ObjectiveTo systematically evaluate the methodological quality and measurement properties of traditional Chinese medicine （TCM） syndrome efficacy evaluation scales， and to provide evidence-based references for selecting high-quality assessment tools in TCM clinical practice. MethodsChina National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP Database， Chinese Biomedical Literature Database （CBM）， PubMed， the Cochrane Library， Embase， and Web of Science were searched from inception to April 2， 2025， for studies evaluating the measurement properties of TCM syndrome efficacy evaluation scales. Data were extracted， and the methodological quality and measurement properties of the included scales were assessed according to the consensus-based standards for the selection of health measurement instruments （COSMIN）. Recommendation levels were formulated based on the grading of evidence. ResultsA total of 46 studies were included， involving 22 generic syndrome efficacy evaluation scales and 24 disease-specific syndrome efficacy evaluation scales. None of the scales reported cross-cultural validity or measurement error. According to the recommendation grades， 2 scales met Grade A recommendations and are suggested for clinical use； 38 scales were classified as Grade B， indicating potential applicability but requiring further validation； and 6 scales were classified as Grade C， suggesting the need for further refinement. ConclusionExisting TCM syndrome efficacy evaluation scales exhibit substantial variability in methodological quality， incomplete reporting of measurement properties， and insufficient attention to scale revision. Future efforts should emphasize standardized design in the development of TCM syndrome scales， strengthen validation procedures for key measurement properties， and prioritize dynamic revision of scales， thereby providing high-quality tools to support the precise evaluation of syndrome efficacy.

[摘 要] 目的：探索淋巴细胞亚群对非小细胞肺癌（NSCLC）患者接受程序性死亡受体1（PD-1）单抗联合化疗的疗效预测及预后评估的价值。方法：回顾性分析2022年1月至2023年12月在兰州大学第二医院确诊的接受PD-1单抗联合化疗的50例NSCLC患者的临床资料，收集患者治疗前及治疗2周期后的外周血淋巴细胞亚群（包括总T细胞、CD4+ T细胞、CD8+ T细胞、NK细胞、总B淋巴细胞、CD4+/CD8+ T细胞比值等）的数据。治疗2周期后进行影像学检查评价治疗的疗效，分为疾病控制（DC）组和疾病进展（PD）组。使用卡方检验、秩和检验和Logistic回归分析淋巴细胞亚群表达水平与NSCLC患者近期疗效的关系，采用Kaplan-Meier法分析无进展生存期（PFS）预测疗效的价值。结果：PD-1单抗联合化疗对NSCLC患者的免疫状态产生了显著影响，接受免疫联合化疗后，患者外周血CD4+ T细胞、CD4+/CD8+ T细胞比值均显著升高（均P < 0.01），CD8+ T细胞下降。近期疗效显示，DC组患者血清CD4+ T细胞比例及CD4+/CD8+ T细胞比值均高于PD组（均P < 0.01）。Logistic多因素分析显示，CD4+/CD8+ T细胞比值是PD-1单抗联合化疗疗效的独立影响因素。通过ROC曲线分析，CD4+/CD8+ T细胞比值变化量AUC为0.820 > 0.5，截断值为0.15，CD4+/CD8+ T细胞比值变化量 ≥ 0.15的患者的PFS更长。结论：晚期NSCLC患者外周血中CD4+ T细胞和CD8+ T细胞比例、CD4+/CD8+ T细胞比值可以预测PD-1单抗联合化疗的疗效和预后。

OBJECTIVE To summarize the clinical features and treatment methods of subglottic cysts in infants.METHODS A single-center retrospective study was conducted,enrolling twelve pediatric patients with subglottic cysts who were treated at Beijing Children's Hospital,Affiliated to Capital Medical University,between December 2016 and October 2024.Clinical data were collected and analyzed,including patient age,body weight,perinatal history,presenting symptoms,findings from flexible laryngoscopy and imaging studies,as well as surgical treatment modalities.RESULTS Among the 12 patients,8 were male and 4 were female,with a median age of 7 months.Preterm infants accounted for 83.3%(10/12),low birth weight was observed in 58.3%(7/12),and 75%(9/12)had a history of tracheal intubation.The primary clinical manifestations included stridor,respiratory distress,and feeding difficulties.All patients were diagnosed by laryngoscopy and imaging studies,which confirmed the presence of subglottic cysts.Among these,9 were located on the right side and 3 on the left.All patients underwent subglottic cyst excision under general anesthesia using suspension laryngoscopy combined with endoscopy.Among them,two cases experienced recurrence and required a second surgical procedure three months postoperatively.Histopathological examination revealed a cyst wall lined by stratified squamous epithelium and pseudostratified ciliated columnar epithelium.All patients were followed up for a period ranging from 6 months to 6 years,with no recurrence observed during this time.CONCLUSION Infants presenting with stridor and dyspnea should undergo prompt laryngoscopy for definitive diagnosis.Subglottic cysts should be highly suspected in preterm,low-birth-weight infants with a history of intubation who develop stridor or respiratory distress during development.Once diagnosed,surgical intervention should be performed promptly to avoid the need for a tracheostomy.Surgical excision under general anesthesia using suspension laryngoscopy combined with endoscopy is an effective treatment for subglottic cysts.

Objective: To explore the alleviating effect of geniposide on ulcerative colitis (UC) and to investigate its potential mechanism. Methods: A UC mouse model was induced using 5% dextran sulfate sodium ( DSS) . These mice were randomly divided into 6 groups ( n = 8) : control group , model group , sulfasalazine group[ 100 mg/(kg ·d) ] , low-dose geniposide group[ 10 mg/(kg ·d) ] , medium-dose geniposide group[20 mg/(kg ·d) ] , and high-dose geniposide group[40 mg/( kg · d) ] . The mice were orally administered for consecutive 10 days . The colon length and mouse body mass were measured , and the colon mucosal damage index (CMDI) and disease activity index (DAI) were scored . The pathological changes in colon tissue were observed using hematoxylin-eosin (HE) staining. The reagent kits were used to measure the levels of malondialdehyde ( MDA) , myeloperoxidase (MPO) , catalase ( CAT) , and glutathione ( GSH) in colon tissue . The enzyme linked immunosorbent assay (ELISA) was used to analyze the expression levels of tumor necrosis factor-α ( TNF-α) , interleukin-6 ( IL-6) , and IL-1βin colon tissue . Western blot was used to detect the protein expression of mucin 1 (MUC-1) , occludin , IL-6 , p-JAK2 , and p-STAT3 in colon tissue . Results: Compared with the normal control group , the body mass and colon length of the model group mice significantly reduced . The expression of MUC-1 and occludin proteins sig- nificantly reduced (P < 0. 01) . The activities of CAT and SOD significantly reduced . DAI score and CMDI score significantly increased (P < 0. 01) . The expression levels of TNF-α, IL-6 , and IL-1βsignificantly increased (P < 0. 01) . The content of MPO and MDA significantly increased (P < 0. 01) . The expression of IL-6 , p-JAK2 and p- STAT3 proteins significantly increased ( P < 0. 01) . Compared with the model group , the body mass and colon length of mice in sulfasalazine group and geniposide medium and high-dose groups significantly increased (P < 0. 05 or P < 0. 01) , the expression of MUC-1 and occludin proteins increased (P < 0. 05 or P < 0. 01) , as well as the activity of CAT and SOD (P < 0. 05 or P < 0. 01) . DAI score and CMDI score in Sulfasalazine group and genipo- side medium and high-dose groups significantly reduced (P < 0. 05 or P < 0. 01) , as well as the expression levels of TNF-α, IL-6 , and IL-1β(P < 0. 05 or P < 0. 01) . MPO and MDA content in Sulfasalazine group and genipo- side medium and high-dose groups significantly reduced (P < 0. 05 or P < 0. 01) , as well as the expression of IL- 6 , p-JAK2 , and p-STAT3 proteins (P < 0. 05 or P < 0. 01) . Conclusion Geniposide maintaines intestinal home- ostasis by regulating the structure of the intestinal flora and improves colitis injury in UC mice by inhibiting the acti- vation of the IL-6/JAK2/STAT3 pathway.

Objective:To investigate the pathogenesis, clinical signs and diagnosing procedures of relapsing polychondritis(RP) in children with airway involvement.Methods:The medical history, clinical symptoms, physical examination, electronic laryngoscopy and imaging findings of six patients were retrospectively analyzed. The patients diagnosed as relapsing polychondritis with involving the airway from January 2018 to December 2021 were in our hospital. The clinical features of the 6 cases were summarized.Results:All 6 patients were male, ranging in age from 8 years 1 month to 14 years 1 month, with a median age of 12.04 years. Stridor and dyspnea were observed in all patients, with hoarseness in 2 patients and frequently nocturnal dyspnea during sleep in 2 patients. Initially, all children were diagnosed as laryngitis or laryngotracheitis, and were treated symptomatically with glucocorticoids and aerosol inhalation. Immunosuppressants and targeted therapy with biologics were given after patients diagnosed as RP. All patients were ultimately required tracheostomy. The time from the onset of airway symptoms to tracheostomy ranged from 1 month to 27 months. Two children had a history of endotracheal intubation prior to tracheostomy. All 6 patients underwent electronic laryngoscopy, revealing involvement of the laryngeal and subglottic mucosa and cartilage structures, which showed gradual improvement with medical therapy. Computed tomography (CT) of the trachea with three-dimensional reconstruction was performed in all patients, demonstrating moderate to severe subglottic stenosis. Two patients exhibited complete airway obstruction at the C4-C6 cervical level. Three children underwent suspension laryngoscopy under general anesthesia and endotracheal mucosal biopsy.Of the 6 children, 3 presented with nasal tip collapse or saddle nose, 2 had auricular cartilage changed, and 1 had scleralinvolvement. One patient underwent PET-CT scanning, which revealed tracheal collapse, diffuse increase in FDG(Flurodeoxyglucose)metabolism with increased FDG uptake in the nasal alar regions. All children were followed up for 2-3 years, 1 child died, while the remaining five continued to receive medical treatment.Conclusions:Relapsing polychondritis with airway involvement has an insidious onset and is difficult to diagnose. The airway stenosisresulting from RP is always severe and necessitating tracheotomy to maintain airway patency in the majority of cases.The treatment coursef or RP is prolonged, requiring long-term tracheostomy tube placement.

Objective To describe and analyze the current situation of the four same type of departments in an hospital in order to provide a reference for the construction of"the most cost-effective medical care".Methods The CN-DRG were used to automatically group and compare the medical capacity and inpatient service efficiency of the hospital department groups,and in the refined analysis,one DRG disease group of in situ cancer and non-malignant disease loss uterine surgery and single species uterine fibroid was included,and the Kruskal-Wallis H test was used to further compare the differences in length of stay and various costs.Results It included a total of 22630 patients,whose weights varied from a maximum of 3948.62 in diagnostic group 1 to a minimum of 133.55 in diagnostic group 11.The cost consumption indexes ranged from a minimum of 0.89 in diagnostic group 5 to a maximum of 1.04 in diagnostic group 2,while the time consumption indexes ranged from a minimum of 0.48 in diagnostic group 11 to a maximum of 0.81 in diagnostic group 5.When comparing the diagnostic groups,there were statistically significant differences(P＜0.05)in hospitalization days,total cost,diagnostic cost,therapeutic cost,and cost of supplies.Specifically,when comparing the diagnostic and treatment groups within departments,the differences in hospitalization days and all costs were statistically significant(P＜0.05)in departments 1 and 2,the differences in diagnostic cost,therapeutic cost,and cost of supplies were statistically significant(P＜0.05)in department 3.Conclusion There exists a notable disparity in the extent to which each diagnostic and treatment group contributes to the hospital's service capacity and cost variability.Consequently,it is necessary to reasonably evaluate the length of hospital stay and medical cost of patients to achieve the highest cost-effective medical treatment.

Objective:This study aimed to analyze the genomic characteristics of Varicella-Zoster Virus (VZV) strains circulating in Jilin province from 2010 to 2023.Methods:Vesicle fluid from 78 sporadic cases with VZV infection were collected in Jilin province from 2010 to 2023, after detecting by Real-time PCR, 26 specimens (CT<25) were detected by PCR. Open reading frame 22(ORF22), ORF38 and ORF62 were amplified and analyzed. Genotyping was confirmed by SNPs ORF22 (37902, 38019, 38055, 38081 and 38177) and ORF38 (69424). Vaccine strains were indentified from wild-type strains according to ORF38 (69349) and ORF62 (106262, 107252, and 108111). Sequences were analyzed by homologous comparison and phylogenetic analysis.Results:The comparison with Dumas sequence revealed that SNPs (37902, 38055, 38081 and 38177) in ORF22 and ORF38 (69424) have mutations similar to the pOka strain, which belong to clade 2. Compared to the Dumas and Baike strains, all 26 samples were wild-type strains. JL2016-4 strain changes from threonine to asparaginyl at position 38059, JL2021-4 strain changes from arginine to proline at position 37933, from aspartic acid to tyrosine at position 37935, and from aspartic acid at base 38031 to tyrosine. JL2023-1 strain changes from arginine to leucine at position 37933.Conclusions:VZV has been prevalent for 14 years in Jilin province. The main epidemic strains belong to the clade 2. We should strengthen the monitoring of VZV outbreaks and raise the coverage rate of VZV vaccination.

OBJECTIVE To investigate the therapeutic effect of autologous costal cartilage transplantation with anterior/posterior split of cricoid cartilage on laryngotracheal stenosis in children.METHODS A retrospective analysis of 12 cases of laryngotracheal stenosis in children treated with anterior/posterior split of cricoid cartilage combined with T-tube implantation in Beijing Children's Hospital Affiliated to Capital Medical University in recent years.There were 5 males and 7 females,aged from 2 years and 6 months to 16 years and 9 months,with an average age of 8 years and 9 months.There were 2 cases of grade Ⅱ stenosis,9 cases of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.All cases underwent tracheotomy before operation.The course of disease ranged from 4 months to 6 years,with an average of 3 years.RESULTS Of the 12 patients,10(83.3％)were cured,and the tracheotomy cannula was successfully removed to restore normal breathing and pronunciation function.There were 2 cases of extubation failure,including 1 case of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.CONCLUSION The etiology of laryngotracheal stenosis in children is complex and difficult to treat.Anterior/posterior split costal cartilage transplantation combined with T-tube implantation through internal/external cervical approach can achieve good therapeutic effect in the treatment of laryngotracheal stenosis in children.

OBJECTIVE Aims to investigate the expression changes of immunoregulatory cytokines in peripheral blood and local lesions of patients with juvenile onset recurrent respiratory papillomatosis(JORRP),and analyze their correlation with the severity of JORRP.METHODS Peripheral blood samples were collected from JORRP patients,along with peripheral blood samples from healthy children matched for gender and age as the control group.Papillomas of JORRP patients were collected,and the epithelial tissue from the palatine tonsils of patients undergoing tonsillectomy served as a control.ELISA was used to detect cytokine concentrations in plasma samples.The tissue samples were detected by mRNAseq and verified by RT-PCR.Furthermore,the correlation between cytokine expression levels and disease severity was analyzed.RESULTS The concentration of interleukin-10(IL-10)in the plasma of JORRP patients was significantly higher than that in the healthy control group(P<0.05),and it was negatively correlated with the age of onset(r=-0.3307,P<0.05).At the level of mRNA,the relative quantity of IL-10 in papillomas was significantly higher in the aggressive group compared to the non-aggressive group(P>0.05).Additionally,the concentration of TGF-β in plasma of JORRP patients was positively correlated with the number of surgeries(r=0.5144,P<0.05),and the concentration of TGF-β in the aggressive group was significantly higher than that in the non-aggressive group(P<0.05).The TGF-β mRNA expression level was significantly higher in the papillomas of JORRP patients compared to the control(P<0.001).CONCLUSION Inhibitory immunoregulatory cytokines IL-10 and TGF-β are overexpressed in JORRP patients and positively correlated with disease severity.

Objective To study the effects of ultrasound-guided quadratus lumborum block(QLB)on intraoperative hemodynamics and opioid dosage in emergency patients with ectopic pregnancy.Methods A total of 70 patients with ectopic pregnancy undergoing laparoscopic surgery in Langfang People's Hospital from January 2021 to February 2024 were selected as subjects.According to the different anesthesia methods,the patients were divided into the control group and the study group,with 35 cases in each group.The control group was given general anesthesia,while the study group additionally added ultrasound-guided QLB.The intraoperative sedation effect,hemodynamics,postoperative pain,incidence of adverse reactions and opioid use at different times(admission,entry,intubation,skin incision,extubation,and discharge)were observed in the two groups.Results There were no statistically significant differences in the onset time of sedation,the rate of salvage sedation,the incidence of intraoperative body movements,the modified observer's assessment of alert/sedation(MOAA/S)at each time,and the hemodynamics at the time of admission,entry and intubation between the two groups.The mean arterial pressure(MAP),systolic blood pressure(SBP)and heart rate(HR)in the study group were significantly lower than those in the control group during skin incision,extubation and discharge[skin incision:MAP(mmHg,1 mmHg≈0.133 kPa)was 85.24±4.59 vs.96.95±4.68,SBP(mmHg)was 92.24±4.85 vs.99.49±5.13,HR(times/min)was 85.33±2.96 vs.94.51±2.92;extubation:MAP(mmHg)was 94.84±5.02 vs.102.05±5.13,SBP(mmHg)was 96.48±4.72 vs.105.03±5.07,HR(times/min)was 95.51±4.95 vs.102.49±5.87;discharge:MAP(mmHg)was 86.14±4.99 vs.93.71±5.25,SBP(mmHg)was 96.48±4.69 vs.104.37±5.02,HR(times/min)was 84.05±4.57 vs.90.51±4.86,all P<0.05]and pulse oxygen saturation(SpO2)was higher than those in the control group(skin incision:0.988 5±0.012 2 vs.0.965 4±0.012 3,extubation:0.974 7±0.012 4 vs.0.963 2±0.012 1,discharge:0.981 1±0.012 4 vs.0.970 3±0.012 3,all P<0.05).The resting numeric rating scale(NRS)scores and active NRS scores in the study group were lower than those in the control group at 3,6,12,and 24 hours after surgery,the random time was prolonged,the resting NRS and active NRS in the two groups gradually increased,reaching a peak at 24 hours after surgery,and the resting NRS and active NRS in the study group were significantly lower than those in the control group(resting NRS:3.86±0.82 vs.4.53±1.04,active NRS:4.26±1.05 vs.4.85±1.13,all P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group[11.43%(4/35)vs.34.29%(12/35),P<0.05].The dosage of Sufentanil in 24 hours and 48 hours,the number of analgesic pump in 48 hours and the number of relief analgesia cases in the study group were lower than those in the control group[the dosage of Sufentanil in 24 hours(μg):23.28±4.02 vs.36.14±4.57,the dosage of Sufentanil in 48 hours(μg):41.61±4.82 vs.59.33±6.25,the number of analgesic pump in 48 hours(times):2.94±1.22 vs.6.15±1.71,the proportion of relief analgesia:8.57%(3/35)vs.28.57%(10/35),all P<0.05].Conclusion Ultrasound-guided QLB can reduce hemodynamic fluctuations,relieve postoperative pain,reduce adverse reactions and opioid use in emergency patients with ectopic pregnancy,demonstrating a positive impact.