ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Objective To establish a model to predict the severity of patients with COVID-19 associated diarrhea by analyzing the differences of laboratory detection indicators in different grades of patients with COVID-19 associated diarrhea.Methods A total of 649 COVID-19 patients combined with diarrhea hospitalized in Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively selected,and the patients with obvious causes of diarrhea had been excluded.They were further divided into the common group(n=282),severe group(n=314),and critical group(n=53),and the differences in clinical and laboratory indicators among the three groups were compared.The XGBoost model was established,and its diagnostic efficacy in predicting the severity of patients with COVID-19 associated diarrhea was evaluated by the ROC curve.Results There were statistically significant differences in blood routine test,liver function,electrolytes,fecal occult blood and other laboratory indicators among the three groups of COVID-19 associ-ated diarrhea(P＜0.05).The white blood cell count,absolute value and percentage of neutrophils,and levels of serum lactate dehydro-genase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),γ-glutamyl transpeptidase(GGT),B-type natriuretic peptide,and blord glucose(Glu)in the critical group were significantly higher than those in the common group and severe group(P＜0.05),while the percentages of lymphocytes,monocytes,eosinophils,and basophils,and chloride concentration were significantly lower than those in the common group and severe group(P＜0.05).The results of the ROC curve showed that the prediction model constructed by eight indicators,including C-reactive protein(CRP),LDH,interleukin-6(IL-6),Glu,PT％activity,chloride(Cl-),D-dimer(DD),and procalcitonin(PCT),had significant predictive value for critical patients(AUCROC=0.939),but no obvious predictive value for the patients in the common group(AUCROC=0.630)and severe group(AUCROC=0.553).Conclusion The COVID-19 patients com-bined with diarrhea have a higher probability of developing severe or critical conditions compared with those without diarrhea.The indi-cators such as CRP,LDH,IL-6,Glu,PT％activity,Cl-,DD,and PCT have significant predictive value on whether the COVID-19 patients combined with diarrhea turn to critical illness.

Objective To investigate the effect of unilateral or bilateral transcranial direct current stimulation(tDCS)on post-stroke dysphagia.Methods From February,2023 to March,2025,27 stroke patients with dysphagia and nasal feeding in Beijing Bo'ai Hos-pital were randomly divided into healthy side stimulation group,bilateral stimulation group and sham stimulation group,with nine cases in each group.All the groups received conventional swallowing training and tDCS,while the healthy side stimulation group stimulated on the healthy side of oropharyngeal cortex;and the bilateral stimu-lation group alternatively stimulated bilateral oropharyngeal cortex,with one hour interval between bilateral stim-ulation;the sham stimulation group stimulated the healthy side of oropharyngeal cortex for 30 seconds and then stop.The course lasted two weeks.The scores of Standard Swallowing Function Assessment Scale(SSA),Modi-fied Mann Assessment of Swallowing Ability(MMASA)and Rosenbek Penetration-Aspiration Scale(PAS)were compared before and after treatment.Results The intra-group effect(F=16.185,P<0.01)was significant in the scores of SSA,the intra-group effect(F=28.650,P<0.01)and interaction effect(F=3.453,P<0.01)were significant in the scores of MMASA,and there was no significant difference in the inter-group effect,intra-group effect and interaction effect in the scores of PAS(P>0.05).Post hoc test showed that there was no significant difference in the scores of SSA,MMASA and PAS among three groups(P>0.05).There was significant difference in the score difference of MMASA be-fore and after treatment among three groups(F=4.698,P<0.05).Post hoc test showed that the score difference of MMAS was more in the healthy side stimulation group than in the bilateral stimulation group and the sham stimulation group(P<0.05),with no significant difference between the bilateral stimulation group and the sham stimulation group(P>0.05).Conclusion tDCS can partly improve post-stroke dysphagia.The healthy side anode stimulation is superior to the alter-nating bilateral hemisphere anode stimulation.

Objective To establish a model to predict the severity of patients with COVID-19 associated diarrhea by analyzing the differences of laboratory detection indicators in different grades of patients with COVID-19 associated diarrhea.Methods A total of 649 COVID-19 patients combined with diarrhea hospitalized in Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively selected,and the patients with obvious causes of diarrhea had been excluded.They were further divided into the common group(n=282),severe group(n=314),and critical group(n=53),and the differences in clinical and laboratory indicators among the three groups were compared.The XGBoost model was established,and its diagnostic efficacy in predicting the severity of patients with COVID-19 associated diarrhea was evaluated by the ROC curve.Results There were statistically significant differences in blood routine test,liver function,electrolytes,fecal occult blood and other laboratory indicators among the three groups of COVID-19 associ-ated diarrhea(P＜0.05).The white blood cell count,absolute value and percentage of neutrophils,and levels of serum lactate dehydro-genase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),γ-glutamyl transpeptidase(GGT),B-type natriuretic peptide,and blord glucose(Glu)in the critical group were significantly higher than those in the common group and severe group(P＜0.05),while the percentages of lymphocytes,monocytes,eosinophils,and basophils,and chloride concentration were significantly lower than those in the common group and severe group(P＜0.05).The results of the ROC curve showed that the prediction model constructed by eight indicators,including C-reactive protein(CRP),LDH,interleukin-6(IL-6),Glu,PT％activity,chloride(Cl-),D-dimer(DD),and procalcitonin(PCT),had significant predictive value for critical patients(AUCROC=0.939),but no obvious predictive value for the patients in the common group(AUCROC=0.630)and severe group(AUCROC=0.553).Conclusion The COVID-19 patients com-bined with diarrhea have a higher probability of developing severe or critical conditions compared with those without diarrhea.The indi-cators such as CRP,LDH,IL-6,Glu,PT％activity,Cl-,DD,and PCT have significant predictive value on whether the COVID-19 patients combined with diarrhea turn to critical illness.

Objective:To determine the prevalence of self-reported food allergies among children in the grasslands of North China and to analyze its associated risk factors.Methods:In this study, a cross-sectional epidemiological survey method was used to select children under 14 years old by multi-stage, stratified and random cluster sampling in the grassland ecological area of Zhangbei County, Hebei Province, China from May to July 2018. Face-to-face questionnaires were administered to gather food allergy-related information from the participants. Multivariate logistic regression analysis was used to analyze the risk factors associated with self-reported food allergy.Results:A total of 2 086 children completed the survey. The prevalence of self-reported food allergies was 22.0%(459/2 086). The prevalence of multiple food allergies (≥3 types) was 3.1%(64/2 086) versus 16.3% (341/2 086) for a single food allergy among all children. Mango allergy (6.1%, 127/2 086) was the most common, followed by peach allergy (4.1%, 85/2 086). Children who reported food allergies had a significantly higher prevalence of all 4 atopic disorders (eczema, asthma, allergic rhinitis, and allergic conjunctivitis than those without food allergies(35.73% vs. 20.65%, 5.88% vs. 2.77%, 17.86% vs. 7.38%, 16.78% vs. 10.45%, χ2 =44.663 1, 10.434 3, 45.038 3, 13.728 4, all P<0.001).Significantly associated risk factors of food allergy were found to be pollen allergy ( OR: 2.29; 95% CI: 1.80-2.92) and drug allergy ( OR: 1.53; 95% CI: 1.12-2.09). Conclusions:The prevalence of self-reported food allergies among children in the Zhangbei County area of the North China Grassland was relatively high. Pollen allergy and drug allergy are major risk factors.

Objective:To investigate the disease-modifying effect of long-course use of Omalizumab (OMZ) on children and adolescents with allergic asthma.Methods:Retrospective cohort study.The clinical data of 66 children with moderate to severe allergic asthma treated with OMZ in the Department of Pediatrics, the Second Hospital of Tianjin Medical University from April 2019 to June 2024 were analyzed.According to the course of OMZ, the patients were divided into a short course group (33 cases), a medium course group (21 cases), and a long course group (12 cases).The courses of treatment of the 3 groups were 6-<12, 12-<24 and 24 months or more, respectively.Pulmonary ventilation functions [including the percentage of forced expiratory volume in the first second to the expected value (FEV 1%pred), the peak expiratory flow rate to the expected value (PEF%pred), and the maximum mid-expiratory flow to the expected value (MMEF%pred)], fractional exhaled nitric oxide (FeNO) and the absolute value of peripheral blood eosinophils (EOS) were analyzed before and after OMZ treatment.Moreover, whether allergic asthma and comorbidities such as allergic rhinitis (AR), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU) were controlled was explored.Changes in inhaled corticosteroids (ICS) and serum total immunoglobulin E (TIgE) levels were measured.The paired t-test was used for testing measurement data with normal distribution, and the rank sum test for testing non-normally distributed data. Results:(1)Changes of pulmonary ventilation function, FeNO and EOS: the pulmonary ventilation function in the short course group, the FEV 1%pred and MMEF%pred in the medium course group, and the PEF%pred and MMEF%pred in the long course group were improved compared with those at baseline (all P<0.05).FeNO levels in all the 3 groups decreased, compared with those at baseline (all P<0.05).There was no significant difference in peripheral blood EOS between the 3 groups compared with those at baseline (all P>0.05).(2)Control status of allergic asthma and comorbidities: the Asthma Control Test/Childhood Asthma Control Test (ACT/C-ACT), Asthma Control Questionnaire (ACQ) scores and the visual analogue scores (VAS) of rhinitis improved in all 3 groups, compared with those at baseline (all P<0.05).Among 4 patients complicated with AD, 3(75.0%) showed decreased Scoring Atopic Dermatitis Index(SCORAD) scores, compared with those at baseline.Of the 6 children complicated with CSU, 5(83.3%) did not develop rash after injection.(3)Frequency of acute exacerbations of asthma: the number of acute exacerbations of asthma after treatment was lower than that before treatment in all the 3 groups (all P<0.05).The number of attacks in the long course group was decreased in the third year, compared with that in the first year ( P<0.05).(4)The ICS consumption: the ICS consumption in all the 3 groups was significantly decreased, compared with that at baseline (all P<0.05).Six patients (28.6%) in the medium course group had no recurrence within 1 year after stopping ICS therapy.One of the 7 patients (14.3%) in the long course group had stopped ICS for more than 2 years, and 3 patients (42.9%) had stopped ICS for more than 1 year.These 4 children had no recurrence.(5)The change of TIgE: in the short and medium course groups, serum TIgE levels at the end of treatment were higher than those at baseline (all P<0.05).The serum TIgE level in the second year of treatment was higher than that at baseline in the long course group ( P<0.05).The serum TIgE level in the third year of treatment was decreased, compared with that in the second year ( P<0.05). Conclusions:OMZ can improve lung function and FeNO levels, reduce the incidence of acute exacerbations of asthma, and lower ICS usage in children.At the same time, it can also improve the allergic diseases AR, AD and CSU.The prolonged treatment of OMZ can bring long-term sustained benefits to children.The changes in serum TIgE and FeNO levels may suggest that the long-term application of OMZ plays a disease-modifying role in allergic asthma.

Objective To investigate the effects and underlying mechanisms of Shexiang Baoxin pill(SBP)on wire injury-induced valvular dysfunction in rats.Methods A rat model of aortic valve injury was established using a standardized wire injury method.Animals were randomly divided into control,sham,model,and SBP low-,medium-,and high-dose(SBP-L,SBP-M,SBP-H)intervention groups.Aortic valve function was evaluated using echocardiography.Histopathological changes were assessed using hematoxylin-eosin(HE)and Masson's staining.Serum levels of lipid peroxides(LPO),malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH),and total iron were measured using biochemical assays.Expression levels of ferroptosis-related proteins(ACSL4,SLC7A11,and GPX4)and osteogenic markers(RUNX2 and BMP2)in valve tissues were detected through Western blot and RT-qPCR.Results The SBP-M and SBP-H groups showed significantly higher aortic valve orifice areas((3.70±0.04)mm2 and(3.90±0.11)mm2 vs(2.25±0.37)mm2,P＜0.0001),lower transvalvular pressure gradients((0.52±0.09)mmHg and(0.49±0.13)mmHg vs(0.90±0.17)mmHg,P＜0.01),and lower aortic valve peak flow velocities((68.83±4.98)cm/s and(63.61±11.43)cm/s vs(87.14±11.22)cm/s,P＜0.05,P＜0.01)than those in the model group.HE and Masson's staining result demonstrated that SBP alleviates valve thickening and fibrosis(fibrotic area:(35.98±5.2)5％vs(53.01±2.44)％,P＜0.01).Biochemical tests showed that SBP reduces serum levels of lipid peroxidation products(LPO and MDA)and total iron ions while increasing SOD and GSH levels(P＜0.001,P＜0.0001).SBP downregulated the ferroptosis-related protein ACSL4(P＜0.01),upregulated the anti-ferroptosis proteins SLC7A11 and GPX4(P＜0.05,P＜0.01),and inhibited the expression of the osteogenic molecules RUNX2 and BMP2(P＜0.05,P＜0.01,P＜0.0001).Conclusions SBP may alleviate mechanical injury-induced valve dysfunction in rats through the modulation of oxidative stress and restoration of iron homeostasis.These findings provide experimental evidence for the role of SBP in the early intervention of valvular disease.The precise active components,molecular targets,and clinical translation of SBP require further investigation.

Objective:To explore the incidence of delirium in patients of advanced age hospitalized in internal medicine departments and analyze its influencing factors.Methods:A retrospective analysis was conducted on the medical records of 586 patients of advanced age hospitalized in internal medicine departments at the Beijing University of Chinese Medicine Third Affiliated Hospital from May 2023 to May 2024. Patients were divided into a delirium group and a non-delirium group based on whether delirium occurred. Univariate analysis and binary Logistic regression analysis were used to explore the factors influencing delirium in patients of advanced age hospitalized in internal medicine departments.Results:Among 586 patients of advanced age hospitalized in internal medicine departments, the incidence of delirium was 21.2% (124/586). Binary Logistic regression analysis showed that age, activities of daily living (Barthel Index), folate deficiency, sleep disorders, and indwelling catheters were factors influencing delirium in patients of advanced age hospitalized in internal medicine departments ( P<0.05) . Conclusions:The incidence of delirium is high among patients of advanced age hospitalized in internal medicine departments. Healthcare professionals should pay particular attention to elderly patients with advanced age, limited activities of daily living, folate deficiency, sleep disorders, and indwelling catheters, and should implement targeted preventive strategies as early as possible.

Objective:To investigate the significance of dynamic quantitative detection of(cytomegalovirus)CMV antibodies in assessing the risk of fetal CMV infection.Methods:A total of 171 pregnant women with positive/weakly positive CMV IgM antibody ELISA screening results from Huizhou Central People's Hospital from August 2019 to March 2022 were selected as the study objects.IgM and IgG levels were measured by electrochemical luminescence(ECLIA),and re-examined 2 to 4 weeks later;at the same time,CMV nucleic acid was detected by real-time PCR fluorescent probe,and the fetal outcome was followed up.Results:In 171 cases,135 CMV IgM antibody ELISA(+)/ECLIA(-)specimens were positive for IgG antibodies and had stable levels after 2～4 weeks,one case was diagnosed with severe β thalassemia at 19+5 weeks,and the remaining fetuses were in good condition.There were 36 cases of IgM antibody ELISA(+)/ECLIA(+)specimens,one was negative for IgG antibody;35 cases had positive IgM antibody and stable IgG antibody level after 2～4 weeks,the fetus was in good condition;one case had IgM antibody level decreased and IgG antibody level increased significantly,urinary CMV DNA level gradually decreased,and was diagnosed as disseminated congenital CMV infection.Conclusion:The false positive rate of CMV IgM antibody detected by ELISA method is significantly higher than that of ECLIA method,and the dynamic quantitative detection can effectively eliminate interference.Maternal women with significant changes in CMV IgM,IgG antibodies and urinary DNA levels are at high risk of intrauterine infection and had a high probability of fetal congeni-tal CMV infection.

Objective:To investigate the disease-modifying effect of long-course use of Omalizumab (OMZ) on children and adolescents with allergic asthma.Methods:Retrospective cohort study.The clinical data of 66 children with moderate to severe allergic asthma treated with OMZ in the Department of Pediatrics, the Second Hospital of Tianjin Medical University from April 2019 to June 2024 were analyzed.According to the course of OMZ, the patients were divided into a short course group (33 cases), a medium course group (21 cases), and a long course group (12 cases).The courses of treatment of the 3 groups were 6-<12, 12-<24 and 24 months or more, respectively.Pulmonary ventilation functions [including the percentage of forced expiratory volume in the first second to the expected value (FEV 1%pred), the peak expiratory flow rate to the expected value (PEF%pred), and the maximum mid-expiratory flow to the expected value (MMEF%pred)], fractional exhaled nitric oxide (FeNO) and the absolute value of peripheral blood eosinophils (EOS) were analyzed before and after OMZ treatment.Moreover, whether allergic asthma and comorbidities such as allergic rhinitis (AR), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU) were controlled was explored.Changes in inhaled corticosteroids (ICS) and serum total immunoglobulin E (TIgE) levels were measured.The paired t-test was used for testing measurement data with normal distribution, and the rank sum test for testing non-normally distributed data. Results:(1)Changes of pulmonary ventilation function, FeNO and EOS: the pulmonary ventilation function in the short course group, the FEV 1%pred and MMEF%pred in the medium course group, and the PEF%pred and MMEF%pred in the long course group were improved compared with those at baseline (all P<0.05).FeNO levels in all the 3 groups decreased, compared with those at baseline (all P<0.05).There was no significant difference in peripheral blood EOS between the 3 groups compared with those at baseline (all P>0.05).(2)Control status of allergic asthma and comorbidities: the Asthma Control Test/Childhood Asthma Control Test (ACT/C-ACT), Asthma Control Questionnaire (ACQ) scores and the visual analogue scores (VAS) of rhinitis improved in all 3 groups, compared with those at baseline (all P<0.05).Among 4 patients complicated with AD, 3(75.0%) showed decreased Scoring Atopic Dermatitis Index(SCORAD) scores, compared with those at baseline.Of the 6 children complicated with CSU, 5(83.3%) did not develop rash after injection.(3)Frequency of acute exacerbations of asthma: the number of acute exacerbations of asthma after treatment was lower than that before treatment in all the 3 groups (all P<0.05).The number of attacks in the long course group was decreased in the third year, compared with that in the first year ( P<0.05).(4)The ICS consumption: the ICS consumption in all the 3 groups was significantly decreased, compared with that at baseline (all P<0.05).Six patients (28.6%) in the medium course group had no recurrence within 1 year after stopping ICS therapy.One of the 7 patients (14.3%) in the long course group had stopped ICS for more than 2 years, and 3 patients (42.9%) had stopped ICS for more than 1 year.These 4 children had no recurrence.(5)The change of TIgE: in the short and medium course groups, serum TIgE levels at the end of treatment were higher than those at baseline (all P<0.05).The serum TIgE level in the second year of treatment was higher than that at baseline in the long course group ( P<0.05).The serum TIgE level in the third year of treatment was decreased, compared with that in the second year ( P<0.05). Conclusions:OMZ can improve lung function and FeNO levels, reduce the incidence of acute exacerbations of asthma, and lower ICS usage in children.At the same time, it can also improve the allergic diseases AR, AD and CSU.The prolonged treatment of OMZ can bring long-term sustained benefits to children.The changes in serum TIgE and FeNO levels may suggest that the long-term application of OMZ plays a disease-modifying role in allergic asthma.