Objective To analyze the value of serum neutrophil count (NEUT), homocysteine (Hcy), adiponectin (APN) and blood glucose in predicting the occurrence of acute myocardial infarction (AMI) in patients with coronary heart disease. Methods The clinical data of 98 patients with coronary heart disease who were admitted to the hospital from March 2022 to March 2024 were collected retrospectively. Patients included were divided into AMI group (n=33) and non-AMI group (n=65) according to the presence and absence of AMI. Baseline data, complications, ultrasound examination data and laboratory examination data were collected. Multivariate logistic regression analysis was performed to identify the influencing factors of AMI in patients with coronary heart disease. The receiver operating characteristic curves were used to evaluate the predictive value of NEUT, Hcy, APN and blood glucose for AMI in patients with coronary heart disease. Results The levels of fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbA1c), NEUT, APN, Hcy, N-terminal pro B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), red blood cell distribution width (RDW) and white blood cell (WBC) in the AMI group were higher than those in the non-AMI group (P<0.05). Logistic regression analysis found that FPG, 2hPG, HbA1c, NEUT, APN, Hcy, NT-proBNP, CRP, RDW, and WBC were independent influencing factors of AMI in patients with coronary heart disease (P<0.05). ROC curves indicated that the levels of FPG, 2hPG, HbA1c, NEUT, APN and Hcy were abnormally elevated in patients with coronary heart disease. Above indicators were helpful for predicting the occurrence of AMI. The area under the curve (AUC) and sensitivity of FPG for predicting AMI in patients with coronary heart disease were the best (P<0.05). Conclusion Abnormal elevated levels of FPG, 2hPG, HbA1c, NEUT, APN and Hcy are independent risk factors for AMI in patients with coronary heart disease. All of these indicators have predictive value.

ObjectiveAccording to the etiology， pathogenesis， and clinical characteristics of dry eye （DE）， this paper aims to analyze existing DE animal models to provide recommendations for building more clinically relevant DE models that integrate traditional Chinese and Western medicine. MethodsBy the retrieval and analysis of relevant literature on DE animal experiments， combined with expert consensus， an evaluation scale was created to assess relevance from the perspectives of pathogenesis， diagnostic criteria， and traditional Chinese medicine （TCM） differentiation. On the basis of data provided by the literature， the clinical relevance was evaluated for the animal models constructed in the literature. ResultsAmong the existing methods for establishing a DE animal model， benzalkonium chloride eye-drop induction showed the highest clinical relevance， demonstrating 98% alignment with Western medicine. However， current models generally showed higher relevance to Western medicine than to TCM， and there was a lack of models integrating disease with syndrome. ConclusionAs DE involves diverse causes and pathogenesis， single-factor models cannot fully simulate the complex pathology of DE. Future research should focus on building multi-mechanism DE models， exploring new etiological directions， standardizing model evaluation systems， and promoting integration of traditional Chinese and Western medicine. This will help precisely simulate the pathophysiological process of human DE and provide more valuable guidance for clinical diagnosis and treatment， ultimately enhancing patient outcomes and satisfaction.

This article seeks to delve into the correlation between pituitary neuroendocrine tumors(PitNET)and neuropsychiatric disorders while summarizing the most recent advancements in related research.Some patients with PitNET,benign tumors arising from pituitary gland cells,may develop specific clinical symptoms due to either tumor compression or abnormal hormone secretion.In recent years,investigators have identified a significant association between PitNET and neurological as well as psychiatric disorders.Patients with PitNET frequently manifest neurological and psychiatric symptoms,including depression,anxiety,and cognitive impairment,significantly impacting their quality of life and prognosis.These symptoms may be associated with distorted body image,hormonal imbalances,and inadequate treatment.The holistic approach to PitNET encompasses surgical intervention,radiation therapy,and drug therapy,each with its distinct set of advantages and drawbacks.Presently,transsphenoidal resection stands out as the most frequently employed method in treating PitNET to ameliorate the patient's neurological and psychiatric disorders.However,the use of dopamine agonists(DAs)in the treatment of prolactin(PRL)tumors and growth hormone(GH)adenomas may potentially induce or exacerbate neurological and psychiatric symptoms.The impact of radiation therapy on PitNET patients varies depending on the radiation dose and treatment area.Given that both the PitNET disease itself and its treatment may lead to neurological and psychiatric disorders,it is essential to assess and address the neurological and psychiatric status of all PitNET patients.Careful consideration should be given to PitNET patients with neurological and psychiatric disorders to determine whether these issues stem from dopamine agonist(DAs)treatment.The primary consideration should be given to patients with PRL microadenomas with normal PRL levels to minimize the dose of bromocriptine or cabergoline to the most effective level or even discontinue the medication with subsequent follow-up.Caution is advised when considering the discontinuation or reduction of medication for PRL large adenomas.A gradual reduction approach may be undertaken based on related factors such as PRL levels and tumor size.Close follow-up through monitoring patient PRL levels and enhanced pituitary MRI is crucial to prevent tumor enlargement following the reduction of medication.While some PitNET patients have experienced improvement or recovery from neurological and psychiatric disorders through personalized comprehensive treatment,it is important to note that certain patients may exhibit irreversible symptoms.Currently,research on the combination of PitNET and neuropsychiatric disorders remains relatively limited.Moving forward,it is imperative to delve deeper into its pathogenesis,aiming to enhance diagnostic methods for neuropsychiatric disorders in PitNET patients.This includes refining and updating diagnostic criteria and expanding intervention methods.These efforts are crucial in mitigating the incidence of PitNET in conjunction with neuropsychiatric disorders,ultimately improving the overall quality of life for patients.

Objective To investigate the effects of Jianpi Yichang Powder on regulating the NLRP3 inflammasome signaling pathway to inhibit dendritic cells(DCs)inflammatory injury induced by TNF-α;To explore its mechanism in the treatment of ulcerative colitis.Methods C57BL/6 mice DCs were primitively isolated and cultured.The cultured DCs were randomly divided into the normal group,model group,negative control group,positive drug group and TCM group.DCs inflammatory microenvironment model was established by TNF-α induction.After corresponding treatments were given to each group,CCK-8 method was used to detect cell proliferation ability,immunofluorescence and Western blot were used to detect the protein expressions of NLRP3,ASC and Caspase-1 in DCs respectively,Western blot and RT-PCR were used to detect the protein and mRNA expressions of IL-1β and IL-18 in DCs.Results Compared with the normal group,the proliferation ability in DCs of model group significantly decreased(P<0.01),the positive expressions of NLRP3,ASC and Caspase-1 significantly increased,the expressions of NLRP3,ASC,Caspase-1,IL-18,IL-1β protein and IL-18,IL-1β mRNA in DCs significantly increased(P<0.01).Compared with the model group and negative control group,the proliferation ability of DCs significantly increased in positive drug group and TCM group(P<0.01),the positive expressions of NLRP3,ASC,and Caspase-1 significantly decreased(P<0.01),the protein expressions of NLRP3,ASC,Caspase-1,IL-1β and IL-18 significantly decreased(P<0.05,P<0.01),and the mRNA expressions of IL-1β and IL-18 significantly decreased(P<0.01).The cell proliferation ability,Caspase-1 positive expression,and IL-18 mRNA expression of TCM group were significantly higher than those of the positive drug group(P<0.05),while the mRNA expression of IL-1β was lower than that of the positive drug group(P<0.05).Conclusion Jianpi Yichang Powder can inhibit the inflammatory response of DCs induced by TNF-α,and its mechanism in the treatment of ulcerative colitis may be related to regulating the expressions of the NLRP3 inflammasome signaling pathway,including the expressions of NLRP3,ASC,Caspase-1,IL-18 and IL-1β.

Objective To investigate the application efficiency and potential of CT radiomics in differentiating malignant and benign sub-centimeter solid pulmonary nodules. Methods A retrospective study was performed on the sub-centimeter ( ≤ 10 mm) solid pulmonary nodules detected by enhanced CT in our hospital from March 2020 to January 2023. Malignancy was confirmed by surgical pathology, and benignity was confirmed by surgical pathology or follow-up. Lesions were manually segmented and radiomic features were extracted. The feature dimension was reduced via feature correlation analysis and least absolute shrinkage and selection operator (LASSO). The 5-fold cross validation was used to validate the model. Support vector machine, logistic regression, linear classification support vector machine, gradient boosting, and random forest models were established for CT radiomics. Receiver operating characteristic curves were drawn. Delong test was used to compare the diagnostic performance of the five classifiers. The optimal model was selected and compared to radiologists with medium and high seniority. Results A total of 303 nodules, 136 of which were malignant, were examined. Radiomics models were established after feature extraction and selection. On test set, the areas under the receiver operating characteristic curves of support vector machine, logistic regression, linear classification support vector machine, random forest, and gradient boosting models were 0.922 (95%CI: 0.893, 0.950), 0.910 (95%CI: 0.878, 0.942), 0.905 (95%CI: 0.872, 0.938), 0.899 (95%CI: 0.865, 0.933), and 0.896 (95%CI: 0.862, 0.930), respectively. Delong test indicated no significant differences in the performance of the five radiomics models, and the support vector machine model showed the highest accuracy and F1 score. The support vector machine model showed significantly higher diagnostic accuracy as compared to radiologists (83.8% vs. 55.4%, P < 0.001). Conclusion The radiomics models achieved high diagnostic efficiency and may help to reduce the uncertainty in diagnosis of malignant and benign sub-centimeter solid nodules by radiologists.

Munchausen syndrome by proxy（MSBP）in children refers to the caregivers who enforce unnecessary medication-seeking on children by falsifying symptoms or inducing disease（exacerbation），resulting in different degrees of physical or mental damage.And it may lead to adverse psychosocial consequences of the victims in adulthood，and even become the new "MSBP caregivers".First reported in 1977，MSBP in children has attracted widespread attention in European and American countries，and gradually attracted attention worldwide.However，Chinese pediatricians have insufficient knowledge of the disease at present，and there are just a few relevant literature reports in China.This article reviews the clinical features and progress on diagnosis and treatment of MSBP in children.

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.

Objective:To observe the changes of macular morphology and blood flow after minimally invasive vitrectomy (PPV) in patients with severe non-proliferative diabetic retinopathy (sNPDR).Methods:A prospective clinical study. From January 2020 to April 2021, 17 consecutive sNPDR patients with 17 eyes who were diagnosed and received PPV treatment at the Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study. There were 12 males with 12 eyes and 5 females with 5 eyes; the average age was 55 years old; the average duration of diabetes was 11 years; the average glycosylated hemoglobin was 7.9%. Before the operation and 1, 3, and 6 months after the operation, all the affected eyes underwent best corrected visual acuity (BCVA), standard 7-field fundus color photography, and optical coherence tomography angiography (OCTA). An OCTA instrument was used to scan the macular area of the affected eye with in the range of 3 mm×3 mm to measure the central subfoveal thickness (CST), the thickness of the ganglion cell complex (GCC) in the macular area, the thickness of the retinal nerve fiber layer (RNFL), and the superficial capillary plexus (SCP) vessel density and perfusion density in the macular area, macular avascular zone (FAZ) area, a-circularity index (AI). Before the operation and 6 months after the operation, the least significant difference test was used for the pairwise comparison.Results:Before the operation, 1, 3, and 6 months after the operation, the FAZ area of the macular area were 0.34±0.14, 0.35±0.10, 0.37±0.10, 0.36±0.13 mm 2, respectively; AI were 0.52±0.13, 0.54±0.11, 0.57±0.10, 0.60±0.11; CST was 282.6±66.7, 290.4±70.9, 287.2±67.5, 273.2± 49.6 μm; GCC thickness were 77.1±15.5, 74.3±13.9, 72.6±16.2, 78.5±18.3 μm; the thickness of RNFL was 97.9±13.8, 101.3±14.6, 97.7±12.0, 96.1±11.4 μm, respectively. The overall blood flow density of SCP in the macula were (16.79±1.43)%, (16.71±1.82)%, (17.30±2.25)%, (17.35±1.22)%; the overall perfusion density were 0.32±0.02, 0.32±0.03, 0.33±0.03, 0.33±0.02, respectively. After the operation, the CST increased first and then decreased; the thickness of RNFL increased 1 month after the operation, and then gradually decreased. Comparison of the parameters before and 6 months after the operation showed that the AI improved, and the difference was statistically significant ( P=0.049); the difference in FAZ area and the thickness of CST, GCC, and RNFL was not statistically significant ( P=0.600, 0.694, 0.802, 0.712); There was no statistically significant difference in the retina SCP blood flow density and perfusion density in the macular area ( P=0.347, 0.361). Conclusion:Compared with before surgery, there is no significant change in macular structure and blood flow density in sNPDR patients within 6 months after minimally invasive PPV.

The etiology of abnormal liver function in children is complex.Food allergy can cause liver immunity injury, which is one of the causes of abnormal liver function in children.The common clinical manifestation is hypertransaminasemia, mostly without cholestasis and hepatomegaly.After the exclusion of common causes of abnormal liver function, food challenge test to observe the changes of transaminase is used to diagnose abnormal liver function related to food allergy.This article reviews the research status, potential mechanism and clinical characteristic of abnormal liver function related to food allergy, aiming to improve the understanding of the phenomenon of clinicians, and better diagnosis and treatment of the disease.

Objective This study examined the research status and development process of FU Qingzhu’s Obstetrics and Gynecology (Fu Qing Zhu Nv Ke,《傅青主女科》, FQZNK) in the past 40 years with bibliometrics and visual analysis. Methods Retrieved all related literature in the research field of FQZNK from the domestic and foreign databases: China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and Web of Science (WOS) core database, including Science Citation Index Expanded (SCIE), Social Sciences Citation Index (SSCI), and Arts & Humanities Citation Index (A&HCI). The search range was from January 1, 1980 to March 10, 2021. In addition, bibliometrics and CiteSpace 5.7.R2 software were used to analyze literature types, published journals, cited literature, the number of author publications, co-author networks, co-institution networks, keyword co-occurrence networks, keyword clusters, and keyword bursts. Results A total of 678 valid records were included in the final dataset. Literature types, high publication journals, highly cited literature, high-yield institutions, high-yield research teams, and high-productivity scholars in this research field were found through bibliometrics. Literature types can be divided into four categories, among which 451 are theoretical studies on academic thoughts of FQZNK, accounting for 66.5% of the included journals. The Journal of Shanxi Traditional Chinese Medicine had the largest volume of published articles (61), accounting for 9.0% of the total number of the included journals. The most cited literature was ZHOU Mingxin’s article “Using the quantitative method to discuss author’s authenticity and formula characteristics of FU Qingzhu’s Obstetrics and Gynecology”, which was cited 94 times. Hunan University of Chinese Medicine, the institution with the most publications, published 45 articles, and YOU Zhaoling, the most published author, published 33 articles. Moreover, it was found that most high-yield researchers came from high-yield institutions and that Hunan University of Chinese Medicine had the most research on FQZNK. Keyword co-occurrence analysis revealed that the keyword “FQZNK” had the highest frequency (597 times) and the highest centrality (1.00). Keyword cluster analysis used the Log-Likelihood Ratio (LLR) algorithm to form eleven important clusters: #0 treatment aiming at its root causes, #1 gynecopathy, #2 Siwu Decoction (四物汤), #3 FU Qingzhu, #4 post-partum, #5 infertility, #6 dysmenorrhea, #7 sterility, #8 coordinate the heart and kidney, #9 Danggui Buxue Decoction (当归补血汤), and #10 treatment. It was found that the prescriptions of FQZNK were studied mainly before 2000, the theoretical studies were mainly conducted before 2010, and its clinical application was mainly explored from 2010 until now. Diseases such as dysmenorrhea, morbid vaginal discharge, infertility, metrorrhagia, and polycystic ovarian syndrome (PCOS) have recently become popular topics in this field. Conclusion The current study provides more scientific, accurate, and comprehensive scientific support for further research and development of traditional Chinese medicine (TCM) in FQZNK. With this foundation, people can use burst detection to ascertain the current hotspots in research, get their development trends, and forecast future research directions. In addition, infertility, morbid vaginal discharge, flooding, and PCOS treatments based on TCM syndrome differentiation are currently popular research topics for FQZNK.