Objective:To analyze the clinical characteristics of adverse reactions caused by dinutuximab β for the treatment of neuro-blastoma(NB)in China and to provide safety evidence for the rational use of dinutuximab β in clinical practice.Methods:Clinical data were retrospectively collected from 16 pediatric patients with NB who had been treated with dinutuximab β at Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to November 2023,and the adverse reactions caused by dinutuximab β were summarized and analyzed.Results:The male-to-female ratio was 5:3 among the 16 children with NB.The retroperitoneum was the main initial site of involvement,accounting for 75%.Thirteen(81.25%)patients had high-risk NB.The adverse reactions caused by dinutuximab β mainly included decreased hemoglobin,fever,vomiting,and diarrhea.The inci-dence of adverse reactions was highest in the first course of treatment,and the median time of adverse reactions was 2-5 days.Conclu-sion:Targeted monitoring should be carried out at an early stage during dinutuximab β administration.Adverse reactions should be de-tected and managed early to ensure the safety of medication for children.

ObjectiveTo analyze the clinical treatment plan and traditional Chinese medicine （TCM） medication rule of children with primary nephrotic syndrome （PNS） in the First Affiliated Hospital of Henan University of Chinese Medicine. MethodsThe gender and age of children firstly diagnosed with nephrotic syndrome in the pediatric nephrology department of the First Affiliated Hospital of Henan University of Chinese Medicine from November 2019 to December 2022 were collected， and the use of immunosuppressive agents and related frequencies were counted. According to the inclusion and exclusion criteria， an independent TCM prescription database for children with nephrotic syndrome was established. Excel was used to analyze the relevant information of the literature. The frequency counting， association rule analysis， and cluster analysis were carried out on TCM in the prescription， and the high-frequent drugs were analyzed. Results（1） General information： A total of 711 children were included， consisting of 522 males （73.42%） and 189 females （26.58%）. The ratio of male to female was about 2.76∶1. The disease mainly occurred in infants and preschool age， and the average age of onset was （4.74 ± 3.48） years old. （2） Clinical treatment plan and use of immunosuppressive agents： Of the 711 children with PNS， 237 were treated with hormone alone （32.33%）， and 474 （66.67%） received immunosuppressive agents combined with hormones. In the initial treatment， hormone combined with Tacrolimus （TAC） was the preferred treatment （32.91%）. For children with refractory PNS who exhibited poor clinical efficacy， Rituximab （RTX） was mostly used for treatment， with a ratio of up to 23.63%. （3） TCM syndrome and medication rule： In PNS syndrome differentiation， Qi and Yin deficiency was identified as the main syndrome. This involved a total of 477 cases， accounting for 67.09%. Yang deficiency of spleen and kidney was observed in 118 cases， accounting for 16.60%. A total of 711 children were included， of which 706 children were treated with TCM. This involved a total of 706 prescriptions， 226 TCM， and 9 793 frequencies. There were 30 herbs used more than 95 times. The top five TCM were Radix et Rhizoma Glycyrrhizae （81.16%）， Radix Astragali （71.81%）， Poria （68.84%）， Rhizoma Atractylodis Macrocephalae （63.60%）， and Fructus Corni （57.37%）. The drug association rules and network diagram showed that the combination of ''Radix Astragali-Rhizoma Atractylodis Macrocephalae-Poria'' was the closest， and five types of combinations were obtained by cluster analysis. ConclusionIn the diagnosis and treatment of PNS in children， TAC combined with hormones shows good clinical efficacy and high safety. For children with refractory PNS， RTX combined with hormones can be used. TCM medication for PNS should follow the basic principles of strengthening the body and vital Qi and make good use of drugs such as Radix Astragali， Poria， Rhizoma Atractylodis Macrocephalae， and cornus to regulate the Yin and Yang balance and achieve better clinical efficacy.

ObjectiveTo analyze the clinical treatment plan and traditional Chinese medicine （TCM） medication rule of children with primary nephrotic syndrome （PNS） in the First Affiliated Hospital of Henan University of Chinese Medicine. MethodsThe gender and age of children firstly diagnosed with nephrotic syndrome in the pediatric nephrology department of the First Affiliated Hospital of Henan University of Chinese Medicine from November 2019 to December 2022 were collected， and the use of immunosuppressive agents and related frequencies were counted. According to the inclusion and exclusion criteria， an independent TCM prescription database for children with nephrotic syndrome was established. Excel was used to analyze the relevant information of the literature. The frequency counting， association rule analysis， and cluster analysis were carried out on TCM in the prescription， and the high-frequent drugs were analyzed. Results（1） General information： A total of 711 children were included， consisting of 522 males （73.42%） and 189 females （26.58%）. The ratio of male to female was about 2.76∶1. The disease mainly occurred in infants and preschool age， and the average age of onset was （4.74 ± 3.48） years old. （2） Clinical treatment plan and use of immunosuppressive agents： Of the 711 children with PNS， 237 were treated with hormone alone （32.33%）， and 474 （66.67%） received immunosuppressive agents combined with hormones. In the initial treatment， hormone combined with Tacrolimus （TAC） was the preferred treatment （32.91%）. For children with refractory PNS who exhibited poor clinical efficacy， Rituximab （RTX） was mostly used for treatment， with a ratio of up to 23.63%. （3） TCM syndrome and medication rule： In PNS syndrome differentiation， Qi and Yin deficiency was identified as the main syndrome. This involved a total of 477 cases， accounting for 67.09%. Yang deficiency of spleen and kidney was observed in 118 cases， accounting for 16.60%. A total of 711 children were included， of which 706 children were treated with TCM. This involved a total of 706 prescriptions， 226 TCM， and 9 793 frequencies. There were 30 herbs used more than 95 times. The top five TCM were Radix et Rhizoma Glycyrrhizae （81.16%）， Radix Astragali （71.81%）， Poria （68.84%）， Rhizoma Atractylodis Macrocephalae （63.60%）， and Fructus Corni （57.37%）. The drug association rules and network diagram showed that the combination of ''Radix Astragali-Rhizoma Atractylodis Macrocephalae-Poria'' was the closest， and five types of combinations were obtained by cluster analysis. ConclusionIn the diagnosis and treatment of PNS in children， TAC combined with hormones shows good clinical efficacy and high safety. For children with refractory PNS， RTX combined with hormones can be used. TCM medication for PNS should follow the basic principles of strengthening the body and vital Qi and make good use of drugs such as Radix Astragali， Poria， Rhizoma Atractylodis Macrocephalae， and cornus to regulate the Yin and Yang balance and achieve better clinical efficacy.

Objective:To investigate the relationship between lipid levels and cognitive impairment in the elderly Chinese population using prospective cohort data.Methods:Based on the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) cohort, this study included 24 380 individuals aged ≥60 years who participated in the cognitive function follow-up survey from 2018 to 2019. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), with cognitive impairment defined according to different educational levels: MMSE ≤17 for illiterate individuals, MMSE ≤20 for those with primary education and MMSE ≤24 for those with secondary education or above. Multivariable linear regression and logistic regression models were employed to examine the associations between six baseline lipid indicators and cognitive scores, as well as cognitive impairment. Additionally, restricted cubic splines were used to explore the exposure-dose relationship between lipid levels and cognitive function.Results:The study population had a median follow-up time of 11.6 years, with a baseline age of (59.7±6.8) years. Among the participants, 9 510 (39.0%) were males, and the mean MMSE score was 24.7±6.8. A total of 3 887 individuals (15.9%) were identified as cognitively impaired. The results of multivariable linear regression and logistic regression indicated that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were not only significantly positively associated with cognitive scores but also significantly associated with a lower risk of cognitive impairment. Each 1 mmol/L increase in these lipid levels corresponded to β values (95% CI) of 0.267 (0.173-0.361), 0.385(0.271-0.499) and 0.331(0.231-0.431), respectively. Each 1 mmol/L increase in these lipid levels corresponded to odds ratio ( OR) (95% CI) values of 0.915 (0.876-0.956), 0.875 (0.830-0.923) and 0.886 (0.848-0.927), respectively. The dose-response curve demonstrated that the negative association was primarily observed within the guideline-recommended optimal lipid level range. Specifically, when LDL-C was less than 3.4 mmol/L and non-HDL-C was less than 4.1 mmol/L, the corresponding OR (95% CI) values were 0.859 (0.796-0.926) and 0.876 (0.818-0.939). Conclusion:Lipid levels exhibit a certain linear negative association with cognitive impairment in elderly Chinese adults, with LDL-C and non-HDL-C demonstrating a stronger effect, particularly within the guideline-recommended optimal range.

Purpose To investigate the clinical features of gastrointestinal leiomyomas(GLs)with scattered ex-pression of CD117 and DOG1,and to evaluate their biological behavior as well as their different diagnositic value from gastrointestinal stromal tumors(GISTs).Methods Clinical data from 17 cases of surgically resected GLs were col-lected.Immunohistochemistry using the EnVision method was performed to detect SMA,desmin,h-caldesmon,DOG1,CD117,and CD34.First-generation sequencing was performed to analyze exons 9-20 of the KIT gene and ex-ons 12 and 18 of the PDGFRA gene.Results Tumors occured in the stomach(8 cases)and esophagus(9 cases).Clinical manifestations included dull upper abdominal pain,dysphagia,chest pain,and fever.During a follow-up peri-od of 58-88 months,no recurrence was observed,and all patients had a favorable prognosis.Histologically,tumor cells were spindle-shaped and arranged in bundles or a woven pattern.Interstitial cells of Cajal appeared spindle-shaped or stellate with indistinct borders and dispersed chromatin.Tumor cells showed diffuse positivity for SMA,desmin,and h-caldesmon(100％).Interstitial cells of Cajal exhibited focal positive for CD117 and DOG1,with an o-verall positive rate of 9％for each marker.No pathogenic mutations of the KIT or PDGFRA genes were detected by first-generation sequencing.Conclusion Although some GLs contained interstitial cells of Cajal that showed focal pos-itivity for CD117 and DOG1,sequencing and long-term follow-up confirmed that their biological behavior differed from that of GISTs,with no malignant potential.Surgical resection remained the mainstay of treatment,and the prognosis was favorable.

Objective:To retrieve and summarize the best evidence for cognitive function improvement in Alzheimer's disease patients, so as to provide reference for clinical practice.Methods:Following the "6S" evidence model, guidelines, expert consensus, clinical decision, and systematic reviews on cognitive function improvement in Alzheimer's disease patients were systematically retrieved from domestic and foreign databases and websites. The search keywords included "Alzheimer's disease, cognitive function, improvement". Evidence-based nursing methods were used to evaluate the quality of literature and extract evidence. The search period was from July 1, 2000 to July 31, 2024.Results:A total of 15 articles were included, including five guidelines, four expert consensus, two clinical decision, and four systematic reviews. Sixteen pieces of best evidence were summarized from four aspects of evaluation and identification, pharmacological intervention, non-pharmacological intervention, and caregiver support.Conclusions:Patients with Alzheimer's disease require timely identification of symptoms related to cognitive impairment and assessment using standardized scales. Multiple intervention methods, such as pharmacological intervention, non-pharmacological intervention, and caregiver support, should be used to enhance patients' quality of life. Evidence application should be tailored to each patient's specific circumstances through individualized selection and adjustment to ensure the effectiveness and scientific rigor of cognitive function improvement strategies, thereby facilitating the translation of optimal evidence into clinical practice.

Objective:To retrieve and summarize the best evidence for cognitive function improvement in Alzheimer's disease patients, so as to provide reference for clinical practice.Methods:Following the "6S" evidence model, guidelines, expert consensus, clinical decision, and systematic reviews on cognitive function improvement in Alzheimer's disease patients were systematically retrieved from domestic and foreign databases and websites. The search keywords included "Alzheimer's disease, cognitive function, improvement". Evidence-based nursing methods were used to evaluate the quality of literature and extract evidence. The search period was from July 1, 2000 to July 31, 2024.Results:A total of 15 articles were included, including five guidelines, four expert consensus, two clinical decision, and four systematic reviews. Sixteen pieces of best evidence were summarized from four aspects of evaluation and identification, pharmacological intervention, non-pharmacological intervention, and caregiver support.Conclusions:Patients with Alzheimer's disease require timely identification of symptoms related to cognitive impairment and assessment using standardized scales. Multiple intervention methods, such as pharmacological intervention, non-pharmacological intervention, and caregiver support, should be used to enhance patients' quality of life. Evidence application should be tailored to each patient's specific circumstances through individualized selection and adjustment to ensure the effectiveness and scientific rigor of cognitive function improvement strategies, thereby facilitating the translation of optimal evidence into clinical practice.

Objective To investigate the expression and clinical significance of long non-codingRNA HCG11 (lncRNA HCG11) mRNA and microRNA (miR)-4465 in patients with triple-negative breast cancer(TNBC). Methods The clinicopathological data of 110 TNBC patients hospitalized in Jiulong Hospital of Suzhou from June 2017 to June 2020 were collected,and the clinical significance of the expression of lncRNA HCG11mRNA and miR-4465 was analyzed. Results The expression of lncRNA HCG11 mRNA (1.81±0.53) in cancer tissues was higher than that in adjacent tissues (0.87±0.13),while the expression of miR-4465 (0.68±0.14) was lower than that in adjacent tissues (1.09±0.18),and the differences were statistically significant(t=18.066,18.857,all P<0.05). The results of Pearson analysis showed that lncRNA HCG11mRNA was negatively correlated with the expression of miR-4465 (r=-0.443,P<0.001). The proportion of patients with high expression of lncRNA HCG11mRNA and low expression of miR-4465 in cancer tissues with lymph node metastasis in TNM stage Ⅲ+Ⅳ was higher than that in TNM stage Ⅰ+Ⅱ,and the proportion of patients without lymph node metastasis was higher (x2=6.614,18.510;8.093,22.976,all P<0.05) The 3-year survival rate of lncRNA HCG11mRNA patients with high expression was lower than that of lncRNA HCG11mRNA patients with low expression,and the 3-year survival rate of patients with high expression of miR-4465 was higher than that of patients with low expression of miR-4465 (Log-rank x2=14.45,13.39,all P<0.05). The proportion of patients with clinical stage Ⅲ+Ⅳ in death group was higher than that in survival group (x2=12.667,18.026,all P<0.05). LncRNA HCG11mRNA(HR=2.623,95％CI:1.344～5.118) was risk factors for 3-year death in TNBC patients,while miR-4465(HR=0.891,95％CI:0.821～0.967) was a protective factor (P<0.05). Conclusion The high expression of lncRNA HCG11 mRNA and the low expression of miR-4465 in triple negatire breast cancer were related to the clinicopathological characteristics and prognosis of patients,and are expected to become prognostic marker for TNBC.

Neuroblastoma is a common extracranial solid tumors in children，and patients with high-risk disease have poor prognosis. Since the pathogenesis of neuroblastoma has not been fully elucidated，early diagnosis and timely，effective clinical intervention are key strategies to improve survival in affected children. As a neuroendocrine tumor，neuroblastoma is characterized by abnormal secretion of catecholamine compounds，the synthesis and release of which are closely associated with both diagnosis and prognosis. This review summarizes the biosynthetic and metabolic pathways of catecholamines and their clinical applications in neuroblastoma，and further discusses the molecular mechanisms by which catecholamines contribute to neuroblastoma progression.

Objective:To explore the relationship between the expression levels of succinate receptor 1 (SUCNR1) and Y-box binding protein 1 (YBX1) in colorectal cancer tissues of patients with colorectal cancer liver metastases (CRLM) and their clinicopathological characteristics and prognosis.Methods:One hundred and five CRLM patients who underwent surgical treatment in Suzhou Kowloon Hospital of Shanghai Jiao Tong University School of Medicine from January 2016 to May 2020 were taken as the study subjects. The high expression rates of SUCNR1 and YBX1 in cancer tissues and adjacent tissues were compared. Clinicopathological characteristics and prognosis of patients with high and low SUCNR1 and YBX1 expression were compared. Univariate and multivariate Cox proportional risk regression models were applied to analyze prognostic influencing factors.Results:SUCNR1 staining was mainly located on the cell membrane in colorectal cancer tissues, and positive staining showed yellow or brownish yellow; YBX1 was mainly located in the cytoplasm of colorectal cancer tissues, and positive staining showed yellow or brownish yellow. The high expression rate of SUCNR1 in cancer tissues (74.29%, 78/105) of CRLM patients was obviously higher than that in adjacent tissues (27.62%, 29/105), and the high expression rate of YBX1 in cancer tissues (84.76%, 89/105) was obviously higher than that in adjacent tissues (32.38%, 34/105), with statistically significant differences ( χ2=45.75, P<0.001; χ2=59.36, P<0.001). There were statistically significant differences in histological grade ( χ2=7.43, P=0.006) and the time from colorectal cancer diagnosis to liver metastasis ( χ2=9.19, P=0.002) between patients with high and low expression of SUCNR1; there was a statistically significant difference in time from colorectal cancer diagnosis to liver metastasis ( χ2=13.08, P<0.001) between patients with high and low expression of YBX1. The 3-year overall survival (OS) rates of patients with high and low expression of SUCNR1 were 52.56% and 77.78%, respectively, with a statistically significant difference ( χ2=6.10, P=0.014) ; the 3-year OS rates of patients with high and low expression of YBX1 were 53.93% and 87.50%, respectively, with a statistically significant difference ( χ2=6.02, P=0.014). Univariate analysis showed that, histological grade ( HR=4.69, 95% CI: 1.14-19.36, P=0.033), time from colorectal cancer diagnosis to liver metastasis ( HR=4.05, 95% CI: 1.02-16.62, P=0.048), cancer tissues SUCNR1 ( HR=5.12, 95% CI: 1.17-22.34, P=0.030), and YBX1 expression ( HR=6.29, 95% CI: 1.55-25.47, P=0.010) were all influencing factors for OS in CRLM patients. Multivariate analysis showed that, histological grade ( HR=4.16, 95% CI: 1.12-15.54, P=0.034), time from colorectal cancer diagnosis to liver metastasis ( HR=5.59, 95% CI: 1.25-24.99, P=0.024), expression of SUCNR1 in cancer tissues ( HR=3.68, 95% CI: 1.28-10.54, P=0.015), and expression of YBX1 in cancer tissues ( HR=3.42, 95% CI: 1.56-7.52, P=0.002) were all independent influencing factors for OS in CRLM patients. Conclusions:The high expression rates of SUCNR1 and YBX1 in cancer tissues of CRLM patients are higher than those in adjacent tissues. Patients with high and low SUCNR1 expression have differences in tumor histological grade, time from colorectal cancer diagnosis to liver metastasis, patients with high and low YBX1 expression has a difference in time from colorectal cancer diagnosis to liver metastasis. The 3-year OS rates of patients with low expression of SUCNR1 and YBX1 are higher than those of patients with high expression. The histological grade, the time from colorectal cancer diagnosis to liver metastasis, and the expression of SUCNR1 and YBX1 in cancer tissues are all independent influencing factors for OS in CRLM patients.