Objective:To evaluate the efficacy of corticosteroids in male children with Duchenne muscular dystrophy (DMD), and provide evidence for the rational clinical use of medication.Methods:This was a multicenter medical record series study which conducted from January 15 th to March 14 th, 2025. A total of 53 male children with DMD admitted to the Department of Rehabilitation of Children′s Hospital, Zhejiang University School of Medicine, Children′s Hospital of Chongqing Medical University and Affiliated Children′s Hospital of Soochow University from 2020 to 2024 were enrolled. Clinical data, corticosteroid usage, and the follow-up data were collected. The North star ambulatory assessment (NSAA) was used as the primary efficacy indicator. Generalized estimating equations (GEE) exchangeable working matrices were used for longitudinal analysis, and the least squares mean were used to compare the change trend of the efficacy evaluation index across different medication durations. Results:The age at the initiation of corticosteroid treatment was (6.3±1.9) years. The follow-up duration was 1.2 (0.9, 2.2) years. After treatment, the raw scores and linear scores of NSAA were both significantly higher than those before treatment ((22±7) vs. (19±5) points, (60±16) vs. (53±8) points; t=3.98, 3.69; both P<0.001). The 10 meter running time and time rising from floor were both shorter than those before treatment (6 (4, 8) vs. 7 (6, 9) s, 5 (3, 6) vs. 6 (5, 9) s; Z=2.62, 3.47; both P<0.01). GEE model analysis revealed all nonlinear correlation between motor function (NSAA linear score, 10-meter running velocity, and rising from floor velocity) and the duration of corticosteroid treatment (all P<0.05). Least squares mean comparison all showed that the medication effect first increased and then decreased with duration, reaching the peak at 1.1-2.0 years after treatment (all P<0.05). Conclusions:Corticosteroids can improve the motor function in male children with DMD, with the maximum treatment effect occurring 1 to 2 years after the initiation of treatment. It is necessary to comprehensively leverage time-varying efficacy of corticosteroids to optimize individualized treatment regimens for maximal motor function benefits in children with DMD.

Objective To investigate the effect of triglyceride-glucose index(TyG)on the short-term prognosis of patients with initial acute ischemic stroke.Methods A total of 391 patients with initial acute ischemic stroke who were hospitalized in Kunshan Second People's Hospital and The Affiliated Suzhou Hospital of Nanjing Medical University from Jun.2020 to Jun.2023 were retrospectively included.According to the modified Rankin scale(mRS)scores at 90 d follow-up,they were assigned to good prognosis group(286 cases)or poor prognosis group(105 cases).Logistic regression and receiver operating characteristic(ROC)curve were used to evaluate the effect of TyG on the short-term prognosis of patients with initial acute ischemic stroke.Results Compared with the good prognosis group,the patients of poor prognosis group had older age,higher proportion of atrial fibrillation,higher levels of homocysteine,triglyceride,total cholesterol,low-density lipoprotein,and TyG,and higher National Institutes of Health stroke scale(NIHSS)score(all P＜0.05).Multivariate logistic regression analysis showed that age,homocysteine,TyG and NIHSS score were independent risk factors for poor prognosis in patients with initial acute ischemic stroke(all P＜0.05).ROC curve analysis showed that TyG combined with NIHSS score had good predictive value for poor prognosis of patients with initial acute ischemic stroke,and the area under curve value was 0.795.Conclusion The combination of TyG and NIHSS score is an independent influencing factor for poor short-term prognosis in patients with initial acute ischemic stroke.

Objective:To evaluate the efficacy of corticosteroids in male children with Duchenne muscular dystrophy (DMD), and provide evidence for the rational clinical use of medication.Methods:This was a multicenter medical record series study which conducted from January 15 th to March 14 th, 2025. A total of 53 male children with DMD admitted to the Department of Rehabilitation of Children′s Hospital, Zhejiang University School of Medicine, Children′s Hospital of Chongqing Medical University and Affiliated Children′s Hospital of Soochow University from 2020 to 2024 were enrolled. Clinical data, corticosteroid usage, and the follow-up data were collected. The North star ambulatory assessment (NSAA) was used as the primary efficacy indicator. Generalized estimating equations (GEE) exchangeable working matrices were used for longitudinal analysis, and the least squares mean were used to compare the change trend of the efficacy evaluation index across different medication durations. Results:The age at the initiation of corticosteroid treatment was (6.3±1.9) years. The follow-up duration was 1.2 (0.9, 2.2) years. After treatment, the raw scores and linear scores of NSAA were both significantly higher than those before treatment ((22±7) vs. (19±5) points, (60±16) vs. (53±8) points; t=3.98, 3.69; both P<0.001). The 10 meter running time and time rising from floor were both shorter than those before treatment (6 (4, 8) vs. 7 (6, 9) s, 5 (3, 6) vs. 6 (5, 9) s; Z=2.62, 3.47; both P<0.01). GEE model analysis revealed all nonlinear correlation between motor function (NSAA linear score, 10-meter running velocity, and rising from floor velocity) and the duration of corticosteroid treatment (all P<0.05). Least squares mean comparison all showed that the medication effect first increased and then decreased with duration, reaching the peak at 1.1-2.0 years after treatment (all P<0.05). Conclusions:Corticosteroids can improve the motor function in male children with DMD, with the maximum treatment effect occurring 1 to 2 years after the initiation of treatment. It is necessary to comprehensively leverage time-varying efficacy of corticosteroids to optimize individualized treatment regimens for maximal motor function benefits in children with DMD.

Drug-induced autoimmune-like hepatitis(DI-ALH)is a special clinical phenotype of drug-induced liver injury and has similar clinical features and laboratory test results to autoimmune hepatitis,and it is often difficult to distinguish them through liver biopsy.Therefore,correct differential diagnosis DI-ALH and autoimmune hepatitis is a crucial and difficult point in clinical practice.This article analyzes the research advances in the pathogenesis,clinical features,diagnosis and treatment,and prognosis of DI-ALH,in order to provide ideas for the diagnosis and treatment of such diseases among clinicians.

Objective To investigate the related influencing factors of seizures in early pregnancy.Methods Patients with epilepsy and pregnancy in Suzhou Hospital Affiliated to Nanjing Medical University from July 2019 to July 2023 were retrospectively enrolled and divided into epileptic group(n=35)and non-epileptic group(n=48)according to whether they had epilepsy in early pregnancy.Uni-variate and multivariate Logistic regression models were used to analyze the influencing factors of seizures in early pregnancy.And the re-ceiver operating characteristic(ROC)curve was further used to evaluate the predictive efficiency of the relevant models.Results Univa-riate analysis showed that there were statistically significant differences in the occurrence of seizures,frequency of seizures in 9months be-fore pregnancy and whether adjusted treatment plan after pregnancy between epileptic group and non-epileptic group(P＜0.05).Multi-variate Logistic regression analysis showed that the occurrence of seizures,the frequency of seizures in 9months before pregnancy,and the whether adjusted treatment plan after pregnancy were correlated with seizures in early pregnancy(P＜0.05).The area under the ROC curve of the predicted model was 0.750(95％CI:0.652-0.858)based on the results of multivariate Logistic regression analysis.Conclusion The occurrence of seizures,the frequency of seizures in 9months before pregnancy and whether adjusted treatment plan after pregnancy are related to the onset of seizures in early pregnancy.The prediction model established according to the results of multivariate Logistic regression analysis has some predictive value.

Objective To investigate the related influencing factors of seizures in early pregnancy.Methods Patients with epilepsy and pregnancy in Suzhou Hospital Affiliated to Nanjing Medical University from July 2019 to July 2023 were retrospectively enrolled and divided into epileptic group(n=35)and non-epileptic group(n=48)according to whether they had epilepsy in early pregnancy.Uni-variate and multivariate Logistic regression models were used to analyze the influencing factors of seizures in early pregnancy.And the re-ceiver operating characteristic(ROC)curve was further used to evaluate the predictive efficiency of the relevant models.Results Univa-riate analysis showed that there were statistically significant differences in the occurrence of seizures,frequency of seizures in 9months be-fore pregnancy and whether adjusted treatment plan after pregnancy between epileptic group and non-epileptic group(P＜0.05).Multi-variate Logistic regression analysis showed that the occurrence of seizures,the frequency of seizures in 9months before pregnancy,and the whether adjusted treatment plan after pregnancy were correlated with seizures in early pregnancy(P＜0.05).The area under the ROC curve of the predicted model was 0.750(95％CI:0.652-0.858)based on the results of multivariate Logistic regression analysis.Conclusion The occurrence of seizures,the frequency of seizures in 9months before pregnancy and whether adjusted treatment plan after pregnancy are related to the onset of seizures in early pregnancy.The prediction model established according to the results of multivariate Logistic regression analysis has some predictive value.

Objective To investigate the plasma levels of glutamate (Glu) andγ-aminobutyric acid (GABA) in Par?kinson’s disease patients with depression (PDD) and their clinical significance. Methods Plasma levels of Glu and GA?BA were measured in 88 PD patients including 43 PDD patients and 45 PD patients without depression, and 68 healthy controls by using high performance liquid chromatography (HPLC-RF). Depression was assessed in enrolled subjects by using the Hamilton Depression Scale (HAMD). The plasma levels of Glu and GABA were compared among different groups and their associations with HAMD scores were subsequently evaluated by correlation analysis. Results The plas?ma levels of Glu and GABA were significantly lower in PD group(49.81±22.79,249.17±62.57)than in normal control group(149.59±50.08,276.66±85.43)(all P<0.05). In addition, PD patients with depression exhibited significantly low?er plasma levels of Glu and GABA(40.34±15.77 and 233.63±53.56)compared to PD patients without depression(58.86± 24.87 and 264.02±67.39)and healthy controls (all P<0.05). Correlation analysis indicated that HAMD scores were nega?tively associated with plasma levels of Glu ( r=-0.366,P=0.000 ) and GABA ( r=-0.217,P=0.043 ). Conclusion The decrease in plasma levels of Glu and GABA may be implicated in the pathogenesis of depression in PD patients.