ObjectiveTo investigate the intervention effects of modified Linggui Zhugan Tang （LGZGT） on patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） of the spleen deficiency and dampness obstruction with blood stasis type， reveal its possible mechanisms， and provide a theoretical basis for the clinical treatment of OSAHS with traditional Chinese medicine （TCM）. MethodsEighty OSAHS patients with spleen deficiency and dampness obstruction with blood stasis were randomly assigned to a control group and an observation group （1∶1） using a random number table， with 40 patients in each group. The control group received standard basic treatment combined with oral Doxofylline tablets， while the observation group received standard basic treatment combined with modified LGZGT. Serum levels of macrophage migration inhibitory factor （MIF）， microRNA-223 （miR-223）， and interleukin-18 （IL-18） were measured by enzyme-linked immunosorbent assay （ELISA）， and the mRNA expression levels of MIF， miR-223， and IL-18 were measured by real-time quantitative polymerase chain reaction （Real-time PCR）. After two months of treatment， the total clinical efficacy， apnea-hypopnea index （AHI）， lowest nocturnal oxygen saturation （LSpO₂）， body mass index （BMI）， TCM syndrome scores， and expression levels of MIF， miR-223， and IL-18 before and after treatment were compared between the two groups. Correlations between MIF， miR-223， IL-18 and AHI and LSpO₂ were also analyzed. ResultsCompared with the control group， the observation group showed a significantly higher total clinical effective rate （P<0.01， Z=-3.49）. Within the control group， no significant changes were observed in AHI， LSpO₂， BMI， TCM syndrome scores， or MIF， miR-223， IL-18 levels and their mRNAs after treatment. In the observation group， AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs decreased significantly， while LSpO₂ increased significantly （P<0.01）. After treatment， compared with the control group， the observation group exhibited significantly lower AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs， and significantly higher LSpO₂ （P<0.01）. Correlation analysis showed that MIF and IL-18 were positively correlated with AHI （P<0.01） and negatively correlated with LSpO₂ （P<0.01）， whereas miR-223 was negatively correlated with AHI （P<0.01） and positively correlated with LSpO₂ （P<0.01）. ConclusionModified LGZGT may improve OSAHS of the spleen deficiency and dampness obstruction with blood stasis type by reducing airway inflammatory factors， alleviating airway inflammation， relieving airway edema and stenosis， and improving airway obstruction.

ObjectiveTo evaluate the predictive value of six surrogate indices of insulin resistance （IR） for cardiovascular disease （CVD） risk in adults with cardiovascular-kidney-metabolic syndrome （CKM） stages 0-3. MethodsRelated data of 6 813 participants from the China health and retirement longitudinal study （CHARLS） were analyzed. Cox proportional hazards models and restricted cubic spline （RCS） analyses were performed to evaluate the associations between six insulin resistance surrogate indices （TyG， TyG-BMI， TyG-WC， TyG-WHtR， TyG-CVAI， CVAI） and CVD incidence. Predictive performance of 6 indices was comprehensively compared from 3 dimensionalities， using receiver operating characteristic （ROC） curves for discriminative ability， net reclassification improvement （NRI） for incremental predictive value， and decision curve analysis （DCA） for clinical utility. ResultsAll six IR surrogate indices significantly predicted CVD in the CKM population. RCS analysis revealed linear associations between each index and CVD incidence. ROC analysis showed that CVAI had the highest AUC （0.628，95%CI： 0.611-0.646）， significantly outperforming the single TyG index （P=0.001 6）. NRI analysis indicated significant reclassification improvement for the event group with CVAI （event NRI=0.042 8）. DCA demonstrated that CVAI achieved the highest net benefit across most thresholds. Subgroup analysis confirmed stronger associations between CVAI and CVD risk in CKM stages 2-3. ConclusionsThese six IR surrogate indices serve as valuable tools for predicting CVD incidence in individuals with CKM stages 0-3. Among them， CVAI exhibits optimal predictive value for future CVD risk in adults with CKM stages 1-3.

Objective:To analyze the clinical characteristics and gene variations of children with cystic fibrosis (CF), and to improve the understanding of pediatrician on CF.Methods:The data of 7 children with CF admitted to Xi'an Children 's Hospital from July 2018 to January 2024 were retrospectively analyzed. Results:The 7 patients (2 males and 5 females) were diagnosed at a median age of 3 years and 9 month(ranging from 1 year and 1 month to 10 years).The main clinical manifestations included recurrent respiratory tract infection (7 cases), bronchiectasis (3 cases), malnutrition (5 cases), steatosis (5 cases), false Bartter syndrome(2 cases), cirrhosis (1case),infantile vomiting (1 case),and meconium intestinal obstruction (1 case). A total of 14 mutation sites were found in 7 cases by whole exon sequencing and Sanger sequencing verification, including 7 missense mutations, 4 nonsenses mutations, 2 shear mutations, and 1 frameshift mutation which was a new mutation. After symptomatic treatment including anti-infection, chest physical therapy, hypertonic saline atomization, fat-soluble vitamin supplementation and pancreatic enzyme supplementation, the respiratory symptoms were controlled, the number of hospitalization due to respiratory infection was significantly reduced. However，the nutritional status of the 7 children did not reach the expected improvement.Conclusion:The clinical manifestations of CF are varied, among which recurrent respiratory tract infection, bronchiectasis and malnutrition are common.Timely targeted anti-infection and other symptomatic treatments can improve the prognosis. The compliance of the confirmed children with nutritional support is poor, and it is still necessary to strengthen the intervention of nutritional support.

Objective:To analyze the clinical characteristics and gene variations of children with cystic fibrosis (CF), and to improve the understanding of pediatrician on CF.Methods:The data of 7 children with CF admitted to Xi'an Children 's Hospital from July 2018 to January 2024 were retrospectively analyzed. Results:The 7 patients (2 males and 5 females) were diagnosed at a median age of 3 years and 9 month(ranging from 1 year and 1 month to 10 years).The main clinical manifestations included recurrent respiratory tract infection (7 cases), bronchiectasis (3 cases), malnutrition (5 cases), steatosis (5 cases), false Bartter syndrome(2 cases), cirrhosis (1case),infantile vomiting (1 case),and meconium intestinal obstruction (1 case). A total of 14 mutation sites were found in 7 cases by whole exon sequencing and Sanger sequencing verification, including 7 missense mutations, 4 nonsenses mutations, 2 shear mutations, and 1 frameshift mutation which was a new mutation. After symptomatic treatment including anti-infection, chest physical therapy, hypertonic saline atomization, fat-soluble vitamin supplementation and pancreatic enzyme supplementation, the respiratory symptoms were controlled, the number of hospitalization due to respiratory infection was significantly reduced. However，the nutritional status of the 7 children did not reach the expected improvement.Conclusion:The clinical manifestations of CF are varied, among which recurrent respiratory tract infection, bronchiectasis and malnutrition are common.Timely targeted anti-infection and other symptomatic treatments can improve the prognosis. The compliance of the confirmed children with nutritional support is poor, and it is still necessary to strengthen the intervention of nutritional support.

Objective To investigate the loci in the STRtyper-21G kit that are prone to tolerance mismatches when compared with the GlobalFilerTM kit and the PowerPlex? 21 kit,and to analyze the underlying causes.Methods A total of 5,870 database comparison reports involving STRtyper-21G profiles and other autosomal STR kits were examined for identity alignment.Samples showing mismatched loci were re-tested using the STRtyper-21G,GlobalFilerTM,and PowerPlex? 21 kits.For loci with mismatches,primers were redesigned and sequencing was performed.Results Eight mismatched samples(8/5 870)were identified,involving the loci D18S51,D8S1179,and D2S1338.Sequencing revealed that the allele dropout at D18S51 was due to a G→A mutation at the 79th base upstream of the core sequence;at D8S1179,a C→A mutation at the 4th base upstream;and at D2S1338,a C→T mutation at the 22nd base downstream.Conclusion All mismatches were attributable to mutations in primer binding regions.These findings provide reference for interpreting mismatch results in the STRtyper-21G database.When mismatches occur at these loci and the profiles are homozygous,exclusion conclusions should be made with caution.

Objective:To evaluate the clinical efficacy of liquid phase concentrated growth factors (LPCGF) combined with a stabilization splint in treating temporomandibular joint osteoarthritis (TMJOA) compared to a stabilization splint alone.Methods:A retrospective analysis of 60 TMJOA patients from December 2020 to June 2022 at Department of Maxillofacial Surgery, Yinchuan Stomatology Hospital was conducted. Patients were divided into experimental group (LPCGF+stabilization splint) and control group (stabilization splint only). The experimental group received an initial LPCGF injection, followed by biweekly injections for two sessions. Clinical assessments, including visual analogue scale (VAS) scores, maximum mouth opening (MMO), and Friction index, were conducted at baseline and at 3, 6, and 12 months post-treatment.Results:At 3 months post-treatment, the VAS scores of both the control group and the experimental group [6.00 (5.00, 7.00), 6.00 (5.00, 7.00)] were significantly lower than those before treatment [2.00 (2.00, 3.00), 2.00 (2.00, 3.00)] (all P<0.001), and there was no statistically significant difference between the groups ( P>0.05). The MMO [36.00 (34.75, 39.00), 37.50 (35.00, 40.00) mm] were significantly larger than those before treatment [(29.32±4.83), (27.63±6.43) mm] (all P<0.001), and there was no statistically significant difference between the groups ( P>0.05). The craniiomandibular index (CMI), dysfunction index (DI), and palpation (PI) of both groups were significantly lower than those before treatment (all P<0.001), and there were no statistically significant differences between the groups ( P>0.05). At 6 months post-treatment, the VAS scores of both the control group and the experimental group were significantly higher than those before treatment (all P<0.001), the MMO were significantly larger than those before treatment ( P<0.001), and the Fricton index was significantly lower than that before treatment ( P<0.05). Among them, the VAS score, DI, and CMI of the experimental group were significantly lower than those of the control group (all P<0.05), and there was no statistically significant difference in MMO and PI between the two groups ( P>0.05). At 12 months post-treatment, the VAS score of the experimental group was significantly lower than that before treatment ( P<0.001), while there was no statistically significant difference between the control group and before treatment ( P>0.05). The VAS score of the experimental group was significantly lower than that of the control group ( P<0.001). The MMO of both the control group and the experimental group were significantly larger than those before treatment ( P<0.001), and the DI and CMI were significantly lower than those before treatment (all P<0.001). There were no statistically significant differences between the two groups ( P>0.05). There were no statistically significant differences in PI between the two groups compared with before treatment (all P>0.05), and there was no statistically significant difference between the two groups ( P>0.05). Conclusions:LPCGF combined with a stabilization splint offers a more effective long-term pain relief for TMJOA.

Objective To construct a patient decision aid(PtDA)for exercise training in pa-tients with chronic obstructive pulmonary disease(COPD)and explore its impacts on decision-making quality of patients' exercise regimens.Methods The development of the PtDA for exercise training in COPD patients was accomplished through literature analysis,the Delphi method,and user surveys,followed by an intervention study.A total of 59 inpatients with COPD were included as study sub-jects.The control group received routine care along with general exercise training guidance,while the intervention group received routine care combined with shared decision-making for exercise training based on the PtDA.The decision conflict and decision preparedness levels of patients in both groups were compared before the intervention and on the day of discharge.The exercise self-efficacy of pa-tients was measured before intervention,on the day of discharge,and 1 month and 3 months after dis-charge.Results The intervention group had significantly lower scores for decision conflict and signif-icantly higher scores for decision preparedness and exercise self-efficacy compared with the control group(P＜0.05).Conclusion The PtDA for exercise training can improve decision conflict and de-cision preparedness in COPD patients,enhance their exercise self-efficacy levels,and provide references for healthcare professionals in improving exercise adherence.

Objective: To understand the dynamic temporal evolution pathways of Internet addiction among university students and to identify the core driving nodes, so as to provide theoretical evidences for the precise implementation of targeted interventions. Methods: Using a convenient cluster sampling method, a total of 1 066 full time freshmen and sophomores were recruited from three universities in Guizhou, Jiangxi, and Guangdong Provinces for a follow up survey (T1:January-March 2024; T2:January-March 2025). The Revised Chen Internet Addiction Scale (CIAS-R) was employed to assess the status of Internet addiction among university students, and cross sectional as well as cross lagged panel network models were constructed to analyze Internet addiction and its multidimensional influencing factors. Results: The T1 network comprised 19 nodes and 114 non zero edges, while the T2 network comprised 19 nodes and 126 non zero edges. Cross sectional network analysis revealed the strongest association between "insufficient sleep" and "daytime fatigue"; the core nodes were "first thought upon waking for going online" and "feeling low after disconnection" (characteristics of psychological dependence) at T1, while the core nodes shifted to "impaired health" and "excitement when online" (characteristics of functional impairment and addictive psychodynamic features) at T2. Cross lagged network analysis further indicated that "reduced leisure" directly predicted "sleep compression", and a bidirectional relationship was observed between "needing more time to achieve satisfaction" and "academic decline". Conclusions Internet addiction among university students exhibits dynamic evolutionary characteristics. Stage specific targeted interventions focusing on core driving nodes are needed, integrating behavioral regulation and academic support to break the vicious cycle and enhancing the ability to cope with real life demands.

Acute myeloid leukemia (AML) is the most common type of leukemia in adults, which is characterized by a complex genetic background, high heterogeneity, and poor prognosis. With the advance in molecular biology and novel drug development, the pathogenesis of AML has been further elucidated. Some novel therapies for AML have been widely applied, including epigenetic modulators, molecular targeted agents, monoclonal antibodies and antibody-drug conjugates, many of which have been approved and incorporated into treatment guidelines. Targeted monotherapy or combination therapies are precise and show mild adverse effects. Currently, whether targeted therapies can challenge conventional treatment methods for AML patients has become a research focus. This paper reviews the recent progress of targeted therapies for AML (non-acute promyelocytic leukemia).

Objective:To evaluate the clinical efficacy of liquid phase concentrated growth factors (LPCGF) combined with a stabilization splint in treating temporomandibular joint osteoarthritis (TMJOA) compared to a stabilization splint alone.Methods:A retrospective analysis of 60 TMJOA patients from December 2020 to June 2022 at Department of Maxillofacial Surgery, Yinchuan Stomatology Hospital was conducted. Patients were divided into experimental group (LPCGF+stabilization splint) and control group (stabilization splint only). The experimental group received an initial LPCGF injection, followed by biweekly injections for two sessions. Clinical assessments, including visual analogue scale (VAS) scores, maximum mouth opening (MMO), and Friction index, were conducted at baseline and at 3, 6, and 12 months post-treatment.Results:At 3 months post-treatment, the VAS scores of both the control group and the experimental group [6.00 (5.00, 7.00), 6.00 (5.00, 7.00)] were significantly lower than those before treatment [2.00 (2.00, 3.00), 2.00 (2.00, 3.00)] (all P<0.001), and there was no statistically significant difference between the groups ( P>0.05). The MMO [36.00 (34.75, 39.00), 37.50 (35.00, 40.00) mm] were significantly larger than those before treatment [(29.32±4.83), (27.63±6.43) mm] (all P<0.001), and there was no statistically significant difference between the groups ( P>0.05). The craniiomandibular index (CMI), dysfunction index (DI), and palpation (PI) of both groups were significantly lower than those before treatment (all P<0.001), and there were no statistically significant differences between the groups ( P>0.05). At 6 months post-treatment, the VAS scores of both the control group and the experimental group were significantly higher than those before treatment (all P<0.001), the MMO were significantly larger than those before treatment ( P<0.001), and the Fricton index was significantly lower than that before treatment ( P<0.05). Among them, the VAS score, DI, and CMI of the experimental group were significantly lower than those of the control group (all P<0.05), and there was no statistically significant difference in MMO and PI between the two groups ( P>0.05). At 12 months post-treatment, the VAS score of the experimental group was significantly lower than that before treatment ( P<0.001), while there was no statistically significant difference between the control group and before treatment ( P>0.05). The VAS score of the experimental group was significantly lower than that of the control group ( P<0.001). The MMO of both the control group and the experimental group were significantly larger than those before treatment ( P<0.001), and the DI and CMI were significantly lower than those before treatment (all P<0.001). There were no statistically significant differences between the two groups ( P>0.05). There were no statistically significant differences in PI between the two groups compared with before treatment (all P>0.05), and there was no statistically significant difference between the two groups ( P>0.05). Conclusions:LPCGF combined with a stabilization splint offers a more effective long-term pain relief for TMJOA.