OBJECTIVE To study the effect of different doses of aspirin on clinical efficacy in acute stage of Kawasaki’s disease, and to explore the optimal dose of aspirin. METHODS A total of 150 patients suffered from Kawasaki’s disease were randomly selected by hospital information system from March to May 2022 for retrospective analysis. According to different doses of aspirin, they were divided into three groups: high dose group(>50 mg·kg−1·d−1), medium dose group(30−50 mg·kg−1·d−1) and low dose group(<30 mg·kg−1·d−1). The antipyretic time, the incidence of non-response to intravenous human immunoglobulin, the improvement of laboratory indexes and prevalence of adverse drug reaction were compared among the three groups. RESULTS There was no significant difference in body temperature recovery among the three groups under different doses of aspirin. There was no significant difference in patients with non-response to intravenous human immunoglobulin among the three groups. Before treatment, there were no significant differences in white blood cell(WBC) count, blood platelet(PLT) count and C-reactive protein(CRP) concentration among the three groups. After treatment, the count of WBC, PLT and CRP in the three groups was significantly improved compared with that before treatment, and the difference was statistically significant(P<0.05). However, there was no significant difference in the above indexes among the three groups after treatment. There was a higher incidence of adverse reactions in children treated with medium or high dose aspirin. CONCLUSION Different doses of aspirin combined with intravenous human immunoglobulin have good therapeutic effect on Kawasaki’s disease, but considering the safety and economy of aspirin, low dose administration is recommended.

Objective:To investigate the efficacy and safety of irreversible electroporation in focal ablation of localized prostate cancer.Methods:Clinical data of 128 patients with localized prostate cancer treated with irreversible electroporation from August 2019 to September 2023 at Renji Hospital of Shanghai Jiaotong University School of Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Dongfang Hospital of Tongji University, were retrospectively analyzed. The median age was 68 (62, 75) years. The median PSA was 8.64 (5.83, 12.57) ng/ml. Gleason score was 6 in 57 cases, 7 in 39 cases, and greater than 7 in 19 cases. There were 4 cases of T 1c, 69 cases of T 2a, 27 cases of T 2b, and 28 cases of T 2c. No lymph node or distant metastasis was seen in preoperative examination. All patients had no preoperative urinary retention or urinary incontinence. Irreversible electroporation treatment was administered under general anesthesia with patients in the lithotomy position. A transrectal ultrasound probe was used to measure prostate lesion size, determining the type and number of electrode needles. Electrode needles were strategically positioned around the targeted lesion. The distance between each pair of needles used for ablation ranged from 0.5 to 2.0 cm. The system automatically generated treatment parameters, including voltage, current, and the number of pulses, with each pulse cycle lasting approximately 5 minutes. After treatment, the needles were removed, gauze was applied for 1 minute. The urethra was then irrigated with a painless iodine solution diluted 1∶1 with 0.9% saline, followed by the insertion of a urinary catheter. Treatment efficacy and adverse reactions were documented. Biochemical recurrence was defined as a PSA increase of over 2 ng/ml from the post-treatment nadir; imaging recurrence was identified by abnormal lesions on MRI or contrast-enhanced ultrasound. Results:All 128 surgeries were successfully completed. At 6 months postoperatively, 116 cases were followed. Tne median PSA was 1.58 (0.56, .95) ng/ml, which was 82.22% (65.37%, 93.33%) lower than preoperative level( P<0.01). Five patients (4.31%) had biochemical recurrence, and MRI or contrast-enhanced ultrasound examinations were negative, 1 patient underwent radical prostatectomy with pathology of prostate cancer, and the remaining 4 were continued to be followed up. Ninety-eight patients underwent MRI or contrast-enhanced ultrasound review, including 6 patients (6.12%) detected imaging recurrence, of which 2 patients underwent radical prostatectomy with pathology of prostate cancer, and the remaining 4 underwent endocrine therapy. The postoperative continence rate was 98.28%, and 8 patients (6.89%) had complications of class II. Conclusions:Irreversible electroporation for focal treatment of localized prostate cancer has shown favorable results in terms of tumor control, safety and urinary continence.

Feature extraction methods and classifier selection are two critical steps in heart sound classification. To capture the pathological features of heart sound signals, this paper introduces a feature extraction method that combines mel-frequency cepstral coefficients (MFCC) and power spectral density (PSD). Unlike conventional classifiers, the adaptive neuro-fuzzy inference system (ANFIS) was chosen as the classifier for this study. In terms of experimental design, we compared different PSDs across various time intervals and frequency ranges, selecting the characteristics with the most effective classification outcomes. We compared four statistical properties, including mean PSD, standard deviation PSD, variance PSD, and median PSD. Through experimental comparisons, we found that combining the features of median PSD and MFCC with heart sound systolic period of 100-300 Hz yielded the best results. The accuracy, precision, sensitivity, specificity, and F1 score were determined to be 96.50%, 99.27%, 93.35%, 99.60%, and 96.35%, respectively. These results demonstrate the algorithm's significant potential for aiding in the diagnosis of congenital heart disease.
Humans ; Heart Sounds ; Neural Networks, Computer ; Algorithms ; Heart Defects, Congenital

Objective:To evaluate incision scars of transaxillary breast augmentation by different methods of scar assessment.Methods:A retrospective study was carried out on 30 patients (age range 20 to 50 years, with mean age of 32 years) who underwent endoscopic assisted transaxillary type Ⅰ dual plane breast implant augmentation by a same surgeon from August 2014 to November 2016. Scars were estimated by 3 methods which included Vancouver Scar Scale (VSS), Visual Assessment Scale (VAS) and patients' questionnaire.Results:VAS score for left side scars ranged from 0 to 8 and the median was 1. VAS score for right side scars ranged from 0 to 8.3 and the median was 1. A total of 48 scars were scored in the 0-2 point range, representing 80% of the 60 total. VSS score for left side scars ranged from 0 to 11.6 and the median was 0.8. VSS score for right side scars ranged from 0 to 11.3 and the median was 1.2. A total of 46 scars were scored in the 0-2 point range, representing 76.7% of the total 60 breats. The scores between VSS and VAS had significant statistical differences ( P<0.001). 80.0% of our patients regarded scars as unconspicuous or basically invisible in our questionnaire. Conclusions:The majority of transaxillary incision scars recover in favorable status with high patients satisfactory rate. VAS is a practical tool for evaluating transaxillary incision scars. The VSS score is not equivalent to the VAS score when grading scars only by photos.

Immunotherapy combined with effective therapeutics such as chemotherapy and photodynamic therapy have been shown to be a successful strategy to activate anti-tumor immune responses for improved anticancer treatment. However, developing multifunctional biodegradable, biocompatible, low-toxic but highly efficient, and clinically available transformed nano-immunostimulants remains a challenge and is in great demand. Herein, we report and design of a novel carrier-free photo-chemotherapeutic nano-prodrug COS-BA/Ce6 NPs by combining three multifunctional components-a self-assembled natural small molecule betulinic acid (BA), a water-soluble chitosan oligosaccharide (COS), and a low toxic photosensitizer chlorin e6 (Ce6)-to augment the antitumor efficacy of the immune adjuvant anti-PD-L1-mediated cancer immunotherapy. We show that the designed nanodrugs harbored a smart and distinctive "dormancy" characteristic in chemotherapeutic effect with desired lower cytotoxicity, and multiple favorable therapeutic features including improved ¹O₂ generation induced by the reduced energy gap of Ce6, pH-responsiveness, good biodegradability, and biocompatibility, ensuring a highly efficient, synergistic photochemotherapy. Moreover, when combined with anti-PD-L1 therapy, both nano-coassembly based chemotherapy and chemotherapy/photodynamic therapy (PDT) could effectively activate antitumor immunity when treating primary or distant tumors, opening up potentially attractive possibilities for clinical immunotherapy.

Objective To investigate the effect of couch rotation angle on non-coplanar static intensity-modulated radiotherapy (IMRT) plan for gastric cancer and to provide a reference for clinical planning. Methods A retrospective analysis was conducted on patients who recently underwent postoperative IMRT for gastric cancer. Twenty patients who received radiotherapy in the centre of Radiation Oncology of Huanggang Central Hospital from August 2022 to January 2023 were selected. That were selected to receive a seven-field coplanar static IMRT plan based on a couch rotation angle of 0° as the control group. Then, based on the coplanar IMRT plan, only the couch rotation angle of gantry angles 30° and 330° was changed to 10°, 20°, 30°, 40°, 50°, 60°, 70°, 80°, and 90°, respectively, and nine different non-coplanar plans were established. The homogeneity index (HI), conformity index (CI) of the target volume, and monitor unit (MU), as well as D_mean, V₂₀, and V₃₀ of the left and right kidneys, D_max, D_mean, V₁₀, V₂₀, and V₃₀ of the spinal cord, and D_max, D_mean, V₁₀, V₂₀, V₃₀, and V₄₀ of the small intestine and liver were compared among the 10 plans. The MU and the dosimetric parameters of the target volumes and When the couch rotation angle was 60°, the minimum HI and maximum CI of the target volume were 0.0714±0.0089 and 0.9271±0.0108, respectively, and the minimum MU was 438±26, with the best homogeneity and conformity in the target volume and the shortest machine treatment time (P＜0.05). When the couch rotation angle was 10°, the D_max of the small intestine was lowest, being (4620.73±99.27) cGy. When the couch rotation angle was 60°, the D_mean of the left and right kidneys was lowest, being (1246.30±130.35) cGy and (1001.52±103.33) cGy, respectively; the V₂₀ of the left and right kidneys was lowest, being 22.87±6.29 and 19.69±1.84, respectively; the V₁₀ and V₃₀ of the spinal cord were lowest, being 40.08±4.92 and 1.68±0.34, respectively (P＜0.05). Conclusion The couch rotation angle has some influence on the postoperative treatment planning for patients with gastric cancer. In the design of non-coplanar plan for gastric cancer, the couch rotation angle of 60° contributes to establishing a better radiotherapy plan.

Currently, there is still no effective curative treatment for the development of late-stage liver fibrosis. Here, we have illustrated that TB001, a dual glucagon-like peptide-1 receptor/glucagon receptor (GLP-1R/GCGR) agonist with higher affinity towards GCGR, could retard the progression of liver fibrosis in various rodent models, with remarkable potency, selectivity, extended half-life and low toxicity. Four types of liver fibrosis animal models which were induced by CCl₄, α-naphthyl-isothiocyanate (ANIT), bile duct ligation (BDL) and Schistosoma japonicum were used in our study. We found that TB001 treatment dose-dependently significantly attenuated liver injury and collagen accumulation in these animal models. In addition to decreased levels of extracellular matrix (ECM) accumulation during hepatic injury, activation of hepatic stellate cells was also inhibited via suppression of TGF-β expression as well as downstream Smad signaling pathways particularly in CCl₄-and S. japonicum-induced liver fibrosis. Moreover, TB001 attenuated liver fibrosis through blocking downstream activation of pro-inflammatory nuclear factor kappa B/NF-kappa-B inhibitor alpha (NFκB/IKBα) pathways as well as c-Jun N-terminal kinase (JNK)-dependent induction of hepatocyte apoptosis. Furthermore, GLP-1R and/or GCGR knock-down results represented GCGR played an important role in ameliorating CCl₄-induced hepatic fibrosis. Therefore, TB001 can be used as a promising therapeutic candidate for the treatment of multiple causes of hepatic fibrosis demonstrated by our extensive pre-clinical evaluation of TB001.

Pancreaticoduodenectomy (PD) is an established surgical treatment for pancreatic and periampullary diseases. Abdominal drainage after PD has been routinely used for many years to early detect complications and to promote rapid recovery of patients. However, with the introduction of enhanced recovery after surgery, controversies exist on the safety and effectiveness of routine use of abdominal drainage after PD. This article reviewed the controversies on whether routine abdominal drainage are necessary after PD, how to place abdominal drains, and when to remove abdominal drains.

Objective To investigate the fertility history and demand for reproductive health services of new residents in Shanghai. Methods A questionnaire survey was conducted among 1 358 new residents in 36 survey sites in 7 districts of Shanghai from July to September 2020. The content includes fertility history， induced abortion history， demand for reproductive health-related services， awareness rate of the Shanghai Family Planning Association and service access rate， etc. Results Among the new residents themselves and their spouses/sexual partners， 31.3% （374/1 194） had been pregnant once and 33.6% （401/1 194） had been pregnant twice； 46.3% （533/1 194）had one child and 29.7% （355/1 194）had two children. The difference of number of births among new residents with different residence time， those who did or did not possess permanent residency or residence permits， and those from different sources （urban or rural） was statistically significant （ χ ²=158.664， 50.263， 16.011， 114.419， all P <0.001）. Among the new residents themselves and their spouses / sexual partners， the proportion of induced abortion of more than once was 36.1%. The difference of the number of abortions of new residents with or without permanent residency was statistically significant （ χ ²=19.389， P <0.001）. The awareness rate of new residents of the harm of induced abortion to health was 92.1% （1 100/1 194）； There were significant differences in the scientific knowledge of harm of induced abortion to health among new residents with different local residence time and those with or without a residence permit （ χ ²=36.590， 20.926， both P <0.001）. The awareness rate of the Family Planning Association was 82.6% （986/1 194）， and the service access rate was 51.3% （613/1 194）. Permanent residency and residence permits are the main factors that affect the service accessibility of the Shanghai Family Planning Association. 44.8% （535/1 194） of new residents hope to receive reproductive health services in their place of residence， and they are most concerned about knowledge on good prenatal and postnatal care. Conclusion We should further publicize the "three-child" fertility policy， advocate a friendly fertility culture， and provide new residents with people-centered and accurate reproductive health services adapted to their needs through multi-sectoral cooperation， so as to improve their reproductive health level.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.