Objective To examine the diagnosis and treatment of disseminated infection caused by Enterocytozoon bieneusi in a child with leukemia and improve the awareness of the pathogen in clinical and laboratory practice.Methods A case of disseminated infection caused by Enterocytozoon bieneusi in a child with leukemia in Shanghai Children's Hospital was retrospectively analyzed,including diagnosis and treatment details.Similar cases were identified from PubMed,Wanfang Data,VIP,and CNKI databases since database establishment until June 30,2024,using search terms"Enterocytozoon bieneusi".The relevant literature was reviewed.Results This child had acute lymphoblastic leukemia as the underlying disease and was admitted to hospital for antimicrobial treatment due to fever and abdominal discomfort.The case was considered bacterial infection complicated with Enterocytozoon bieneusi infection,confirmed by detection of Klebsiella pneumoniae in blood and detection of Enterocytozoon bieneusi in blood and ascites by metagenomic next-generation sequencing(mNGS).The treatment was switched to tigecycline plus trimethoprim-sulfamethoxazole at a sufficient dose,which resulted in resolution of symptoms.Six months later,the patient suffered from acute lymphoblastic leukemia and bone marrow depression,Enterocytozoon bieneusi disseminated infection,septic shock.Her family gave up treatment and the child died.Literature review indicated that most patients infected with Enterocytozoon bieneusi had underlying conditions such as organ transplantation,AIDS,and leukemia associated with poor immunity.The onset symptoms are diarrhea,abdominal discomfort,and fever.Enterocytozoon bieneusi was detected by using methods such as modified Masson's trichrome stain,fluorescent calcofluor white staining,molecular detection techniques,and immunofluorescence.The patients were treated with drugs such as albendazole,nitazoxanide,fumagillin,and trimethoprim-sulfamethoxazole.Conclusions Enterocytozoon bieneusi is an opportunistic pathogenic fungus that infects immunocompromised patients and can cause abdominal discomfort,diarrhea,fever,and even disseminated infection and death.Conventional laboratory methods cannot culture Enterocytozoon bieneusi.Molecular detection techniques can be used to identify the pathogen early.

Objective:To observe the clinical efficacy of gentle moxibustion at different temperatures in treating people with diarrhea-predominant bowel syndrome(IBS-D)due to spleen deficiency.Methods:A total of 108 IBS-D patients were divided into two groups using the random number table method,with 54 participants in each group.Moxibustion group 1 received gentle moxibustion at(43±1)℃at bilateral Tianshu(ST25)and Zusanli(ST36),lasting 30 min each session;moxibustion group 2 received gentle moxibustion at(37±1)℃at the same points.Both groups received the intervention 3 times weekly for a total of 18 sessions.Abdominal pain intensity,stool form,pattern-based efficacy,quality of life,and mental health assessments were performed at weeks 0,3,6,and 8.Results:The total effective rate for abdominal pain intensity was 87.8%in moxibustion group 1 versus 51.1%in moxibustion group 2,and the difference was statistically significant(P<0.05).When the treatment finished,abdominal pain intensity,the Bristol score,IBS-symptom severity scale(IBS-SSS)score,self-rating anxiety scale(SAS)score,and self-rating depression scale(SDS)score dropped significantly in both groups(P<0.05),and the IBS-quality of life(IBS-QOL)score increased markedly(P<0.05).Between-group comparisons demonstrated that abdominal pain intensity,the Bristol general score,IBS-SSS score,traditional Chinese medicine(TCM)pattern score,and SDS score were significantly lower in moxibustion group 1 than in moxibustion group 2 at treatment week 6(P<0.05),and the IBS-QOL score was notably higher in moxibustion group 1(P<0.05).Conclusion:Whether at 43℃or 37℃,gentle moxibustion at Tianshu(ST25)and Zusanli(ST36)can improve abdominal pain,stool form,and quality of life,reduce disease severity,and mitigate TCM pattern in IBS-D patients;43℃gentle moxibustion performs better than 37℃gentle moxibustion in improving abdominal pain,stool form,disease severity,TCM pattern,quality of life,anxiety,and depression in IBS-D.

Objective To examine the diagnosis and treatment of disseminated infection caused by Enterocytozoon bieneusi in a child with leukemia and improve the awareness of the pathogen in clinical and laboratory practice.Methods A case of disseminated infection caused by Enterocytozoon bieneusi in a child with leukemia in Shanghai Children's Hospital was retrospectively analyzed,including diagnosis and treatment details.Similar cases were identified from PubMed,Wanfang Data,VIP,and CNKI databases since database establishment until June 30,2024,using search terms"Enterocytozoon bieneusi".The relevant literature was reviewed.Results This child had acute lymphoblastic leukemia as the underlying disease and was admitted to hospital for antimicrobial treatment due to fever and abdominal discomfort.The case was considered bacterial infection complicated with Enterocytozoon bieneusi infection,confirmed by detection of Klebsiella pneumoniae in blood and detection of Enterocytozoon bieneusi in blood and ascites by metagenomic next-generation sequencing(mNGS).The treatment was switched to tigecycline plus trimethoprim-sulfamethoxazole at a sufficient dose,which resulted in resolution of symptoms.Six months later,the patient suffered from acute lymphoblastic leukemia and bone marrow depression,Enterocytozoon bieneusi disseminated infection,septic shock.Her family gave up treatment and the child died.Literature review indicated that most patients infected with Enterocytozoon bieneusi had underlying conditions such as organ transplantation,AIDS,and leukemia associated with poor immunity.The onset symptoms are diarrhea,abdominal discomfort,and fever.Enterocytozoon bieneusi was detected by using methods such as modified Masson's trichrome stain,fluorescent calcofluor white staining,molecular detection techniques,and immunofluorescence.The patients were treated with drugs such as albendazole,nitazoxanide,fumagillin,and trimethoprim-sulfamethoxazole.Conclusions Enterocytozoon bieneusi is an opportunistic pathogenic fungus that infects immunocompromised patients and can cause abdominal discomfort,diarrhea,fever,and even disseminated infection and death.Conventional laboratory methods cannot culture Enterocytozoon bieneusi.Molecular detection techniques can be used to identify the pathogen early.

Objective:To observe the clinical efficacy of gentle moxibustion at different temperatures in treating people with diarrhea-predominant bowel syndrome(IBS-D)due to spleen deficiency.Methods:A total of 108 IBS-D patients were divided into two groups using the random number table method,with 54 participants in each group.Moxibustion group 1 received gentle moxibustion at(43±1)℃at bilateral Tianshu(ST25)and Zusanli(ST36),lasting 30 min each session;moxibustion group 2 received gentle moxibustion at(37±1)℃at the same points.Both groups received the intervention 3 times weekly for a total of 18 sessions.Abdominal pain intensity,stool form,pattern-based efficacy,quality of life,and mental health assessments were performed at weeks 0,3,6,and 8.Results:The total effective rate for abdominal pain intensity was 87.8%in moxibustion group 1 versus 51.1%in moxibustion group 2,and the difference was statistically significant(P<0.05).When the treatment finished,abdominal pain intensity,the Bristol score,IBS-symptom severity scale(IBS-SSS)score,self-rating anxiety scale(SAS)score,and self-rating depression scale(SDS)score dropped significantly in both groups(P<0.05),and the IBS-quality of life(IBS-QOL)score increased markedly(P<0.05).Between-group comparisons demonstrated that abdominal pain intensity,the Bristol general score,IBS-SSS score,traditional Chinese medicine(TCM)pattern score,and SDS score were significantly lower in moxibustion group 1 than in moxibustion group 2 at treatment week 6(P<0.05),and the IBS-QOL score was notably higher in moxibustion group 1(P<0.05).Conclusion:Whether at 43℃or 37℃,gentle moxibustion at Tianshu(ST25)and Zusanli(ST36)can improve abdominal pain,stool form,and quality of life,reduce disease severity,and mitigate TCM pattern in IBS-D patients;43℃gentle moxibustion performs better than 37℃gentle moxibustion in improving abdominal pain,stool form,disease severity,TCM pattern,quality of life,anxiety,and depression in IBS-D.

Objective:To investigate the epidemiological characteristics, genotypes and genetic evolution of respiratory syncytial virus (RSV) isolated in Shanghai from April 2020 to December 2021, which was a period from the COVID-19 outbreak to the phase of regular epidemic prevention and control.Methods:This retrospective study collected the nasopharyngeal secretions or nasopharyngeal aspirates of children with acute respiratory tract infection (ARTI) admitted to the Shanghai Children′s Hospital from April 2020 to December 2021. PCR-capillary electrophoresis and RT-PCR were used for virus identification and the amplification of the gene fragment of the second hypervariable region of RSV G protein. Homology analysis and phylogenetic analysis were conducted using bioinformatics software. Chi-square test was used to compare the detection rates of RSV. Results:A total of 6 211 samples were collected and 13.62% (846/6 211) of them were positive for RSV. The positive rates of RSV in male and female patients were 14.07% (503/3 574) and 13.01% (343/2 637), respectively, with no significant gender difference (χ 2=1.467, P=0.226). The highest detection rate of RSV was found in children ≤6 months of age, and the rate of RSV infection decreased gradually with age (χ 2=352.942, P<0.001). No RSV-positive specimens were detected from April 2020 to August 2020, after which the detection rate of RSV gradually increased with two epidemic peaks occurring from December 2020 to February 2021 and from August to October 2021. The predominant epidemic subtype was RSV subtype B in 2020 and the first 9 months of 2021, which was gradually replaced by RSV subtype A in the last 3 months of 2021. The 176 strains of RSV subtype A obtained in this study were all ON1 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.20%-99.50%. All of the 250 strains of RSV subtype B were BA9 genotype, and the nucleotide homology of the Shanghai epidemic strains was 90.10%-100.00%. Conclusions:From April 2020 to December 2021, with the regular prevention and control of COVID-19, there is a change in the epidemic season of RSV. The prevalent genotypes of RSV subtypes A and B are ON1 and BA9, respectively, and the subtype A gradually replaces subtype B as the most prevalent subtype.

Objective:To observe any effect of fast walking on walking speed, 6-minute walking test (6MWT) time, and on serum levels of growth differentiation factor-8 (GDF-8) and insulin-like growth factor-1 (IGF-1) in patients with sarcopenia.Methods:A total of 61 sarcopenia patients were randomly divided into an observation group ( n=31) and a control group ( n=30). Both groups were given conventional drug therapy. In addition, the observation group underwent 30-minutes of walking at 100-120 steps/min (about 60% of maximum heart rate) three times a week for 12 weeks. The control group also walked, but at 70-90 steps/min (less than 50% of maximum heart rate). Grip strength, walking speed, 6MWT time, skeletal muscle index (ASMI) and serum GDF-8 and IGF-1 were compared before and after the intervention. Results:There were no significant differences in grip strength or ASMI between observation group and control group (comparing males with males and females with females) before the experiment. Afterward, grip strength and ASMI in the observation group had increased significantly on average. Both were then significantly higher than the control groups′ averages, which had not changed significantly. Average walking speed, 6MWT time and serum IGF-1 levels had improved significantly in both groups, but the observation group′s average improvement was significantly greater. A significant decrease the average serum GDF-8 level was observed in the observation group, but not in the control group.Conclusion:Fast walking can improve the walking of persons with sarcopenia, raise serum IGF-1 levels, and significantly reduce serum GDF-8.

Objective : To explore the "clinical normal reference range" of pulpal blood flow (PBF) in the physiological state in an effort to provide a reference for clinical diagnosis and treatment. Methods: According to the working principle and operational considerations of laser Doppler flowmetry (LDF), the PBF blood flow value of the first molars of the upper and lower mandibles of normal adults was detected by LDF, and the clinical reference value range under physiological conditions was analyzed and calculated. The differences in PBF values by sex, dental position and location (left and right side, upper and lower jaw) were analyzed. Results : A total of 200 normal adult participants with an average age of (22.76 ± 3.26) years were included. The cohort included 95 males and 105 females, with a total of 800 first molars. Neither the PBF values of the left and right first molars nor the PBF values of the upper and lower first molars in males or females significantly differed (P>0.05). The PBF value for females was higher than that of males. Specifically, the clinical reference PBF values for males and females were (8.56 ± 3.25) PU and (9.51 ± 3.47) PU, respectively. Conclusion The PBF values of normal adult first molars in healthy subjects were higher in females than in males, and in the PBF values of first molars of the same sex did not significantly differ between the left side and right side or upper and lower jaw; these values could be used as a reference for the selection of control teeth.

Objective To establish an HPLC method for the simultaneous determination of harpagide and harpagoside content in Scrophularia ningpoensis (SN). Methods An Eclipse C₁₈ column was used for determination of methanol extract of S. ningpoensis with a HPLC-PDA method and mobile phase of acetonitrile-0.03% phosphate solution in a gradient elution manner. The flow rate of mobile phase was 1.0 ml/min, and the detection wavelengths were 210 nm and 280 nm. Results Harpagide and harpagoside contents in SN showed good linear relationships within 0.1020-0.5100 mg/ml (r=0.9999) and 0.0340-0.1700 mg/ml (r=0.9999). Their average recovery rates were 97.44% and 97.08%.The RSDs were 0.93% and 1.24%.. There were significant differences in the contents of harpagide and harpagoside in SN from 15 origins (P<0.01). The content of harpagoside in Sichuan Long-dong, Zhejiang Lin-an, Zhejiang Pan-an and Henan Nan-feng is higher. Conclusion This method is stable, accurate and reproducible and can be used for the quality control of SN.

OBJECTIVE： To systematically evaluate the efficacy and safety of risperidone versus haloperidol in the treatment of behavioral and psychological symptoms of dementia （BPSD）， and to provide evidence-based reference for clinical drug use. METHODS： Cochrane library， PubMed， EMbase， CNKI， CBM， Wanfang and VIP database were searched for the randomized controlled trials （RCT） on risperidone （trial group） versus haloperidol （control group） in the treatment of BPSD. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 software. RESULTS： A total of 26 studies were included， involving 2 219 patients. The results of Meta-analysis showed that the total response rate [RR＝1.11， 95％CI（1.05， 1.18）， P＝0.000 3] and CMAI score [SMD＝0.19， 95％CI（0.04， 0.34）， P＝0.01] in trial group were significantly higher than control group. MMSE score [SMD＝－0.32， 95％CI（－0.63， －0.01）， P＝0.04]， and the incidence of extrapyramidal reaction [RR＝0.39， 95％CI（0.31， 0.49）， P＜0.000 1]， gastrointestinal reaction [RR＝0.51， 95％CI（0.38， 0.68）， P＜0.000 1]， somnolence [RR＝0.47， 95％CI （0.25， 0.88）， P＝0.02]， thirst [RR＝0.50， 95％CI（0.33， 0.74）， P＝0.000 5] and constipation [RR＝0.33， 95％CI（0.20， 0.54）， P＜0.000 1] in trial group were significantly lower than control group. There were no statistical significance in BEHAVE-AD score [SMD＝0.03， 95％CI（－0.09，0.16）， P＝0.62] and the incidence of insomnia [RR＝1.26， 95％CI（0.76， 2.11）， P＝0.37]， headache/dizziness [RR＝0.65， 95％CI（0.38， 1.12）， P＝0.12] and tachycardia[RR＝0.40， 95％CI（0.12， 1.31）， P＝0.13] between two groups. CONCLUSIONS： The efficacy and safety of risperidone in the treatment of BPSD are signi- ficantly better than haloperidol， and risperidone can improve agitation behavior and general cognitive state of patients.

Objective To introduce a method of automatically identifying critical values from medical image examination reports and prompt the physician to report it,to prevent the omission of the critical value reporting and improve the medical quality.Methods According to the requirement of critical value reporting system,regular expressions were made for each emergency situation of medical image examination,in order to form a critical value feature library.And an algorithm was designed to find critical value and prompt doctors automatically.Results According to this method,the critical value auto recognize software was developed and had been tested in Nanfang Hospital for 6 months.The software ran well.Conclusion Using regular expressions to define a criteria value feature library and design an algorithm of identifying criteria values,can recognize critical values and prompt physician automatically.