Attention deficit hyperactivity disorder （ADHD） is often accompanied by tic disorder. The core pathogenesis is considered to be ministerial fire scorching yin and internal stirring of deficient wind， which leads to disharmony between the body and spirit， resulting in clinical manifestations. The treatment principles emphasize nourishing yin fluids， calming ministerial fire， and extinguishing endogenous wind （内风）. The method of nourishing yin fluids is applied throughout the entire treatment process， commonly using ingredients such as Shudihuang （Rehmanniae Radix Praeparata）， Shanzhuyu （Corni Fructus）， Gouqizi （Lycii Fructus）， Wuweizi （Schisandrae Chinensis Fructus）， and Tusizi （Cuscutae Semen）. These are combined with approaches to harmonize the zang-fu organs， primarily including extinguishing liver wind， clearing heart fire， nourishing kidney water， and strengthening spleen earth， thereby stabilizing ministerial fire and extinguishing endogenous wind. Additionally， emotional regulation and smoothing emotional constraint are essential to improve clinical symptoms in children with ADHD comorbid with tic disorder.

BACKGROUND: Recent studies have shown that sodium-glucose cotransporters-2 (SGLT2) inhibitors significantly improve major adverse cardiovascular events in heart failure with preserved ejection fraction (HFpEF) patients, but the exact mechanism is unknown. Ferritinophagy is a special form of selective autophagy that participates in ferroptosis. In this study, we aimed to investigate whether ferritinophagy was activated during the occurrence of HFpEF, and whether canagliflozin (CANA) could inhibite ferritinophagy. METHODS: We reared Dahl salt-sensitive (DSS) rats on a high-salt diet to construct a hypertensive HFpEF model, and simultaneously administered CANA intervention. Then we detected indicators related to ferritinophagy. RESULTS: The expression of nuclear receptor coactivator 4 (NCOA4), as well as microtubule-associated proteins light chain 3 (LC3), Bcl-2 interacting protein 1 (Beclin-1) and p62, were upregulated in HFpEF rats, accompanied by the downregulation of ferritin heavy chain 1 (FTH1), upregulation of mitochondrial iron transporter sideroflexin1 (SFXN1) and increased reactive oxygen species (ROS) production. Above changes were diminished by CANA. CONCLUSION Ferritinophagy is activated in HFpEF rats and then inhibited by CANA, leading to HFpEF benefits. The inhibition of ferritinophagy could provide new prospective targets for the prevention and treatment of HFpEF, and provide new ideas for investigating the mechanism of cardiovascular benefit of SGLT2 inhibitors.

The concept of harmony between heaven and man is an important concept in TCM. The theory of "harmful hyperactivity and responding inhibition" has been developed and perfected by medical professionals throughout history to explain physiological and pathological changes in humans based on a natural understanding. Guided by the TCM philosophy of "harmful hyperactivity and responding inhibition", it provides guidance for attention deficit hyperactivity disorder (ADHD). Sorting out the complex pathogenesis, it has been found that core pathogenesis of the disease is the excessive damage to the five organs, which leads to the overall state of yin deficiency and yang hyperactivity in the human body. The treatment mainly focuses on regulating the hyperactivity and damage of the organs, restoring the balance of yin and yang, while also taking into account the harm of pathological products. Based on clinical manifestations, the secondary selection of medication for liver and liver hyperactivity and spleen and kidney dysfunction has been determined, while improving the hyperactivity of the external environment, in order to achieve the goal of "tolerance is control", which fully embodies the TCM syndrome differentiation thinking of "unity of heaven and man, holistic concept".

Objective: To systematically evaluate the influencing factors for autism spectrum disorder (ASD) in Chinese children, so as to provide the evidence for risk prediction and intervention of ASD. Methods: The publications pertaining to the influencing factors for ASD in Chinese children were retrieved from CNKI, Wanfang Data, VIP, PubMed and Embase database from inception to August 2024. A meta-analysis was performed using R package version 4.4.1. Sensitivity analysis was performed using the "leave-one-out" evaluation procedure. Publication bias was assessed using Egger regression test. Results: A total of 38 high-quality articles out of 9 015 articles were finally included, covering 149 607 individuals, with 5 974 cases of ASD. The meta-analysis showed that demographic factors including family history of related diseases (OR=14.958), maternal age of ≥35 years (OR=2.287) and parental history of hazardous occupations (OR=3.511); pregnancy-related factors including history of abortion (OR=5.832), no folate supplementation before and during pregnancy (OR=4.566), tobacco exposure before and during pregnancy (OR=2.596), history of other adverse exposures before and during pregnancy (OR=3.533), history of infectious diseases during pregnancy (OR=3.753), history of non-infectious diseases during pregnancy (OR=2.563), psychological problems during pregnancy (OR=3.864), history of medication during pregnancy (OR=6.651), adverse environmental exposures during pregnancy (OR=3.754), severe pregnancy reactions (OR=5.082), abnormal perinatal period (OR=2.987), cesarean delivery (OR=1.659), other perinatal adverse factors (OR=3.856), history of neonatal asphyxia (OR=2.792) and neonatal jaundice (OR=3.687); parenting factors including non-exclusive breastfeeding (OR=2.510), early/excessive screen exposure (OR=3.589) and feeding problems (OR=3.113); and individual factors including being male (OR=3.333) and history of convulsions/epilepsy (OR=7.035) were influencing factors for ASD in Chinese children. Conclusions The prevalence of ASD in Chinese children is primarily associated with 23 influencing factors, including family history of related diseases, history of abortion, no folate supplementation before and during pregnancy, medication during pregnancy, early/excessive screen exposure and history of convulsions/epilepsy.

Objective:To summarized the clinical characteristics and surgical management of anterior cervical enterogenic in pediatric patients. Methods:Clinical data were retrospectively analyzed for 9 children with pathologically confirmed anterior cervical enterogenic cysts（including bronchogenic and esophagogenic subtypes） treated at the Children's Hospital of Shandong University（Jinan Children's Hospital） between January 1, 2020, and November 30, 2023. Results:Nine patients（6 males and 3 females） were involved in this study, aged 14 days to 10 years old. There were 4 cases on the left side, 4 on the right side, and 1 in the middle of the neck. All patients presented with neck masses. The patients were followed up from 3 months to 35 months after surgery and recovered well, with no recurrence or complications observed. Conclusion:①Anterior intestinal cysts in children are rare and easy to be misdiagnosed. ②Concurrent branchial cleft fistulas or associated anomalies may coexist, necessitating comprehensive evaluation. ③Preoperative diagnosis is not easy and mainly depends on pathological diagnosis. ④The treatment of anterior cervical enterogenic cysts in children is surgical resection of the lesion.
Humans ; Male ; Female ; Child ; Retrospective Studies ; Child, Preschool ; Infant ; Neck ; Cysts/surgery*

Proteus mirabilis is a significant foodborne pathogen that frequently causes diseases in humans and animals.Understanding the cytokine profile alterations following gastrointestinal in-fection with P.mirabilis is crucial for developing effective treatment strategies.This study em-ployed an intragastric infection model in mice to observe clinical symptoms and pathological chan-ges.Blood samples were collected at various time points post-infection,and the concentrations of 21 cytokines in the serum of both infected and control mice were quantitatively analyzed using the Bio-Plex suspension array system.The results of the infection experiment indicated that gastroin-testinal infection with P.mirabilis in mice led to splenic hemorrhage and significant splenomegaly.A notable difference in spleen index between the infected and control groups was observed at 24 hours post-infection(P=0.001 688),with the greatest difference occurring at 96 hours post-infec-tion(P=0.000 074).Cytokine analysis revealed significant elevations in IL-2,IL-17A,KC,Eotax-in,MCP-1,RANTES,MIP-1α,MIP-1β,IFN-γ,G-CSF,and IL-10 levels in the infected group.A-mong these,the pro-inflammatory cytokines IL-17A and G-CSF exhibited the most substantial changes,positively correlating with the splenomegaly,and peaking at 96 hours post-infection,with concentrations of(104.74±3.91)and(5 184.08±280.22)ng/L,respectively,which were 26.79 and 36.25 times higher than those in the control group.These findings indicate that IL-17A and G-CSF play significant roles in the pro-inflammatory response following gastrointestinal infection with P.mirabilis.

Objective To identify the key influencing factors and role mechanisms of large-scale medical equip-ment allocation decision-making in public hospitals,and to provide a reference basis for optimizing resource alloca-tion strategies.Methods Through searching the literature related to large-scale medical equipment decision-making in public hospitals and combing the policies,the system of decision-making influencing factors was initially screened.The Delphi method and decision-making trial and evaluation laboratory method were used to obtain the key influencing factors of equipment allocation decision-making and to determine the interaction effects among the factors.Results A total of seven cause factors and nine effect factors were screened.Among them,cost-benefit analysis,equipment technical performance,and evaluation of similar equipment were the top three key drivers;leadership emphasis,equipment market price,and equipment supporting facilities were the top three key con-straints.Conclusion Priority be given to strengthening the management of driving factors,mainly by conducting a full-cycle assessment of cost-effectiveness,paying attention to the clinical value output of equipment technical performance,and monitoring regionally similar equipment.A dynamic response mechanism for constraints should be established,mainly to strengthen leadership decision-making,implement a centralized procurement price nego-tiation model and improve the pre-assessment system for ancillary facilities.

Ulcerative colitis(UC)is a recurrent,chronic,nonspecific inflammatory bowel disease.Shaoyao Decoction has shown good efficacy in the treatment of UC,which mainly regulates the balance of cytokines to achieve the purpose of treating UC.This article reviewed the research progress in the mechanism of Shaoyao Decoction in the treatment of UC from two aspects of pro-inflammatory cytokines and anti-inflammatory cytokines.Research has shown that Shaoyao Decoction can regulate the body's immune response,alleviate intestinal inflammation,protect the intestinal mucosal barrier,restore normal structure and function of the colon mucosa through pro-inflammatory cytokines such as tumor necrosis factor-α,interferon-γ,interleukin(IL)-1β,IL-6,IL-8,IL-17,and anti-inflammatory cytokines such as transforming growth factor-β,IL-4,IL-10,IL-13,which can provide reference for UC related mechanism research and clinical treatment.

Objective:To summarize the surgical management strategy for pediatric pancreatic tumors.Methods:Clinical data of 17 children with pancreatic tumors who underwent surgical treatment in Children's Hospital Affiliated to Shandong University from January 2018 to April 2024 were retrospectively analyzed, including 6 males and 11 females, ranging in age from 1 month to 13 years, with a median age of 10 years and 2 months. The data of tumor length and diameter, tumor location, surgical method and postope-rative pathology were analyzed. The prognostic data of all children were followed up by regular telephone and outpatient follow-up.Results:In 17 cases, the tumor diameter was (7.3±2.2) cm, 10 cases were located in the head of the pancreas, 7 cases were located in the tail of the pancreatic body, 1 case was accompanied by liver metastasis, and 1 case was accompanied by left adrenal invasion. Among these cases, 10 cases had pancreatic head tumor, 6 cases had simple pancreatic tumor resection, 1 case had laparoscopic pancreatic tumor resection, and 3 cases had pancreatic head resection plus pancreato-jejunal Roux-en-Y anastomosis. Among the 7 cases of pancreatic body and tail tumors, 3 cases underwent pancreatic body and tail resection, 1 case underwent laparoscopic pancreatic body and tail resection, 1 case underwent tumor resection, 1 case underwent pancreatic body and tail resection plus splenectomy plus hepatic metastasis resection, 1 case underwent pancreatic body and tail resection plus left adrenal resection plus splenectomy. Postoperative pathology showed that there were 13 cases of solid pseudopapilloma, 3 cases of pancreatic blastoma, and 1 case of pancreatic cyst. The median follow-up time was 36 months (2-71 months). All patients survived well.Conclusion:Solid pseudopapillary of the pancreas is the most common type of pancreatic tumor in children, with surgical resection being the first choice of of treatment, offering a favorable prognosis postope-ratively.

Objective:This study aims to explore the independent and interactive effects of childhood trauma (CT) and major depressive disorder (MDD) on amygdala subregion volumes and to examine whether volumetric changes in these subregions mediate the relationship between CT and depressive severity.Methods:A total of 129 MDD patients and 127 age- and sex-matched healthy controls were recruited from Nanjing Brain Hospital between October 2022 and November 2024. All participants underwent 3D-T 1 weighted MRI scans,and amygdala subregions were segmented using the FreeSurfer software. Depressive and anxiety symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HAMD 17) and the Hamilton Anxiety Scale (HAMA),respectively. Childhood trauma exposure was evaluated via the Childhood Trauma Questionnaire (CTQ). Generalized linear models (GLM) were applied to analyze the main and interactive effects of MDD diagnosis (depression/healthy controls) and CT (presence/absence),adjusting for age,estimated intracranial volume,sex,medication history,and education years. Partial correlation and mediation analyses were conducted to explore associations between amygdala subregion volumes and clinical measures in MDD patients. Results:MDD diagnosis was independently associated with increased volumes in the right central nucleus ( Wald χ2=9.09, P=0.026) and medial nucleus ( Wald χ2=10.08, P=0.026). CT exposure was independently associated with reduced volumes in the right central nucleus ( Wald χ2=7.99, P=0.047) and medial nucleus ( Wald χ2=9.20, P=0.047). No significant interaction effects between MDD and CT were observed in any amygdala subregion. Mediation analysis revealed that reduced right medial nucleus volume partially mediated the relationship between total CTQ scores and depressive severity (proportion mediated: 26.69%,95% CI=0.002-0.060) and mediated the association between emotional neglect and depressive severity (proportion mediated: 26.75%,95% CI=0.006-0.150). Such mediating effects were not found for the right central nucleus. Conclusion:CT and MDD exhibit divergent patterns of influence on amygdala subregions. CT is linked to volumetric reductions,whereas MDD is associated with volumetric enlargement. Reduced volume of the right medial nucleus mediates the relationship between CT and depression severity.