Pulmonary complications， the most common postoperative complications of lung cancer， not only affect the quality of life of the patients after surgery but also increase the prognostic risks of postoperative recurrence and metastasis， threatening the life safety. At present， a multidisciplinary model of diagnosis and rehabilitation with integrated traditional Chinese medicine （TCM） and Western medicine has been initially formed under the guidance of the concept of rapid rehabilitation post operation for lung cancer. However， the treatment that only aims at shortening hospital stay and reducing the incidence of postoperative complications does not pay enough attention to the postoperative functional rehabilitation of the lung and the impact of follow-up adjuvant therapy， which affects the completeness of rehabilitation. This paper classifies the typical postoperative symptoms and manifestations of lung cancer into five groups： Lung system， emotion， digestive tract， pain， and nerve. On this basis， this paper summarizes the three core pathogeneses of postoperative complications of lung cancer as failure of Qi to ascend and descend leading to insecurity of defensive exterior， vessel block leading to Qi stagnation and fluid retention， and lung Qi deficiency leading to spleen and kidney deficiency. Accordingly， this paper proposes the treatment principle of protecting healthy Qi and treating Qi with the core of descending-tonifying-ascending-dispersing Qi and puts forward three treatment methods. The first is replenishing Qi and consolidating exterior， and expelling phlegm and regulating lung. The second is replenishing Qi and promoting blood flow to resolve stasis and relieving pain. The third is replenishing Qi and tonifying lung， and invigorating spleen and tonifying kidney. Furthermore， this paper elaborates on the pathogenesis and treatment principles of four common postoperative complications： Lung infection， pleural effusion， atelectasis， and bronchopleural fistula. On the basis of Western medical treatment， the TCM treatment characteristics of treating symptoms in the acute phase and eradicating the root cause in the chronic phase should be played. While dispelling the pathogen， measures should be taken to protect the healthy Qi， including tonifying lung Qi， regulating spleen Qi， and replenishing kidney Qi. This study summarizes the pathogenesis and treatment strategy of common postoperative complications of lung cancer according to the principle of protecting healthy Qi and treating Qi， aiming to provide guidance for the future treatment of postoperative complications of lung cancer.

Objective:By analyzing the disease spectrum and composition of inpatients in general surgery department of a children′s hospital in Beijing from January 2018 to June 2024, to understand the impact of the COVID-19 on the number of inpatients in children′s hospitals and the composition of disease types, and to provide scientific evidence for hospital capacity building and medical response after the outbreak of the epidemic.Methods:The hospitalization medical records of children in the general surgery ward of the children′s hospital from January 1, 2018 to June 30, 2024 were collected. SPSS 22.0 software and EXCEL tools were used to analyze the ranking and composition of general surgery diseases in the hospital from three dimensions: different years, different genders, and different age groups. At the same time, the source of children in the hospital was counted by province.Results:Overall, the total number of hospitalized children has shown a significant decrease since 2020, and has since slowly rebounded; Acute appendicitis, inguinal hernia, and common bile duct cyst rank among the top three diseases annually; From a gender perspective, inguinal hernia and acute appendicitis are the most common in male children, while acute appendicitis and common bile duct cysts are the most common in female children; In terms of age, the 1-year-old group has the highest number of patients with inguinal hernia, while the 5-year-old and 10-18-year-old groups have the highest number of patients with acute appendicitis; Compared with 2018-2019, the number of hospitalized children with inguinal hernia decreased sharply in the first half of 2020-2024, and the first priority disease changed from inguinal hernia to acute appendicitis.Conclusions:This study analyzed the disease spectrum and composition of the children′s hospital before and after the COVID-19 epidemic, which has important reference value for the capacity building, resource allocation and epidemic response of the children′s hospital.

Objective:To explore the risk factors of delayed extubation after expanded thymectomy in patients with myasthenia gravis.Methods:Patients with myasthenia gravis who underwent expanded thymectomy from May 2021 to January 2024 and were admitted to Intensive Care Unit (ICU) after surgery were retrospectively analyzed. Patients were divided in to the delayed extubation and successful extubation according to the length of mechanical ventilation whether exceeding than 48 hours. Multivariable logistics regression was used to explore the risk factors for delayed extubation after expanded thymectomy in patients with myasthenia gravis.Results:A total of 95 patients were included.15 (15.8%) of whom were delayed extubation. Compared with the successful extubation patients, the length of mechanical ventilation (94.0 h vs. 15.5 h, P<0.001), ICU station (7.1 days vs. 1.7 days, P<0.001), and hospitalization station (16.0 days vs. 9.1 days, P<0.001) were significantly prolonged in the delayed extubation patients. Adjusted for age,gender, BMI, clinical classification, pathological classification of thymoma, dose of pyridostigmine preoperative, perioperative pneumonia, preoperative pulmonary dysfunction, SBT passing for the first time, neck lift time greater than 20 seconds, the multivariable logistic regression shown, the risk of delayed extubation increased by 29% ( OR=1.290, 95% CI 1.090-1.714), 1% ( OR=1.009, 95% CI 1.002-1.034), 3.9-fold ( OR=4.977, 95% CI 1.486-10.939), and 64% ( OR=1.635, 95% CI 1.396-2.682) for every 60 mg/day increase in preoperative dose of pyridostigmine, pathological classification of thymoma, perioperative pneumonia, and preoperative pulmonary dysfunction, respectively. Neck lift time greater than 20 seconds can reduce the risk of delayed extubation 48% ( OR=0.524, 95% CI 0.322-0.794). Conclusion:Preoperative administration of a large dose of pyridostigmine, pulmonary dysfunction, pathological classification of thymoma, and perioperative pneumonia were risk factors for delayed extubation after thymectomy in these patients. And neck lift time greater than 20 seconds decreased the risk of delayed extubation. In the clinical practice,for high risk of MG patients with delayed extubation, the neck lifting test may be used to assess muscle strength and reduce the occurance of tracheal reintubation and its advise effects.

Objective:To explore the value of ultrasound imaging characteristics combined with clinical indicators in assessing the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC).Methods:A retrospective analysis was conducted for patients who underwent pancreatic contrast-enhanced ultrasound (CEUS) from September 2017 to October 2023 at Peking Union Medical College Hospital and were diagnosed with PDAC based on pathological findings. Various parameters were recorded, including CA19-9 levels, tumor size, location, morphologic features, echogenicity, presence of internal cystic components, dilatation of the main pancreatic duct, peripheral vascular invasion, CEUS characteristics, presence or absence of liver metastasis, and treatment methods. In April 2024, patient survival information was obtained through telephone follow-up or review of medical records. Based on the results of the cox regression model analysis, a nomogram model of the risk of death was developed. The receiver operating characteristic (ROC) curves were applied to evaluate the predictive efficacy of the model. The calibration curves were plotted to evaluate the accuracy of the model, and clinical decision curves were used to evaluate the clinical benefit of the model.Results:This study included a total of 207 patients with PDAC. As of April 2024, 71 patients were alive and 136 died, with a median survival time of 14 months (95% CI: 12 -17). Multivariate analysis confirmed that the elevated CA19-9 ( HR=1.689, 95% CI: 1.102-2.588), tumor size >4 cm ( HR=1.641, 95% CI: 1.159-2.322), taller-than-wide shapes ( HR=1.450, 95% CI: 1.019-2.065), incomplete hypo-enhancement ( HR=1.618, 95% CI: 1.100-2.380), and liver metastasis ( HR=1.687, 95% CI: 1.175-2.423) were independent risk factors for survival in patients with PDAC. A nomogram model was further constructed for 6-month, 12-month and 3-year survival of patients with PDAC. The areas under the ROC curve were 0.679, 0.705 and 0.815, respectively. The calibration curves suggested that the model was more accurate, and the clinical decision curves showed that the model had a better clinical benefit. Conclusion:The combined use of ultrasound imaging characteristics and clinical indicators could effectively predict the prognosis of PDAC patients. Specifically, tumor size >4 cm, taller-than-wide shapes, incomplete hypo-enhancement, elevated CA19-9, and the presence of liver metastasis are correlated with poorer survival outcomes. The nomogram model constructed on the basis of these factors can be used to assess the survival of patients with PDAC.

The patient was a 25-year-old male who initially presented with emotional issues and later developed involuntary movements following the use of antipsychotic and antidepressant medications. He was initially misdiagnosed with Tardive Dyskinesia, a condition commonly associated with psychotropic drugs. However, due to the severity of his involuntary movements, the ineffectiveness of treatment, and a notable family history, genetic testing was performed. The test indicated a mutation in the VPS13A gene of the patient, and provided evidence for a final diagnosis of Chorea Acanthocytosis. This case report aims to enhance the recognition of movement disorders among psychiatrists and facilitate earlier identification of neurological diseases whose primary manifestation is involuntary movement.

Lactate, the end product of glycolysis within the central nervous system (CNS), functions not only as a crucial neuronal energy source but also as a potent signaling molecule. Recently, lactate-mediated protein lactylation has been recognized as a novel post-translational modification influencing CNS pathophysiology. Lactate-mediated protein lactoylation modification regulates key pathological processes such as neuroinflammation and oxidative stress by modulating the structure and function of histones and non-histones, thereby influencing the occurrence and development of CNS diseases. This article reviews the research progress on mechanism of lactylation modification in CNS diseases, aiming to explore the regulatory potential of lactylation modification in CNS diseases and provide new ideas for the study of CNS diseases.

Objective To investigate the acupoint selection patterns for treating diabetic cardiac autonomic neuropathy(DCAN)using data mining techniques,providing evidence for clinical practice.Methods Literature on acupuncture treatment for DCAN was retrieved from CNKI,Wanfang,VIP,and PubMed.The publication dates of the included literature ranged from the inception of each database to April 2024.Descriptive analysis,association rule analysis,and cluster analysis were performed on acupoint prescriptions,with the selection patterns of meridians and acupoints were summarized.Results A total of 27 articles were included,involving 18 acupoints.The top 10 high-frequency acupoints were Neiguan(PC6),Xinshu(BL15),Pishu(BL20),Zusanli(ST36),Sanyinjiao(SP6),Shenmen(HT7),Taixi(KI3),Lingtai(GV10),Shendao(GV11),and Shenshu(BL23).The primary meridians selected were the bladder meridian of foot-taiyang and the pericardium meridian of hand-jueyin.Specific acupoint categories predominantly included back-shu points and five transport points.Association rule and cluster analyses identified core acupoint combinations centered on Xinshu,Neiguan,Pishu,and Zusanli.Conclusion The core acupoint combination for treating DCAN with acupuncture comprises Xinshu,Neiguan,Pishu,and Zusanli.

Objective To explore the medication rules of Professor Li Huilin in treating Hashimoto's thyroiditis(HT)complicated with hypothyroidism using data mining techniques based on the R language.Methods Prescription data of the patients with HT complicated with hypothyroidism treated by Professor Li Huilin in outpatient clinics from March 2023 to March 2024 were collected.A database was established using Microsoft Excel 2021,and R language was employed to analyze the frequency,efficacy,properties and flavors,and meridian tropism of the medicinals from Chinese herbal prescriptions.Additionally,correlation analysis,association rule analysis,and cluster analysis were performed on the medicines from Chinese herbal prescriptions.Results A total of 57 Chinese herbal prescriptions involving 125 medicinals with 782 medication frequencies were included.The top 10 frequently-used medicinals were Glycyrrhizae Radix et Rhizoma Praeparata cum Melle(Zhigancao),Angelicae Sinensis Radix(Danggui),Atractylodis Macrocephalae Rhizoma(Baizhu),Astragali Radix(Huangqi),Bupleuri Radix(Chaihu),Cinnamomi Ramulus(Guizhi),Leonuri Herba(Yimucao),Paeoniae Radix Alba(Baishao),Poria(Fuling),and Fici Simplicissimae Radix(Wuzhimaotao).Most of the medicinals had therapeutic action of tonifying deficiency.The analysis of properties and flavors showed that the majority of medicinals were mild or warm in nature,and sweet in flavor.The top three meridians having the tropism of medicinals were the liver,lung,and spleen meridians.Correlation analysis identified five strongly-correlated herbal combinations.Association rule mining revealed a core herbal combination consisting of seven medicinals of Zhigancao,Huangqi,Danggui,Chaihu,Codonopsis Radix(Dangshen),Baizhu,and Cyperi Rhizoma(Xiangfu).Cluster analysis of medicinals with a frequency of≥5 yielded five groups of herbal combination.Conclusion For the treatment of HT complicated with hypothyroidism,Professor Li Huilin follows the principle of addressing the root cause of the disease,and focuses on strengthening the spleen and replenishing qi.Moreover,attention is given to soothing the liver and regulating qi,harmonizing qi and blood simultaneously,and treating symptoms and root cause simultaneously.

Objective:To investigate the distribution and epidemiological patterns of hepatitis B virus（HBV）serological markers among pediatric surgical inpatients in Beijing.Methods:A retrospective cross-sectional study was conducted using data from all surgical inpatients（0?18 years of age）at a tertiary children’s hospital in Beijing between January 2019 and December 2024. Five HBV serological markers（HBsAg，anti-HBs，anti-HBc，HBeAg，anti-HBe）were analyzed and compared across sex，age，and ethnicity.Results:Of 15 339 children included，56.50% were male and 43.50% female；the 6?12-year age group predominated（37.41%），and Han ethnicity accounted for 91.61%. The overall positive rates were 0.78% for HBsAg，75.32% for anti-HBs，7.42% for anti-HBc，0.02% for HBeAg，and 3.05% for anti-HBe. The prevalences of “big three-positive”（HBsAg+/HBeAg+/anti-HBc+）and “small three-positive”（HBsAg+/anti-HBe+/anti-HBc+）patterns were only 0.02% and 0.04%，respectively. Boys had significantly higher anti-HBs（76.02% vs 74.40%）and anti-HBc（8.01% vs 6.69%）positivity than girls. HBsAg peaked in the 1?3-year group（1.75%）and was lowest in the 6?12-year group（0.19%）. Anti-HBs reached its highest level in the 3?6-year group（81.25%）and declined to 56.07% in adolescents（12?18 years）. No ethnic differences were observed.Conclusion:Universal HBV vaccination has achieved remarkable success among surgical inpatients in Beijing，as evidenced by high anti-HBs levels and very low rates of active or chronic infection. However，antibody titers wane with age，underscoring the need for targeted booster strategies for school-aged children.