Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Objective To explore the effects of glycyrrhizic polysaccharide(GP)on the biological activity of salivary adenoid cystic carcinoma tumor cells and its mechanisms of anti-tumor action.Methods GP was prepared,and human adenoid cystic carcinoma high-metastatic cell line SACC-LM and low-metastatic cell line SACC-83 were used as target cells.Different concentrations of GP were used for intervention.The cell counting kit-8(CCK-8)assay was employed to detect cell proliferation and apoptosis.Reverse transcrip-tion polymerase chain reaction(RT-PCR)and Western blot experiments were conducted to detect the expression of genes and proteins related to tumor invasion and metastasis.The scratch assay was used to observe the effect of GP on the migration ability of SACC cells.In vivo experiments were conducted to verify the inhibitory effect of GP on tumor cells.Results Glycyrrhiza polysaccharides signifi-cantly inhibited the proliferation and migration of the highly metastatic human adenoid cystic carcinoma cell line SACC-LM by regulating the expression of epithelial-mesenchymal transition(EMT)-related markers.In vivo experiments showed that glycyrrhiza poly-saccharides had no significant hepatotoxicity,could significantly reduce the volume and weight of tumors,and inhibit the growth rate of tumors in nude mice.Conclusion GP has a certain inhibitory effect on the growth and migration ability of SACC.

The prevalence of neurodevelopmental disorders in children remains high, and the largest populations at the highest risk are premature babies.Neurodevelopmental disorders in children have become a significant global public health concern, impacting the health of children worldwide.Neurodevelopmental disorders of preterm infants usually present as impairment or delay in cognition, motor, visual and auditory functions, social adaptability, and neuropsychological performance.However, its clinical characteristics vary significantly with the gestational age, life stage, and complicated comorbidity or complication.Inspired by the currently accepted early diagnosis and early intervention strategy, a novel preventive early intervention strategy has been developed abroad, which has achieved promising results.In this article, the clinical characteristics of neurodevelopmental disorders in preterm infants at different gestational ages and life stages, and with different complicated comorbidities or complications were comprehensively reviewed.The aim is to provide basic knowledge for the development of proper preventive early intervention strategies in high-risk premature babies, and ultimately reduce the incidence of neurodevelopmental disorders in this high-risk population.

Objective To investigate the changes and clinical significance of synovial fluid Asporin level in patients with tem-poromandibular joint disorders(TMD).Methods A total of 48 TMD patients who were treated in our hospital from January 2021 to December 2023 due to irritant pain and mouth opening limitation were randomly selected as the observation group,and 48 healthy vol-unteers were selected as the control group.The synovial fluid Asporin levels of the two groups were detected by enzyme-linked immu-nosorbent assay(ELISA).The difference of synovial fluid Asporin levels between the two groups was compared.The correlation be-tween the synovial fluid Asporin levels and the clinical symptoms of TMD was analyzed.Results The synovial fluid Asporin level in the experimental group was significantly higher than that in the control group(P＜0.05).The synovial fluid Asporin level was positively correlated with the pain degree of TMD patients(Rs=0.825,P＜0.001),negatively correlated with the degree of mouth opening(Rs=-0.945,P＜0.001).Conclusion The level of Asporin in synovial fluid of TMD patients was significantly increased.The level of As-porin in synovial fluid of TMD patients is correlated with the clinical symptoms of TMD,which provides a basis for the diagnosis and evaluation of TMD.

Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

Objective To explore the mechanism of Chaipo Decoction in intervening lipopolysaccharide(LPS)-induced acute lung injury(ALI)based on network pharmacology and experimental verification.Methods TCMSP database was used to screen the active components and targets of Chaipo Decoction.ALI disease targets were retrieved through GeneCards and OMIM databases,the intersection genes of drug and disease were obtained.They were imported into STRING platform and Cytoscape 3.9.1 software to construct protein interaction network and drug-active components-target network,core components and targets were screened,and GO and KEGG pathway enrichment analysis was performed on them.AutoDock 1.5.6 and PyMOL software were used to verify the molecular docking between the main active components and core targets.The ALI model of mice was induced by LPS,and was intervened by Chaipo Decoction.The pathological changes of lung tissue in mice were observed by HE staining.The contents of IL-6,IL-10 and TNF-α in serum of mice were detected by ELISA.Western blot was used to verify the expressions of target proteins in lung tissue.Results Totally 214 active components of Chaipo Decoction,such as norwogonin,baicalein,quercetin and ursolic acid were screened,with 1 101 targets and 271 potential targets for intervention in ALI,mainly SRC,STAT3,AKT1,EGFR,GRB2,PIK3CA,etc.It mainly affected PI3K/Akt signaling pathway,MAPK signaling pathway,apoptosis,Ras signaling pathway,etc.Molecular docking showed that the main active components of Chaipo Decoction had strong binding ability with core targets SRC,STAT3,AKT1,EGFR and GRB2.The results of animal experiments showed that Chaipo Decoction could alleviate the lung lesions in ALI mice,decrease the contents of IL-6 and TNF-α in serum,increase the content of IL-10,and significantly decreased the expressions of EGFR,PI3K,AKT and NF-κB p65 protein in lung tissue.Conclusion Chaipo Decoction can exert anti-ALI effect through multiple pathways and multiple targets,and its mechanism may be related to the inhibition of EGFR/PI3K/Akt signaling pathway.

OBJECTIVE To elucidate the burden of lower respiratory tract infections(LRIs)attributable to non-op-timal temperature risk and its changing trends in China from 1990 to 2021,and to provide insights for identifying susceptible populations.METHODS The changing trends in mortality and disability-adjusted life years(DALYs)of LRIs attributed to non-optimal,low and high temperature risks were analyzed through the 2021 global burden of disease(GBD)database.Joinpoint software was used to analyze the trend changes of time series and explore the standardized mortality rate and the standardized DALYs rate of LRIs attributed to non-optimal temperature risk.RESULTS In 2021,LRIs mortality and DALYs rates attributable to non-optimal temperature risk in China were 1.92 per 100,000(down 66.80%from 5.76 per 100,000 in 1990)and 37.99 per 100,000(down 90.47%from 398.77 per 100,000 in 1990),respectively.The burden of LRIs attributed to non-optimal temperature risks was higher in males than that in females,with the mortality rates of 2.86 per 100,000 and 2.48 per 100,000,and DA-LYs rates of 44.90 per 100,000 and 30.75 per 100,000,respectively.The burden of LRIs increased significantly in children under 5 years old and elderly individuals aged 75 and above.From 1990 to 2021,the standardized mortali-ty rate and the standardized DALYs rate of LRIs attributed to non-optimal temperature factors in China showed a declining trend[average annual percentage change(AAPC):-5.04%and-7.33%,respectively].CONCLUSIONS The overall burden of LRIs attributable to non-optimal temperature in China has generally declined from 1990 to 2021.with higher burden in males than that in females,and higher burden in individuals under 5 years old and those aged 75 and above.In China,low temperature risk plays an important role in the non-optimal temperature effect.To reduce the burden of LRIs disease,early intervention measures should be implemented for males,the middle-aged and elderly people and children,and early protection for susceptible populations should be provided based on changes in external environmental temperature,which are of significant public health importance for re-ducing disease burden.

Objective To explore the value of the albumin-to-alkaline phosphatase ratio(AAPR)with modified Glasgow prognostic score(mGPS)in assessing the response to and prognosis of intravesical Bacillus Calmette-Guérin(BCG)therapy in patients with non-muscle invasive bladder cancer(NMIBC).Methods A total of 153 high-risk NMIBC patients treated with intravesical BCG in our hospital during Jan.2018 and Oct.2021 were enrolled.Patients were divided into response and non-response groups based on the treatment efficacy,and into good and poor prognosis groups based on the clinical outcomes.AAPR and mGPS were calculated.The relationship between AAPR,mGPS and BCG treatment non-response was analyzed with multivariate logistic regression.Clinical data and scores were compared between prognosis groups.The associations between AAPR,mGPS,and poor prognosis after BCG treatment were assessed with a Cox proportional hazards model.Patients were stratified into high-and low-A APR groups,and into mGPS 0,1,and 2 groups.Kaplan-Meier survival curves were plotted for progression-free survival(PFS)across different AAPR and mGPS strata.The diagnostic performance of AAPR combined with mGPS in predicting treatment non-response and poor prognosis was evaluated using receiver operating characteristic(ROC)curves.Results Among the 153 patients,the response rate to BCG treatment was 71.90％(110/153),the 3-year poor prognosis rate was 45.75％(70/153),and the 3-year PFS rate was 54.25％(83/153).Increased AAPR was identified as an independent protective factor for both treatment response and good prognosis,while higher mGPS was an independent risk factor(P＜0.05).The 3-year PFS rate was significantly higher in the high-AAPR group than in the low-A APR group(P＜0.001).Among the mGPS groups,the 3-year PFS rate was lowest in the mGPS 2 group,followed by mGPS 1 and mGPS 0 groups(P＜0.001).The area under the ROC curve(AUC)for AAPR with mGPS in predicting BCG treatment non-response and poor prognosis was 0.864 and 0.901,respectively,significantly higher than using AAPR(0.774,0.781)or mGPS alone(0.798,0.809)(P＜0.05).Conclusion Lower AAPR and higher mGPS are associated with non-response and poor prognosis in NMIBC patients undergoing intravesical BCG therapy.The combination of AAPR and mGPS has high predictive value.

The esophagogastric junction serves as a natural anti-reflux barrier and possesses a complex anatomical configuration composed of several key components, including the lower esophageal sphincter, diaphragmatic crura, His angle, and phrenoesophageal ligament. Alterations in these anatomical structures or dysfunction thereof may predispose individuals to gastroesophageal reflux disease (GERD). In response to such structural and functional impairments, various therapeutic strategies have been developed. Surgical intervention is currently regarded as an effective approach for fundamentally addressing GERD, with commonly employed techniques including laparoscopic fundoplication, magnetic sphincter augmentation, and endoscopic radiofrequency ablation. The author classifies the anti-reflux mechanisms at the esophagogastric junction into intramural and extramural components, and based on this classification, systematically reviews and evaluates the indications and clinical applications of major surgical interventions for GERD, aiming to provide clinicians with evidence-based guidance for selecting appropriate therapeutic modalities.