Pegylated interferon α-2b （PEG-IFN-α-2b） is currently a first-line drug for the treatment of chronic hepatitis B virus infection and is widely used in clinical practice. This drug has multiple effects of inhibiting viral replication， regulating immunity， and improving liver function， and some patients can achieve clinical cure. However， it often causes various adverse reactions during treatment， which are important factors for compromising treatment compliance and efficacy. This article systematically reviews the adverse reactions and their mechanisms during PEG-IFN-α-2b therapy for chronic hepatitis B， including influenza-like symptoms， peripheral blood cytopenia， thyroid dysfunction， and neuropsychiatric symptoms， and it also summarizes the monitoring and management strategies for these adverse reactions， in order to provide evidence-based guidance for clinical decision-making and emphasize the importance of individualized treatment.

Lung cancer is the cancer with the highest incidence of morbidity and mortality in the world, and the number of lung cancer cases in China is also increasing year by year, which seriously threatens the life and health of human beings. Circulating tumor cells (CTCs) refer to the tumor cell that falls off from primary tumor tissue or metastatic focus into the peripheral blood, which is the key to tumor metastasis. Currently, there are various methods for CTCs testing, each with its own advantages and disadvantages. In recent years, there have been numerous studies on the application of CTCs in lung cancer around the world. Further exploration of the progress of clinical application of CTCs in lung cancer can provide a new basis for the role of CTCs in early diagnosis, efficacy assessment and prognostic monitoring of lung cancer.

Objective:To investigate the distribution characteristics of TCM syndromes in patients with diabetic nephropathy (DN) and their relationship with microinflammatory status and nutritional status.Methods:A retrospective study. Gender, age, TCM syndrome types, chronic kidney disease (CKD) staging, nutritional status and other medical records of 302 patients with DN from January 2021 to October 2024 in Affiliated Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine were collected and retrospectively analyzed. The neutrophil count and lymphocyte count were detected by automatic blood cell analyzer, and the neutrophil lymphocyte ratio (NLR) was calculated; the levels of IL-1β and IL-10 were detected by ELISA; malnutrition inflammation score (MIS) was used to evaluate nutritional status. Cramer's V and Eta2 correlation coefficient were used to analyze the correlation between TCM syndrome types and CKD stage, micro inflammatory state and nutritional status in patients with DN. Results:Among the 302 patients, the primary syndromes in descending order were qi-yin deficiency (106 cases), spleen-kidney deficiency (94 cases), liver-kidney yin deficiency (71 cases), and yin-yang deficiency (31 cases). The associated syndromes in descending order were blood stasis (75 cases), phlegm-stasis (66 cases), dampness-turbidity (62 cases), damp-heat (52 cases), and none (47 cases). The top three combined syndromes were spleen-kidney deficiency with damp-heat, qi-yin deficiency with blood stasis, and qi-yin deficiency with phlegm-stasis. For primary syndromes, CKD stage I was mainly qi-yin deficiency and liver-kidney yin deficiency; stage Ⅱ, qi-yin deficiency and liver-kidney yin deficiency; stage Ⅲ, qi-yin deficiency and spleen-kidney deficiency; stage Ⅳ, spleen-kidney deficiency. Differences across CKD stages were statistically significant ( χ2=86.08, P<0.001). For associated syndromes, CKD stage Ⅰ was mainly none; stage Ⅱ and Ⅲ, blood stasis; stage Ⅳ, dampness-turbidity, with statistical significance ( χ2=58.92, P<0.001). NLR and IL-1β levels in yin-yang deficiency, spleen-kidney deficiency, and liver-kidney yin deficiency were higher than in qi-yin deficiency, while IL-10 levels were lower ( P<0.05); for associated syndromes, dampness-turbidity showed higher NLR and IL-1β and lower IL-10 compared with blood stasis and phlegm-stasis ( P<0.05). There was statistical significance in the distribution of DN patients with different syndrome types and nutritional status ( χ2=75.16, P<0.001); there was no statistical significance in the distribution of patients with different syndrome types and nutritional status ( χ2=13.93, P>0.05). Qi-yin deficiency and liver-kidney yin deficiency were mainly mildly malnourished, while spleen-kidney deficiency and yin-yang deficiency were mainly moderately malnourished. Cramer's V/ Eta2 analysis indicated that primary TCM syndromes were correlated with CKD stage, nutritional status (Cramer's V values were 0.308, 0.288), NLR, IL-1β, IL-10 ( Eta2 values were 0.865, 0.984, 0.916) ( P<0.001), while associated syndromes were correlated with CKD stage (Cramer's V=0.255), NLR, IL-1β, and IL-10 ( Eta2 values were 0.891, 0.958, 0.908) ( P<0.001). Conclusions:DN patients is mainly qi-yin deficiency syndrome, and blood-stasis syndrome. The TCM syndrome type is mainly spleen-kidney deficiency and damp-heat syndrome, and the TCM syndrome type is related to micro inflammatory state and nutritional status.

Background::High body mass index (BMI) results in decreased fecundity, and women with high BMI have reduced rates of clinical pregnancy and live birth in in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Meanwhile, ovarian responses show great heterogeneity in patients with a high BMI. This study aimed to analyze the effects of a high BMI on IVF/ICSI outcomes in the Chinese female with normal ovarian response. Methods::We performed a retrospective cohort study comprising 15,124 patients from the medical record system of the Reproductive Center of Peking University Third Hospital, with 3530 (23.3%) in the overweight group and 1380 (9.1%) in the obese group, who had a normal ovarian response (5-15 oocytes retrieved) and underwent fresh embryo transfer (ET) cycles from January 2017 to December 2018, followed by linked frozen-thawed embryo transfer (FET) cycles from January 2017 to December 2020. Cumulative live birth rate (CLBR) was used as the primary outcome. Furthermore, a generalized additive model was applied to visually illustrate the curvilinear relationship between BMI and the outcomes. We used a decision tree to identify the specific population where high BMI had the greatest effect on IVF/ICSI outcomes.Results::High BMI was associated with poor IVF/ICSI outcomes, both in cumulative cycles and in separate fresh ET or FET cycles. In cumulative cycles, compared with the normal weight group, obesity was correlated with a lower positive pregnancy test rate (adjusted odds ratio [aOR]: 0.809, 95% confidence interval [CI]: 0.682-0.960), lower clinical pregnancy rate (aOR: 0.766, 95% CI: 0.646-0.907), lower live birth rate (aOR: 0.706, 95% CI: 0.595-0.838), higher cesarean section rate (aOR: 2.066, 95% CI: 1.533-2.785), and higher rate of large for gestational age (aOR: 2.273, 95% CI: 1.547-3.341). In the generalized additive model, we found that CLBR declined with increasing BMI, with 24 kg/m 2 as an inflection point. In the decision tree, BMI only made a difference in the population aged ≤34.5 years, with anti-Mullerian hormone >1.395 ng/mL, and the first time for IVF. Conclusions::High BMI was related to poor IVF/ICSI outcomes in women with a normal ovarian response, and CLBR declined with increasing BMI, partly due to suppressed endometrial receptivity. A high BMI had the most negative effect on young women with anticipated positive prognoses.

The hemodynamics of children with congenital heart disease (CHD) often changes during the perioperative period. Unfortunately, the evaluation of cardiac function in children with CHD is mainly focused on the left ventricle. With the further understanding of cardiac hemodynamics, the monitoring of RV function has gradually become an important part of cardiac intensive care department. We totally searched five databases including Pubmed, Embase, Cochrane, Wanfang Med, as well as China National Knowledge Infrastructure (CNKI) and reviewed the clinical research progress of the application of TAPSE in the evaluation of RV systolic function in children with CHD to provide a theoretical basic for the monitoring of RV function before and after operation in children with CHD.

Background As emerging environmental contaminants with ecological risks, flame retardants (FRs) exhibit obvious toxicity and persistence. In recent years, as FRs have been widely detected in indoor environments and human samples, the human health risks after FRs exposure are of great concern. Objective To systematically understand the topic evolution, research status, progress, and development trends on the toxicity and health effects of FRs on humans worldwide. Methods We retrieved the literature regarding toxicity of FRs and their effects on human health through the Web of Science database from 2000 to 2020, screened and processed the literature using Endnote software, and analyzed annual publications, important citations, and authors. CiteSpace and VOSviewer were employed to draw co-citation network, keyword co-occurrence network, and keyword clustering map for bibliometric visualization analysis. Results From 2000 to 2020, 472 international papers on toxic effects and human health impacts of FRs were published. In terms of publication years, FRs-related research was mainly divided into three stages: the infancy and exploration stage (2001—2006), when the research on the toxic effects of FRs was just starting; the growth stage (2007—2015), when the risk assessments of FRs on human health were conducted; and the acceleration stage (2016—), when the studies have shifted to the mechanism of FRs damage to human health. In this field, China published the largest number of published articles in the world (177 papers), but the intermediary centrality (reflecting academic influence) was only 0.19, far lower than that of European and American countries such as the Netherlands (0.78), Britain (0.51), and Germany (0.44). Among the top 10 research institutions in terms of the number of articles published, the Chinese Academy of Sciences topped the list with 49 articles. Van der Veen and other researchers had a strong influence on the research of the toxic effects of phosphorous FRs since their papers published in 2012 were cited 1319 times and in the most prominent node in the literature co-citation network. The high-frequency keywords in the literature on the human health effects of FRs were polybrominated diphenyl ethers (217 times), brominated FRs (166 times), toxicity (147 times), FRs (102 times), exposure, polychlorinated biphenyls, in vitro experiment, plasticizer, etc. Through keyword clustering and co-occurrence analyses, it was found that current research is systematically exploring the toxic mechanism of FRs from a perspective integrating pollution source-exposure route-final receptor of pollutants, and is evaluating the environmental health risks via different exposure routes. The visualized bibliometric analysis findings suggested that future studies understand the underlying mechanisms of various cell damage caused by FRs toxicity, identify the key factors of change and their relationships, aiming to provide a scientific basis for targeted prevention of health effects of FRs. Conclusion The research hotspots on the toxic effects of FRs and their effects on human health have changed over time, and the breadth and depth have been increasing. The toxic effects of brominated/phosphorus FRs have always been the mainstream direction in this field. Further studies will focus on the molecular mechanisms of human toxicity after FRs exposure.

Objective To investigate the effect of butylphthalide and sodium chloride injection on patients who received endovascular treatment for acute anterior circulation large vessel occlusive stroke.Methods A total of 173 patients were identified from February 2015 to December 2017 in the Department of Neurology of Jingling Hospital in this retrospective observational study.Propensity score-matching analysis was performed to balance differences in baseline characteristics between patients who received butylphthalide injection (butylphthalide group) and those who did not (control group).The modified Rankin Scale scores at 90 days were compared between the butylphthalide and control groups.Results A total of 144 patients who received endovascular treatment for acute anterior circulation large vessel occlusive stroke were finally analyzed,54 cases in the butylphthalide group and 90 cases in the control group.The proportion of good functional outcome at 90 days in the butylphthalide group was higher than that in the control group (63.0％ (34/54) vs 44.4％ (40/90);x2=4.633,P=0.031).Thirty-six pairs were matched successfully by the propensity score matching,36 patients in the butylphthalide group and 36 in the control group.There was no statistically significant difference in the 90-day functional outcome between the two groups (66.7％ (24/36) vs 44.4％ (16/36);x2=3.600,P=0.058).One hundred and fifteen patients were recanalized,47 cases in the butylphthalide group and 68 cases in the control group,and after the propensity score matching,30 pairs were analyzed.The proportion of good functional outcome at 90 days in the butylphthalide group was higher than that in the control group (73.3％ (22/30) vs 46.7％ (14/30);x2=4.444,P=0.035).Conclusion After propensity score-matching,butylphthalide and sodium chloride injection could improve 90-day functional outcome in patients with acute anterior circulation large vessel occlusive stroke and obtained recanalization by endovascular treatment while could not before propensity score-matching.

Objective To investigate the clinical features, diagnosis and management of pancreatic lesions in patients with von Hippel-Lindau (VHL) disease, and improve the current understanding on pancreatic lesions in VHL disease.Methods The clinical data of three VHL disease patients with pancreatic lesions were analyzed retrospectively, including clinical features, laboratory findings, imaging, pathological features, operation method and follow-up.Results Two patients had a family history of hemangioblastoma in central neural system, and 1 patient had retinal multiple angioma and angioma in central neural system, who were diagnosed as VHL.One patient with pancreatic portal hypertension had splenectomy and biopsy of left renal tumor.During the surgery, pancreatic cystic lesions were observed and the transparent cysts were diffusively distributed on the surface.The other 2 patients were diagnosed as pancreatic multiple cysts and non functional pNETs, and pancreatic multiple cysts, respectively, based on the imaging.All the three patients had stable disease status, and followed up by outpatient visits.Conclusions VHL disease can manifest as simple pancreatic cyst, pancreatic serous cystadenoma and pNETs.The optimal individualized treatment should be determined by Multidisciplinary team (MDT) according to the general condition of patient.

Objective:To investigate the prognostic significance of high sensitivity-C reactive protein (Hs-CRP) in patients with peripher-al T-cell lymphoma (PTCL). Methods:A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retro-spectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index (IPI), were determined. Af-ter a median follow-up of 23 months, the relationship between Hs-CRP and overall survival (OS) was observed. Results:Serum Hs-CRP level positively correlated with IPI score (r=0.132, P<0.001), tumor stage (r=0.183, P=0.005), B symptoms (r=0.225, P=0.001), and lactic dehydrogenase (r=0.169, P=0.009), but negatively correlated with plasma albumin levels (r=?0.343, P<0.001), hemoglobin concentra-tion (r=?0.239, P<0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion:The baseline Hs-CRP level can serve as a major indicator of prognosis in PT-CL patients.