OBJECTIVE To improve the inventory turnover rate of traditional Chinese medicine （TCM） decoction pieces in hospitals and achieve refined inventory management for cost reduction and efficiency improvement. METHODS Inventory data of TCM decoction pieces in our hospital from 2022 to 2023 were collected. Based on the sale amount and demand coefficient of variation respectively， the ABC classification method and XYZ analysis method were adopted for classification. The two classification results were combined through a cross matrix to divide them into three-level management priorities： level Ⅰ （AX， AY， BX）， level Ⅱ （AZ， BY， CX）， and level Ⅲ （BZ， CY， CZ）. Differentiated inventory strategies were formulated for each level， and core indicators such as turnover rate and inventory cost before and after inventory management optimization were compared. RESULTS There were 58 types （14.22%） in level Ⅰ， 85 types （20.83%） in level Ⅱ， and 265 types （64.95%） in level Ⅲ. After inventory management optimization， the average inventory value of TCM decoction pieces decreased by 341 800 yuan， the average turnover rate increased by 73.03%， and the average turnover days decreased by 4.98 days. The differences in all indicators before and after optimization were statistically significant （ P ＜0.01）. CONCLUSIONS The ABC-XYZ analysis method can break through the single-dimensional limitation of the traditional ABC classification method， adapt to characteristics such as the strong seasonality of TCM decoction pieces， significantly optimize the inventory structure， improve turnover efficiency， and reduce operating costs. It provides a feasible plan for the refined and scientific management of hospital TCM warehouses.

Objective:To explore the application value of the new inflammatory index in predicting the prognosis of patients with liver cirrhosis complicated with esophageal and gastric varices.Methods:This study was a single-center cross-sectional study. Patients who were hospitalized in the Department of Gastroenterology of Minhang Hospital, Fudan University due to liver cirrhosis combined with esophageal and gastric varices from January 2019 to February 2024 were included. All patients were diagnosed clearly based on clinical data, laboratory tests and imaging examination results. According to the results of the first fasting blood routine test after the patient′s admission, the monocyte/lymphocyte ratio (MLR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune inflammation index (SII) were calculated. Multivariate Cox regression analysis was used to screen the independent risk factors affecting the prognosis of patients with liver cirrhosis complicated with esophagogastric varices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value of MLR on survival. Kaplan-Meier survival analysis was used to compare the survival differences between patients with MLR>0.33 and those with MLR≤0.33.Results:A total of 177 patients were included, among which 155 were in the survival group and 22 were in the death group. The results of multivariate Cox regression analysis indicated that MLR was an independent risk factor for the prognosis of patients with liver cirrhosis complicated with esophageal and gastric varices [ HR=5.16(95% CI: 1.39-19.15), P=0.014]. The Kaplan-Meier survival curve analysis results showed that the survival rate of patients in the MLR>0.33 group was significantly lower than that in the MLR≤0.33 group (80.90% vs 94.32%, P=0.012). Stratified analysis showed that in patients who did not receive endoscopic intervention, MLR was closely related to prognosis. Conclusions:MLR can be used as an independent risk factor for the prognosis of patients with liver cirrhosis complicated with esophageal and gastric varices, which is helpful for clinicians to conduct risk assessment and thereby formulate personalized treatment strategies.

OBJECTIVE: To investigate the clinical and genetic features of a Chinese pedigree with Progressive familial intrahepatic cholestasis (PFIC) and explore its genotype-phenotype correlation. METHODS: A patient with PFIC diagnosed at Xinxiang Central Hospital in 2023 was selected as the study subject. The patient was subjected to abdominal magnetic resonance imaging (MRI) and painless gastroscopy. Peripheral blood samples were collected from the patient and his parents for the extraction of genomic DNA and trio-whole exome sequencing (trio-WES). Candidate variants were verified by Sanger sequencing. This study has been approved by the Medical Ethics Committee of Xinxiang Hospital (Ethics No. 2023-241). RESULTS: MRI scan showed that the patient had significantly enlarged liver and spleen. WES revealed that he has harbored compound heterozygous variants of the ATP8B1 gene, including a c.1710_1711insCCTC (p.A571Pfs*12) frameshifting variant in exon 16 and a c.2989G>A (p.V997M) missense variant in exon 24, which were respectively inherited from his father and mother, and rated as pathogenic (PVS1+PM2_Supporting+PM3+PP1) and likely pathogenic (PM2_Supporting+PM3+PP1) based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). CONCLUSION WES can clarify the genetic etiology of patients with speed and accuracy, and facilitate clinical decision-making. The detection of pathogenic variants has provided a basis for clinical diagnosis and enriched the mutational spectrum of the ATP8B1 gene.
Humans ; Male ; Pedigree ; Cholestasis, Intrahepatic/diagnostic imaging* ; Adenosine Triphosphatases/genetics* ; Female ; Adult ; Exome Sequencing ; Mutation ; East Asian People

OBJECTIVE: To analyze the clinical and genetic features of a child with Primary ciliary dyskinesia (PCD) due to compound heterozygous variants of the CCDC39 gene and a 22q11.21 deletion, and to explore the potential role of the two types of variants in the formation of complex phenotypes. METHODS: A child presented at the Shanxi Children's Hospital in March 2025 due to multiple congenital anomalies was selected as the study subject. Peripheral blood samples were taken from the child and her parents and subjected to whole-exome sequencing (WES). Candidate variants were verified by Sanger sequencing. Effect of splicing variant was predicted using SpliceAI, and pathogenicity was assessed based on the ACMG guidelines. Copy number variation (CNV) analysis was also performed. This study has been approved by the Medical Ethics Committee of the Hospital (Ethics No.: IRB-WZ-2025-019). RESULTS: The patient has exhibited multiple features including severe pneumonia, bronchiectasis, localized pulmonary emphysema, scoliosis, tetralogy of Fallot, and atrial septal defect. Genetic testing revealed that she has harbored compound heterozygous variants of the CCDC39 gene, namely c.1167+1G>A and c.1009A>T, which were inherited from her father and mother, respectively, with the latter being a novel likely pathogenic variant. In addition, a heterozygous deletion of approximately 708 kb at 22q11.21 was detected. CONCLUSION The coexistence of CCDC39 gene variants and a 22q11.21 deletion may underlay the development of complex clinical phenotypes in this child.
Humans ; Female ; Chromosomes, Human, Pair 22/genetics* ; Chromosome Deletion ; DNA Copy Number Variations/genetics* ; Child ; Ciliary Motility Disorders/genetics* ; Exome Sequencing

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

OBJECTIVE To establish and verify the risk prediction models for postoperative multidrug-resistant or-ganisms(MDROs)infections in the liver transplantation patients based on the machine learning algorithms so as to provide bases for identification of the population at high risk of postoperative MDROs infections.METHODS The liver transplantation patients who were retrospectively collected from intensive care Ⅳ database(MIMIC-Ⅳ)and eICU collaborative research database(eICU)were recruited as the research subjects,meanwhile,the patients who underwent liver transplantation in the First Hospital of Shanxi Medical University from Jan.2021 to Jul.2024 were assigned as the external verification group.The variables were selected by Lasso regression,and the models were established based on 7 types of machine learning algorithms such as extreme gradient boosting algorithm and random forest.The predictive performances of the models were evaluated by comparing the areas under receiver operating characteristic(ROC)curves and the accuracy,the characteristic variables were interpreted by Shapley additive explanations(SHAP),and the risk prediction calculator was established.RESULTS A total of 637 pa-tients were finally enrolled in the study,and the incidence of postoperative MDROs infections was 35.79％.Total-ly 15 variables were finally selected for construction of the model.The area under the receiver operating character-istic curve of XGBoost model was 0.82 for the internal test set,0.78 for the external test set;the predictive per-formance of XGBoost model was better than that of the rest of 6 models.SHAP algorithm indicated that the top 5 important predictive factors were as follows:hepatic encephalopathy,length of intensive care unit(ICU)stay,albumin,model of end-stage liver disease(MELD)and total length of hospital stay.CONCLUSION The risk pre-diction models that are established based on the machine learning algorithms have remarkable effect on prediction of the postoperative MDROs infections and can accurately identify the liver transplantation patients at high risk of postoperative MDROs infections,which may provide guidance for the identification of high-risk population and the development of prevention and treatment measures for infections.

Objective:To explore the application value of the new inflammatory index in predicting the prognosis of patients with liver cirrhosis complicated with esophageal and gastric varices.Methods:This study was a single-center cross-sectional study. Patients who were hospitalized in the Department of Gastroenterology of Minhang Hospital, Fudan University due to liver cirrhosis combined with esophageal and gastric varices from January 2019 to February 2024 were included. All patients were diagnosed clearly based on clinical data, laboratory tests and imaging examination results. According to the results of the first fasting blood routine test after the patient′s admission, the monocyte/lymphocyte ratio (MLR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune inflammation index (SII) were calculated. Multivariate Cox regression analysis was used to screen the independent risk factors affecting the prognosis of patients with liver cirrhosis complicated with esophagogastric varices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value of MLR on survival. Kaplan-Meier survival analysis was used to compare the survival differences between patients with MLR>0.33 and those with MLR≤0.33.Results:A total of 177 patients were included, among which 155 were in the survival group and 22 were in the death group. The results of multivariate Cox regression analysis indicated that MLR was an independent risk factor for the prognosis of patients with liver cirrhosis complicated with esophageal and gastric varices [ HR=5.16(95% CI: 1.39-19.15), P=0.014]. The Kaplan-Meier survival curve analysis results showed that the survival rate of patients in the MLR>0.33 group was significantly lower than that in the MLR≤0.33 group (80.90% vs 94.32%, P=0.012). Stratified analysis showed that in patients who did not receive endoscopic intervention, MLR was closely related to prognosis. Conclusions:MLR can be used as an independent risk factor for the prognosis of patients with liver cirrhosis complicated with esophageal and gastric varices, which is helpful for clinicians to conduct risk assessment and thereby formulate personalized treatment strategies.

This study analyzed the epidemiological characteristics and trends of respiratory syncytial virus (RSV) infections among inpatients with acute respiratory infections (ARI) in a children′s hospital in Shenzhen City inpatients from 2020 to 2023. From January 2020 to December 2023, multiple reverse transcription polymerase chain reaction (RT-PCR) combined with capillary electrophoresis fragment analysis technology was used to detect the nucleic acids of 12 respiratory pathogens, including RSV, in hospitalized children diagnosed with ARI. The patients were divided into six age groups: 0 to <6 months, 6 months to <1 year, 1 to <2 years, 2 to <5 years, 5 to <10 years, and 10 to <18 years. A total of 53 033 children were tested, including 6 830 RSV positive cases, with an overall positivity rate of 12.88%. The annual RSV positivity rates from 2020 to 2023 were 20.04%, 16.18%, 4.89%, and 13.33%, respectively, with statistically significant differences between the years ( χ2=1 185.994, P<0.001). The positive rate of RSV detection decreased with increasing age across all years (all P trend<0.05). From 2020 to 2023, the proportion of RSV-positive cases aged 2 to 5 years and older showed an increasing trend ( P trend<0.001 for all years). Compared to 2023, the median age of RSV-infected children was lower in 2020 ( Z=7.826, P<0.001) and 2021 ( Z=6.106, P<0.001). The proportion of severe infections requiring ICU admission did not change significantly across all years ( χ2=0.179, P=0.981). The RSV epidemic season in 2020 mainly occurred during 28-43 weeks, and in 2021, it spanned from 22-43 weeks. However, in 2022, the season was delayed until the 49th week and lasted for three weeks. In 2023, the seasonal epidemic appeared earlier, starting in the 14th week and lasting for 28 weeks. From 2020 to 2023, the rate of RSV co-infections with other pathogens (mycoplasma pneumoniae, human parainfluenza virus, human bocavirus, human coronavirus, human metapneumovirus, and influenza A) significantly increased (all P trend<0.01). In conclusion, the epidemiological characteristics of RSV infections in Shenzhen Children′s Hospital changed from 2020 to 2023. In 2022, there were only delayed, low-intensity and short-lived seasonal epidemics. However, in 2023, there was an earlier and prolonged epidemic, with increased infections in children aged 2 to 5 years and older and a rise in co-infections, while the proportion of severe infections requiring ICU admission remained unchanged.

Objective:To investigate the characteristic distribution of vaginal microbiota in infertile women.Methods:We collected the results of vaginal microbiological examinations from 19322 initial visit infertile women who visited the Reproductive Medicine Center of the Department of Obstetrics and Gynecology,the Second Affili-ated Hospital of Air Force Medical University from March 1,2023 to July 31,2024.The vaginal microbiota infection status of patients was compared in different age groups(＜25 years old,25-＜30 years old,30-＜35 years old,35-＜40 years old,≥40 years old)and different seasons(spring,summer,autumn,winter).Results:①Among 19322 women,6027 cases(31.19％)showed abnormal vaginal microecology.Pathogenic microorganisms were detected in 3093 cases,including 2882 cases of single vaginitis,211 cases of mixed vaginitis,3764 cases with vagi-nal cleanliness grade Ⅲ-Ⅳ,and 3965 cases with abnormal lactobacilli.Among patients with single vaginitis,1349 cases(46.81％)were diagnosed with vulvovaginal candidiasis(VVC),which was the highest proportion.Aerobic vaginitis(AV)followed with 752 cases(26.09％),and bacterial vaginosis(BV)had 671 cases(23.28％),trichomonal vaginitis(TV)with 110 cases(3.82％).Among patients with mixed vaginitis,AV+BV was the most common with 96 cases(45.49％).②The detection rates of cleanliness grade Ⅲ-Ⅳ,abnormal lactobacilli,abnor-mal microorganisms(unclear pathogen),single vaginitis(BV,VVC and TV),and mixed vaginitis showed statisti-cally significant differences across different seasons(P＜0.05).Specifically,the detection rates of cleanliness grade Ⅲ-Ⅳ and abnormal microorganisms(unclear pathogens)were significantly higher in autumn than in other seasons(P＜0.05),while the detection rate of abnormal lactobacilli was higher in spring than in other seasons(P＜0.05).③The detection rates of abnormal lactobacilli,abnormal microorganisms(unclear pathogen),single vaginitis(BV,VVC and AV),and mixed vaginitis showed significant differences among different age groups(P＜0.05).Specifically,the detection rate of abnormal microorganisms(unclear pathogen)was higher in the age group＜25 years than in other age groups(P＜0.05),while the detection rate of BV among single vaginitis cases was higher in the age group≥40 years than in other age groups(P＜0.05).Conclusions:The vaginal microecol-ogy of infertile women varies in terms of infection rates across different age groups and seasons.Patients with simple vaginitis have the highest rate of VVC,while those with mixed vaginitis have the highest proportion of AV+BV infection.

Objective: To investigate the mental health status and related factors among primary and secondary school students in western Yunnan Province, so ao to provide scientific evidences for advancing mental health education. Methods: In June 2024, a stratified cluster sampling method was employed to select 4 584 students from 18 schools across Diqing Tibetan Autonomous Prefecture, Lincang City and Baoshan City three regions in western Yunnan Province. The Mental Health Test (MHT) was used for assessment. Latent class analysis (LCA) and Logistic regression were applied for data classification and related factor analysis respectively. Results: The overall positive detection rate of MHT was 11.81%, with a mean total score of 40.50±19.25. The predominant issues were learning anxiety (58.4%), hypersensitivity tendency (31.1%), and self blame tendency (23.1%). LCA categorized students into four groups:severe psychological problems group (74.4% detection rate), learning anxiety hypersensitivity group ( 16.4 %), learning anxiety physical symptoms group (9.2%), and healthy group (0). Logistic regression revealed that compared with the healthy group, the severe problems group showed higher risks among females ( OR =3.01), junior/senior high school students ( OR =1.88/4.02), and those with authoritarian parenting ( OR =3.54); the anxiety hypersensitivity group had higher risks for females ( OR =1.87), senior high students ( OR =1.54), boarders ( OR =1.31), and authoritarian parenting recipients ( OR = 1.85 ); the anxiety physical symptoms group demonstrated increased risks among females ( OR =2.22), senior high students ( OR =2.58), and authoritarian parenting recipients ( OR =2.74), while lower risks were observed for students with parent/grandparent guardians ( OR =0.38) and non only children ( OR =0.58) (all P <0.05). Conclusions Mental health problems are prominent among students in western Yunnan, with gender, grade level, boarding status, guardian type, and parenting style being key determinants. Recommendations include strengthening mental health education, prioritizing left behind children s psychological well being and promoting healthy development.