Objective:To compare the differences in postoperative upper airway morphology and sleep apnea improvement between low temperature plasma ablation(LTPA)and traditional adenoidectomy(TAC)for severe adenoid hypertrophy in children.Methods:A total of 80 children with severe adenoid hypertrophy combined with obstructive sleep apnea-hypopnea syndrome(OSAHS)admitted to our hospital from January 2021 to January 2024 were randomly divided into two groups:LTPA group and TAC group,each with 40 cases.The study compared the upper airway morphological parameters(nasopharyngeal transverse diameter,sagittal diameter,nasopharyngeal airway volume,etc.),degree of OSAHS symptom improvement(apnea-hypopnea index,lowest blood oxygen saturation,etc.),intraoperative bleeding volume,surgical time,postoperative pain score,and incidence of postoperative complications in both groups before surgery,one week after surgery,one month after surgery,and three months after surgery.Results:The intraoperative blood loss in the LTPA group was significantly less than that in the TAC group,and the operation time was shorter(P＜0.05).Follow-up at 1 week,1 month,and 3 months postoperatively showed that both groups had significant improvements in upper airway morphology parameters compared to preoperative conditions.The increase in transverse diameter,sagittal diameter,and nasopharyngeal airway volume in the LTPA group was greater than in the TAC group(P＜0.05).Both groups also showed significant improvements in sleep-related breathing disorders,with a greater reduction in apnea-hypopnea index in the LTPA group compared to the TAC group(P＜0.05).Postoperative pain scores were lower in the LTPA group than in the TAC group(P＜0.05).The incidence of postoperative complications such as bleeding and nasopharyngeal stenosis was significantly lower in the LTPA group than in the TAC group(P＜0.05).Conclusions:Compared with traditional adenoid curettage,low temperature plasma ablation has the advantages of less surgical trauma,less intraoperative bleeding,less postoperative pain,better recovery of upper airway morphology and more significant improvement of sleep apnea in children with severe adenoid hypertrophy,and can be used as the preferred surgical mode for treating severe adenoid hypertrophy.

Objective:To compare the differences in postoperative upper airway morphology and sleep apnea improvement between low temperature plasma ablation(LTPA)and traditional adenoidectomy(TAC)for severe adenoid hypertrophy in children.Methods:A total of 80 children with severe adenoid hypertrophy combined with obstructive sleep apnea-hypopnea syndrome(OSAHS)admitted to our hospital from January 2021 to January 2024 were randomly divided into two groups:LTPA group and TAC group,each with 40 cases.The study compared the upper airway morphological parameters(nasopharyngeal transverse diameter,sagittal diameter,nasopharyngeal airway volume,etc.),degree of OSAHS symptom improvement(apnea-hypopnea index,lowest blood oxygen saturation,etc.),intraoperative bleeding volume,surgical time,postoperative pain score,and incidence of postoperative complications in both groups before surgery,one week after surgery,one month after surgery,and three months after surgery.Results:The intraoperative blood loss in the LTPA group was significantly less than that in the TAC group,and the operation time was shorter(P＜0.05).Follow-up at 1 week,1 month,and 3 months postoperatively showed that both groups had significant improvements in upper airway morphology parameters compared to preoperative conditions.The increase in transverse diameter,sagittal diameter,and nasopharyngeal airway volume in the LTPA group was greater than in the TAC group(P＜0.05).Both groups also showed significant improvements in sleep-related breathing disorders,with a greater reduction in apnea-hypopnea index in the LTPA group compared to the TAC group(P＜0.05).Postoperative pain scores were lower in the LTPA group than in the TAC group(P＜0.05).The incidence of postoperative complications such as bleeding and nasopharyngeal stenosis was significantly lower in the LTPA group than in the TAC group(P＜0.05).Conclusions:Compared with traditional adenoid curettage,low temperature plasma ablation has the advantages of less surgical trauma,less intraoperative bleeding,less postoperative pain,better recovery of upper airway morphology and more significant improvement of sleep apnea in children with severe adenoid hypertrophy,and can be used as the preferred surgical mode for treating severe adenoid hypertrophy.

Objective:To assess the current level of acceptance of generative artificial intelligence (GAI) among maternal and infant care providers and to explore the factors influencing their acceptance.Methods:A convenience sampling method was used to survey 164 maternal and infant care providers from Beijing Hospital and China-Japan Friendship Hospital between March and May 2024. The survey instruments included a general information questionnaire, GAI Acceptance among Maternal and Infant Care Providers Scale, and Self-assessment Scales for Digital Technology Awareness and Self-assessment Scales for Digital Competence. Multiple linear regression analysis was conducted to identify influencing factors.Results:The total acceptance score of GAI among 164 participants was [181 (158, 200) ]. Multiple linear regression analysis showed that interest in GAI, digital technology awareness, and digital competence were significant influencing factors for GAI acceptance, with statistically significant differences ( P<0.05) . Conclusions:The level of GAI acceptance among maternal and infant care providers was relatively high. It is recommended to strengthen the promotion and training on the application and precautions of GAI, improve their digital competence and professional literacy, while fostering critical and independent thinking, to enhance the integration of GAI into maternal and infant care services.

Objective:To investigate the value of a multi-parameter MRI nomogram model in evaluating the recurrence risk of hormone receptor (HR)-positive breast cancer.Methods:This study was a retrospective cross-sectional study. A retrospective analysis was conducted on the clinicopathological data (age, menopausal status, axillary lymph node metastasis, etc.) and imaging data of 220 patients with HR-positive breast cancer who underwent breast MRI examination and were pathologically confirmed at the Second Affiliated Hospital of Nantong University from January 2018 to December 2023. All patients underwent preoperative MRI examinations. Their MRI features were analyzed, and the maximum diameter of the lesion and the apparent diffusion coefficient (ADC) value were measured. Finally, the clinical treatment score (CTS5 score) after 5 years was calculated, and all patients were divided into a low recurrence risk (CTS5 score 3.13 points) and a medium to high recurrence risk (CTS5 score≥3.13 points) group. The patients were followed up through the electronic medical record system or by phone until December 31, 2024 to determine recurrence status. The patients were divided into the recurrence group and the non-recurrence group. The differences in clinicopathological data, MRI features and CTS5 scores between the recurrence group and the non-recurrence group were compared using independent sample t-tests, Mann-Whitney U tests or χ2 tests. Indicators with P0.05 in the univariate analysis were included in the multivariate logistic regression to screen the independent risk factors for predicting the recurrence of HR receptor-positive breast cancer, and a nomogram was constructed to establish the nomogram model. The receiver operating characteristic curves and the area under the curve (AUC) were used to evaluate the efficacy of the nomogram model in predicting the postoperative recurrence risk of patients with HR-positive breast cancer. The variance inflation factor (VIF) was used to evaluate the multicollinearity among independent variables. Calibration curves and decision curve analysis (DCA) were used to assess the fit and net clinical benefit of the nomogram model. Results:Among 220 patients with HR-positive breast cancer, 196 cases were in the non-recurrence group and 24 cases were in the recurrence group. There were statistically significant differences in the maximum diameter of the lesion, axillary lymph node metastasis, ADC value, CTS5 grouping, and CTS5 score between the recurrence group and the non-recurrence group ( P0.05). Multivariate logistic regression analysis showed that the maximum diameter of the lesion ( OR=1.110, 95% CI 1.169-1.503, P0.001), ADC value ( OR=0.993, 95% CI 0.993?0.989, P0.001), and axillary lymph node metastasis ( OR=8.842; 95% CI 2.120?36.884, P=0.003) were independent factors influencing postoperative recurrence in patients with HR-positive breast cancer, and a nomogram model was constructed based on this. VIF analysis showed that no significant multicollinearity was detected among the variables (VIF5). The AUC value of the nomogram model for predicting postoperative recurrence in patients with HR-positive breast cancer was 0.868 (95% CI 0.794-0.942), the sensitivity was 0.875, and the specificity was 0.781. The calibration curve showed that the prediction curve of this model for predicting postoperative recurrence in HR-positive breast cancer patients was basically consistent with the ideal curve trend. DCA showed that this model had a relatively high clinical benefit within the threshold probability range of 0.01% to 90.00%. Conclusion:The nomogram constructed based on multi-parameter MRI features can predict the postoperative recurrence risk of HR-positive breast cancer patients, with good consistency and predictive ability.

AIM To investigate the protective effect of Sanfeng Tongqiao Dropping Pills against house dust mite(HDM)-induced allergic asthma in mice.METHODS Compared to the intact BALB/c mice in the blank control group,the BALB/c mice randomly assigned into the model group,the dexamethasone group(0.67 mg/kg),and the low-dose,medium-dose,and high-dose Sanfeng Tongqiao Dropping Pills groups(15,30 and 60 mg/kg),were induced into acute allergic asthma models via weekly intraperitoneal sensitization with 0.1 mL HDM solution(0.5 mg/mL)for three weeks followed by three consecutive daily intranasal challenges with 10 μL HDM solution(2.5 mg/mL)starting in the third week.The drug administered continuously 7 days after the last excitation.The mice had their airway reactive Penh value detected,their pulmonary pathological changes observed by HE staining,their blood eosinophils(EOS)counted,their Th2 cytokines in lung tissue and serum IgE levels detected by ELISA,and their number of peripheral blood mononuclear cells(PBMC)and pulmonary Th2 cells detected by flow cytometry.Chronic allergic asthma was induced in grouped BALB/c mice through repeated intranasal challenges with 10 μL HDM solution(2.5 mg/mL)administered five times weekly for five consecutive weeks.Drug treatment continued for 14 days following the final challenge.After the final treatment,the mice had their pulmonary pathological changes observed by HE staining,and their levels of Th2 cytokines in B ALF and lung tissue and serum IgE detected by ELISA.RESULTS Compared to the blank control group,the acute allergic asthma model group exhibited increases in Penh value,EOS count and IgE level in serum,IL-4 and IL-5 levels in lung tissue(P＜0.01);obvious pulmonary inflammatory cells infiltration,and thickened airway wall;and increase in pulmonary number of Th2 cells(P＜0.01).Compared to the model group,the groups intervened with Sanfeng Tongqiao Dropping Pills demonstrated decreased Penh value,serum EOS count,IgE level and IL-5 level in lung tissue(P＜0.05,P＜0.01);reduced pulmonary inflammatory infiltration and alleviated airway wall thickening;and decreased number of pulmonary Th2 cells.Compared to the blank group,the chronic allergic asthma model group showed obvious pulmonary inflammatory infiltration and airway wall thickening;and increased EOS count and IgE level in serum,IL-4 and IL-13 in lung tissue and IL-14 in BALF(P＜0.05,P＜0.01).Compared to the model group,the groups intervened with either medium-dose or high-dose Sanfeng Tongqiao Dropping Pills demonstrated reduced pulmonary inflammatory infiltration;and decreased serum EOS count,IgE level,IL-13 in lung tissue and IL-14 in BALF(P＜0.05,P＜0.01).CONCLUSION Sanfeng Tongqiao Dropping Pills reduce Th2 cells in peripheral blood and lung tissue,suppress type 2 inflammation,and thereby alleviate allergic asthma.

Objective To observe the effects of Angelica and Astragalus ultrafiltration membrane extracts on Keap1/Nrf2 signaling pathway-related factors in diabetes kidney disease(DKD)model rats;To explore its mechanism in treating oxidative stress injury of DKD.Methods Totally 70 SPF-grade male SD rats were randomly divided into 10 rats for the blank group and the remaining 60 rats were fed with high-sugar and high-fat diet,streptozotocin was intraperitoneally injected after 4 weeks to establish the DKD model.The established model rats were randomly divided into the model group,positive control group(GKT137831 30 mg/kg)and TCM high-,medium-and low-dosage groups(Angelica and Astragalus ultrafiltration membrane extracts 6,3,1.5 g/kg),which were orally administered with corresponding drugs.The blank group and model group were given equivalent volume of distilled water orally once daily for 12 consecutive weeks.Random blood glucose,body mass and 24 h urinary total protein content(24 h-UTP)were detected,biochemical assays were conducted to detect serum creatinine(SCr),blood urea nitrogen(BUN),triglycerides(TG),total cholesterol(TC)and albumin(ALB)contents,HE and Masson staining were used to observe the morphology in renal tissue,the contents of reactive oxygen species(ROS),glutathione(GSH)and malondialdehyde(MDA)were measured by ELISA,the protein expressions of nicotinamide adenine dinucleotide phosphate oxidase 4(Nox4),Kelch-like ECH-associated protein 1(Keap1),nuclear factor erythroid 2-related factor 2(Nrf2),glutamate-cysteine ligase modifier subunit(GCLM)and glutathione peroxidase 4(GPX4)in renal tissue were detected by Western blot.Results Compared with the blank group,the random blood glucose at each time point of model group rats significantly increased(P<0.01),the 24 h-UTP significantly increased(P<0.01),the contents of SCr,BUN and serum TG,TC increased(P<0.01),and ALB content decreased(P<0.01);with loose arrangement and disordered structure of renal tissue,consolidation of glomeruli,shedding of renal tubular epithelial cells,and increased deposition of collagen fibers;the contents of serum ROS and MDA were significantly elevated(P<0.01),while GSH contents decreased(P<0.01);the protein expression of Nox4 and Keap1 in renal tissue significantly increased(P<0.01),the expression of Nrf2,GCLM and GPX4 protein significantly decreased(P<0.01).Compared with the model group,the random blood glucose were significantly reduced at 6,8,10,12 weeks in the treatment groups(P<0.01),24 h-UTP decreased(P<0.01),the contents of SCr,BUN,TG,TC in positive control group and TCM high-,medium-dosage group decreased,with increased ALB content(P<0.01,P<0.05);renal tubular and glomerular lesions were improved,and collagen fiber proliferation decreased;serum ROS and MDA contents were reduced,while GSH content increased(P<0.01,P<0.05);the protein expression of Nox4 and Keap1 in renal tissue decreased(P<0.01),and Nrf2,GCLM and GPX4 protein expression increased(P<0.01).Conclusion Angelica and Astragalus ultrafiltration membrane extracts can effectively alleviate injury of renal tissue in DKD rats,and its mechanism may be related to the regulation of the Keap1/Nrf2 signaling pathway and inhibition of oxidative stress response.

Objective:To explore patterns of traditional Chinese medicine (TCM) use among patients with inflammatory bowel disease (IBD) in Jiangsu Province, China from 2019 to 2023.Methods:Using data from the IBD health data platform of the National Healthcare Big Data (Eastern) Center, a retrospective cohort study was conducted. We performed descriptive analyses on hospitalised patients diagnosed with IBD between 2019 and 2023, who received TCM treatment.Results:The study included 11 095 case records from 4 760 patients, with TCM diagnoses primarily indicating diarrhoea and abdominal pain. Ulcerative colitis (UC) accounted for 4 782 hospitalizations (3 103 patients), while Crohn's disease (CD) accounted for 6 313 hospitalizations (1 657 patients). Patient demographics showed a trend towards younger age and a higher proportion of males. Treatment utilisation was highest in southern Jiangsu compared with the central and northern regions. In terms of disease burden, all treatment costs showed a downward trend. In terms of external TCM therapies, UC patients tend to prefer plasters and enemas, while CD patients are more inclined to use acupuncture. Regarding herbal medicine, licorice, white atractylodes, and white peony root are commonly used single herbs for IBD patients.Conclusions:The number of IBD patients treated with TCM in Jiangsu Province has steadily increased from 2019 to 2023. It is important to identify effective TCM treatment methods to reduce the burden of patients.

Objective: To compare the efficacy of heat and acid elution methods for IgG anti-M and anti-Ku. Methods: Ten samples with IgG anti-M and two samples with IgG anti-Ku were selected and standardized to a titer of 64. These antibodies underwent overnight absorption at 4℃ with O-type MM and kk-type erythrocytes, and then heat and acid elution methods were used on the absorbed sensitized erythrocytes respectively by detecting the titer of anti-M and anti-Ku in the eluate to compare the differences in the elution efficiency of IgG anti-M and anti-Ku between the two elution methods. Results: In heat elution tests, all 10 anti-M samples showed positive results with titers ranging from 8 to 64, while 2 anti-Ku samples yielded negative results. In acid elution tests, all 10 anti-M samples demonstrated negative results, whereas both anti-Ku (n=2) samples exhibited positive reactions with consistent titers of 32. Following acid elution with subsequent heat elution, 8 of 10 anti-M samples showed positive results with titers ranging from 8 to 32, while 2 remained negative. Both anti-Ku samples demonstrated positive with titers of 4. Conclusion: Heat elution demonstrated superior efficiency for IgG anti-M compared to acid elution, whereas acid elution showed greater efficacy for IgG anti-Ku than heat elution.

ObjectiveTo investigate the triglyceride-glucose (TyG) index and the level of serum homocysteine (Hcy) in association with the incidence of stroke in type 2 diabetes mellitus (T2DM) patients. MethodsBased on the chronic disease risk factor surveillance cohort in Pudong New Area, Shanghai, excluding those with stroke in baseline survey, T2DM patients who joined the cohort from January 2016 to October 2020 were selected as the research subjects. During the follow-up period, a total of 318 new-onset ischemic stroke patients were selected as the case group, and a total of 318 individuals matched by gender without stroke were selected as the control group. The Cox proportional hazards regression model was used to adjust for confounding factors and explore the serum TyG index and the Hcy biochemical indicator in association with the risk of stroke. ResultsThe Cox proportional hazards regression results showed that after adjusting for confounding factors, the risk of stroke in T2DM patients with 10 μmol·L⁻¹-¹ and Hcy>15 μmol·L⁻¹ was 1.532 times (95%CI: 1.017‒2.309 times, P=0.041) and 1.738 times (95%CI: 1.119‒2.699 times, P=0.014) higher respectively, compared to T2DM patients with Hcy≤10 μmol·L⁻¹. T2DM patients with TyG>9.074 had 1.396 times higher risk of stroke (95%CI: 1.091‒1.787, P=0.008) compared to those with TyG≤9.074. The study found that urea and α1-antitrypsin (α1-AT) were independent risk factors for the incidence of stroke in T2DM patients. For every unit increase in urea andα1-AT, the risk of stroke in T2DM patients increased by 233.6% (HR=3.336, 95%CI: 1.588‒7.009, P=0.001) and 11.3% (HR=1.113, 95%CI: 1.028‒1.205, P=0.008), respectively. Cumulative risk curves showed that Hcy>10 μmol·L⁻¹ and TyG>9.074 accelerated the time to stroke occurrence in T2DM patients. ConclusionElevated levels of Hcy>10 μmol·L⁻¹ and a higher TyG index are risk factors for stroke in T2DM patients. Effective interventions for Hcy and TyG should be conducted for diabetic patients to reduce the incidence of stroke.

AIM: To explore the diagnostic value of combining the corneal stress-strain index(SSI)with corneal biomechanical parameters for early keratoconus.METHODS:A retrospective study was conducted on 34 patients(53 eyes)with early keratoconus diagnosed and treated in our hospital from March 2022 to February 2024. Additionally, 112 normal volunteers(112 eyes)who underwent physical examinations in our hospital during the same period were selected as a healthy control group. The CorvisST equipment was utilized for measurement and recorded deformation with Scheimpflug camera to obtain 10 biomechanical parameters: first applanation time(A1T), first applanation length(A1L), velocity of initial applanation(Vin), second applanation time(A2T), second applanation length(A2L), velocity of outward applanation(Vout), highest concavity time(HCT), highest concavity depth of applanation(HCDA), highest concavity radius(HCR), and peak distance(PD), as well as stress-strain index(SSI), and the corneal biomechanical parameters of the two groups were compared. Furthermore, Logistic regression analysis was used to identify the risk factors for keratoconus, and ROC curves were plotted to analyze the biomechanical parameters of the cornea for early diagnosis of keratoconus.RESULTS:The SSI(0.77±0.17)in patients with keratoconus was lower than that in healthy controls(1.01±0.24; P<0.001). Patients with keratoconus had lower A1T, A1L, A2L, and HCR, and higher Vout, HCDA, and PD compared to healthy controls(all P<0.001). Logistic regression analysis showed that decreased SSI, A1T, A1L, A2L, and HCR, as well as increased Vout, HCDA, and PD, were risk factors for the development of keratoconus(P<0.001). ROC curve analysis showed that the AUC value for combined diagnosis of early keratoconus was 0.997, with a Youden's index of 0.954, sensitivity and specificity of 98.1% and 97.3%, respectively, and a 95% CI of 0.994-1.000.CONCLUSION:The combination of SSI and corneal biomechanical parameters holds diagnostic significance for early keratoconus, and the joint diagnostic value is even higher. It can be considered as a diagnostic or screening indicator for early keratoconus.