To investigate the epidemiological characteristics of co-infection involving macrolide-resistant Mycoplasma pneumoniae (MRMP) and non-bacterial pathogens in hospitalized children at Women and Children′s Hospital of Ningbo University from 2021 to 2024, a retrospective cross-sectional study was conducted. Throat swabs were collected from children admitted for respiratory tract infections between January 2021 and December 2024. A total of 22 311 children aged 0-18 years old were included, including 12 021 males and 10 290 females. The median age was 5.00 years and the mean age was (5.02±3.25) years. Real-time fluorescence quantitative polymerase chain reaction (PCR) and multiplex PCR were employed to determine the MP infection rate, the prevalence of MRMP, and the co-infection rates with non-bacterial pathogens across different years. Patients with MRMP were categorized into two groups based on the presence or absence of co-infections: simple infection group and mixed infection group. The differences in age, gender, and onset time between these groups were analyzed, along with the distribution of pathogens in the mixed infection group. Chi-square tests were used for intergroup comparisons. The results showed that the overall positive rate of MP among the 22 311 children was 39.42% (8 794/22 311), with a detection rate of MP drug resistance gene mutations at 70.42% (6 193/8 794). The co-infection rate of MRMP was 24.29% (1 504/6 193). Statistically significant differences were observed in the MP positive rate and the detection rate of drug resistance gene mutations from 2021 to 2024 ( χ2=1 674.420, P<0.05; χ2=67.733, P<0.05), with peak values in 2023 (50.87% and 73.83%, respectively). Among the annual co-infections, the highest rate was in 2024 (28.72%), while the lowest was in 2022 (7.30%). In the age distribution, the rate of mixed infections decreased with increasing age ( χ2=84.742, P<0.05). Seasonally, the infection rates in winter 2023 and the spring, summer, and autumn of 2024 were significantly higher than those in 2022 ( χ2=24.243, 13.101, 26.181, and 10.687, respectively; all P<0.05), with the lowest mixed infection rate observed in winter 2022 over the four-year period. Over the four years, the highest positive rate for rhinovirus was consistently observed in MRMP co-infections each year, particularly in the 3-to 6-year-old age group. The positive rate for mixed infections involving respiratory syncytial virus, human bocavirus, and parainfluenza virus was notably higher in the 0- to 3-year-old age group. Following the removal of non-pharmaceutical interventions (NPIs) in December 2022, the co-infection rate of other respiratory viruses and MRMP increased in Ningbo City. In conclusion, the positive rate of MRMP has shown an upward trend from 2021 to 2023. Post-NPI removal, MRMP mixed infections have become more prevalent in 2023 and 2024, predominantly affecting children aged 0-6 years, with rhinovirus being the most common co-pathogen.

Objective To explore the efficacy and safety of doxycycline in the treatment of Mycoplasmal pneumoniae pneumonia(MPP)in children under 8 years old.Methods A retrospective selection was made of 258 children with MPP under 8 years old who were admitted to Women and Children's Hospital of Ningbo University from July 2023 to June 2024 as the research subjects.The children were divided into the azithromycin group(n=156)and the doxycycline group(n=102)according to the different drugs used.The clinical indicators,inflammation-related indicators,liver function indicators before and after treatment and adverse reactions of two groups of children were compared.Results After treatment,the defervescence time,cough relief time,pneumonia image absorption time and hospital stay in doxycycline group were shorter than those in azithromycin group(P＜0.05),the number of patients who needed to use steroids and bronchoscope intervention,and the number of patients with total hospitalization costs more than 10 000 yuan were less than those in azithromycin group(P＜0.05).The C-reactive protein(CRP),D-dimer(DD),serum ferritin(SF)and lactate dehydrogenase(LDH)in both groups of children were significantly lower than those before treatment in this group(P＜0.05),and the reduction amplitzes of CRP,DD,SF and LDH in doxycycline group were significantly greater than those in azithromycin group(P＜0.05).There were no significant changes in alanine aminotransferase,aspartate aminotransferase and prealbumin between two groups of children before and after treatment(P＞0.05).The adverse reactions of two groups of children were mainly gastrointestinal reactions,and there was no statistically significant difference in the incidence rate(x2=0.254,P=0.204).Conclusion Doxycycline in treatment of MPP in children under 8 years old can effectively relieve clinical symptoms,reduce inflammatory responses,decrease hormone and bronchoscopy interventions,shorten hospital stays and reduce hospitalization costs,and has good safety.

The transcription factor HOXB13 plays crucial roles in cancer development. HOXB13 is abnormally expressed in most cancers, which makes it a valuable therapeutic target for cancer therapy. The level of HOXB13 differs significantly between healthy and cancer tissues, which indicates that the level of HOXB13 is closely related to carcinogenesis. The regulatory network mediated by HOXB13 in cancer proliferation, metastasis, and invasion has been systematically investigated. Moreover, HOXB13 variants play distinct roles in different cancers and populations. By understanding the molecular mechanisms and mutation features of HOXB13, we provide a comprehensive overview of carcinogenesis networks dependent on HOXB13. Finally, we discuss advancements in anticancer therapy targeting HOXB13 and the roles of HOXB13 in drug resistance to molecular-targeted therapies, which serves as a foundation for developing HOXB13-targeted drugs for clinical diagnosis and cancer therapies.
Humans ; Neoplasms/metabolism* ; Homeodomain Proteins/metabolism* ; Carcinogenesis/genetics* ; Mutation ; Gene Expression Regulation, Neoplastic ; Molecular Targeted Therapy ; Drug Resistance, Neoplasm/genetics*

AIM: To identify research articles on myopia in preschool children and explore its current status and development trends based on bibliometric analysis.METHODS: Data from the Web of Science Core Collection database were analyzed using the search term “TS=Preschool children myopia” to retrieve all relevant publications from January 1, 2004, to December 31, 2023.RESULTS: A total of 171 articles were included in the analysis. China was identified as the leading country in terms of publication volume, making significant contributions to this field. The National University of Singapore and Nanjing Medical University were recognized as key institutions at the forefront of this research. Investigative Ophthalmology & Visual Science and Ophthalmology emerged as the journals with the highest citation frequencies. High-frequency keywords highlighted the current status and future directions of myopia research in preschool children. Specifically, “prevalence”, “refractive error” and “risk factors” were identified as potential focal points for future investigations.CONCLUSION: This study provides a comprehensive bibliometric analysis of global literature on myopia in preschool children. It identifies the most frequently cited articles in this field, outlines the global research landscape, and highlights emerging hotspots and trends. These findings offer valuable insights and directions for researchers and practitioners focusing on this area.

Objectives:To explore whether short-course radiotherapy (SCRT)-based total neoadjuvant therapy (TNT) combined with PD-1 inhibitors could further promote tumor regression and improve the prognosis.Methods:This is a prospective, multicenter, two-arm randomized controlled, seamless phase Ⅱ/Ⅲ trial for proficient mismatch repair or microsatellite stable (pMMR/MSS) locally advanced rectal cancer (LARC). Eligible patients were randomly assigned to the iTNT (TNT+PD-1) group or the TNT group. Patients in the TNT group received SCRT (5 Gy×5) followed by 4 cycles of CAPOX or 6 cycles of mFOLFOX chemotherapy, with the iTNT group receiving SCRT followed by the same regime in combination with 4 cycles of Sintilimab. Total mesorectal excision (TME) surgery or watch and wait (W&W) was performed after neoadjuvant therapy and then 2 cycles of same regimen as before were recommended. The primary endpoints are the complete response (CR) rate for phase Ⅱ trial and 3-year disease-free survival (DFS) for phase Ⅲ trial. A total of 588 patients will be enrolled for the phase Ⅱ/Ⅲ trial. Short-term efficacy and safety data from the initial 100 treated patients were analyzed as planned.Results:From 2022-8-31 to 2023-5-24 the initial 100 patients were enrolled from 10 hospitals in China, 76.0%(76/100) patients were male, and the median age was 61 years (21-74 years). More patients had tumors located in the lower rectum (78.0%, 78/100), staged T3-4 (97.0%, 97/100) and N1-2 (93.0%, 93/100), and about half of the tumors invaded the mesorectal fascia (52.0%, 52/100) and with extramural vascular invasion (51.0%, 51/100). Analyses were performed according to the per-protocal (PP) set. All patients in the iTNT group ( n=52) and the TNT group ( n=48) completed SCRT; The 4-cycle chemotherapy±Sintilimab completion rates were 86.5% and 100.0% in the iTNT and TNT groups, respectively. In the iTNT group, 82.7% (43/52), 11.5% (6/52), and 5.8% (3/52) of the patients received 4, 3, and 2 cycles of PD-1 inhibitor. After TNT, 68 patients underwent radical surgery and 15 patients achieved cCR and adopted W&W. The pathological complete response (pCR) rates were 48.5% (16/33) and 17.1% (6/35) in the iTNT and TNT groups, with CR rates of 50.0% (25/50) and 26.1% (12/46), respectively. The incidence of treatment-related grade 3-4 adverse events was 26.9% (14/52, iTNT group) and 18.8% (9/48, TNT group), with thrombocytopenia and leukopenia being the most common. Among patients receiving immunotherapy, grade 3 immunotherapy-related adverse events occurred in 2 (3.8%, 2/52) patients: one case was pancreatitis, another case was hepatitis combined with myositis and myocarditis. Conclusion:The preliminary results show that SCRT-based TNT combined with PD-1 inhibitors could further improve the CR rate for LARC without unexpected serious adverse events.

Objective:To investigate the operation opportunity for vascular rings in infants and assess the impact of prenatal and postnatal integrated management strategies on treatment outcomes.Methods:A retrospective analysis was conducted on the clinical data of 75 infants with vascular rings who underwent surgical treatment at the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2023. Among them, 54 were males and 21 were females, with a median age at surgery of 1.7 (0.7-6.9) months and a median weight of 5.3 (3.5-8.0) kg. Vascular rings malformation was diagnosed by real-time three-dimensional color doppler echocardiography during pregnancy in 51 cases. Preoperatively, 28 cases presented with respiratory or digestive system-related symptoms, and 26 cases had a history of hospitalization due to related symptoms. All patients underwent preoperative cardiac CTA+ CTVE and three-dimensional reconstruction examinations, and 56 cases showed varying degrees of airway compression and stenosis on imaging. Among them, 10 patients presented with preoperative stridor and respiratory distress; fiberoptic bronchoscopy performed after anesthesia induction confirmed significant tracheal compression/stenosis. One patient was ventilator-dependent preoperatively, and bronchoscopy revealed main bronchomalacia. The cohort included: Complete vascular rings (62 cases of double aortic arch, 10 cases of right aortic arch with aberrant left subclavian artery and left-sided ductus arteriosus/ligamentum) and incomplete vascular rings (3 cases of pulmonary artery sling). Additionally, 5 cases had associated Kommerell’s diverticulum, and 12 had intracardiac malformation. All patients successfully completed surgery, and those with intracardiac malformation underwent extracorporeal circulation and primary radical surgery concurrently. Based on prenatal diagnosis and implementation of prenatal and postnatal integrated management, patients were divided into an observation group (prenatal and postnatal integrated management group) and a control group (postnatally diagnosed group). The perioperative data of the two groups were compared to analyze the surgical outcomes and the advantages of prenatal and postnatal integrated treatment.Results:All 75 patients successfully completed surgery. Preoperatively, 56 cases (74.66%) presented with varying degrees of tracheal stenosis. Except for 1 case that died after abandoning treatment and 1 case that underwent tracheal surgery due to repeated failed ventilator weaning, all other patients were successfully discharged from the hospital. The overall mortality rate was 1.33%, and the rate of tracheal surgery was 1.35%. The age and weight at surgery in the observation group were lower than those in the control group ( P<0.05), and the proportion of preoperative hospitalization history was lower in the observation group ( P<0.05). No significant differences were observed between the two groups in terms of tracheal compression and stenosis, postoperative monitoring time, operation time, ventilator time, and risk of postoperative complications ( P>0.05). Conclusion:Tracheal stenosis is a common complication in children with vascular rings. Early surgical intervention is recommended for complete vascular rings and pulmonary artery slings (as an incomplete ring). Timely prenatal diagnosis of vascular ring anomalies combined with the implementation of an integrated prenatal-postnatal management strategy can significantly reduce the risk of preoperative hospitalization due to related symptoms and may lower the risk of subsequent tracheal surgery, potentially improving long-term prognosis.

Objective To optimized the extraction process of the"Honghuangbai"gel and to establish the content determination method of the gel.Methods The contents of salidroside,berberine hydrochloride and 1,4-bis[4-(glucose-oxy)benzyl]-2-isobutyl malate in"honghuangbai"extract were determined by HPLC with gradient elution;the content of total polysaccharide was determined by anthrone-sulfuric acid method.AHP-CRITIC composite weighting method was used to calculate the weight coefficient of 4 indicators,and the comprehensive score was taken as the evaluation index.Combined with L9(34)orthogonal experiment design,the effects of solid-liquid ratio,extraction time and times on the extraction process of"honghuangbai"gel were investigated,and the optimal extraction process was selected and verified.The method for the determination of 4 index components in the gel was established and the methodology was investigated.Results The optimal solid-liquid ratio was 1∶45,the optimal extraction time was 2 h and the optimal extraction times was twice.The linear relationships of the four indexes were good in their respective linear ranges,with R2＞0.999 0.The average recoveries were 98.67％～102.09％,and RSD was 0.77％～3.17％.Good precision,repeatability and stability,RSD≤2.28％.Conclusion The optimal extraction process of"honghuangbai"gel optimized by AHP-CRITIC combined with orthogonal test is stable and economical.The method of the gel content determination is feasible and the result is reliable,which provides experimental basis for the establishment of the quality standard of the gel.

Objectives:To explore whether short-course radiotherapy (SCRT)-based total neoadjuvant therapy (TNT) combined with PD-1 inhibitors could further promote tumor regression and improve the prognosis.Methods:This is a prospective, multicenter, two-arm randomized controlled, seamless phase Ⅱ/Ⅲ trial for proficient mismatch repair or microsatellite stable (pMMR/MSS) locally advanced rectal cancer (LARC). Eligible patients were randomly assigned to the iTNT (TNT+PD-1) group or the TNT group. Patients in the TNT group received SCRT (5 Gy×5) followed by 4 cycles of CAPOX or 6 cycles of mFOLFOX chemotherapy, with the iTNT group receiving SCRT followed by the same regime in combination with 4 cycles of Sintilimab. Total mesorectal excision (TME) surgery or watch and wait (W&W) was performed after neoadjuvant therapy and then 2 cycles of same regimen as before were recommended. The primary endpoints are the complete response (CR) rate for phase Ⅱ trial and 3-year disease-free survival (DFS) for phase Ⅲ trial. A total of 588 patients will be enrolled for the phase Ⅱ/Ⅲ trial. Short-term efficacy and safety data from the initial 100 treated patients were analyzed as planned.Results:From 2022-8-31 to 2023-5-24 the initial 100 patients were enrolled from 10 hospitals in China, 76.0%(76/100) patients were male, and the median age was 61 years (21-74 years). More patients had tumors located in the lower rectum (78.0%, 78/100), staged T3-4 (97.0%, 97/100) and N1-2 (93.0%, 93/100), and about half of the tumors invaded the mesorectal fascia (52.0%, 52/100) and with extramural vascular invasion (51.0%, 51/100). Analyses were performed according to the per-protocal (PP) set. All patients in the iTNT group ( n=52) and the TNT group ( n=48) completed SCRT; The 4-cycle chemotherapy±Sintilimab completion rates were 86.5% and 100.0% in the iTNT and TNT groups, respectively. In the iTNT group, 82.7% (43/52), 11.5% (6/52), and 5.8% (3/52) of the patients received 4, 3, and 2 cycles of PD-1 inhibitor. After TNT, 68 patients underwent radical surgery and 15 patients achieved cCR and adopted W&W. The pathological complete response (pCR) rates were 48.5% (16/33) and 17.1% (6/35) in the iTNT and TNT groups, with CR rates of 50.0% (25/50) and 26.1% (12/46), respectively. The incidence of treatment-related grade 3-4 adverse events was 26.9% (14/52, iTNT group) and 18.8% (9/48, TNT group), with thrombocytopenia and leukopenia being the most common. Among patients receiving immunotherapy, grade 3 immunotherapy-related adverse events occurred in 2 (3.8%, 2/52) patients: one case was pancreatitis, another case was hepatitis combined with myositis and myocarditis. Conclusion:The preliminary results show that SCRT-based TNT combined with PD-1 inhibitors could further improve the CR rate for LARC without unexpected serious adverse events.

To investigate the epidemiological characteristics of co-infection involving macrolide-resistant Mycoplasma pneumoniae (MRMP) and non-bacterial pathogens in hospitalized children at Women and Children′s Hospital of Ningbo University from 2021 to 2024, a retrospective cross-sectional study was conducted. Throat swabs were collected from children admitted for respiratory tract infections between January 2021 and December 2024. A total of 22 311 children aged 0-18 years old were included, including 12 021 males and 10 290 females. The median age was 5.00 years and the mean age was (5.02±3.25) years. Real-time fluorescence quantitative polymerase chain reaction (PCR) and multiplex PCR were employed to determine the MP infection rate, the prevalence of MRMP, and the co-infection rates with non-bacterial pathogens across different years. Patients with MRMP were categorized into two groups based on the presence or absence of co-infections: simple infection group and mixed infection group. The differences in age, gender, and onset time between these groups were analyzed, along with the distribution of pathogens in the mixed infection group. Chi-square tests were used for intergroup comparisons. The results showed that the overall positive rate of MP among the 22 311 children was 39.42% (8 794/22 311), with a detection rate of MP drug resistance gene mutations at 70.42% (6 193/8 794). The co-infection rate of MRMP was 24.29% (1 504/6 193). Statistically significant differences were observed in the MP positive rate and the detection rate of drug resistance gene mutations from 2021 to 2024 ( χ2=1 674.420, P<0.05; χ2=67.733, P<0.05), with peak values in 2023 (50.87% and 73.83%, respectively). Among the annual co-infections, the highest rate was in 2024 (28.72%), while the lowest was in 2022 (7.30%). In the age distribution, the rate of mixed infections decreased with increasing age ( χ2=84.742, P<0.05). Seasonally, the infection rates in winter 2023 and the spring, summer, and autumn of 2024 were significantly higher than those in 2022 ( χ2=24.243, 13.101, 26.181, and 10.687, respectively; all P<0.05), with the lowest mixed infection rate observed in winter 2022 over the four-year period. Over the four years, the highest positive rate for rhinovirus was consistently observed in MRMP co-infections each year, particularly in the 3-to 6-year-old age group. The positive rate for mixed infections involving respiratory syncytial virus, human bocavirus, and parainfluenza virus was notably higher in the 0- to 3-year-old age group. Following the removal of non-pharmaceutical interventions (NPIs) in December 2022, the co-infection rate of other respiratory viruses and MRMP increased in Ningbo City. In conclusion, the positive rate of MRMP has shown an upward trend from 2021 to 2023. Post-NPI removal, MRMP mixed infections have become more prevalent in 2023 and 2024, predominantly affecting children aged 0-6 years, with rhinovirus being the most common co-pathogen.

Objective To optimized the extraction process of the"Honghuangbai"gel and to establish the content determination method of the gel.Methods The contents of salidroside,berberine hydrochloride and 1,4-bis[4-(glucose-oxy)benzyl]-2-isobutyl malate in"honghuangbai"extract were determined by HPLC with gradient elution;the content of total polysaccharide was determined by anthrone-sulfuric acid method.AHP-CRITIC composite weighting method was used to calculate the weight coefficient of 4 indicators,and the comprehensive score was taken as the evaluation index.Combined with L9(34)orthogonal experiment design,the effects of solid-liquid ratio,extraction time and times on the extraction process of"honghuangbai"gel were investigated,and the optimal extraction process was selected and verified.The method for the determination of 4 index components in the gel was established and the methodology was investigated.Results The optimal solid-liquid ratio was 1∶45,the optimal extraction time was 2 h and the optimal extraction times was twice.The linear relationships of the four indexes were good in their respective linear ranges,with R2＞0.999 0.The average recoveries were 98.67％～102.09％,and RSD was 0.77％～3.17％.Good precision,repeatability and stability,RSD≤2.28％.Conclusion The optimal extraction process of"honghuangbai"gel optimized by AHP-CRITIC combined with orthogonal test is stable and economical.The method of the gel content determination is feasible and the result is reliable,which provides experimental basis for the establishment of the quality standard of the gel.