Objective:To investigate the association between small vulnerable newborn (SVN) phenotypes and the risk of neurodevelopmental delay at the age of 1 year.Methods:A prospective cohort study was conducted. A total of 25 860 singleton infants from "The Born in Guangzhou Cohort Study" who completed the Gesell developmental scale assessment at 1 year of age between January 2013 and June 2025 were included. Maternal sociodemographic characteristics, and other information were collected using a self-administered questionnaire, and maternal pregnancy-related information and neonatal birth data were extracted from medical records. Global developmental delay (GDD) was defined as a developmental quotient below 86 in ≥3 domains of the Gesell developmental scale, which assesses the adaptive, gross motor, fine motor, language, and personal-social domains. The random forest algorithm was employed for missing data imputation. Based on prematurity, small for gestational age (SGA), and low birth weight (LBW), newborns were categorized into 6 phenotypes: preterm-SGA-LBW, preterm-appropriate for gestational age (AGA)-LBW, preterm-AGA-nonLBW, term-SGA-LBW, term-LBW-only or term-SGA-only, and term-AGA-nonLBW phenotype. Among these, the first 5 were classified as SVN phenotypes, and the last one served as the reference group. Inter-group comparisons were performed using analysis of variance (ANOVA), χ2 tests, or Kruskal-Wallis test, as appropriate.?? Multivariable robust Poisson regression models were applied to analyze the association of different SVN phenotypes with the risks of GDD and developmental delays in specific domains, with stratified analyses by sex. Results:Among the 25 860 infants, 13 719 (53.1%) were male and 12 141 (46.9%) were female. The gestational age at birth was 39.4 (38.6, 40.0) weeks. The overall detection rate of GDD at 1 year of age was 3.7% (962/25 860). The rates of delay across developmental domains, in descending order, language in 8 134 cases (31.5%), gross motor in 4 488 cases (17.4%), personal-social in 1 271 cases (4.9%), adaptive in 1 262 cases (4.9%), and fine motor in 621 cases (2.4%). Compared with the reference group, preterm-AGA-LBW, preterm-SGA-LBW, preterm-AGA-noneLBW, and term-SGA-LBW phenotypes were all associated with an increased risk of GDD, with the adjusted RR (95% CI) of 6.07(5.01-7.35), 4.81(3.11-7.46), 2.10(1.54-2.88) and 1.89(1.29-2.76) respectively.The preterm-AGA-noneLBW phenotype was all associated with an increased risk of delay in gross motor, language and personal-social functional domains (all P<0.05). The term-SGA-LBW phenotype was associated with an increased risk of delay in gross motor, fine motor and personal-social functional domains (all P<0.01). Whereas the term-LBW-only or term-SGA-only phenotype showed no statistically association with developmental delay in any functional domain (all P≥0.05). Conclusion:The combined classification based on gestational age and birth weight helps identify infants at high risk for neurodevelopmental delay at 1 year of age, suggesting that it may offer a reference for the rational allocation of clinical resources.

AIM: To explore the therapeutic effect and prognosis of intense pulsed light combined with pralprofen eye drops for meibomian gland cysts in children. METHODS: Children with meibomian gland cysts visited the hospital for treatment from April 2023 to October 2024 were selected as the research subjects. All subjects were grouped using the random number table methed. In the control group, patients were treated with hot compress. In the drug group, patients were treated with pralprofen eye drops combined with hot compress. In the laser group, patients were treated with intense pulsed light combined with hot compress. In the combination group, patients were treated with pralprofen eye drops combined with intense pulsed light and hot compress. The treatment effective rate, cyst surface area, ocular symptom score, and occurrence of adverse reactions of children in each group were compared. RESULTS: A total of 80 children(80 eyes)were enrolled in this study, with 20 cases(20 eyes)in each of the control group, drug group, laser group, and combination group. The mean age was 7.49±1.09 y in the control group(9 males and 11 females), 7.63±0.98 y in the drug group(11 males and 9 females), 7.39±0.59 y in the laser group(12 males and 8 females), and 7.63±1.21 y in the combination group(12 males and 8 females). The total effective rate was 70%(14/20)in the combination group, which was significantly higher than that in the control group, drug group, and laser group(all P<0.05). After treatment, the cyst surface area and ocular symptom scores decreased to varying degrees in all groups. Notably, at 21 d post-treatment, the cyst surface area and ocular symptom scores in the combination group were significantly lower than those in the control group, drug group, and laser group(all P<0.05). No adverse reactions occurred in the combination group, which was lower than that in the control group, drug group, and laser group, with no statistically significant difference among the four groups(P>0.05).CONCLUSION: Intense pulsed light combined with pralprofen eye drops can improve the ocular symptoms of children with meibomian gland cysts, reduce the surface area of meibomian gland cysts, increase the clinical cure rate, and this treatment method is highly safe.

To evaluate the application value of the Peyton four-step teaching method in the standardized training of intestinal ultrasound and compare it with traditional teaching methods, so as to provide an optimized approach for clinical ultrasound training.

Platelets are small, anucleated cells generated by cytoplasmic fragmentation and shedding from mature megakaryocytes. Upon vascular stimulation or injury, platelets become activated and adhere to exposed vascular endothelial cells, ultimately forming thrombi to promote blood coagulation and wound healing. In recent years, increasing evidence from in-depth studies on platelet function has revealed that autophagy plays a crucial role in platelet production and functional performance. Autophagy is an intracellular process of material recycling and reuse, involving autophagosome formation, cargo degradation, and nutrient recycling, which facilitates the maintenance of homeostasis and defense against pathogen infection. Numerous studies have demonstrated that autophagy participates in the regulation of platelet production, activation, and aggregation, and is closely implicated in the pathogenesis of platelet dysfunction-related diseases such as immune thrombocytopenia. Additionally, platelet-rich plasma therapy, by modulating the autophagic process, has shown great potential in treating osteoarthritis and promoting diabetic foot wound healing. This review thoroughly explores the potential roles of autophagy in regulating platelet production and function, as well as in platelet-related diseases. Future research should focus on the molecular mechanisms of platelet autophagy, investigate its dynamic changes under different disease conditions, and explore how autophagy modulation can improve platelet function and treat related diseases. This will provide a theoretical foundation for developing novel therapeutic strategies and is expected to bring breakthroughs in the treatment of platelet-related diseases.

Objective:To investigate the association between small vulnerable newborn (SVN) phenotypes and the risk of neurodevelopmental delay at the age of 1 year.Methods:A prospective cohort study was conducted. A total of 25 860 singleton infants from "The Born in Guangzhou Cohort Study" who completed the Gesell developmental scale assessment at 1 year of age between January 2013 and June 2025 were included. Maternal sociodemographic characteristics, and other information were collected using a self-administered questionnaire, and maternal pregnancy-related information and neonatal birth data were extracted from medical records. Global developmental delay (GDD) was defined as a developmental quotient below 86 in ≥3 domains of the Gesell developmental scale, which assesses the adaptive, gross motor, fine motor, language, and personal-social domains. The random forest algorithm was employed for missing data imputation. Based on prematurity, small for gestational age (SGA), and low birth weight (LBW), newborns were categorized into 6 phenotypes: preterm-SGA-LBW, preterm-appropriate for gestational age (AGA)-LBW, preterm-AGA-nonLBW, term-SGA-LBW, term-LBW-only or term-SGA-only, and term-AGA-nonLBW phenotype. Among these, the first 5 were classified as SVN phenotypes, and the last one served as the reference group. Inter-group comparisons were performed using analysis of variance (ANOVA), χ2 tests, or Kruskal-Wallis test, as appropriate.?? Multivariable robust Poisson regression models were applied to analyze the association of different SVN phenotypes with the risks of GDD and developmental delays in specific domains, with stratified analyses by sex. Results:Among the 25 860 infants, 13 719 (53.1%) were male and 12 141 (46.9%) were female. The gestational age at birth was 39.4 (38.6, 40.0) weeks. The overall detection rate of GDD at 1 year of age was 3.7% (962/25 860). The rates of delay across developmental domains, in descending order, language in 8 134 cases (31.5%), gross motor in 4 488 cases (17.4%), personal-social in 1 271 cases (4.9%), adaptive in 1 262 cases (4.9%), and fine motor in 621 cases (2.4%). Compared with the reference group, preterm-AGA-LBW, preterm-SGA-LBW, preterm-AGA-noneLBW, and term-SGA-LBW phenotypes were all associated with an increased risk of GDD, with the adjusted RR (95% CI) of 6.07(5.01-7.35), 4.81(3.11-7.46), 2.10(1.54-2.88) and 1.89(1.29-2.76) respectively.The preterm-AGA-noneLBW phenotype was all associated with an increased risk of delay in gross motor, language and personal-social functional domains (all P<0.05). The term-SGA-LBW phenotype was associated with an increased risk of delay in gross motor, fine motor and personal-social functional domains (all P<0.01). Whereas the term-LBW-only or term-SGA-only phenotype showed no statistically association with developmental delay in any functional domain (all P≥0.05). Conclusion:The combined classification based on gestational age and birth weight helps identify infants at high risk for neurodevelopmental delay at 1 year of age, suggesting that it may offer a reference for the rational allocation of clinical resources.

The study focuses on the concept of multifunctional traditional Chinese medicine (TCM) formulas and aims to evaluate the efficacy of the classical formula Xiaoyao San (逍遥散). Study employs the integrated evidence chain (Eff-iEC) method to organize, integrate, and evaluate its therapeutic efficacy in treating different diseases with the same therapy, and to investigate the feasibility of using Eff-iEC to evaluate the multifunctionality of TCM formulas. The evaluation covered Xiaoyao San's therapeutic effects on depression, premenstrual syndrome, chronic hepatitis, irritable bowel syndrome, dyspepsia, and menopausal syndrome. Concurrently, the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for evaluation, and authoritative medical documents were incorporated to corroborate the recognition of Xiaoyao San within the medical community. Depression and menopausal syndrome received higher ratings than other conditions in the Eff-iEC, GRADE, and Medical Community Recognition assessments. The Eff-iEC evidence grade for Xiaoyao San was rated as "High" or above for chronic hepatitis, irritable bowel syndrome, dyspepsia, and menopausal syndrome. Premenstrual syndrome received a "Moderate ⁺" rating. The GRADE evidence level was "Low-〇〇⨁⨁" for depression, premenstrual syndrome, and chronic hepatitis; "Moderate-〇⨁⨁⨁" for dyspepsia and menopausal syndrome; and "Very Low-〇〇〇⨁" for irritable bowel syndrome. Depression and menopausal syndrome had the highest inclusion frequency, appearing in all 4 categories. Premenstrual syndrome, chronic hepatitis, and dyspepsia are not recommended in Western medical guidelines, but they are included in TCM guidelines, the China National Basic Medical Insurance Drug List, and the China National Essential Drug List. Irritable bowel syndrome appears only in the China National Basic Medical Insurance Drug List and China National Essential Drug List. The evaluation results obtained using the Eff-iEC method align with Medical Community Recognition, providing an objective and comprehensive assessment of Xiaoyao San's efficacy. The findings suggest that Xiaoyao San has strong evidence for treating depression and menopausal syndrome. However, further experimental and clinical trials are needed to assess its efficacy in treating premenstrual syndrome, chronic hepatitis, irritable bowel syndrome, and dyspepsia. These results support the clinical efficacy and rational use of Xiaoyao San, expand the application scope of the Eff-iEC method, and offer valuable insights and methodological references for the comparative evaluation of multifunctional TCM formulas.

OBJECTIVE To investigate the risk factors for carbapenem-resistant gram-negative bacteria(GNB)bloodstream infection(BSI)in patients with hematological malignancies(HMs)and their prognosis,and to devel-op a nomogram prediction model.METHODS A total of 316 patients with HMs and GNB-BSI admitted to the First Affiliated Hospital of Xi'an Jiaotong University from Jan.2017 to Dec.2022 were selected as the training set,and 106 patients admitted from Jan.2023 to Oct.2024 were selected as the validation set.Variables were selected by lasso regression and multifactor logistic regression,and a nomogram model was constructed.The prediction model was internally validated by the receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA),respectively.RESULTS Granulocytopenia for ≥7 days(OR=14.525),use of cephalosporins/β-lactamase inhibitors within 30 days before BSI(OR=3.510),exposure history of carbapenem antibacterial drug(OR=4.840)and albumin＜30 g/L(OR=2.697)were risk factors for CR-GNB BSI in patients with HMs(P＜0.05).Septic shock(OR=6.934),central venous catheterization(OR=5.586),inappropriate empirical antibac-terial drug therapy(OR=4.744),CR-GNB infection(OR=2.916)and albumin＜30 g/L(OR=3.324)were risk factors for 30-day mortality in patients with HMs and GNB-BSI(P＜0.05).Based on these indicators,two nomogram models were constructed.The areas under the ROC curve(AUC)for the internal validation set were 0.775 and 0.849,respectively.The calibration curves demonstrated high predictive performance for the pre-diction models(P=0.998 and 0.660,respectively),and DCA showed high clinical application value for both models.CONCLUSION The nomogram prediction model constructed in this study based on multifactor analy-sis not only demonstrates good predictive value but also exhibits significant clinical efficacy,aiding in the early i-dentification of high-risk patients for targeted therapy.

Objective To compare and find an optimal model for predicting the risk of DKD occurrence in patients with type 2 diabetes mellitus(T2DM).Methods A total of 2005 patients with T2DM were enrolled in this study from The Second Hospital of Shijiazhuang City during December 2017 to December 2022.All the subjects were divided into a training set(n=1403)and a validation set(n=602)according to the ratio of 3∶1 by simple random sampling.With the occurrence of DKD as the outcome variablein the training set,important feature variables were screened by LASSO regression.Six different machine learning models were established according to the feature variables,thenthe optimal model was determined by comparison,and anonlinerisk predictor for DKD occurrence was constructed in patients with T2DM.Results Taking the occurrence of DKD as the outcome variable in the training set,the results of LASSO regression analysis showed that the optimal value of the model was 10-fold cross validation lambda.1se=0.01662473,and 15 characteristic variables with nonzero coefficient were screened out to be related to the occurrence of DKD.The data included sex,age,family history of DM,DM duration,LDL-C,HbA1c,WBC,PDW,Scr,urine α1-microglobulin,urine β2-microglobulin,urine microalbumin,hypertension,hypokalemia,and DR.In the training set and validation set,the prediction performance of XGBoost model was better than that of other models(AUC=0.872,0.893,95%CI 0.853～0.891,0.865～0.921),the sensitivity was 0.779,0.863,and the specificity was 0.721,0.758,respectively.The F1 scores were 0.774 and 0.787.DCA analysis showed that the XGBoost model had a greater net benefit and threshold probability.According to the XGBoost model,the online predictor of DKD risk in T2DM patients was laid out,and two patients were selected for application,the results showed that the predictive value of the model was 0.185 in non-DKD patients,and the predictive value was 0.510 in DKD patients.Conclusions The XGBoost model is the best model for predicting the occurrence of DKD in T2DM patients,and an online predictor was successfully built.

Objective To explore the longitudinal changes of symptoms after discharge in patients with daytime lung cancer surgery by factor analysis,in order to strengthen nursing countermeasures and improve the quality of life of patients.Methods Patients who underwent day surgery in the thoracic surgery department of a tertiary general hospital in Zhejiang Province from October 2023 to January 2024 were selected using convenience sampling.On the 1st,3rd,14th and 30th day after discharge,the general information questionnaire and the postoperative symptom inventory for patients with lung cancer were used for investigation.Exploratory factor analysis was performed to extract the symptom clusters.Results A total of 227 patients were followed up in this study,including 19 shed cases and 2 excluded cases,and 206 patients were finally included.The percentage of the 9 major symptoms of patients with daytime lung cancer surgery after discharge showed dynamic changes.The highest percentage symptom on the 1st day after discharge was pain in 197 cases(95.63％).The highest percentage on the 30th day after discharge was cough in 129 cases(62.62％).The results of exploratory factor analysis were P＜0.001 and KMO＞0.500 for Bartlett's test of sphericity on days 1,3,and 14 after discharge,except for P=0.874 and KMO=0.495 on day 30,with digestive and respiratory symptom clusters on day 1;respiratory,digestive,and fatigue symptom clusters on day 3;fatigue and respiratory symptom clusters on day 14.Conclusion The single symptom and symptom clusters of patients with daytime lung cancer surgery after discharge showed dynamic changes at different time points.Therefore,in clinical work,targeted intervention strategies should be adopted,and precise symptom management should be implemented according to the characteristics of symptom clusters in different periods of discharge of patients undergoing daytime lung cancer surgery,so as to reduce the symptom burden of patients.

OBJECTIVE To investigate the risk factors for carbapenem-resistant gram-negative bacteria(GNB)bloodstream infection(BSI)in patients with hematological malignancies(HMs)and their prognosis,and to devel-op a nomogram prediction model.METHODS A total of 316 patients with HMs and GNB-BSI admitted to the First Affiliated Hospital of Xi'an Jiaotong University from Jan.2017 to Dec.2022 were selected as the training set,and 106 patients admitted from Jan.2023 to Oct.2024 were selected as the validation set.Variables were selected by lasso regression and multifactor logistic regression,and a nomogram model was constructed.The prediction model was internally validated by the receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA),respectively.RESULTS Granulocytopenia for ≥7 days(OR=14.525),use of cephalosporins/β-lactamase inhibitors within 30 days before BSI(OR=3.510),exposure history of carbapenem antibacterial drug(OR=4.840)and albumin＜30 g/L(OR=2.697)were risk factors for CR-GNB BSI in patients with HMs(P＜0.05).Septic shock(OR=6.934),central venous catheterization(OR=5.586),inappropriate empirical antibac-terial drug therapy(OR=4.744),CR-GNB infection(OR=2.916)and albumin＜30 g/L(OR=3.324)were risk factors for 30-day mortality in patients with HMs and GNB-BSI(P＜0.05).Based on these indicators,two nomogram models were constructed.The areas under the ROC curve(AUC)for the internal validation set were 0.775 and 0.849,respectively.The calibration curves demonstrated high predictive performance for the pre-diction models(P=0.998 and 0.660,respectively),and DCA showed high clinical application value for both models.CONCLUSION The nomogram prediction model constructed in this study based on multifactor analy-sis not only demonstrates good predictive value but also exhibits significant clinical efficacy,aiding in the early i-dentification of high-risk patients for targeted therapy.