Objective To investigate the clinical characteristics of severe and critical influenza children and analyze the risk factors affecting the prognosis of children.Methods Clinical data from children diagnosed with severe and critical influenza who were hospitalized in the pediatric intensive care unit of Tongji hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to December 2023 were retrospectively collected and analyzed.Results Among the 121 children,86 cases had severe influenza and 35 cases had critical influenza.There were 102 children in the good prognosis group and 19 children in the poor prognosis group.In all,93 cases(76.9％)were infected with influenza A,27 cases(22.3％)were in-fected with influenza B,and 1 case(0.8％)was infected with both influenza A and B.Sixty-seven cases(55.4％)were under 5 years old.The main clinical manifestations were fever,cough and convulsions.Seventy-five cases(62.0％)were complicated with pneumonia,65 cases(53.7％)were diagnosed with influenza-associated encephalopathy,and 22 cases(18.2％)developed multiple organ dysfunction syndrome.Fifty-five cases(45.5％)were infected with other pathogens,21 cases(17.4％)had bacterial infec-tion.The incidence of bacterial infection in children with critical influenza(31.4％)was higher than that in children with severe influenza(11.6％)(P＜0.05).Bacterial infection,neurological symptoms and elevated PCT were independent risk factors for poor prognosis(P＜0.05).Conclusion Children under 5 years old are more likely to develop severe and critical influen-za.Bacterial co-infection increases the risk of poor prognosis.Poor-prognostic severe or critical influenza is often accompanied by neurological manifestations and residual neurological sequelae.

Objective To investigate the characteristics of left ventricular hypertrophy in patients with primary aldosteron-ism(PA)accompanied by varying severity of obstructive sleep apnea(OSA),and to further identify potential factors contributing to ventricular hypertrophy in this population.Methods A retrospective analysis was performed on 308 patients with PA who received treatment at Kunming Medical University Affiliated Cardiovascular Hospital from January 2021 to June 2022.For com-parison,309 hospitalized patients diagnosed with essential hypertension(EH)during the same period were included as the control group.According to polysomnography findings,the patients were categorized into PA/EH with OSA group and PA/EH without OSA group.PA patients with OSA were further stratified into mild,moderate,and severe OSA subgroups based on the apnea-hypopnea index(AHI).Demographic characteristics,biochemical profiles,and echocardiographic parameters were compared across the groups.Results Compared to the EH groups with or without OSA,interventricular septal diastolic thickness(IVS-DT),left ventricular mass index(LVM),and left ventricular mass index(LVMI)was increased in PA with OSA group(all P＜0.05).The body mass index(BMI)was increased in both the PA with OSA group and EH with OSA group compared to their counterparts without OSA(all P＜0.05).Within the three subgroups of PA patients with OSA,left ventricular end-diastolic di-mension(LVEDD),IVSDT,left ventricular posterior wall diastolic thickness(LVPWDT),and LVM measurements were in-creased in severe OSA group compared to the mild OSA group(all P＜0.05).Conclusion Aldosterone is an independent risk factor from OSA for left ventricular hypertrophy;In PA patients with OSA,cardiac impairment is severer in the moderate and severe OSA subgroups compared to those without OSA,and the severity of cardiac impairment escalates as OSA severity increa-ses.These findings highlight the necessity of screening for OSA in PA patients to stratify cardiac impairment risk and enable early therapeutic intervention.

Objective To observe the effectiveness of intrasaccular flow disruption device treatment for ruptured wide-necked bifurcation intracranial aneurysms(WNBA).Methods Five cases(5 aneurysms)of ruptured wide-necked bifurcation an-eurysms treated with intrasaccular flow disruption device embolization at Union Hospital,Tongji Medical College,Huazhong U-niversity of Science and Technology,from January 2022 to August 2023.Digital subtraction angiography or magnetic resonance imaging was performed at 6 and 12 months postoperatively,and the aneurysm occlusion effect was evaluated according to the WEB Occlusion Scale(WOS).Results The surgical success rate was 100％,with no adverse events such as intraoperative or postoperative rebleeding or thrombus formation.The complete occlusion rate at 12 months postsurgery was also 100％.Conclu-sion The efficacy and safety of intraluminal flow-diverting device therapy for ruptured WNBA are promising.However,further observation is warranted to assess the long-term occlusion outcomes.

Objective To investigate the effect of electrotherapy on liver and intestinal mucosal injury in hyperlipidemia rats.Methods Wistar rats were divided into control group,model group and electroacupuncture group,with 6 rats in each group.Both the model group and the electroacupuncture group were fed with high-fat diet,and the electroacupuncture group re-ceived electroacupuncture intervention.After treatment,HE staining was used to detect the pathological changes of liver and ile-al mucosa.The contents of TC,TG,LDL-C and HDL-C in serum of rats were detected by biochemical method.AB-PAS staining was used to detect ileum mucosa in rats.The protein expressions of FXR,FGF19,ZO-1,occludin and JAM-C in rat ileum were detected by Western blotting.Results Compared with the control group,the body weight was significantly increased in the model group(P＜0.05),and the liver and ileum tissues were seriously damaged.The levels of TC,TG and LDL-C in serum and the expression of JAM-C protein in ileum were increased(P＜0.01).HDL-C level in serum,FXR,FGF19,ZO-1 and occludin in ileum tissue were decreased(P＜0.01).Compared with model group,the weight gain of rats in electroacupuncture group was significantly reduced(P＜0.01),and the pathological injury of liver and ileum tissue was alleviated.The levels of TC,TG and LDL-C in serum and the expression of JAM-C protein in ileum were decreased(P＜0.01).HDL-C level in serum as well as FXR,FGF19,ZO-1 and occludin levels in ileum tissue were increased(P＜0.01).Conclusion Electroacupuncture stimulation can improve the damage of intestinal barrier by activating FXR/FGF19 pathway in rats,play a protective role in liver,and inhibit dyslipidemia.

Objective To investigate the inhibitory effect of MyD88 inhibitor St-2825 on inflammatory pathways and its protective efficacy on gastric tissue in sodium taurocholate-induced acute pancreatitis-associated gastric injury.Methods An a-cute pancreatitis rat model was established by subcapsular pancreatic injection of sodium taurocholate.Rats were randomly di-vided into normal control group(Group C,received saline+saline treatment),acute pancreatitis group(Group P,received sodium taurocholate+saline treatment),and intervention group(Group T,received sodium taurocholate+MyD88 inhibitor St-2825 treatment),with 16 rats in each group,48 rats in total.Pancreatic and gastric tissue samples were collected at 2 h and 6 h post-modeling.The samples were paraffin-embedded,sectioned,and stained with hematoxylin-eosin(HE)for comparative pathological scoring.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),and interleukin-6(IL-6)were measured by ELISA.Immunofluorescence staining was performed to assess immune cell infiltration in gastric tissues.Western blot was used to determine the protein expression of MyD88 and the phosphorylation ratio of p65 in the TLR/MyD88/NF-κB p65 signaling pathway in rat gastric tissues.Results In sodium taurocholate-induced acute pancreatitis-associated gastric injury rats,both pancreatic and gastric pathological scores were increased progressively over time.The plasma levels of TNF-α,IL-1 and IL-6 were significantly elevated.During pancreatic injury,gastric tissues exhibited markedly increased infiltration of neutrophils,mac-rophages,dendritic cells and T lymphocytes.The upregulated MyD88 in tissues stimulated NF-κB pathway activation,leading to phosphorylated p65 nuclear translocation and downstream inflammatory factors transcription.MyD88 inhibitor St-2825 inter-vention effectively blocked p65 phosphorylation and nuclear translocation,attenuated downstream inflammatory responses,and reduced immune cell infiltration in gastric tissues.Conclusion Gastric tissues undergo progressive damage during pancreatic in-jury.The MyD88 inhibitor St-2825 attenuates inflammatory responses and mitigates immune cell infiltration in acute pancreati-tis-associated gastric injury,thereby exerting protective effects.

Nutrition sensing is a hot topic of life science in recent years,which has produced a series of original research re-sults and greatly expanded the scientific understanding of molecular nutrition science.Nutritional homeostasis is very important to human health.This review summarizes the latest results of the scientific community on nutrition sensing in recent years,de-scribing the sensing process of life essential nutrients such as glucose,amino acids,fatty acids,cholesterol and oxygen,and their close relationship with human diseases.

Objective To introduce the method and results of modeling validation of the treatment planning system used in the first Mevion proton therapy system in China.Methods The SOBP(Spread-Out Bragg Peak)beams in water were designed according to the TG-185 report.The treatment plans in water were designed according to the TG-350 report.The treatment plans of patients were designed on the CT images.The plane dose of each beam was measured by using the MatriXX ONE ioni-zation chambers at different depths in the water,and the measurment results were compared with the TPS calculated results to verify the accuracy of the output doses,the error requirements were 2％/2 mm.Results Except for the distal fall-off position,the doses deviation at the SOBP beams center were less than 3％,and the γ analysis pass rates of plane doses were more than 90％.The measured results of the treatment plan beams were within the tolerance of deviation,and the output doses of the beams without or with static adaptive aperture were more accurate in general.With the decrease of beam energy,the error of dose calculation will increase.Conclusion According to the accuracy requirements of the planning system calculation and treat-ment system implementation,the proton therapy system supporting the treatment planning system has been modeled.Some basic performance such as IDD and beam spot is consistent with the actual measurement,and the TPS modeling conforms to the actual performance of the machine executing when calculating the same proton radiotherapy plan.

Objective To establish and evaluate an animal model of cardiac aging by D-galactose(D-Gal).Methods Thirty mice were randomly divided into two groups,with 15 mice in each group.The experimental group(D-gal group)was injected with D-gal solution(150 mg/kg,once a day)on the back of neck to establish the cardiac aging mice model.The control group(Vehicle group)was injected with 0.9％sodium chloride injection on the neck and back.Weight was measured once a week,and the dose was adjusted according to body weight,and the phenotype of the model was evaluated by ultrasound,histopathological staining,Western blotting and other techniques.Results In the experimental group,there were significant changes in general condition,cardiac cavity size,ejection fraction and aging-related protein expression,which were consistent with the indexes of natural aging of the heart.No mice death was observed.Conclusion It is feasible to establish heart aging animal model with D-galactose.This method has the advantages of simple operation,short modeling time and high success rate,which is a satisfying method to establish heart aging animal model.

Objective To explore the cause of dislocation after femoral head replacement(FHR)surgery in elderly patients with failed intramedullary treatment of femoral intertrochanteric fracture(FIF).Methods Elderly patients(175 cases)with FIF who underwent FHR treatment due to failure of intramedullary nails after proximal femoral nail anti-rotation(PFNA)treatment in our hospital from December 2018 to January 2023 were selected as the research subjects.According to whether the femoral head was dislocated after FHR surgery,the patients were divided into dislocation group(45 cases)and non-dislocation group(130 cases).The clinical efficacy of FHR surgery was evaluated,and clinical data of patients(including age,gender,perioperative da-ta,etc.)was collected for comparative analysis.Multicollinearity of these factors was determined.LASSO regression analysis was used to screen for predictive factors.Based on multivariate logistic regression analysis of risk factors,simple risk scoring model was constructed using the odds ratio(OR)values of each risk factor.Receiver operating characteristic(ROC)curves were constructed to evaluate the discriminability of the model.Hosmer Lemeshow(H-L)test was used to judge the calibration of the model.Results Compared with preoperative,the Harris scores of patients at 1 and 12 months after surgery were significantly improved(P＜0.05).Postoperative complications in FHR patients were relatively low,mainly including pulmonary infection(2.86％),lower limb thrombosis(2.86％),and cardiac dysfunction(2.86％).The LASSO regression model obtained 6 predic-tive factors,among which age,neurological and muscular system diseases,surgical approach,postoperative lifestyle habits,and postoperative care were all independent influencing factors for the occurrence of femoral head dislocation(P＜0.05).The score of the simplified risk scoring model was 0～21.6 points,which can be divided into three risk levels:low risk(＜11 points),medi-um risk(11-15 points),and high risk(＞15 points).There was no significant difference in the incidence of dislocation between the two episodes of patients(P＞0.05).The model validation results showed good discrimination and calibration.Conclusion FHR can effectively improve hip joint function in elderly patients after failure of FIF intramedullary nail fixation,and there are fewer postoperative complications.Age,neurological and muscular system diseases,surgical approach,postoperative lifestyle habits,and postoperative care are independent influencing factors for the occurrence of femoral head dislocation,and should be taken seriously and prevented in clinical treatment.

Cadmium is a pervasive environmental pollutant with strong bioaccumulative properties and multisystem toxici-ty.Elderly individuals,as a vulnerable group,are particularly susceptible to the detrimental effects of long-term cadmium expo-sure on cognitive function.This review summarizes domestic and international research on the association between cadmium ex-posure,cognitive impairment in older adults,and Alzheimer's disease,while also discussing the potential underlying biological mechanisms.Current epidemiological studies predominantly use cross-sectional or case-control designs.Numerous studies have reported that cadmium exposure is associated with cognitive impairment in the elderly and an increased incidence or mortality of Alzheimer's disease.The neurotoxic mechanisms of cadmium are complex and varied,including disruption of the blood-brain barrier,impairment of mitochondrial function,interference with synaptic transmission,induction of autophagy and apoptosis,as well as disturbances in metal ion homeostasis and glycogen metabolism.Although numerous studies support the adverse effects of cadmium exposure on cognitive function in the elderly,these conclusions remain controversial,and the underlying biological mechanisms have not been fully elucidated.Therefore,further prospective cohort studies and in-depth biological research are ur-gently needed to better understand the health risks posed by cadmium exposure in the elderly.