Objective:To evaluate the prognostic value of 18F-fluorodeoxyglucose ( 18F-FDG) PET/CT metabolic parameters in small cell lung cancer (SCLC) . Methods:A retrospective analysis was conducted on the clinical and imaging data of 156 SCLC patients, who underwent 18F-FDG PET/CT imaging and were diagnosed by histopathological examination at Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School from September 2013 to February 2024. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), linear regression slope, area under the curve of cumulative standard uptake value (SUV) volume histogram (AUC-CSH), and coefficient of variation (CV) were calculated using LIFEx software with different SUV thresholds. Univariate and multivariate analyses were performed using Cox proportional hazards model. Patient stratification was based on the critical values determined by receiver operator characteristic (ROC) curve analysis. The survival curve was plotted using the Kaplan-Meier method and log-rank test was performed. Results:Univariate analysis showed that MTV 40% ( HR=2.91, 95% CI: 1.55-5.47, P=0.001), MTV 60% ( HR=2.31, 95% CI: 1.29-4.17, P=0.005), TLG 40% ( HR=2.07, 95% CI: 1.19-3.60, P=0.010), linear regression slope ( HR=0.45, 95% CI: 0.26-0.79, P=0.005), and CV 40% ( HR=0.27, 95% CI: 0.08-0.84, P=0.024) were factors affecting progression-free survival (PFS) in SCLC patients. MTV 40% ( HR=1.98, 95% CI: 1.22-3.22, P=0.005), MTV 60% ( HR=1.80, 95% CI: 1.12-2.88, P=0.015), MTV 80% ( HR=1.71, 95% CI: 1.08-2.74, P=0.024), TLG 40% ( HR=3.68, 95% CI: 1.59-8.49, P=0.002), linear regression slope ( HR=0.49, 95% CI: 0.30-0.80, P=0.004), and AUC-CSH 80% ( HR=0.44, 95% CI: 0.23-0.84, P=0.013) were found to be factors affecting overall survival (OS) in SCLC patients. Multivariate analysis revealed that MTV 40% ( HR=4.76, 95% CI: 1.11-20.50, P=0.036) was an independent factor influencing PFS, and TLG 40% ( HR=3.19, 95% CI: 1.02-9.92, P=0.046) was an independent factor influencing OS in SCLC patients. ROC curve analysis identified the optimal cutoff value for MTV 40% in predicting PFS as 5.5cm 3 and the optimal cutoff value for TLG 40% in predicting OS as 41.5 g in SCLC patients. Survival analysis showed that patients with MTV 40%≤5.5 cm 3 ( n=33) had a median PFS that was not reached, while patients with MTV 40%>5.5 cm 3 ( n=123) had a median PFS of 10.3 months, with a statistically significant difference ( χ2=12.09, P=0.001). For patients with TLG 40%≤41.5 g ( n=35), the median OS was not reached, whereas for TLG 40%>41.5 g ( n=121), the median OS was 31.6 months, with a statistically significant difference ( χ2=10.55, P=0.001) . Conclusions:The 18F-FDG PET/CT metabolic parameter MTV 40% is an independent factor influencing PFS, while TLG 40% is an independent factor influencing OS in SCLC patients. The above two parameters may serve as indicators for assessing the prognosis of SCLC patients.

AIM: To investigate the alterations in corneal aberration and relative refractive power following the reduction of back optic zone diameters(BOZD)of orthokeratology lenses.METHODS: Myopic children aged 8-12 years, deemed suitable and willing to wear orthokeratology lenses, were randomly allocated to wear lenses with a 6.0 mm BOZD or a 5.0 mm BOZD. Data collection included changes in higher-order aberrations, relative refractive power and the treatment zone diameter of the two groups after wearing lenses for 1 d, 1 wk, 1, and 3 mo. The correlation of increase in corneal higher-order aberrations with refractive power was analyzed.RESULTS: The increases in total higher-order aberrations, spherical aberrations and coma aberrations varied over time following lens wear(all P<0.001), and there were no statistically significant differences in the changes of total higher-order aberrations and coma aberrations between the two groups of patients(all P>0.05). A significant difference was observed in the increment of spherical aberrations in the 5 mm range between the two groups of patients, which varied over time(Ftime=40.179, Ptime<0.001; Fgroup=11.948, Pgroup=0.001; Finteraction=3.262, Pinteraction=0.03). A significant difference was observed in the increment of spherical aberrations in the 4 mm range between the two patient groups(Ftime=34.462, Ptime<0.001; Fgroup=13.094, Pgroup<0.001; Finteraction=1.372, Pinteraction=0.25). There was no statistically significant distinction in relative refractive power between the two groups(Fgroup=0.048, Pgroup=0.83; Finteraction=1.208, Pinteraction=0.31); however, relative refractive power changed over time(Ftime=40.030, Ptime<0.001). The difference in treatment zone diameter between the two groups was statistically significant, with changes over time(Ftime=11.212, Ptime<0.001; Fgroup=74.073, Pgroup<0.001; Finteraction=0.312, Pinteraction=0.82). The total higher-order aberrations, spherical aberrations, and coma aberrations in 4, 5 and 6 mm range showed a positive correlation with relative refractive power values(all P<0.001). Statistically significant difference was observed in the axial length between the two groups after wearing lenses for 3, 6 and 12 mo(Ftime=185.398, Ptime<0.001; Fgroup=5.618, Pgroup=0.02; Finteraction=2.315, Pinteraction=0.11).CONCLUSION: Orthokeratology lenses leaded to elevated higher-order aberrations. Orthokeratology lenses with smaller BOZD produced significantly greater spherical aberrations at 4 and 5 mm range and smaller treatment zone diameters. The corneal total higher-order aberration was positively correlated with relative refractive power. Wearing orthokeratology lenses with a smaller BOZD can cause slower axial growth and better myopia control.

Objective: To examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.

As people’s attention to health continues to increase, the market demand for traditional Chinese medicine (TCM) is growing steadily. The quality and safety of Chinese medicinal materials have attracted unprecedented social attention. In particular, the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society. The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM. This not only reflects China’s high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision. Basis on this study, by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detection standards in the Chinese Pharmacopoeia 2025 Edition, deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition. Moreover, it interprets the future development directions of the detection of exogenous residues in TCM, aiming to provide a reference for the formulation of TCM safety supervision policies.

Objective To identify issues and summarize experiences through the analysis and discussion of the current measurement comparison activity, and to improve the radiation detection ability of the social radiation environment detection institutions in Jiangsu Province, China. Methods Fixed measurement points were established. The institutions were assigned to different groups and carried out measurements one-by-one on site. For cosmic ray response value, each institution measured and recorded 50 original data; for γ dose rate in fields, roads, and indoor environments, each reference institution measured and recorded 10 original data. The institutions calculated the monitoring results independently, and the organizer’s expert group checked the results to ensure that there were no calculation errors. Gross errors were eliminated by Grubbs test, and the comparison results were evaluated by Z-score method (median/normalized interquartile range). Results Among the 75 measurement results (excluding the cosmic ray response values), 94.7% were rated as “satisfactory”, 5.3% as “problematic”, and none as “unsatisfactory”. The “problematic” results involved two FH40G γ radiation dose rate meters and one AT1121 γ radiation dose rate meter. Conclusion The cosmic ray response value of the instrument does not necessarily affect the comparison and evaluation of environmental γ radiation dose rate measurement results. AT1121 γ radiation dose rate meter may not be suitable for measuring the air-absorbed dose rate of γ radiation in general environment.

Ischemic heart disease (IHD) is associated with high morbidity and mortality rates. Reperfusion therapy is the best treatment option for this condition. However, reperfusion can aggravate myocardial damage through a phenomenon known as myocardial ischemia/reperfusion (I/R) injury, which has recently gained the attention of researchers. Several studies have shown that Chinese herbal medicines and their natural monomeric components exert therapeutic effects against I/R injury. This review outlines the current knowledge on the pathological mechanisms through which mitochondria participate in I/R injury, focusing on the issues related to energy metabolism, mitochondrial quality control disorders, oxidative stress, and calcium. The mechanisms by which mitochondria mediate cell death have also been discussed. To develop a resource for the prevention and management of clinical myocardial I/R damage, we compiled the most recent research on the effects of Chinese herbal remedies and their monomer components.

ObjectiveTo explore the establishment of performance assessment indicators for the classification and grading of public health staff in district-level Centers for Disease Control and Prevention (CDCs), and to provide a basis for such evaluations. MethodsThrough literature review and group interviews, performance evaluation indicators were developed based on competency evaluation. Experts were invited to evaluate the weight of performance evaluation indicators for public health staff from different categories, with the average value used to represent the weight of each indicator. ResultsTwenty-nine experts from universities in Shanghai, municipal CDCs, and district CDCs participated, yielding an expert authority coefficient of 0.86. The performance evaluation indicators for department managers were categorized into three levels, with 4 indicators at the primary level, 16 indicators at the secondary level, and 42 indicators at the tertiary level, while those for general staff included 4 primary indicators, 15 secondary indicators, and 36 tertiary indicators. Significant differences were observed in the weight coefficients of the primary indicators (internal operations, professional work, and learning and growth) between department managers and general staff. The top three secondary indicators for department managers were department management, monitoring and prevention, and level of expertise. For mid-level and senior staff, the top three secondary indicators were monitoring and prevention, level of expertise, and research work. The top three secondary indicators for junior staff were monitoring and prevention, professional expertise, and professional attitude. No significant statistical differences were found among tertiary indicators. ConclusionThe developed performance evaluation indicators are reliable. Staff at different levels and classifications should be evaluated using different performance evaluation standards to accurately reflect individual performance and contributions.

Objective: To explore the correlation and lag effects of environmental factors on pediatric respiratory disease visits at hospital, so as to provide scientific basis for disease prediction and optimizing clinical diagnosis and treatment. Methods: Data from 503 889 pediatric respiratory disease outpatient and emergency visits a central hospital in Minhang District of Shanghai between 2017 and 2019, along with concurrent meteorological data were collected. A distributed lag non-linear models (DLNM) was constructed to explore the specific relationship between pediatric respiratory disease consultations and various environmental factors and to quantify the cumulative lag effects of environmental factors on respiratory disease consultations. Results: Among the environmental factors, temperature, fine particulate matter (PM 2.5 ), inhalable particulate matter (PM 10 ), nitrogen dioxide (NO 2), and sulfur dioxide (SO 2) were associated with pediatric respiratory disease visits. After adjusting for temperature, PM 2.5 and PM 10 concentrations did not show significant immediate or lag effects. The relative risk (RR) of pediatric respiratory disease visits increased with rising NO 2 concentrations. When NO 2 concentration ≥55 μg/m 3, significant immediate and lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.05, 1.13, 1.17, and 1.21( P <0.05). The RR values showed an inverted “U” shaped relationship with SO 2 concentrations. When SO 2 concentration ≥5 μg/m 3, significant lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.03 , 1.03, and 1.04 ( P <0.05). Conclusion High concentrations of NO 2 and SO 2 increase the risk of pediatric respiratory disease visits, with observable lag effects.

OBJECTIVE: To evaluate the effectiveness of double joystick technique assisted closed reduction and Kirschner wire internal fixation in the treatment of Gartland type Ⅲ supracondylar fractures of the humerus (SCFH) in children. METHODS: A retrospective study was conducted on 28 cases of Gartland type Ⅲ SCFH with complete data available, who underwent closed reduction and Kirschner wire internal fixation with the double joystick technique between August 2022 and July 2024. There were 23 boys and 5 girls, with an average age of 6.4 years (range, 1-12 years). All fractures resulted from falls and were classified as extension-type. X-ray film showed the radial displacement of the distal fragment in 15 cases and unlar displacement in 13 cases. The interval from injury to operation was 3-36 hours (mean, 19.5 hours). X-ray film re-examination was conducted to evaluate the fracture healing, and the Baumann angle of affected elbow joint and carrying angle of bilateral elbow joints were measured. Elbow joint function was evaluated using the range of motion (flexion and extension) and the Flynn criteria. The above indicators were compared between affected and healthy sides. RESULTS: All operation were successfully completed. The operation time ranged from 15 to 40 minutes (mean, 25.2 minutes). The length of hospital stay was 2-5 days (mean, 3.5 days). All patients were followed up 3-24 months (mean, 11.8 months). X-ray film confirmed fracture healing in all patients, with a mean healing time of 5.4 weeks (range, 4-6 weeks). At last follow-up, the Baumann angle of the affected elbow joint was (73.50±3.46)°, and the carrying angle and the range of motion in flexion and extension of the affected elbow joint were significantly less than the contralateral side (P<0.05). According to the Flynn criteria, the elbow joint function of the affected elbow was evaluated as excellent in 25 cases and good in 3 cases, with an excellent and good rate of 100%. CONCLUSION The double joystick technique is a safe and effective method which can facilitate the closed reduction and Kirschner wire internal fixation of Gartland type Ⅲ SCFH in children without increasing risk of complications.
Humans ; Male ; Female ; Humeral Fractures/diagnostic imaging* ; Fracture Fixation, Internal/instrumentation* ; Child ; Retrospective Studies ; Bone Wires ; Child, Preschool ; Fracture Healing ; Treatment Outcome ; Infant ; Elbow Joint/physiopathology* ; Range of Motion, Articular ; Closed Fracture Reduction/methods*

BACKGROUND:At present,there are many clinical studies on dysphagia,but little is known about the stress of bones and hyoid muscles caused by dysphagia.OBJECTIVE:To establish a three-dimensional model of swallowing musculoskeletal system to investigate the stress changes of hyoid and suprahyoid muscles during swallowing.METHODS:A healthy adult male was selected for head and neck CT scanning.A three-dimensional model was constructed by image extraction method.According to hyoid motion,the lowest and highest positions of hyoid were set,and the muscle strength of suprahyoid muscles was successively loaded to observe the stress influence of suprahyoid muscles on hyoid under physiological state.By changing the material properties of muscles,we simulated different degrees of dysphagia and observed the stress changes of suprahyoid muscle group under the condition of dysphagia.RESULTS AND CONCLUSION:(1)The finite element models including C2-C4 vertebrae,partial temporal bone,mandible,hyoid,and mylohyoid-geniohyoid muscle were established,which could reflect the displacement of hyoid and stress changes during swallowing.(2)Under physiological conditions,among suprahyoid muscles,mylohyoid muscle had the greatest influence on hyoid stress,followed by digastric muscle,geniohyoid muscle,and stylohyoid muscle.(3)By simulating different degrees of dysphagia,it was found that with the increase of the severity of dysphagia,the stress of suprahyoid muscles gradually increased.(4)These findings conclude that among suprahyoid muscles,mylohyoid muscle and digastric muscle have the greatest influence on hyoid stress,which suggests the importance of specific muscle stimulation.The aggravation of dysphagia was positively correlated with the stress change of suprahyoid muscles,which could provide a biomechanical reference for the mechanism study and clinical diagnosis and treatment of dysphagia.