ObjectiveTo clarify the associations between plasma fibrinogen （Fbg） and volumetric bone mineral density （vBMD） as well as osteoporosis measured by quantitative computed tomography （QCT）， and to explore the role of plasma Fbg in early screening and diagnosis of osteoporosis. MethodsPatients with hypertension who were hospitalized in the Department of Endocrinology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to June 2022 and underwent QCT examinations were included for cross-sectional analysis. The study analyzed the correlation between plasma Fbg and osteoporosis in patients. The diagnostic efficacy of plasma Fbg for osteoporosis was evaluated by the area under the receiver operating characteristic （ROC） curve （AUC）. ResultsTotally 441 subjects were included in the analysis， with an average age of 46.0±14.5 years and a prevalence of osteoporosis of 6.4% （28/441）. As the level of plasma fibrinogen increased， the incidence of osteoporosis significantly increased （P<0.000 1）while the average bone mineral density of L1 and L2 were significantly decreased （P<0.05）. Compared with the first quartile of plasma Fbg（1.99g/L -2.37g/L）， the risk of osteoporosis in the fourth quartile of plasma Fbg （3.67g/L-4.46g/L） increased by 8.85 times after adjusting for related confounding factors. ConclusionThis study found a negative correlation between plasma fibrinogen levels and bone density in patients with hypertension. Plasma fibrinogen levels may serve as a potential screening indicator for osteoporosis， aiding in early diagnosis and therapeutic monitoring. This discovery offers a new perspective for the study of bone metabolic diseases and warrants further investigation.

Objective To analyze the trends in the disease burden of pertussis in China from 1990 to 2021, and to provide a basis for the development of effective prevention and control strategies. Methods Using the 2021 Global Burden of Disease Study (GBD) database, the incidence, mortality, and disability-adjusted life years (DALYs), as well as the age-standardized rates of pertussis in China from 1990 to 2021 were analyzed. Descriptive statistical methods were employed to analyze the characteristics of the pertussis disease burden, and the Joinpoint regression model was used to analyze the trends in pertussis disease burden. Results From 1990 to 2021, the incidence, mortality, and DALYs of pertussis in China decreased from 1 503 800 cases, 10 951 deaths, and 954 900 person-years to 65 400 cases, 548 deaths, and 46 500 person-years, representing a decrease of 95.65%, 95.00%, and 95.13%, respectively. The corresponding age-standardized rates also decreased by 93.58%, 92.47%, and 92.53%, respectively. The Joinpoint regression model revealed a significant downward trend in the age-standardized incidence, mortality, and DALYs rates for pertussis (AAPCs were -8.32%, -9.65%, and -9.58%, respectively, P<0.001). The disease burden was slightly higher in females than in males, with the majority of cases occurring in children under 10 years old, particularly in infants under 1 year old, where the burden was the heaviest. As age increased, the disease burden decreased. Conclusion Between 1990 and 2021, the overall disease burden of pertussis in China showed a significant downward trend, with gender and age differences. Special attention should be given on the prevention and control of pertussis in children under 10 years old, especially in infants under 1 year old.

OBJECTIVE To further standardize the dispensing management standard of intravenous infusion drugs for clinical trials in pharmacy intravenous admixture services （PIVAS）， and provide reference for medical institutions to provide high-quality pharmaceutical services. METHODS Initiated by PIVAS Group， Hospital Pharmacy Professional Committee， Shanghai Pharmaceutical Association， jointly led by Longhua Hospital， Shanghai University of Traditional Chinese Medicine and Shanghai Geriatric Medical Center， a writing group was established by PIVAS experts from multiple medical institutions to discuss the basic requirements and dispensing process of intravenous infusion drugs for clinical trials in PIVAS. The experts from the leading unit sorted out， summarized， analyzed， fed back and revised the opinions， and finally reached Expert Consensus on Dispensing Management of Intravenous Infusion Drugs for Clinical Trials in PIVAS. RESULTS & CONCLUSIONS The main contents of this consensus include information management， operation process， fund management and document management of intravenous infusion drugs for clinical trials in PIVAS. This consensus establishes a more standardized model for dispensing management of intravenous infusion drugs for clinical trials in PIVAS， by standardizing clinical trail drug management operational procedures， accurately recording and preserving drug-related information， with the aim of achieving standardized and meticulous management of PIVAS’s receipt of clinical trial drugs.

Objective To investigate the influencing factors associated with the comorbidity of inflammatory bowel disease (IBD) and depression. Methods A case-control study was conducted based on the ^“Healthcare Big Data Platform^” of a tertiary class-A comprehensive hospital in Shandong Province. IBD comorbid with depression was served as the case group and IBD without depression was served as the control group. Propensity score matching (PSM) was performed by matching the case group with the control group in a ratio of 1:2 according to the age and gender of the patients. Conditional logistic regression model was used to explore the influencing factors associated with the comorbidity of IBD and depression. Results A total of 405 patients with IBD were enrolled in this study, including 270 patients without depression and 135 patients comorbid with depression. The results of conditional logistic regression showed that the use of immunosuppressants (OR=2.84, 95% CI: 1.00-8.07) and glucocorticoids (OR=2.05, 95% CI: 1.17-3.58), dementia (OR=5.20, 95% CI:1.59-17.05), cardiovascular disease (OR=3.58, 95% CI: 1.84-6.98) and cancer (OR=2.63, 95% CI: 1.16-5.95) were associated with the comorbidity of depression and IBD. Conclusion Attention should be paid to the use of immunosuppressants and glucocorticoids in the population of IBD comorbid with depression, and the coexistence of physical diseases such as dementia, cardiovascular disease and cancer. Early prevention and targeted treatment measures should be taken for high-risk populations to reduce their risk of depression and improve their quality of life and health.

Objective To investigate the predictive value of serum lactate dehydrogenase(LDH)level com-bined with high-throughput sequencing in children with severe Mycoplasma pneumoniae pneumonia(SMPP).Methods The clinical data of 99 children with Mycoplasma pneumoniae pneumonia(MPP)admitted to Hua-zhong University of Science and Technology Union Hospital from October 2023 to March 2024 were retro-spectively analyzed.According to the severity of the disease,the children were divided into mild group(33 ca-ses)and severe group(66 cases).Spearman correlation analysis was used for correlation analysis,Logistic re-gression was used to analyze the influencing factors of SMPP,and the receiver operating characteristic(ROC)curve was used to evaluate the value of LDH in predicting SMPP.Results The level of LDH in the severe group was higher than that in the mild group(P<0.05).The results of high-throughput sequencing showed that the proportions of virulence positive and drug resistance gene A2063G mutation in the severe group were higher than those in the mild group(P<0.05).Multivariate Logistic regression analysis showed that LDH level and drug resistance gene A2063G mutation were related to the SMPP(P<0.05).ROC curve analysis showed that LDH combined with high-throughput sequencing detection of drug resistance gene A2063G muta-tion had a high value in predicting SMPP,and the area under the curve was 0.724.Conclusion Serum LDH combined with high-throughput sequencing detection of drug resistance gene A2063G mutation can be used as an effective indicator to predict SMPP.

Objective:To explore the mechanism of Yiqi Huoxue Prescription in regulating ferroptosis in endometriosis through MIR-143-3P targeting.Methods:The adherent purification method was used to culture in vitro the isolated endometrial tissue from patients with endometriosis, both in situ and ectopic. The CCK-8 assay was used to detect cell viability. ELISA was used to detect the levels of Fe 2+, MDA, and reduced GSH, and qPCR was used to detect the mRNA expressions of GPX4 and MIR-143-3P. Female SD rats were randomly divided into five groups: sham-operation group, model group, and Yiqi Huoxue Prescription low -, medium -, high - dosage groups, with 8 rats in each group. An endometriosis rat model was established through surgery. Yiqi Huoxue Prescription low-, medium-, and high- dosage groups were administered the solution at dosages of 6.25, 12.5, and 25 g/kg respectively. The sham-operation group and the model group were given the same volume of normal saline. Administration was done twice a day for four consecutive weeks. The volume and weight of ectopic endometrial lesions in rats were measured. HE staining was used to observe pathological changes in the lesions. Levels of Fe 2+, MDA, and GSH were determined. PCR was used to detect GPX4 and MIR-143-3P mRNA levels, and Western blot analysis was used to assess the protein expressions of solute carrier family 7 member 11 (SLC7A11) and GPX4. Results:Compared with the eutopic endometrial cells, the viability of ectopic endometrial cells was enhanced, and the levels of Fe 2+, MDA, and MIR-143-3P mRNA decreased ( P<0.01), while the levels of GSH and GPX4 mRNA increased ( P<0.01). Compared with the model group, the volume and weight of ectopic lesions were reduced in Yiqi Huoxue Prescription high-dosage group ( P<0.01), levels of MIR-143-3P, Fe 2+, and MDA in ectopic lesions were elevated ( P<0.05 or P<0.01), and GSH and GPX4 mRNA levels, as well as the expression levels of SLC7A11 and GPX4 in ectopic lesions, decreased ( P<0.05 or P<0.01). Conclusion:MIR-143-3P is involved in the regulation of ferroptosis in ectopic endometrial cells, and high-dosage Yiqi Huoxue Prescription may promote ferroptosis in ectopic endometrial cells by up-regulating the expression of MIR-143-3P, thereby reducing the ectopic endometrial lesions in endometriosis rats.

As the most distal branches of the meridian system,tertiary collaterals(sunluo)are morphologically similar to microvessels in western medicine,while Henoch-Sch?nlein purpura(HSP)is a manifestation of systemic vascular inflammation.The discussion in Huang Di Nei Jing(The Yellow Emperor's Inner Classic)regarding tertiary collaterals"draining pathogenic factors and regulating ying-wei"provides valuable theoretical guidance for the traditional Chinese medicine(TCM)treatment of HSP.This article thoroughly analyzes the physiological functions of tertiary collaterals and proposes that the formation of HSP is due to the invasion of pathogenic factors into the tertiary collaterals,leading to the imbalance of ying-wei,heat stasis obstructing the vessels,and blood extravasation,resulting in symptoms such as skin purpura,gastrointestinal bleeding,and joint pain.These symptoms further interfere with the convergence and biochemical processes of ying-wei,causing an imbalance of body fluids and blood.The overflow of body fluids from the tertiary collaterals,unable to return,leads to fluid stagnation.The accumulation of blood stasis and dampness in the kidney collaterals may cause kidney damage,manifesting as hematuria and proteinuria.The pathogenesis at different stages of the disease can be summarized as follows:in the early stage,pathogenic factors invade the tertiary collaterals,causing wei stagnation and ying obstruction;in the middle stage,fire toxin scorches the tertiary collaterals,affecting ying-wei,damaging yang and yin;or damp pathogens invade the lower regions through the tertiary collaterals,affecting the yin organs;in the late stage,deficiency of vital qi and collateral stasis lead to kidney dysfunction.Based on these pathological mechanisms,the treatment principle should focus on"harmonizing pathogenic wind and blood circulation,and unblocking the tertiary collaterals,"aiming to alleviate purpura symptoms,shorten the disease course,promote recovery,and achieve comprehensive prevention and treatment effects.

Objective To explore the correlation between traditional Chinese medicine(TCM)syndromes of chronic gastritis and the indicators of five circuits and six qi,revealing the influence of different congenital qi endowments on TCM syndrome differentiation and providing evidence for individualized treatment.Methods Medical records meeting inclusion/exclusion criteria were collected from the Hospital Information System(HIS)of Rui Bao Street Community Health Service Center in Haizhu District,Guangzhou between January 20,2017 and January 20,2023.Data included age,birth date,and syndrome differentiation.Yearly circuit(Suiyun),celestial control-terrestrial effect(Sitian-Zaiqian)qi,three patterns of five circuits(Wuyun-Sanji),and syndrome patterns were statistically analyzed using Excel for database construction,with SPSS 23.0 for x2 tests and Logistic regression.Results(1)Among 1 882 chronic gastritis patients,spleen-stomach weakness(25.3％,477/1 882)was the most prevalent syndrome,followed by liver-stomach disharmony type,damp-heat in the spleen-stomach type,stomach-yin deficiency type,and stasis obstruction of stomach collateral type(x2=69.950,P=0.000).(2)Significant differences existed in Suiyun(Taijiao,Taigong,Taiyu,Taizhi,Shaogong,Taishang),Sitian-Zaiqian(Shaoyin-Yangming,Taiyin-Taiyang,Yangming-Shaoyin,Taiyang-Taiyin),and Wuyun-Sanji(excessive/insufficient earth/metal/water circuit)distributions among syndromes(P＜0.05 or P＜0.01).(3)For Suiyun-syndrome relationships:Birth in Taijiao/Shaogong years was the high-risk factor for developing chronic gastritis of liver-stomach disharmony type(P＜0.01);Taishang years were associated with stomach yin deficiency type(P＜0.05);Taijiao/Shaogong/Taiyu years were protective against damp-heat in the spleen-stomach type(P＜0.05 or P＜0.01).(4)For Sitian-Zaiqian-syndrome relationships:Jueyin-Shaoyang/Yangming-Shaoyin years linked to spleen-stomach weakness type(P＜0.05);Shaoyang-Jueyin years were correlated with damp-heat in the spleen-stomach type(P＜0.05).(5)For Wuyun-Sanji-syndrome relationships:Insufficient earth/water circuit years were associated with liver-stomach disharmony type(P＜0.05 or P＜0.01);excessive/balanced metal circuit years linked to stomach yin deficiency type(P＜0.05 or P＜0.01);insufficient metal circuit years were correlated with damp-heat in the spleen-stomach type(P＜0.05).Conclusion TCM syndromes of chronic gastritis are influenced by environment-body interactions,disordered visceral function and yin-yang imbalance.Clinical treatment should integrate the varied indicators of five circuits and six qi variations for personalized regimens to improve symptoms and quality of life.

Objective:To describe a novel approach for intractable Meniere's disease exclusively through a transcanal endoscopic ear surgery（TEES）. Methods:This retrospective chart review included patients with intractable Menière's disease who underwent endoscopic transcanal labyrinthectomy in the Department of Otolaryngology Head and Neck Surgery, Guangxi Hospital Division, First Affiliated Hospital, Sun Yat-sen University, between February 2023 and October 2024. The first 70-year-old woman and the other 67-year-old woman, who underwent multiple conservative treatment and chemical labyrinthectomy during outpatient and hospitalization, had frequent vertigo, tinnitus and severe sensorineural deafness. The TEES approach provided a wide exposure of the oval window. The incus and the stapes were removed, expanded the oval window. The perilymph was suctioned, The saccule, utricule, macula utriculi and macula sacculi were removed. The ampulla tissue of the three semicircular canal were destroyed with the right-angle crochet. The oval window was obliterated using the perichondrium of the tragal cartilage and cartilage. Results:Two patients underwent endoscopic transcanal labyrinthectomy, and no intraoperative or postoperative complications were observed. Vertigo was controlled in 2 patients during the follow-up of 6 to 12 months. Two patients complained of total hearing loss after surgery. Conclusion:Even though this study presents a limited number of cases, endoscopic transcanal labyrinthectomy is a promising, safe, and effective procedure in selected cases. Additional studies are needed to determine the risk-benefit profile of this technique.
Humans ; Aged ; Female ; Meniere Disease/surgery* ; Retrospective Studies ; Endoscopy/methods* ; Otologic Surgical Procedures/methods* ; Ear, Inner/surgery* ; Treatment Outcome