OBJECTIVE To evaluate the efficacy of Compound glutamine enteric-coated capsules in the treatment and prevention of radiotherapy- and chemotherapy-related intestinal dysfunction in patients with malignant tumors. METHODS PubMed， Embase， CNKI， and Wanfang data were searched to collect randomized controlled trial （RCT） and cohort studies comparing Compound glutamine enteric-coated capsules （experimental group） with or without other treatments versus other treatments or blank control （control group）. The search period was from the establishment of each database to November 19， 2025. After literature screening， data extraction， and quality assessment， a meta-analysis was performed using RevMan 5.4 software. RESULTS A total of 23 studies were included， involving 2 014 patients. Meta-analysis results showed that the effective rate in the experimental group was significantly higher than that in the control group， the overall incidence and moderate-to-severe incidence of radiotherapy- and chemotherapy-related intestinal dysfunction， quality of life scores， and interleukin-6 levels in the experimental group were significantly lower than those in the control group （ P ＜0.05）. However， no statistically significant differences were observed between the two groups in terms of Karnofsky Performance Status score improvement rate and tumor necrosis factor-α levels （ P ＞0.05）. The results of subgroup analysis based on different medications in the control group showed that， when used for treatment， regardless of whether patients in the control group received blank control or positive control， the efficacy in the experimental group was significantly higher than that in the control group （ P ＜0.05）. When used for prevention， compared with patients who received blank control in the control group， the overall incidence and the incidence of moderate-to-severe radiotherapy- and chemotherapy-related intestinal dysfunction in the experimental group were significantly reduced （ P ＜0.05）. No statistically significant difference was found in the overall incidence or incidences of moderate-to-severe radiotherapy- and chemotherapy-related intestinal dysfunction with positive control between the two groups （ P ＞0.05）. CONCLUSIONS Compound glutamine enteric-coated capsules can effectively treat and prevent radiotherapy- and chemotherapy-related intestinal dysfunction in patients with malignant tumors， improve patients’ quality of life， and alleviate inflammatory responses.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.

Objective:To investigate the foot development of children and adolescents in Guangzhou and provide reference for clinical diagnosis and treatment of pediatric flat feet.Methods:Cross-sectional study.The foot health screening data of students from 3 kindergartens, 1 primary school, and 1 middle school in Guangzhou between January 2023 and June 2023 were collected.Foot parameters including foot length, arch index (AI), arch volume (AV), hallux valgus angle, forefoot width, and heel width were measured.Additionally, general information such as gender, age, height, weight, and body mass index (BMI) was also recorded.The students were divided into groups by gender, left and right sides, and subgroups by age (in years).The changes of foot parameters with age were observed in each group, and percentile line charts were drawn.Furthermore, the correlation among BMI, AI, AV, hallux valgus angle and foot length were analyzed.Results:A total of 2 520 students aged 3-18 years were included according to the inclusion criteria.There were 1 382 males and 1 138 females, with a total of 5 040 feet on both sides.The AI of boys decreased at a constant rate before the ages of 14 years.However, the AI values between the ages of 14 and 18 years showed no statistical difference ( P=0.743), with the mean value of 0.27 (0.25, 0.30).The AI of girls decreased at a constant rate before the ages of 12 years.The AI values between the ages of 12 and 18 years had no statistical difference ( P=0.155), with the mean value of 0.25 (0.23, 0.28).In every age group from 3 to 18 years old, the AI value of girls was smaller by 0.01-0.04 than that of boys (all P<0.05).At the ages of 3, 4, 5, 6, 11, and 17 years, the AI of the right foot was 0.01 smaller than that of the left foot (all P<0.05).There were statistically significant differences in arch type between boys and girls at ages other than 3 and 8 years old (all P<0.05).In some age groups, BMI is positively correlated with AI and AV, foot length is positively correlated with AI, and hallux valgus angle is correlated with AI positively and AV negatively.There was a negative correlation between AI and AV across all age groups. Conclusions:Chinese children and adolescents, represented by Guangzhou, have slower development in foot and a larger AI.The arch is in the development stage before the age of 14 years in boys and 12 years in girls.A proper physical therapy is recommended if the AI value deviates from the normal range during development.

Objective:To investigate the foot development of children and adolescents in Guangzhou and provide reference for clinical diagnosis and treatment of pediatric flat feet.Methods:Cross-sectional study.The foot health screening data of students from 3 kindergartens, 1 primary school, and 1 middle school in Guangzhou between January 2023 and June 2023 were collected.Foot parameters including foot length, arch index (AI), arch volume (AV), hallux valgus angle, forefoot width, and heel width were measured.Additionally, general information such as gender, age, height, weight, and body mass index (BMI) was also recorded.The students were divided into groups by gender, left and right sides, and subgroups by age (in years).The changes of foot parameters with age were observed in each group, and percentile line charts were drawn.Furthermore, the correlation among BMI, AI, AV, hallux valgus angle and foot length were analyzed.Results:A total of 2 520 students aged 3-18 years were included according to the inclusion criteria.There were 1 382 males and 1 138 females, with a total of 5 040 feet on both sides.The AI of boys decreased at a constant rate before the ages of 14 years.However, the AI values between the ages of 14 and 18 years showed no statistical difference ( P=0.743), with the mean value of 0.27 (0.25, 0.30).The AI of girls decreased at a constant rate before the ages of 12 years.The AI values between the ages of 12 and 18 years had no statistical difference ( P=0.155), with the mean value of 0.25 (0.23, 0.28).In every age group from 3 to 18 years old, the AI value of girls was smaller by 0.01-0.04 than that of boys (all P<0.05).At the ages of 3, 4, 5, 6, 11, and 17 years, the AI of the right foot was 0.01 smaller than that of the left foot (all P<0.05).There were statistically significant differences in arch type between boys and girls at ages other than 3 and 8 years old (all P<0.05).In some age groups, BMI is positively correlated with AI and AV, foot length is positively correlated with AI, and hallux valgus angle is correlated with AI positively and AV negatively.There was a negative correlation between AI and AV across all age groups. Conclusions:Chinese children and adolescents, represented by Guangzhou, have slower development in foot and a larger AI.The arch is in the development stage before the age of 14 years in boys and 12 years in girls.A proper physical therapy is recommended if the AI value deviates from the normal range during development.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.

Objective:To propose a differential privacy fuzzy C-means clustering algorithm based on Gaussian kernel function(DPFCM_GF)to optimize the data privacy and security issues brought about by data analysis and mining of medical data in the context of big data,and to provide a theoretical basis for data privacy protection.Methods:In order to solve the problem of reducing the accuracy of the algorithm by randomly initializing the fuzzy C-mean membership matrix,the maximum distance method was used to determine the initial center point,the Gaussian value of the clustering center point was used to calculate the privacy budget allocation ratio,and the Laplace noise was added to complete the differential privacy protection and the DPFCM_GF was constructed.The effectiveness of DPFCM_GF was verified by collecting and collating the heart disease,breast cancer,thyroid disease and diabetes public data sets from the machine learning repository of the University of California,Irvine,and the gastric cancer and lung cancer datasets of The Second People's Hospital Huai'an were collected to verify the usability of the DPFCM_GF,and the analysis results were compared with the fuzzy C-means clustering algorithm(FCM)and the differentially private fuzzy C-means clustering algorithm(DPFCM).Results:For public datasets of heart disease,breast cancer,thyroid disease and diabetes,the optimal clustering effects of DPFCM_GF and DPFCM were equivalent to those of FCM;compared with DPFCM,the iteration time of DPFCM_GF was faster,the convergence speed was significant,the difference was statistically significant(t=4.01,4.71,4.01,12.38,P<0.05).For lung cancer and gastric cancer dataset,with the increase of privacy budget ε,the correct recognition rate of DPFCM_GF gradually converged to 91.9%and 93.9%,and the AUC values converged to 0.79 and 0.81,respectively,and when the privacy function ε was 0.1,0.5,1 and 2(ε<3),the DPFCM_GF clustering effect was significantly better than that of DPFCM,and the clustering effect was better and the difference was statistically significant(x2=12.25,87.12,68.58,7.76,P<0.05;x2=4.74,43.51,42.47,4.89,P<0.05).Conclusion:The DPFCM_GF is an effective method for protecting the privacy of medical data,and can also perform data analysis and mining tasks,which has certain research significance and prospects.

Objective To develop an nomogram model for predicting the lung hemorrhage after CT-guided microwave ablation(MWA)in stage ⅠA non-small cell lung cancer(NSCLC)patients.Methods Stage ⅠA NSCLC patients treated with MWA were randomly divided into a training group and a validation group in a 3∶1 ratio.The risk factors of lung hemorrhage identified by univariable and multivariable logistic regression analysis in the training group were used to develop a nomogram model.The C-statistic was used to evaluate the predictive accuracy in both the training and validation groups.Results A total of 208 patients(training group,156 cases;validation group,52 cases)were included in this study.The risk factors of lung hemorrhage after MWA were the number of vessels passing through the lung parenchyma[odds ratio(OR)=3.815;95％confidence interval(CI)1.485-9.800;P=0.005],number of focal blood supplies(OR=2.922;95％CI 1.198-7.126;P=0.018)and number of punctures(OR=2.802;95％CI 1.792-4.381;P＜0.001).The C-statistic in training group was 0.928(95％CI 0.875-0.963)and the C-statistic in validation group was 0.906(95％CI 0.793-0.969).The optimal cut-off value for lung hemorrhage was 0.14.Conclusion The nomogram model can effectively predict the lung hemorrhage after MWA.Patients showing a high risk(＞0.14)on the nomogram model should be monitored for lung hemorrhage.

With the widespread use of CT scan in lung cancer screening,in clinical practice the detection rate of pulmonary ground-glass nodule(GGN),especially multiple GGNs,has become higher and higher.So far,the guidelines for the treatment of multiple pulmonary nodules mainly focus on the high-risk nodules,while there is no uniform guideline for the management of multiple high-risk GGNs.The main treatment strategies for GGNs include follow-up check and surgical resection.However,for patients who are unable to undergo or refuse to receive surgery,non-surgical therapies such as stereotactic body radiation therapy(SBRT),interventional ablation(such as radiofrequency ablation,micro wave ablation,cryoablation,etc.)can be considered.This article reviews the clinical management strategies and therapeutic evaluation of multiple pulmonary nodules,aiming to provide reference for the clinical management of multiple pulmonary nodules.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Objective To evaluate the accuracy of bioelectrical impedance analysis(BIA)in measurement of appendicular skeletal muscle mass(ASM)of adults.Methods A total of 836 adults aged 18-42 years were recruited in Guangzhou using a convenient sampling method from April 2021 to September 2022.ASM was measured using BIA and Dual-energy X-ray absorptiometry(DXA).Using DXA as the standard method,the consistency between the BIA and DXA measurements was evaluated by intra-class correlation coefficients(ICCs)and Bland-Altman analysis in logarithmically transformed data,in order to evaluate the accuracy of BIA in ASM measurement.Receiver operating characteristic curve was plotted to evaluate the diagnostic value of BIA for screening low muscle mass.Results A total of 774 individuals were included for analysis finally.ICCs for ASM measured by BIA and DXA were 0.774 and 0.667 in males and females,respectively.Mean ratios(limits of Agreement)of ASM were 0.94(0.80-1.10)and 0.91(0.78-1.05)in males and females,respectively.Area under curve of BIA for screening low muscle mass were 0.91 and 0.94 in males and females,respectively.The optimal cut-off values of Z-score by BIA for males and females were-0.57 and-0.66,respectively.Sensitivity and specificity for males were 82.5%and 86.0%,while being 86.8%and 93.8%,for females.Conclusion BIA shows a moderate consistency with DXA for measuring ASM in adults.Furthermore,BIA yields a good diagnostic value in identifying low muscle mass in adults aged 18-42 years.