Objective To propose a lightweight end-to-end neural network model for automated Korotkoff sound phase recognition and subsequent blood pressure (BP) measurement, aiming to improve measurement accuracy and population adaptability. Methods We developed a streamlined architecture integrating depthwise separable convolution (DSConv), multi-head attention (MHA), and bidirectional gated recurrent unit (BiGRU). The model directly processes Korotkoff sound time-series signals to identify auscultatory phases. Systolic BP (SBP) and diastolic BP (DBP) were determined using phase Ⅰ and phaseⅤdetections, respectively. Given the clinical relevance of phase Ⅳ for specific populations (e.g., children and pregnant women, denoted as DBPⅣ), BP values from this phase were also recorded.Results The study enrolled 106 volunteers with 70 males and 36 females at mean age of (40.0±12.0) years. The model achieved 94.25% phase recognition accuracy. Measurement errors were (0.1±2.5) mm Hg (SBP), (0.9±3.4) mm Hg (DBPⅣ), and (0.8±2.6) mm Hg (DBP). Conclusion Our method enables precise phase recognition and BP measurement, demonstrating potential for developing population-adaptive blood pressure monitoring systems.

Objective To investigate the clinical value of metagenomic next-generation sequencing(mNGS)in the detection of pathogenic microorganisms in pediatric infectious diseases and to analyze the clinical characteristics of relevant cases.Methods A retrospective analysis was conducted on 30 pediatric patients who underwent mNGS pathogen detection in Hangzhou Red Cross Hospital from January 2023 to January 2024,along with 30 patients who did not undergo mNGS testing as the control group.Clinical information,including age,gender,hospital stay,symptoms and signs,routine blood tests,C-reactive protein(CRP),imaging findings,mNGS pathogen detection results,and patient outcomes,was collected.The differences between mNGS and conventional microbiological testing(CMT)results were compared,and the impact of mNGS testing on infection treatment and hospitalization duration was analyzed.Results Among the 30 patients who underwent mNGS testing,21 were male and 9 were female;with an age range of 1 year 5 months to 12 years 9 months,mean age:(7.15±3.13)years.The mNGS test identified 9 viruses,10 Gram-positive bacteria,5 Gram-negative bacteria,3 fungi,and 5 specific pathogens.Based on the test results,12 patients had their anti-infective treatment plans adjusted,with an average hospital stay of(10.63±3.15)days.In the control group,7 patients had their treatment plans adjusted,with an average hospital stay of(12.64±2.79)days.The average hospital stay was significantly shorter in the mNGS group compared to the control group(P<0.05).Conclusions The clinical symptoms and signs of pediatric infectious diseases often lack specificity,and CMT methods are suboptimal.mNGS exhibits high sensitivity for pathogen detection and demonstrates significant value in etiological diagnosis and therapeutic guidance when CMT fails to identify pathogens.However,interpretation of mNGS results requires integration with clinical presentations and other auxiliary diagnostic findings.

Objective To investigate the clinical value of metagenomic next-generation sequencing(mNGS)in the detection of pathogenic microorganisms in pediatric infectious diseases and to analyze the clinical characteristics of relevant cases.Methods A retrospective analysis was conducted on 30 pediatric patients who underwent mNGS pathogen detection in Hangzhou Red Cross Hospital from January 2023 to January 2024,along with 30 patients who did not undergo mNGS testing as the control group.Clinical information,including age,gender,hospital stay,symptoms and signs,routine blood tests,C-reactive protein(CRP),imaging findings,mNGS pathogen detection results,and patient outcomes,was collected.The differences between mNGS and conventional microbiological testing(CMT)results were compared,and the impact of mNGS testing on infection treatment and hospitalization duration was analyzed.Results Among the 30 patients who underwent mNGS testing,21 were male and 9 were female;with an age range of 1 year 5 months to 12 years 9 months,mean age:(7.15±3.13)years.The mNGS test identified 9 viruses,10 Gram-positive bacteria,5 Gram-negative bacteria,3 fungi,and 5 specific pathogens.Based on the test results,12 patients had their anti-infective treatment plans adjusted,with an average hospital stay of(10.63±3.15)days.In the control group,7 patients had their treatment plans adjusted,with an average hospital stay of(12.64±2.79)days.The average hospital stay was significantly shorter in the mNGS group compared to the control group(P<0.05).Conclusions The clinical symptoms and signs of pediatric infectious diseases often lack specificity,and CMT methods are suboptimal.mNGS exhibits high sensitivity for pathogen detection and demonstrates significant value in etiological diagnosis and therapeutic guidance when CMT fails to identify pathogens.However,interpretation of mNGS results requires integration with clinical presentations and other auxiliary diagnostic findings.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.

Background: During hot environment work tasks with whole-body enclosed anti-bioaerosol suit, the combined effect of heavy sweating and exhaled hot humid air may cause the N95 medical respirator to saturate with water/sweat (i.e., water-blocking). Methods: 32 young male subjects with different body mass indexes (BMI) in whole-body protection (N95 medical respirator + one-piece protective suit + head covering + protective face screen + gloves + shoe covers) were asked to simulate waste collecting from each isolated room in a seven-story building at 27-28°C, and the weight, inhalation resistance (Rf), and aerosol penetration of the respirator before worn and after water-blocking were analyzed. Results: All subjects reported water-blocking asphyxia of the N95 respirators within 36-67 min of the task. When water-blocking occurred, the Rf and 10-200 nm total aerosol penetration (Pt) of the respirators reached up to 1270-1810 Pa and 17.3-23.3%, respectively, which were 10 and 8 times of that before wearing. The most penetration particle size of the respirators increased from 49-65 nm before worn to 115-154 nm under water-blocking condition, and the corresponding maximum size-dependent aerosol penetration increased from 2.5-3.5% to 20-27%. With the increase of BMI, the water-blocking occurrence time firstly increased then reduced, while the Rf, Pt, and absorbed water all increased significantly. Conclusions This study reveals respirator water-blocking and its serious negative impacts on respiratory protection. When performing moderate-to-high-load tasks with whole-body protection in a hot environment, it is recommended that respirator be replaced with a new one at least every hour to avoid water-blocking asphyxia.

OBJECTIVE：To systematically evaluate the efficacy and safety of linezolid （LZD）combined with routine anti- tuberculosis drugs in the treatment of tuberculous meningitis （TBM），so as to provide evidence-based reference for clinical medi- cation. METHODS ：Retireved from PubMed ，Cochrane Library ，Embase，CNKI and Wanfang database ，randomized controlled trials（RCT）of LZD combined with routine anti-tuberculosis drugs （trial group ）versus routine anti-tuberculosis drugs （control group）were collected from the inception to Jan. 2020. After literature screening and data extraction ， the quality of the included literature were evaluated with bias risk assessment tool recommended by Cochrane system evaluator handbook 5.2. Meta-analysis was conducted by using Rev Man 5.3 software，and sensitivity analysis and publication bias analysis were performed. RESULTS ： Totally 9 RCTs involving 602 patients were included. Meta-analysis showed that total response rate [OR ＝4.05，95％CI（2.26，7.26）， P＜0.000 01]， changes of protein content of cerebrospinal fluid [MD ＝0.48，95％CI（0.20，0.77），P＝0.000 8]，changes of white blood cells count of cerebrospinal fluid [MD ＝44.43，95％CI（20.06，68.81），P＝0.000 4]，changes of cerebrospinal fluid glucose/ synchronous blood glucose [MD ＝0.09，95％CI（0.05，0.14），P＜0.000 1] of trial group were significantly higher than those of control group. There was no statistical significance in the changes of chloride content of cerebrospinal fluid [MD ＝8.08，95％CI（－0.64， 16.80），P＝0.07] and the incidence of ADR [OR ＝1.34，95％CI（0.57，3.11），P＝0.50] between 2 groups. The results of sensitivity analysis showed that there were significant differences comparison with before exclusion when the change of protein content in cerebrospinal fluid and the change of glucose/synchronous blood glucose in cerebrospinal fluid were taken as indexes ，and there was no significant difference comparison with before exclusion when the changes of white blood cell count and chloride content in cerebrospinal fluid were taken as indexes. The results of publication bias analysis showed that there was a certain publication bias in this study. CONCLUSIONS ：LZD combined with conventional anti-tuber culosis drugs is effective and safe for TBM. Because the inconsistent results of sensitivity analysis and publication bias exists in publication bias analysis ，the conclusions need to be further confirmed by more large sample and multi-center studies.

Rheumatoid Arthritis is a kind of chronic autoimmune diseases mainly involving joint, which is characterized by systemic inflammatory response.Studies have shown that Rheumatoid arthritis patients showed associated antineutrophil cytoplasmic antibody (ANCA) and inflammatory cytokines such as interleukin (IL) , tumor necrosis factor (TNF) increased, the positive of ANCA and the increase of IL-1, IL-6, TNF-αare especially seen in the Rheumatoid arthritis patients who have inflammatory reaction, and which are roughly equal to the articular synovitis pathological mechanism of wind dampmess heat accumulation pattern in the traditional Chinese medicine.The treatment for Rheumatoid arthritis patients, Western treatment is use the methotrexate (MTX) as basic drugs, combined with other drugs to control the positive of ANCA and the higher of IL-1, IL-6, TNF-α.And combining traditional Chinese medicine treatment, the effect is not only at to increase Western effection but also be able to reduce the side effects of Western medicine.Therefore, the research of combined rheumatoid factor ANCA, IL-1, IL-6, TNF-αdetection is benefit to diagnosing rheumatoid arthritis.

Objective To observe the value of MRI in preoperative staging of tongue squamous cell carcinomas (TSCC).Methods Totally 154 patients with TSCC underwent MR scanning.MR manifestations of TSCC were analyzed,and the preoperative staging of Tumor (T),Node (N) and American Joint Committee on Cancer (AJCC) were performed.Then the consistency between preoperative MRI staging and postoperative pathology staging was evaluated.Results Preoperative MRI T staging were T1 in 37 patients,T2 in 54,T3 in 7 and T4 in 56 patients,respectively,while N staging were N0 in 104 patients,N1 in 31 and N2 in 19 patients,respectively.For AJCC staging,there were 34 patients in Ⅰ stage,37 in Ⅱ stage,21 in Ⅲ stage and 62 in Ⅳ stage,respectively.Between preoperative MRI and postoperative pathology staging,the Kappa of T,N and AJCC staging was 0.814,0.786 and 0.790,respectively (all P＜0.01).The accuracy rate of preoperative MRI T,N and AJCC staging of TSCC was 87.01％ (134/154),88.96％ (137/154) and 85.06％ (131/154),respectively.Conclusion The consistency was good between preoperative MRI T,N and AJCC staging and postoperative pathology staging of TSCC.

Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness. Four cases did not undergo nasal endoscopic optic nerve decompression because of the diagnoses of internal carotid artery trauma. One case was diagnosed after nasal endoscopic optic nerve decompression because of fatal bleeding during the operation. One case was diagnosed because of late-onset recurrent epistaxis. Among the 6 cases with internal carotid artery trauma, 3 cases were successfully treated with endovascular interventional treatment (stent embolization was used in one case, Coil embolization was used in two cases), and 3 patients refused treatment. Conclusions The patients with traumatic optic neuropathy have the possibility of severe carotid artery trauma. Endoscopic optic nerve decompression is not suitable for these cases. It should pay more attention to patients with traumatic optic neuropathy. For suspected cases, vascular-enhanced computed tomography screening and digital subtraction angiography should be recommended and patients should be treated by endovascular intervention in a timely manner.

Objective To study the curative effect and the prognostic factors of endoscopic traumatic optic neuropathy (TON). Methods The clinical data of 53 patients with TON from 2010 to 2015 years was retrospectively analyzed. Divided the patients into the surgery group and the non-surgery group, according to whether or not accept the treatment of endoscopic optic decompression. And evaluating the potential prognostic factors in chi-square test, group t-test and multiple regression analysis. Results In 53 patients (55 eyes ), 31 eyes have no visual acuity before treated: 8 eyes’ visual acuity was improved in 16 eyes (8/16) that accepted operation; 3 eyes’ visual acuity was improved in 15 eyes (3/15) that with non-operation;24 eyes have visual acuity before treated:11 eyes’ visual acuity was improved in 14 eyes (11/14) that accepted operation;3 eyes’ visual acuity was improved in 10 eyes (3/10) that with non-operation;19 eyes’ visual acuity was improved in 30 eyes (19/30) that accepted operation, the total effective rate was 63.3%, and there was no complications happened in the patients who accepted operation. The age, eye-side, sex, visual acuity, optic canal fracture , orbit fracture , all these factors have no correlation to the prognosis (P>0.05), but the interval time between injury and operation (less than 3 days) and the way of the treatment are benefit to improve vision (P<0.05). Conclusions The endoscopic optic decompression is an effective treatment in TON, and it’s better to improve vision in 3-day after TON.