Objective:To observe the efficacy and safety of combined lienal polypeptide injection therapy in the treatment of Mycoplasma pneumoniae pneumonia（MPP）in children aged 3 to 14 years old in multiple clinical centers.Methods:A randomized，controlled，multi-center clinical study design was adopted.A total of 240 hospitalized children aged 3 to 14 years old with MPP from 7 hospitals from September 1，2023 to January 31，2024 were included.According to the severity of pneumonia，they were divided into the mild MPP group with 80 cases and the severe MPP/refractory MPP（SMPP/RMPP）group with 160 cases，and then randomly divided into the control group and the experimental group at a ratio of 1 ∶1，using the random number table method.After screening，subjects entered a treatment period of 5 to 7 days.The control group was treated with azithromycin，while the experimental group was treated with azithromycin plus lienal polypeptide injection .The recovery of lung CT，length of hospital stay，duration of fever，cough score，whether mild cases developed into severe or refractory cases，duration of hormone use，use of intravenous immunoglobulin（IVIG），bronchoscopy treatment，and immune function were observed between the two groups to evaluate the efficacy of lienal polypeptide injection.Adverse events after medication，vital signs，blood routine，urine routine，liver function，myocardial enzymes，renal function，and electrocardiogram were observed to evaluate the safety. Results:A total of 231 subjects have completed the trial in the 7 hospitals，including 118 cases in the experimental group and 113 cases in the control group.Main observation index：the rate of lung CT aggravation in the experimental group was lower than that in the control group（2.6% vs 15.3%， P<0.01），and the difference was statistically significant.Secondary indexes：there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.However，the rate of cases of plastic bronchitis（PB）found under bronchoscopy in the experimental group was lower than that in the control group（0 vs 18.8%， P=0.03），and the difference was statistically significant.Among the mild MPP（72 cases），there were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and the improvement rate of lung CT between the two groups（all P>0.05）.However，compared with the control group，the rate of cases developing into SMPP/RMPP in the experimental group was less（24.3% vs 48.6%， P=0.03），and the difference in IgG before and after treatment was small［0.53（-0.04，1.18）g/L vs 1.33（0.48，2.25）g/L， P=0.01］.Among the SMPP/RMPP cases（159 cases），the rate of cases of PB found under bronchoscopy in the experimental group was less than that in the control group（0 vs 20%， P=0.04），and the rate of cases with aggravated lung CT in the experimental group was less than that in the control group（1.3% vs 19.5%， P<0.01），and the improvement rate of lung CT in the experimental group was higher than that in the control group（88.8% vs 75.3%， P=0.03），with statistically significant differences.There were no statistically significant differences in the length of hospital stay，duration of fever，cough score，duration of hormone use，whether IVIG treatment was used，the number of bronchoscopy treatment cases，and immunoglobulin between the two groups（all P>0.05）.Two cases in the experimental group developed rashes，which improved after the drug was discontinued.There were no serious adverse reactions such as abnormal vital signs like dyspnea and cyanosis due to the use of lienal polypeptide injection.There were no obvious changes in blood routine，liver function，myocardial enzymes，renal function，electrocardiogram，and urine routine values before and after medication compared with the baseline. Conclusion:The combined use of lienal polypeptide injection in the treatment of MPP in children can reduce the probability of the transformation from mild cases to SMPP/RMPP，reduce the rate of aggravation of the image findings，promote the absorption of lung inflammation，reduce the rate of PB found under bronchoscopy，and has good safety.

ObjectiveTo investigate the mechanism of Si Junzitang in treating liver injury in rats with spleen Qi deficiency syndrome based on transcriptomics and to experimentally verify its effects. MethodsSixty male SD rats were randomly divided into blank group， model group， low-dose Si Junzitang （6 g·kg^-1·d^-1）， medium-dose Si Junzitang group （12 g·kg^-1·d^-1）， high-dose Si Junzitang group （24 g·kg^-1·d^-1）， and natural recovery group， with 10 rats in each group. A composite multifactorial modeling method （forced swimming + intragastric administration of Xiao Chengqitang + irregular diet） was used to establish a spleen Qi deficiency model. After 30 days of continuous intervention， body weight and 3-hour food intake were measured， and macroscopic symptom scores for spleen Qi deficiency syndrome were evaluated. Serum levels of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） in each group were detected， and hematoxylin and eosin （HE） staining was used to observe histopathological changes in liver tissue. Transcriptome sequencing （RNA-Seq） was used to identify differentially expressed genes （DEGs） among the blank， model， and high-dose Si Junzitang groups. Gene ontology（GO） and Kyoto encyclopedia of genes and genome（KEGG） enrichment analyses were performed on the DEGs. Immunofluorescence （IF） and Western blot were used to detect NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein （ASC）， Caspase-1， and the N-terminal domain of gasdermin D （GSDMD-N）. Immunohistochemistry （IHC） was used to detect the expression of downstream inflammatory cytokines interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and interleukin-18 （IL-18）. ResultsCompared with the blank group， the model group showed significantly reduced body weight and 3-hour food intake， significantly increased macroscopic symptom scores， and elevated serum AST and ALT levels （P<0.01）， with mild inflammatory liver injury observed histologically. Compared with the model group， Si Junzitang at all doses significantly improved these parameters and alleviated liver injury in a dose-dependent manner （P<0.05，P<0.01）. RNA-Seq analysis revealed 1 254 DEGs between the blank and model groups， and 842 DEGs between the model and high-dose Si Junzitang groups. GO and KEGG enrichment analyses indicated that the NOD-like receptor signaling pathway was activated in liver injury associated with spleen Qi deficiency， suggesting that the NLRP3 inflammasome may be a key target. Results from IF， IHC， and Westernblot showed that compared with the blank group， the expression of NLRP3， ASC， Caspase-1， GSDMD-N， and the downstream inflammatory cytokines IL-1β， IL-6， and IL-18 were significantly increased in the model group （P<0.01）， while these levels were markedly decreased in the high-dose Si Junzitang group （P<0.01）. ConclusionSi Junzitang effectively improves mild inflammatory liver injury in rats with spleen Qi deficiency syndrome in a dose-dependent manner. Its mechanism may be associated with inhibition of the NLRP3/ASC/Caspase-1 signaling pathway， downregulation of the pyroptosis executioner protein GSDMD-N， and reduction of pyroptosis-related inflammatory cytokine release.

Low-intensity pulsed ultrasound(LIPUS)is a low-cost,non-invasive and safe treatment method mainly used for musculoskeletal diseases,especially for fractures and nonunion.This article reviews the therapeutic effects of LIPUS on various musculoskeletal and nervous system diseases and analyzes its mechanism and potential targets.It is found that besides fracture and nonunion,LIPUS also has clinical application prospect in treating osteoporosis,muscle injury,and motor nervous system diseases.

Objective To construct a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer and to evaluate its efficacy.Methods Through literature review and Delphi expert correspondence,a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer was constructed.By the convenience sampling method,200 consecutive children who received chemotherapy in the neurosurgery department of a tertiary children's hospital in Zhejiang province from February 1 to October 31,2023 were included as the application subjects,with 100 cases in an experimental group and 100 cases in a control group.The experimental group applied the non-drug intervention program of acute chemotherapy-related nausea and vomiting in children with cancer,and the routine measures were applied in the control group.The incidence of nausea and vomiting,severity of vomiting,compliance rate of normal sleep duration and incidence of negative emotions were compared between the 2 groups.Results The recovery rate of the valid questionnaire in 2 rounds of expert letter inquiry was 100％,and the expert authority coefficient was 0.836.The Kendall harmony coefficients were 0.471 and 0.820(P＜0.001),and the final non-drug intervention program for pediatric acute chemotherapy-related nausea and vomiting included 5 primary,14 secondary and 18 tertiary items.The results showed that the incidence of nausea,vomiting and negative emotions in the experimental group were lower than that in the control group,with statistically significant differences(P＜0.05).The severity of vomiting was less than it in the control group,with statistically significant difference(P＜0.05).The standard rate of normal sleep time was higher than that of the control group,and the difference was statistically significant(all P＜0.05).Conclusion The non-drug intervention program of chemotherapy-related nausea and vomiting in children is scientific and feasible,and the implementation of the program can reduce the incidence of nausea,vomiting and negative emotions,reduce the severity of vomiting,and improve the standard rate of normal bedtime in children.

Objective:To evaluate the effect of novel erythrocyte preservation solution on the quality of erythrocytes in stored blood of type 2 diabetes mellitus (T2DM) rats.Methods:Forty SPF male Sprague-Dawley rats, aged 8 weeks, weighing 180-220 g, were used in this study. Ten rats randomly selected served as conventional erythrocyte preservation solution group (group A). T2DM model was prepared in the remaining 30 rats. Twenty T2DM rats were divided into 2 groups ( n=10 each) using a random number table method: T2DM conventional erythrocyte preservation solution control group (group C) and T2DM novel erythrocyte preservation solution observation group (group Y). Erythrocyte preservation solution was prepared to simulate the preoperative autologous blood donation process, and blood was collected from the tail vein to isolate the red blood cells, and then the corresponding preservation solution was added. Immediately after blood collection (T 0) and at 7, 14 and 21 days of preservation (T 1-3), the morphological structure of erythrocytes was observed with a light microscope, and the concentrations of 2, 3-diphosphoglycerate (2, 3-DPG) and reactive oxygen species (ROS) were also determined by enzyme-linked immunosorbent assay at T 0-T 3 and 28 days of preservation (T 4). PKH26 was used to label the erythrocytes stored in vitro for 28 days, and then the erythrocytes were transfused back into rats. The survival rate of erythrocytes was detected by flow cytometry at 1, 7, 13 and 18 h after retransfusion. Results:The erythrocyte damage was aggravated at different time points of preservation in group C when compared with group A. Compared with group C, the damage to erythrocytes was significantly alleviated at different time points of preservation in group Y. Compared with group A, the concentration of 2, 3-DPG in erythrocytes was significantly decreased at T 0 and T 2-T 4, the concentration of ROS was increased at T 0-T 4, and the survival rate of erythrocytes was decreased at 1, 7 and 18 h after retransfusion in group C ( P<0.05). Compared with group C, the concentration of 2, 3-DPG in erythrocytes was significantly increased at T 0-T 4, the content of ROS was decreased at T 1, T 3 and T 4, and the survival rate of erythrocytes was increased at 1, 7 and 18 h after retransfusion in group Y ( P<0.05). Conclusions:The novel erythrocyte preservation solution can improve the quality of stored erythrocytes and increase the survival rate of erythrocytes in vivo after retransfusion in T2DM rats.

AIM: To observe the effect of RBC preservation solution with sodium pyruvate on the morphology, structure and function of RBC stored in vitro in type 2 diabetes rats. METHODS: Thirty SPF male SD rats, were randomly divided into 3 groups (n=10): non-T2DM conventional RBC preservation solution (group A), T2DM conventional RBC preservation solution (group B) and T2DM sodium pyruvate RBC preservation solution (group C). The leukoreduced RBC from the tail vein and stored for 0 d (T0), 7 d (T1), 14 d (T2), 21 d (T3) and 28 d (T4) to detect the morphology, structure and the contents of 2, 3-DPG, reactive oxygen species (ROS), malondialdehyde (MDA) and lactic acid (LA) of RBC in group A, B and C. The RBC stored for 14 days in vitro were labeled with PKH26, and its survival rate were tested in vivo at 1, 4, 10 and 16 hours after intravenous infusion. RESULTS: At T0, the RBC morphology of group A was intact, which was better than that of group B and group C. With the extension of storage time, the morphology of RBC in each group gradually transformed into a spindle-spherical shape. Compared with group A, the incidence of acanthocytes in group B and group C was higher, and the incidence of acanthocytes in group C was lower than that in group B. Compared with group A, the content of 2, 3-DPG in group B and group C decreased, while ROS and MDA increased at different time points (P<0.05). The content of 2,3-DPG in group C was higher than that in group B (P<0.05), and the contents of ROS and MDA were lower than those in group B (P<0.05). LA content in group B was higher than that in group A and group C (P<0.05). At T2-T4, the LA content in group C was lower than that in group A (P<0.05). The survival rate of RBC in group A was higher than that in group B and C, and the survival rate of RBC in group B was lower than that in group C (P<0.05). CONCLUSION: Sodium pyruvate added RBC preservation solution has a certain protective effect on RBC stored in vitro in type 2 diabetic rats, and its mechanism may be related to its antioxidant effect.

The"common medicines for various diseases"in the preface of Collective Commentaries on the Classic of Materia Medica has been highly praised by medical practitioners for its unique"disease-medicine"outline and clinical practicality,and has continued to be included and developed in later works on materia medica and prescriptions,laying the foundation for the research and develop-ment of"specialized prescriptions for specialized diseases"and"specialized medicines for specialized diseases".Tao Hongjing used"the root of major diseases"in Shen Nong's Classic of the Materia Medica as the basic framework,referred to the prescriptions and med-icines in Treatise on Cold Damage and Miscellaneous Diseases,and expanded his own and other medical experience to create the"com-mon medicines for various diseases"system,relating and summarizing the representative diseases and main therapeutic effects of medi-cines,and creating a"disease-medicine"outline system.The construction of the"common medicines for various diseases"system has opened up the precedent of"specialized prescriptions for specialized diseases"and"specialized medicines for specialized diseases",providing new prescription ideas for clinical differentiation and treatment.

【Objective】 To investigate the diagnostic efficiency of ¹⁸F-PSMA-1007 PET/CT in assessing the metastasis of newly diagnosed prostate cancer （PC）， and evaluate its relationship with clinical risk classification. 【Methods】 The clinical data of 257 newly diagnosed PC patients who underwent ¹⁸F-PSMA-1007 PET/CT between March 2019 and April 2021 were retrospectively reviewed in this study. All images were interpreted by two senior PET/CT diagnostic specialists. According to the D’Amico risk classification， the patients were divided into low-， intermediate- and high-risk groups. According to Gleason score （GS）， the patients were divided into GS≤6， GS=7， and GS≥8 groups. According to the level of serum total prostate-specific antigen （tPSA）， the patients were divided into <10 ng/mL， 10-20 ng/mL， and >20 ng/mL groups. Finally， in the groups with D’Amico risk classification， the subgroups were divided according to tPSA level and GS， and the differences of ¹⁸F-PSMA-1007 PET/CT in the detection of metastasis were compared among the subgroups. 【Results】 A total of 257 patients were enrolled with a median tPSA 16.34 （3.38-783.12） ng/mL and median Gleason score （GS） 8 （range： 6-10）. There were 10 （3.89%）， 36 （15.01%）， and 211（80.10%） PC patients in the low-， intermediate-， and high-risk groups， respectively. The rate of metastasis in high-risk group， GS ≥ 8 group， and tPSA >20 ng/mL group was 45.02%， 46.50%， and 47.02%， respectively. The rate of metastasis in low-risk group， GS ≤6 group and tPSA <10 ng/mL group was 0， 8.82%， and 15.63%， respectively. When tPSA <10 ng/mL， the rate of metastasis in low-risk group （0） was lower than that in high-risk group （33.33%）. When tPSA was 10-20 ng/mL， the rate of metastasis in intermediate-risk group （7.69%） was lower than that in high-risk group （38.71%）. When GS ≤6， the rate of metastasis in low-risk group （0） was lower than that in high-risk group （38.71%）. 【Conclusion】 The detection rate of metastasis in patients with newly diagnosed prostate cancer by ¹⁸F-PSMA-1007 PET/CT is positively correlated with GS， preoperative tPSA level， and D’Amico risk grade.

【Objective】 To analyze the correlation between metabolic parameters of ¹⁸F-deoxyglucose-labeledpositron emission tomography/computed tomography（¹⁸F-FDG PET/CT） scan and the immunohistochemistry （IHC） expression in patients with primary breast cancer so as to explore the predictive value of the metabolic parameters for molecular subtypes. 【Methods】 We retrospectively recruited 97 patients who underwent ¹⁸F-FDG PET/CT scan from November 2016 to June 2020 with breast cancer. The clinical stages （Ⅰ,Ⅱ,Ⅲ and Ⅳ） and menstrual status （pre-menopause or menopause） were collected. Metabolic parameters， including the maximum standardized uptake value （SUVmax）， mean standardized uptake value （SUVmean）， metabolic tumor volume （MTV） and total lesion glycolysis （TLG） of the primary tumor， were calculated by physician according to the 40% SUVmax principle. The IHC expressions （positive or negative） of the estrogen receptor （ER）， progesterone receptor （PR）， human epidermal growth factor receptor 2 （HER2）， proliferating cell nuclear antigen （Ki-67） and p53； the ipsilateral axillary lymph node metastasis （with or without）， and the molecular subtypes （Luminal A， Luminal B， HER2 overexpression， and triple negative） were determined by an experienced pathologist. The correlations between the metabolic parameters and IHC expression were analyzed by Pearson test or Spearman test， and were further stratified by different menstrual status and ipsilateral axillary lymph node metastasis. Finally， we analyzed metabolic parameters among different molecular subtypes. 【Results】 For all the patients， SUVmax and SUVmean had significantly negative correlation with ER and PR expressions （P<0.05）； SUVmax， SUVmean， and TLG were significantly positively correlated with Ki-67 expression （P<0.05）. SUVmax， SUVmean， and TLG of premenopausal patients （n=57） were negatively correlated with ER and PR expressions （P<0.05）， but positively correlated with Ki-67 expression （P<0.05）. MTV， TLG and PR expressions in postmenopausal patients （n=40） were positively correlated （P<0.05）. In patients with （n=27） or without （n=57） ipsilateral axillary lymph node metastasis， Ki-67 was negatively correlated with SUVmax and SUVmean （P<0.05）； in patients without ipsilateral axillary lymph node metastasis， SUVmax， SUVmean， and TLG were negatively correlated with PR （P<0.05）. Among different molecular types， SUVmax of HER2 overexpression was significantly higher than that of Luminal A （P<0.05）. 【Conclusion】 The ¹⁸F-FDG PET/CT metabolic parameters of breast cancer patients have a good correlation with the expression of immunohistochemistry， and SUVmax has predictive value for the expression of hetergeneous molecular types.

Objective:To explore the effects of micro-class combined with closed-loop modularized teaching in practical course of emergency nursing.Methods:From March to July 2018, this study selected nursing students of four classes in Grade 2016 of Xianyang Vocational Technical College as subjects by convenience sampling. All of nursing students were randomly divided into observation group ( n=160) and control group ( n=162) with the method of tossing a coin by classes. Control group carried out the routine teaching, while observation group applied the micro-class combined with closed-loop modularized teaching in practical course of emergency nursing. This study compared the nursing students' examination scores and recognition on teaching model between two groups. Results:At the end of practical course of emergency nursing, the theoretical and operation achievements of observation group were (85.59±7.24) and (88.34±5.62) respectively higher than those of control group with statistical differences ( t=-6.308, -7.008; P<0.05) . Recognition of observation group on teaching model was higher than that of control group also with a statistical difference ( P<0.05) . Conclusions:Micro-class combined with closed-loop modularized teaching can improve the learning effects of nursing students in practical course of emergency nursing and is recognized highly by nursing students which is worthy of generalization and application.