The American Institute of Ultrasound in Medicine(AIUM)practice parameter for the performance of an ultrasound examination of the neonatal and infant spine was revised and published by the AIUM in collaboration with other academic organizations in the United States,to intend to provide the medical ultrasound community with recommendations for the performance of high-quality ultrasound examination of the neonatal and infant spine.The practice parameter propose indications and contraindications for the performance of an ultrasound examination of the neonatal and infant spine,elaborate on specifications of the spinal ultrasound examination,especially the methods for determining the vertebral body level of the end of the spinal cord and key points for evaluating the movement of nerve roots.Following this practice parameter will maximize the detection of abnormalities of the infant spine.This interpretation aims to help beginners and primary care practitioners more easily master the techniques of an ultrasound examination of the neonatal and infant spine,promote the standardized implementation and popularization of this examination,and enhance the diagnostic accuracy for intraspinal pathologies.

The American Institute of Ultrasound in Medicine(AIUM)practice parameter for the performance of an ultrasound examination of the neonatal and infant spine was revised and published by the AIUM in collaboration with other academic organizations in the United States,to intend to provide the medical ultrasound community with recommendations for the performance of high-quality ultrasound examination of the neonatal and infant spine.The practice parameter propose indications and contraindications for the performance of an ultrasound examination of the neonatal and infant spine,elaborate on specifications of the spinal ultrasound examination,especially the methods for determining the vertebral body level of the end of the spinal cord and key points for evaluating the movement of nerve roots.Following this practice parameter will maximize the detection of abnormalities of the infant spine.This interpretation aims to help beginners and primary care practitioners more easily master the techniques of an ultrasound examination of the neonatal and infant spine,promote the standardized implementation and popularization of this examination,and enhance the diagnostic accuracy for intraspinal pathologies.

Objective To systematically evaluate the safety and efficacy of Kangfuxin liquid combined with adenosine monophosphate in the treatment of paediatric herpetic stomatitis.Methods Randomised controlled trials(RCTs)of Kangfuxin liquid combined with adenosine monophosphate for the treatment of paediatric herpetic stomatitis were searched in various databases,and Meta-analysis was performed using RevMan 5.4 software.Results A total of 12 RCTs with a sample size of 1,094 cases were included.Meta-analysis showed that the combination of Kangfuxin liquid with adenosine monophosphate significantly increased[RR=1.21,95%CI(1.16,1.28),P<0.000 01]the overall clinical efficacy rate of paediatric herpetic stomatitis.Compared with the conventional antiviral treatment group with adenosine monophosphate,the incidence of adverse events was lower in the Kangfuxin liquid group[RR=0.26,95%CI(0.14,0.51),P<0.000 01].In addition,the Kangfuxin liquid group could effectively shorten the time for herpes disappearance(skin lesion healing),pain disappearance,fever reduction,salivation disappearance and recovery of diet(P<0.05),and had advantages in promoting the recovery of lymphocytes(CD3+,CD4+,CD8+,and CD4+/CD8+),serological levels(CRP,TNF-α,WBC,IL-10,VEGF,EGF,and IL-6)(P<0.05).Conclusion Kangfuxin liquid combined with adenosine monophosphate has the better efficacy and safety in the treatment of paediatric herpetic stomatitis,and has advantages in shortening the symptomatic recovery time and improving the indicators of lymphocyte and serological levels in paediatric herpetic stomatitis.

Objective To analyze the clinical characteristics of 310 patients with anti-tuberculosis drug-induced liver injury(ATB-DILI),to explore prognostic influencing factors,and to provide reference for its prevention and treatment.Methods Primary tuberculosis patients hospitalized in the Department of Tuberculosis of the Third People's Hospital of Kunming from November 2020 to November 2022 who met the diagnosis of ATB-DILI were enrolled.Statistics by gender,age,history,type of tuberculosis,co-morbidities,frequency of anti-tuberculosis regimens leading to liver injury,use of hepatoprotective drugs,and management and regression were performed to analyze the clinical characteristics of the patients and the factors influencing their prognosis.Results 310 patients were included,male,148(47.74%)and female,162(52.26%).The mean age was 44.33±17.47 years.Thirty-four patients had a history of allergy.The combination of isoniazid,rifampicin,pyrazinamide,and ethambutol(244 patients,78.71%)was the anti-tuberculosis regimen that resulted in the highest number of cases of hepatic injury.The median time between initiation of the tuberculosis regimen and the development of hepatic injury in patients with ATB-DILI was 30 d,and the mean duration of hospitalization was 16.39±7.01 d.The most used hepatoprotective drug was reduced glutathione(154 patients,49.68%),and most patients used a combination of 2 hepatoprotective drugs(128 patients,41.29%).Liver injury improved in 257 cases(82.90%)and failed in 53 cases(17.10%).The differences in alcohol consumption,severity,clinical staging,TT,ALP,TBIL,DBIL,IBIL,and GGT were statistically significant compared to those who did not recover(P<0.05),and severity and high ALP were independent risk factors for poor prognosis.Conclusions Patients should be carefully asked if they have a history of basic liver disease and alcoholism before using anti-tuberculosis drugs.In the course of anti-tuberculosis treatment,the combined use of anti-tuberculosis drugs is more serious than the use of single drugs to cause liver damage.Drugs that may cause liver damage should be used with caution and improved anti-tuberculosis programs should be explored.At the same time,liver function should be monitored regularly during anti-tuberculosis treatment,especially 30 days after medication,in order to reduce the occurrence of adverse reactions.

Objective:To investigate the clinic opathological features, treatment and prognosis of children newly diagnosed with ependymoma.Methods:Clinical data of 127 pediatric ependymoma (EPN) patients (0-16 years old) treated with tumor resection and postoperative radiotherapy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University between 2001 and 2021 were retrospectively analyzed. Among them, 53 children were female and 74 were male. Local control (LR), event-free survival (EFS) and overall survival (OS) rates were analyzed by Kaplan-Meier method. The relationship between clinic opathological factors and clinical prognosis, and the effect of treatment on clinical prognosis of patients were analyzed by Cox proportional hazards model.Results:At a median follow-up time of 29 months (3-251 months), the 3-year OS and EFS rates were 89.5% and 71.5%, respectively. For patients undergoing incomplete resection followed by postoperative adjuvant radiotherapy, the 3-year LR, OS and EFS rates were 78.3%, 65.8% and 85.7%, respectively. A total of 43 children were aged <3 years old when diagnosed and 84 aged ≥3 years old. The interval time between surgery and radiotherapy in children aged <3 years old was 91 d, and 35.5 d in those aged ≥3 years old ( P<0.001). For patients <3 years old, the median EFS was 90 months when initiating radiotherapy within ≤70 d after surgery, compared to 43 months for those who initiated radiotherapy at >70 d after surgery ( P=0.053). According to fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5), 39 children were classified as posterior fossa ependymoma group A (PFA group). The OS and EFS rates in the PFA group were significantly less than those in other groups (3-year OS rate were 69.2% vs. 94.6%, P<0.001; 3-year EFS rate were 46.9% vs. 79.1%, P<0.001). In the PFA group, 12 patients received postoperative adjuvant chemotherapy, 14 did not receive chemotherapy, and whether chemotherapy was given was unknown in 13 cases. No significant differences were observed in OS and EFS between patients treated with and without chemotherapy ( P=0.260, P=0.730). Univariate Cox analysis showed that tumor location and WHO CNS5 molecular classification were significantly associated with EFS, and WHO CNS5 molecular classification was significantly correlated with OS. Multivariate Cox analysis showed that tumor location in the posterior fossa was an independent risk factor for EFS ( HR=2.72, 95% CI=1.1~6.71, P=0.03). Conclusions:Patients newly diagnosed with pediatric ependymoma can obtain favorable survival after surgery combined with postoperative adjuvant radiotherapy. Patients with residual tumors can achieve favorable LC and survival after postoperative adjuvant radiotherapy. Delaying of radiotherapy tends to lead to poor survival for patients aged <3 years old when diagnosed. Children in the PFA group obtain worse prognosis compared to their counterparts in other groups. The tumor location in the posterior fossa is an independent risk factor for pediatric ependymoma.

Objective:To investigate the value of MRI radiomics features in predicting breast cancer lymphovascular invasion (LVI).Methods:Totally of 216 patients with breast invasive ductal carcinoma who underwent preoperative MR examination confirmed by postoperative pathology from January to July 2021 in Liaoning Cancer Hospital were analyzed retrospectively. The patients were all females and ranged in age from 27 to 80 (53±11). Among them, 68 patients had LVI and 148 patients had no LVI. Patients were divided into the training set and the validation set in a ratio of 7∶3. The clinical features model was constructed with independent risk factors for LVI. The factors were extracted based on the clinical and MRI performance. Regions of interest in the tumor and peritumoral 1, 2, 3 mm annular region were delineated in the second phase of dynamic contrast-enhanced (DCE) MRI and DWI, respectively, and radiomics features extraction and screening were performed to construct a radiomics feature model. Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic efficacy of models.Results:Apparent diffusion coefficient value (ADC) (OR=0.09, 95%CI 0.01-0.97, P=0.047), the axillary lymph node enlargement (OR=2.51, 95%CI 1.18-5.37, P=0.017), the peritumoral edema (OR=2.34, 95%CI 1.15-4.75, P=0.019) were independent risk factors for LVI. The clinical feature model was established with ADC value, the axillary lymph node enlargement and the peritumoral edema. At last, 10 radiomics features were selected to construct the DCE-MRI tumor model, 8 radiomics features were selected to construct the DCE-MRI peritumoral 1 mm model, 9 radiomics features were selected to construct the DCE-MRI peritumoral 2 mm model, 5 radiomics features were selected to construct the DCE-MRI peritumoral 3 mm model, 8 radiomics features were selected to construct the DWI tumor model, 5 radiomics features were selected to construct the DWI peritumoral 1 mm model, 10 radiomics features were selected to construct the DWI peritumoral 2 mm model, 9 radiomics features were selected to construct the DWI peritumoral 3 mm model. The ROC curve analysis showed that DWI peritumoral 1 mm model had the largest area under curve values for predicting breast cancer LVI status both in the training set (0.928) and the validation set (0.907), and there were significant differences compared with other models ( P<0.05). Conclusion:MRI radiomics features can effectively predict LVI of breast invasive ductal carcinoma, and DWI peritumoral 1 mm radiomics features model have the highest prediction efficiency for LVI.

Mindful self-care (MSC) involves paying attention to what is happening in the mind, body, and external environment in the present moment with curiosity and kindness. In recent years, mindfulness has become a key topic in the medical field. MSC abilities have been shown to significantly improve empathy fatigue, job burnout and emotional stability in medical and nursing staff. By summarizing and sorting out the existing research, this article reviews the overview, current situation, impact on individuals, relevant assessment tools and intervention methods of MSC, so as to provide a reference for domestic research on MSC.

The development of nanomedicine has recently achieved several breakthroughs in the field of cancer treatment; however, biocompatibility and targeted penetration of these nanomaterials remain as limitations, which lead to serious side effects and significantly narrow the scope of their application. The self-assembly of intermediate filaments with arginine-glycine-aspartate (RGD) peptide (RGD-IFP) was triggered by the hydrophobic cationic molecule 7-amino actinomycin D (7-AAD) to synthesize a bifunctional nanoparticle that could serve as a fluorescent imaging probe to visualize tumor treatment. The designed RGD-IFP peptide possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. This fluorescent nanoprobe with RGD peptide could be targeted for delivery into tumor cells and released in acidic environments such as endosomes/lysosomes, ultimately inducing cytotoxicity by arresting tumor cell cycling with inserted DNA. It is noteworthy that the RGD-IFP/7-AAD nanoprobe tail-vein injection approach demonstrated not only high tumor-targeted imaging potential, but also potent antitumor therapeutic effects in vivo. The proposed strategy may be used in peptide-driven bifunctional nanoparticles for precise imaging and cancer therapy.

The clinical data of 69 patients with non-HIV-related cryptococcal meningitis admitted in the Second Hospital of Hebei Medical University from January 2013 to May 2019 were analyzed retrospectively.The main presentations of 69 patients are headache,fever,nausea,vomiting, visual impairment, hearing damage.Among them, 36 cases (52%) had underlying diseases, 30 cases (43%) were misdiagnosed, and 38 cases (55%) were complicated with high intracranial pressure. Cerebrospinal fluid examination showed that leukocytes increased in 47 cases, protein increased in 55 cases, chloride decreased in 41 cases, glucose decreased in 34 cases. The imaging findings were cerebral ischemia, hydrocephalus, meningeal or cerebral parenchyma enhancement. During the induction period, 63 cases were treated with combined antifungal drugs and 6 cases were treated with single antifungal drugs. The clinical symptoms were improved in 54 cases, 9 cases were discharged automatically and 6 cases died. The clinical manifestations, routine and biochemical examination of cerebrospinal fluid, imaging findings are not specific for patients with non-HIV-related cryptococcal meningitis.So early and multiple lumbar puncture should be performed to find etiological evidence to reduce misdiagnosis. The combination of antifungal drugs during the induction period is safe and effective.