Objective:To investigate the effects of different doses of whole abdominal ultra‐high dose rate (FLASH) irradiation on the intestinal microbiota of mice.Methods:A total of 25 healthy male C57BL/6J mice were randomly divided into the control ( n=5) and FLASH irradiation groups ( n=20) by simple randomization method, and the FLASH irradiation group was further divided into different radiation dose subgroups of 10, 15, 20, 25 Gy, 5 in each group. The mice were irradiated with a single whole abdomen at a dose rate of 100 Gy/s, then sacrificed 3.5 d after irradiation. Fresh fecal specimens and intestinal tissues of mice were collected for 16S rRNA sequencing, microbiota analysis, hematoxylin eosin (HE) staining and injury severity score analysis. Two-group comparison was performed by independent sample t-test. Multi-group comparison was conducted by one-way ANOVA. Results:HE staining revealed that the whole abdomen FLASH irradiation caused varying degree of intestinal injury in mice, and the intestinal injury reaction was aggravated with the increase of irradiation dose. β‐diversity analyses showed that there were differences in the composition of intestinal microbiota between FLASH irradiation group and control group ( P=0.001), but the differences in the relative abundance of the species between the irradiation groups at different doses were relatively small, and there were their own dominant genera of bacteria. Comparison of different doses of FLASH irradiation groups with control group screened out 16 species of bacteria with shared differences at the genus level, in which Lactobacillus, Ligilactobacillus and unclassified Lactobacillus were more abundant in the control group, while Escherichia, Allobaculum, and Muribaculum were more abundant in the FLASH irradiation groups. Conclusions:The whole‐abdominal FLASH irradiation induces intestinal damage in mice, and the intestinal damage response is worsened with the increase of irradiation dose. Different doses of whole abdominal FLASH irradiation alter the intestinal microbiota composition of mice. Sixteen species of common intestinal differential microbiota at the genus level are screened out in the different doses of FLASH irradiation groups compared with the control group, which may serve as a marker for measuring intestinal injury in mice irradiated with whole‐abdominal FLASH.

Objective:To investigate the effects of different doses of whole abdominal ultra‐high dose rate (FLASH) irradiation on the intestinal microbiota of mice.Methods:A total of 25 healthy male C57BL/6J mice were randomly divided into the control ( n=5) and FLASH irradiation groups ( n=20) by simple randomization method, and the FLASH irradiation group was further divided into different radiation dose subgroups of 10, 15, 20, 25 Gy, 5 in each group. The mice were irradiated with a single whole abdomen at a dose rate of 100 Gy/s, then sacrificed 3.5 d after irradiation. Fresh fecal specimens and intestinal tissues of mice were collected for 16S rRNA sequencing, microbiota analysis, hematoxylin eosin (HE) staining and injury severity score analysis. Two-group comparison was performed by independent sample t-test. Multi-group comparison was conducted by one-way ANOVA. Results:HE staining revealed that the whole abdomen FLASH irradiation caused varying degree of intestinal injury in mice, and the intestinal injury reaction was aggravated with the increase of irradiation dose. β‐diversity analyses showed that there were differences in the composition of intestinal microbiota between FLASH irradiation group and control group ( P=0.001), but the differences in the relative abundance of the species between the irradiation groups at different doses were relatively small, and there were their own dominant genera of bacteria. Comparison of different doses of FLASH irradiation groups with control group screened out 16 species of bacteria with shared differences at the genus level, in which Lactobacillus, Ligilactobacillus and unclassified Lactobacillus were more abundant in the control group, while Escherichia, Allobaculum, and Muribaculum were more abundant in the FLASH irradiation groups. Conclusions:The whole‐abdominal FLASH irradiation induces intestinal damage in mice, and the intestinal damage response is worsened with the increase of irradiation dose. Different doses of whole abdominal FLASH irradiation alter the intestinal microbiota composition of mice. Sixteen species of common intestinal differential microbiota at the genus level are screened out in the different doses of FLASH irradiation groups compared with the control group, which may serve as a marker for measuring intestinal injury in mice irradiated with whole‐abdominal FLASH.

Objective:To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD).Methods:This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People′s Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed.Results:There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients.Conclusion:Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

Objective:To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD).Methods:This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People′s Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed.Results:There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients.Conclusion:Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

BACKGROUND:In the selection of minimally invasive total hip arthroplasty approaches,there is considerable debate about whether direct anterior and posterior approaches differ in postoperative gait,limb balance,and hip motor capacity,and therefore further investigation is warranted. OBJECTIVE:To assess the gait and hip ambulation ability of direct anterior and posterior approaches for primary unilateral total hip arthroplasty with a prospective randomized controlled study. METHODS:A total of 61 patients with unilateral avascular necrosis of the femoral head in Qingdao Municipal Hospital from January 2019 to June 2020 were included in the study.There were 40 males and 21 females,at a mean age of(64.83±5.52)years.All the patients were randomly divided into a direct anterior approach group(n=28)and a posterior approach group(n=33),and received initial total hip arthroplasty by direct anterior approach and posterior approach,respectively.Gait analysis(gait time-space parameters such as stride length,stride frequency,single-leg support time,and plantar pressure difference)and hip ambulation ability(standing-walking timing test and 2-minute walking test)were performed before and 1,3 and 6 months after operation. RESULTS AND CONCLUSION:(1)With the extension of postoperative time,gait time-space parameters in both groups were gradually improved.The stride length,stride frequency,single-leg support time,and plantar pressure difference in the direct anterior approach group were significantly better than those in the posterior approach group 1 month after surgery(P<0.01).The stride frequency,single-leg support time,and plantar pressure difference in the direct anterior approach group were significantly better than those in the posterior approach group 3 months after surgery(P<0.05).The plantar pressure difference in the direct anterior approach group was significantly better than that in the posterior approach group 6 months after surgery(P<0.01).(2)With the extension of postoperative time,the results of the standing-walking timing test and 2-minute walking test were gradually improved in both groups.The results of the standing-walking timing test and 2-minute walking test 1 and 3 months after operation in the direct anterior approach group were better than those in the posterior approach group(P<0.05).(3)The results have indicated that the recovery of postoperative gait and hip ambulation ability of the two groups is inconsistent.The direct anterior approach group has some advantages in the improvement of postoperative gait and hip ambulation ability compared with the posterior approach group in the early postoperative period.

Objective:To investigate the prevalence of norovirus and the correlation between norovirus infection and stool traits and clinical symptoms in children with acute gastroenteritis during 2021-2022.Method:A total of 2 195 anal swab samples were collected from cases of acute gastroenteritis in Beijing Children 's Hospital Affiliated to Capital Medical University from January 2021 to December 2022. PCR fluorescent probe assay was performed to detect norovirus，the clinical information and test results were performed by statistical analysis. Results:The detection rate of norovirus was 19.09%（419/2 195）in 2 195 children. The detection rates of male and female were 17.80%（244/1 371）and 21.24%（175/824），respectively，with statistically significant differences between genders（ χ2=3.945, P<0.05）. The positivity rate of noroviruses was higher in aged 1 month to 3 years［29.09%（64/220）~40.69%（94/231）］，especially in 1 year［40.69%（94/231）］. The norovirus detection rate ranged from 2.44%（2/82）to 35.84%（62/173）in different months，with a high detection rate between January and March，higher in the winter and spring［28.36%（150/529），21.07%（146/693）］，showing a clear seasonal distribution.Clinical symptoms of both vomiting and diarrhea were significantly more common among norovirus positive than negative children，the difference was statistically significant（ χ2=57.29, P<0.05）. Conclusion:In the high incidence season of winter and spring，for infants and young children aged 1 month to 3 years with diarrhea accompanied by vomiting symptoms，especially those aged 1 year，it is recommended to undergo norovirus related testing in time. Early treatment and isolation measures should be taken for diagnosed children to reduce cross infection and prevent outbreaks.

Objective:This study aimed to analyze the test results and changing trend of specific IgE (sIgE) for common allergens in children in the hospital from 2019 to 2023, so as to provide a basis for the diagnosis and treatment of allergic diseases in children.Methods:The test results of children who were admitted to Beijing Children′s Hospital, Capital Medical University and underwent serum allergen sIgE quantitative detection (Immuno CAP system) from January 1, 2019 to December 31, 2023 were retrospectively included. According to the allergen type, the allergens were divided into food allergens and inhaled allergens (dust mite group, mold group, animal dander group and pollen group). The trends in sIgE positive rates across different years, age-related differences, and monthly distribution characteristics were analyzed.Results:A total of 44 633 allergen sIgE quantitative test results were included in the study. Among them, 23 024 samples were tested for food allergen sIgE and 21 609 samples were tested for inhaled allergen sIgE. The positive rates of food allergens (egg white, milk, wheat, peanut, soybean, shrimp) sIgE increased year by year, and the differences were statistically significant ( χ2=97.3, 78.9, 95.6, 122.4, 84.7, 24.5, P<0.001). The positive rate of inhaled allergen sIgE also increased year by year, and the difference was statistically significant ( χ2=36.2, 326.2, 432.2, 973.2, P<0.001). There were significant differences in the sensitization patterns of food and inhaled allergens among different age groups. The most common food allergen was egg white in infant group (<1 year old) (23.0%), milk in young children group (1-2 years old) (40.7%), and egg white in preschool group (3-6 years old) (28.8%). Peanut was the most common allergen in school-age group (7-12 years old) and adolescent group (13-18 years old) (16.9% and 14.1%, respectively). Among the inhaled allergens, animal dander (3.6%) was the most common allergen in the infant group (<1 year old), and mold (15.3%) was the most common allergen in the young child group (1-2 years old). The most common allergens in preschool group (3-6 years old), school-age group (7-12 years old) and adolescent group (13-18 years old) were pollen (39.7%, 53.0%, 53.5%). There were significant differences in the positive rates of inhaled allergens (dust mite, mold, animal dander, pollen) sIgE in the 12 months of 2023 ( χ2=26.9, 26.7, 56.7, 55.5, P=0.005, 0.005,<0.001,<0.001). The positive rate of pollen sIgE was the highest, with peaks in April (54.8%) and September (60.5%). The positive rate of sIgE for molds peaks in June (46.4%). Conclusion:The trends in sIgE levels among children visiting Beijing Children′s Hospital, Capital Medical University, from 2019 to 2023, suggests to a certain extent that the prevalence of allergic diseases among children in Beijing City is increasing annually. There were significant age differences in sIgE sensitization patterns among children of different ages, and the distribution of sIgE positive rates for inhaled allergens was also different in different months. In clinical practice, the allergen test report is interpreted comprehensively according to the patient′s medical history, age, visit month and other factors.

Objective:This study aimed to analyze the test results and changing trend of specific IgE (sIgE) for common allergens in children in the hospital from 2019 to 2023, so as to provide a basis for the diagnosis and treatment of allergic diseases in children.Methods:The test results of children who were admitted to Beijing Children′s Hospital, Capital Medical University and underwent serum allergen sIgE quantitative detection (Immuno CAP system) from January 1, 2019 to December 31, 2023 were retrospectively included. According to the allergen type, the allergens were divided into food allergens and inhaled allergens (dust mite group, mold group, animal dander group and pollen group). The trends in sIgE positive rates across different years, age-related differences, and monthly distribution characteristics were analyzed.Results:A total of 44 633 allergen sIgE quantitative test results were included in the study. Among them, 23 024 samples were tested for food allergen sIgE and 21 609 samples were tested for inhaled allergen sIgE. The positive rates of food allergens (egg white, milk, wheat, peanut, soybean, shrimp) sIgE increased year by year, and the differences were statistically significant ( χ2=97.3, 78.9, 95.6, 122.4, 84.7, 24.5, P<0.001). The positive rate of inhaled allergen sIgE also increased year by year, and the difference was statistically significant ( χ2=36.2, 326.2, 432.2, 973.2, P<0.001). There were significant differences in the sensitization patterns of food and inhaled allergens among different age groups. The most common food allergen was egg white in infant group (<1 year old) (23.0%), milk in young children group (1-2 years old) (40.7%), and egg white in preschool group (3-6 years old) (28.8%). Peanut was the most common allergen in school-age group (7-12 years old) and adolescent group (13-18 years old) (16.9% and 14.1%, respectively). Among the inhaled allergens, animal dander (3.6%) was the most common allergen in the infant group (<1 year old), and mold (15.3%) was the most common allergen in the young child group (1-2 years old). The most common allergens in preschool group (3-6 years old), school-age group (7-12 years old) and adolescent group (13-18 years old) were pollen (39.7%, 53.0%, 53.5%). There were significant differences in the positive rates of inhaled allergens (dust mite, mold, animal dander, pollen) sIgE in the 12 months of 2023 ( χ2=26.9, 26.7, 56.7, 55.5, P=0.005, 0.005,<0.001,<0.001). The positive rate of pollen sIgE was the highest, with peaks in April (54.8%) and September (60.5%). The positive rate of sIgE for molds peaks in June (46.4%). Conclusion:The trends in sIgE levels among children visiting Beijing Children′s Hospital, Capital Medical University, from 2019 to 2023, suggests to a certain extent that the prevalence of allergic diseases among children in Beijing City is increasing annually. There were significant age differences in sIgE sensitization patterns among children of different ages, and the distribution of sIgE positive rates for inhaled allergens was also different in different months. In clinical practice, the allergen test report is interpreted comprehensively according to the patient′s medical history, age, visit month and other factors.

With the continuous in-depth study of minimally invasive cardiac surgery(MICS), minimally invasive cardiac surgery in children has also been developed in this period, but there is still a certain gap compared with adults. Because of the large difference in body size and the low tolerance of surgery in children, minimally invasive cardiac surgery in children still has a short board on complex cardiac diseases. This article reviews several commonly used minimally invasive techniques: (1) small incision cardiac surgery; (2) thoracoscopic and robot-assisted cardiac surgery; (3) minimally invasive cardiopulmonary bypass(MiECC) and cardiac surgery to avoid cardiopulmonary bypass; (4) hybrid surgery and enhanced cardiac rehabilitation surgery(ERACS) in pediatric cardiac surgery and their application and research progress.

Objective:To investigate the effect of peripheral plus ring size and its potential associations with pupil diameter (PD) on axial length (AL) elongation in myopic patients after wearing orthokeratology lenses.Methods:A case-control study was conducted.One hundred eyes from 100 myopic patients who underwent orthokeratolokgy lenses fitting were enrolled at Beijing Ming Vision and Ophthalmology from January to June 2020.AL and central corneal thickness (CCT) measurements were obtained using Lenstar LS900 ocular biometry, and steep keratometry (Ks), flat keratometry (Kf) were assessed using the TMS-4 corneal topographer.The patients were divided into larger peripheral plus ring diameter (LPPRD) group consisting of 55 eyes with PD0.05). There was no significant difference in PD at different time points before and after wearing orthokeratology lenses between the two groups ( Fgroup=1.133, P=0.293; Ftime=231.427, P=0.112). Conclusions:The size of peripheral plus ring and its relationship with PD are key factors influencing the AL elongation rate in myopic patients after wearing orthokeratology lenses.With smaller PPRD, patients have slower AL elongation and better myopia control.