Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder primarily caused by pathogenic variants in the TSC1 or TSC2 genes. It is characterized by multisystem hamartomatous lesions and neuropsychiatric manifestations. Here we report a young male patient with TSC involving multiple organs, caused by a heterozygous frameshift mutation in TSC2 (c.2071delC, p.Arg691Alafs^*7). The patient initially presented with classic facial angiofibromas and hypomelanotic macules, and subsequently developed psychiatric and behavioral disturbances with auditory hallucinations. Neuroimaging revealed an intracranial mass lesion, which was confirmed as a subependymal giant cell astrocytoma on postoperative histopathology following surgery performed at an outside institution. After admission, the patient underwent a comprehensive diagnostic workup, and multidisciplinary treatment evaluation revealed extensive multisystem involve-ment, including the nervous system, skin, kidneys, lungs, heart, eyes, pancreas, liver and bones. Combined with relevant literature, this article discusses the molecular mechanisms, clinical phenotypes, and comprehensive management of TSC, in order to provide a reference for the standardized and individualized management of this disease.

Diabetic nephropathy（DN） is a common and severe microvascular complication of diabetes. In recent years， the classical herbal formula Shenqi dihuang decoction has demonstrated unique advantages in the clinical treatment of DN. This article conducts a systematic review of the mechanisms of action and clinical applications of Shenqi dihuang decoction in the treatment of DN. It reveals that the mechanism by which this formula improves DN involves multi-target synergistic regulation. For instance, Shenqi dihuang decoction exerts multiple pharmacological effects by regulating signaling pathways including phosphatidy linostiol 3-kinase/protein kinase B， AMP-activated protein kinase/silent information regulator 1/forkhead box O1， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 pathways.These effects include regulating glucose and lipid metabolism， inhibiting oxidative stress， reducing inflammation， improving insulin resistance， modulating cell death （apoptosis/autophagy/ferroptosis/pyroptosis）， and preventing renal fibrosis. Existing clinical studies indicate that Shenqi dihuang decoction and its modified formulas， alone or in combination with other therapeutic methods， can significantly improve glucose and lipid metabolism， reduce proteinuria， and delay renal function decline in patients with DN. These effects are superior to those of Western medicines such as irbesartan， valsartan， and empagliflozin， and the treatment demonstrates good safety. Future research should leverage systems biology and artificial intelligence technologies to further elucidate the integrated mechanisms in the treatment of DN by Shenqi dihuang decoction， thereby advancing the precision and standardization of its clinical application.

Objective To screen the influencing factors associated with adverse clinical out-comes in hospitalized elderly patients with Alzheimer's disease(AD)using LASSO-Logistic regression analysis and to construct a nomogram prediction model.Methods A retrospective selection of 214 hospitalized elderly patients with AD who visited the Department of Geriatric Medicine in the hospital from February 2021 to March 2023 was conducted,and clinical data of all patients were collected.Patients were divided into adverse events group(n=53)and non-adverse events group(n=161)based on the occurrence of adverse clinical outcomes.After variable screening using LASSO regres-sion,multivariate Logistic regression analysis was performed to identify independent factors influen-cing adverse clinical outcomes in hospitalized elderly patients with AD.A Nomogram model for pre-dicting adverse clinical outcomes in these patients was established based on the results of multivariate analysis.The predictive performance,calibration,and clinical utility of the Nomogram model were evaluated using the concordance index,calibration curve,and decision curve analysis(DCA).The diagnostic performance of the Nomogram model for adverse clinical outcomes in hospitalized elderly patients with AD was assessed using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results LASSO-Logistic regression analysis revealed that the Mini-Men-tal State Examination(MMSE)score was an independent protective factor against adverse clinical outcomes in hospitalized elderly patients with AD(P＜0.05),while the Charlson Comorbidity In-dex(CCI score),creatinine,urea,and fasting blood glucose(FBG)levels were all independent risk factors for adverse clinical outcomes in these patients(P＜0.05).The Nomogram model con-structed based on the influencing factors screened by LASSO-Logistic regression analysis showed a concordance index of 0.994(95％CI,0.958 to 1.000)for predicting adverse clinical outcomes in hospitalized elderly patients with AD.The Hosmer-Lemeshow test results indicated x2=1.909,P=0.984,suggesting good model fit.The DCA result demonstrated that the model had favorable threshold probabilities and net clinical benefits.Conclusion The Nomogram model for predicting clinical outcomes in elderly inpatients with AD constructed based on LASSO-Logistic regression anal-ysis exhibits high predictive value,and can be used to forecast the occurrence of adverse clinical outcomes in these patients.

Objective To explore the application effect of the dual-track nursing intervention model in the treatment process of children with lobar pneumonia.Methods A total of 186 children with lobar pneumonia were selected and randomly divided into control group and intervention group u-sing a double-blind method,with 93 cases in each group.The control group received conventional nursing intervention,while the intervention group implemented the dual-track nursing intervention model on the basis of conventional nursing.This model included the establishment and training of nurs-ing teams,personalized nursing plans,health education,and psychological support.Outside the hos-pital,it emphasized family support,regular follow-up guidance,and community-based collaborative ed-ucation.Both groups received a 3-week intervention.The improvement times of clinical symptoms,hos-pital stay,pulmonary function indicators before and after nursing,treatment compliance,and family members' satisfaction with nursing were compared and analyzed between the two groups.Results The fever resolution time[(3.89±0.96)d],cough relief time[(6.21±1.34)d],disappearance time of pulmonary rales[(7.89±1.56)d],and hospital stay duration[(9.45±1.89)d]in the intervention group were all shorter than those in the control group[(5.23±1.14),(7.45±1.67),(9.32±2.01),and(11.28±2.35)d,respectively],with statistically significant differences(P＜0.05).After nursing,the forced expiratory volume in one second(FEV1)[(1.51±0.22)L],forced vital capacity(FVC)[(1.75±0.25)L],and FEV1/FVC[(94.12±5.65)％]in the intervention group were all higher than those in the control group[(1.42±0.15)L,(1.66±0.22)L,and(85.73±8.41)％,respectively],with statistically significant differences(P＜0.05).The scores for exami-nation cooperation[(23.91±3.82)points],nursing cooperation[(24.19±4.03)points],standardized medication use[(24.26±3.94)points],and rational diet[(23.77±3.62)points]in the intervention group were higher than those in the control group[(20.16±3.53),(19.64±3.46),(23.05±3.68),and(18.85±3.41)points,respectively],with statistically significant differences(P＜0.05).The satisfaction rate of family members with nursing work in the intervention group was higher than that in the control group,with a statistically significant difference(98.92％versus 89.25％,P＜0.05).Conclusion The dual-track nursing intervention model has a signifi-cant application effect in children with lobar pneumonia.It can accelerate their recovery process,improve treatment compliance,promote pulmonary function improvement,and enhance family mem-bers' satisfaction.

The European Federation of Periodontology (EFP) and the Association for Dental Education in Europe (ADEE) jointly held the second European Consensus Workshop on Education in Periodontology in February, 2023. Building on the first consensus workshop in 2009, expert working groups from European Workshop Committee updated four educational levels: undergraduate, specialist, continuing professional development (CPD), as well as teaching methods, culminating in the updated consensus report in March, 2024. This article introduces and interprets the contents of the 2024 consensus report. Specific to China′s national conditions, we also propose future perspectives and considerations on different levels of periodontal education in China based on this consensus.

Objective:To evaluate the epidemiological protective effect of a booster dose of acellular DTP vaccine (DTaP) against pertussis in 6-year-old children.Methods:A retrospective cohort study was conducted to compare the incidence of pertussis in 6-year-old children who received DTaP versus DT vaccine boosters in 2023 over a two-year period from May 2023 to May 2025. The protective effect of the fifth dose of DTaP against pertussis in 6-year-old children was evaluated.Results:A total of 960 participants were enrolled in this study, including 480 children in the experimental group who received the fifth dose of DTaP vaccine and 480 children in the control group who received the DT vaccine booster. Baseline characteristics were balanced between the two groups. There were six confirmed cases of pertussis in the experimental group, with a reported incidence rate of 1.25%. In the control group, 14 pertussis cases were reported, with a reported incidence rate of 2.92%. The protective effectiveness(VE) of the DTaP vaccine against pertussis was 57.14% (95% CI:-10.59%-83.39%). For 6-year-old children who completed the booster immunization, the incidence data of pertussis were collected from the 14 th day after vaccination (i.e., the study day 0). Based on the annual cumulative incidence rate, the VE of DTaP against pertussis at 6, 12, 18, and 24 months after vaccination was 100%, 63.80% (95% CI:-14.49%-88.55%), 64.59% (95% CI: 1.17%-87.31%), and 57.60% (95% CI:-10.80%-83.78%), respectively. In the DTaP group, the annual cumulative incidence rate of 12 to 24 months did not show a significant upward or downward trend ( Z=-0.995, P=0.320). Conclusion:Boosting 6-year-old children with the DTaP vaccine provides measurable protection against pertussis. The protective efficacy is significant in the early stage (0 to 6 months) after vaccination, and it still remains effective at 12 to 24 months.

Objective:To investigate the therapeutic value of visual endoscopic retrograde appendicitis therapy (vERAT) in pediatric patients with acute suppurative appendicitis (ASA).Methods:This was a retrospective cohort study. A total of 55 ASA patients who underwent vERAT at the Pediatric Department of the Tangdu Hospital of Air Force Medical University between November 2023 and January 2025 were selected and divided into groups based on the presence or absence of fecaliths: fecalith group and non-fecalith group. The baseline characteristics, initial treatment success rates, treatment costs, hospital stay duration, procedure time, and recurrence rates between two groups were compared. Mann-Whitney U test and χ2 test were used to evaluate group differences. Results:A total of 55 ASA patients were enrolled, including 38 males and 17 females, with the age of 11.2 (9.2, 13.1) years. Based on the presence of fecaliths, patients were divided into two groups: fecalith group (32 cases) and non-fecalith group (23 cases). No statistically significant differences were observed between the two groups in terms of age, gender, duration of abdominal pain, white blood cell count, neutrophil percentage, diameter of appendix, thickness of appendix clinical symptoms or signs (all P>0.05). The initial treatment success rates were 91% (29/32) in fecalith group and 96% (22/23) in non-fecalith group, with no statistically significant difference ( P=0.632). However, significant differences were noted in stent placement ( χ2=5.85, P=0.026) and procedure time ( Z=4.75, P<0.001). The follow-up duration time was 6.0 (2.0, 12.0) and 7.0 (2.0, 8.5) months for the fecalith and non-fecalith groups, respectively, with no significant difference ( Z=0.05, P=0.962). The recurrence rates were 14% (4/29) in fecalith group and 5% (1/22) in non-fecalith group, with no statistically significant difference ( P=0.375). Conclusions:vERAT can safely and effectively treat pediatric ASA, regardless of the presence or absence of fecaliths. It can provide a new treatment option for ASA.

Objective:To establish a dose-response curve of dicentric chromosomes and centromeric rings (dic+ r) in γ-ray irradiation-induced chromosomal aberrations in human peripheral blood lymphocytes through automated analysis.Methods:Peripheral blood samples from three healthy donors were irradiated in vitro at doses of 0, 0.5, 0.75, 1, 1.5, 2, 3, 4, and 5 Gy and a dose rate of 0.80 Gy/min using a 137Cs γ-ray source. Post-irradiation, lymphocytes were cultured based on standard protocols, harvested using an automatic cell harvester, and prepared on slides using an automatic slide preparation system. dic+ r were analyzed fully automatically using the DCScore software, and a dose-response curve of dic+ r was established through fitting and then validated using the CABAS software. Results:The dose-response curve followed a linear-quadratic model, i. e., y = 0.093 65+ 0.030 21 D+ 0.025 31 D2 ( R2 = 0.999 2), where y was the quantity of dic+ r and D was the absorbed dose of γ-ray irradiation (Gy). Doses to samples for blind validation were estimated using this curve, yielding deviations of less than 24% from the actual irradiation doses. Conclusions:The fully automated analysis of dic+ r in 137Cs γ-ray irradiation-induced chromosomal aberrations, followed by the construction of the dose-response curve, holds significant potential for rapid, high-throughput biodosimetry in large-scale nuclear emergencies.

Objective To investigate the efficacy,safety,and postoperative recovery of plasma radiofrequency ablation at varying dose parameters in pediatric adenoid hypertrophy,while analyzing the dose-effect relationship and determining the optimal parameter range,thus providing a scientific basis for clinical practice.Methods A retrospective analysis was conducted on 55 children diagnosed with adenoid hypertrophy.According to plasma radiofrequency ablation energy,patients were categorized into low-dose group(100 W,n=20),medium-dose group(200 W,n=20),and high-dose group(300 W,n=15).These groups were compared for adenoid-nasopharyngeal ratio improvement at 1-month follow-up,intraoperative blood loss,postoperative pain score,complication rate,and postoperative recovery time.Results Postoperative adenoid-nasopharyngeal ratio improvement was significantly greater in both medium-and high-dose groups as compared with low-dose group(P<0.05),while no significant difference was observed between medium-and high-dose groups(P>0.05).The high-dose group had intraoperative blood loss of(26.4±4.8)mL and higher postoperative wound bleeding incidence than low-and medium-dose groups(P<0.05).The postoperative pain scores on postoperative days 1 and 3 were higher in high-dose group than in the other two groups(P<0.05).These results suggested that medium-dose group achieved the optimal balance between efficacy,safety,and postoperative recovery.Conclusion Plasma radiofrequency ablation with a medium-dose setting of 200 W provides optimal adenoid removal while reducing intraoperative bleeding,minimizing postoperative complications,and shortening recovery time.