In order to standardize the clinical diagnosis and treatment of upper airway cough syndrome (UACS) for children in China, Dongzhimen Hospital of Beijing University of Chinese Medicine and Affiliated Hospital of Liaoning University of Traditional Chinese Medicine initiated the development of this Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Children with Upper Airway cough Syndrome based on evidence-based medical evidence. This guideline will process registration, write a plan, and develop relevant processes and writing norms, develop and publish official documents. This plan mainly introduces the scope of the guidelines, the purpose and significance, the composition of the guidelines working group, the management of conflicts of interest, the collection, selection and determination of clinical problems, the retrieval, screening and rating of evidence, and the consensus of recommendations. Registration information: This study has been registered in the international practice guidelines registry platform with the registration code of PREPARE-2023CN087.

Chronic lumbar and back pain caused by degenerative vertebral endplates presents a challenging issue for pa-tients and clinicians.As a new minimally invasive spinal treatment method,radiofrequency ablation of vertebral basal nerve in bone can denature the corresponding vertebral basal nerve through radiofrequency ablation of degenerative vertebral endplate.It blocks the nociceptive signal transmission of the vertebral base nerve,thereby alleviating the symptoms of low back pain caused by the degenerative vertebral endplate.At present,many foreign articles have reported the operation principle,opera-tion method,clinical efficacy and related complications of radiofrequency ablation of the vertebral basal nerve.The main pur-pose of this paper is to conduct a comprehensive analysis of the current relevant research,and provide a reference for the follow-up clinical research.

Objective To investigate the incidence and risk factors of blood transfusion during hospitalization in patients receiving hip arthroplasty.Methods Clinical data of 347 hip arthroplasty patients admitted between January and January 2019 and December 2021.Patients were divided into 184 patients in the transfusion group and 164 patients in the nontransfusion group according to whether they received blood transfusion during hospitalization.The basic medical history data,biochemical results and surgical conditions of the patients in two groups were collected and compared.They were divided into total hip arthroplasty(THA)and hemiarthroplasty(HA)according to the different surgical methods.One-way analysis and Spearman correlation were used to analyze the factors associated with blood transfusion in hip arthroplasty patients.Multi-factor logistic regression analysis was performed for statistically significant(P＜0.05)indicators,thus screening for independent risk factors for blood transfusion during hospitalization in hip arthroplasty patients.The receiver operating characteristic(ROC)curves for in-traoperative bleeding in all hip arthroplasty patients,total hip arthroplasty patients,and hemi arthroplasty patients were plotted and compared,and area under curve(AUC)and the optimal threshold were calculated.Results A total of 347 patients were in-cluded for hip arthroplasty,including 207 total hip arthroplasty and 140 hemi arthroplasty.The transfusion rates of all hip arthroplasty patients,total hip arthroplasty patients and hemi arthroplasty patients were 53.03％(184/347),53.14％(110/207)and 52.86％(74/140),respectively.Multifactorial logistic regression analysis showed that preoperative cystatin C(OR=2.739,P=0.001),hemoglobin at admission(OR=0.960,P＜0.000 1),intraoperative bleeding(OR=1.010,P＜0.000 1),postoperative pneumonia(OR=1.897,P=0.024),and right hip arthroplasty(OR=2.277,P=0.002)were independent risk factors for all hip arthroplasty patients;hemoglobin at admission(OR=0.978,P=0.016),intraoperative bleeding(OR=1.012,P＜0.000 1),and postoperative pneumonia(OR=2.769,P=0.013)were independent risk factors for total hip arthroplasty;hemoglobin at admis-sion(OR=0.930,P＜0.000 1),intraoperative bleeding(OR=1.010,P＜0.000 1),preoperative cystatin C(OR=2.277,P=0.023),and right hip arthroplasty(OR=2.428,P=0.046)were independent risk factors for hemi arthroplasty.Hemoglobin on admission and intraoperative bleeding were common risk factors for total and hemi arthroplasty.The AUCs were 0.688,0.778,and 0.652 for total hip arthroplasty patients,total hip arthroplasty patients,and hemi arthroplasty patients,respectively.Con-clusion Intraoperative bleeding volume and preoperative hemoglobin are important risk factors for transfusion during hip arthroplasty hospitalization,and cystatin C may be a new biomarker for transfusion during hip arthroplasty hospitalization.At the same time,given the high incidence and potential risk of blood transfusion in hip arthroplasty,interventions should be made during hospitalization for identified risk factors.

ObjectiveTo investigate the dynamic change of monocyte-derived macrophages （MDMs） in chronic hepatitis B （CHB） during the treatment by ETV or TDF， and the association between the polarization of monocyte-derived macrophages （MDMs） and HBV DNA， HBeAg in CHB. MethodsPeripheral blood of 101 patients with chronic hepatitis B and 20 healthy donors were enrolled. MDMs were purified from 86 patients with CHB and 12 healthy donors by peripheral blood mononuclear cell （PBMC）. Flow cytometry was use to analyze the expression of specific markers on polarized macrophages to further evaluate the polarization of MDMs （M1/M2 MDMs）， including CD80， HLA-DR， CD163 and CD206. Additionally， qPCR was used to evaluate the mRNA expression of inflammatory factors of MDMs in 15 patients with chronic hepatitis B and 8 healthy controls. ResultsThe proportion of CD163⁺CD206⁺MDMs （M2 MDMs） were reduced in patients with CHB （P = 0.030）， compared with healthy controls. Correspondingly， the mRNA expression of anti-inflammatory factor， IL-10， decreased significantly （P = 0.040）. With the progress of nucleos（t）ide analogs （NAs） therapy， the proportion of CD163⁺CD206⁺MDMs （M2 MDMs） increased gradually （P < 0.001）， while the proportion of CD80⁺HLA-DR⁺MDMs （M1 MDMs） decreased gradually （P = 0.005）. In addition， M2 MDMs were negatively associated with both HBeAg （P = 0.019）， HBV DNA （P = 0.002）， AST （P = 0.048） and ALT （P = 0.030） in patients with CHB. ROC curve analysis showed that CD163⁺CD206⁺MDMs （M2 MDMs） had high predicting value for the virologic response of CHB during NA therapy， and could be used to predict undetectable HBV DNA ［ROC 95％CI： 0.705 （0.594，0.815）］ and HBeAg seroconversion ［ROC 95％CI： 0.740 （0.634，0.847）］. ConclusionsThere are dynamic changes of MDMs polarization in patients with CHB during NA therapy， and the negative correlation between the proportion of M2 MDMs and HBV DNA， HBeAg indicates that M2 MDMs could have a high predicting value in the virologic response of CHB during NA therapy.

Objective:This study aims to analyze the characteristics and basic principles of emergency surgery risks and anesthesia care of medical support at the landing site for China’s taikonauts of the Shenzhou-12, and to summarize China’s experience in medical support at the landing site for manned spaceflight, and ensure supports in special environments such as an emergency return of manned spaceflight.Methods:This study was carried out through literature research on relevant reports on the emergency surgery risks and aids of domestic and foreign astronauts at the landing sites, and summaries of the experience in medical support for taikonauts of spacecrafts from Shenzhou-5 to Shenzhou-11 at the landing sites. At the same time, according to the characteristics of Shenzhou-12 such as the long on-orbit time, the adjustment in the landing area, the optimization of the mission mode, and new search and rescue power, a series of organization, pre-arranged planning, equipment allocation, and effective anesthesia treatment plan were proposed and inspected in practice.Results:Based on the original anesthesia care plan of medical support, the first-aid carrier was adjusted and modified, the first-aid procedure was optimized, a new generation of supraglottic airway opening tool, video laryngoscope, portable ultrasound, and other devices were added, and the anesthesia care plan at the landing site for manned spaceflight was formulated to provide strong support for the medical care of taikonauts that had stayed in the outer space for a long time.Conclusions:Upon the targeted improvement and process optimization, the anesthesia care plan of medical support for taikonauts of Shenzhen-12 in the landing area fully meets the anesthesia requirement of medical support in special environments such as the emergency return of the taikonauts that have stayed in the outer space for a long time under the new orbital altitude.

Objective:Summarize the experience of the medical rescue team at the main landing site of China's manned space mission, analyze the new characteristics of the Shenzhou 12 space station mission, and take corresponding countermeasures and measures to ensure the strong medical rescue guarantee for astronauts.Methods:Search the publications about astronaut medical aid domestic and abroad, summarize the rescue and medical aid experiences from Shenzhou 5 to Shenzhou 11. In consideration of prolonged on-orbit time, Location adjustment of the landing site and the new characteristics of the complex terrain, new targeted strategies were presented.Results:The astronauts flew in orbit for 90 days, and the main landing site and launch site are in the same area. The medical security includes three parts: launch section, running section and return section. Desert rescue model were added. Ten injuries were simulated and each injury first-aid procedure was standardized.Conclusion:After targeted improvement and optimization, the Shenzhou 12 astronauts medical rescue support program ensures the safety of the whole process, all-weather and all-terrain emergency and rear delivery of the astronauts in the new mission environment and complex terrain.

BACKGROUND: Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China. METHODS: The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD. RESULTS: A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05). CONCLUSION Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
Birth Weight ; Bronchopulmonary Dysplasia ; China/epidemiology* ; Delivery Rooms ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Pregnancy

Objective: To explore the influencing factors for the primary and secondary school students with abnormal angle of trunk rotation for the prevention. Methods: The students of Grade Four to Nine in Jiashan County of Zhejiang Province were selected by cluster sampling method. A self-designed questionnaire was used to collect social demographic data, diet behaviors, physical activities, reading and writing habits. The angle of trunk rotation was measured by scoliometer. Logistic regression model was used to investigate the influencing factors for abnormal angle of trunk rotation. Results: This study included 2 942 schoolchildren, with 1 582 ( 53.78% ) boys and 1 360 ( 46.23% ) girls. The incidence rate of abnormal angle of trunk rotation was 7.82%. The incidence rate of abnormal angle of trunk rotation in girls was 10.74%, which was higher than 5.31% in boys ( P<0.05 ). Grade ( OR=1.485, 95%CI: 1.058-2.085 ), gender ( OR=2.084, 95%CI: 1.536-2.828 ), frequency of eating fresh vegetables in the past week ( OR=0.749, 95%CI: 0.633-0.887 ) and watching electronic screen in the dark ( OR=1.188, 95%CI: 1.002-1.408 ) were the influencing factors for abnormal angle of trunk rotation in primary and secondary school students. Grade ( OR=2.664, 95%CI: 1.481-4.791 ) and watching electronic screen in the dark ( OR=1.325, 95%CI: 1.030-1.704 ) were influencing factors for abnormal angle of trunk rotation in boys. Frequency of eating fresh vegetables in the past week ( OR=0.714, 95%CI: 0.574-0.887 ) and uncorrected eyesight less than 5.0 ( OR=1.795, 95%CI: 1.164-2.767 ) were influencing factors for abnormal angle of trunk rotation in girls. Conclusion The abnormal angle of trunk rotation in primary and secondary school students is related to gender, grade, reading and writing behaviors as well as diets; and the influencing factors are different in male and female students.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

Steroidal saponins are efficacious substances wildly existed in the herbs，and consist of glycosyl and steroid sapogenin. The biosynthesis pathways of steroidal saponins mainly include the cytosolic mevalonate （MVA） pathway and the plastidial methylerythritol 4-phosphate （MEP） pathway，with the MVA pathway as the main pathway. The key enzymes are involved in the biosynthetic pathway, including 3-hydroxy-3-methyl glutaryl coenzyme A reductase（HMGR），1-deoxy-D-xylulose 5-phosphate synthase（DXS），1-deoxy-D-xylulose-5-phosphatereduetoisomerase（DXR），farnesyl pyrophosphate synthase（FPS），squalene synthase（SS），squalene epoxidase（SE），cycloartenol synthase（CAS），cytochrome P450（CYP450），and steroidalglycosyltransferase（SGTase）. In the paper，the biosynthesis roadmap of steroidal saponins was optimized based on previous studies. According to a comprehensive analysis on studies of key enzymes for the past five years, genes, like HMGR，SS，CYP450 and UGT，were studied more，while other genes，like FPS，SE，CAS，were known less. In conclusion， current studies still focus on the primary stage，but lack direct evidence for the roles of key enzymes. This paper would provide a reference and theoretical support for subsequent studies.