By analyzing the connotation of "kenang （窠囊）" and its relationship with adenoid hypertrophy （AH） in children， this paper suggests that kenang plays a significant role in the development process of pediatric AH， from the initial accumulation of phlegm-dampness in the early stage， to the binding of phlegm and stasis in the middle stage， and finally the healthy qi deficiency with phlegm stagnation in the late stage， and may also serve as a key entry point for the diagnosis and treatment. From the perspective of "kenang"， and in combination with the core pathogenesis of pediatric AH characterized by lung heat and phlegm stasis， this paper proposes that the key therapeutic principles include clearing heat to resolve phlegm， activating blood to remove stasis， and reducing swelling to dissipate nodules. A staged treatment strategy based on the self-formulated Bizhi Formula （鼻窒方） with modifications is used. In the early stage of the disease， the treatment should be soothing the wind and relieving the exterior， resolving phlegm and dredging the orifices to prevent the initial knot of kenang， for which Bizhi Formula and Cangerzi Powder （苍耳子散） with modifications can be used. In the middle stage， the treatment should be dissolving phlegm and expelling stasis， dispersing knots and unblocking orifices to break down the establishment of kenang， and Bizhi Formula combined with Haizao Yuhu Decoction （海藻玉壶汤） with modifications is suggested. In the late stage， the treatment emphasizes reinforcing healthy qi and consolidating the root， resolving phlegm and dredging collaterals in order to prevent recurrence of kenang， and the suggested prescription is modified Bizhi Formula combined with Shenling Baizhu Powder （参苓白术散）.

By analyzing the connotation of "kenang （窠囊）" and its relationship with adenoid hypertrophy （AH） in children， this paper suggests that kenang plays a significant role in the development process of pediatric AH， from the initial accumulation of phlegm-dampness in the early stage， to the binding of phlegm and stasis in the middle stage， and finally the healthy qi deficiency with phlegm stagnation in the late stage， and may also serve as a key entry point for the diagnosis and treatment. From the perspective of "kenang"， and in combination with the core pathogenesis of pediatric AH characterized by lung heat and phlegm stasis， this paper proposes that the key therapeutic principles include clearing heat to resolve phlegm， activating blood to remove stasis， and reducing swelling to dissipate nodules. A staged treatment strategy based on the self-formulated Bizhi Formula （鼻窒方） with modifications is used. In the early stage of the disease， the treatment should be soothing the wind and relieving the exterior， resolving phlegm and dredging the orifices to prevent the initial knot of kenang， for which Bizhi Formula and Cangerzi Powder （苍耳子散） with modifications can be used. In the middle stage， the treatment should be dissolving phlegm and expelling stasis， dispersing knots and unblocking orifices to break down the establishment of kenang， and Bizhi Formula combined with Haizao Yuhu Decoction （海藻玉壶汤） with modifications is suggested. In the late stage， the treatment emphasizes reinforcing healthy qi and consolidating the root， resolving phlegm and dredging collaterals in order to prevent recurrence of kenang， and the suggested prescription is modified Bizhi Formula combined with Shenling Baizhu Powder （参苓白术散）.

Objective A scoping review of studies on pulmonary prehabilitation in cardiac surgery patients was conducted to provide evidence support for the construction of a preoperative pulmonary rehabilitation program for cardiac surgery patients that suitable for China's national conditions.Methods In accordance with the scope review's research methodologies,databases including PubMed,Embase,Web of Science,CINAHL,CNKI and Wanfang were searched by the computer for relevant studies.The deadline for retrieval is from the establishment of databases to June,2024.The included literature was systematically analyzed.Results 26 articles were finally included.Among them,4 were quasi-experiment studies,while the other 22 were randomized controlled trials.Forms of the intervention included comprehensive breathing exercises,inspiratory muscle training,positive expiratory pressure,incentive spirometer training and balloon blowing training.The intervention initiation ranged from 10 weeks to 1 day preoperatively;the outcome measures included postoperative pulmonary complications,lung function metrics,the 6-Minute Walk Test,duration of mechanical ventilation,length of hospital stay,patient-reported outcomes and so on.Conclusion There remains a deficiency in standardized protocols for preoperative pulmonary rehabilitation training among patients undergoing cardiac surgery.High-quality studies should be conducted,and intervention strategies for pulmonary prehabilitation in cardiac surgery patients should be optimized and a unified evaluation standard system should be established.

Objective A scoping review of studies on pulmonary prehabilitation in cardiac surgery patients was conducted to provide evidence support for the construction of a preoperative pulmonary rehabilitation program for cardiac surgery patients that suitable for China's national conditions.Methods In accordance with the scope review's research methodologies,databases including PubMed,Embase,Web of Science,CINAHL,CNKI and Wanfang were searched by the computer for relevant studies.The deadline for retrieval is from the establishment of databases to June,2024.The included literature was systematically analyzed.Results 26 articles were finally included.Among them,4 were quasi-experiment studies,while the other 22 were randomized controlled trials.Forms of the intervention included comprehensive breathing exercises,inspiratory muscle training,positive expiratory pressure,incentive spirometer training and balloon blowing training.The intervention initiation ranged from 10 weeks to 1 day preoperatively;the outcome measures included postoperative pulmonary complications,lung function metrics,the 6-Minute Walk Test,duration of mechanical ventilation,length of hospital stay,patient-reported outcomes and so on.Conclusion There remains a deficiency in standardized protocols for preoperative pulmonary rehabilitation training among patients undergoing cardiac surgery.High-quality studies should be conducted,and intervention strategies for pulmonary prehabilitation in cardiac surgery patients should be optimized and a unified evaluation standard system should be established.

Objective To assess the safety of paliperidone palmitate(PP)injection versus other antipsychotic drugs long-acting injections(LAIs)in the treatment of schizophrenia.Methods PubMed,Web of Science,Embase,Cochrane Library,PsycINFO,CNKI,SinoMed,VIP and WanFang Data databases were searched to collect randomized controlled trials(RCTs)on PP injection versus other antipsychotic drugs LAIs in the treatment of schizophrenia from the inception to April 30,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis was then performed using RevMan 5.2 software.Results A total of 12 RCTs involving 4 368 patients were included.The results of Meta-analysis showed that there was no significant difference in clinical efficacy between PP injection treated group and risperidone LAIs treated group(P＞0.05),no significant difference was found for positive and negative syndrome scale(PANSS)overall score changes between PP injection treated group and other antipsychotic drugs LAIs treated group(P＞0.05).Compared with other antipsychotic LAIs treated groups,PP injection treated group had a significantly higher rate of total withdrawls(RR=1.14,95％CI 1.06 to 1.24,P＜0.01)and the incidence of adverse reactions of abnormal injection site(RR=2.08,95％CI 1.03 to 4.22,P=0.04).Conclusion Current evidence indicates that PP injection didn't show significant difference in efficacy outcomes,while may increase the incidence of some adverse reactions when compared with other antipsychotic drugs LAIs for schizophrenic.However,due to the limitations of the quantity and quality of the included studies,the above conclusions still need to be validated by more high-quality studies.

Objective To investigate the influence of Wechat follow-up on the treatment compliance and quality of life for young adult patients with type 2 diabetes mellitus.Methods A total of 120 cases, who were able to use Wechat independently,were selected as the research objects from patients with type 2 diabetes mellitus during February 2015 to December 2015. They were randomly divided into control group (60 cases) and intervention group (60 cases). Patients in control group received routine nursing and health education,while patients in intervention group received knowledge about type 2 diabetes mellitus and nursing care through Wechat. Data of the patients in these two groups were obtained after 6 months. And the parameters including treatment compliance,blood glucose control,the incidence of complications,sleeping quality (PSQI), depression (SDS),and anxiety (SAS) of these patients were analyzed.Results After intervention,the score of treatment compliance in intervention group (12.7±1.5) was higher than (8.7±1.7) of control group (t=-3.056, P<0.05). The compliance of reasonable diet,standardized medication,moderate exercise,benign psychology and regular blood glucose monitoring for intervention group were significantly improved than that of control group (P<0.05). The infection,glycopenia,diabetic eye diseases,acute complications in the intervention group were lower than that of control group (P<0.05),but neuropathy and rate of nephropathy in intervention group were better than that of control group,but there were no statistical significance (P>0.05). Before intervention, there were no statistical significance between two groups in the levels of fasting blood glucose,postprandial 2 h plasma glucose and glycosylated hemoglobin,as well as PSQI,SDS and SAS (P>0.05). However,the levels of fasting blood glucose,postprandial 2h plasma glucose and glycosylated hemoglobin,as well as PSQI,SDS and SAS were significantly decreased compared with the control group with statistical significance (P<0.05). Conclusions Follow-up by Wechat can effectively improve the treatment compliance of young adult patients with type 2 diabetes mellitus,and improve the quality of life and patients' satisfaction.

Mucinous adenocarcinoma is a rare epithelial malignant tumor which usually arises in appendix, pancreas, breast and other sites, rarely occurs in salivary gland. In this article, a mucinous adenocarcinoma of salivary gland was reported and relevant literatures were reviewed.
Adenocarcinoma, Mucinous ; Carcinoma ; Humans ; Salivary Glands

OBJECTIVETo study clinicopathological features, diagnosis, differential diagnosis of oral Langerhans cell histiocytosis (LCH), retrospective clinicopathologic study was carried on and a variety of immune phenotype were detected.

METHODSThe clinicopathological features of 29 cases of oral LCH were analyzed. The immunohistochemical staining of S-100 protein, CD1a, CD83 and Ki-67 were used in above cases by immunohistochemical streptavidin-biotin peroxidase (SP) and Elivison two-step method. Statistical analysis was adopted for the results.

RESULTSOf the 29 cases of LCH, the expression of S-100 protein and CD1a were positive in 24 cases and negative in 5 cases, so 5 cases were excluded from the diagnosis of LCH. Among 24 cases of LCH, 15 patients were male and 9 were female. The median age was 7.50 years. 14 lesions were in the mandible, 5 were in the maxilla and 5 involved the mandible and maxilla. 9 cases were in stage I, 13 in stage II and 2 in stage III, according to Bartnick classification. Immunohistochemistry showed all 24 cases staining for S-100 protein and CD1a were positive. Comparing with maxillofacial lesions involved soft tissue, Ki-67 positive rate was lower and CD83 positive rate was higher in maxillofacial single bone lesion.

CONCLUSIONThe immunohistochemical staining of S-100 protein and CD1a are important for the diagnosis of LCH. Maxillofacial bone single LCH might have lower proliferative activity and a higher state of maturity. Maxillofacial LCH involved soft tissue might have a higher proliferative activity and a lower state of maturity.

Antigens, CD1 ; Diagnosis, Differential ; Female ; Histiocytosis, Langerhans-Cell ; Humans ; Immunohistochemistry ; Male ; Mandible ; Maxilla ; Retrospective Studies ; S100 Proteins