Objective To analyze the distribution characteristics of 13 common respiratory pathogens in children in Zibo area from 2020 to 2022.Methods A total of 3091 hospitalized children with respiratory infections admitted to Zibo Maternal and Child Health Hospital from January 2020 to December 2022 were selected as the subjects.Throat swabs or bronchoalveolar lavage fluid samples were collected from the patients,and 13 common respiratory pathogens were tested to analyze the distribution differences among different genders,ages,and seasons.Results Among 3091 pediatric patients,1794 were found to be infected with pathogens.The top three pathogens were Mycoplasma pneumoniae,rhinovirus,and respiratory syncytial virus(RSV).The single infection rate was 47.75％,while the mixed infection rate was 10.28％,with the most common scenario being a mixed infection of two pathogens.There were statistically significant differences in the pathogen profiles across different age groups(P＜0.001):infants had the highest detection rate of RSV,young children were primarily infected with rhinovirus,preschool and school-age children were predominantly infected with Mycoplasma pneumoniae.Seasonal distribution showed that the highest positive rate was in autumn,while the lowest was in spring(P＜0.05).In spring,the main pathogens were rhinovirus and Mycoplasma pneumoniae;in summer,they were rhinovirus and parainfluenza virus;in autumn,they were Mycoplasma pneumoniae and RSV;and in winter,the detection rates of Mycoplasma pneumoniae and influenza B virus were higher.Conclusion From 2020 to 2022,Mycoplasma pneumoniae,rhinovirus and RSV were the main pathogens of children's respiratory tract infection in Zibo area,and there were significant differences in the distribution of pathogens among different ages and seasons.

Objective:To identify risk factors affecting survival outcomes in elderly patients (≥75 years) with early gastric cancer (EGC) and establish a predictive scoring system to aid in treatment decision-making.Methods:A retrospective analysis was conducted on EGC patients who underwent gastroscopy, endoscopic submucosal dissection (ESD), surgical resection, or conservative treatment at the Endoscopy Center of the First Affiliated Hospital of Dalian Medical University between January 2016 and January 2023. Clinical data were analyzed to identify prognostic risk factors and develop a predictive scoring system. The low-risk group and high-risk group were divided according to the scores, and the overall survival of patients who received different treatments were compared between two groups.Results:A total of 180 patients were included, of whom 50 underwent ESD, 97 surgery, and 33 conservative treatment. Cox proportional risk model multivariate analysis identified three independent risk factors for survival: Charlson comorbidity index (CCI) >2 ( P=0.014, HR=2.411, 95% CI: 1.196-4.864), prognostic nutritional index (PNI) ≤43.275 ( P=0.011, HR=2.294, 95% CI: 1.205-4.365), and presence of multiple primary cancers ( P=0.004, HR=2.797, 95% CI: 1.401-5.585). A weighted scoring system assigned 1 point each for CCI>2, PNI≤43.275, and multiple primary cancers. Receiver operating characteristic curve analysis determined an optimal cutoff score of 1.5 ( P<0.001, area under curve=0.726). Patients were stratified into low-risk (score≤1) and high-risk (score≥2) groups. In the low-risk group, both ESD and surgical resection demonstrated superior overall survival compared with conservative treatment (95.1%, 87.5%, and 61.5%, respectively, P=0.003), with no significant difference between ESD and surgery ( P=0.466). In the high-risk group, no statistically significant overall survival difference was observed among ESD, surgery, and conservative treatment (55.6%, 64.7%, and 30.0%, respectively, P=0.152). Conclusion:CCI, PNI, and multiple primary cancers are critical prognostic factors for elderly EGC patients. The proposed scoring system (total 3 points) guides treatment decisions: ESD or surgery is recommended for low-risk patients (score≤1), while conservative management may benefit high-risk patients (score≥2).

Objective:To investigate the metabolic pathways and potential molecular targets associated with dapagliflozin in the treatment of type 2 diabetes mellitus.Methods:Plasma samples from patients with type 2 diabetes mellitus were collected before and after 12 months of dapagliflozin treatment and analyzed using UPLC-VION IMS Q-Tof-based metabolomics and timsTOF Pro2 diaPASEF-based proteomics. Multivariate statistical analyses were performed to identify significant differences pre- and post-treatment. Correlation analysis was then conducted to assess relationships between differentially expressed metabolites and proteins closely associated with type 2 diabetes mellitus. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses were used to construct metabolic pathway maps and predict therapeutic targets.Results:After 12 months of dapagliflozin treatment, 162 differential metabolites were identified, with 59 upregulated and 103 downregulated. A total of 440 differentially expressed proteins were detected, of which 272 were upregulated and 168 were downregulated. The main classes of differential metabolites included sphingolipids, glycerophospholipids, and glycosphingolipids. Key differentially expressed proteins included importin subunit alpha-11, synemin, Janus kinase 1, and far upstream element-binding protein 2. Correlation analysis revealed 98 shared enriched pathways between differential metabolites and proteins, involving neurotrophin signaling, chemokine signaling, and B cell receptor signaling pathways. Metabolic pathway analysis suggested that dapagliflozin might regulate insulin secretion by modulating glucose-dependent insulinotropic polypeptide, calmodulin-dependent protein kinase, and diacylglycerol levels.Conclusion:Dapagliflozin may exert therapeutic effects in type 2 diabetes mellitus through multiple mechanisms, including the modulation of metabolic and proteomic profiles, participation in key cellular signaling pathways, and regulation of insulin secretion.

Objective:By analyzing the concentration distribution and hydrophilic/hydrophobic proportion differences of 15 bile acid subtypes in the serum of patients with hepatitis B virus（HBV）infection complicated with liver cirrhosis and primary biliary cholangitis（PBC）complicated with liver cirrhosis，this study aims to explore the potential associations between bile acid metabolism and these diseases，providing a reference basis for identifying disease-specific metabolic fingerprints in the diagnosis，treatment，and prognosis of liver diseases. Furthermore，building on the pharmacological mechanisms of ursodeoxycholic acid（UDCA）in the treatment of PBC，this research investigates potential therapeutic applications of bile acid drugs in HBV infection.Methods:A retrospective analysis method was adopted. We enrolled 27 HBV infection complicated with liver cirrhosis patients and 59 PBC complicated with liver cirrhosis patients who received outpatient or inpatient treatment at the Fifth Medical Center of PLA General Hospital from November 2024 to April 2025. The general data and routine clinical laboratory data of the two groups of patients were collected and analyzed. Using the ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry（UHPLC-QqQ-MS/MS）platform，precise quantification and differential analysis of 15 bile acid subtypes were performed in serum samples. Partial least squares discriminant analysis（PLS-DA）was employed to perform discriminant analysis on serum bile acid profiles data between the two groups，and variable importance in projection（VIP）values were calculated to identify key bile acid subtypes that could differentiate the two diseases. Box plots were constructed to analyze proportion differences in serum hydrophilic and hydrophobic bile acids between the two groups，aiming to explore potential associations between bile acid metabolism and the diseases.Results:The HBV infection group and the PBC group exhibited similar impairment of routine liver function parameters. The HBV infection group had higher serum concentrations of cholic acid（CA），chenodeoxycholic acid（CDCA）and deoxycholic acid（DCA），but lower concentrations of UDCA，glycoursodeoxycholic acid（GUDCA）and tauroursodeoxycholic acid（TUDCA）. The score plot generated by the PLS-DA model demonstrated significant differences in bile acid profile characteristics between the two diseases，with VIP values for UDCA，CDCA，GUDCA，TUDCA，and DCA all greater than 1. Box plots demonstrated a higher proportion of hydrophobic bile acids in the bile acid profile of the HBV infection group compared to the PBC group.Conclusion:This study found significant differences in serum bile acid profile characteristics between patients with HBV infection complicated with liver cirrhosis and those with PBC complicated with liver cirrhosis，specific bile acid subtypes such as CDCA and DCA have the potential to become specific metabolic fingerprints for these two diseases. HBV infection group exhibited higher proportion of hydrophobic bile acids in their bile acid profiles compared to PBC group. The characteristic changes in bile acid profiles can reflect the pathological characteristics of liver diseases，and their differences in hydrophilic/hydrophobic bile acids proportion represents a novel dimension independent of traditional liver function indicators，with potential value for disease prognosis assessment. UDCA or its derivatives may hold therapeutic potential for HBV infection patients with liver cirrhosis who exhibit accumulation of hydrophobic bile acids.

Objective:To observe the clinical efficacy of immediate repair of extracranial branch defects in the facial nerve through transplantation of the great auricular nerve.Methods:A retrospective inclusion was carried out on 17 patients with extracranial branch defects of the facial nerve caused by parotid malignant tumors and neurogenic tumors in the Department of Stomatology of Xuzhou Central Hospital from June 2021 to January 2023, including 10 males and 7 females, with the age ranged from 28 to 68 (42.4±11.4) years old. All patients underwent immediate transplantation of the greater auricular nerve during the operation. The facial nerve function was evaluated according to the House-Brackmann (HB) facial paralysis grading standard at the last follow-up. Grade Ⅰ-Ⅲ was considered effective, and grade Ⅳ-Ⅵ was considered ineffective. The quality of life was evaluated using the physical function score (FDIP) and social function score (FDIS).Results:The follow-up time was 6-30 (18.3 ±6.6) months. The facial nerve function was classified as grade Ⅰ in four cases, grade Ⅱ in six cases, grade Ⅲ in four cases, and grade Ⅳ in three cases. This resulted in an effective rate of 14/17. The FDIP score at the final follow-up was (84.7 ±9.1) points, which was higher than the (54.1 ±20.6) points recorded at the immediate moment of repair ( P<0.001). In contrast, the FDIS score was (11.8 ±8.9) points, which was lower than the (57.5 ±11.7) points recorded at the immediate moment of repair ( P<0.001). Conclusion:The transplantation of the auricular great nerve can effectively enhance facial nerve function and improve the life quality in the immediate repair of defects in the extracranial branches of the facial nerve.

Objective:To understand the feelings and experiences of patients with dizziness caused by cerebrovascular diseases, and to provide a reference basis for the development of nursing intervention measures.Methods:Semi-structured interviews were carried out from November 2024 to February 2025 by phenomenology method. The patients with dizziness caused by cerebrovascular diseases who were hospitalized in the First Affiliated Hospital of Zhengzhou University were selected by purposive sampling method. The interview data were analyzed by the Colaizzi 7-step analysis method to summarize and extract the themes.Results:Finally, 16 patients with dizziness caused by cerebrovascular diseases were interviewed, including 6 males and 10 females, aged 43 to 73 years. The feeling and experience of patients with dizziness caused by cerebrovascular diseases could be summarized into three themes: persistent physical symptoms (physiological function imbalance, the superposition of multiple symptoms); patients had cognitive biases (symptom risk cognitive bias, symptom knowledge cognitive bias, drug effect cognitive bias); patients' self-perceived burden was obvious(physical burden, emotional burden, and economic burden).Conclusions:The patients with dizziness caused by cerebrovascular diseases show multi-dimensional characteristics, and there are many burdens and needs in physiological, psychological and social aspects. We should pay attention to the symptom experience and psychological feelings of such patients, and give targeted health education and multi-dimensional social support.

Objective To analyze the distribution characteristics of 13 common respiratory pathogens in children in Zibo area from 2020 to 2022.Methods A total of 3091 hospitalized children with respiratory infections admitted to Zibo Maternal and Child Health Hospital from January 2020 to December 2022 were selected as the subjects.Throat swabs or bronchoalveolar lavage fluid samples were collected from the patients,and 13 common respiratory pathogens were tested to analyze the distribution differences among different genders,ages,and seasons.Results Among 3091 pediatric patients,1794 were found to be infected with pathogens.The top three pathogens were Mycoplasma pneumoniae,rhinovirus,and respiratory syncytial virus(RSV).The single infection rate was 47.75％,while the mixed infection rate was 10.28％,with the most common scenario being a mixed infection of two pathogens.There were statistically significant differences in the pathogen profiles across different age groups(P＜0.001):infants had the highest detection rate of RSV,young children were primarily infected with rhinovirus,preschool and school-age children were predominantly infected with Mycoplasma pneumoniae.Seasonal distribution showed that the highest positive rate was in autumn,while the lowest was in spring(P＜0.05).In spring,the main pathogens were rhinovirus and Mycoplasma pneumoniae;in summer,they were rhinovirus and parainfluenza virus;in autumn,they were Mycoplasma pneumoniae and RSV;and in winter,the detection rates of Mycoplasma pneumoniae and influenza B virus were higher.Conclusion From 2020 to 2022,Mycoplasma pneumoniae,rhinovirus and RSV were the main pathogens of children's respiratory tract infection in Zibo area,and there were significant differences in the distribution of pathogens among different ages and seasons.

Objective:To identify risk factors affecting survival outcomes in elderly patients (≥75 years) with early gastric cancer (EGC) and establish a predictive scoring system to aid in treatment decision-making.Methods:A retrospective analysis was conducted on EGC patients who underwent gastroscopy, endoscopic submucosal dissection (ESD), surgical resection, or conservative treatment at the Endoscopy Center of the First Affiliated Hospital of Dalian Medical University between January 2016 and January 2023. Clinical data were analyzed to identify prognostic risk factors and develop a predictive scoring system. The low-risk group and high-risk group were divided according to the scores, and the overall survival of patients who received different treatments were compared between two groups.Results:A total of 180 patients were included, of whom 50 underwent ESD, 97 surgery, and 33 conservative treatment. Cox proportional risk model multivariate analysis identified three independent risk factors for survival: Charlson comorbidity index (CCI) >2 ( P=0.014, HR=2.411, 95% CI: 1.196-4.864), prognostic nutritional index (PNI) ≤43.275 ( P=0.011, HR=2.294, 95% CI: 1.205-4.365), and presence of multiple primary cancers ( P=0.004, HR=2.797, 95% CI: 1.401-5.585). A weighted scoring system assigned 1 point each for CCI>2, PNI≤43.275, and multiple primary cancers. Receiver operating characteristic curve analysis determined an optimal cutoff score of 1.5 ( P<0.001, area under curve=0.726). Patients were stratified into low-risk (score≤1) and high-risk (score≥2) groups. In the low-risk group, both ESD and surgical resection demonstrated superior overall survival compared with conservative treatment (95.1%, 87.5%, and 61.5%, respectively, P=0.003), with no significant difference between ESD and surgery ( P=0.466). In the high-risk group, no statistically significant overall survival difference was observed among ESD, surgery, and conservative treatment (55.6%, 64.7%, and 30.0%, respectively, P=0.152). Conclusion:CCI, PNI, and multiple primary cancers are critical prognostic factors for elderly EGC patients. The proposed scoring system (total 3 points) guides treatment decisions: ESD or surgery is recommended for low-risk patients (score≤1), while conservative management may benefit high-risk patients (score≥2).

OBJECTIVE To systematically evaluate pharmacoeconomic studies on treatment strategies for transfusion- dependent β thalassemia （TDT） both in China and internationally， to inform clinical decision-making and health resource allocation， and provide methodological references for future domestic research in China. METHODS Databases including PubMed， Embase， Web of Science， the Cochrane Library， CNKI， Wanfang Data， and VIP were searched for pharmacoeconomic studies related to TDT treatments from inception to December 2024. Two researchers independently screened the literature， extracted data， and assessed risk of bias using the Consolidated Health Economic Evaluation Reporting Standards 2022 （CHEERS 2022） checklist. A qualitative systematic review was conducted focusing on model structure， costs， health outcomes， uncertainty analysis， and economic evaluation results. RESULTS A total of 1 685 articles were initially identified， and 13 pharmacoeconomic studies were ultimately included. The overall quality of the included studies was relatively high， covering interventions including blood transfusion and iron chelation therapy （BT-ICT）， hematopoietic stem cell transplantation （HSCT）， and gene therapy. All studies employed cost-utility analysis from societal， healthcare system， and payer perspectives. Markov models were most frequently used in model design. Most studies adopted a lifetime horizon with a cycle length of one year and a discount rate of 1.5% to 5%. Costs mainly focused on direct medical costs， sourced from national insurance databases and published literature. Utility values were primarily derived from literature or measured using techniques such as time trade-off. Most studies conducted both deterministic and probabilistic sensitivity analyses， identifying the costs of iron chelators and utility values as key influential parameters. Some studies also performed scenario analyses. CONCLUSIONS HSCT was likely more cost-effective than BT-ICT for pediatric/ adolescent patients. BT-ICT demonstrated superior cost-utility for adult patients， with the deferiprone regimen potentially being the most cost-effective option. Current domestic and international pharmacoeconomic evaluations for TDT remain limited. Future research should adopt a societal perspective， use a lifetime horizon， and strictly follow the CHEERS 2022 checklist when conducting pharmacoeconomic evaluations of treatments for TDT.

Objective:To investigate the metabolic pathways and potential molecular targets associated with dapagliflozin in the treatment of type 2 diabetes mellitus.Methods:Plasma samples from patients with type 2 diabetes mellitus were collected before and after 12 months of dapagliflozin treatment and analyzed using UPLC-VION IMS Q-Tof-based metabolomics and timsTOF Pro2 diaPASEF-based proteomics. Multivariate statistical analyses were performed to identify significant differences pre- and post-treatment. Correlation analysis was then conducted to assess relationships between differentially expressed metabolites and proteins closely associated with type 2 diabetes mellitus. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses were used to construct metabolic pathway maps and predict therapeutic targets.Results:After 12 months of dapagliflozin treatment, 162 differential metabolites were identified, with 59 upregulated and 103 downregulated. A total of 440 differentially expressed proteins were detected, of which 272 were upregulated and 168 were downregulated. The main classes of differential metabolites included sphingolipids, glycerophospholipids, and glycosphingolipids. Key differentially expressed proteins included importin subunit alpha-11, synemin, Janus kinase 1, and far upstream element-binding protein 2. Correlation analysis revealed 98 shared enriched pathways between differential metabolites and proteins, involving neurotrophin signaling, chemokine signaling, and B cell receptor signaling pathways. Metabolic pathway analysis suggested that dapagliflozin might regulate insulin secretion by modulating glucose-dependent insulinotropic polypeptide, calmodulin-dependent protein kinase, and diacylglycerol levels.Conclusion:Dapagliflozin may exert therapeutic effects in type 2 diabetes mellitus through multiple mechanisms, including the modulation of metabolic and proteomic profiles, participation in key cellular signaling pathways, and regulation of insulin secretion.