Objective:To investigate the clinical characteristics of Mycoplasma pneumonia infection in children of different ages, and to provide a basis for precise treatment. Methods:A total of 216 children with Mycoplasma pneumonia infection who were admitted to the Xi 'an Children's Hospital from January 2019 to December 2021 were included in this study. These children consisted of 117 males and 99 females. These children were divided into school-age group (> 6 years old, n = 75), preschool group (3-6 years old, n = 72) and infant and toddler group (< 3 years old, n = 69) according to age. Data on general demographics, clinical manifestations, complications, laboratory indicators, imaging findings, and bronchoscopic results, as well as treatment efficacy and outcomes, were collected and compared among the three groups. Results:There were statistically significant differences among the school-age, preschool, and infant and toddler groups in terms of dry cough [45 (60.00%), 34 (47.22%), 18 (26.08%)], wheezing [13 (17.33%), 19 (26.39%), 41 (59.42%)], concurrent pleural effusion [26 (34.67%), 20 (27.78%), 11 (15.94%)], pulmonary necrosis [12 (16.00%), 3 (4.17%), 0 (0)], pulmonary imaging findings (patchy shadows [12 (16.00%), 22 (30.56%), 46 (66.67%)], ground-glass opacities [11 (14.67%), 18 (25.00%), 40 (57.97%)], consolidation shadows [58 (77.33%), 42 (58.33%), 8 (11.59%)]), fever duration [(9.58 ± 4.85) days, (9.48 ± 4.89) days, (6.58 ± 3.64) days], and cough relief time [9 (8,12) days, 9 (8,11) days, 8 (7,11) days] ( χ2 = 16.94, 31.10, 6.59, 15.53, 41.51, 33.40, 65.12, F = 11.97, H = 6.05, all P < 0.05). However, there were no statistically significant differences in fever, dyspnea, concurrent atelectasis, or prognosis ( χ2 = 0.21, 0.27, 0.61, 1.74, all P > 0.05). The percentage of neutrophils [(63.91 ± 10.96)%, (58.26 ± 13.79)%, (50.98 ± 13.79)%], platelet count [(305.01 ± 96.13) × 10 9/L, (324.91 ± 108.05) × 10 9/L, (342.41 ± 120.50) × 10 9/L], erythrocyte sedimentation rate [(47.07 ± 26.46) mm/h, (48.29 ± 26.33) mm/h, (38.16 ± 18.23) mm/h], creatinine [(39.10 ± 7.02) μmol/L, (31.50 ± 5.43) μmol/L, (25.85 ± 4.57) μmol/L], alanine aminotransferase [14 (11, 21) U/L, 12 (9, 20) U/L, 15 (11, 19) U/L], creatine kinase isoenzyme [17 (14, 21) U/L, 20 (16, 24) U/L, 23 (19, 27) U/L], and lactate dehydrogenase [260.0 (224.5, 343.5) U/L, 294.5 (252.0, 379.3) U/L, 317.0 (266.5, 384.5) U/L] levels in the peripheral blood differed significantly among the school-age, preschool, and infant and toddler groups ( F = 37.07, 4.91, 3.55, 167.22, H = 7.54, 57.34, 33.58, all P < 0.05). However, there were no statistically significant differences in peripheral blood white blood cell count, C-reactive protein, or procalcitonin levels ( H = 1.09, 2.49, 2.21, all P > 0.05). The bronchoscopic examinations revealed mucosal congestion and edema in all three groups ( χ2 = 0.51, P > 0.05). However, the detection of lymphoid follicles [43 (57.33%), 28 (38.89%), 18 (26.09%)], longitudinal folds [58 (77.33%), 34 (47.22%), 10 (14.49%)], mucus plugs [46 (61.33%), 32 (44.44%), 6 (8.70%)], and airway shaping [16 (21.33%), 5 (6.94%), 0 (0.00%)] increased with age, showing statistically significant differences among the three groups ( χ2 = 14.72, 56.94, 43.30, 19.58, all P < 0.05). Conclusions:The clinical characteristics of children with Mycoplasma pneumonia infection vary among children of different ages. In infants and young children, wheezing symptoms are more common, and they are prone to multiple organ dysfunction. Lung imaging primarily shows scattered patchy shadows and ground-glass opacities. In contrast, older children mainly present with dry cough, and lung imaging typically reveals large areas of consolidation. Bronchoscopic examinations reveal characteristic findings such as lymphoid follicles, longitudinal folds, mucus plugs, and airway shaping, with longer durations of fever and cough relief.

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective To analyze the changing trends of the burden of non-alcoholic fatty liver disease(NAFLD)in China from 1990 to 2021 and provide a basis for formulating prevention and treatment strategies.Methods The standardized incidence rate,prevalence,mortality,and disability-adjusted life year(DALY)rate of NAFLD in China from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021.The average annual percentage change of rate data was calculated by Joinpoint 4.2 and the age,period,and birth cohort effects of the prevalence and DALY rate were analyzed by the age-period-cohort model.Results Compared to 1990,the incidence rate and prevalence of NAFLD have been on the rise,while the mortality and DALY rate have been declining.The age effect curves of prevalence and DALY rate showed an upward trend followed by a downward trend for both males and females.With the period from 1992 to 1996 as the reference group,the period effect curve of prevalence showed a downward trend followed by an upward trend,being the lowest in the period from 2002 to 2006(RR=0.93).The period effect curve of DALY rate showed a downward trend from 1992 to 2011 and then tended to flatten out.With the period from 1972 to 1981 as the reference group,the birth cohort effect curve of prevalence showed a steady upward trend in the general population and both male and female populations.The birth cohort effect curve of DALY rate showed an overall upward trend followed by a downward trend,with the peak occurring in the birth cohort group between 1922 and 1931.The DALY rate of NAFLD caused by smoking and high fasting blood glucose has shown a downward trend since 2014,and fasting blood glucose gradually became the dominant factor as age increased.Conclusions From 1990 to 2021,NAFLD in China has shown a rising prevalence but a significantly declining DALY rate.This suggests that current prevention and control strategies are effective,and further efforts should be made to raise residents' health awareness in controlling the occurrence and development of NAFLD.
Humans ; Non-alcoholic Fatty Liver Disease/epidemiology* ; China/epidemiology* ; Prevalence ; Female ; Male ; Incidence ; Disability-Adjusted Life Years ; Middle Aged ; Adult

Objective:To explore the effectiveness, safety, and cost among urinary follicle-stimulating hormone (u-FSH), recombinant FSH (r-FSH)α, and r-FSHβ in the early follicular phase prolonged protocol for patients under 35 years old with normal ovarian function.Methods:It was a retrospective cohort study. Patients under 35 years old with normal ovarian function who underwent early follicular phase prolonged protocol for ovulation stimulation and using in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) for fertilization in Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2018 to December 2023 were recruited, including the fresh and frozen-thawed embryo transfer (FET) cycles. Patients were divided into u-FSH group, r-FSHα group, and r-FSHβ group. A total of 1 048 ovarian stimulation cycles were included, with 150 cycles, 490 cycles and 408 cycles in the three groups respectively. A total of 710 FET cycles with fresh cycle cancellation were included, with 95 cycles, 320 cycles and 295 cycles in the three groups respectively. The baseline data, pregnancy outcomes, safety, and cost were compared among the three groups. The main observation indicators were cumulative pregnancy rate and cumulative live birth rate (CLBR). A binary logistic regression model was used to control confounding factors, and to analyze the relationship between three ovulation inducing medicine and CLBR. Results:The difference in the number of oocytes retrieved among the u-FSH group, r-FSHα group, and r-FSHβ group was statistically significant [13.0 (10.0, 16.0), 14.0 (11.0, 18.0), 15.0 (11.0, 19.0), respectively, P=0.012], and the difference in the number of 2PN embryos was statistically significant [9.0 (6.0, 12.0), 10.0 (7.0, 13.0), 10.0 (7.0, 13.0), respectively, P=0.046]. There were no statistically significant differences in the number of available embryos, available embryo rate, the number of high-quality embryos, high-quality embryo rate, available blastocyst formation rate, fresh cycle clinical pregnancy rate, live birth rate in fresh cycle, cumulative pregnancy rate of frozen embryos with fresh cycle cancellation, CLBR of frozen embryos with fresh cycle cancellation, cumulative clinical pregnancy rate, CLBR, moderate to severe ovarian hyperstimulation syndrome incidence, ectopic pregnancy rate, multiple pregnancy rate and neonatal malformation rate among the three groups (all P>0.05). In terms of economy, the u-FSH group had the lowest total gonadotropin cost for each patient, while the r-FSHα group had the highest. The differences among the three groups were statistically significant [u-FSH group 4 429.08 (3 198.78, 5 044.23) yuan, r-FSHα group 6 023.72 (5 433.75, 7 529.65) yuan, r-FSHβ group 5 480.00 (4 550.90, 6 437.86) yuan, P<0.001]. Binary logistic regression analysis was conducted, using u-FSH as a control. The CLBR of the r-FSHα group and r-FSHβ group showed no statistically significant difference compared with the u-FSH group (a OR=0.95, 95% CI: 0.57-1.58, P=0.838; a OR=0.89, 95% CI: 0.54-1.48, P=0.654). Conclusion:For patients under 35 years old with normal ovarian function undergoing long protocol ovarian stimulation, the effectiveness and safety of the three ovarian-stimulating medicine are similar, but u-FSH has economic advantages.

Objective To improve and refine the relevant regulations and guiding principles of warnings on drug instructions and labels in China.Methods This paper sorted out the drug instructions of small molecule anti-tumor drugs listed by the U.S.Food and Drug Administration(FDA)from 2005 to 2022,included the drugs mentioned in the QT interval prolongation risk,analyzed the clinical research and QT research results,and sorted out the identification and warning rules of the instructions.Results A total of 35 drugs were included,4 drugs wrote the risk of QT interval prolongation in the black box warning,21 drugs were wrote in the warning and precautions position,6 drugs were wrote in the adverse reaction section,and 2 drugs were only described under clinical pharmacology section.According to the severity of the QT interval prolongation caused by the drug and whether there were serious clinical consequences,they were displayed in the warnings(black box warnings),precautions(warnings and precautions)and adverse reactions in the instructions.Conclusion The aim of this article is to provide a reference for the writing of QT risk warning information of the instructions of domestic drug production enterprises and regulatory departments.It is recommended to clarify the severity of drug safety and the location of the instructions in clinical research,and continue to carry out safety monitoring and update the instructions in time after listing.

Objective:To investigate the treatment regimens, therapeutic effects, and adverse events of immune checkpoint inhibitors (ICI) in the treatment of progressive multifocal leukoencephalopathy (PML).Methods:A retrospective analysis was performed on patients with PML who received ICI treatment at the Department of Neurology of Peking Union Medical College Hospital from October 2020 to September 2024. The patients′ demographic characteristics, baseline immune status, clinical manifestations, laboratory tests, treatment regimens, and clinical outcomes were analyzed.Results:A total of 2 male patients with PML, aged 40 and 59 years, received ICI treatment. One patient had underlying combined immunodeficiency, while the other had acute myeloid leukemia subtype M2 and had previously undergone umbilical cord blood stem cell transplantation. Both patients were treated with pembrolizumab (dosage range: 2-3 mg/kg, administered every 3-4 weeks), receiving a total of 2-4 courses of treatment. In terms of therapeutic effects, both patients showed significant improvement. Regarding adverse events, 1 patient experienced immune-related adverse event (irAE) of immune-related pneumonia combined with immune-related hypophysitis.Conclusions:ICI may be an effective treatment option for PML. However, the use of ICI may be accompanied by the occurrence of irAE, necessitating close monitoring during treatment.

Objective:To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods:A total of 420 cases with chronic HBV infection with nodular liver lesions examined by imaging at the Third Hospital of Hebei Medical University from January 2021 to June 2024 were retrospectively selected. They were divided into the HBV-HCC group (182 cases) and the control group (238 cases) according to the current HCC diagnostic criteria. The basic information of patients, liver-related biochemical indicators, serum DCP, alpha-fetoprotein (AFP) levels, and the efficacy of combined detection in diagnosing early-stage HCC were collected and analyzed. A DSGAA model based on DCP (D) combined with gender (S), γ-glutamyl transferase (GGT, G), AFP (A) and age (A) as independent variables was constructed. The diagnostic performance of the novel model was compared with that of the traditional model through nomogram visualization output and calibration curve.Results:The age, sex, hemoglobin, albumin, alanine aminotransferase, alkaline phosphatase, and GGT levels were significantly higher in patients with HCC than those of the control group ( P<0.05). The positivity detection rate in patients with HBV-HCC was significantly higher in DCP than that of AFP (85.71% vs. 59.89%, P<0.05). The abnormal detection rate of DCP in patients with AFP-negative was 76.7%. The sensitivity for diagnosing HCC was significantly higher in DCP than AFP (73.63% vs. 64.29%, P<0.05), with specificity of 83.6% in all. The specificity for diagnosing early-stage HCC was 89.09%, surpassing that of AFP at 68.06% ( P<0.05). The area under the receiver operating characteristic curve (AUC) for the constructed DSGAA diagnostic model was 0.8841, with an optimal cutoff value of 0.377, a sensitivity of 80.22%, and a specificity of 86.13%. The AUC for diagnosing early-stage HCC was 0.8122, with a sensitivity of 66.18%, and a specificity of 86.13%, and the diagnostic efficacy was higher than other models ( P<0.05). Conclusion:DCP has superior diagnostic efficacy for HBV-related HCC, and the DSGAA model is expected to be used as a new method for screening and diagnosing early-stage HBV-related HCC.

Objective To build a hospital data service portal system based on central authentication service(CAS)to solve the problems of dispersed user identity data and low management efficiency caused by independent operation of multiple systems.Methods The CAS-based hospital data service portal system was designed with B/S architecture and developed with Spring MVC framework,which implemented unified authentication with CAS technology and achieved standardized access protocols for integrated access,centralized management and service consolidation across various application systems.There were five functional modules involved in the system for homepage,workflow management,system administration,log management and message management.Results The system significantly enhanced user accessibility and data extraction efficiency,effectively reduced the complexity of system integration and operational maintenance burdens and ensured user privacy and data security.Conclusion The portal system provides users with an easy-to-use,secure and reliable data service portal,laying the foundation for building an efficient,intelligent and safe hospital data service system.

Objective:To compare the efficacy and safety of continuous venetoclax combined azacitidine (VA) chemotherapy and intermedium/high-dose cytarabine (I/HDAC) consolidation in patients with acute myeloid leukemia (AML) fit for standard chemotherapy (transform from UNFIT) .Methods:Clinical data of patients who were fit for standard chemotherapy were collected among those with AML who underwent VA induction in the Department of Hematology, the Second Hospital of Hebei Medical University. The overall survival (OS), relapse-free survival (RFS), event-free survival (EFS), and incidence of adverse events were analyzed retrospectively.Results:This study enrolled 69 patients, consisting of 46 cases in the VA group and 23 cases in the I/HDAC group. We revealed the following. ① The median OS, RFS, EFS were 26.18, 24.69, 20.34 months in the VA group, and 34.14, 30.99, 28.42 months in the I/HDAC group, respectively, with no statistically significant difference (all P>0.05). Median OS of patients who underwent I/HDAC consolidation with European Leukemia Net (ELN) favorable-risk, positive measurable residual disease (MRD), wild type FLT3, or IDH1/2 mutation was significantly longer than those who received VA ( P<0.05). ②Adverse events rate of grade 3 - 4 neutropenia, grade 3 - 4 thrombocytopenia, and bacteremia were significantly lower in the VA group than in the I/HDAC group ( P<0.05) . Conclusions:I/HDAC consolidation was more likely to help get survival benefits for patients with ELN favorable-risk, positive MRD, wild type FLT3, or IDH1/2 mutation. Continuous VA chemotherapy exhibited superior safety than I/HDAC consolidation.

Objective To improve and refine the relevant regulations and guiding principles of warnings on drug instructions and labels in China.Methods This paper sorted out the drug instructions of small molecule anti-tumor drugs listed by the U.S.Food and Drug Administration(FDA)from 2005 to 2022,included the drugs mentioned in the QT interval prolongation risk,analyzed the clinical research and QT research results,and sorted out the identification and warning rules of the instructions.Results A total of 35 drugs were included,4 drugs wrote the risk of QT interval prolongation in the black box warning,21 drugs were wrote in the warning and precautions position,6 drugs were wrote in the adverse reaction section,and 2 drugs were only described under clinical pharmacology section.According to the severity of the QT interval prolongation caused by the drug and whether there were serious clinical consequences,they were displayed in the warnings(black box warnings),precautions(warnings and precautions)and adverse reactions in the instructions.Conclusion The aim of this article is to provide a reference for the writing of QT risk warning information of the instructions of domestic drug production enterprises and regulatory departments.It is recommended to clarify the severity of drug safety and the location of the instructions in clinical research,and continue to carry out safety monitoring and update the instructions in time after listing.