Objective: To explore the association between warning signs of psychological and behavioral development problems with emotional and behavioral problems in preschool children in Bao an District, Shenzhen, so as to provide an empirical basis for optimizing psychological screening strategies in kindergartens. Methods: From September 2023 to August 2024, a total of 49 804 preschool children aged 4-6 years from all 401 kindergartens in Bao an District were enrolled as study subjects. The Warning Signs Checklist for Screening Psychological, Behavioral and Developmental Problems of Children and the parent version of the Strengths and Difficulties Questionnaire (SDQ) were used to assess children s developmental status and emotional and behavioral problems, respectively. Multivariable Logistic regression analysis was used to examine the association between warning signs and emotional and behavioral problems, stratified by sex. Results: The overall positive screening rate for developmental warning signs was 1.5%, and the detection rate for high risk in the SDQ total difficulties score was 6.3%. Multivariable Logistic regression analysis revealed that after adjusting for age, children who screened positive for warning signs exhibited a significantly higher risk of elevated SDQ total difficulties and subscale scores compared to those who screened negative, across both sexes (a OR boys =1.66-13.42, a OR girls =2.04-22.15, all P <0.01). The only exceptions were gross motor skills and conduct problems in boys, and personal social skills and conduct problems in girls. Notably, abnormalities in the personal social domain demonstrated the strongest association with emotional/behavioral problems (a OR boys =7.72-13.42, a OR girls =3.88-22.15), followed by the language domain (a OR boys =4.63-9.23, a OR girls =3.78-14.41) (all P <0.01). Conclusion A positive screening result for warning signs, particularly in the personal social and language domains, serves as a strong indicator of emotional and behavioral problems in preschool children.

Objective To investigate the early clinical efficacy of a 3D-printed external fixation guide combined with video-assisted thoracic surgery (VATS) in the treatment of flail chest, and to provide evidence for its clinical application. Methods Patients with flail chest admitted to Xiamen University Affiliated Chenggong Hospital between January 2010 and January 2023 were retrospectively selected as the study subjects. Based on the surgical methods, the patients were divided into two groups: patients treated with the 3D-printed external fixation guide combined with VATS were assigned to a 3D group, and those who underwent open reduction and internal fixation were assigned to an internal fixation group. The operative time, intraoperative blood loss, duration of chest tube drainage, recovery of thoracic volume, visual analogue scale (VAS) scores at 1 month postoperatively, and complications were compared between the two groups. Results A total of 40 patients were included, with 20 patients in each group. The 3D group consisted of 13 males and 7 females, with a mean age of (45.7±3.8) years; the internal fixation group consisted of 14 males and 6 females, with a mean age of (47.3±4.1) years. There were no statistical differences between the two groups in terms of gender, age, number of rib fractures, or preoperative VAS scores (P>0.05). The surgeries were performed successfully in both groups, primary wound healing was achieved in all patients, and pain symptoms were significantly alleviated compared to preoperation. No postoperative complications occurred in the 3D group, whereas 1 patient each of chronic postoperative pain, fracture malunion, and incision infection occurred in the internal fixation group, resulting in a complication rate of 15.0%. The operative time, intraoperative blood loss, and duration of chest tube drainage in the 3D group were significantly shorter or less than those in the internal fixation group (P<0.05). There were no statistical differences in the recovery of thoracic volume or the VAS scores at 1 month postoperatively between the two groups (P>0.05). Conclusion The early clinical efficacy of a 3D-printed external fixation guide combined with VATS in the treatment of flail chest is satisfactory. This technique offers the advantages of being minimally invasive, highly efficient, promoting rapid recovery, and resulting in fewer postoperative complications, and can effectively reconstruct the thoracic contour and restore thoracic volume.

Objective To explore the potential mechanism of Polygonum cuspidatum in alleviating silicosis using network pharmacology, molecular docking, and experimental validation. Methods i) The targets of active components of Polygonum cuspidatum and silicosis-related targets were retrieved from multiple databases. The overlapping targets were imported into Venny2.1.0 and STRING platforms. "Polygonum cuspidatum-active components-potential therapeutic targets for silicosis" network was constructed and core targets of Polygonum cuspidatum that can alleviate silicosis were identified using the Cytoscape3.10.2 software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using the DAVID database, and molecular docking was conducted with AutoDock software. ii) Human embryonic lung fibroblast MRC-5 cells were divided into three groups. Cells in the control group were cultured in high-glucose Dulbecco's modified Eagle's medium containing 10.00% (V/V)fetal bovine serum. Cells in the silica group were treated with silica suspension at a final concentration of 150 μg·cm² (equivalent to 75 mg/L) for 48 hours. Cells in the silica + β-sitosterol group were first treated with silica suspension for 24 hours, then were cultured in medium containing β-sitosterol at a mass concentration of 50 μg/L for another 24 hours. Immunofluorescence assay and Western blotting were used to detect the effects of β-sitosterol, a core component of Polygonum cuspidatum, on the expression of phosphorylated protein kinase B (p-AKT), B-cell lymphoma-2 (BCL-2), and α-smooth muscle actin (α-SMA) in cells. Results i) A total of ten main active components of Polygonum cuspidatum, 840 targets of the active components, and 231 potential therapeutic targets for silicosis were screened through retrieval. A total of 10 core therapeutic targets were further screened, including tumor protein p53, serine/threonine protein kinase B1 (AKT1), heat shock protein 90-α, interleukin (IL)-6 , tumor necrosis factor, Src tyrosine kinase, estrogen receptor 1, epidermal growth factor receptor, BCL-2, and IL-1β. KEGG enrichment analysis yielded 178 related target pathways, among which, the phosphatidylinositol 3-kinase-protein kinase B (PI3K/AKT) signaling pathway was most relevant to silicosis. Molecular docking results showed that the top five compounds of Polygonum cuspidatum with high degree centrality, including quercetin, luteolin, physovenine, rhein, and β-sitosterol, had strong binding affinities with core targets. Among them, β-sitosterol, a key component of Polygonum cuspidatum, ranked high in binding affinity to all core targets. Molecular docking visualization indicated that β-sitosterol ranked high in binding affinitiy with the core target proteins AKT1 and BCL-2. ii) Both immunofluorescence and Western blotting results showed that, the relative expression of p-AKT, BCL-2, and α-SMA proteins increased in MRC-5 cells of the silica group compared with the control group (all P<0.05), except for p-AKT detected by Western blotting. Compared with the silica group, the relative expression levels of p-AKT, BCL-2, and α-SMA proteins in the silica+β-sitosterol group decreased (all P<0.05). Conclusion β-sitosterol, the core component of Polygonum cuspidatum, may alleviate silicosis fibrosis via the PI3K/AKT signaling pathway.

Objective:To investigate the relationship between the longitudinal trajectory of perioperative changes in TSH and recovery after microwave ablation of benign thyroid nodules.Methods:251 BTN patients admitted to our hospital from October 2021 to October 2024 were selected as the study subjects,and the group-based trajectory mod-eling(GBTM)model grouping principle was applied to determine the development trajectory of TSH levels.Multiple lin-ear regression was used to analyze the relationship between thyroid function and serum inflammatory factors before and after surgery in patients with different TSH level development trajectories;Cox regression was used to analyze the relationship between TSH level change trajectories and therapeutic efficacy and trend test was performed;binary log-binomial regression model was applied to calculate the relative risk(RR)of postoperative complication rates in different groups of patients.Results:In patients with BTN,four different trajectories of TSH level development were identified:low-stable(90 cases),low-growth(47 cases),medium-growth(63 cases),and high-growth(51 cases).There was a sta-tistically significant difference in surgical efficacy between the developmental trajectories of different TSH levels(P＜0.05),and the low-stable type had the highest apparent and overall efficacy rates,followed by the low-growth type.The postoperative and preoperative thyroid function indexes and serum inflammatory factors of patients with different TSH level development trajectories showed statistical differences(P＜0.05),the postoperative index levels of FT3 and FT4 were lower than preoperative,and the postoperative index levels of IL-8,hs-CRP,and TNF-α were higher than the preoperative ones,and the postoperative indexes of thyroid function(FT3,FT4)and serum inflammatory factors of the four groups of patients(IL-8,hs-CRP,TNF-α)showed statistically significant differences(P＜0.05).The results of multiple linear regression showed that TSH levels were negatively correlated(P＜0.05)with thyroid function indices(FT3,FT4)and positively correlated(P＜0.05)with serum inflammatory factors(IL-8,hs-CRP,TNF-α).The results of COX re-gression analysis showed that the difference in trend test was statistically significant(P＜0.001)among low-growth,medium-growth,and high-growth types,using low-stable type as a reference.The difference in the total postopera-tive complication rate among the four groups was statistically significant(P＜0.05),and the risk of total postoperative complications was elevated in patients with low-growth,medium-growth,and high-growth types compared with low-stable types(RR>1,P＜0.05).Conclusion:TSH levels were closely associated with recovery after microwave ablation of benign thyroid nodules,TSH levels were negatively correlated with FT3 and FT4,and positively correlated with IL-8,hs-CRP,and TNF-α.The low-stabilized type had the highest apparent and total efficiency,followed by the low-growth type.

Lens injury is an important etiological factor in the reduction of visual function following ocular trauma.Currently, there are no clear standards for the classification of lens injury, and comprehensive diagnostic tools are lacking.This deficiency leads to numerous controversies and challenges in critical areas, such as diagnosis and preoperative evalution, timing of surgery, surgical strategy, and assessment of postoperative prognosis.Tomographic imaging technology, such as computed tomography, magnetic resonance imaging, optical coherence tomography, has introduced a new dimension to the evaluation of lens injury, which is crucial for assessing the transparency, texture, location, morphology, and integrity of the lens, as well as the zonules and nearby intraocular structures.However, the use of tomographic imaging technology is somewhat limited due to the limitations of relying on a single method.With the ongoing advancement of imaging technologies and the rapid development of big data and artificial intelligence, tomographic imaging will become an increasingly essential tool in the future management of lens injury.Our expert group reviewed the epidemiological characteristics and classification of lens injury and the major challenges currently faced in the diagnosis and treatment of lens injury, and provided expert recommendations mainly focusing on the application, shortcomings and limitations of current tomographic imaging technology in the diagnosis and treatment of lens injury, and future development directions.

A 55-year-old male patient received immunotherapy combined with chemotherapy regimen(intravenous infusions of tislelizumab 200 mg on day 1, paclitaxel protein-bound 470 mg, and carboplatin 500 mg on day 1) after surgery for left upper lung squamous cell carcinoma, with 21 days as a treatment cycle. After more than half a month of medication in the 1st cycle, the patient developed multiple symmetrical purple red bruises on both lower limbs, which did not fade when pressed. The purple red bruising disappeared the next day after treatment with anti-allergic drugs. After 3 days of medication in the 3rd cycle, the patient developed a large number of scattered red papules on both lower limbs, protruding from the surface of the skin and accompanied by itching, a small number of red papules were scattered on both upper limbs and the face; after 15 days, the patient felt poor appetite; after 16 days, the patient experienced abdominal pain accompanied by vomiting and loose yellow stool. Laboratory tests showed a blood creatinine level of 204 μmol/L and occult blood in urine (+++). Pathological examination of skin tissue at the lesion site of the patient suggested IgA vasculitis (IgAV). After excluding other factors such as primary disease and infection, it was considered that the IgAV was probably related to tislelizumab. Tislelizumab was discontinued, anti-allergic and anti-inflammatory drugs, and glucocorticoid were given. After 2 weeks of treatments, the skin purpura gradually disappeared, and the abdominal pain and renal function indicators were improved. After fully aware of the risks, the patient was restarted tislelizumab immunotherapy combined with chemotherapy, and anti-allergic drugs were add at the same time. IgVA did not recur.

This study analyzed the epidemiological characteristics and trends of respiratory syncytial virus (RSV) infections among inpatients with acute respiratory infections (ARI) in a children′s hospital in Shenzhen City inpatients from 2020 to 2023. From January 2020 to December 2023, multiple reverse transcription polymerase chain reaction (RT-PCR) combined with capillary electrophoresis fragment analysis technology was used to detect the nucleic acids of 12 respiratory pathogens, including RSV, in hospitalized children diagnosed with ARI. The patients were divided into six age groups: 0 to <6 months, 6 months to <1 year, 1 to <2 years, 2 to <5 years, 5 to <10 years, and 10 to <18 years. A total of 53 033 children were tested, including 6 830 RSV positive cases, with an overall positivity rate of 12.88%. The annual RSV positivity rates from 2020 to 2023 were 20.04%, 16.18%, 4.89%, and 13.33%, respectively, with statistically significant differences between the years ( χ2=1 185.994, P<0.001). The positive rate of RSV detection decreased with increasing age across all years (all P trend<0.05). From 2020 to 2023, the proportion of RSV-positive cases aged 2 to 5 years and older showed an increasing trend ( P trend<0.001 for all years). Compared to 2023, the median age of RSV-infected children was lower in 2020 ( Z=7.826, P<0.001) and 2021 ( Z=6.106, P<0.001). The proportion of severe infections requiring ICU admission did not change significantly across all years ( χ2=0.179, P=0.981). The RSV epidemic season in 2020 mainly occurred during 28-43 weeks, and in 2021, it spanned from 22-43 weeks. However, in 2022, the season was delayed until the 49th week and lasted for three weeks. In 2023, the seasonal epidemic appeared earlier, starting in the 14th week and lasting for 28 weeks. From 2020 to 2023, the rate of RSV co-infections with other pathogens (mycoplasma pneumoniae, human parainfluenza virus, human bocavirus, human coronavirus, human metapneumovirus, and influenza A) significantly increased (all P trend<0.01). In conclusion, the epidemiological characteristics of RSV infections in Shenzhen Children′s Hospital changed from 2020 to 2023. In 2022, there were only delayed, low-intensity and short-lived seasonal epidemics. However, in 2023, there was an earlier and prolonged epidemic, with increased infections in children aged 2 to 5 years and older and a rise in co-infections, while the proportion of severe infections requiring ICU admission remained unchanged.

Dendrobium is the largest genus of the Orchidaceae family.The fresh and dried stems of many species of this genus have been used as Shihu(Dendrobii Caulis)in traditional Chinese medicine,it is known as the foremost of the"Nine Great Herbs of China".Ancient texts highlight its uses for"strengthening yin,enhancing essence,nourishing the five viscera,alleviating fatigue,and dispelling skin heat and prickly heat".Modern research confirms that the polysaccharides and alkaloids it contains have antiviral ef-fects,it can apply in treating immunodeficiency caused by viral infections clinically.While studies are gradually uncovering the antivi-ral mechanisms and material basis of Dendrobium,the lack of systematic analysis and organization has hindered its resource develop-ment.The paper employed CiteSpace software for bibliometric analysis of Chinese and English literature on Dendrobium.It reviewed the herbalism,material basis,and mechanisms of its antiviral properties building upon the systematic review of ancient materia medica and modern literature.Results indicate that Dendrobium can boost vital energy and resist pathogens,showing great potential in antiviral drug development.

Objective:Based on the background of high-quality development,we analyze the operational efficiency of traditional Chinese medicine(TCM)hospitals in China's Yangtze River Economic Belt in 2021 and explore the impact of external environmental factors on operational efficiency,so as to provide a reference for promoting the high-quality development of TCM hospitals in the Yangtze River Economic Belt.Methods:The three-stage DEA model was used to analyze the operational efficiency of TCM hospitals in 11 provinces and cities in the Yangtze River Economic Zone in China in 2021.Results:After three-stage DEA analysis,the values of comprehensive efficiency,pure technical efficiency and scale efficiency of TCM hospitals in China's Yangtze River Economic Belt are 0.976,0.986 and 0.990,respectively.5 provinces and cities,Shanghai,Jiangsu,Hunan,Chongqing and Guizhou,are efficient before and after the adjustment,and the comprehensive efficiency of Zhejiang,Anhui,Hubei,Jiangxi,Sichuan and Yunnan have increased compared with that before the adjustment.Ranking of the average value of the comprehensive efficiency of TCM hospitals operation in the three major city clusters of the Yangtze River Economic Belt after adjustment:Chengdu-Chongqing city cluster(0.998)>city cluster in the Yangtze River Delta(0.964)>city cluster in the middle reaches of the Yangtze River(0.962).Conclusion:The operational efficiency of TCM hospitals in the Yangtze River Economic Zone has been underestimated,and the comprehensive efficiency is mainly affected by scale efficiency;there are differences in the operational efficiency of TCM hospitals in the three major urban agglomerations,and balanced development is needed between regions;the operational efficiency of TCM hospitals is affected by the external environment,and it is necessary to improve the external environment;it is necessary to strengthen the construction of digital and informatization of TCM,and to pay attention to the role of talents in TCM,so as to promote the high-quality development of TCM hospitals.

Dendrobium is the largest genus of the Orchidaceae family.The fresh and dried stems of many species of this genus have been used as Shihu(Dendrobii Caulis)in traditional Chinese medicine,it is known as the foremost of the"Nine Great Herbs of China".Ancient texts highlight its uses for"strengthening yin,enhancing essence,nourishing the five viscera,alleviating fatigue,and dispelling skin heat and prickly heat".Modern research confirms that the polysaccharides and alkaloids it contains have antiviral ef-fects,it can apply in treating immunodeficiency caused by viral infections clinically.While studies are gradually uncovering the antivi-ral mechanisms and material basis of Dendrobium,the lack of systematic analysis and organization has hindered its resource develop-ment.The paper employed CiteSpace software for bibliometric analysis of Chinese and English literature on Dendrobium.It reviewed the herbalism,material basis,and mechanisms of its antiviral properties building upon the systematic review of ancient materia medica and modern literature.Results indicate that Dendrobium can boost vital energy and resist pathogens,showing great potential in antiviral drug development.