Objective: To investigate the efficacy, safety, and traditional Chinese medicine (TCM) medication patterns of rituximab (RTX) combined with TCM on treating children with steroid-dependent nephrotic syndrome (SDNS). Methods: One hundred and forty-three children with SDNS who visited the Pediatric Nephrology Department of the First Affiliated Hospital of Henan University of Chinese Medicine from January 2018 to December 2022 were enrolled. A cohort study design was adopted, with " RTX treatment" as the exposure factor. Children who met this exposure factor were assigned to the RTX cohort (RTX, glucocorticoid, immunosuppressive agent, combined with traditional Chinese medicine syndrome differentiation treatment), whereas those who did not were assigned to the basic treatment cohort (glucocorticoid, immunosuppressive agent, combined with traditional Chinese medicine syndrome differentiation treatment ), and followed up for 6 months. The frequency of urinary protein recurrences, urinary protein remission duration, proportion and duration of steroid reduction and cessation, cumulative usage of steroids, proportion of recurrence, recurrence amount of steroid used, efficacy of TCM syndrome, and laboratory and safety indicators after treatment, and height and CD19+ B cell count before and after treatment were compared between the two cohorts. The medication patterns of TCM in the two cohorts were analyzed using frequency statistics, association rule analysis, and systematic clustering analysis. Results: Compared with the basic treatment cohort, the RTX cohort showed a decrease in the frequency of urinary protein recurrence, extended sustained remission of urinary protein, an increase in the proportion of steroid reduction and cessation, a shorter duration of steroid reduction and cessation, a decrease in cumulative steroid dosage, a lower recurrence rate, a decrease in CD19+ B cell count, and a decrease in 24-h urinary total protein quantification and the level of cholesterol (P<0.05). No significant difference in the recurrence amount of steroid used, height, TCM syndrome efficacy, albumin, aspartate transaminase, blood urea nitrogen, platelet count, and safety indicators between the two cohorts. Children with SDNS were mostly characterized by qi and yin deficiency syndrome, followed by spleen and kidney yang deficiency syndrome. A total of 175 TCMs were included, including 28 high-frequency drugs such as Huangqi, Fuling, Gancao, Baizhu, Dangshen, and Jiuyurou. The primary use of medication is to nourish the qi and spleen, nourish the kidney, and warm yang. The analysis of association rules yielded eight binary associations and ten three-phase associations, with Huangqi, Baizhu, Fuling, and Dangshen, being the most closely related. Cluster analysis identified four TCM combinations, primarily focusing on tonifying kidney and replenishing essence, benefiting qi and nourishing yin, and removing blood stasis. Conclusion RTX combined with TCM syndrome differentiation treatment can reduce the recurrence frequency of SDNS, prolong the remission period, reduce the glucocorticoid dosage, and have no marked effect on height growth. No apparent adverse reactions were observed. TCM should focus on nourishing qi and yin while removing blood stasis.

Objective To analyze the current status of clinical trial registration in the TCM treatment of diabetic nephropathy(DN);To provide references for the registration and implementation of relevant clinical trials.Methods Clinical trials about TCM treatment for DN registered in the Chinese Clinical Trial Registry(ChiCTR)and the U.S.Clinical Trial Registry(ClinicalTrials.gov)from their inception to August 18,2024 were retrieved.The following information was analyzed:registration year,geographical distribution,funding sources,TCM syndrome patterns of participants,number of research centers,sample size,study type,study design,randomization method,blinding method,intervention measures,outcome indicators and safety indicators.Results A total of 88 clinical trials were included,comprising 79 interventional studies and 9 observational studies.The number of registrations has increased annually.The domestic registered trials were distributed across 17 provincial-level administrative regions in China,with Beijing and Shanghai having the highest number of registrations.The primary sources of funding were local and national government funds.The most common TCM syndrome pattern among participants was qi-yin deficiency with blood stasis.Most trials were single-center studies,with the majority having a sample size between 31 and 60.The predominant study type was interventional,mostly randomized controlled trials(RCTs),with simple randomization being the most frequently used method.31 trials reported blinding methods,with double-blinding being the most common.The intervention measures were mostly oral Chinese patent medicines or TCM compounds,and the outcome indicators were mainly efficacy indicators,with less safety indicators.Conclusion The number of registered clinical trials on TCM treatment for DN has increased annually;however,the overall number remains limited.There is uneven regional distribution and incomplete registration information for various factors such as randomization methods,blinding methods,number of research centers,intervention measures,and outcome indicators.

Objective To review the diagnostic information of 3368 viral hepatitis B inpatient cases reported by some healthcare institutions in Qinghai Province in the National Notifiable Disease Report System(NNDRS)in 2021,and to analyse the consistency of their reports and influence factor.Methods The study used the typical survey method to study 3368 hospitalized cases of hepatitis B reported by 32 medical institutions in Qinghai Province in 2021 from July 2022 to April 2023.The consistency between the reported classification and the reviewed classification was evaluated by reviewing diagnostic information of the cases,combined with the Kappa consistency test,and the consistency-influencing factors were analysed in a univariate and multivariate analysis.Results The consistency between acute,chronic,and unclassified reporting classifications and review classifications was poor(Kappa＜0.40);the consistency between acute and chronic review was poor(Kappa＜0.40).The main influence factor of the consistency of review included the level of medical institution,the patient's gender,occupation,past history,and the unit of diagnosis of initial onset of illness.Provincial medical institutions reported higher consistency,and male cases and herder cases had better consistency than female cases and other occupations.Review consistency of cases with past history was better than that of cases with unclear past history.Conclusion The consistency of diagnosis and reporting of hepatitis B cases in healthcare institutions in Qinghai Province in 2021 was low,with problems of inaccurate classification and duplicate reporting.It is recommended to strengthen the training and supervision of healthcare institutions,standardise the filling of'attached card'information,and promote the hepatitis B core antibody IgM test to improve the classification and diagnosis of acute and chronic hepatitis B,so as to comprehensively improve the accuracy of the diagnosis and reporting of hepatitis B cases.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective To evaluate the correlation between MRI burden of cerebral small vessel disease and cognitive impairment in elderly hypertensive people.Methods Data of elderly hypertensive people with CSVD at Xingtai People's Hospital Affiliated to Hebei Medical University from January 2018 to September 2024 were analyzed.According to the total MRI burden score,patients were divided into mild to moderate(0-2)and severe(3-4)burden groups.The baseline data and cognitive impairment were compared between groups.The correlation between risk factors of MRI burden and cognitive impairment was analyzed.Results The severe burden group had higher systolic blood pressure[178(155,180)mmHg vs.159.50(147.75,170)mmHg,higher fasting blood glucose[5.70(5.37,5.92)mmHg vs.5.38(4.83,5.70)mmHg,P<0.05]and higher the proportion of cognitive impairment[8(28.1%)vs.3(6.8%),P<0.05]than the mild to moderate group.Multivariate logistic regression analysis revealed that systolic blood pressure(OR=1.033,95%CI:1.001-1.067,P<0.05)was the independent risk factor for total MRI burden.Spearman correlation analysis revealed that MRI total burden was negatively correlated with MMSE score(r=-0.315,P=0.011)and MoCA score(r=-0.662,P<0.001).Compared with the mild to moderate burden group,the severe group performed worse in the areas of orientation,attention and computation,language ability on the MMSE,and worse in visual space and executive ability,attention,language,delayed recall,and orientation on the MoCA(P<0.05).Conclusion Systolic blood pressure is the independent risk factor of MRI total burden in elderly hypertensive people.The higher the total MRI burden,the more severe the cognitive impairment,the worse performance in orientation,visual space and executive ability,attention and computation,language,and delayed recall.

Objective To explore the transvaginal three-dimensional ultrasound characteristics in women with abnormal uterine cavity and compare the diagnostic value with hysteroscopy.Methods A total of 102 women who underwent transvaginal three-dimensional ultrasound and hysteroscopy in the Department of Ultrasound of Lu'an People's Hospital for various reasons were selected as the research subjects.Hysteroscopy was the gold standard.The three-dimensional ultrasound characteristics of patients with different uterine cavity lesions were statistically analyzed.A 2×2 4-grid table was drawn to calculate the diagnostic value of transvaginal three-dimensional ultrasound for various types of uterine cavity lesions.Results There were 22 cases of endometrial polyps,9 cases of intrauterine adhesions,and 5 cases of submucosal fibroids.The accuracy rates of diagnosing endometrial polyps,intrauterine adhesions and submucosal fibroids through transvaginal three-dimensional ultrasound were 90.91%,88.89%and 80.00%,respectively.The transvaginal three-dimensional ultrasound of patients with endometrial polyps mainly showed deformation of the uterine cavity line,high echoic masses,clear differentiation between the edge of the echogenic mass and the endometrium,almost no deformation of the endometrial basal line,and scattered distribution of blood flow on CDFI ultrasound.Intrauterine adhesions mainly manifested as uneven endometrial thickness and low echogenicity by transvaginal three-dimensional ultrasound,and fluid accumulation may found in the uterine cavity of some patients.Transvaginal three-dimensional ultrasound showed that submucosal fibroids were mainly hypoechoic,elliptical or irregular in shape,with CDFI revealing abundant blood flow signals.Conclusion When women with abnormal uterine cavity are examined with transvaginal three-dimensional ultrasound,patients with different types of lesions have different typical ultrasound characteristics,and transvaginal three-dimensional ultrasound diagnosis has a high diagnostic accuracy with respect to hysteroscopy as the gold standard,exhibiting its advantages of non-invasive and rapid diagnosis,worthy of clinical promotion.

Objective This study aims to elucidate the functional mechanism through which seminal plasma exosomal miR-26a-5p and its target genes contribute to idiopathic teratozoospermia,with emphasis on their regulatory pathways in sperm morphogenesis defects,thereby establishing a theoretical foundation for novel diagnostic markers and targeted therapies.Methods A case-control study design was adopted,enrolling 154 male subjects(84 in the teratozoospermia group[TZS]and 70 in the normal control group[NC]).Seminal plasma exosomes were isolated to screen differentially expressed miRNAs,followed by prediction and analysis of target genes and signaling pathways.Dual-luciferase reporter gene assays were employed to validate the direct binding of miR-26a-5p to PTEN.Quantitative real-time PCR and Western blot were used to measure miRNA and protein expression levels.Spearman correlation analysis evaluated relationships between miR-26a-5p,PTEN,and sperm morphological parameters,while ROC curve analysis assessed diagnostic efficacy.Results Seminal plasma exosomal miRNA sequencing identified 11 differentially expressed miRNAs,with miR-26a-5p significantly upregulated in the TZS group(P<0.05)and negatively correlated with the percentage of normal sperm morphology in TZS(r=-0.762,P<0.05).PTEN was confirmed as a direct target of miR-26a-5p,with its expression significantly reduced in the TZS group(P<0.05)and positively correlated with normal sperm morphology(r=0.821,P<0.05).A negative correlation was observed between miR-26a-5p and PTEN(r=-0.878,P<0.05).Dual-luciferase assays demonstrated that miR-26a-5p specifically inhibited PTEN 3'UTR activity(45%reduction in luciferase activity,P<0.05).Functional enrichment analysis revealed that the miR-26a-5p-PTEN axis exacerbates oxidative stress,DNA damage,and abnormal spermatocyte division by regulating the PI3K/AKT/mTOR,p53,Wnt/β-catenin,and NF-κB pathways.ROC analysis showed diagnostic efficacy for teratozoospermia with AUCROC values of 0.785(sensitivity 78.9%,specificity 71.3%)for miR-26a-5p and 0.754(sensitivity 73.3%,specificity 75.1%)for PTEN.Conclusions miR-26a-5p suppresses PTEN through targeted inhibition,activating PI3K/AKT/mTOR signaling pathways while impairing DNA repair functions.This cascade leads to accumulated oxidative stress and sperm morphological abnormalities.The combined pattern of elevated seminal plasma exosomal miR-26a-5p expression and reduced PTEN levels demonstrates diagnostic potential for idiopathic teratozoospermia,with its molecular mechanism providing a theoretical foundation for biomarker development.Targeted silencing of miR-26a-5p,either alone or in combination with AKT/mTOR inhibitors and antioxidant therapy,may represent a novel strategy for improving sperm morphology.

Objective To investigate the expression levels of serum miR-186-5p and miR-942-5p in patients with glioma and their clinical significance.Methods A total of 98 patients with glioma who were treated in this hospital from October 2019 to December 2021 were selected as the monitored group,and 101 healthy indi-viduals who underwent physical examinations a the same time were selected as the control group.Quantitative fluorescent PCR(qPCR)method was applied to detect the expression levels of miR-186-5p and miR-942-5p in serum,and multivariate COX regression was applied to analyze the prognostic factors of glioma patients.Re-ceiver operating characteristic(ROC)curve and area under curve(AUC)were used to analyze the diagnostic value of serum miR-186-5p and miR-942-5p in glioma.Kaplan-Meier survival curve was used to analyze the re-lationship between serum miR-186-5p and miR-942-5p expression and prognosis of patients.Results The ex-pression level of serum miR-186-5p in monitored group was lower than that in the control group(P＜0.05),and the expression level of miR-942-5p was higher than that in the control group(P＜0.05).The AUC of ser-um miR-186-5p and miR-942-5p in the diagnosis of glioma alone and in combination were 0.735,0.809 and 0.895,respectively.There were significant differences in the proportion of low miR-186-5p expression and high miR-942-5p expression in serum of patients with different preoperative Karnofsky performance status(KPS)scores,World Health Organization(WHO)grades and local infiltration(P＜0.05).The 2-year surviv-al rate of patients with high expression of miR-186-5p was higher than that of patients with low expression of miR-186-5p(x2=6.455,P=0.011).The 2-year survival rate of patients with high miR-942-5p expression was lower than that of patients with low miR-942-5p expression(x2=9.858,P=0.002).miR-186-5p was a protective factor for mortality in glioma patients(P＜0.05),while miR-942-5p was a risk factor(P＜0.05).Conclusion Serum miR-186-5p expression level decreases and miR-942-5p expression level increases in glioma patients,both of which have certain diagnostic value for the occurrence of glioma.

Objective To analyze the current status of clinical trial registration in the TCM treatment of diabetic nephropathy(DN);To provide references for the registration and implementation of relevant clinical trials.Methods Clinical trials about TCM treatment for DN registered in the Chinese Clinical Trial Registry(ChiCTR)and the U.S.Clinical Trial Registry(ClinicalTrials.gov)from their inception to August 18,2024 were retrieved.The following information was analyzed:registration year,geographical distribution,funding sources,TCM syndrome patterns of participants,number of research centers,sample size,study type,study design,randomization method,blinding method,intervention measures,outcome indicators and safety indicators.Results A total of 88 clinical trials were included,comprising 79 interventional studies and 9 observational studies.The number of registrations has increased annually.The domestic registered trials were distributed across 17 provincial-level administrative regions in China,with Beijing and Shanghai having the highest number of registrations.The primary sources of funding were local and national government funds.The most common TCM syndrome pattern among participants was qi-yin deficiency with blood stasis.Most trials were single-center studies,with the majority having a sample size between 31 and 60.The predominant study type was interventional,mostly randomized controlled trials(RCTs),with simple randomization being the most frequently used method.31 trials reported blinding methods,with double-blinding being the most common.The intervention measures were mostly oral Chinese patent medicines or TCM compounds,and the outcome indicators were mainly efficacy indicators,with less safety indicators.Conclusion The number of registered clinical trials on TCM treatment for DN has increased annually;however,the overall number remains limited.There is uneven regional distribution and incomplete registration information for various factors such as randomization methods,blinding methods,number of research centers,intervention measures,and outcome indicators.

Objective To review the diagnostic information of 3368 viral hepatitis B inpatient cases reported by some healthcare institutions in Qinghai Province in the National Notifiable Disease Report System(NNDRS)in 2021,and to analyse the consistency of their reports and influence factor.Methods The study used the typical survey method to study 3368 hospitalized cases of hepatitis B reported by 32 medical institutions in Qinghai Province in 2021 from July 2022 to April 2023.The consistency between the reported classification and the reviewed classification was evaluated by reviewing diagnostic information of the cases,combined with the Kappa consistency test,and the consistency-influencing factors were analysed in a univariate and multivariate analysis.Results The consistency between acute,chronic,and unclassified reporting classifications and review classifications was poor(Kappa＜0.40);the consistency between acute and chronic review was poor(Kappa＜0.40).The main influence factor of the consistency of review included the level of medical institution,the patient's gender,occupation,past history,and the unit of diagnosis of initial onset of illness.Provincial medical institutions reported higher consistency,and male cases and herder cases had better consistency than female cases and other occupations.Review consistency of cases with past history was better than that of cases with unclear past history.Conclusion The consistency of diagnosis and reporting of hepatitis B cases in healthcare institutions in Qinghai Province in 2021 was low,with problems of inaccurate classification and duplicate reporting.It is recommended to strengthen the training and supervision of healthcare institutions,standardise the filling of'attached card'information,and promote the hepatitis B core antibody IgM test to improve the classification and diagnosis of acute and chronic hepatitis B,so as to comprehensively improve the accuracy of the diagnosis and reporting of hepatitis B cases.