Objective To compare the efficacy and safety of injectable azithromycin generics and originator in the treatment of mycoplasma pneumoniae pneumonia(MPP)in children,aiming to provide scientific evidence for clinical drug selection.Methods A retrospective collection of data from Xiamen Children's Hospital on children with MPP from January to July 2024,divided into domestic and original drug groups based on medication type.Comparing time indicators and infection indicators between two groups.Kaplan-Meier curves were used to analyze cumulative efficacy.A multivariable logistic regression model(stepwise adjustment of confounding factors)was used to calculate OR and corresponding 95％CI with effective outcomes as the dependent variable.Results After baseline correction,a total of 322 children were included.There were no significant differences in baseline characteristics between two groups(P＞0.05).The generic drug group had longer hospital stays,cough durations,and blood test recovery times compared to original drug group(P＜0.05),but there were no statistically significant differences in total treatment time,fever duration,or lung symptom improvement(P＞0.05).The recovery rates for infection indicators and cumulative clinical efficacy rates were similar in both groups(P＞0.05).Furthermore,there was no statistically significant difference in adverse event rates between domestic and original drug groups(P＞0.05).Conclusion The generic azithromycin is as effective as original drug in treating children with MPP and has good safety,making it an economically superior alternative medication.This study provides evidence to support the rational clinical use of generic drugs and expands the methodological reference value of real-world data in the consistency evaluation of pediatric drugs.

Objective To construct a risk prediction model for admission sepsis in preterm infants,providing a basis for early clinical identification and intervention of admission sepsis.Methods Data of preterm infants admitted to Xiamen Children's Hospital from January 2020 to December 2023 were retrospectively collected and used for model construction.According to whether sepsis occurred after admission,they were divided into sepsis group(n=65)and non-sepsis group(n=394).LASSO regression combined with multivariate Logistic regression were used to screen risk factors,and a nomogram prediction model was constructed.External validation of the model was performed with 174 preterm infants admitted from January to December 2024.Results Gestational age,Apgar score ≤7 points at 10 minutes,total bilirubin,respiratory failure,and respiratory rate were identified as independent risk factors for admission sepsis in preterm infants.The area under the curve(AUC)of the training set was 0.853,and the external validation AUC was 0.937.The calibration results in the calibration curve were close to the ideal curve(Hosmer-Lemeshow test x2=6.599,P=0.580).Conclusion The prediction model developed based on seven bedside indicators demonstrates excellent performance,enabling rapid risk stratification and antimicrobial decision-making without the need for microbiological culture support.

BACKGROUND:Mitophagy is closely associated with the development of idiopathic pulmonary fibrosis,but its mechanism remains unclear.OBJECTIVE:To investigate the biological mechanism of mitophagy in idiopathic pulmonary fibrosis and provide ideas for the risk prediction of idiopathic pulmonary fibrosis and subtype differentiation.METHODS:The mitophagy-related genes in idiopathic pulmonary fibrosis were obtained through GEO and Reactome Pathway databases.The mitophagy-related characteristic genes in idiopathic pulmonary fibrosis were screened based on intergroup differences and random forest model.GO functional enrichment analysis and KEGG,Reactome with WIKI pathway enrichment analyses were performed by g:Profiler database.Mitophagy subtypes in idiopathic pulmonary fibrosis were distinguished by consensus clustering method and immune infiltration analysis was performed.The mitophagy-related key gene was screened.Finally,the predictive value of mitophagy-related key gene for the risk of idiopathic pulmonary fibrosis was quantified by alignment diagram and the correlation between mitophagy-related key gene and clinical characteristics of idiopathic pulmonary fibrosis was explored.RESULTS AND CONCLUSION:(1)A total of 13 genes related to mitophagy in idiopathic pulmonary fibrosis were identified and 5 characteristic genes were screened,containing PINK1,RPS27A,SRC,HIF1A,and CDH6.(2)GO analysis was mainly involved in ubiquitin protein ligase binding,and cellular response to hypoxia.Pathway enrichment analysis was mainly involved in PINK1-PRKN mediated mitophagy,NOTCH signaling pathway,signaling by EGFR and angiogenesis.(3)HIF1A had significant expression differences between subtypes,which might serve as a key gene for the differentiation of mitophagy subtypes of idiopathic pulmonary fibrosis.(4)Immune infiltration analysis suggested that myeloid-derived suppressor cell,neutrophil and type 1 T helper cell might have infiltration differences between subtypes,while HIF1A was positively correlated with multiple immune cells.(5)Alignment diagram suggested that the risk of idiopathic pulmonary fibrosis might be predicted by the expression level of HIF1A.(6)Clinical characteristics analysis indicated patients with high expression of HIF1A might have poorer lung function and more severe fibrosis.It is concluded that PINK1,RPS27A,SRC,HIF1A,and CDH6 may influence the development of idiopathic pulmonary fibrosis through mitophagy,in which HIF1A may serve as a key gene for risk prediction with clinical subtype differentiation and HIF1A is strongly associated with the lung function of patients.

Health communication aims to improve public health attitudes and behaviors by propagating health information. It plays an important role in promoting public health literacy and "Healthy China Initiative". The basic theories of health communication include "7 W" and Theory of Planned Behavior. Clinicians with profound medical expertise and a wealth of clinical practice play key roles in the communication, and they hold an unparalleled advantage in health communication by delivering authoritative and trustworthy information to the public. The capacity of health communication among clinicians in the nation is determined by various factors including professional characteristics, policy support, dissemination platforms and pathways, time and effort. Meanwhile, some problems in the research on the health communication capacity of clinicians remain, such as lack of well-established motivation systems, limited dissemination pathways, and imperfect evaluation frameworks. In some regions of China, health communication performance has been considered as part of the professional title evaluation for clinical physicians. Medical institutions and universities have also initiated relevant training and practice programs. It is crucial to improve evaluation frameworks, strengthen training pathways and effectiveness assessment, promote interdisciplinary integration, and enhance the role of clinicians in health communication in the future.

[This corrects the article DOI: 10.1016/j.apsb.2021.10.012.].

Objective To explore the target and mechanism of Fengliao Changweikang in treating irritable bowel syndrome(IBS)based on network pharmacology and molecular docking technology.Methods The effective components of Fengliao Changweikang were screened by data mining,and the drug-target network was constructed to identify the key targets and their pathways related to IBS.The molecular docking verification of the main active ingredients and core target proteins was carried out,and the binding energy was evaluated and the results were visualized.Results Fengliao Changweikang contained 24 potential active ingredients,134 active ingredient targets,and 2353 disease-related targets.After intersecting these,70 potential target points were identified,involving 898 biological processes,96 molecular functions,and 66 cellular components.Kyoto Encyclopedia of Genes and Genomes enrichment analysis suggested that its mechanism of action in treating IBS may involve regulating key signaling pathways such as cancer pathways,PI3K/Akt signaling pathways,and phospholipase D pathways through interactions with core targets.Molecular docking analysis indicated that the core compounds in Fengliao Changweikang exhibit good binding activity with core receptor proteins.Conclusion Fengliao Changweikang works through multiple signaling pathways and multiple target mechanisms to treat IBS.

IL-32 is a multifunctional cytokine with both pro-inflammatory and anti-inflammatory properties.It has been proved that expression of IL-32 increases with progression of gastric mucosal diseases and severity of gastric cancer(GC),thus participating in process of gastric"inflammation-cancer"transformation.However,how IL-32 affects malignant transformation of gastric"inflamma-tion-cancer"and finally leads to adverse outcome of GC invasion and migration is still controversial.In order to better clarify regulatory effect and possible mechanism of abnormal expression of IL-32 on different histopathological stages of gastric"inflammation-cancer"transformation,and to explore new directions and breakthroughs in molecular mechanism of early truncation and treatment of gastric precancerous lesion(GPL),we searched literatures related to IL-32 in six authoritative databases at home and abroad,such as Pubmed,Web of Science and CNKI,in past 30 years.It was found that pathogenicity or protective function of IL-32 in different histo-pathological stages of gastric"inflammation-cancer"transformation depended on its different subtypes,secretory forms,surrounding cytokine environment,disease status and genetic factors.IL-32 may regulate polarization of macrophages through NF-κB,MAPK,COX2,PR3,IDO,NOD,PKCδ,FAK and STAT3,amplify or inhibit chronic inflammatory stimulation of gastric mucosa,and thus participate in process of gastric"inflammation-cancer"transformation.Our new understanding of role of IL-32 in different stages of Cor-rea cascade may contribute to development of cytokine-directed therapy,and therapy aimed at regulating different alternative splicing subtypes of IL-32 and targeting IL-32 signals can be used as a new strategy for medical treatment of GPL and GC in future.

Objective To construct a risk prediction model for admission sepsis in preterm infants,providing a basis for early clinical identification and intervention of admission sepsis.Methods Data of preterm infants admitted to Xiamen Children's Hospital from January 2020 to December 2023 were retrospectively collected and used for model construction.According to whether sepsis occurred after admission,they were divided into sepsis group(n=65)and non-sepsis group(n=394).LASSO regression combined with multivariate Logistic regression were used to screen risk factors,and a nomogram prediction model was constructed.External validation of the model was performed with 174 preterm infants admitted from January to December 2024.Results Gestational age,Apgar score ≤7 points at 10 minutes,total bilirubin,respiratory failure,and respiratory rate were identified as independent risk factors for admission sepsis in preterm infants.The area under the curve(AUC)of the training set was 0.853,and the external validation AUC was 0.937.The calibration results in the calibration curve were close to the ideal curve(Hosmer-Lemeshow test x2=6.599,P=0.580).Conclusion The prediction model developed based on seven bedside indicators demonstrates excellent performance,enabling rapid risk stratification and antimicrobial decision-making without the need for microbiological culture support.

Objective To compare the efficacy and safety of injectable azithromycin generics and originator in the treatment of mycoplasma pneumoniae pneumonia(MPP)in children,aiming to provide scientific evidence for clinical drug selection.Methods A retrospective collection of data from Xiamen Children's Hospital on children with MPP from January to July 2024,divided into domestic and original drug groups based on medication type.Comparing time indicators and infection indicators between two groups.Kaplan-Meier curves were used to analyze cumulative efficacy.A multivariable logistic regression model(stepwise adjustment of confounding factors)was used to calculate OR and corresponding 95％CI with effective outcomes as the dependent variable.Results After baseline correction,a total of 322 children were included.There were no significant differences in baseline characteristics between two groups(P＞0.05).The generic drug group had longer hospital stays,cough durations,and blood test recovery times compared to original drug group(P＜0.05),but there were no statistically significant differences in total treatment time,fever duration,or lung symptom improvement(P＞0.05).The recovery rates for infection indicators and cumulative clinical efficacy rates were similar in both groups(P＞0.05).Furthermore,there was no statistically significant difference in adverse event rates between domestic and original drug groups(P＞0.05).Conclusion The generic azithromycin is as effective as original drug in treating children with MPP and has good safety,making it an economically superior alternative medication.This study provides evidence to support the rational clinical use of generic drugs and expands the methodological reference value of real-world data in the consistency evaluation of pediatric drugs.