Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.

Objective: To understand the epidemiological characteristics of a pertussis outbreak in Guangzhou, so as to provide references for outbreak response and prevention strategies. Methods: From April 5 to June 9, 2024, case screening was conducted among 246 preschool children, 35 staff members, and one full time school nurse in a kindergarten in Guangzhou based on case definition. Field epidemiological investigation methods were employed to collect relevant information, and screening samples were collected from individuals involved in the outbreak. The clinical manifestations, epidemiological characteristics, and risk factors for transmission of the outbreak were analyzed, with rate comparisons performed using the χ 2 test. Results: There were a total of 15 confirmed cases of pertussis in the kindergarten. The main clinical manifestations included intermittent cough in 14 cases ( 93.33 %), sputum production in 5 cases (33.33%), fever in 2 cases (13.33%), paroxysmal spasmodic cough in 1 case (6.67%), and vomiting in 1 case (6.67%). There was no statistically significant difference in the reporting rates of interrupted cough symptoms between pertussis cases (93.33%) and non pertussis cases (92.86%)( χ 2=3.74, P >0.05). The cases were aged 4-5 years, including 5 males and 10 females. The interval between symptom onset and diagnosis ranged from 2 to 25 days, with a median of 10 days. The outbreak involved two classes, with attack rates of 48.28% and 3.45%, respectively. Laboratory testing confirmed 14 close contacts positive for Bordetella pertussisnucleic acid. Among close contacts, only one received prophylactic medication as required. Conclusion The outbreak is a pertussis outbreak in a kindergarten caused by Bordetella pertussis infection, demonstrating distinct temporal and spatial clustering characteristics.

Short stature(SS) and disorder of sex development(DSD) are two types of conditions characterized by high clinical heterogeneity and complex etiology. There is interplay and mutual influence between the pathways regulated by growth hormone and sex hormones in skeletal and gonadal development. Causing co-occurrence of SS and DSD, as seen in conditions such as Turner syndrome, mixed gonadal dysgenesis, Noonan syndrome, and Prader-Willi syndrome. Patients with these disorders are often accompanied by distinctive facial features, endocrine and metabolic disturbances, cardiovascular disease, and other systemic complications. Genetic factors involved include chromosomal numerical and structural abnormalities; mutations in genes such as SHOX, CHD7, SOX8, and PTPN11, dysregulation of the RAS/mitogen activated protein kinase signaling pathway, and defects in imprinted genes. This article aims to systematically review the relevant research progress, in order to provide a reference for the clinical diagnosis and treatment strategies of patients with coexisting SS and DSD.

ObjectiveTo evaluate the safety and efficacy of oxycodone versus sufentanil for postoperative analgesia in patients with moderate to severe obstructive sleep apnea （OSA） undergoing uvulopalatopharyngoplasty （UPPP）. MethodsWe enrolled 73 consecutive patients with moderate-to-severe OSA （confirmed by polysomnography） scheduled for elective UPPP under general anesthesia at our institution between August 2023 and August 2025. Patients were randomly assigned to receive oxycodone （n = 37） or sufentanil （n = 36） using a random number table . The sufentanil group received 1.5 μg per kilogram of body weight， and the oxycodone group received 0.9 mg per kilogram； both groups used patient-controlled intravenous analgesia （PCIA） pumps with a total volume of 100 mL. A 2 mL loading dose was administered 10 minutes before the end of surgery， followed by a background infusion of 2 mL per hour， 2 mL bolus doses on demand， an 8-minute lockout interval， and a maximum hourly volume of 10 mL. We assessed pain scores （Numerical Rating Scale） at rest and during swallowing， Ramsay sedation scores， morphine-equivalent opioid consumption， PCIA bolus demands， patient satisfaction， time to first oral intake， and adverse events （including respiratory depression， nausea， and vomiting） at 4， 12， 24， and 48 hours postoperatively. ResultsBaseline characteristics were well balanced between the two groups （all P＞0.05）. No significant between-group differences were observed in resting and swallowing NRS scores or Ramsay sedation scores at each postoperative time point， PCIA satisfaction， time to first oral intake， or adverse event incidence across all postoperative time points （all P＞0.05）. Morphine-equivalent opioid consumption was significantly lower in the oxycodone group at all time points， as were unsuccessful PCIA bolus demands at 24 and 48 hours postoperatively （both P＜0.05）. ConclusionsLow-dose oxycodone provided analgesic efficacy similar to that of sufentanil for PCIA after UPPP in patients with moderate-to-severe OSA， with no significant between-group differences in adverse events， time to first oral intake， or satisfaction .The oxycodone group had numerically lower adverse event rates and a shorter time to first oral intake， suggesting a favorable safety profile and potential benefits for reducing opioid-related events and facilitating earlier recovery in this patient population.

ObjectiveTo evaluate the safety and efficacy of oxycodone versus sufentanil for postoperative analgesia in patients with moderate to severe obstructive sleep apnea （OSA） undergoing uvulopalatopharyngoplasty （UPPP）. MethodsWe enrolled 73 consecutive patients with moderate-to-severe OSA （confirmed by polysomnography） scheduled for elective UPPP under general anesthesia at our institution between August 2023 and August 2025. Patients were randomly assigned to receive oxycodone （n = 37） or sufentanil （n = 36） using a random number table . The sufentanil group received 1.5 μg per kilogram of body weight， and the oxycodone group received 0.9 mg per kilogram； both groups used patient-controlled intravenous analgesia （PCIA） pumps with a total volume of 100 mL. A 2 mL loading dose was administered 10 minutes before the end of surgery， followed by a background infusion of 2 mL per hour， 2 mL bolus doses on demand， an 8-minute lockout interval， and a maximum hourly volume of 10 mL. We assessed pain scores （Numerical Rating Scale） at rest and during swallowing， Ramsay sedation scores， morphine-equivalent opioid consumption， PCIA bolus demands， patient satisfaction， time to first oral intake， and adverse events （including respiratory depression， nausea， and vomiting） at 4， 12， 24， and 48 hours postoperatively. ResultsBaseline characteristics were well balanced between the two groups （all P＞0.05）. No significant between-group differences were observed in resting and swallowing NRS scores or Ramsay sedation scores at each postoperative time point， PCIA satisfaction， time to first oral intake， or adverse event incidence across all postoperative time points （all P＞0.05）. Morphine-equivalent opioid consumption was significantly lower in the oxycodone group at all time points， as were unsuccessful PCIA bolus demands at 24 and 48 hours postoperatively （both P＜0.05）. ConclusionsLow-dose oxycodone provided analgesic efficacy similar to that of sufentanil for PCIA after UPPP in patients with moderate-to-severe OSA， with no significant between-group differences in adverse events， time to first oral intake， or satisfaction .The oxycodone group had numerically lower adverse event rates and a shorter time to first oral intake， suggesting a favorable safety profile and potential benefits for reducing opioid-related events and facilitating earlier recovery in this patient population.

Objective:To evaluate any effect of transcranial direct current stimulation (tDCS) on cognitive impairment after an ischemic stroke (IS) using tract-based spatial statistics (TBSS).Methods:Fifty-one patients with mild or more serious cognitive impairment after an IS were divided into an electrical stimulation group (26 cases) and a control group (25 cases) using a random number table. In addition to conventional rehabilitation treatment, the electrical stimulation group was given tDCS, while the control group was given sham tDCS for 15 days. Before and after the treatment, both groups were evaluated using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Diffusion tensor imaging (DTI) was also performed. TBSS were computed for the differences in fractional anisotropy (FA) between the two groups before and after the treatment, and Pearson correlation analysis was applied to the pre-treatment and post-treatment FA differences within each group and the improvements in MMSE and MoCA scores.Results:After the treatment, the average MMSE and MoCA scores of both groups had improved significantly, but the improvement was significantly greater in the electrical stimulation group. After the treatment, the FA values among the electrical stimulation group had increased significantly in the bilateral genu of the corpus callosum, the bilateral inferior fronto-occipital fasciculus, the bilateral anterior thalamic radiation and the left superior longitudinal fasciculus. In the control group significant increases were recorded only in the left superior longitudinal fasciculus and the left anterior thalamic radiation. The FA change in the left superior longitudinal fasciculus of the electrical stimulation group was then positively correlated with the improvement in MMSE scores ( r=0.42), and that in the left anterior thalamic radiation was positively correlated with the improvement in MoCA scores ( r=0.45). Conclusions:tDCS can significantly improve the cognition of stroke survivors with cognitive impairment and promote the recovery of white matter fiber tracts. The FA values of the anterior thalamic radiation and the superior longitudinal fasciculus may be useful predictors and indicators of the recovery of cognitive function among such patients.

Objective To analyze the clinical characteristics of children with moyamoya disease and the influence of Chinese medicine identification and acupuncture treatment plan on their prognosis.Methods A retrospective analysis was conducted on the diagnosis and treatment of children diagnosed with moyamoya disease who underwent surgery and were treated with acupuncture at Tianjin Children's Hospital on July 10,2023.The main acupuncture points were as follows:Points on head and face:shangxing,yintang,touwei,middle line of vertex,anterior oblique line of vertex-temporal(the upper 1/5 section),lateral line 1 of vertex,anterior temporal line,renzhong,shanglianquan,sibai,yingxiang,quanliao,xiaguan,and dicang;Points on upper extremities:jiquan,chize,neiguan(quick stabbing without leaving needles),jianyu,jianliao,quchi,waiguan,yangxi,houxi,hegu;Points on lower extremities:weizhong,weiyang(quick stabbing without leaving needles),biguan,xuehai,liangqiu,zusanli,qiuxu,sanyinjiao,and taichong),the needles were performed once a day,and continuous treatment for 5 days each week,and the general conditions of the children were observed after 2 weeks of treatment,and the Fugl-Meyer assessment(FMA),the Barthel index(BI),and the simple test for evaluating hand function(STEF)were used,to assess left upper limb motor function;neurophysiologic techniques were used to examine motor nerve conduction in the left limb.Results The child was an 8-year-old male admitted to the hospital on July 10,2023.①Complaint:unfavorable movement of the left limb for more than 1 month.②History:the child had an abnormal seizure during waking hours 2 years before admission,which lasted for about 1 minute and then resolved on its own,and he could recall the course of the seizure afterward.Attended at the department of neurology of our hospital and diagnosed with moyamoya disease after being discharged from the hospital,the child was found at home to have weakness of the left limbs,unable to lift the upper limbs and unable to walk on the lower limbs.Attended at the department of neurosurgery of a certain hospital and was diagnosed with acute cerebral infarction and underwent cranio-cerebral vascular anastomosis.After the operation,the child's left limb activity is unfavorable,the right limb has no motor disorder and sensory abnormality,speech expression is unclear,to further improve the motor function of the child's limbs,the patient was referred to the rehabilitation department of our hospital,the initial diagnosis of moyamoya disease disease recovery(left hemiplegia),according to the specific conditions of the adjustment of the acupuncture program,2 weeks after the treatment,the patient's facial lines were basically symmetrical,crying and laughing,the corner of the mouth does not droop.After 4 weeks of treatment,the child was able to walk on the ground independently,but hemiplegic gait,left lower limb muscle tone basically relieved,proximal muscle strength grade Ⅲ-Ⅳ,distal muscle strength grade Ⅱ-Ⅲ.After 6 weeks of treatment,the child's hemiplegic gait was improved,proximal muscle strength was grade Ⅳ,distal muscle strength was grade Ⅲ-Ⅳ,the left hand could hold objects for a few minutes,left thumb flexor strength was grade Ⅲ,dorsal extensor strength was grade Ⅱ,and the rest of the four fingers flexor and dorsal extensor strength was grade Ⅳ.The proximal muscle strength was grade Ⅴ and distal muscle strength was grade Ⅳ.The left wrist could move freely,the left interphalangeal joint could extend and hold objects,and the motor function of the left upper limb was basically established,and the condition was stabilized.FMA,BI and STEF scores all increased with the prolongation of the treatment time,and the latency and nerve conduction velocity of the median nerve,peroneal nerve and tibial nerve tended to normal after treatment.Conclusion The efficacy of traditional acupuncture in treating pediatric moyamoya disease after cerebral infarction surgery rehabilitation is remarkable,which can significantly improve the clinical symptoms of children recovering from moyamoya disease.

Objective To explore the application values of different detection methods in monitoring the decline pattern of syphilis-spe-cific antibody in the non-congenital syphilis children.Methods A total of 80 non-congenital syphilis children were included in the study.The serum specimens were collected after birth,and the syphilis-specific antibodies were detected using electrochemilumines-cence immunoassay(ECLIA),western blotting(WB),treponema pallidum particle agglutination assay(TPPA),enzyme-linked im-munosorbent assay(ELISA),and toluidine red unheated serum test(TRUST).Follow-up was conducted every three months until the positive results of ELISA and TRUST turned to negative.Results The results of ECLIA showed that the syphilis-specific antibody lev-els in the non-congenital syphilis children declined to 25％of the level at birth within 2 to 3 months,and the rate of decline was inde-pendent of the initial concentration.WB analysis indicated that the specific IgG bands in non-congenital syphilis children at birth were consistent with those of their mother,and the sequence of specific antibodies decline was as follows:TPN47,TPN15,TPN45,and TPN17.Due to methodological limitations,the absorbance values of ELISA showed no significant change during the first three months after birth when high concentrations of antibodies were present in the samples,but it showed high sensitivity in the detection for the samples with low-concentration of syphilis antibodies.The detection rates of ECLIA,TPPA,and WB were compared by using ELISA as the reference method.At birth,the detection rates of syphilis antibodies were 100％,100％,and 90％,respectively.In 3 months after birth,the detection rates were 100％,100％,and 75％.In 6 months after birth,,they were 100％,46％,and 15％.In 9 months after birth,they were 83％,33％,and 0％.The positive rate of TRUST was 17.5％at birth.and turned to negative in 3 month of follow-up.Conclusion Syphilis specific IgG antibodies may fully transferred to the fetus and decline in a predictable pattern after birth.The comprehensive analysis for the results of the four methods suggested that dynamic detection using ECLIA method could be used to pre-dict the risk of non-congenital syphilis or terminate the follow-up at 3 months,while the seroconversion detected by WB was earlier than that by TPPA,while ELISA required the longest follow-up period.

Objective To analyze the clinical characteristics of children with moyamoya disease and the influence of Chinese medicine identification and acupuncture treatment plan on their prognosis.Methods A retrospective analysis was conducted on the diagnosis and treatment of children diagnosed with moyamoya disease who underwent surgery and were treated with acupuncture at Tianjin Children's Hospital on July 10,2023.The main acupuncture points were as follows:Points on head and face:shangxing,yintang,touwei,middle line of vertex,anterior oblique line of vertex-temporal(the upper 1/5 section),lateral line 1 of vertex,anterior temporal line,renzhong,shanglianquan,sibai,yingxiang,quanliao,xiaguan,and dicang;Points on upper extremities:jiquan,chize,neiguan(quick stabbing without leaving needles),jianyu,jianliao,quchi,waiguan,yangxi,houxi,hegu;Points on lower extremities:weizhong,weiyang(quick stabbing without leaving needles),biguan,xuehai,liangqiu,zusanli,qiuxu,sanyinjiao,and taichong),the needles were performed once a day,and continuous treatment for 5 days each week,and the general conditions of the children were observed after 2 weeks of treatment,and the Fugl-Meyer assessment(FMA),the Barthel index(BI),and the simple test for evaluating hand function(STEF)were used,to assess left upper limb motor function;neurophysiologic techniques were used to examine motor nerve conduction in the left limb.Results The child was an 8-year-old male admitted to the hospital on July 10,2023.①Complaint:unfavorable movement of the left limb for more than 1 month.②History:the child had an abnormal seizure during waking hours 2 years before admission,which lasted for about 1 minute and then resolved on its own,and he could recall the course of the seizure afterward.Attended at the department of neurology of our hospital and diagnosed with moyamoya disease after being discharged from the hospital,the child was found at home to have weakness of the left limbs,unable to lift the upper limbs and unable to walk on the lower limbs.Attended at the department of neurosurgery of a certain hospital and was diagnosed with acute cerebral infarction and underwent cranio-cerebral vascular anastomosis.After the operation,the child's left limb activity is unfavorable,the right limb has no motor disorder and sensory abnormality,speech expression is unclear,to further improve the motor function of the child's limbs,the patient was referred to the rehabilitation department of our hospital,the initial diagnosis of moyamoya disease disease recovery(left hemiplegia),according to the specific conditions of the adjustment of the acupuncture program,2 weeks after the treatment,the patient's facial lines were basically symmetrical,crying and laughing,the corner of the mouth does not droop.After 4 weeks of treatment,the child was able to walk on the ground independently,but hemiplegic gait,left lower limb muscle tone basically relieved,proximal muscle strength grade Ⅲ-Ⅳ,distal muscle strength grade Ⅱ-Ⅲ.After 6 weeks of treatment,the child's hemiplegic gait was improved,proximal muscle strength was grade Ⅳ,distal muscle strength was grade Ⅲ-Ⅳ,the left hand could hold objects for a few minutes,left thumb flexor strength was grade Ⅲ,dorsal extensor strength was grade Ⅱ,and the rest of the four fingers flexor and dorsal extensor strength was grade Ⅳ.The proximal muscle strength was grade Ⅴ and distal muscle strength was grade Ⅳ.The left wrist could move freely,the left interphalangeal joint could extend and hold objects,and the motor function of the left upper limb was basically established,and the condition was stabilized.FMA,BI and STEF scores all increased with the prolongation of the treatment time,and the latency and nerve conduction velocity of the median nerve,peroneal nerve and tibial nerve tended to normal after treatment.Conclusion The efficacy of traditional acupuncture in treating pediatric moyamoya disease after cerebral infarction surgery rehabilitation is remarkable,which can significantly improve the clinical symptoms of children recovering from moyamoya disease.

Objective:To evaluate any effect of transcranial direct current stimulation (tDCS) on cognitive impairment after an ischemic stroke (IS) using tract-based spatial statistics (TBSS).Methods:Fifty-one patients with mild or more serious cognitive impairment after an IS were divided into an electrical stimulation group (26 cases) and a control group (25 cases) using a random number table. In addition to conventional rehabilitation treatment, the electrical stimulation group was given tDCS, while the control group was given sham tDCS for 15 days. Before and after the treatment, both groups were evaluated using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Diffusion tensor imaging (DTI) was also performed. TBSS were computed for the differences in fractional anisotropy (FA) between the two groups before and after the treatment, and Pearson correlation analysis was applied to the pre-treatment and post-treatment FA differences within each group and the improvements in MMSE and MoCA scores.Results:After the treatment, the average MMSE and MoCA scores of both groups had improved significantly, but the improvement was significantly greater in the electrical stimulation group. After the treatment, the FA values among the electrical stimulation group had increased significantly in the bilateral genu of the corpus callosum, the bilateral inferior fronto-occipital fasciculus, the bilateral anterior thalamic radiation and the left superior longitudinal fasciculus. In the control group significant increases were recorded only in the left superior longitudinal fasciculus and the left anterior thalamic radiation. The FA change in the left superior longitudinal fasciculus of the electrical stimulation group was then positively correlated with the improvement in MMSE scores ( r=0.42), and that in the left anterior thalamic radiation was positively correlated with the improvement in MoCA scores ( r=0.45). Conclusions:tDCS can significantly improve the cognition of stroke survivors with cognitive impairment and promote the recovery of white matter fiber tracts. The FA values of the anterior thalamic radiation and the superior longitudinal fasciculus may be useful predictors and indicators of the recovery of cognitive function among such patients.