Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

AIM: To compare the effects of defocus incorporated multiple segments(DIMS)lens with highly aspherical lenslets(HAL)on delaying the progression of myopia in adolescents.METHODS: Clinical randomized controlled study. Totally 301 students aged 7-12 who underwent optometry in our hospital from January 2021 to June 2023 were randomly divided into two groups. The first group consisted of 154 patients who were fitted with DIMS lenses(DIMS group). In the second group, 147 cases were fitted with HAL(HAL group). Both groups used 0.01% atropine eye drops to control myopia and all students wore glasses for more than 12 h every day. The spherical equivalent(SE)and axial length(AL)after rapid mydriasis were recorded. The data of the right eyes were taken, and the results after fitting for 12 mo were compared between the two groups.RESULTS: Multiple linear regression analysis showed that baseline age was significantly correlated with the changes of SE and AL(all P<0.01). After controlling baseline variables, the adjusted changes in SE for 12 mo after wearing glasses in the DIMS group and HAL group were -0.41±0.18 and -0.34±0.13 D, respectively(P<0.001); the changes of AL in the DIMS group and HAL group were 0.31±0.08 and 0.27±0.06 mm, respectively(P<0.001). Patients were divided into younger group(7-9 years old)and older group(10-12 years old). The changes in SE(t=2.250, P=0.025)and AL(t=3.120, P=0.002)of the younger group who wearing DIMS lens were greater than those with HAL after 12 mo, and the same was true in the older group(t=5.931, 5.033, both P<0.001).CONCLUSION: Under the condition of combined use of 0.01% atropine eye drops, HAL is more effective than DIMS lens in controlling myopia diopter and AL of adolescents.

Charcot-Marie-Tooth diseases are a group of most common inherited peripheral neuropathies. The predominant clinical presentations include distal predominance of limb-muscle weakness and atrophy, and sensory loss, as well as skeletal deformities such as pes cavus and scoliosis. On the basis of electrophysiological studies, nerve pathology, and inheritance characteristics, Charcot-Marie-Tooth diseases are subdivided into several types. Genetic tests are helpful to identify the pathogenic genes. Rehabilitation, surgical treatment, and symptomatic drug therapy contribute to ameliorate symptoms and skeletal deformities. Some specific therapeutic drugs targeting pathogenesis have been tested in clinical trials, though their efficacy and safety require further investigation.

Objective To analyze serum characteristics and determine the reference range for thyroid function among healthy 11～16 year-old teenagers in Xi'an in order to offer a theoretical basis for clinical diagnosis and therapy.Methods A sum of 1 378 healthy 11～16 year-old teenagers who met the inclusion criteria from the First Affiliated Hospital of the Air Force Medical University(Xijing Hospital)between January 2020 and December 2022 were selected as research subjects,including 628 males and 750 females.They were divided into three groups based on age:Group 1:11～＜13 year-olds(433 cases),Group 2:13～＜15 year-olds(425 cases),and Group 3:15～≤16 year-olds(520 cases).Differences in serum thyroid function indices among different genders and age groups were analyzed,the reference ranges for these indices were established,and 99 healthy 11-16 year-old teenagers who met the inclusion criteria were chosen for verification.Results There were no significant differences between different genders in thyroid stimulating hormone[TSH,2.56(1.80,3.63)μIU/ml vs 2.43(1.68,3.48)μIU/ml]and total thyroxine[TT4,97.84(85.34,111.00)nmol/L vs 98.20(87.16,111.23)nmol/L],the differences were statistically significant(Z=-1.881,-0.638,all P＞0.05).Meanwhile,the differences in free thyroxine[FT4,16.93(15.49,18.60)pmol/L vs 16.26(14.80,17.83)pmol/L],free triiodothyronine[FT3,6.21(5.66,6.80)pmol/L vs 5.59(4.98,6.19)pmol/L],and total triiodothyronine[TT3,2.24(1.96,2.55)nmol/L vs 2.04(1.78,2.34)nmol/L]between different genders were significant(Z=-5.368,-11.994,-6.417 all P＜0.01).The differences in thyroid function indices were significant among different age groups(Z=10.649～261.003,all P＜0.05).The reference ranges for thyroid function indices across different age groups and genders were established,in which thyroid function indicators were verified to be within the established reference range by 99 samples.Conclusion Teenage hormone secretion varies greatly,and the secretion of thyroid hormones is influenced by various factors.Thus,the diagnosis and treatment of teenage thyroid diseases cannot fully rely on the reference ranges provided by adults or manufacturers.This study established the reference range of the thyroid function indices of 11～16 year-old teenagers in Xi'an,offering clinical doctors'diagnosis and treatment data support.

Objective:To explore the clinical characteristics and pathogenic variant in a child with Cantú syndrome (CS).Methods:A male who was admitted to the Children′s Hospital Affiliated to Zhengzhou University on February 23, 2022 was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and his parents were collected and subjected to whole-exome sequencing (WES). Candidate variant was verified by Sanger sequencing. This study was approved by Medical Ethics Committee of the Children′s Hospital Affiliated to Zhengzhou University (Ethics No. 2023-K-087).Results:The child, a 3-year-and-2-month-old male, was born with hirsutism, with heavy hair all over the body and peculiar facial features. Routine echocardiography 1 month before had discovered atrial septal defect. Sequencing revealed that the child has harbored a heterozygous c. 2438G>C (p.S813T) variant of the ABCC9 gene, which was de novo in origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c. 2438G>C variant was classified as likely pathogenic (PS2+ PM2_Supporting+ PP3). Conclusion:The heterozygous c. 2438G>C variant of the ABCC9 gene probably underlay the pathogenesis of CS in this child.

Purpose To investigate the value of MYB and Notch1 immunohistochemical staining in the differential diagno-sis of classic adenoid cystic carcinoma of the breast(C-AdCC)and solid-basaloid adenoid cystic carcinoma of the breast(SB-AdCC).Methods MYB and Notch1 immunohistochemical staining were performed in 20 cases of C-AdCC,6 cases of SB-AdCC and 65 cases of other breast lesions in the archives of pa-thology department.26 cases of AdCC were detected by FISH,and 6 cases of SB-AdCC were detected by NGS.Results MYB immunohistochemical staining showed that C-AdCC(20/20)was moderately or strongly positive,while SB-AdCC(4/6)was mod-erately or strongly positive.Collagenous spherulosis(5/5)showed focal or diffuse weak positivity;Malignant adenomyoepi-thelioma(3/3)was focally moderately or strongly positive;8 matrix-producing carcinomas and 9 secretory carcinomas and 40 non-specific triple-negative breast cancers were negative.Immu-nohistochemistry of Notch1 showed diffuse moderate positive for SB-AdCC(3/6)and negative for C-AdCC(20/20).3 cases of malignant adenomyoepithelioma,5 cases of collagenous spherulo-sis,8 cases of matrix-producing carcinoma,9 cases of secretory carcinoma and 40 cases of non-specific triple-negative breast cancer were negative.FISH showed MYB gene disruption in C-AdCC(12/19)and NGS showed SB-AdCC(3/6)Notch1 muta-tion.Conclusion Moderately or strongly diffuse expression of MYB and Notch1 by immunohistochemistry can assist in the dif-ferentiation of C-AdCC from SB-AdCC,and it can be further clarified by molecular detection when it is difficult to distinguish malignant adenomyoepithelioma.

Objective To investigate changes and clinical significance of serum microRNA-155(miR-155)and microRNA-205-5p(miR-205-5p)levels in patients with hepatitis C virus(HCV)infection.Methods A total of 141 patients with HCV infection were collected and divided into the HCV-1b group(92 cases)and the non HCV-1b group(49 cases)according to their genotype,and another 141 healthy volunteers who underwent physical examinations in our hospital during the same period were collected as the control group.The general information,biochemical indicators and serum levels of miR-155 and miR-205-5p were compared between the three groups.According to the grading of hepatitis activity,HCV infected patients were classified into the G0,G1,G2,G3 and G4 groups,and serum levels of miR-155 and miR-205-5p were compared between the five groups.Receiver operating characteristics(ROC)curve was used to analyze clinical values of serum miR-155 and miR-205-5p in diagnosing hepatitis activity of G1-G4 in patients with HCV infection.Results The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)were obviously higher in the HCV-1b group and the non HCV-1b group than those in the control group,while the level of ALB was obviously lower than that in the control group(P＜0.05).The serum level of miR-155 was increased in turn in the control group,the non-HCV-1b group and the HCV-1b group,and the serum level of miR-205-5p was decreased in turn(P＜0.05).The serum level of miR-155 increased in turn with the increased grading of hepatitis activity,while the serum miR-205-5p level decreased in turn(P＜0.05).The area under curve(AUC)values of serum miR-155,miR-205-5p and their combination in diagnosing hepatitis activity of G1-G4 in HCV infected patients were 0.855,0.793 and 0.913,respectively,and the combination of the two is superior to each individual diagnosis(P＜0.05).Conclusion The serum miR-155 level increases and miR-205-5p level decreases in HCV infected patients.The combination of the two has high efficacy in diagnosing hepatitis activity of G1-G4 in HCV infected patients.

This article reported a typical case of paroxysmal kinesigenic dyskinesia(PKD).The patient was a 26-year-old female with a medical history of 10 years.The patient manifested as paroxysmal choreoathetosis of the limb and head triggered by sudden movement in a quiet state,without sensory aura.The symptoms resolved spontaneously after tens of seconds.She was conscious during and between attacks,had a clear family history and a normal neurological examination.No abnormalities were found in brain magnetic resonance image and electroencephalogram.Genetic test showed a frame-shift mutation of c.776del in PRRT2 gene of the proband and her father with similar phenotype.The patient was diagnosed with PKD according to the diagnostic criteria for PKD.The symptoms were significantly relieved after one month of oxcarbazepine treatment with good prognosis.PKD is a rare movement disorder.The patient has typical symptoms,and the mutation site has not been reported in the Human Gene Mutation Database.Therefore,this article enriched the pathogenic gene mutation spectrum of PKD,provided a basis for genetic counseling of PKD and increased the awareness of this rare disease among physicians.

The aim of the present study was to investigate the protective mechanism of Forsythia suspensa extracts(FSE)on S.aureus-induced inflammatory injury of rat mammary epithelial cells.Fifty lactating rats were selected and randomly divided into five groups with 10 rats each:the blank control group(the fourth pair of mammary glands were injected with saline),the model group(the fourth pair of mammary glands were injected with 100 pL of S.aureus bacterial solution),the high-dose group(the fourth pair of mammary glands were injected with S.aureus bacterial solu-tion for 24 h,and then the rats were administered by gavage of 3.750 g/(kg·d)FSE for 1-7 d),the medium-dose group(24 h after the fourth pair of mammary injections,the rats were adminis-tered by gavage 1.875 g/(kg·d)FSE for 1-7 d),and in the low-dose group(24 h after the fourth pair of mammary injections,the rats were administered by gavage 0.935 g/(kg·d)FSE for 1-7 d),blood samples were collected 24 h after the last administration of the drug and then the rats were executed.The results showed that the mammary tissue of the model group was severely dam-aged,and the mRNA expression of IKKβ,MyD88,NF-κB,and TLR4 was significantly increased in the mammary tissue(P＜0.05).The relative expression of IKKβ,MyD88,NF-κB,and TLR4 pro-teins in the mammary tissue of the model group was significantly decreased(P＜0.05)by medium and high doses of FSE compared with the model group.Therefore,FSE may play an anti-inflammatory role by inhibiting the Toll-like signaling pathway to improve S.aureus-induced inflammatory re-sponse in rat mammary epithelial cells and decrease the expression of the downstream pathway proteins IKKβ,MyD88,NF-κB,and TLR4.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.