Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective To discuss the clinical characteristics and treatment methods of lumbar disc herniation in adolescent and to in-crease the awareness of lumbar disc herniation among orthopedists.Methods Retrospectively reviewed the clinical data of 201 adolescent pa-tients(aged 20 years or less)with lumbar disc herniation who were admitted in General Hospital of Shenyang Military Area Command from January 2001 to December 2010.Analyzed the clinical characteristics and treatment methods,and compared the VAS score and ODI score be-fore operation,one week after operation and at the last follow up.Meanwhile,the complications were observed and compared.Results Among the 201 patients,187 patients(93.0%)presented with low back pain with or without radiating pain,20 patients(10.0%)presented with leg pain for the first symptom.There were only 97 patients(48.3%)were diagnosed with lumbar disc herniation for their first diagnosis in other hospital.Totally 70 patients(34.8%)had a history of trauma before the onset.The most common segments were L4 /L5 (101 cases,50.2%) and L5 /S1 (70 cases,34.8%).There were 140 patients treated by microendoscopy discectomy(MED),25 patients treated by percutaneous endoscopic lumbar discectomy(PELD),and 36 patients treated by open lumbar discectomy(OLD).All the patients were followed up for more than 12 months with averagely followed up for(22.9 ±11.7)months.There was significant improvement one week after operation and at the last follow up compared with the preoperative VAS score and ODI score,and the differences were statistically significant(P <0.05).The rate of postoperative complications was 3.6%,4.0%,8.3% in patients with MED,PELD and OLD respectively.Conclusion Diagnosis of LDH in adolescent is usually delayed.Increase the awareness of lumbar disc herniation could help orthopedists to get a exact medical history,per-form a directed physical examination,and order appropriate imaging studies.Minimally invasive surgery is an effective method to treat lumbar disc herniation in adolescent.

Objective To investigate of mental health level and coping style in emergency nurses. Methods Investigations were conducted in 78 emergency nurses who had been m the emergency department over one year from 4 general hospitals in Huizhou using general condition questionnaire, symptom checklist 90 (SCL-90) and simple coping style questionnaire, the results underwent analysis. Results The subfactor score of SCL- 90 was significantly higher than that of Chinese norm. Emergency nurses adopted positive coping style more then conunon adillt group. The positive coping style of nurses was negatively correlated with the total score of SCL-90, somatization, interpersonal relationship, depression and anxiety factor of SCL-90. The negative coping style was positively correlated with the total score, sornatization, depression and anxiety factor of SCL-90.Conchusions Emergency nurses have poor mental health. We must adopt effective means to improve theirs mental health level.

Objective To explore the aursing points for patients with acute pancreatitia.Methods Retrospectively summarized the nursing courses among 65 patients with acute pancreatitis.Results Among the 65 patients with acute pancreatitis,there were 10 patients receiving operation,there were 55 patients receiving conservative treatment.5 cases died,and the others rccoverd.Conclusion The key nursing points for patients with acute pancreatitis are careful observation,systematic nursing intervention according to the conditions of patients and preventing complications.

Objective To explore the psychological stress of young nurses facing patients' death. Methods Young nurses in emergency department, ICU and hospice care ward (96 cases, research group) and young nurses in other departments(94 cases,control group)from 8 general hospitals were investigated by self-rating anxiety scale (SAS)and serf-rating depression scale (SDS).The results underwent comparison and analysis. Results SAS and SDS score,incidence of anxiety and depression in the research group were higher than those of the control group (P ＜ 0.05). Conclusions Young nurses who face patients' death frequently have high incidence rate of psychological stress.They show low psychological health level which deserves the close attention of nursing managers.

Objective Isolating and purifying the major allergens from Metapenaeus ensis and identifying its immunoreactivity for diagnostic application. Methods The proteins extracted from Metapenaeus ensis were purified by DEAE-52 ion-exchange chromatography and Sephadex G-100 gel filtration. The eluted peaks were detected by dot-ELISA,and the immunoreactivity of the purified allergens was detected by ELISA with the sera from patients allergic to shrimp. The molecular weights of the purified allergic proteins were detected by SDS-PAGE. Results Two major allergic proteins which have highly immunoreactivity in ELISA detection were purified from Metapenaeus ensis. The molecular weights of which were 36 and 68kDa,respectively. Conclusion The major allergens of Metapenaeus ensis purified by ion-exchange chromatography and gel filtration have effective immunoreactivity and can be used as specific antigen in ELISA reagent.