Objective:To investigate the current status and risk factors of central venous catheter-related thrombus（CRT）in critically ill children，and to provide evidence for proposing preventive measures.Methods:This study was a single-center cross-sectional survey.The hospitalized children with central venous catheters implanted in the intensive care unit of Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine from January to March 2024 were included.Based on the ultrasound diagnosis indicating CRT or the presence of visually detectable thrombi after central venous catheter removal,the children included in the study were categorized into the CRT group and the non-CRT group.The data of demographic，clinical data，laboratory tests，medication treatment，and catheter related information of the affected children were collected.Univariate and multivariate analyses were performed to identify risk factors associated with CRT.Results:A total of 328 children were included，of which 158 cases（48.2%）were female，with the median age of 35.00（9.00，88.75）months.There were 51 cases（15.6%）in CRT group and 277 cases（84.4%）in non-CRT group.After adjusted by pediatric critical illness score，multivariate binary Logistic analysis revealed that the use of normal saline for catheter flushing and sealing (adjust OR=26.52,95% CI 8.32-84.60, P<0.001),longer duration of vasoactive drug use (adjust OR=5.06,95% CI 1.93-13.26, P=0.001),higher Caprini scale score (adjust OR=3.09,95% CI 1.38-6.91, P=0.006),presence of high-risk comorbidities or complications (adjust OR=2.87,95% CI 1.11-7.45, P=0.030),longer immobilization time (adjust OR=1.13,95% CI 1.07-1.19, P<0.001),and lower international normalized ratio after catheter placement (adjust OR=0.10,95% CI 0.02-0.53, P=0.007) were independent risk factors affecting the occurrence of CRT. Conclusion:The incidence of CRT is relatively high among critically ill children,and medical staff can develop targeted intervention measures by taking relevant risk factors into consideration.

Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI)-42 PET/CT and 18F-FDG PET/CT for bone metastasis in patients with malignant tumors. Methods:From January 2022 to October 2023, the data of 238 patients (160 males, 78 females; age: 58(50, 66) years) with various malignant tumors who underwent both 18F-FAPI-42 and 18F-FDG PET/CT imaging at Nanfang Hospital, Southern Medical University were retrospectively reviewed. An abnormal focal radioactive uptake in bones on the PET images was considered as positive lesion for bone metastasis. The efficacy of 2imaging methods and the supplementary role of CT in the diagnosis of bone metastasis were evaluated by McNemar test. Results:Of 238 patients, 95 were with bone metastases and 143 were without bone metastases, including 436 lesions with bone metastases and 358 lesions without bone metastases. Based on the visual analysis, 18F-FAPI-42 PET showed a higher diagnostic sensitivity than 18F-FDG PET (98.4%(429/436) vs 86.5%(377/436); χ2=41.95, P<0.001), while 18F-FDG PET had a higher diagnostic specificity than 18F-FAPI-42 PET (83.2%(298/358) vs 70.4%(252/358); χ2=22.50, P<0.001), and the accuracies of both methods were similar (85.8%(681/794) vs 85.0%(675/794); χ2=0.16, P=0.685). However, when the positive lesions seen in PET were analyzed combined with the image features on CT by the same scanner, the diagnostic specificity of 18F-FAPI-42 PET/CT was significantly improved compared to that of 18F-FAPI-42 PET alone (91.3%(327/358) vs 70.4%(252/358); χ2=73.01, P<0.001), and was similar to 18F-FDG PET/CT (93.0%(333/358); χ2=0.78, P=0.377). Meanwhile, this combined analysis brought a higher sensitivity and accuracy of 18F-FAPI-42 PET/CT than 18F-FDG PET/CT in diagnosing bone metastases (sensitivity: 98.4%(429/436) vs 86.5%(377/436); χ2=41.95, P<0.001; accuracy: 95.2%(756/794) vs 89.4%(710/794); χ2=21.54, P<0.001). Conclusions:The diagnostic sensitivity of 18F-FAPI-42 PET for bone metastasis is superior to 18F-FDG PET, but the specificity is lower. However, when CT features is combined for analysis, the diagnostic specificity of 18F-FAPI-42 PET/CT is significantly improved, which thus can be used to diagnose bone metastasis accurately and is superior to 18F-FDG PET/CT.

This study utilized data from the non-communicable diseases (NCDs) Progress Monitor Reports (2015, 2017, 2020, 2022) released by World Health Organization (WHO) to analyze the implementation of NCDs prevention and control policies in China from 2014 to 2021 through descriptive statistical method, aiming to provide evidence for strengthening national NCDs strategies. The analysis focuses on WHO-recommended ‘best buys’ policies for NCDs prevention and control, covering 10 categories (18 interventions): national NCDs targets, mortality data, risk factor surveys, national integrated NCDs policies/strategies/action plans, tobacco demand-reduction measures, harmful use of alcohol reduction measures, unhealthy diet reduction policies, physical activity campaigns, national clinical guidelines for cancer/CVD/diabetes/CRD management, and drug therapy/counselling for cardiovascular diseases. In accordance with the WHO′s NCDs progress monitor scoring methodology, policies are assigned 1.0 point for full implementation, 0.5 points for partial implementation, and 0 points for non-implementation or missing data, with a maximum total score of 18.0 points. The analytical metrics encompass the policy implementation score, implementation rate, and period-on-period implementation growth rate. The results showed that China′s total policy implementation scores for NCDs prevention and control in 2014, 2016, 2019, and 2021 were consistently higher than the global average (8.5, 10.5, 9.5, 9.5 vs 6.7, 8.3, 8.6, 8.6). From 2014 to 2021, the total score increased by 1.0 point, and the implementation rate improved by 8.9%. From 2014 to 2016, China′s total policy implementation score rose from 8.5 to 10.5, primarily driven by improvements in tobacco tax increases and unhealthy diet reduction measures (salt reduction, restrictions on high-fat foods, and regulation of breast-milk substitute sales). However, this progress was partially offset by a decline in scores for physical activity campaigns. From 2016 to 2019, the total score decreased to 9.5, largely due to lower scores in harmful use of alcohol reduction measures (alcohol taxation and advertising bans). From 2019 to 2021, the total score remained stable, with increases in marketing to children restrictions balanced by declines in scores for drug therapy/counselling for cardiovascular diseases. In 2021, China′s total policy implementation score (9.5) exceeded the global average (8.6) but fell below the G20 average (11.2). Significant gaps remained compared to top-performing G20 countries such as Turkey (16.5), particularly in tobacco control and restrictions on harmful alcohol use. In conclusion, from 2014 to 2021, China′s total policy implementation score for NCDs prevention and control consistently exceeded the global average, demonstrating an upward trend, and various NCDs prevention and control policies have been continuously improved.

This study utilized data from the non-communicable diseases (NCDs) Progress Monitor Reports (2015, 2017, 2020, 2022) released by World Health Organization (WHO) to analyze the implementation of NCDs prevention and control policies in China from 2014 to 2021 through descriptive statistical method, aiming to provide evidence for strengthening national NCDs strategies. The analysis focuses on WHO-recommended ‘best buys’ policies for NCDs prevention and control, covering 10 categories (18 interventions): national NCDs targets, mortality data, risk factor surveys, national integrated NCDs policies/strategies/action plans, tobacco demand-reduction measures, harmful use of alcohol reduction measures, unhealthy diet reduction policies, physical activity campaigns, national clinical guidelines for cancer/CVD/diabetes/CRD management, and drug therapy/counselling for cardiovascular diseases. In accordance with the WHO′s NCDs progress monitor scoring methodology, policies are assigned 1.0 point for full implementation, 0.5 points for partial implementation, and 0 points for non-implementation or missing data, with a maximum total score of 18.0 points. The analytical metrics encompass the policy implementation score, implementation rate, and period-on-period implementation growth rate. The results showed that China′s total policy implementation scores for NCDs prevention and control in 2014, 2016, 2019, and 2021 were consistently higher than the global average (8.5, 10.5, 9.5, 9.5 vs 6.7, 8.3, 8.6, 8.6). From 2014 to 2021, the total score increased by 1.0 point, and the implementation rate improved by 8.9%. From 2014 to 2016, China′s total policy implementation score rose from 8.5 to 10.5, primarily driven by improvements in tobacco tax increases and unhealthy diet reduction measures (salt reduction, restrictions on high-fat foods, and regulation of breast-milk substitute sales). However, this progress was partially offset by a decline in scores for physical activity campaigns. From 2016 to 2019, the total score decreased to 9.5, largely due to lower scores in harmful use of alcohol reduction measures (alcohol taxation and advertising bans). From 2019 to 2021, the total score remained stable, with increases in marketing to children restrictions balanced by declines in scores for drug therapy/counselling for cardiovascular diseases. In 2021, China′s total policy implementation score (9.5) exceeded the global average (8.6) but fell below the G20 average (11.2). Significant gaps remained compared to top-performing G20 countries such as Turkey (16.5), particularly in tobacco control and restrictions on harmful alcohol use. In conclusion, from 2014 to 2021, China′s total policy implementation score for NCDs prevention and control consistently exceeded the global average, demonstrating an upward trend, and various NCDs prevention and control policies have been continuously improved.

Objective:To investigate the current status and risk factors of central venous catheter-related thrombus（CRT）in critically ill children，and to provide evidence for proposing preventive measures.Methods:This study was a single-center cross-sectional survey.The hospitalized children with central venous catheters implanted in the intensive care unit of Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine from January to March 2024 were included.Based on the ultrasound diagnosis indicating CRT or the presence of visually detectable thrombi after central venous catheter removal,the children included in the study were categorized into the CRT group and the non-CRT group.The data of demographic，clinical data，laboratory tests，medication treatment，and catheter related information of the affected children were collected.Univariate and multivariate analyses were performed to identify risk factors associated with CRT.Results:A total of 328 children were included，of which 158 cases（48.2%）were female，with the median age of 35.00（9.00，88.75）months.There were 51 cases（15.6%）in CRT group and 277 cases（84.4%）in non-CRT group.After adjusted by pediatric critical illness score，multivariate binary Logistic analysis revealed that the use of normal saline for catheter flushing and sealing (adjust OR=26.52,95% CI 8.32-84.60, P<0.001),longer duration of vasoactive drug use (adjust OR=5.06,95% CI 1.93-13.26, P=0.001),higher Caprini scale score (adjust OR=3.09,95% CI 1.38-6.91, P=0.006),presence of high-risk comorbidities or complications (adjust OR=2.87,95% CI 1.11-7.45, P=0.030),longer immobilization time (adjust OR=1.13,95% CI 1.07-1.19, P<0.001),and lower international normalized ratio after catheter placement (adjust OR=0.10,95% CI 0.02-0.53, P=0.007) were independent risk factors affecting the occurrence of CRT. Conclusion:The incidence of CRT is relatively high among critically ill children,and medical staff can develop targeted intervention measures by taking relevant risk factors into consideration.

Objective:To compare the diagnostic efficacy of 18F-fibroblast activation protein inhibitor (FAPI)-42 PET/CT and 18F-FDG PET/CT for bone metastasis in patients with malignant tumors. Methods:From January 2022 to October 2023, the data of 238 patients (160 males, 78 females; age: 58(50, 66) years) with various malignant tumors who underwent both 18F-FAPI-42 and 18F-FDG PET/CT imaging at Nanfang Hospital, Southern Medical University were retrospectively reviewed. An abnormal focal radioactive uptake in bones on the PET images was considered as positive lesion for bone metastasis. The efficacy of 2imaging methods and the supplementary role of CT in the diagnosis of bone metastasis were evaluated by McNemar test. Results:Of 238 patients, 95 were with bone metastases and 143 were without bone metastases, including 436 lesions with bone metastases and 358 lesions without bone metastases. Based on the visual analysis, 18F-FAPI-42 PET showed a higher diagnostic sensitivity than 18F-FDG PET (98.4%(429/436) vs 86.5%(377/436); χ2=41.95, P<0.001), while 18F-FDG PET had a higher diagnostic specificity than 18F-FAPI-42 PET (83.2%(298/358) vs 70.4%(252/358); χ2=22.50, P<0.001), and the accuracies of both methods were similar (85.8%(681/794) vs 85.0%(675/794); χ2=0.16, P=0.685). However, when the positive lesions seen in PET were analyzed combined with the image features on CT by the same scanner, the diagnostic specificity of 18F-FAPI-42 PET/CT was significantly improved compared to that of 18F-FAPI-42 PET alone (91.3%(327/358) vs 70.4%(252/358); χ2=73.01, P<0.001), and was similar to 18F-FDG PET/CT (93.0%(333/358); χ2=0.78, P=0.377). Meanwhile, this combined analysis brought a higher sensitivity and accuracy of 18F-FAPI-42 PET/CT than 18F-FDG PET/CT in diagnosing bone metastases (sensitivity: 98.4%(429/436) vs 86.5%(377/436); χ2=41.95, P<0.001; accuracy: 95.2%(756/794) vs 89.4%(710/794); χ2=21.54, P<0.001). Conclusions:The diagnostic sensitivity of 18F-FAPI-42 PET for bone metastasis is superior to 18F-FDG PET, but the specificity is lower. However, when CT features is combined for analysis, the diagnostic specificity of 18F-FAPI-42 PET/CT is significantly improved, which thus can be used to diagnose bone metastasis accurately and is superior to 18F-FDG PET/CT.

Premature ovarian insufficiency(POI),also known as"ovarian insufficiency",has an incidence of 1％～5％.The incidence has been on the rise in recent years,seriously affecting women's physical and mental health and quality of life.At present,the cause and mechanisms of POI are still unclear,and the method and applications of model construction are also confusing.Most models have some shortcomings in pertinence and stability.The limitations greatly limit research into the clinical diagnosis and treatment of POI.This paper summarizes and discusses the etiology and pathogenesis of POI and the construction of POI animal models to provide a comprehensive reference for those studying POI.

Objective:To evaluate the predictive value of preoperative frailty combined with nutritional status for prolonged postoperative ileus (PPOI) in the patients with gynecological malignancies.Methods:Patients undergoing elective surgery for gynecological malignancies in the Affiliated Hospital of Jiangnan University from April 2022 to February 2023 were selected. The Frail scale was used to evaluate the frailty within 24 h of admission, and the nutritional status was evaluated by the Controlling Nutritional Status score. The general characteristics of patients and occurrence of PPOI were recorded, and the risk factors for PPOI were analyzed by multivariate logistic regression. The ability of frailty, nutritional status and their combination to predict PPOI was assessed by the receiver operating characteristic curve.Results:Two hundred and fourteen patients were finally included, 52 cases developed of PPOI, and 98 cases were frail patients. Preoperative frailty combined with moderate to severe malnutrition was an independent risk factor for PPOI in the patients with gynecological malignancies ( P<0.05), and the area under the curve in predicting the occurrence of PPOI was 0.796 (95% confidence interval 0.736-0.857) in the patients with gynecological malignancies. Conclusions:Preoperative frailty combined with moderate to severe malnutrition has a higher accuracy in predicting PPOI in the patients with gynecological malignancies.

Objective:To test the hypothesis that Pertussis toxin (PTX) can promote the occurrence of interstitial lung disease (ILD) in experimental autoimmune myositis (EAM) model and clarify the potential pathogenic mechanism.Methods:EAM mice model were induced by Skeletal muscle thomogenate with or without PTX, and the relationship between ILD phenotypes and neutrophil extracellular traps (NETs) infiltration was analyzed by histopathological and serological studies in EAM with PTX group and EAM without PTX group. Healthy mice were given PTX alone intraperitoneally to clarify whether NETs formation could be induced in vivo, and neutrophils separated from healthy human blood were intervened with PTX to induce NETs formation in vitro. The data was tested for normality using Shapiro-Wilk. Statistical methods and were analyzed using t-test or ANOVA, and multiple comparisons between different groups were tested using Tukey test. Results:Compared with EAM without PTX group, lung tissues in EAM with PTX group had multiple pathological changes similar to polymyositis/dermatomyositis-related ILD. Nonspecific interstitial pneumonia and usual interstitial pneumonia were the main pathological types. The pulmonary interstitial lesions were accompanied by significant infiltration of NETs; and serum NETs markers levels were obviously elevated in EAM with PTX group, compared with the control group [ n=5, (87±10) ng/ml], cfDNA levels were statistically significantly elevated in both the EAM without PTX group [ n=4, (115±27) ng/ml] and the EAM with PTX group [ n=7, (150±50) ng/ml] ( F=4.24, P=0.038); Cit-H3-DNA levels were elevated in the EAM without PTX group ( n=4, 0.24±0.09), and in the EAM EAM with PTX group ( n=6, 0.33±0.11) compared with the control group ( n=4, 0.13±0.02) ( F=6.21, P=0.016). After PTX intervention, serum cfDNA levels were higher in the PTX group [ n=3, (100±40) ng/ml] than in the control group [ n=3, (45±12) ng/ml, t=2.27, P=0.086]; PTX also induced neutrophils to form NETs in vitro. Conclusion:PTX may promote the development of ILD in EAM mice model by inducing the formation of NETs, indicating that EAM mice can serve as a model for targeting NETs to study the pathogenesis ILD.

Objective:To analyze the correlation between cuproptosis genes and immune infiltration during the occurrence and development of multiple sclerosis(MS),and to predict the traditional Chinese medicine,to provide theoretical basis for the mecha-nism study of cuproptosis in MS immune infiltration and Chinese medicine to intervene in immune regulation.Methods:The gout chip of MS was downloaded from the GEO database and standardized;based on the processed data,immune cells and functions were ex-tracted and quantified,and the correlation and differences of immune cells and functions were analyzed;at the same time,cuproptosis genes related to MS were screened out,a risk model was constructed,and enrichment analysis was carried out;the prediction of cu-proptosis genes and immune-related biological processes were carried out.Results:① Among immune cells,T follicular helper cell and B cell showed the strongest positive correlation;among the immune functions,parainflammation and typeⅠIFN reponse showed the strongest positive correlation;②B cell,T helper cell and human leukocyte antigen were lowly expressed in MS patients,while major histocompatibility complex class Ⅰ,parainflammation and typeⅠIFN response were significantly expressed;③ The cupropto-sis genes associated with MS were SLC31A1,PDHA1,NLRP3,MTF1,GLS and DBT,of which DBT was the most likely risk factor for MS;④The occurrence and development of MS involves biological processes such as IL-4 production,T-helper cell differentiation,and acute inflammatory response,which were related to pathways such as arginine biosynthesis,citrate cycle,and propanoate metabo-lism;⑤Banxia,Danshen,Jianghuang and other traditional Chinese medicines may be used as potential molecular drug sources.Con-clusion:The expression of cuproptosis gene is closely related to MS-related immune cells and functions,which can provide support for the basic research of MS.