ObjectiveThis paper aims to investigate the distribution patterns of traditional Chinese medicine syndromes in patients with chronic hepatitis B （CHB） comorbid with metabolically associated fatty liver disease （MAFLD） and analyze their correlation with clinical characteristics and the progression of liver fibrosis. MethodsA cross-sectional study method was employed， and 506 patients with CHB comorbid with MAFLD who attended the Hepatology Outpatient Department of Public Health Clinical Center of Chengdu from June 2024 to December 2024 were enrolled. General information， traditional Chinese medicine syndromes information， laboratory indicators， and imaging examination results were collected using case report forms （CRF）. Tongue images of patients were acquired using a tongue diagnosis instrument， and tongue feature parameters were extracted using computer image processing technology. Frequency analysis， factor analysis， and cluster analysis， and other methods were used to explore syndrome categories and distribution patterns. Non-parametric tests were used to compare the differences in clinical characteristics among different syndromes. Univariate and multivariate logistic regression analyses were performed to investigate the correlation between traditional Chinese medicine syndromes and the progression of liver fibrosis. ResultsThe main traditional Chinese medicine syndromes in patients with CHB comorbid with MAFLD were mainly dominated by damp-heat accumulation syndrome， liver stagnation and spleen deficiency syndrome， and phlegm-blood stasis syndrome， with damp-heat accumulation syndrome accounting for the highest proportion （41.89%）. Compared with those without damp-heat accumulation syndrome， patients with damp-heat accumulation syndrome had significantly lower tongue proper H value， tongue coating H value， and tongue coating a^* value （P<0.05）， significantly higher tongue coating b^* value （P<0.05）， significantly increased levels of white blood cell （WBC）， red blood cell （RBC）， hemoglobin （HGB）， and glucose （GLU）， increased CAP values （P<0.05）， a higher proportion of males （P<0.05）， and a younger age （P<0.05）. Univariate and multivariate logistic regression analyses show that age， hepatitis B surface antigen （HBsAg）， diabetes， and damp-heat accumulation syndrome are independent risk factors for liver fibrosis （P<0.05）， and that damp-heat accumulation syndrome is predominantly distributed in liver fibrosis stage F0-F1. ConclusionDamp-heat accumulation syndrome is a typical syndrome in patients with CHB comorbid with MAFLD， which is significantly associated with enhanced inflammatory response， metabolic disorders， and early liver fibrosis， and is a key link in disease progression. Clinical attention and early intervention are needed.

ObjectiveThis paper aims to conduct the feature analysis and correlation analysis on the ocular collateral features and differential metabolites in patients with chronic hepatitis B （CHB） complicated by glucose metabolism disorder （GMD），particularly those with the damp-heat syndrome type，by integrating shadowless scleral imaging and metabolomics technologies. MethodsA total of 313 patients were recruited from the Hepatology and Endocrinology Outpatient Departments of Public Health Clinical Center of Chengdu according to the inclusion/exclusion criteria，and they were divided into a CHB group and a CHB complicated by GMD groups （damp-heat syndrome group and non-damp-heat syndrome group）. All patients underwent high-definition ocular image acquisition and feature extraction using an intelligent analysis system for shadowless scleral imaging to analyze the differences in the counting of morphological feature scores of ocular collaterals among groups. By using a digital sampling method，24 patients from each group were randomly selected，along with 20 healthy volunteers，for untargeted metabolomic analysis of peripheral serum. Differential metabolites were identified，statistically analyzed，and subjected to potential biomarker analysis and pathway enrichment. Spearman method was performed to conduct the correlation analysis on the differential ocular collateral features and differential metabolites，followed by correlation network construction. ResultsCompared with those in the CHB group，patients with CHB complicated by GMD showed significant changes in ocular collateral feature scores such as "hillock"，"blood vessels"，and "pale dusky coloration" （P<0.05）. In comparison with those in the healthy group，metabolites including N-acetylglucosamine，acetylhomoserine，and myo-inositol （AUC>0.7） were identified as potential biomarkers for the disease. Compared with those in the CHB complicated by GMD group with non-damp-heat syndrome，patients with damp-heat syndrome exhibited significant changes in feature scores of "plaques"，"yellow coloration"，"spleen"，and "gallbladder" （P<0.05）. In comparison with those in the healthy group，metabolites such as O²′-4a-cyclic tetrahydrobiopterin，theobromine，xanthurenic acid，and L-glutamic acid 5-phosphate （AUC>0.7） were identified as potential biomarkers for the damp-heat syndrome type. The Spearman correlation analysis reveals weak to moderate linear correlations between the differential scleral collateral features and metabolites. By constructing a "disease-syndrome" network of ocular diagnosis and metabolites，"xanthurenic acid-gallbladder" and "theobromine-plaque/yellow coloration" were identified as specific molecular-phenotypic correlated biomarker clusters for CHB complicated by GMD with dampness-heat syndrome. ConclusionPatients with CHB complicated by GMD demonstrate differential ocular diagnostic features and serum metabolites corresponding to disease states and dampness-heat syndrome. These objective biomarkers can guide both clinical syndrome differentiation and medication. The macro-micro integration based on ocular feature clusters and potential metabolic biomarkers offers an innovative approach to a combined traditional Chinese and Western medicine diagnosis and treatment model for this disease.

With the advancement of modern research methods,machine learning(ML)algorithms have been widely applied in traditional Chinese medicine(TCM)diagnosis,transforming subjective syndrome differentiation into a more objective process,thereby providing a feasible pathway for the objectification and quantification of TCM diagnostics.However,challenges persist,including the dual"black-box"nature of disease-syndrome models(lacking interpretability),missing spatiotemporal dynamic data,and the"disconnect"between clinical phenotyping and molecular biomarker research.Focusing on non-alcoholic fatty liver disease(NAFLD),this study proposes a novel framework guided by the biological"multiple-hit"theory and TCM's"disease-syndrome-symptom-stage"approach,which involves:Constructing a mathematical model of NAFLD progression(simple steatosis→steatohepatitis→fibrosis→cirrhosis)via multi-level(phenotypic-cellular-molecular)network modules;And developing an interpretable multidimensional model integrating syndrome-imaging phenomics(macro)and metabolomics-derived biomarkers(micro)to enable personalized NAFLD diagnosis.

With the advancement of modern research methods,machine learning(ML)algorithms have been widely applied in traditional Chinese medicine(TCM)diagnosis,transforming subjective syndrome differentiation into a more objective process,thereby providing a feasible pathway for the objectification and quantification of TCM diagnostics.However,challenges persist,including the dual"black-box"nature of disease-syndrome models(lacking interpretability),missing spatiotemporal dynamic data,and the"disconnect"between clinical phenotyping and molecular biomarker research.Focusing on non-alcoholic fatty liver disease(NAFLD),this study proposes a novel framework guided by the biological"multiple-hit"theory and TCM's"disease-syndrome-symptom-stage"approach,which involves:Constructing a mathematical model of NAFLD progression(simple steatosis→steatohepatitis→fibrosis→cirrhosis)via multi-level(phenotypic-cellular-molecular)network modules;And developing an interpretable multidimensional model integrating syndrome-imaging phenomics(macro)and metabolomics-derived biomarkers(micro)to enable personalized NAFLD diagnosis.

Objective:To analyze the predictive value of combined detection of color ultrasound parameters,coagulation indicators and soluble leukocyte antigen G (sHLA-G) on pregnancy outcomes of patients with threatened abortion after tocolysis. Methods:A total of 100 patients,who met the diagnostic condition of threatened abortion and admitted to Dongguan People's Hospital Xiegang Branch between January 2019 and January 2021,were selected. They were divided into success group and failure group according to pregnancy outcomes after tocolysis,with 50 cases in each group. The color ultrasound parameters,coagulation indicators and sHLA-G levels were measured,and logistic regression and receiver operating characteristic (ROC) curve were used to analyze predictive value of the above indicators on the pregnancy outcomes of patients with threatened abortion after tocolysis. Results:The inner diameter of the yolk sac (5.37±1.02) ml and sHLA-G level (65.37±12.38)U/ml in success group were significantly higher than yolk sac and sHLA-G level in failure group,and the differences were statistically significant (t=12.566,19.989,P<0.05),respectively. The resistance index (RI) and D-dimer (D-D) levels of success group were significantly lower than those of failure group,and the differences were statistically significant (t=20.344,17.603,P<0.05),respectively. The inner diameter of the yolk sac,RI,D-D and sHLA-G were risk factors that affected the pregnancy outcome of patients with threatened abortion after tocolysis (OR=2.349,2.115,2.266,2.21,P<0.05),respectively. The sensitivity,specificity,accuracy and area under curve (AUC) of the combined detection of inner diameter of yolk sac,RI,D-D and sHLA-G in predicting pregnancy outcomes of patients with threatened abortion after tocolysis were 96.00％,98.00％,97.00％ and 0.991,respectively,which were significantly higher than those of the singly each indicator (t=2.514,3.628,4.258,6.134,P<0.05). Conclusion:The combined detection of inner diameter of yolk sac,coagulation indicators and sHLA-G has predictive value for the pregnancy outcomes of patients with threatened abortion after tocolysis. Moreover,the combined detection of inner diameter of yolk sac,RI,D-D and sHLA-G levels can significantly improve the sensitivity,specificity and accuracy of prediction.

Objective:To analyze the predictive value of combined detection of color ultrasound parameters,coagulation indicators and soluble leukocyte antigen G (sHLA-G) on pregnancy outcomes of patients with threatened abortion after tocolysis. Methods:A total of 100 patients,who met the diagnostic condition of threatened abortion and admitted to Dongguan People's Hospital Xiegang Branch between January 2019 and January 2021,were selected. They were divided into success group and failure group according to pregnancy outcomes after tocolysis,with 50 cases in each group. The color ultrasound parameters,coagulation indicators and sHLA-G levels were measured,and logistic regression and receiver operating characteristic (ROC) curve were used to analyze predictive value of the above indicators on the pregnancy outcomes of patients with threatened abortion after tocolysis. Results:The inner diameter of the yolk sac (5.37±1.02) ml and sHLA-G level (65.37±12.38)U/ml in success group were significantly higher than yolk sac and sHLA-G level in failure group,and the differences were statistically significant (t=12.566,19.989,P<0.05),respectively. The resistance index (RI) and D-dimer (D-D) levels of success group were significantly lower than those of failure group,and the differences were statistically significant (t=20.344,17.603,P<0.05),respectively. The inner diameter of the yolk sac,RI,D-D and sHLA-G were risk factors that affected the pregnancy outcome of patients with threatened abortion after tocolysis (OR=2.349,2.115,2.266,2.21,P<0.05),respectively. The sensitivity,specificity,accuracy and area under curve (AUC) of the combined detection of inner diameter of yolk sac,RI,D-D and sHLA-G in predicting pregnancy outcomes of patients with threatened abortion after tocolysis were 96.00％,98.00％,97.00％ and 0.991,respectively,which were significantly higher than those of the singly each indicator (t=2.514,3.628,4.258,6.134,P<0.05). Conclusion:The combined detection of inner diameter of yolk sac,coagulation indicators and sHLA-G has predictive value for the pregnancy outcomes of patients with threatened abortion after tocolysis. Moreover,the combined detection of inner diameter of yolk sac,RI,D-D and sHLA-G levels can significantly improve the sensitivity,specificity and accuracy of prediction.

Objective To explore the influence of Clostridium butyricum on the expression of vascular endothelial cell growth factor (VEGF) and its receptor 2 (VEGFR-2), proliferating cell nuclear antigen (PCNA), and tight junction protein claudin-2 in intestinal tissue in newborn rat with necrotizing enterocolitis (NEC). Methods Forty-eight-hour-old Sprague-Dewley (SD) rats were randomly divided into model group, control group, low-dose group, mid-dose group, and high-dose group, 12 rats each. Rats in each group were fed with milk substitute. The NEC model were created by hypoxia and cold stimulation for 3 consecutive days in model group, low-dose group, mid-dose group, and high-dose group. Meanwhile, low-dose group, mid-dose group, and high-dose group were intervened by being fed with Clostridium butyricum 0.2, 0.4, and 0.8 g/(kg·d), respectively. All rats in each group were sacriifced on day 4 and the intestines tissue was obtained. The pathological changes had been observed. The expression of VEGF, PCNA, and claudin-2 were detected by immunohistochemistry. The expression of VEGFR-2 was detected by RT-PCR. Results The intestines pathological scores was signiifcantly different among ifve groups (P?0 . 05 ). Conclusion The expression of VEGF, VEGF-2 , and claudin-2 were higher in rats with NEC, while the expression of PCNA was lower. Supplementation of Clostridium butyricum may protect newborn rats by its act on these factors.

Objective To determine whether the fixation method of electrode of the improved pediatric video electroencephalogram (VEEG) is better than the traditional fixation method. Methods A total of 746 children patients who needed VEEG monitoring were divided into the experimental group and the control group with random digit table with 373 patients in each group. Improved fixation method and traditional fixation method of electrode were adopted during VEEG monitoring in the experimental group and the control group. The advantage and disadvantage of the two fixation method were compared through evaluation of skin injury of scalp and deltoideus triangularis, electrode loss and electrode breakage. Results The incidence of skin injury of scalp and deltoideus triangularis, electrode loss and electrode breakage in the experimental group were 7, 0, 29, and 12, which were less than 29, 6, 71, and 37 of the control group, the differences were of statistical significance (χ2=14.126, 20.371, 13.652, P<0.01 or 0.05). Conclusions Improved electrode fixation method during pediatric VEEG can avoid skin injury of scalp and deltoideus triangularis, reduce electrode loss and electrode breakage, besides, it also can reduce medical cost and discomfort of children. The modified electrode fixation method proved to be superior to the traditional method and it is worth popularization and application.

Objective:To explore the related risk factors of antepartum depression and anxiety,and to provide the theoretical support for early screening,clinical intervention and prevention of antepartum depression and anxiety.Methods:At the time of 28 weeks of prenatal examination,the Edinburgh Postnatal Depression Scale (EP-DS),Self-Rating Anxiety Scale (SAS)were used to survey 2112 pregnant women who were selected from Maternal and Child Health Hospital of Kunming City.Non conditional logistic regression analysis was used to explore the re-lated risk factors of prenatal depression and anxiety.Results:At the 28 weeks of pregnancy,the detection rate of de-pression symptoms and anxiety symptoms were 25.4% and 6.6%.Logistic regression analysis showed that the risk factors for perinatal depression symptoms were younger age (OR =0.80,95%CI:0.68 -0.94),not stick to work during pregnancy (OR =1.18,95%CI:1.02 -1.36),not satisfied with the living environment (OR =1.50,95%CI:1.23 -1.83),expectations for boys (OR =0.86,95%CI:0.77 -0.96),not only daughter (OR =1.37,95%CI:1.06 -1.76),unplanned pregnancy (OR =1.38,95%CI:1.10 -1.72).The risk factors for perinatal anxiety symp-toms were being not satisfied with the living environment (OR =1.64,95%CI:1.19 -2.26),not harmonious with her husband (OR =2.01,95%CI:1.20 -3.37),unplanned pregnancy (OR =1.50,95%CI:1.05 -2.14).Conclu-sion:It suggests that the pregnant women with younger age,less working during pregnancy,being not satisfied with the living environment,having more expectations for boys,being not only daughter,with unplanned pregnancy are more likely to suffer from antepartum depression;those being not satisfied with living environment,having harmoni-ous relation with her husband,and with unplanned pregnancy are more likely to suffer from antepartum anxiety.

Objective To explore the cooperation of video electroencephalogram (VEEG) and nursing in the use of correcting iatrogenic refractory epilepsy in children.Methods We implemented the following nursing measures:making an appointment to understand the patients' history and seizures; controlling the condition of VEEG seriously to reduce the interference of potential difference; performing the recording of the background wave of the VEEG with eyes test,hyperventilation,flash stimulation and other evoked tests; giving experiment to induce seizure,such as vertical test,hot water stimulation and so on,which was according to the characteristics of children with seizures; informing the parents and children to review the VEEG and perfect the relevant inspection to correct the diagnosis of epilepsy clearly.Results 5 patients in 9 cases had corrected the diagnosis and classification of epilepsy.2 cases who had been diagnosed as BECT (benign childhood epilepsy with centrotemporal spikes) appeared new type of seizure in the course of disease,then we diagnosed the variant of BECT,according to the characteristics of VEEG.2 cases were excluded the diagnosis of epilepsy.Conclusions During application of VEEG in the use of correcting iatrogenic refractory epilepsy in children,we should pay attention to the communication with children and parents,strictly implement monitoring standard,give testing stimulation according to characteristics of children,so that we can get real and satisfying monitoring results.