Objective To investigate the expression of forkhead box P3(Foxp3)in peripheral blood of children with bronchial asthma and its relationship with airway hyper-responsiveness and body allergy.Methods A total of 80 children with bronchial asthma treated in the Affiliated Hospital of Yangzhou University from July 2024 to June 2025 were selected as experimental group,and 47 health-y children with physical examinations in the same period were selected as control group.Airway hy-per-responsiveness indicators(respiratory resistance,bronchial stimulant reaction threshold,and re-sistance increase slope),body allergy indicators[serum immunoglobulin E(IgE),eosinophil cationic protein(ECP),and eosinophil count(EOS)],pulmonary function indicators[peak expiratory flow(PEF),forced expiratory volume in the first second(FEV,),forced vital capacity(FVC),and the ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC)],and the expression level of Foxp3 in peripheral blood were compared between the two groups.Pearson corre-lation analysis was used to explore the correlations of Foxp3 with airway hyper-responsiveness and body allergy.Results The respiratory resistance and resistance increase slope in the control group were significantly lower than those in the experimental group,while the reaction threshold was signif-icantly higher than that in the experimental group(P＜0.05).The levels of IgE,ECP and EOS in the experimental group were significantly higher than those in the control group(P＜0.05).The FEV1,FVC,PEF,and FEV1/FVC in the experimental group were significantly lower than those in the control group(P＜0.05).The expression level of Foxp3 in the experimental group was(3.04±0.22),which was significantly lower than(4.22±0.41)in the control group(P＜0.05).Foxp3 was significantly correlated with respiratory resistance(r=-0.700,P＜0.001),reaction thresh-old(r=0.704,P＜0.001),resistance increase slope(r=-0.842,P＜0.001),IgE(r=0.864,P＜0.001),ECP(r=-0.684,P＜0.001),and EOS(r=-0.854,P＜0.001).Con-clusion The decreased Foxp3 in peripheral blood in children with bronchial asthma is associated with aggravated airway hyper-responsiveness and body allergy,suggesting that Foxp3 may be in-volved in the pathogenesis of bronchial asthma.

ObjectiveTo investigate the association between the maintenance treatment of modified Yiqi Huoxue Jiedu Formula （益气活血解毒方） or poly ADP ribose polymerase （PARP） inhibitors and the recurrence and metastasis of advanced ovarian cancer. MethodsA case-control study design was employed， dividing patients with advanced ovarian cancer into two groups based on the occurrence of recurrence and metastasis following first-line maintenance treatment. Patients with recurrence and metastasis comprised the case group， while those without recurrence and metastasis served as the control group. The previous first-line maintenance treatment method was set as the exposure factor in the study （with the use of modified Yiqi Huoxue Jiedu Formula defined as exposed and PARP inhibitors defined as unexposed）. Basic information was collected for both groups， including the achievement of satisfactory R0 surgery， age， stage， neoadjuvant chemotherapy， lymph node metastasis， germline BRCA1/2 mutations， homologous recombination deficiency positivity， first-line maintenance treatment method （modified Yiqi Huoxue Jiedu Formula or PARP inhibitors）， and CA125 levels after the last chemotherapy. The baseline data of the two groups were assessed for differences. If there exists difference， a 1∶1 nearest neighbor matching method was used for propensity score matching. Univariate and multivariate logistic regression analyses were employed to evaluate the association between the modified Yiqi Huoxue Jiedu Formula or PARP inhibitors and the recurrence and metastasis of ovarian cancer. ResultsA total of 201 patients with advanced ovarian cancer were included， with 97 in the case group and 104 in the control group. Both groups showed statistically significant differences in R0 surgery， stage， neoadjuvant chemotherapy， and CA125 levels after the last chemotherapy （P＜0.05）， indicating baseline imbalance. After propensity score matching， there were 71 patients in both the case and control groups， achieving baseline balance （P＞0.05）. Univariate logistic regression analysis indicated that the achievement of satisfactory R0 surgery （P = 0.006）， disease stage （P = 0.001）， the use of neoadjuvant chemotherapy （P = 0.024）， treatment modality （P = 0.006）， and CA125 levels after the last chemotherapy （P = 0.013） were associated with the recurrence and metastasis of ovarian cancer. Multivariate logistic regression analysis revealed that disease stage was an independent influencing factor for the recurrence and metastasis of ovarian cancer （P = 0.030）， whereas the P-value for the correlation between first-line maintenance treatment and ovarian cancer was 0.188. ConclusionFirst-line maintenance treatment of ovarian cancer patients with the use of modified Yiqi Huoxue Jiedu Formula or PARP inhibitors does not correlate with the recurrence and metastasis of ovarian cancer.

The development of Traditional Chinese Medicine(TCM)medical alliances plays a pivotal role in enhancing grassroots TCM service capabilities and meeting public demand for TCM healthcare.However,challenges persist in establishing these alliances,including insufficient Party leadership at primary TCM institutions and deficiencies in clinical services,talent de-velopment,and emergency care capacity.This study examines innovative Party building approaches in public hospitals within the new era context,analyzing practical cases of alliance development.Our findings demonstrate that integrating Party building into the governance structure of medical alliances not only strengthens Party leadership at primary TCM institutions but also significant-ly promotes TCM service development.Systematic analysis of case hospital practices reveals several key insights.Firstly,strengthening top-level design through Party committee leadership is crucial.Secondly,addressing the most pressing public healthcare concerns with genuine commitment forms the foundation.Thirdly,deep integration of Party building with core medical services represents the essential approach.Lastly,policy-responsive innovation based on consolidated achievements serves as the key driver.

The development of Traditional Chinese Medicine(TCM)medical alliances plays a pivotal role in enhancing grassroots TCM service capabilities and meeting public demand for TCM healthcare.However,challenges persist in establishing these alliances,including insufficient Party leadership at primary TCM institutions and deficiencies in clinical services,talent de-velopment,and emergency care capacity.This study examines innovative Party building approaches in public hospitals within the new era context,analyzing practical cases of alliance development.Our findings demonstrate that integrating Party building into the governance structure of medical alliances not only strengthens Party leadership at primary TCM institutions but also significant-ly promotes TCM service development.Systematic analysis of case hospital practices reveals several key insights.Firstly,strengthening top-level design through Party committee leadership is crucial.Secondly,addressing the most pressing public healthcare concerns with genuine commitment forms the foundation.Thirdly,deep integration of Party building with core medical services represents the essential approach.Lastly,policy-responsive innovation based on consolidated achievements serves as the key driver.

Objective To explore expression and significance in serum levels of soluble receptor for advanced glycation end products (sRAGE) and interleukin-36 (IL-36) in patients with Hashimoto's thyroiditis (HT). Methods A total of 180 individuals suspected of HT were enrolled as study subjects and divided into HT group (n=137) and non-HT group (n=43) based on final diagnostic outcomes. Within the HT group, patients were further divided into serum immunoglobulin G4 (IgG4)-related HT group (IgG4≥135 mg/dL) and non-IgG4-related HT group (IgG4 < 135 mg/dL) according to serum IgG4 levels. Serum levels of sRAGE and IL-36γ were measured in all subjects using enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of serum sRAGE and IL-36γ levels forHT and its IgG4 phenotype. Results Serum sRAGE levels were significantly lower in the HT group compared to the non-HT group, while serum IL-36γ levels were significantly higher (P < 0.001). Patients in the IgG4-related HT group had significantly lower serum sRAGE levels and higher serum IL-36γ levels compared to those in the non-IgG4-related HT group (P < 0.001). ROC curve analysis revealed that the combined diagnosis of serum sRAGE and IL-36γ for HT had an area under the curve (AUC) of 0.900 (95%CI, 0.846 to 0.939), demonstrating significantly higher diagnostic efficiency than either indicator (P < 0.05). For the IgG4 phenotype in HT patients, the combined AUC of serum sRAGE and IL-36γ was 0.897 (95%CI, 0.934 to 0.943), which also significantly higher than individual indicator (P < 0.05). Conclusion Serum sRAGE levels are significantly decreased, while serum IL-36γ levels are significantly increased in HT patients. Combined detection of serum sRAGE and IL-36γ levels can effectively diagnose HT and assess the IgG4 phenotype.

Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective To investigate the efficacy of rituximab combined with immunosuppressive pulse therapy for thyroid-associated ophthalmopathy(TAO)and analyze its influence on clinical activity score(CAS)and prognosis.Meth-ods A total of 136 patients(272 eyes)with TAO who were admitted to Huanggang Central Hospital from March 2020 to October 2022 were selected and divided into an observation group(68 patients)and a control group(68 patients)using a random number table method.Patients in the control group were given immunosuppressive pulse therapy,while patients in the observation group were given rituximab plus immunosuppressive pulse therapy.Both groups were treated for 4 courses(7 days per course).The clinical efficacy,eye signs,CAS score,thyroid conditions[thyrotropin receptor antibody(TRAb),thyroid peroxidase antibody(TPOAb),thyroid volume],T lymphocyte subsets,and adverse reactions were compared between the two groups.After a follow-up period of six months,the prognosis of patients in the two groups was compared.Results After 4 courses of treatment,the total effective rate of patients in the observation group was 94.12％(64/68),which was higher than that in the control group(82.35％,56/68)(P＜0.05).After 2 and 4 courses of treat-ment,the degree of exophthalmos,intraocular pressure,average palpebral fissure width,retrobulbar soft tissue volume,distance from the bulbus oculi,CAS score,TPOAb,TRAb,and thyroid volume of patients in the observation group were smaller than those in the control group,and all decreased compared to before treatment(all P＜0.05);the thickness of the tear film lipid layer was greater than that in the control group,and both increased compared to before treatment(all P＜0.05).There were no significant differences in the said indicators between the two groups before treatment(all P＞0.05).The CD3+,CD4+,and CD8+T lymphocyte levels of patients showed no significant difference between the two groups before treatment(all P＞0.05).After 2 and 4 courses of treatment,the levels of CD3+and CD4+T lymphocyte in both groups were higher than those before treatment.Except that the CD4+T lymphocyte level in the observation group was lower than that in the control group after 2 courses of treatment,the levels of CD3+and CD4+T lymphocyte in the obser-vation group were higher than those in the control group at other time points(all P＜0.05).After 2 and 4 courses of treat-ment,the level of CD8+T lymphocyte in both groups decreased compared to before treatment,and it was lower in the ob-servation group than the control group(all P＜0.05).There was no significant difference in the incidence of adverse reac-tions such as low fever,nausea,and hypokalemia between the two groups(all P＜0.05).After the 6-month follow-up,the improvement rate of patients in the observation group was 95.59％(65/68),which was higher than that in the control group(79.41％,54/68)(P＜0.05).Conclusion Rituximab combined with immunosuppressive pulse therapy is effec-tive for TAO.It can alleviate eye signs and thyroid conditions,reduce clinical activity,and promote prognosis.

Objective To explore esomeprazole(EMZ)on acetaminophen(APAP)pharmacokinetics and intestinal microbial balance.Methods A total of 14 rats were randomly allocated into two groups,with 7 rats in each group:acetaminophen group(APAP group),and acetaminophen+esomeprazole combination group(APAP+EMZ group),respectively.Rats in the combination group were fed in the metabolic cage.Equivalent 3.6 mg·kg-1·d-1 esomeprazole was administered intragastrically to the combination group for 14 days;Similarly,an equal volume of 0.9％sodium chloride soution(NaCl)was fed to the APAP group for 14 days.During this period,fecal samples were collected from the rats before and after 14 days of EMZ administration for microbial 16S rRNA sequencing.On the 15th day,both the APAP group and APAP+EMZ groups were administratered an equivalent of 44.82 mg·kg-1 APAP by the same method after the regular EMZ administration.The concentrations of APAP in rat plasma were determined by the UPLC-MS/MS method.Main pharmacokinetic parameters were processed and compared using the software DAS 3.0.1 and SPSS 24.0.Results The pharmacokinetic parameter Cmax of APAP was significantly different between APAP group and APAP+EMZ group(P＜0.05).Compared with APAP group,Cmax increased by 120.38％in the APAP+EMZ group.The pharmacokinetic parameters(AUC(0-∞)、CL、t 1/2、tmax)of APAP showed no statistical differences between APAP group and APAP+EMZ group(P＞0.05).The results of 16SrRNA of intestinal flora showed that the abundance of Lactobacillus,Bacteroides,Clostridium,and Escherichia decreased compared with that before drug administration,while the abundance of Bifidobacterium increased.However,the relative abundance of the above flora showed no prominent differences before and after the EMZ intervention(P＞0.05).Conclusions This study showed that when combining EMZ with APAP,the relative abundance of those related flora,which may influence the β-Glucuronidase,all changed to some extent,but made no difference in statistics.The effect of EMZ on the Cmax of APAP was statistically significant.However,the use of EMZ for two weeks did not alter the other pharmacokinetics of APAP by affecting the gut microbiota.

Objective To explore the intestinal flora distribution characteristics in patients with Hashimoto's thyroiditis(HT)and analyze the correlation between intestinal flora changes and HT and the predictive value on the occurrence of HT,so as to provide reference for clinical diagnosis and treatment of HT.Methods A total of 120 patients with HT admitted to Qinhuangdao Traditional Chinese Medicine Hospital from June 2022 to June 2023 were included in observation group,and 30 healthy physical examination subjects during the same period were enrolled as control group.Both groups performed intestinal flora detection and thyroid function detection.The α diversity and the relative abundance of intestinal flora at phylum level were compared between the two groups and among HT patients with different thyroid functions,and the correlation between α diversity of intestinal flora and relative abundance of intestinal flora at phylum level,serum levels of anti-thyroglobulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)and thyroid function was analyzed by spearman correlation analysis.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of α diversity and relative abundance of intestinal flora at phylum level on HT.Results Compared with control group,the intestinal flora α diversity indexes of shannon-wiener diversity index(shannon)and simpson diversity index(simpson)were lower in observation group[4.66±0.61 vs 5.21±0.46,0.89±0.06 vs 0.93±0.07],and the differences were statistically significant(r=4.617,3.156,P＜0.05).The relative abundance of Bacteroidetes in observation group was lower than that in control group(52.31％±2.02％vs 58.59％±2.11％),while the relative abundances of Firmicutes,Proteobacteria,Fusobacteria,Actinobacteria and Verrucomicrobia were higher than those in control group(37.15％±2.43％vs 33.46％±2.56％,3.36％±0.26％vs 2.79％±0.19％,1.02％±0.09％vs 0.65％±0.11％,1.01％±0.12％vs 0.57％±0.13％,0.82％±0.11％vs 0.41％±0.09％),and the differences were statistically significant(t=15.096,7.360,11.267,19.231,17.665,18.882,all P＜0.001).The levels of serum TgAb(169.12±10.23 IU/ml vs 18.59±1.78 IU/ml)and TPOAb(56.43±12.11 IU/ml vs 2.51±0.57 IU/ml)in observation group were higher compared with those in control group,and the differences were statistically significant(t=80.097,24.319,all P＜0.001).Among 120 HT patients in this study,there were 89 cases with normal thyroid function and 31 cases with abnormal thyroid function.The intestinal flora α diversity indexes of shannon(4.49±0.64 vs 4.83±0.58),and simpson(0.87±0.07 vs 0.91±0.05)in patients with abnormal thyroid function were lower than those in normal patients,and the differences were statistically significant(t=2.736,3.439,all P＜0.05).The relative abundance of Bacteroides was lower(49.10％±1.99％vs 55.52％±2.05％),while the relative abundances of Firmicutes,Proteobacteria,Fusobacteria,Actinobacteria and Verrucomicrobia were higher than those in normal people(38.87％±2.60％vs 35.43％±2.26％,3.60％±0.26％vs 3.12％±0.19％,1.15％±0.09％vs 0.89％±0.11％,1.16％±0.13％vs 0.86％±0.11％,0.97％±0.13％vs 0.67％±0.09％)],and the differences were statistically significant(t=15.128,7.016,9.849,14.576,12.464,14.148,all P＜0.001).Spearman correlation analysis showed that the intestinal flora α diversity indexes(shannon and simpson)and relative abundance of Bacteroides in patients with HT were negatively correlated with serum TgAb and TPOAb levels(r=-0.436,-0.427,-0.402;-0.419,-0.456,-0.416,all P＜0.001),but were positively correlated with thyroid function(r=0.401,0.409,0.487,all P＜0.001).The relative abundances of Firmicutes,Proteobacteria,Fusobacteria,Actinobacteria and Verrucomicrobia were positively correlated with serum TgAb and TPOAb levels(r=0.411,0.441,0.447,0.421,0.447;0.425,0.415,0.438,0.402,0.469,all P＜0.001),but were negatively correlated with thyroid function(r=-0.412,-0.417,-0.475,-0.463,-0.471,all P＜0.001).ROC curve analysis revealed that the best cut-off value,the area under curve(AUC),sensitivity,specificity,95％confidence interval(95％CI)and Youden index in shannon,simpson,combined detection of simpson and shannon,and the combined detection of relative abundance of intestinal bacteria at phylum level for predicting HT were 4.677,0.749,49.17％,96.67％,95％CI(0.672～0.816)and 0.458;0.940,0.644,80.00％,53.33％,95％CI(0.562～0.721)and 0.333;0.752,85.83％,50.00％,95％CI(0.664～0.810)and 0.462;0.743,96.67％,46.67％,95％CI(0.665～0.811)and 0.548,respectively Conclusion HT had intestinal flora imbalance which was related to thyroid cell destruction and thyroid dysfunction in patients with HT.Intestinal flora detection has predictive efficiency on HT.