Objective To investigate the changes in the gut microflora(GM)composition and metabo-lites in children with allergic rhinitis(AR)based on high-throughput sequencing technology.Methods From December 2023 to May 2024,11 preschool children with allergic rhinitis(AR)who visited the pediatric outpa-tient department of Shantou University Medical College Longgang Maternal and Child Health Hospital Clini-cal College(Longgang District Maternal and Child Health Hospital)were selected as the AR group,and 21 healthy children of the same age who underwent physical examinations in the child health care department during the same period were selected as the control group.Fecal samples were collected from both groups,and DNA was extracted and amplified.High-throughput sequencing technology was used to analyze the composi-tion of gut microbial genes,and the differences in gut microbiota composition and metabolites between the two groups were compared.Results Compared with the control group,the AR group had a higher Shannon index,with a significant increase in the abundance of Proteobacteria and Saccharibacteria.The relative abundance of Veillonella,Enterococcus,Escherichia coli/Shigella,Haemophilus,and Streptococcus was significantly high-er,while the relative abundance of Lachnospira,Anaerostipes,Enterobacteriaceae,Anaerobacterium,and Eu-bacterium was significantly lower(P＜0.05).There were statistically significant differences in the principal components of GM metabolites between the two groups(P＜0.05).A total of 2 540 different metabolites were identified,of which 1 185 metabolites were significantly increased,20 metabolites were significantly de-creased,and 1 335 metabolites showed no significant changes.Variable importance in projection(VIP)analy-sis revealed 30 significantly different metabolites.Compared with the control group,2 fecal metabolites were significantly downregulated in the AR group,specifically 3-furanmethanol glucoside and membrane heptosyl A.Conclusion The gut microbiota of preschool children with AR has undergone significant changes,which are related to inflammation and immune function.

Objective To analyze clinical characteristics affecting survival outcomes in gastric adenocarcinoma(GAC)patients with second primary malignancies(SPM)and construct a predictive model with a web-based calculator.Methods Patients diagnosed with GAC between January 2010 and December 2017 in the SEER database(n=24 085)were analyzed,comparing non-SPM(n=22 963)and SPM cohorts(n=1 122).SPM patients were randomized(3:1)into training(n=842)and internal validation cohorts(n=280).Univariate/multivariate Cox regression identified prognostic factors for model construction.Model performance was evaluated via ROC curves,calibration plots,and decision curve analysis(DCA).A web-based calculator was deployed using DynNom(https://kunma697.shinyapps.io/dynnomapp-1/).External validation used 192 SPM patients diagnosed at Yantai Yuhuangding Hospital(2010-2017).Results χ2 tests revealed SPM patients had higher age(56.3%),earlier T-stage(T1:29.2%;T2:10.5%),predominant gastric cardia involvement(43.7%),fewer distant metastases(12.3%),and higher rates of radiotherapy(32.5%)and surgery(77.2%)vs.non-SPM(P<0.05).Cox analyses identified GAC primary site,T-stage,SEER stage,radiotherapy/surgery history,plus SPM grade/stage/treatment history as significant predictors(P<0.05).AUCs in the training cohort were 0.771(95%CI:0.722～0.820),0.839(95%CI:0.796～0.882),and 0.836(95%CI:0.792～0.879)for 1-/3-/5-year survival;internal validation showed 0.751(95%CI:0.700～0.801),0.746(95%CI:0.695～0.797),and 0.772(95%CI:0.723～0.821);external validation yielded 0.713(95%CI:0.648～0.778),0.805(95%CI:0.749～0.861),and 0.851(95%CI:0.801～0.901).Calibration indicated high prediction-actuality concordance;DCA confirmed clinical utility.Conclusion The model and web calculator incorporating GAC/SPM characteristics effectively predict SPM patient prognosis.

Objective:To develop a validation method for microbial targeted next generation sequencing (tNGS) detection for respiratorypathogens, and to evaluate the performance of the pathogen-targeted high-throughput sequencing test implemented in local hospital.Methods:Cross-sectional study. A total of 14 patients with severe pulmonary infections were admitted to Huangshi Central Hospital from December 2023 to January 2024. Samples were collected as follows:Bronchoalveolar lavage fluid (BALF) samples ( n=7) subjected to culture, fluorescent PCR, and tNGS testing. Sputum samples ( n=2) analyzed via sputum culture, fluorescent PCR, and tNGS. Throat swab samples ( n=5) tested using fluorescent PCR-capillary electrophoresis and tNGS. Reference samples were prepared using representative species such as Influenza A virus, Adenovirus C, Klebsiella pneumoniae, Aspergillus fumigatus, Staphylococcus aureus, Staphylococcus epidermidis, Candida parapsilosis, and Candida albicans. Jurkat cells at different concentrations were used as a source of human cells. Traditional detection methods such as fluorescent PCR-capillary electrophoresis and culture methods were used as reference methods. The detection performance of tNGS was evaluated by assessing the detection limit, precision, human cell impact, stability, cross-reactivity, and accuracy of metagenomic next-generation sequencing for pathogen detection. Results:The detection limits for Klebsiella pneumoniae, Human Adenovirus C, and Influenza A virus were 2×10 2 copies/ml, and for Aspergillus fumigatus, Staphylococcus aureus, Staphylococcus epidermidis, Candida parapsilosis, and Candida albicans, the detection limits were 4×10 2 copies/ml. The consistency rate of repeated detection results for all pathogens in the reference samples was 100%. The impact assessment experiment of human cells showed that when the concentration of Jurkat cells reached 1×10 6 cells/ml, Influenza A virus, Adenovirus C, Klebsiella pneumoniae, and Aspergillus fumigatus could all be detected. Stability experiments showed that there was no significant change in the number of pathogen sequences after the specimens were stored at 4 ℃ and -20 ℃ for 1 day, 4 days, and 7 days, respectively. Cross-reactivity experiments showed that when the concentration ratios of Staphylococcus aureus, Staphylococcus epidermidis, Candida parapsilosis, and Candida albicans were (5∶1∶1∶5), (1∶5∶5∶1), and (1∶1∶1∶1), respectively, the detection rate of closely related microbial species was 3/3. Accuracy assessment showed that the accuracy of 19 clinical specimens was 18/19 cases. Conclusion:Compared with traditional detection methods as the reference, tNGS demonstrates high sensitivity and a high positive concordance rate, underscoring its significant clinical value in the detection of respiratory pathogens.

Objective To observe the impact factors of vascular heat sink effect during in vitro microwave ablation(MWA)of porcine lung.Methods Simulation models were established using in vitro porcine lung tissue blocks based on isobaric inflation with an air pump and cyclic perfusion of duck blood with a glass tube and peristaltic pump,etc.MWA was performed under 8 different combining conditions(vessel diameter of 3 or 5 mm,blood perfusion of 30 or 50 cm/s,as well as distance between vessel and ablation antenna of 5 or 10 mm)each for 3 times.The highest temperature TV on vessel side and TC on control side during MWA,and ablation depth DV on vessel side and DC on control side after MWA were recorded.Multi-factor linear regression equations were constructed based on simulated vessel diameters,blood perfusion and distance between vessel and ablation antenna,and the impact factors of|TC-TV|and|DC-DV|were screened,respectively.Results Simulated vessel diameter showed linear positive correlation with both|TC-TV|and|DC-DV|(both P＜0.001).Simulated distance between vessel and ablation antenna showed linear negative correlation with both|TC-TV|and|DC-DV|(both P＜0.001),and the latter had more obvious impact on vascular heat sink effect than the former.Meanwhile,no significant linear relationship was found between simulated blood perfusion and|TC-TV|nor|DC-DV|(both P＞0.05).Conclusion Simulated vessel diameter and distance between vessel and ablation antenna were both impact factors of vascular heat sink effect during in vitro MWA of porcine lung,and the latter was more influential,whereas simulated blood perfusion showed no significant impact on it.

Objective:To review the applications of key technologies of 5G+helicopter medical rescue and predict future developments. Literature resource and selection Related literature in this field that was published at home and abroad. Literature quotation Forty articles published at home and abroad. Literature synthesis 5G+helicopter medical rescue is a new medical rescue model that integrates airborne 5G network technology, body area network disease awareness technology and 5G air-ground collaborative rapid diagnosis and treatment technology. It can shorten the time and space distance of medical rescue and improve the efficiency. The clinical applications of 5G+helicopter medical rescue, including the development of rescue schemes, daily and disaster scenarios 5G networking schemes, and air-ground collaborative emergency rescue information sharing platforms, have delivered remarkable results in the field of medical rescue. Despite the challenges facing 5G technology such as high cost and inconsistent technical standards, its development will promote innovation and progress in low-airspace helicopter medical rescue and offer more efficient, more accurate and safer rescue services. Conclusions:It is recommended that 5G network be given more weight, the auto-flight technology of helicopters developed, rescue command and dispatch platforms established, rescue personnel better-trained and supervision and safety guarantee be enhanced.

Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

Objective:To observe the effectiveness of extracorporeal counterpulsation therapy in patients with heart failure in ischaemic cardiomyopathy.Methods:A total of 112 patients with ischemic cardiomyopathy and heart failure admitted to the Second Affiliated Hospital of Xingtai Medical College from August 2020 to June 2023 were prospectively selected and divided into two groups by random number table method. The control group was treated with conventional drugs and conventional cardiac rehabilitation program, and the observation group was combined with external counterbeating therapy on the basis of the control group. The levels of N-terminal B-type brain natriuretic peptide (NTproBNP), soluble growth stimulation-expression gene-2 protein (sST2), neutrophil gelatinase-associated lipid carrier protein (NGAL), galactin-3 (Gal-3), cardiopulmonary exercise test (CPET) parameters and cardiac ultrasound indexes were compared between the two groups before and after treatment. The curative effect and the rate of re-hospitalization within 6 months were compared between the two groups.Results:After treatment, the levels of NTproBNP, sST2, NGAL and Gal-3 in the observation group were lower than those in the control group: (1941.36 ± 312.59) ng/L vs. (2674.22 ± 404.64) ng/L, (44.78 ± 3.97) ng/L vs. (52.45 ± 4.13) ng/L, (22.63 ± 3.65) μg/L vs. (26.41 ± 3.77) μg/L, (4.63 ± 1.29) ng/L vs. (6.11 ± 1.78) ng/L, there were statistical differences ( P<0.05); the maximum kilogram oxygen uptake (VO 2max/kg), maximum kilogram oxygen uptake as a percentage of predicted value (VO 2max/kg%pred), maximum minute ventilation as a percentage of predicted value (VEmax%pred) in the observation group were higher than those in the control group: (22.41 ± 2.23) ml/(min·kg) vs. (21.35 ± 2.09) ml/(min·kg), (83.79 ± 11.04)% vs. (78.74 ± 10.14)%, (88.95 ± 12.74)% vs. (75.45 ± 11.14)%, there were statistical differences ( P<0.05 or <0.01); the left ventricular ejection fraction (LVEF) in the observation group was higher than that in the control group and the left ventricular posterior wall thickness (LVPWT) and left ventricular posterior wall end-systolic thickness (PWS) were lower than those in the control group: (50.12 ± 3.87)% vs. (48.63 ± 3.74)%, (8.77 ± 1.58) mm vs. (9.63 ± 1.97) mm, (9.34 ± 1.54) mm vs. (10.14 ± 1.79) mm, there were statistical differences ( P<0.05). There was no statistical difference in the total effective rate between the two groups ( P>0.05). The patient readmission rate within 6 months of follow-up in the observation group was lower than that in the control group: 5.45%(3/55) vs. 20.00%(11/55), there was statistical difference( χ2 = 5.24, P<0.05). Conclusions:Extracorporeal counterpulsation therapy for the treatment of heart failure in ischaemic cardiomyopathy can improve the cardiorespiratory function, reduce the expression of NTproBNP, sST2, NGAL and Gal-3, and decrease the patient readmission rate.

Objective To investigate the relationship between the expression levels of lymphocyte activation gene-3(LAG-3)and pen-traxin-3(PTX3)and the disease severity of the patients with allergic rhinitis(AR).Methods A total of 128 AR patients visited the Department of Otolaryngology,Chengdu Integrated TCM and Western Medicine Hospital from January 2021 to June 2023 were retro-spectively selected as the research subjects(AR group).According to the severity of the condition,the patients were further divided into the mild group(n=40),moderate group(n=42),and severe group(n=46).In addition,80 healthy volunteers who underwent physical examinations in our hospital were selected as the control group.The clinical data such as the gender,age,body mass index(BMI),allergens,and disease onset time of all subjects were recorded and analyzed,and all patients were scored using the Score For Allergic Rhinitis(SFAR).The enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of serum LAG-3 and PTX3 in all subjects.The correlation between the expression levels of serum LAG-3 and PTX3 was analyzed by the Pearson correla-tion analysis.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum LAG-3 and PTX3 levels,both individually and in combination,for AR.Results The expression levels of serum LAG-3 in the AR group(468.74±104.32 μg/L)were significantly lower than that in the control group(691.53±184.65 μg/L,t=7.795,P<0.05),while those of ser-um PTX3 in the AR group(24.83±7.54 ng/L)were significantly higher than that in the control group(17.34±5.37 ng/L,t=7.793,P<0.05).The expression levels of serum LAG-3 in the AR patients with positive immunoglobulin(IgE)and SFAR score≥7 were 442.46±92.37 μg/L and 448.27±103.24 μg/L,respectively,which were significantly lower than that in the AR patients with negative IgE(497.61±115.32 μg/L)and SFAR score<7(498.66±112.76 μg/L,P<0.05).While the expression levels of serum PTX3 in the AR patients with positive IgE and SFAR score≥7 were 28.24±8.17 ng/L and 26.43±8.73 ng/L,respectively,which were significantly higher than that in the AR patients with negative IgE(21.08±6.25 ng/L)and SFAR score<7(22.51±6.89 ng/L,P<0.05).Com-pared with the mild group,the expression levels of serum LAG-3 in both the moderate and severe groups were reduced,and that of ser-um LAG-3 in the severe group was significantly lower than that in the moderate group.While the expression levels of serum PTX3 showed an opposite trend,and the levels of serum PTX3 in the severe group were significantly higher than that in the moderate group(P<0.05).The Pearson correlation results showed a significant negative correlation between serum LAG-3 and PTX3 levels in AR pa-tients(r=-0.402,P=0.000).The analysis of the ROC curve showed that the area under the ROC curve(AUCROC),sensitivity,and specificity of the combination of serum LAG-3 and PTX3 in the diagnosis of AR were 0.881,89.80％,and 73.80％,respectively,which were better than that of serum LAG-3 and PTX3 alone.Conclusion The combined detection of serum LAG-3 and PTX3 for the diagnosis of AR has higher clinical application value and may be used to evaluate the severity of the disease.

Objective:To construct a medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory,starting from the entire process of medical treatment.Method:A comprehensive study was conducted on the screening of medical quality evaluation indicators for hospitalized patients using literature analysis,key informant interviews,and expert inquiry methods.Results:The effective recovery rate of the two rounds of expert consultation was 100%,with high enthusiasm from the experts.The authority coefficient was above 0.7,and Kendall's W coordination coefficient was 0.267(P＜0.05).The evaluation indicators for medical quality of hospitalized patients,including 3 primary indicators,10 secondary indicators,and 51 tertiary indicators,were determined.Conclusions:The medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory has certain scientificity and reliability.However,the weight analysis of the index system has not been carried out and is still in the theoretical exploration stage.Further empirical research is needed for verification and improvement.

Objective To analyze the effects of nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection on inflammatory markers in peripheral blood of sinonasal inverted papilloma(SINP)and their correlations with recurrence.Methods A retrospective analysis was performed on 60 SINP patients admitted to Chengdu First People's Hospital from May 2021 to May 2023,all of whom were treated with endoscopic low temperature plasma ablation and nasal dynamical system-assisted resection;and another 60 healthy persons who underwent physical examination in the same period were enrolled and set as control group.The changes of peripheral blood inflammatory markers before and at various time points after operation were compared between control group and SINP patients.General data of patients were collected by self-made scales.The recurrence was recorded,and its influence factors were analyzed for further exploring and the correlation between recurrence and levels of peripheral blood inflammatory factors.Results Statistically significant differences between control group and SINP group were found in serum tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),eosinophilic cationic protein(ECP)and eosinophilic granulocytes(EOS)before operation,3 days and 1 month after operation(all P<0.001).Univariate analysis identified that TNF-α,CRP,IL-6,IL-8,mitotic counts,atypical hyperplasia and course of disease were associated with postoperative recurrence in SINP patients.Spearman correlation analysis showed that the postoperative recurrence in SINP patients showed no correlation with IL-6 level(P>0.05),but positively correlated with TNF-α,CRP and IL-8 levels(P<0.05).Conclusion Nasal endoscopic low temperature plasma ablation combined with nasal dynamical system-assisted resection is effective for SINP,with a low postoperative recurrence rate.Moreover,peripheral blood inflammatory markers are closely related to the occurrence and development of SINP,which may be involved in the recurrence,and there is a synergistic effect.