OBJECTIVE To upgrade and perfect the quality standard of Psidii Guajavae Folium. METHODS A total of 24 batches of Psidii Guajavae Folium samples were adopted in this study. The macroscopic traits and powder microscopic features of the medicinal materials were observed， and thin-layer chromatography （TLC） identification was carried out. In accordance with corresponding methods documented in Volume Ⅳ of the 2025 edition of the Chinese Pharmacopoeia， multiple indexes were determined， including foreign matter， moisture， total ash， acid-insoluble ash， water-soluble extractives， heavy metals （lead， cadmium， copper， arsenic， mercury） as well as residues of 47 prohibited pesticides. A high-performance liquid chromatography （HPLC） method was established to quantify guaijaverin in Psidii Guajavae Folium. Meanwhile， the HPLC fingerprint of the herb was constructed， followed by similarity evaluation and cluster analysis of all samples. RESULTS The macroscopic traits of Psidii Guajavae Folium complied with relevant specifications of quality standards. Distinct microscopic characteristics were observed in medicinal powder， including non-glandular hairs， calcium oxalate crystals， vessels and stomata. TLC results revealed identical fluorescent spots at positions corresponding to the guaijaverin reference substance on chromatograms of test samples. Among the 24 batches of samples， the detection ranges were 0.3%-2.8% for foreign matter， 5.1%-10.7% for moisture， 5.3%-7.2% for total ash， 0.4%-1.8% for acid-insoluble ash， and 11.8%-26.3% for water-soluble extractives. The test results of heavy metals， harmful elements and prohibited pesticide residues all satisfied the Chinese Pharmacopoeia limit criteria. Methodological validation of content determination and fingerprint analysis met relevant validation requirements. The guaijaverin content of the 24 batches ranged from 0.14% to 0.28%. The HPLC fingerprint similarity values of all samples fluctuated between 0.828 and 0.997； fifteen common peaks were calibrated， six of which were chemically identified. The 24 batches were divided into two major clusters， and cluster classification showed high consistency with sample origins. CONCLUSIONS This research optimizes the TLC identification protocol of Psidii Guajavae Folium and supplements new quality control items including quantitative assay and chromatographic fingerprint. Tentative quality limits are proposed as follows： moisture ≤12.0%， total ash ≤8.0%， water-soluble extractives ≥10.0%， and guaijaverin content ≥0.14% （calculated based on dry products）.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To understand the serologic prevalence and infection status of Cytomegalovirus(CMV)in children aged 0～1 years,and explore the risk factors of CMV infection for clinical reference.Methods The data of 4 938 children aged 0～1 years who underwent chemiluminescence enzyme immunoassay for TORCH in Department of Inpatient and Department of Pediatrics Outpatient of Maternal and Child Health Hospital of Inner Mongolia from January 2020 to December 2022 were retrospectively analyzed to understand the seroprevalence of human CMV(HCMV)among children in the region,and analyzed the risk factors associated with HCMV infections by combining the results of laboratory tests and clinical information.Results In 4 938 children,the total antibody positivity rate was 94.01%(4 642/4 938),the total IgG antibody positivity rate was 93.86%(4 635/4 938),the total IgM antibody positivity rate was 8.10%(400/4 938),and the positive rate of the two simultaneous detections was 7.96%(393/4 938).The difference in HCMV-IgG and HCMV-IgM antibodies positivity rates beteen different age groups were statistically significant(χ2=36.350,1 043.199,all P<0.05),and the differences in HCMV-IgG and IgM antibodies between boys and girls were not statistically significant(χ2=0.215,1.184,all P＞0.05).According to univariate analysis,the breast-feeding and vaginal delivery rates in the infected group were higher than those in the control group,and the differences in feeding and birth methods were statistically significant(χ2=10.777,5.725,all P<0.05).Multifactorial analysis found that breast-feeding and transvaginal delivery were independent risk factors for HCMV infection,and the differences was statistically significant(Wald χ2=6.247,10.057,all P<0.05).Conclusion The serologic antibody positivity rate of HCMV in children within 1 year of age is as high as 94.01%,and infants aged 3 months to 6 months are most susceptible to infection.Breastfeeding and transvaginal delivery are independent risk factors for HCMV infection in children within 1 year of age.

Objective:To investigate the risk factors affecting live birth outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) and to establish a predictive model. Methods:A retrospective case-control study was conducted by collecting data from 563 patients with PCOS who were treated at the Reproductive Medicine Department of the General Hospital of Northern Theater Command between June 2018 and January 2023. Patients were divided into live birth ( n=341) and non-live birth ( n=222) groups based on pregnancy outcomes. Univariate and multivariate logistic regression analyses were performed to identify risk factors, followed by construction of a nomogram prediction model based on values with P<0.05 in multiple regression analysis. The model's predictive performance was evaluated using receiver operating characteristic curve analysis, calibration curves, Hosmer-Lemeshow (H-L) goodness-of-fit test, and decision curve analysis. Results:1) Univariate analysis revealed that there were statistically significant differences in age, body mass index (BMI), insulin level, the number of high-quality embryos, and the rate of high-quality embryos between the two groups (all P<0.05). 2) After adjusting for confounding factors, the results of multivariate logistic regression analysis on variables associated with live birth outcomes in the live birth group showed that: age ( OR=1.151, 95% CI: 1.061-1.249, P=0.001), body mass index ( OR=1.141, 95% CI: 1.074-1.214, P<0.001), and insulin level ( OR=1.206, 95% CI: 1.149-1.266, P<0.001) were independent risk factors for live birth outcome; top-quality embryo rate ( OR=0.101, 95% CI: 0.033-0.310, P<0.001) was a protective factor; and the number of top-quality embryos ( OR=0.949, 95% CI: 0.887-1.014, P=0.104) showed no statistically significant association with live birth outcome. 3) A predictive model for the live-birth outcome after IVF/ICSI-ET in PCOS patients was established. The area under the curve (AUC) values for predicting the live-birth outcome based on female age, BMI, the rate of high-quality embryos, and insulin level were 0.581, 0.747, 0.725, and 0.813, respectively. The combined model of these four factors had an AUC value of 0.846 for predicting the live-birth outcome. 4) A nomogram predictive model for the live-birth outcome after IVF/ICSI-ET in PCOS patients was established. The slope of the model's calibration curve was close to 1, and the H-L test yielded a P>0.05, indicating a high consistency between predicted and actual events. The decision analysis curve confirmed the clinical practicality of the predictive model. Conclusion:Age, BMI and insulin level are independent risk factors for live birth outcomes in PCOS patients undergoing IVF/ICSI-ET, while the high-quality embryo rate serves as a protective factor. The established predictive model demonstrates excellent performance and may facilitate clinical decision-making.

Acute ischemic stroke (AIS) is a comprehensive syndrome characterized by neurological dysfunction, resulting from cerebral tissue ischemia and hypoxia due to impaired blood supply, which further leads to tissue softening or even necrosis. Restoring blood flow through recanalization of the occluded vessel is crucial for AIS treatment. Although more and more patients benefit from intravenous thrombolysis or endovascular therapy, some still have poor prognosis after vessel recanalization. Most studies indicate that ineffective recanalization, early neurological deterioration, and hemorrhagic transformation are the three main causes of adverse prognosis after recanalization therapy for AIS. This article systematically reviews the epidemiological characteristics, pathogenesis, and risk factors of the above three aspects based on previous studies, aiming to provide guidance for the diagnosis and treatment of adverse prognosis in AIS patients after recanalization therapy.

Objective:To investigate the effects of thoracolumbar vertebral fracture with incomplete spinal cord injury on male sexual function and postoperative prognosis.Methods:A retrospective review was conducted on data from 144 male patients with thoracolumbar vertebral fractures and incomplete spinal cord injuries treated between May 2009 and May 2021 in the Department of Traumatology and Orthopedics at Peking University Third Hospital. Patients ranged in age from 19 to 55 years (mean: 38.6±10.6 years) and underwent posterior incision and reduction internal fixation. The International Index of Erectile Function-5 (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the International Spinal Cord Injury Male Sexual Function Basic Data Set were used for sexual function evaluation. Based on the American Spinal Injury Association (ASIA) Spinal Cord Injury classification, changes in neurological and sexual function were assessed at the pre-injury stage, 3 months post-injury, 2 years postoperatively, and at the final follow-up. Factors influencing sexual dysfunction and recovery were analyzed. Spearman correlation analysis was used to identify factors affecting sexual function injury and recovery.Results:A total of 117 patients were included in the final analysis. Follow-up duration ranged from 26.2 to 161.7 months (mean: 74.6±40.5 months). After injury, ASIA grades were distributed as follows: 43 patients with grade B, 41 with grade C, and 33 with grade D. At the 2-year follow-up, 30 patients were grade E, 63 grade D, 19 grade C, and 5 grade B. Improvement in ASIA classification was observed in 90.6% (106/117) of patients: 79 improved by one grade, 27 by two grades, 8 remained unchanged, 1 worsened by one grade, and 2 worsened by two grades. Mean IIEF-5 scores were 19.5±6.4 pre-injury, 8.7±8.0 at 3 months post-injury, and 17.5±7.1 at 2 years postoperatively, with statistically significant differences ( F=123.247, P<0.001). Differences between 3 months post-injury vs. pre-injury and 2 years postoperatively vs. 3 months post-injury were statistically significant ( P<0.05). Mean PEDT scores were 5.3±3.1 pre-injury, 6.9±5.2 at 3 months post-injury, and 6.4±5.1 at 2 years postoperatively, with statistically significant differences ( F=17.014, P<0.001). The difference between 3 months post-injury and pre-injury was statistically significant ( P<0.05), but not between 2 years postoperatively and 3 months post-injury ( P>0.05). At the 2-year follow-up, 96 patients had their IIEF-5 classification restored to pre-injury levels, 85 restored PEDT classifications, and 83 restored both. Post-injury ASIA classification was positively correlated with a decrease in IIEF-5 score and an increase in PEDT score at 3 months post-injury ( P<0.05). Injury segment was positively correlated with the decrease in IIEF-5 score ( P<0.05). Time from injury to surgery showed a positive correlation with increased PEDT score at 3 months ( P<0.05). Post-injury ASIA grade, injury segment, time to surgery, age, intraoperative decompression, and spinal cord function recovery all showed significant correlations with changes in IIEF-5 and (or) PEDT scores at 2 years postoperatively ( P<0.05). According to the International Spinal Cord Injury Male Sexual Function Basic Data Set, the proportion of patients willing to discuss sexual issues increased from 29.9% at 3 months post-injury to 47.9% at 2 years postoperatively ( P<0.05). The proportion of patients with absent or diminished psychogenic erections remained stable (48.7% vs. 48.9%, P>0.05), while those with normal reflexive erections increased from 34.2% to 65.0% ( P<0.05). Conclusion:Thoracolumbar fractures with incomplete spinal cord injury result in reduced erectile function and increased incidence of premature ejaculation. The degree of spinal cord injury and the level of the injured segment are strongly correlated with the extent of sexual dysfunction. At the 2-year postoperative follow-up, 70.9% of patients had recovered sexual function to pre-injury levels.

Objective:To investigate the risk factors affecting live birth outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) and to establish a predictive model. Methods:A retrospective case-control study was conducted by collecting data from 563 patients with PCOS who were treated at the Reproductive Medicine Department of the General Hospital of Northern Theater Command between June 2018 and January 2023. Patients were divided into live birth ( n=341) and non-live birth ( n=222) groups based on pregnancy outcomes. Univariate and multivariate logistic regression analyses were performed to identify risk factors, followed by construction of a nomogram prediction model based on values with P<0.05 in multiple regression analysis. The model's predictive performance was evaluated using receiver operating characteristic curve analysis, calibration curves, Hosmer-Lemeshow (H-L) goodness-of-fit test, and decision curve analysis. Results:1) Univariate analysis revealed that there were statistically significant differences in age, body mass index (BMI), insulin level, the number of high-quality embryos, and the rate of high-quality embryos between the two groups (all P<0.05). 2) After adjusting for confounding factors, the results of multivariate logistic regression analysis on variables associated with live birth outcomes in the live birth group showed that: age ( OR=1.151, 95% CI: 1.061-1.249, P=0.001), body mass index ( OR=1.141, 95% CI: 1.074-1.214, P<0.001), and insulin level ( OR=1.206, 95% CI: 1.149-1.266, P<0.001) were independent risk factors for live birth outcome; top-quality embryo rate ( OR=0.101, 95% CI: 0.033-0.310, P<0.001) was a protective factor; and the number of top-quality embryos ( OR=0.949, 95% CI: 0.887-1.014, P=0.104) showed no statistically significant association with live birth outcome. 3) A predictive model for the live-birth outcome after IVF/ICSI-ET in PCOS patients was established. The area under the curve (AUC) values for predicting the live-birth outcome based on female age, BMI, the rate of high-quality embryos, and insulin level were 0.581, 0.747, 0.725, and 0.813, respectively. The combined model of these four factors had an AUC value of 0.846 for predicting the live-birth outcome. 4) A nomogram predictive model for the live-birth outcome after IVF/ICSI-ET in PCOS patients was established. The slope of the model's calibration curve was close to 1, and the H-L test yielded a P>0.05, indicating a high consistency between predicted and actual events. The decision analysis curve confirmed the clinical practicality of the predictive model. Conclusion:Age, BMI and insulin level are independent risk factors for live birth outcomes in PCOS patients undergoing IVF/ICSI-ET, while the high-quality embryo rate serves as a protective factor. The established predictive model demonstrates excellent performance and may facilitate clinical decision-making.

Objective To explore the impact of the interaction between fasting plasma glucose(FPG)and serum uric acid(SUA)on peripheral diabetic retinopathy(DR).Methods Peripheral DR patients(n=188)admitted to our hospital from July 2022 to June 2023 were selected as the research subjects and divided into mild to moderate non-proliferative diabetic retinopathy(NPDR)group(M-NPDR,n=114)and severe NPDR(S-NPDR,n=74)group.DM patients without diabetic retinopathy admitted to our hospital during the same period were set as the control(T2DM,n=100)group.The general data and biochemical indicators were compared among the three groups.Logistic regression was used to analyze the relationship between FPG and SUA and the severity of DR.The interaction between FPG and SUA was evaluated.A nomogram model was established to predict the occurrence of severe NPDR.Results The DM duration,best corrected visual acuity converted to logarithm of minimum resolution angles(logMAR BCVA),FPG,SUA and urinary albumin/creatinine ratio(UACR)in M-NPDR and S-NPDR groups were higher than those in T2DM group(P＜0.05).Subfoveal choroidal thickness(SFCT),albumin(ALB)and free triiodothyronine(FT3)were lower than those in the T2DM group(P＜0.05).BUN in S-NPDR group was higher than that in T2DM group(P＜0.05).The DM duration,logMAR BCVA,FPG,TC,TG and SUA in S-NPDR group were higher than those in M-NPDR group(P＜0.05),and SFCT was lower than that in M-NPDR group(P＜0.05).SFCT,FPG,ALB,SUA,and(UACR)were independent influencing factors of severe NPDR(P＜0.05).The column chart model predicted the probability of severe NPDR occurrence,with area under curve of 0.919 and 0.910 before and after validation,and the average absolute error of the calibration curve 0.013,which can be used as risk tool to predict DR severity of T2DM patients.Conclusions FPG and SUA are risk factors affecting the severity of DR and there is an interaction.Early warning of risk factors based on the nomogram model is helpful to improve the prognosis of patients with peripheral DR.

Intracranial atherosclerotic stenosis(ICAS)is the most prevalent etiology of ischemic stroke in the Asian population.Predicting the risk of stroke in patients with ICAS and stratifying the stroke risk can help clinicians to take early interventional measures so as to improve patient outcomes.Optical coherence tomography(OCT)is a novel ultrahigh-resolution endovascular real-time imaging technique.OCT has multiple advantages in the assessment of atherosclerotic plaque characteristics and lumen morphology,especially in the display of the fine structural features of vulnerable plaques,which provides strong image support for the assessment of the plaque stability.Combined with hemodynamic assessment,OCT can judge the formation and development trend of plaques and predict the risk of stroke recurrence in patients with ICAS,which is of great significance in guiding targeted individualized interventional therapy.This paper aims to make a comprehensive review about the recent progress in OCT technology and its integration with hemodynamic assessment for the diagnosis and treatment of ICAS,to discuss the potential application prospects of OCT in the field of cerebrovascular diseases,so as to provide a scientific basis for the risk assessment,disease monitoring,and decision-making of treatment for patients with ICAS.

Acute ischemic stroke (AIS) is a comprehensive syndrome characterized by neurological dysfunction, resulting from cerebral tissue ischemia and hypoxia due to impaired blood supply, which further leads to tissue softening or even necrosis. Restoring blood flow through recanalization of the occluded vessel is crucial for AIS treatment. Although more and more patients benefit from intravenous thrombolysis or endovascular therapy, some still have poor prognosis after vessel recanalization. Most studies indicate that ineffective recanalization, early neurological deterioration, and hemorrhagic transformation are the three main causes of adverse prognosis after recanalization therapy for AIS. This article systematically reviews the epidemiological characteristics, pathogenesis, and risk factors of the above three aspects based on previous studies, aiming to provide guidance for the diagnosis and treatment of adverse prognosis in AIS patients after recanalization therapy.