ObjectiveTo investigate the incidence rate of sarcopenia in patients with Wilson’s disease （WD）-related liver cirrhosis， as well as the risk factors for sarcopenia and their impact on clinical outcomes. MethodsA total of 140 patients with WD-related liver cirrhosis who were treated in The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2019 to June 2020， and according to the third lumbar skeletal muscle mass index （L3 SMI）， the patients were divided into sarcopenia group and non-sarcopenia group. Nutritional risk screening， anthropometric measurements， and blood biochemical tests were performed for the patients to identify the influencing factors for sarcopenia. The patients were followed up for 36 — 48 months， and survival status and complications were compared between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the chi-square test and the Mann-Whitney U rank sum test were used for comparison of categorical data between two groups. A binary Logistic regression analysis was used to investigate the influencing factors for sarcopenia， and univariate and multivariate Cox regression analyses were used to investigate the risk factors for the prognosis of patients with WD-related liver cirrhosis. The Kaplan-Meier survival curve was plotted， and the Log-rank test was used for comparison between groups. ResultsAmong the 140 patients with WD-related liver cirrhosis， 53 （37.9%） developed sarcopenia， with significantly lower body mass index （BMI） and L3 SMI than the patients without sarcopenia （t=10.550 and 3.982， both P<0.001）. The multivariate Logistic regression analysis showed that age （odds ratio ［OR］=2.243， 95% confidence interval ［CI］： 1.196 — 4.208， P=0.012）， sex （OR=0.450， 95%CI： 0.232 — 0.872， P=0.018）， BMI （OR=0.126， 95%CI： 0.089 — 0.294， P<0.001）， and hepatic encephalopathy （OR=8.367， 95%CI： 2.423 — 28.897， P<0.001） were the main influencing factors for sarcopenia in patients with WD-related liver cirrhosis. Compared with the non-sarcopenia group， the sarcopenia group had significantly higher mortality rate （χ²=6.158， P=0.019） and significantly higher incidence rates of infection （χ²=8.008， P=0.040）， recurrent abdominal/pleural efflux （χ²=17.742， P<0.001）， and hepatic encephalopathy （χ²=4.338， P=0.039）. The multivariate Cox regression analysis showed that sarcopenia （hazard ratio ［HR］=4.685， P=0.002） and hepatic encephalopathy （HR=19.156， P<0.001） were independent risk factors for death in patients with WD-related liver cirrhosis. The Kaplan-Meier survival curve analysis showed a significant reduction in survival rate in the patients with sarcopenia （P=0.003）. ConclusionSarcopenia is one of the manifestations of malnutrition in patients with WD-related liver cirrhosis， which increases the risk of mortality and other complications and has an adverse effect on prognosis. There is an increased risk of sarcopenia in male patients or patients with hepatic encephalopathy， a lower level of BMI or an older age.

BACKGROUND:The definitive cause of adolescent idiopathic scoliosis is not yet known.The search for a clinical approach to address adolescent idiopathic scoliosis is imminent.OBJECTIVE:To investigate the effect of Schroth therapy combined with core strength training on mild adolescent idiopathic scoliosis and to provide more bases for the clinical treatment of mild adolescent idiopathic scoliosis.METHODS:110 patients with mild adolescent idiopathic scoliosis attending the Department of Rehabilitation Medicine and Department of Spine Surgery of Affiliated Hospital of Nantong University from July 2022 to January 2024 were selected as the study subjects.They were divided into the trial group and the control group according to the wishes of the patients and their parents,with 55 cases in each group.The control group was observed and followed up,and the trial group underwent Schroth therapy combined with core strength training for 45 minutes a day for 24 weeks.The differences in imaging parameters,body surface indexes,three-dimensional ultrasound imaging angle,and quality of life were compared between the two groups before and after treatment.RESULTS AND CONCLUSION:(1)At 24 weeks after treatment,major curve Cobb,apical vertebral translation,and cervical lordosis were significantly improved in the trial group(P＜0.05),while there was no significant difference in the control group(P＞0.05).Major curve Cobb and apical vertebral translation in the trial group were significantly better than those in the control group(P＜0.05).(2)At 24 weeks after treatment,angle of trunk rotation in the trial group was significantly lower than that before treatment(P＜0.05),while there was no significant difference between before and after treatment in the control group(P＞0.05),and angle of trunk rotation in the trial group was significantly lower than that of the control group(P＜0.05).(3)At 24 weeks after treatment,the center of laminae angle of three-dimensional ultrasound imaging was significantly reduced in the trial group(P＜0.05),while there was no significant difference in the control group before and after treatment(P＞0.05).The center of laminae angle of three-dimensional ultrasound imaging was smaller in the trial group than that in the control group(P＜0.05).(4)At 24 weeks after treatment,in terms of the quality of life,pain dimension score in the trial group was significantly increased(P＜0.05).Both trial and control groups showed significantly higher scores in the self-image dimension compared with that before treatment(P＜0.05).Both groups had significantly lower scores in the mental health dimension compared with that before treatment(P＜0.05).In the dimensions of pain,self-image,mental health,and satisfaction,the trial group was significantly higher than the control group(P＜0.05).(5)It is indicated that Schroth therapy combined with core strength training can improve the major curve Cobb,apical vertebral translation,and cervical lordosis angle,reduce the angle of trunk rotation,decrease the center of laminae angle of three-dimensional ultrasound imaging,and improve the quality of life,and it is effective in the treatment of mild adolescent idiopathic scoliosis.

Patients with severe fever with thrombocytopenia syndrome (SFTS) often experience coagulation dysfunction. This article reports a case of a critical SFTS patient who developed secondary hemophagocytic lymphohistiocytosis (HLH) and accompanied by significantly prolonged activated partial thromboplastin time (APTT)(111.0 s). APTT mixing test, coagulation factor activity assays, and antiphospholipid antibodies testing excluded coagulation factor deficiencies and classic antiphospholipid syndrome. Combined with elevated endothelial injury markers, it was hypothesized that the prolonged APTT was related to endothelial injury. The patient was treated with dexamethasone, ruxolitinib, and plasma transfusion, the patient′s APTT returned to normal (34.6 s), platelets increased, and levels of ferritin, inflammatory cytokines, and vascular endothelial injury markers decreased. This case suggests that prolonged APTT in SFTS patients may be associated with HLH, cytokine storms, and endothelial injury. Glucocorticoid and Janus kinase inhibitor, by controlling inflammatory responses and reducing endothelial damage, may have potential therapeutic value in correcting coagulation abnormalities.

Objective:Severe fever with thrombocytopenia syndrome (SFTS), caused by the novel bunyavirus, is an emerging infectious disease with a high fatality rate. Co-infections with bacteria or fungi can exacerbate the disease. This study aimed to investigate the characteristics of co-infections in SFTS patients.Methods:A retrospective analysis was conducted on 143 SFTS patients admitted to Qilu Hospital of Shandong University and Juxian People’s Hospital from April 2021 to October 2024.Results:The result showed that 35.7% (51/143) of patients had co-infections, with 85.5% diagnosed within 48 hours of hospitalization. The co-infection group exhibited higher incidences of neurological and respiratory symptoms, lower median platelet counts, and significantly elevated levels of C-reactive protein (CRP), procalcitonin (PCT), blood urea nitrogen (BUN), creatinine (Cr), and ferritin ( P<0.01). Pathogen analysis revealed a predominance of lower respiratory tract Aspergillus infections. Co-infected patients had higher rates of ICU admission (31.4% vs 5.4%), mechanical ventilation (43.1% vs 6.5%), longer hospital stays, higher costs, and lower survival rates (74.5% vs 90.2%). The score within 6 days of disease onset (including age, neutrophil percentage, aspartate transaminase (AST), lactate dehydrogenase (LDH), and BUN) was a significant risk factor for co-infection. A predictive model combining CRP, BUN, and the composite score demonstrated superior performance (AUC=0.851). Conclusions:This study provides critical evidence for early diagnosis and identification of high-risk populations for co-infections in SFTS patients.

Objective To analyze the relationship between abnormal expression of serum neurohemoglobin(NGB)and myelin basic protein(MBP)and the cerebral neurodevelopment of neonates with hypoxic-ischemic encephalopathy(HIE).Methods A total of 89 preterm infants with HIE admitted in the hospital between January 2023 and March 2024 were selected as the observation group,and 60 preterm infants without HIE during the same period were selected as the control group.Serum levels of MBP,NGB and secretagogues in two groups were detected,and the neonates amplitude integration electroencephalogram score was evaluated.The neurological function of neonates was evaluated using 20 items of Neonatal Behavioral Neurological As-sessment(NBNA).The correlation test and diagnostic value were evaluated using Spearman method and re-ceiver operating characteristic(ROC)curve.Results The serum levels of NGB,MBP and secretagogue in the ob-servation group were higher than those in the control group(P<0.05),and the amplitude integration electroencepha-logram score was lower than that in the control group(P<0.05).The serum MBP,NGB and secretagogue levels in the mild,moderate,and severe groups increased sequentially(P<0.05),NBNA score and amplitude integration e-lectroencephalogram score decreased sequentially(P<0.05).The levels of NGB,MBP and secretagogue were the risk factors affecting NBNA score(P<0.05),and the amplitude integration electroencephalogram score was a protective factor affecting NBNA score(P<0.05).The area under the curve of NGB and MBP in diag-nosing HIE was greater than 0.8,which had high application value.Conclusion Serum NGB and MBP levels are closely related to the severity of HIE,and have certain connection with NBNA score.Elevated levels of NGB and MBP in neonates with HIE may be related to the body's stress response to nerve damage,which could reflect to some extent the brain nerve function damage in with HIE.

BACKGROUND:The definitive cause of adolescent idiopathic scoliosis is not yet known.The search for a clinical approach to address adolescent idiopathic scoliosis is imminent.OBJECTIVE:To investigate the effect of Schroth therapy combined with core strength training on mild adolescent idiopathic scoliosis and to provide more bases for the clinical treatment of mild adolescent idiopathic scoliosis.METHODS:110 patients with mild adolescent idiopathic scoliosis attending the Department of Rehabilitation Medicine and Department of Spine Surgery of Affiliated Hospital of Nantong University from July 2022 to January 2024 were selected as the study subjects.They were divided into the trial group and the control group according to the wishes of the patients and their parents,with 55 cases in each group.The control group was observed and followed up,and the trial group underwent Schroth therapy combined with core strength training for 45 minutes a day for 24 weeks.The differences in imaging parameters,body surface indexes,three-dimensional ultrasound imaging angle,and quality of life were compared between the two groups before and after treatment.RESULTS AND CONCLUSION:(1)At 24 weeks after treatment,major curve Cobb,apical vertebral translation,and cervical lordosis were significantly improved in the trial group(P＜0.05),while there was no significant difference in the control group(P＞0.05).Major curve Cobb and apical vertebral translation in the trial group were significantly better than those in the control group(P＜0.05).(2)At 24 weeks after treatment,angle of trunk rotation in the trial group was significantly lower than that before treatment(P＜0.05),while there was no significant difference between before and after treatment in the control group(P＞0.05),and angle of trunk rotation in the trial group was significantly lower than that of the control group(P＜0.05).(3)At 24 weeks after treatment,the center of laminae angle of three-dimensional ultrasound imaging was significantly reduced in the trial group(P＜0.05),while there was no significant difference in the control group before and after treatment(P＞0.05).The center of laminae angle of three-dimensional ultrasound imaging was smaller in the trial group than that in the control group(P＜0.05).(4)At 24 weeks after treatment,in terms of the quality of life,pain dimension score in the trial group was significantly increased(P＜0.05).Both trial and control groups showed significantly higher scores in the self-image dimension compared with that before treatment(P＜0.05).Both groups had significantly lower scores in the mental health dimension compared with that before treatment(P＜0.05).In the dimensions of pain,self-image,mental health,and satisfaction,the trial group was significantly higher than the control group(P＜0.05).(5)It is indicated that Schroth therapy combined with core strength training can improve the major curve Cobb,apical vertebral translation,and cervical lordosis angle,reduce the angle of trunk rotation,decrease the center of laminae angle of three-dimensional ultrasound imaging,and improve the quality of life,and it is effective in the treatment of mild adolescent idiopathic scoliosis.

Patients with severe fever with thrombocytopenia syndrome (SFTS) often experience coagulation dysfunction. This article reports a case of a critical SFTS patient who developed secondary hemophagocytic lymphohistiocytosis (HLH) and accompanied by significantly prolonged activated partial thromboplastin time (APTT)(111.0 s). APTT mixing test, coagulation factor activity assays, and antiphospholipid antibodies testing excluded coagulation factor deficiencies and classic antiphospholipid syndrome. Combined with elevated endothelial injury markers, it was hypothesized that the prolonged APTT was related to endothelial injury. The patient was treated with dexamethasone, ruxolitinib, and plasma transfusion, the patient′s APTT returned to normal (34.6 s), platelets increased, and levels of ferritin, inflammatory cytokines, and vascular endothelial injury markers decreased. This case suggests that prolonged APTT in SFTS patients may be associated with HLH, cytokine storms, and endothelial injury. Glucocorticoid and Janus kinase inhibitor, by controlling inflammatory responses and reducing endothelial damage, may have potential therapeutic value in correcting coagulation abnormalities.

Objective:Severe fever with thrombocytopenia syndrome (SFTS), caused by the novel bunyavirus, is an emerging infectious disease with a high fatality rate. Co-infections with bacteria or fungi can exacerbate the disease. This study aimed to investigate the characteristics of co-infections in SFTS patients.Methods:A retrospective analysis was conducted on 143 SFTS patients admitted to Qilu Hospital of Shandong University and Juxian People’s Hospital from April 2021 to October 2024.Results:The result showed that 35.7% (51/143) of patients had co-infections, with 85.5% diagnosed within 48 hours of hospitalization. The co-infection group exhibited higher incidences of neurological and respiratory symptoms, lower median platelet counts, and significantly elevated levels of C-reactive protein (CRP), procalcitonin (PCT), blood urea nitrogen (BUN), creatinine (Cr), and ferritin ( P<0.01). Pathogen analysis revealed a predominance of lower respiratory tract Aspergillus infections. Co-infected patients had higher rates of ICU admission (31.4% vs 5.4%), mechanical ventilation (43.1% vs 6.5%), longer hospital stays, higher costs, and lower survival rates (74.5% vs 90.2%). The score within 6 days of disease onset (including age, neutrophil percentage, aspartate transaminase (AST), lactate dehydrogenase (LDH), and BUN) was a significant risk factor for co-infection. A predictive model combining CRP, BUN, and the composite score demonstrated superior performance (AUC=0.851). Conclusions:This study provides critical evidence for early diagnosis and identification of high-risk populations for co-infections in SFTS patients.

To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.

To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.