Objective:To investigate the therapeutic effects of fluticasone propionate combined with loratadine syrup and montelukast sodium on asthma and allergic rhinitis in children.Methods:A total of 119 children with asthma and allergic rhinitis, admitted to Department of Pediatrics, Dongyang Maternal and Child Health Hospital from March 2021 to March 2024, were selected for this retrospective study. Based on the different treatment methods recorded in the medical record system, the children were divided into two groups: the control group ( n = 70), which received loratadine syrup combined with montelukast sodium, and the observation group ( n = 49), which received fluticasone propionate combined with loratadine syrup and montelukast sodium. Clinical symptoms (rhinitis and asthma), serum markers (immunoglobulin E, interleukin-4, and interleukin-6), lung function (maximum peak expiratory flow rate, forced expiratory volume in the first second, forced expiratory flow at 25% of vital capacity, forced expiratory flow at 50% of vital capacity, forced expiratory flow at 75% of vital capacity), as well as adverse reactions and clinical efficacy, were observed and compared between the two groups. Results:After treatment, the symptom scores for both rhinitis and asthma in the observation group were significantly lower than those in the control group [(3.65 ± 0.88) vs. (4.55 ± 1.06), t = 4.88, P < 0.001; (2.15 ± 0.56) vs. (3.28 ± 0.89), t = 7.86, P < 0.001]. The levels of immunoglobulin E, interleukin-4, and interleukin-6 in the observation group were significantly lower than those in the control group [(0.31 ± 0.18) g/L vs. (0.42 ± 0.19) g/L, t = 3.18, P = 0.002; (56.83 ± 8.25) ng/L vs. (62.16 ± 9.94) ng/L, t = 3.08, P = 0.003; (32.48 ± 3.11) ng/L vs. (39.61 ± 4.72) ng/L, t = 9.26, P < 0.001]. The values for forced expiratory volume in the first second and forced expiratory flow at 25%, 50%, and 75% of vital capacity in the observation group were significantly higher than those in the control group [(87.18 ± 5.15)% vs. (84.36 ± 4.68)%, t = 3.10, P = 0.002; (89.35 ± 3.88)% vs. (83.25 ± 3.56)%, t = 8.86, P < 0.001; (74.36 ± 6.65)% vs. (65.25 ± 5.36)%, t = 8.26, P < 0.001; (71.68 ± 8.76)% vs. (65.35 ± 7.86)%, t = 4.12, P < 0.001; (69.24 ± 4.38)% vs. (65.35 ± 2.43)%, t = 6.20, P < 0.001]. The incidence of adverse reactions was significantly higher in the observation group than in the control group [8.16% (4/49) vs. 4.29% (3/70), χ2 = 0.60, P = 0.439]. The overall response rate was significantly higher in the observation group than in the control group [95.92% (47/49) vs. 82.86% (58/70), χ2 = 5.26, P = 0.022]. Conclusions:Fluticasone propionate combined with loratadine syrup and montelukast sodium can effectively alleviate symptoms in children with asthma and allergic rhinitis, improve serum indicators, enhance lung function, and increase clinical efficacy without substantially increasing adverse reactions, demonstrating high safety.

Objective: To explore the relationship between beverage dependence and sleep quality among college students, providing empirical evidence for improving their sleep quality. Methods: From December 2024 to January 2025, a convenience sampling method was used to conduct a questionnaire survey among 3 974 college students from four universities in Anhui Province. The Beverage Addiction Scale for College Students (BASCS) was used to assess beverage dependence, and the Self rating Scale of Sleep(SRSS) was used to evaluate sleep quality. A multivariate Logistic regression model was employed to analyze the relationship between beverage dependence and sleep quality, and a restricted cubic spline model was used to examine the dose response relationship between the two. Results: The positive rate of beverage dependence symptoms among college students was 7.6%, with positive rates of 9.6%, 13.8%, and 7.4% for the withdrawal symptoms, health effects, and dependence symptoms dimensions, respectively. The detection rate of sleep disorders was 23.6%. Multivariate Logistic regression analysis showed that after adjusting for covariates such as grade, gender, and body mass index, compared with the no beverage dependence group, students with positive beverage dependence symptoms had a higher risk of sleep disorders( OR =3.71, 95% CI =2.87-4.80, P <0.01). The OR (95% CI ) for sleep disorders among students with positive symptoms in the withdrawal symptoms, health effects, and dependence symptoms dimensions were 2.80(2.22-3.53), 2.38(1.95-2.91), and 2.45(1.89-3.18)(all P <0.01). Further analysis using a restricted cubic spline model revealed that the overall beverage dependence score and its three dimensional scores were approximately linearly related to the risk of sleep disorders among college students (all nonlinear P >0.05). Conclusions Beverage dependence is associated with sleep quality among college students. Schools should take multiple approaches, such as health education on beverage awareness, to improve students sleep quality.

Objective:To investigate the therapeutic effects of fluticasone propionate combined with loratadine syrup and montelukast sodium on asthma and allergic rhinitis in children.Methods:A total of 119 children with asthma and allergic rhinitis, admitted to Department of Pediatrics, Dongyang Maternal and Child Health Hospital from March 2021 to March 2024, were selected for this retrospective study. Based on the different treatment methods recorded in the medical record system, the children were divided into two groups: the control group ( n = 70), which received loratadine syrup combined with montelukast sodium, and the observation group ( n = 49), which received fluticasone propionate combined with loratadine syrup and montelukast sodium. Clinical symptoms (rhinitis and asthma), serum markers (immunoglobulin E, interleukin-4, and interleukin-6), lung function (maximum peak expiratory flow rate, forced expiratory volume in the first second, forced expiratory flow at 25% of vital capacity, forced expiratory flow at 50% of vital capacity, forced expiratory flow at 75% of vital capacity), as well as adverse reactions and clinical efficacy, were observed and compared between the two groups. Results:After treatment, the symptom scores for both rhinitis and asthma in the observation group were significantly lower than those in the control group [(3.65 ± 0.88) vs. (4.55 ± 1.06), t = 4.88, P < 0.001; (2.15 ± 0.56) vs. (3.28 ± 0.89), t = 7.86, P < 0.001]. The levels of immunoglobulin E, interleukin-4, and interleukin-6 in the observation group were significantly lower than those in the control group [(0.31 ± 0.18) g/L vs. (0.42 ± 0.19) g/L, t = 3.18, P = 0.002; (56.83 ± 8.25) ng/L vs. (62.16 ± 9.94) ng/L, t = 3.08, P = 0.003; (32.48 ± 3.11) ng/L vs. (39.61 ± 4.72) ng/L, t = 9.26, P < 0.001]. The values for forced expiratory volume in the first second and forced expiratory flow at 25%, 50%, and 75% of vital capacity in the observation group were significantly higher than those in the control group [(87.18 ± 5.15)% vs. (84.36 ± 4.68)%, t = 3.10, P = 0.002; (89.35 ± 3.88)% vs. (83.25 ± 3.56)%, t = 8.86, P < 0.001; (74.36 ± 6.65)% vs. (65.25 ± 5.36)%, t = 8.26, P < 0.001; (71.68 ± 8.76)% vs. (65.35 ± 7.86)%, t = 4.12, P < 0.001; (69.24 ± 4.38)% vs. (65.35 ± 2.43)%, t = 6.20, P < 0.001]. The incidence of adverse reactions was significantly higher in the observation group than in the control group [8.16% (4/49) vs. 4.29% (3/70), χ2 = 0.60, P = 0.439]. The overall response rate was significantly higher in the observation group than in the control group [95.92% (47/49) vs. 82.86% (58/70), χ2 = 5.26, P = 0.022]. Conclusions:Fluticasone propionate combined with loratadine syrup and montelukast sodium can effectively alleviate symptoms in children with asthma and allergic rhinitis, improve serum indicators, enhance lung function, and increase clinical efficacy without substantially increasing adverse reactions, demonstrating high safety.

Objective To investigate the effect of early activity combined with electrical stimulation of neuromuscular system in improving intensive care unit(ICU)-acquired weakness(ICU-AW)patients with severe pneumonia.Methods A total of 150 patients with ICU-AW caused by severe pneumonia admitted to emergency intensive care unit(EICU)in a tertiary hospital in Shanghai were enrolled as the study subjects,and randomly divided into control group(75 cases)and combined group(75 cases).The control group took early exercise,and the combination group was given early exercise plus electrical stimulation of neuromuscular system.The recovery from mechanical ventilation(ICU length of stay,duration of mechanical ventilation,weaning extubation rate,ICU rollout rate),lung function[forced vital capacity(FVC),forced expiratory volume in the 1 s(FEV1)/FVC,massive inspiratory pressure(MIP)],muscle strength[Medical Research Council(MRC)score],disease severity[acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)],and complications were compared between the two groups.Results The ICU length of stay and mechanical ventilation time in the combined group were significantly lower than those in the control group(P<0.05).After intervention,FVC,FEV1/FVC,MIP and MRC scores in the two groups were significantly increased(P<0.05),and compared with the control group,the combined group was significantly increased(P<0.05).After intervention,APACHEⅡ score was significantly reduced in the two groups(P<0.05),and compared with the control group,APACHEⅡ score in combined group were significantly reduced(P<0.05).The complication rate in the combined group(9.33％)was significantly lower than that of control group(24.00％)(P<0.05).Conclusions Early exercise combined with neuromuscular electrical stimulation in patients with severe pneumonia ICU-AW can effec-tively promote recovery of patients because of improved lung function.This therapy is proved to be be safe and effective.

Objective:To investigate the effect of early protein supplementation on the clinical outcomes of elderly ICU patients with critically ill.Methods:The study was a post-hoc analysis of a multicenter, cluster randomized controlled trial (NEED trial), which aimed to evaluate the impact of feeding protocol on nutritional implementation and outcomes in ICU patients. It was planned to include elderly patients aged ≥70 years from the NEED trial, and patients who had not started nutritional therapy by the Day 3 after enrolment, stayed in the ICU less than 7 days, missing the primary outcome were excluded. The primary outcome of this study was 28-day mortality of enrolment. Patients were categorized into Q1 (<0.6 g/kg/d), Q2 (0.6-0.83 g/kg/d), and Q3 (≥0.83 g/kg/d) groups according to the tertiles of protein supply. The log-rank test was used to compare the Kaplan-Meier survival curves for 28-day mortality. The associations between different protein groups and 28-day mortality were tested by Cox proportional hazards regression models. Subgroup analysis was conducted in patients with high (mNUTRIC score≥5) nutritional risk or patients with baseline acute kidney injury.Results:A total of 789 elderly (≥70 years) patients was included in the study, with a mean protein amount of 0.69 (0.53, 0.91) g/(kg·d) during days 3-7 after ICU admission, and mean protein amounts in the Q1 low-protein group, the Q2 medium-protein group, and the Q3 high-protein group were 0.46 (0.36, 0.53), 0.69 (0.63, 0.76), and 1.03 (0.91, 1.23) g/(kg·d), respectively. The results showed that the medium protein group associated with lower 28-day mortality compared to the high protein group, and the association between the medium protein group and lower 28-day mortality still held after controlling for possible confounders by Cox multivariate regression analysis. In the high-nutritional risk subgroup (mNUTRIC≥5), a significant association was also found between the medium protein group and lower 28-day mortality.Conclusions:Early high protein supply are not beneficial for elderly ICU patients by this large sample size post-hoc analysis, and medium protein supply associate with lower 28-day mortality compared with the high protein group. This study may provide a theoretical basis for the optimal dose of early protein supply in elderly ICU patients, as well as a reference for clinical implementation.

Objective To investigate the prevalence of allergic and infectious diseases in children， and to assess the influence of indoor and outdoor environmental factors on these two common diseases in children. Methods A questionnaire was used to investigate the prevalence of allergic and infectious diseases in 140 children of 7 years old in Laizhou Bay， Shandong Province. Logistic regression was used to analyze the associations between indoor and outdoor environmental factors and children’s allergic and infectious diseases， respectively. Results The prevalence of previous eczema and other allergic diseases for the past year in children was 37.9% and 15.0%， respectively， and the prevalence of infectious diseases for the past year was 35.7%. As for allergic diseases， eye irritation due to outdoor air （ OR =2.977； 95% CI ： 1.407‒6.296） and nose irritation due to outdoor air （ OR =5.147； 95% CI ： 1.272‒20.827） were the risk factors for previous eczema in children. Indoor musty taste increased the risks of urticaria （ OR =4.306； 95% CI ： 1.062‒17.454） and previous eczema （ OR =3.853； 95% CI ： 1.080‒13.743）. The use of cockroach killers indoors increased the risk of rhinitis （ OR =6.102； 95% CI ：1.297‒28.697）. As for infectious diseases， having outdoor pollution sources increased the risk of gastrointestinal infection （ OR =4.937； 95% CI ： 1.050‒23.216）， and the use of mosquito coils and clothing mothproofing agents increased the risks of respiratory （ OR =6.333； 95% CI ： 1.397‒28.714） and gastrointestinal infections （ OR =3.218； 95% CI ： 1.074‒9.644）， respectively. However， we did not find associations between indoor passive smoking and allergic or infectious diseases. Conclusion Except outdoor passive smoking， all the other indoor and outdoor environmental factors increase the risks of children’s allergies and infectious diseases.

Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.

Objective:To understand the levels of Pb, Cd, As, Hg, Mn, and Se in maternal and umbilical cord blood, and to explore the transplacental transfer efficiency (TTE).Methods:From September 2010 to December 2013, a total of 773 pregnant women and their newborns (Laizhou Bay Birth Cohort) were recruited from a second grade hospital in the south bank of Laizhou Bay, Bohai, Shandong Province. According to different detection methods, the six measured elements are classified into three groups including the Hg measurement group (595 mother-newborn pairs), the Pb measurement group (534 mother-newborn pairs), and the Cd, As, Mn and Se measurement group (244 mother-newborn pairs). The demographic characteristics of pregnant women and their newborns were obtained by the questionnaire. The concentrations of elements in maternal and umbilical cord blood were detected and the TTE of each element (elemental concentration in cord blood/elemental concentration in maternal blood) was calculated. The correlation of elements between maternal and cord blood was analyzed using Spearman′s rank correlation coefficient.Results:The mean± SD of maternal age, gestational week and newborn birth weight of 773 mother-infant pairs were (28.34±4.50) years, (39.47±1.39) weeks and (3 419.47±497.39) g respectively. The median concentrations of Pb, Cd, As, Hg, Mn and As in maternal and cord blood were 31.12 and 30.02, 1.19 and 0.47, 8.05 and 6.03, 0.69 and 1.26, 100.70 and 105.55, 127.25 and 115.00 μg/L, respectively. The TTE of Pb, Cd, As, Hg, Mn, and Se was 0.98, 0.41, 0.73, 1.73, 0.96 and 0.91, respectively. Pb, Cd, Hg, Mn, and Se showed a significant positive correlation between maternal blood and cord blood, with Spearman correlation coefficients of 0.397, 0.298, 0.698, 0.555, and 0.285 (all P values<0.001). Conclusion:Each element was commonly detected in maternal blood and cord blood. The TTE of Hg was the highest.

Objective:To understand the levels of Pb, Cd, As, Hg, Mn, and Se in maternal and umbilical cord blood, and to explore the transplacental transfer efficiency (TTE).Methods:From September 2010 to December 2013, a total of 773 pregnant women and their newborns (Laizhou Bay Birth Cohort) were recruited from a second grade hospital in the south bank of Laizhou Bay, Bohai, Shandong Province. According to different detection methods, the six measured elements are classified into three groups including the Hg measurement group (595 mother-newborn pairs), the Pb measurement group (534 mother-newborn pairs), and the Cd, As, Mn and Se measurement group (244 mother-newborn pairs). The demographic characteristics of pregnant women and their newborns were obtained by the questionnaire. The concentrations of elements in maternal and umbilical cord blood were detected and the TTE of each element (elemental concentration in cord blood/elemental concentration in maternal blood) was calculated. The correlation of elements between maternal and cord blood was analyzed using Spearman′s rank correlation coefficient.Results:The mean± SD of maternal age, gestational week and newborn birth weight of 773 mother-infant pairs were (28.34±4.50) years, (39.47±1.39) weeks and (3 419.47±497.39) g respectively. The median concentrations of Pb, Cd, As, Hg, Mn and As in maternal and cord blood were 31.12 and 30.02, 1.19 and 0.47, 8.05 and 6.03, 0.69 and 1.26, 100.70 and 105.55, 127.25 and 115.00 μg/L, respectively. The TTE of Pb, Cd, As, Hg, Mn, and Se was 0.98, 0.41, 0.73, 1.73, 0.96 and 0.91, respectively. Pb, Cd, Hg, Mn, and Se showed a significant positive correlation between maternal blood and cord blood, with Spearman correlation coefficients of 0.397, 0.298, 0.698, 0.555, and 0.285 (all P values<0.001). Conclusion:Each element was commonly detected in maternal blood and cord blood. The TTE of Hg was the highest.

Objective:To investigate the expression and correlation of EHD2 and E-cadherin in hepatocellular carcinoma (HCC). Meth-ods:Western blot and immunohistochemistry were used to detect the expression of EHD2 and E-cadherin in HCC specimens and adja-cent noncancerous tissues. The correlations of EHD2 and E-cadherin with the clinicopathological characteristics and prognosis of pa-tients were further analyzed using Pearsonχ2 test and Kaplan-Meier method. Results:EHD2 expression, along with E-cadherin, was markedly reduced in HCC tissues than in adjacent noncancerous tissues. Moreover, EHD2 and E-cadherin expression were correlated with histological grade, microvascular invasion, and lymph node metastasis (P<0.05). Kaplan-Meier survival analysis showed that HCC patients with decreased EHD2 and E-cadherin expression had shorter overall survival time than those with higher expression. Conclu-sion:The abnormal expression of EHD2 and E-cadherin possibly promote HCC. Detection of EHD2 and E-cadherin may be valuable for diagnosing HCC and evaluating malignancy extent and prognosis.