Objective To analyze the application of combined respiratory training in Mycoplasma-associated bronchopneumonia children and its effect on pulmonary function under family-centered model.Methods A total of 150 Children with Mycoplasma-associated bronchopneumonia treated at Hangzhou Children's Hospital from April 2023 to April 2024 were selected as subjects.The children were divided into control group(n=75)and study group(n=75)using a randomized digital table method.The control group received standard interventions,while the study group received family-centered combined respiratory training in addition to control group's treatment.The two groups were compared in terms of pulmonary function,symptom improvement duration,treatment compliance,and patient satisfaction.Results After intervention,compared with the control group,children in study group had higher forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC levels,total treatment compliance and satisfaction,the improvement time of cough,fever and dyspnea were shorter,the difference were statistically significant(P＜0.05).Conclusion The use of family-centered combined respiratory training can improve the pulmonary function of children with mycoplasma infection and bronchopneumonia,shorten the time for symptom improvement,and improve the treatment compliance and satisfaction of children.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective:To explore the relationship between suicide attempts,school bullying,and psychological resilience in children and adolescents with major depressive disorder(MDD)and school bullying and psychological resilience.Methods:A total of 784 patients with MDD aged 10 to 18 years were included.The Chinese version of the Olweus Bullying Victimization Questionnaire,Adolescent Psychological Resilience Scale,and a suicide attempt assessment were utilized to evaluate school bullying,psychological resilience,and suicide attempt.Stepwise logistic regression was applied to identify the associated factors of suicide attempts.Results:The occurrence of suicide at-tempts in children and adolescents with MDD was positively associated with physical bullying(OR=1.85,95％CI:1.14-3.02)and indirect bullying(OR=1.48,95％CI:1.06-2.04),and negatively associated with higher levels of goal focus(OR=0.62,95％CI:0.45-0.85)and positive cognition(OR=0.62,95％CI:0.45-0.85)at higher levels.Conclusion:Bullying significantly increases the risk of suicide attempts in children and adolescents with MDD,while higher psychological resilience could mitigate this risk.

Objective To analyze the application of combined respiratory training in Mycoplasma-associated bronchopneumonia children and its effect on pulmonary function under family-centered model.Methods A total of 150 Children with Mycoplasma-associated bronchopneumonia treated at Hangzhou Children's Hospital from April 2023 to April 2024 were selected as subjects.The children were divided into control group(n=75)and study group(n=75)using a randomized digital table method.The control group received standard interventions,while the study group received family-centered combined respiratory training in addition to control group's treatment.The two groups were compared in terms of pulmonary function,symptom improvement duration,treatment compliance,and patient satisfaction.Results After intervention,compared with the control group,children in study group had higher forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC levels,total treatment compliance and satisfaction,the improvement time of cough,fever and dyspnea were shorter,the difference were statistically significant(P＜0.05).Conclusion The use of family-centered combined respiratory training can improve the pulmonary function of children with mycoplasma infection and bronchopneumonia,shorten the time for symptom improvement,and improve the treatment compliance and satisfaction of children.

Objective:To compare demographic characteristics,clinical characteristics,therapeutic characteris-tics and physiological indicators of patients with bipolar Ⅰ disorder and bipolar Ⅱ disorder.Methods:A total of 381 patients with bipolar disorder(BD)diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5 th Edi-tion(DSM-5)were selected,including 302 patients with BD-Ⅰ(79.27％),74 patients with BD-Ⅱ(19.42％)and 5 patients with other specific and related disorders(1.31％).Demographic and clinical characteristics were collected with self-designed clinical information questionnaire.Multivariate logistic regression and multivariate linear regres-sion analysis were used for analysis.Results:Compared with patients with BD-Ⅱ,patients with BD-Ⅰ had more risk to have psychotic features(OR=5.75,95％CI:2.82-11.76),longer disease duration,and more repeated transcra-nial magnetic therapy(OR=3.09,95％CI:1.02-9.35),higher uric acid,total cholesterol and high-density lipo-protein.BD-Ⅰ in Han nationality was more common(OR=11.50,95％CI:1.76-75.30),and had lower education level(OR=10.22,95％CI:1.16-89.77),and less family history of psychosis(OR=2.34,95％CI:1.01-5.42).Conclusion:There are significant differences between BD-Ⅰ and BD-Ⅱ in demographic and clinical charac-teristics,treatment status,and physiological indicators,which could provide clues for exploring the pathogenesis of bipolar disorder.

Objective:To explore the ways and methods to improve the ability of hospital ethical review and ensure the quality and efficiency of ethical review.Methods:By consulting the literature and combining the practical experience of the construction of the ethics committee and the ethical review work in the hospital, analyze the present situation of ethical review in our country, and deeply analyze the main problems existing in the work of ethical review in hospitals.Results:The quality and efficiency of ethical review can be effectively improved by implementing centralized management, optimizing work processes, establishing emergency response systems, opening green channels, optimizing the composition of committee members, strengthening ethical training and assessment, establishing emergency response systems, opening green channels, strengthening pre-review communication, establishing emergency response systems, opening green channels, strengthening formal review, increasing publicity, and improving ethical awareness.Conclusions:Clarifing the division of responsibilities and strengthen multi-department interaction can effectively improve the efficiency of ethics review. Optimizing the structure of ethics committee, strengthen the training and assessment of members, can effectively enhance the ability of ethics committee review. Unifing the list of documents, optimizing the work flow and the way of examination can effectively shorten the period of ethical examination. It is suggested that continuous ethical training and assessment should be carried out, that an information-based platform system should be used to achieve dynamic supervision, and that a certification system and assessment mechanism for ethics committees should be established at the national level, to promote the improvement of the ability of ethical review.

Objective This paper summarizes and evaluates the existing animal models of Post-infectious irritable bowel syndrome(PI-IBS)based on the clinical diagnostic criteria and symptom characteristics of PI-IBS in Chinese and western medicine.The goal of this study is to seek out animal models with a high degree of clinical agreement between Chinese and western medicine,and to provide an accurate animal model for the prevention and treatment of PI-IBS in traditional Chinese medicine.Methods The animal strains,modelling methods,and mechanisms of the existing PI-IBS animal models were summarized based on the clinical diagnostic features and symptomatology of PI-IBS,as well as the degree of match was evaluated and the strengths and weaknesses of the preparation of animal models were analyzed,by reviewing the articles related to PI-IBS animal experiments and the preparation of animal models.Results A thorough analysis discovered that Campylobacter jejuni infection model,Trichinella infection model,and liver depression and spleen deficiency syndrome in models of disease and symptom combination showed a comparatively high level of clinical agreement between Chinese and western medicine.Conclusion The existing PI-IBS models had the high degree of coincidence with western medicine,Chinese medicine four diagnoses and syndrome are generally less embodied and collected in the modeling process.The primary symptoms in Chinese medicine diagnosis are primarily based on the observation of animal apparent behaviors,while the observation of the sub-syndrome manifestations is relatively less,which results in failure of judgment of TCM syndrome types.Therefore,it is still necessary to further standardize the criteria for evaluating symptoms and the techniques for identifying disease-syndrome combination animal models.PI-IBS model with the syndrome-clinical characteristics in Chinese and western medicine has significant application value and prospects in the future.The multifactorial composite method of western medicine pathological injury+Chinese medicine etiological stimulation can establish a PI-IBS model with a higher degree of coincidence,which can provide theoretical support for the study of the pathogenesis of PI-IBS,the difference of syndrome,and the prevention and treatment with integrative Chinese and western medicine.It is crucial to guide the clinical diagnosis and treatment of PI-IBS.

Objective:To explore the characteristics of glucose and lipid metabolism and intrauterine growth indicators in fetuses with selective intrauterine growth restriction (sIUGR) in twins.Methods:Sixty cases of sIUGR type I twin fetuses who were registered, underwent regular prenatal care, and were hospitalized for delivery at the Fujian Maternity and Child Health Hospital from January 2021 to January 2023 were selected as the research subjects. Selected 30 fetuses with growth restriction from sIUGR pregnant patients were taken as the observation group, while the 30 fetuses with non-growth-restricted served as the control group. During cesarean section, the umbilical vein blood of two fetuses was collected after the fetus was delivered and before the placenta was delivered, and the factors regulating growth, development and metabolism in the umbilical vein blood were detected: adiponectin, leptin, insulin-like growth factor-1 (IGF-1), blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, apolipoprotein B and other indicators. The measurement data of normal distribution are presented as xˉ± s, and the comparison of means between the two groups is performed using paired t-tests. P<0.05 was considered statistically significant. Results:(1) The levels of adiponectin (83.60±8.91) μg/L, leptin (7.11±0.53) μg/L, and IGF-1 (43.43±0.68) μg/L in the umbilical cord blood of the case group were significantly lower than those of the control group (92.50±10.52) μg/L, leptin (12.00±0.66) μg/L, and IGF-1 (70.34±1.44) μg/L, with statistically significant differences ( t-values of 2.94, 31.33, 99.70, respectively; P values of 0.006, <0.001, <0.001, respectively). (2) There was no statistically significant difference in the levels of blood glucose, triglycerides, HDL-C, and apolipoprotein A1 in umbilical cord blood between the two groups of fetuses (all P>0.05). (3) The total cholesterol (2.626±0.764) mmol/L, LDL-C (1.168±0.482) mmol/L, and apolipoprotein B (0.359±0.133) mmol/L in the umbilical cord blood of the case group were significantly higher than those in the control group, with total cholesterol (2.351±0.725) mmol/L and LDL-C (1.043±0.418) mmol/L. Apolipoprotein B was (0.317±0.107) mmol/L, and there was a statistically significant difference between the two groups ( t-values were 3.42, 3.10, and 3.67, respectively; and P values were 0.002, 0.004, and 0.001, respectively). Conclusion:There are abnormalities in lipid metabolism present in the cord blood of growth-restricted infants. Clinically, adiponectin, leptin, IGF-1, total cholesterol, LDL-C, and apolipoprotein B in twin umbilical blood can be served as key indicators for assessing fetal intrauterine development.

【Objective】 To investigate the risk factors of red blood cell transfusion frequency (fRBCT) toward newborns with very/extremely low birth weight (V/ELBW) who experienced <32 weeks of gestational age and were complicated with neonatal respiratory distress syndrome (NRDS), and to explore related complications and predictive indicators that can arise from increased fRBCT, so as to provide safe and scientific blood transfusion recommendations for children with NRDS. 【Methods】 A total of 585 cases of V/ELBW NRDS newborns who experienced <32 weeks of gestational age between January 2016 and December 2020 were retrospectively collected. They were divided into three groups according to the fRBCT throughout their hospitalization[fRBCT = 0(n = 97), 1 ≤fRBCT≤2(n = 253), and fRBCT≥3(n= 235) ]. Clinical data and laboratory parameters of all three groups were compared to identify the risk factors of increased blood transfusion frequency toward V/ELBW NRDS newborns. 【Results】 Statistically significant differences in gestational age (week) (30.72±1.84 vs 29.87±1.66 vs 28.29±1.46), birth weight(g) (1 366.19± 128.12 vs 1 265.20± 163.98 vs 1 081.73± 196.06), hemoglobin level(g/L) (172.37±19.98 vs 161.96±21.41 vs 154.33±24.61) and hematocrit ratio(%) (50.46±5.74 vs 47.69±5.55 vs 45.46±6.84) at admission, as well as duration of hospital stay(d) (40 vs 51 vs 68), non-invasive ventilation(d) (6 vs 11.01 vs 24.56) and intravenous nutrition (IVN) (d) (16.73 vs 22.37 vs 30.74) were found among all three groups (all P<0.05) . Duration of invasive ventilation in Group fRBCT ≥3 (7.66 days) were significantly higher than those in Group fRBCT = 0 and Group 1 ≤fRBCT≤2, showing statistically significant differences (P<0.05). Pairwise comparison of the incidences of hematosepsis (1%, 1/97 vs 4%, 10/253 vs 9.4%, 22/235 ), retinopathy of prematurity (ROP) (16.5%, 16/97 vs 17%, 43/253 vs 46.8%, 110/235) and bronchopulmonary dysplasia (BPD) (4.1%, 4/97 vs 19%, 48/253 vs 59.1%, 139/235) among the three groups demonstrated statistically significant differences (P<0.05). The incidence of neonatal necrotizing enterocolitis (NEC) in Group fRBCT≥3 (26.8%, 63/235) also showed statistically significant differences in relation to Group fRBCT = 0 (P<0.05). Multivariate logistic regression analysis also proved that duration of hospital stay, invasive ventilation and IVN were independent risk factors for Group fRBCT≥ 3 (OR= 1.048, 1.073, and 1.030; all P<0.05). The receiver operating characteristic (ROC) curves indicated that duration of hospital stay, invasive ventilation and IVN made better predictors for Group fRBCT≥3. Areas under the ROC curves were 0.841, 0.766 and 0.716, while the corresponding cutoff values were respectively >57 days, >2.75 days and >23.75 days. 【Conclusion】 Increased fRBCT may complicate V/ELBW NRDS newborns who experienced <32 weeks of gestational age with NEC, hematosepsis, BPD and ROP. Duration of hospital stay, invasive ventilation and IVN are relatively effective predictive indicators for whether such cases have undergone ≥3 red blood cell transfusions throughout their hospitalization.

Objective:Taking into account of the current situation that domestic laws and regulations of medical technology ethics review are not perfect, we put forward practical suggestions on ethical review supervision of the clinical application of new medical technologies from the perspective of standardization.Methods:Referring to the relevant laws, regulations and specific implementation guidelines of ethical review of clinical research, combined with the practical experience of the ethics committee of the host Hospital, this paper systematically summarizes the concept and characteristics and existing problems of new clinical applied medical technology, optimizes the working steps of technology access and ethical review, and establishes an ethical continuing review model.Results:A series of measurements are proposed, which including formulate the access process, improve the management system, optimize ethical review methods, etc. At the same time, pay more attention to the annual continuing review, adverse event report review, suspension/termination of approved research, closure report review, as well as site visit to improve the initiative and efficiency of ethical review. At last, it ensures the continuing of ethical review.Conclusions:It is very important to regulate new medical technology project entry and ethical review supervision in the practice. On one hand, it can effectively make up for the possible shortcomings of current laws and regulations and promote the introduction of new regulatory requirement. On the other hand, it can effectively reduce the medical technology risks and build good medical quality management, improve the system to better safeguard people′s health rights and interests.