Objective:To investigate the value of auditory evoked potential(BAEP)parameters of brainstem in assessing damage of auditory pathway of preterm infants after they occurred intracranial hemorrhage,and the correlation between the damage and long-term neurodevelopmental outcomes.Methods:This study adopted a prospective cohort study design.A total of 158 preterm infants admitted to the neonatal intensive care unit of Anhui Provincial Hospital between June 2021 and December 2023 were included.According to whether occurred intracranial hemorrhage,they were divided into observation group(n=78,with intracranial hemorrhage)and the control group(n=80,without intracranial hemorrhage).The standardized BAEP test were used to obtain a series of parameters including the Ⅲ～Ⅴ wave interval,Ⅴ wave incubation period,and amplitude.The Papile grading system was combined to assess the severity of hemorrhage.The Gesell Developmental Scale was adopted to assess neurodevelopmental levels when follow-up was conducted until the corrected age of 12 months.The multifactorial logistic regression analysis was used to screen and identify independent risk factors.Results:Compared to the indicators of control group,the observation group significantly prolonged Ⅲ～Ⅴ wave interval and Ⅴ wave incubation period,and decreased Ⅴ wave amplitude,and the differences of them between two groups were statistical significance(t=5.038,5.642,-5.476,P<0.05).With aggravating of bleeding degree,the Ⅲ～Ⅴ wave interval appeared gradient prolonging,and with the grading change,the Ⅴ wave amplitude decreased progressively,and the differences were significant(F=18.326,F=7.894,P<0.001).There was not significant difference in Ⅲ～Ⅴ wave interval among different grading(P>0.05).The correlation analysis revealed that there was a strong negative correlation between Ⅲ～Ⅴ wave interval and the Gesell total score,with the strongest correlation between that and the dimension of language communication.Ⅴ wave amplitude was positively correlated with the Gesell total score,which had the highest correlation with the dimension of language communication,and all correlation coefficients reached to the biggest significant level(r=-0.632,-0.634,0.549,P<0.05).Multifactorial model confirmed that prolonging Ⅲ～Ⅴwave interval,increasing Papile grading,and reducing Ⅴ wave amplitude were independent predictors of neurodevelopmental abnormalities(OR=3.214,2.441,0.133,P<0.001).Conclusion:In the BAEP parameters,the Ⅲ～Ⅴ wave interval and Ⅴ wave amplitude can be used as sensitive indicators for functional damage of brainstem conduction in preterm infants with intracranial hemorrhage,which dynamic changes show significant correlation with long-term neurodevelopmental outcomes.

Objective:To enhance the understanding of clinical doctors on the concurrence of Sj?gren′s syndrome (SS) and myasthenia gravis (MG), provide reference forclinical diagnosis and treatment.Methods:The medical record of SS、MG patient Taian Central hospital in october 2021 was reviewed and a retrospective analysis was conducted. Based on the key words, the main databases domestic and abroad from Jan 1973 to April 2024. The cases reported in the literature were searched out and merged with our case and analyzed by SPSS 27.0. The measurement data of normal distribution were expressed by mean standard deviation ± s, and the measurement data of abnormal distribution were expressed by M( Q1, Q3). Counting data were expressed as examples and percentages (%) . Results:Twenty-one patients with SS complicated with MG were reviewed. Among them, 19(90.5%) patients were female. The average age was (47.6 ± 3.1) years, and the median time from onset to diagnosis was 24 (11, 78) months. There were 11 patients (52.4%) with myasthenia gravis as the initial presentation. The main clinical manifestations of patients with myasthenia muscle fatigue (80.9%, 17/21), gravis include fatigue ptosis (71.4%, 15/21), diplopia, blurred vision (57.1%, 12/21), dysphagia (33.3%, 7/21), joint pain (33.3%, 7/21), odysarthria, and unclear speech (23.8%, 5/21), hair loss (14.3%, 3/21), and swelling of the excocrine glands(9.5%, 2/21). Eighteen patients (85.7%, 18/21) showed positive anti acetylcholine receptor antibodies. Sixteen patients (76.2%) were positive for ANA, and 14 patients (66.8%) were positive for anti SSA or (and) anti SSB antibodies. Four patients (19.0%) also had other autoimmune diseases (Hashimoto′s thyroiditis, rheumatoid arthritis, optic neuritis). In terms of treatment, cholinesterase inhibitors were the most common treatment measure, applied to 18 patients (85.7%), followed by glucocorticoid therapy, and applied to 14 patients (66.8%). In addition, 7 patients (33.3%) received immunosuppressive agents therapy, 5 patients (23.8%) underwent thymectomy, 2 patients (9.5%) received intravenous human immunoglobulin injection, and 1 patient (4.8%) underwent plasma exchange. All patients showed improvement after treatment.Conclusion:SS and MG are both autoimmune diseases, and their coexistence is rare. Clinicans should be aware of this rare association. Early diagnosis is crucial for the treatment and prognosis of patients,and requiresa comprehensive assessment of clinical symptoms, laboratory tests, and auto-antibody test results.

The incidence of leukemia,a malignant cancer originating from the hematopoietic system,is increasing annually.Although traditional treatment method such as chemotherapy and hematopoietic stem cell transplantation have improved patient survival rates to some extent,serious side effects,drug tolerance,and high recurrence rates remain.In recent years,studies have shown that the gut microbiota and its metabolites play an important role in the occurrence,development,and complications of leukemia.Imbalance of the gut microbiota can lead to decreased immune function and an intensified inflammatory response,which is a key factor driving disease progression.Some metabolites,such as short-chain fatty acids,enhance immune function and improve patient prognosis through intestinal barrier repair,while others,such as hydrogen sulfide and bile acids,show potential anti-tumor effects exerted through regulation of tumor cell apoptosis and immune balance.Traditional Chinese medicine aimed at regulating the structure of the gut microbiota and its metabolites has shown great potential in alleviating the side effects of chemotherapy for leukemia.This review covers the role of the gut microbiota and its metabolites in the occurrence,development,and complications of leukemia,and explores treatment strategies for regulating the microbiota,including fecal microbiota transplantation,probiotics,and traditional Chinese medicine intervention.We anticipate that this review will serve as a reference for improving the treatment and prognosis of leukemia.

Objective:To investigate the value of auditory evoked potential(BAEP)parameters of brainstem in assessing damage of auditory pathway of preterm infants after they occurred intracranial hemorrhage,and the correlation between the damage and long-term neurodevelopmental outcomes.Methods:This study adopted a prospective cohort study design.A total of 158 preterm infants admitted to the neonatal intensive care unit of Anhui Provincial Hospital between June 2021 and December 2023 were included.According to whether occurred intracranial hemorrhage,they were divided into observation group(n=78,with intracranial hemorrhage)and the control group(n=80,without intracranial hemorrhage).The standardized BAEP test were used to obtain a series of parameters including the Ⅲ～Ⅴ wave interval,Ⅴ wave incubation period,and amplitude.The Papile grading system was combined to assess the severity of hemorrhage.The Gesell Developmental Scale was adopted to assess neurodevelopmental levels when follow-up was conducted until the corrected age of 12 months.The multifactorial logistic regression analysis was used to screen and identify independent risk factors.Results:Compared to the indicators of control group,the observation group significantly prolonged Ⅲ～Ⅴ wave interval and Ⅴ wave incubation period,and decreased Ⅴ wave amplitude,and the differences of them between two groups were statistical significance(t=5.038,5.642,-5.476,P<0.05).With aggravating of bleeding degree,the Ⅲ～Ⅴ wave interval appeared gradient prolonging,and with the grading change,the Ⅴ wave amplitude decreased progressively,and the differences were significant(F=18.326,F=7.894,P<0.001).There was not significant difference in Ⅲ～Ⅴ wave interval among different grading(P>0.05).The correlation analysis revealed that there was a strong negative correlation between Ⅲ～Ⅴ wave interval and the Gesell total score,with the strongest correlation between that and the dimension of language communication.Ⅴ wave amplitude was positively correlated with the Gesell total score,which had the highest correlation with the dimension of language communication,and all correlation coefficients reached to the biggest significant level(r=-0.632,-0.634,0.549,P<0.05).Multifactorial model confirmed that prolonging Ⅲ～Ⅴwave interval,increasing Papile grading,and reducing Ⅴ wave amplitude were independent predictors of neurodevelopmental abnormalities(OR=3.214,2.441,0.133,P<0.001).Conclusion:In the BAEP parameters,the Ⅲ～Ⅴ wave interval and Ⅴ wave amplitude can be used as sensitive indicators for functional damage of brainstem conduction in preterm infants with intracranial hemorrhage,which dynamic changes show significant correlation with long-term neurodevelopmental outcomes.

The incidence of leukemia,a malignant cancer originating from the hematopoietic system,is increasing annually.Although traditional treatment method such as chemotherapy and hematopoietic stem cell transplantation have improved patient survival rates to some extent,serious side effects,drug tolerance,and high recurrence rates remain.In recent years,studies have shown that the gut microbiota and its metabolites play an important role in the occurrence,development,and complications of leukemia.Imbalance of the gut microbiota can lead to decreased immune function and an intensified inflammatory response,which is a key factor driving disease progression.Some metabolites,such as short-chain fatty acids,enhance immune function and improve patient prognosis through intestinal barrier repair,while others,such as hydrogen sulfide and bile acids,show potential anti-tumor effects exerted through regulation of tumor cell apoptosis and immune balance.Traditional Chinese medicine aimed at regulating the structure of the gut microbiota and its metabolites has shown great potential in alleviating the side effects of chemotherapy for leukemia.This review covers the role of the gut microbiota and its metabolites in the occurrence,development,and complications of leukemia,and explores treatment strategies for regulating the microbiota,including fecal microbiota transplantation,probiotics,and traditional Chinese medicine intervention.We anticipate that this review will serve as a reference for improving the treatment and prognosis of leukemia.

Objective:To enhance the understanding of clinical doctors on the concurrence of Sj?gren′s syndrome (SS) and myasthenia gravis (MG), provide reference forclinical diagnosis and treatment.Methods:The medical record of SS、MG patient Taian Central hospital in october 2021 was reviewed and a retrospective analysis was conducted. Based on the key words, the main databases domestic and abroad from Jan 1973 to April 2024. The cases reported in the literature were searched out and merged with our case and analyzed by SPSS 27.0. The measurement data of normal distribution were expressed by mean standard deviation ± s, and the measurement data of abnormal distribution were expressed by M( Q1, Q3). Counting data were expressed as examples and percentages (%) . Results:Twenty-one patients with SS complicated with MG were reviewed. Among them, 19(90.5%) patients were female. The average age was (47.6 ± 3.1) years, and the median time from onset to diagnosis was 24 (11, 78) months. There were 11 patients (52.4%) with myasthenia gravis as the initial presentation. The main clinical manifestations of patients with myasthenia muscle fatigue (80.9%, 17/21), gravis include fatigue ptosis (71.4%, 15/21), diplopia, blurred vision (57.1%, 12/21), dysphagia (33.3%, 7/21), joint pain (33.3%, 7/21), odysarthria, and unclear speech (23.8%, 5/21), hair loss (14.3%, 3/21), and swelling of the excocrine glands(9.5%, 2/21). Eighteen patients (85.7%, 18/21) showed positive anti acetylcholine receptor antibodies. Sixteen patients (76.2%) were positive for ANA, and 14 patients (66.8%) were positive for anti SSA or (and) anti SSB antibodies. Four patients (19.0%) also had other autoimmune diseases (Hashimoto′s thyroiditis, rheumatoid arthritis, optic neuritis). In terms of treatment, cholinesterase inhibitors were the most common treatment measure, applied to 18 patients (85.7%), followed by glucocorticoid therapy, and applied to 14 patients (66.8%). In addition, 7 patients (33.3%) received immunosuppressive agents therapy, 5 patients (23.8%) underwent thymectomy, 2 patients (9.5%) received intravenous human immunoglobulin injection, and 1 patient (4.8%) underwent plasma exchange. All patients showed improvement after treatment.Conclusion:SS and MG are both autoimmune diseases, and their coexistence is rare. Clinicans should be aware of this rare association. Early diagnosis is crucial for the treatment and prognosis of patients,and requiresa comprehensive assessment of clinical symptoms, laboratory tests, and auto-antibody test results.

Leukemia is a critical disease with a high incidence and extremely high fatality rate.Immune escape by leukemia stem cells(LSC)is the main factor for recurrence and progression after remission.Clinical diagnosis and treatment by Traditional Chinese Medicine(TCM)have distinct advantages of syndrome differentiation and treatment.Based on the purpose of diagnosis and treatment,leukemia treatment by TCM emphasizes the harmony of yin and yang to restore human functions,which is conducive to improve autoimmunity and conforms to the mechanism of intervention for tumor cell immune escape.This article discusses the mechanism and research progress of TCM interventions in LSC immune escape based on literature and TCM theory.

Objective In order to discuss the rationality of clinical use of medication and the strategies of serious adverse reactions(SADR),the reports of SADRs caused by nedaplatin for injection were summarized and analyzed.Methods Methods Serious adverse reactions to all medicines reported to the National Adverse Reaction Monitoring Centre(NARMC)in Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from January 2012 to December 2021 were collected,and a retrospective analysis of 90 patients among those cases with SADR after nedaplatin injection was carried out.Results The occurrence of SADRs was not related to the gender.In monotherapy with nedaplatin,the rate of serious adverse effects was high with the first use of nedaplatin(74.3%).The incidence of adverse reactions was highest within 30 minutes and 2-14 days,including severe allergic reaction(34.4%)and grade Ⅱ-Ⅳ myelosuppression(51.2%),respectively.Drug withdrawal and symptomatic treatment were often the preferred treatment methods in clinical practice.Conclusion While using nedaplatin as a chemotherapy regimen,especially for the first time,patients should be closely monitored for the occurrence of severe anaphylaxis within 30 minutes and severe bone marrow suppression within 2 weeks.A rescue emergency plan for resuscitation and regular checking of the hemogram should be made to prevent the occurrence of serious adverse reactions.

【Objective】 To explore the current status and development trend of research on external therapies in traditional Chinese medicine (TCM) for insomnia over the past 10 years through bibliometrics and visual analysis, to provide references for further research on the topic. 【Methods】 Literature relating to TCM external therapies for insomnia from January 1, 2012 to December 31, 2021 was retrieved from Chinese databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and from the Web of Science Core Collection (WOSCC) for English articles. CiteSpace, VOSviewer, Scimago Graphica, and NoteExpress software were used to analyze publication volumes of the papers and how they were distributed in different journals, as well as to visualize the data of the countries, authors, institutions, and keywords. 【Results】 A total of 6 085 papers were obtained, of which 5 592 were from the Chinese databases and 493 were from the English database, with their publication volumes growing steadily year on year. Approximately 45 countries and regions were found to have published research on the topic. In terms of Chinese publications, the author with the most papers published was CHEN Yunfei from Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine. The closest collaboration was between LIU Chengyong from the Affiliated Hospital of Nanjing University of Chinese Medicine and YUE Zenghui from Hunan University of Chinese Medicine. In terms of English publications, the author with the most papers published was MAO Junj from Sloan-Kettering Cancer Research Center, USA, and LAO Lixing from the University of Hong Kong was his closest partner in collaboration. Heilongjiang University of Chinese Medicine was the institution with the most Chinese publications, and Shanghai University of Traditional Chinese Medicine was the one with the most English papers published. Studies on the topic were published in 386 Chinese journals and 205 English journals, respectively. Nowadays, the clinical application of TCM external treatments for insomnia, the selection of meridians and acupoints, therapies for insomnia and its related diseases are research hotspots. The combined use of different TCM external therapies is a trend in the treatment of insomnia and its concomitant diseases, especially in the fields of oncology, nursing, and psychiatric disorders. The exploration of mechanisms of TCM external therapies for insomnia is also a key direction for future research. In clinical practice, the commonly used external therapies for insomnia include acupuncture, ear-acupressure with beans, acupoint application, etc. The commonly selected acupoints are auricular points, Sishencong (EX-HN1), Shenmen (HT7), etc. The frequently studied meridians are Ren, Du, Qiao, etc. The insomnia concomitant diseases are depression, stroke, anxiety, etc. 【Conclusion】 A wealth of research results have been accumulated in the treatment of insomnia by TCM external therapies, but authoritative research results are not so many. Therefore, institutions in different countries should strengthen communications and cooperation, and researchers should be encouraged to make innovations and breakthroughs on the basis of inherited TCM external therapies, so as to produce more valuable research results and improve TCM external therapies for providing better treatments for patients with sleep disorders.

Objective: To evaluate risk factors for NEC in in term infant. Methods: Risk factors associated with NEC were investigated using a retrospective case-control design.43 patients with Bell's stage NEC≥Ⅱ were identified.Each case was paired with two GA-and weight-matched controls.Data were collected from medical records, including oligohydramnios, ICP,neonatal asphyxia, MAS,neonatal septicemia, CHD,neonatal shock, gestational diabetes, PROM,fetal distress, hypertensive disorders in pregnancy, and univariate/logistic regression analysis was employed. Results: A total of 43 cases and 86 controls were enrolled.The demographic characteristics of the two groups were not statistically significant.The onset time of 43 cases was 2～17 d after birth and the average time was 6.3 d.The single factor analysis indicated that the two group had statistical significance in oligohydramnios, MAS,CHD,neonatal septicemia, neonatal asphyxia, gestational diabetes, neonatal shock, PROM,fetal distress and hypertensive disorders in pregnancy.Logistic regression analysis suggested that CHD(OR=4.27,P=0.029),neonatal septicemia(OR=2.77,P=0.007),Oligohydramnios(OR=2.42,P=0.010),PROM(OR=2.11,P=0.013),neonatal asphyxia(OR=2.06,P=0.031),MAS(OR=1.89,P=0.017),hypertensive disorders in pregnancy(OR=1.86,P=0.015),gestational diabetes(OR=1.75,P=0.032),neonatal shock(OR=1.65,P=0.024)and fetal distress(OR=1.35,P=0.021) were significantly associated with NEC. Conclusion Oligohydramnios, MAS,CHD,neonatal asphyxia, neonatal septicemia, neonatal shock, PROM,fetal distress, hypertensive disorders in pregnancy and gestational diabetes may be associated with an increased risk of NEC in term infant.