ObjectiveTo observe the clinical effectiveness and safety of Qingfei Shenshi Decoction （清肺渗湿汤） combined with western medicine for patients with bronchial asthma of heat wheezing syndrome， and to explore its potential mechanism of action. MethodsEighty-six participants with bronchial asthma of heat wheezing syndrome were randomly divided into treatment group and control group， each group with 43 participants. The control group received conventional western medicine， and the treatment group was additionally administered Qingfei Shenshi Decoction orally on the basis of the control group， 1 dose per day. Both groups were treated for 14 days. The primary outcome measure was clinical effectiveness； secondary outcome measures included traditional Chinese medicine （TCM） syndrome score， asthma control test （ACT） score， pulmonary function indices such as forced expiratory volume in 1 second （FEV₁）， forced vital capacity （FVC）， peak expiratory flow （PEF）， serum inflammatory factor levels including interleukin-4 （IL-4）， tumour necrosis factor-α （TNF-α）， and high-sensitivity C-reactive protein （hs-CRP）， and immune function indices including CD3⁺， CD4⁺， CD8⁺， CD4⁺/CD8⁺. All outcome measures were evaluated before and after treatment. Vital signs were monitored， and electrocardiography， blood routine， urine routine， liver function， and renal function tests were performed before and after treatment. Adverse events and reactions during the study were recorded. ResultsA total of 80 patients completed the trial with 40 in each group. The total clinical effective rate of the treatment group was 97.5% （39/40）， which was significantly higher than that of the control group （85.0%， 34/40， P＜0.05）. After treatment， both groups showed decreased TCM syndrome scores， IL-4， TNF-α， hs-CRP， and CD8⁺ levels， as well as increased ACT scores， CD3⁺， CD4⁺， CD4⁺/CD8⁺， FEV₁， FVC， and PEF levels （P＜0.05 or P＜0.01）. Moreover， the improvements in these indices were more significant in the treatment group than in the control group （P＜0.05 or P＜0.01）. No significant abnormalities in safety indicators were observed in either group， and no adverse events or reactions occurred. ConclusionQingfei Shenshi Decoction combined with conventional western medicine for patients with bronchial asthma of heat wheezing syndrome can effectively improve the clinical symptoms， pulmonary function， and clinical effectiveness， with good safety. Its mechanism may be related to reducing inflammatory factor levels and regulating T lymphocyte subsets to improve immune function.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

In clinical practice,antibiotics have historically been utilized for the treatment of pathogenic bacteria.However,the gradual emergence of antibiotic resistance among bacterial strains has posed a significant challenge to this approach.In 2022,Escherichia coli,a Gram-negative bacterium renowned for its widespread pathogenicity and high virulence,emerged as the predominant pathogenic bacterium in China.The rapid emergence of antibiotic-resistant E.coli strains has rendered antibiotics insufficient to fight E.coli infections.Traditional Chinese medicine(TCM)has made remarkable contributions to the health of Chinese people for thousands of years,and its significant therapeutic effects have been proven in clinical practice.In this paper,we provide a comprehensive review of the advances and mechanisms of TCM and its active ingredients against antibiotic-resistant E.coli infections.First of all,this review in-troduces the classification,antibiotic resistance characteristics and mechanisms of E.coli.Then,the TCM formulas and extracts are listed along with their active ingredients against E.coli,including extraction solution,minimum inhibitory concentration(MIC),and the antibacterial mechanisms.In addition,there is growing evidence supporting the synergistic therapeutic strategy of combining TCM with antibiotics for the treatment of antibiotic-resistant E.coli infections,and we provide a summary of this evidence and its underlying mechanisms.In conclusion,we present a comprehensive review of TCM and highlight its potential and advantages in the prevention and treatment of E.coli infections.We hold the opinion that TCM will play an important role in global health,pharmaceutical development,and livestock farming in the future.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To investigate the practical effects of pediatric rapid sequence intubation(RSI)nursing coordination training based on the LSPPDM(learn,see,practice,prove,do,maintain)framework in order to provide evidence for optimizing pediatric RSI nursing training programs.Methods Nurses from the intensive care unit(ICU)of Children's Hospital,Fudan University during Feb 2023 and Jan 2024 were divided into the experimental group(n=35)and the control group(n=35)by block randomization.The experimental group received LSPPDM framework-based training,while the control group underwent conventional training with theoretical lectures and procedural demonstrations.Outcomes included training satisfaction,theoretical knowledge and procedural skill assessment scores,team collaboration compliance and RSI procedure time were compared between the two groups.Results The experimental group demonstrated significantly higher training satisfaction(123.80±2.04 vs.117.26±9.82,P<0.05),superior post-training theoretical knowledge and procedural skills(P<0.05),enhanced team collaboration compliance(P<0.05),and shorter RSI completion time(P<0.05)compared with the control group.Conclusion Pediatric RSI nursing coordination training based on the LSPPDM framework can effectively increase training satisfaction,promote theoretical and procedural skills and reduce completion time in nurses.

Objective:To observe and analyze the ocular clinical features and pathogenic genes of horizontal gaze palsy with progressive scoliosis (HGPPS).Methods:A pedigree study was conducted.Two families with HGPPS diagnosed by ophthalmology examination at Henan Children's Hospital from November 2023 to April 2024 were included, with 3 people from two generations in each family.Medical history and family history of the subjects were inquired.Vision acuity, diopter, anterior segment, intraocular pressure, wide-angle laser scanning ophthalmoscopy, optical coherence tomography, visual evoked potential (VEP), electroretinogram (ERG), ocular B-ultrasound, full spine AP+ lateral view, orbit+ skull+ cervical spine+ thoracic spine+ lumbosacral spine MRI plain scan were performed on the subjects.Whole genomic DNA was extracted from 2 ml of peripheral venous blood collected from the subjects, and gene sequencing was performed using whole exome sequencing (WES) technology.Suspicious pathogenic variant loci were verified by Sanger sequencing, and the pathogenicity of gene variant loci was analyzed according to the ACMG standards and guidelines for the interpretation of sequence variants.This study followed the Declaration of Helsinki.The study protocol was reviewed and approved by the Ethics Committee of Henan Children's Hospital (No.2024-KY-0024).All subjects and guardians signed informed consent forms and were informed of relevant matters before genetic testing.Results:The proband from family 1 was male, 3 years and 2 months old.At the age of 6 months, he was found to have head tilted to the left with a right scoliosis of the spine centered on T11-12 and no obvious abnormalities on VEP and ERG examinations.The proband from family 2 was male, 3 years and 4 months old, with a left scoliosis of the spine centered on T12.Both probands developed horizontal fixation paralysis, unable to rotate eye outward, slightly limited inward rotation, left eye hypertropia, mild horizontal nystagmus, normal vertical eye movement, backward development of major movements, and normal vision, anterior segment and fundus.MRI examination showed that the medulla oblongata was butterfly shaped, and a brainstem fissure could be seen in the center of the medulla oblongata.The genetic testing showed that the proband from family 1 had compound heterozygous variations c. 1054delC/p.Gln352Serfs *90 (M1) in exon 7 and c. 1219G>T/p.Gly407Cys (M2) in exon 8 of ROBO3 gene.The father of the proband carried M1 and the mother of the proband carried M2.The proband from family 2 had compound heterozygous variations c. 1888C>T/p.R630X (M3) in exon 12 and c. 2684C>A/p.A895E (M4) in exon 17 of ROBO3 gene.M1 and M3 were possible pathogenic, and M2 and M4 were of unknown clinical significance, and prediction software predicted M2 and M4 were harmful variations. Conclusions:The main clinical features of two HGPPS pedigree are horizontal fixation paralysis and progressive scoliosis, accompanied by nystagmus and strabismus.MRI shows brainstem fissure in the central medullary area.Four variants are novel variants, which increases the variation spectrum of ROBO3 gene.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Objective To analyze the impact of balloon post-dilation on cardiac conduction in patients undergoing transcatheter aortic valve replacement (TAVR). Methods From June 2021 to December 2022, patients with severe aortic valve stenosis or regurgitation who underwent TAVR surgery using domestically produced valves at Xijing Hospital, Air Force Military Medical University were selected. The occurrence of intraoperative and postoperative cardiac conduction block was recorded. According to whether balloon post-dilation was performed during the surgery, patients were divided into the post-dilation group and the non-post-dilation group. The baseline data, postoperative cardiac conduction block occurrence, and cardiac function of the two groups were analyzed. Results A total of 126 patients were included, including 52 males and 74 females, with an average age of (66.6±7.6) years. There were 30 patients in the post-dilation group and 96 patients in the non-post-dilation group. On the first day after TAVR, the average QRS intervals in the post-dilation group and the non-post-dilation group were (105.6±13.8) ms and (125.9±28.2) ms, respectively (P=0.017). At discharge, the average PR intervals in the two groups were (168.7±36.8) ms and (192.1±44.2) ms, respectively (P=0.024). At discharge, 9 (7.1%) patients developed new atrioventricular block, 5 (4.0%) patients developed new complete right bundle branch block, and 33 (26.2%) patients developed new complete left bundle branch block. During hospitalization, 2 (1.6%) patients received permanent cardiac pacemakers, both of whom were in the non-post-dilation group. There was no statistical difference in postoperative left ventricular structure and function between the two groups (P>0.05). Conclusion Postoperative expansion using domestically produced interventional valves for TAVR do not increase the incidence of early atrioventricular block and permanent cardiac pacemaker implantation after valve implantation, and there are no significant changes in cardiac structure and function in patients with conduction block in the short term after surgery.