8%, P<0.001) , the ratio of neostomy (63.1% vs. 46.4%, P = 0.024) , the ratio of intraoperative infusion volume>3 L (44.6% vs. 21.9%, P = 0.038) were higher in failed ERAS group, while the the ratio of preoperative enteral nutrition was lower (53.8% vs. 68.2%, P = 0.044) . Multivariate analysis showed that preoperative NRS-2002 score ≥3 points ( OR = 2.212, 95% CI: 1.133-4.321, P = 0.020) , mGPS = 2 points ( OR = 3.510, 95% CI: 1.555-7.926, P = 0.003) and preoperative steroids use within 4 weeks before operation ( OR = 2.600, 95% CI: 1.313-5.146, P = 0.006) were the independent risk factors of ERAS failure in IBD patients with colorectal resection. Conclusions:ERAS failure is more likely to occur in IBD patients after colorectal resection with charactertics including preoperative NRS-2002 score ≥3 points, mGPS=2 points, and preoperative steroids use within 4 weeks before operation. Preoperative nutritional preconditioning, perioperative hormone discontinuation, and control of preoperative inflammatory response may promote the successful implementation of ERAS in IBD patients with surgery.

Objective: To analyze the effectiveness of body image education curriculum on grade 4-6 students of early adolescence in primary schools, so as to provide teaching pructice research eridence for promoting positive body image during adolescence. Methods: A primary school in Chengdu was selected as an experimental school, who offered 6 projects, each project 1 class hour, each chass hour 40 minutes, an average of 1.5 weeks body image education curriculum (body changes during adolescent, values, physical appearance, gender diverity expression and aesthetic diversity). The other school had the same school district conditions, school size and nature, teachers and teaching environment, and had no body image education courses. A pre-test and post-test survey was conducted in April and May 2023 on students in grades 4 to 6 in both schools through the Body Image State Scale adopting cluster sampling. Results: The pre-test scores of body image in experimental school and control school were (34.99±8.72) and (35.74±8.57) respectively, with no significantly statistical difference ( t=-1.29, P >0.05). The post-test scores of body image in experimental school and control school were (37.09±10.40) and (35.70±8.78) respectivily. There was a significant difference in body image between pre-test and post-test scores in experimental school ( t=-5.70, P <0.01), while no significant difference in control school ( t=0.13, P >0.05). There were significant differences in body image between pre-test and post-test scores among students of different BMI groups in experimental and control schools ( F =16.01, 7.19, 9.64, 5.30, P <0.01). Conclusions Body image education curriculum in early adolescence is beneficial for improving students body satisfaction. To help students develop a positive body image in early adolescence, it is necessary to implement relevant curriculum education in schools as early as possible.

Objective:To analyze the risk factors leading to the failure of enhanced recovery after surgery (ERAS) in inflammatory bowel disease (IBD) patients with colorectal resection.Methods:A retrospective case-control study was conducted. Clinical data of consecutive IBD patients who received colorectal resection under ERAS protocol in Jingling Hospital from January 2019 to February 2021 were analyzed. ERAS failure was defined as prolonged postoperative length of hospital stay, or unplanned reoperation, accidental readmission or death within 30 days after operation. The patients were divided into failed ERAS group and successful ERAS group according to whether the ERAS failed. Univariate and Logistic multivariate analyses were performed to identify the risk factors of ERAS failure in IBD patients with colorectal resection.Results:A total of 216 patients were enrolled. There were 65 patients in failed ERAS group and 151 in successful ERAS group. Univariate analysis showed that compared with successful ERAS group, the ratio of body mass index (BMI) <18.5 kg/m 2 (61.5% vs.46.4%, P = 0.041) , the ratio of preoperative nutritional risk screening tools 2002 (NRS-2002) score ≥3 points (69.2% vs. 48.3%, P = 0.005) , the ratio of preoperative modified Glasgow prognostic score (mGPS) = 2 points (30.8% vs. 10.6%, P<0.001) , the ratio of preoperative steroids use within 4 weeks before operation (44.6% vs. 23.8%, P<0.001) , the ratio of neostomy (63.1% vs. 46.4%, P = 0.024) , the ratio of intraoperative infusion volume>3 L (44.6% vs. 21.9%, P = 0.038) were higher in failed ERAS group, while the the ratio of preoperative enteral nutrition was lower (53.8% vs. 68.2%, P = 0.044) . Multivariate analysis showed that preoperative NRS-2002 score ≥3 points ( OR = 2.212, 95% CI: 1.133-4.321, P = 0.020) , mGPS = 2 points ( OR = 3.510, 95% CI: 1.555-7.926, P = 0.003) and preoperative steroids use within 4 weeks before operation ( OR = 2.600, 95% CI: 1.313-5.146, P = 0.006) were the independent risk factors of ERAS failure in IBD patients with colorectal resection. Conclusions:ERAS failure is more likely to occur in IBD patients after colorectal resection with charactertics including preoperative NRS-2002 score ≥3 points, mGPS=2 points, and preoperative steroids use within 4 weeks before operation. Preoperative nutritional preconditioning, perioperative hormone discontinuation, and control of preoperative inflammatory response may promote the successful implementation of ERAS in IBD patients with surgery.

Objective:This study aimed to observe whether the treatment-free remission (TFR) of second-generation tyrosine kinase inhibitors (TKI) in chronic myeloid leukemia (CML) is better than imatinib (IM) .Methods:The clinical data of 274 CML patients who discontinued treatment and with complete clinical data were retrospectively studied from June 2013 to March 2021. Using both univariate and multivariate Cox proportional hazards regression models, risk factors influencing TFR outcomes after drug withdrawal in CML patients were assessed.Results:A total of 274 patients were enrolled, 140 patients were women (51.1%) , with a median age of 48 (9-84) years at the time of TKI discontinuation. Prior to TKI discontinuation, 172 (62.8%) patients were treated with IM, and 102 (37.2%) had received second-generation TKI treatment, including 73 patients who had shifted from IM to a second-generation TKI and 29 patients who used second-generation TKI as the first-line treatment. The rationale for converting to a second-generation TKI are as follows: 37 patients aimed deep molecular response (DMR) to achieve TFR, seven patients changed due to IM intolerance, and 29 patients changed because of failure to achieve the optimal treatment response. The use of the last type of TKI included 96 patients (94.1%) with nilotinib, three patients (2.9%) with dasatinib, and two patients (2%) with flumatinib, including one patient who changed to IM due to second-generation TKI intolerance. No statistical differences were found in the median age at diagnosis and TKI discontinuation, sex, Sokal score, IFN treatment before TKI, median time of TKI treatment to achieve DMR, and the reasons for TKI discontinuation between the second TKI and IM ( P>0.05) .The median cumulative treatment time of TKI (71.5 months vs 88 months, P<0.001) , the last TKI median treatment time (60 months vs 88 months, P<0.001) , and the median duration of DMR (58 months vs 66 months, P=0.002) were significantly shorter in the second-generation TKI compared with IM. In the median follow-up of 22 (6-118) months after TKI discontinuation, 88 patients (32.1%) had lost their MMR at a median of 6 (1-91) months; of the 53 patients (60.2%) who lost MMR within 6 months, the overall TFR rate was 67.9%, and the cumulative TFR rates at 12 and 24 months were 70.5% and 67.5%, respectively. Withdrawal syndrome occurred in 26 patients (9.5%) . For patients who restarted TKI treatment, 72 patients (83.7%) achieved DMR again at a median treatment of 4 (1 to 18) months. The univariate analysis showed that the TFR rate of patients treated with second-generation TKI was significantly higher than those who were treated with IM (77.5% vs 62.2%, P=0.041) . A further subgroup analysis found that the TFR rate of the second-generation TKI patients was significantly higher than those treated with IM (80.8% vs 62.2%, P=0.026) . No significant difference was found in the second-generation TKI used as the first line treatment compared with those who were treated with IM (69.0% vs 62.2%, P=0.599) . The multivariate analysis results showed that second-generation TKI treatment was an independent prognostic factor affecting TFR in patients who discontinued TKI ( RR=1.827, 95% CI 1.015-3.288, P=0.044) . Conclusion:In the clinical setting, more CML patients rapidly achieved TFR using second-generation TKI than IM treatment.