Juvenile idiopathic arthritis（JIA）is the most common chronic rheumatic disease in children，with a high rate of subclinical joint inflammation missed by conventional clinical assessment. Musculoskeletal ultrasound is well-suited for pediatric patients but faces challenges such as operator dependence and the complexity of interpreting dynamic skeletal development. Establishing a standardized ultrasound assessment system is essential for promoting the clinical application of Musculoskeletal ultrasound in JIA. This review outlines the evolution of standardized definitions，scanning protocols，and semi-quantitative scoring systems developed by international organizations，including Outcome Measures in Rheumatology（OMERACT），Paediatric Rheumatology European Society（PReS），and Childhood Arthritis and Rheumatology Research Alliance（CARRA）. The progression from foundational OMERACT frameworks to joint-specific protocols like PIUS-knee reflects advances in technical optimization and multi-dimensional validation. Standardized MSUS assessment improves diagnostic sensitivity，enables objective disease activity evaluation，and aids in relapse prediction. Simplified strategies such as MUSICAL enhance clinical feasibility. Future research should emphasize long-term outcome validation，ultrasound-guided treatment strategies，and multi-modal approaches to support precision management of JIA.

Objective To observe the correlations between left atrial myocardial strain and left ventricular function in children with Duchenne muscular dystrophy(DMD).Methods Fifty-one DMD children(DMD group)and 42 healthy one(control group)were prospectively enrolled.The parameters of routine ultrasound and three-dimensional speckle-tracking echocardiography(3D-STE)were compared between groups,and the correlations between left atrial strain parameters and left ventricular function parameters were analyzed.Results The mitral annular lateral wall velocity(e'),left ventricular ejection fraction(LVEF),left atrial ejection fraction(LAEF),left atrioventricular coupling index(LACI),left ventricular global longitudinal strain(LVGLS),left atrial strain during reservoir phase(LASr)and left atrial strain during conduit phase(LAScd)were all lower,while mitral early diastolic peak flow velocity/e'(E/e'),left atrial stiffness index(LASI)and left atrial filling index(LAFI)were higher in DMD group than those in control group(all P＜0.05).In DMD group,LAEF,LASr and LAScd were moderately positively correlated with LVGLS(r=0.409,0.437,0.440,all P＜0.05),LAFI and LASI were weakly negatively correlated with LVGLS(r=-0.207,-0.223,both P＜0.05),while LASr was moderately positively correlated with e'(r=0.419,P＜0.05).Conclusion The left atrial myocardial strain was correlated with left ventricular systolic and diastolic function in DMD children.

Objective To observe the correlations between left atrial myocardial strain and left ventricular function in children with Duchenne muscular dystrophy(DMD).Methods Fifty-one DMD children(DMD group)and 42 healthy one(control group)were prospectively enrolled.The parameters of routine ultrasound and three-dimensional speckle-tracking echocardiography(3D-STE)were compared between groups,and the correlations between left atrial strain parameters and left ventricular function parameters were analyzed.Results The mitral annular lateral wall velocity(e'),left ventricular ejection fraction(LVEF),left atrial ejection fraction(LAEF),left atrioventricular coupling index(LACI),left ventricular global longitudinal strain(LVGLS),left atrial strain during reservoir phase(LASr)and left atrial strain during conduit phase(LAScd)were all lower,while mitral early diastolic peak flow velocity/e'(E/e'),left atrial stiffness index(LASI)and left atrial filling index(LAFI)were higher in DMD group than those in control group(all P＜0.05).In DMD group,LAEF,LASr and LAScd were moderately positively correlated with LVGLS(r=0.409,0.437,0.440,all P＜0.05),LAFI and LASI were weakly negatively correlated with LVGLS(r=-0.207,-0.223,both P＜0.05),while LASr was moderately positively correlated with e'(r=0.419,P＜0.05).Conclusion The left atrial myocardial strain was correlated with left ventricular systolic and diastolic function in DMD children.

Juvenile idiopathic arthritis（JIA）is the most common chronic rheumatic disease in children，with a high rate of subclinical joint inflammation missed by conventional clinical assessment. Musculoskeletal ultrasound is well-suited for pediatric patients but faces challenges such as operator dependence and the complexity of interpreting dynamic skeletal development. Establishing a standardized ultrasound assessment system is essential for promoting the clinical application of Musculoskeletal ultrasound in JIA. This review outlines the evolution of standardized definitions，scanning protocols，and semi-quantitative scoring systems developed by international organizations，including Outcome Measures in Rheumatology（OMERACT），Paediatric Rheumatology European Society（PReS），and Childhood Arthritis and Rheumatology Research Alliance（CARRA）. The progression from foundational OMERACT frameworks to joint-specific protocols like PIUS-knee reflects advances in technical optimization and multi-dimensional validation. Standardized MSUS assessment improves diagnostic sensitivity，enables objective disease activity evaluation，and aids in relapse prediction. Simplified strategies such as MUSICAL enhance clinical feasibility. Future research should emphasize long-term outcome validation，ultrasound-guided treatment strategies，and multi-modal approaches to support precision management of JIA.

The study was aimed to assess the impact of Brucea javanica oil emulsion(BJOE)on the responsiveness of programmed death receptor-1(PD-1)monoclonal antibody to lung adenocarcinoma in mice.The experimental approach involved subcutaneously inoculating Lewis's lung adenocarcinoma(LLC)cells into C57BL/6 mice,which were then divided into four groups:model group,25 ml·kg-1 BJOE group,10 mg·kg-1 PD-1 group,and combination group(25 ml·kg-1 BJOE and 10 mg·kg-1 PD-1).Tumor volume,mass,and inhibition rate were evaluated;the apoptosis within tumor tissue was detected by TUNEL staining;CD4+and CD8+T cell proportions within tumor tissues were analyzed by flow cytometry;the levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)and granzyme B in tumor tissue were measured by enzyme-linked immunosorbent assay(ELISA).Additionally,LLC cells were categorized into a control group and three BJOE treatment groups(10,30,50 μl·ml-1),and programmed death ligand 1(PD-L1)expression in tumor tissues and LLC cells were assessed by Western blotting.Data showed that as compared with the model group,PD-1 monoclonal antibody alone did not significantly alter tumor volume,tumor mass,CD4+and CD8+T cell proportions,cytokine levels(IFN-γ,TNF-α,Granzyme B),or apoptosis in lung cancer-bearing mice.However,BJOE treatment reduced tumor volume and mass,enhanced CD4+and CD8+T cell proportions,increased cytokine levels,and augmented apoptosis(all P<0.05).Furthermore,the combination therapy of BJOE and PD-1 monoclonal antibody yielded significantly greater reductions in tumor volume and mass,with heightened CD4+and CD8+T cell proportions,cytokine levels,and apoptosis compared to either treatment alone(all P<0.05).Both BJOE treatment and the combination therapy significantly upregulated PD-L1 protein expression in tumor tissues compared to the model or PD-1 monoclonal antibody groups(P<0.05).Similarly,BJOE treatment at all tested concentrations significantly increased PD-L1 protein expression in LLC cells as compared to the control group(P<0.05).In conclusion,BJOE could upregulate PD-L1 expression in LLC cells and enhance the sensitivity of lung adenocarcinoma-bearing mice to PD-1 monoclonal antibodies.

Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51％),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06％)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62％(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57％),and intestinal necrosis was considered in 22 cases(22/53,41.51％).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P＜0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P＞0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged ≤1 year,＞1 and ≤3 years,＞3 and ≤7 years and those＞7 years was 66.67％(12/18),33.33％(4/12),36.36％(4/11)and 41.67％(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.

OBJECTIVE To study the clinical characteristics of leflunomide-induced int erstitial pneumonia （Lef-IP），and to provide reference for its clinical diagnosis ，treatment and prevention. METHODS Lef-IP cases published in domestic and foreign journals from January 2004 to June 2021 were collected. Relevant information of patients were extracted and analyzed retrospectively， including basic characteristics ，clinical manifestations ，imaging manifestations ，laboratory examinations ， histopathological examinations ，treatment and outcome. RESULTS A total of 54 Lef-IP patients from case reports of 24 publications were included ，with a median age of 61 years（9-83 years）. Pulmonary symptoms appeared from 3.3 weeks to 132.9 weeks（median time of 14.5 weeks）. Patients with a loading dose of leflunomide have a shorter median time to pulmonary symptoms appearing （7.5 weeks）. The main clinical manifestations were dyspnea （85.2％），cough（57.4％），fever（53.7％）. CT imaging examination showed 19 cases with ground-glass shadow in both lungs ，and 29 cases showed interstitial infiltration in both lungs on chest radiograph；blood gas analysis showed hypoxemia and hypocapnia ；the levels of C-reactive protein and Krebs von Den lungen- 6 （KL-6）increased；histopathological examination mainly showed interstitial pneumonia （8 cases），including 3 cases of diffuse alveolar injury ，4 cases of lymphocytes in bronchoalveolar lavage fluid ，and 1 case of noncaseating granuloma. After discontinued leflunomide and symptomatic treatment （antibiotics，hormones，colecenamine，plasma exchange ），35 patients（64.8％）recovered or improved their lung symptoms. Twelve patients （22.2％）died，and patients with fever may had a higher mortality rate （34.5％， P＝0.02）. CONCLUSIONS The main clinical manifestations of Lef-IP are dyspnea ，cough and fever. Loading doses of leflunomide should be avoided at the beginning of treatment. When lef-IP occurs ，leflunomide is discontinued and corresponding treatment is given，and most of the patients ’pulmonary symptoms can return to normal or be improved.

Objective:To discuss the medical support strategy by summarizing the experience of medical support in Dongfeng landing site.Methods:According to the current situation of medical support at Dongfeng landing site and the practice and experience of previous medical support, a retrospective summary study was conducted.Results:The main methods were summarized: (1) formulate a feasible plan; (2) strictly screen skilled personnel; (3) provide reasonable medicinal materials and equipments; (4) complete the modification of the rescue carrier; (5) attach importance to the training of first aid techniques; (6) strengthen political and ideological education; (7) carry out physical fitness training; (8) seriously participate in actual combat training. Three points of experience were put forward: (1) the importance of thinking and action is the premise of completing the task; (2) the cooperation between training and actual combat is the basis for completing the task; (3) equal emphasis on education and management is the bottom line for completing the task.Conclusions:The medical support experience of the Dongfeng landing site is summarized to provide support and experience for the long-term in-orbit operation of China's space station and on-site medical rescue after the landing of the manned spacecraft.

A 42-year-old female patient who had a fever for 10 days and was suspected of cytomegalovirus infection received IV infusions of ganciclovir 150 mg dissolved in 0.9% sodium chloride injection 100 ml and cefoperazone sodium and tazobactam sodium 2.25 g dissolved in 0.9% sodium chloride injection 100 ml twice daily. Before medication, the patient′s white blood cell count (WBC) was 12.71×10 9/L, platelet count (PLT) was 262×10 9/L, ren blood cell count (RBC) was 2.99×10 12/L, and hemoglobin (Hb) was 84 g/L. Because the patient developed edema 2 days later, the drugs were adjusted to IV infusions of ganciclovir 150 mg dissolved in 0.9% sodium chloride injection 50 ml once daily and piperacillin sodium tazobactam sodium 2.25 g dissolved in 0.9% sodium chloride injection 50 ml twice daily. On day 11 of medication, laboratory tests showed WBC 3.01×10 9/L, 2.32×10 9/L, PLT 92×10 9/L, RBC 2.39×10 12/L and Hb 68 g/L; on day 13 of medication, her WBC was 1.98×10 9/L, PLT was 86×10 9/L, RBC was 2.44×10 12/L, and Hb was 69 g/L. After tracing the patient′s previous medical records, it was learned that the patient had previously experienced mild myelosuppression due to ganciclovir treatment. Then ganciclovir-induced pancytopenia was considered. Ganciclovir was stopped and subcutaneous injections of recombinant human granulocyte stimulating factor injection 200 μg once daily and recombinant human erythropoietin injection 10 000 U once a week were given. Five days later, laboratory tests showed WBC 3.82×10 9/L, PLT 197×10 9/L, RBC 3.12×10 12/L, and Hb 92 g/L. The patient had renal transplantion 3 years ago. According to the level of creatinine clearance rate, overdose of ganciclovir was used in the patient.

A 42-year-old female patient who had a fever for 10 days and was suspected of cytomegalovirus infection received IV infusions of ganciclovir 150 mg dissolved in 0.9% sodium chloride injection 100 ml and cefoperazone sodium and tazobactam sodium 2.25 g dissolved in 0.9% sodium chloride injection 100 ml twice daily. Before medication, the patient′s white blood cell count (WBC) was 12.71×10 9/L, platelet count (PLT) was 262×10 9/L, ren blood cell count (RBC) was 2.99×10 12/L, and hemoglobin (Hb) was 84 g/L. Because the patient developed edema 2 days later, the drugs were adjusted to IV infusions of ganciclovir 150 mg dissolved in 0.9% sodium chloride injection 50 ml once daily and piperacillin sodium tazobactam sodium 2.25 g dissolved in 0.9% sodium chloride injection 50 ml twice daily. On day 11 of medication, laboratory tests showed WBC 3.01×10 9/L, 2.32×10 9/L, PLT 92×10 9/L, RBC 2.39×10 12/L and Hb 68 g/L; on day 13 of medication, her WBC was 1.98×10 9/L, PLT was 86×10 9/L, RBC was 2.44×10 12/L, and Hb was 69 g/L. After tracing the patient′s previous medical records, it was learned that the patient had previously experienced mild myelosuppression due to ganciclovir treatment. Then ganciclovir-induced pancytopenia was considered. Ganciclovir was stopped and subcutaneous injections of recombinant human granulocyte stimulating factor injection 200 μg once daily and recombinant human erythropoietin injection 10 000 U once a week were given. Five days later, laboratory tests showed WBC 3.82×10 9/L, PLT 197×10 9/L, RBC 3.12×10 12/L, and Hb 92 g/L. The patient had renal transplantion 3 years ago. According to the level of creatinine clearance rate, overdose of ganciclovir was used in the patient.