This paper explores the differentiation and treatment strategies for pediatric IgA vasculitis based on the correlation between blood trubidity theory and oxidative stress. It is proposed that pediatric IgA vasculitis follows an evolution of pathogenesis characterized by "deficiency of healthy qi leading to turbidity generation， accumulation of turbid toxin， and toxin damage to the collateral vessels"， which corresponds to the pathological process of oxidative stress， namely decreased antioxidant capacity with accumulation of reactive oxygen species， metabolite deposition， and endothelial cell injury. A staged treatment strategy is proposed. In the acute stage， wind-toxin invading the colla-terals and reckless movement of heat in the blood are the main manifestations， for which the treatment should focus on dispelling wind and venting pathogens， resolving toxins and unblocking the collaterals， with a modified Yinqiao Powder （银翘散） and Xijiao Dihuang Decoction （犀角地黄汤） to regulate oxidative stress burst. In the prolonged stage， intermingling of turbidity and stasis with collateral obstruction is emphasized； treatment should focus on resolving turbidity and dispelling stasis， harmonizing the blood and stabilizing the collaterals， and a modified Simiao Powder （四妙散） and Taohong Siwu Decoction （桃红四物汤） can be used to improve microcirculatory dysfunction. In the remission stage， when healthy qi remains insufficient and residual pathogens persist， treatment should focus on strengthening the root and clearing the source， reinforcing healthy qi and nourishing the collaterals， for which modified Zhibai Dihuang Pill （知柏地黄丸） and Yupingfeng Powder （玉屏风散） is suggested to rebuild the antioxidant defense system.

Objective: To understand the current status and related factors of oral health behavior in preschool children, so as to provide scientific basis for improving parents oral health care abilities. Methods: From March 5 to 12, 2024, using a stratified cluster sampling method, an online questionnaire survey was conducted among parents of 1 381 preschool children aged 3-6 from 6 selected kindergartens of a district in Beijing. A structural equation model (SEM) was constructed based on the Theory of Planned Behavior framework to analyze the factors associated with preschool children s oral health behaviors. Results: The rates of parental assistance in brushing teeth, regular oral examination, and postprandial rinsing were 44.4%, 18.6% and 23.6%, respectively. Attitude, subjective norms were positively correlated with oral health behavior intention ( r =0.61, 0.55); attitude, perceived behavioral control, and behavioral intention were positively correlated with oral health behavior ( r =0.14, 0.13, 0.16) (all P < 0.01 ). The results of the SEM showed that attitude and subjective norms had a significant direct effect on oral health behavior intention ( β = 0.42 , 0.40), and the direct effect of perceived behavioral control on oral health behavior was statistically significant ( β =0.42) (all P <0.01). Conclusions The overall level of oral health behavior among preschool children needs to be improved. Perceived behavioral control is the most direct positive related factor of oral health behavior. In the future, intervention measures should focus on perceived behavioral control as the entry point and provide systematic intervention guidance in combination with planned behavior theory.

As one of the common systemic vasculitides in children， IgA vasculitis is closely associated with the interaction of "Wind pathogen" and "turbid stasis" in its pathogenesis. Based on the blood turbidity theory， this paper proposes "wind agitating blood turbidity and collateral damage" as the core pathogenesis. Regarding treatment， the sequential therapeutic principle of "stanch bleeding， activating blood circulation， and nourishing blood" is adopted， and combined with the dynamic application of wind-dispelling medicinals to "expel， search， and guard against wind"， turbidity-removing method is applied throughout all stages. In the acute stage，it is recommended to clear heat and purify turbidity， stanch bleeding and secure the collaterals. In the prolonged stage， the method of dissipating stasis and clearing up turbidity should be used， as well as activating blood circulation and unblocking the collaterals. In the recovery stage， it is advised to nourish blood to flourish the collaterals， reinforce healthy qi and resolve turbidity. This therapeutic system integrates the elimination of pathogens and the reinforcement of healthy qi to clear and resolve blood turbidity， ultimately achieving holistic collateral repair through securing， unblocking， and nourishing the collaterals， which provides new insights into the treatment of this disease in traditional Chinese medicine.

ObjectiveTo systematically investigate the medication rules of chicken-derived medicinals for treating children enuresis in ancient Chinese medical classicals. MethodsThe China Medical Classics V5.0 database was searched to identify formulas and passages containing chicken-derived medicinals for pediatric enuresis. A database was established using Microsoft Excel 2021 to extract information including formulas， therapeutic categories， natures， flavors， channel entry， processing methods， dosage forms， and administration methods. Frequency analysis was performed， while association rule analysis and cluster analysis were conducted using R software. Gephi 0.10.1 software was used for complex network analysis. ResultsA total of 171 records were included， comprising 36 single-herb formulas and 135 compound formulas， sourced from 64 classical medical monographs. The identified chicken-derived medicinals included jichang （Intestinum Galli）， jineijin （Endothelium Corneum Gigeriae Galli）， jigan （Gallina Hepar）， jishibai （Faeces Galli Albi）， jisu （Ingluvies Galli）， jiheling （Pluma Alae Galli）， and jiweimao （Chicken tail feathers）. The top three frequently used single herbs were jichang （17 times）， jineijin （8 times）， and jiheling （5 times）. Among compound prescriptions， the three most frequently recorded formulas were Jineijin Powder （鸡内金散， 43 times）， Jichang Powder （鸡肠散， 25 times）， and Guigan Pills （桂肝丸， 24 times）， with jineijin， jichang， and jigan being the predominant chicken-derived medicinals. When converting the daily dosage of chicken-derived medicines into modern dosage units， the dose ranged from 0.53 g to 33.57 g for jineijin， with 4.48 g being the most frequently used dose， and from 0.25 g to 30.00 g for jichang， with 17.90 g being the most frequently used dose. Chicken-derived medicinals were mostly used after processing， commonly employing burning （68 times）， roasting/ stir-baking （37 times）， and calcining （24 times） to preserve properties. Powders （117 times）， pills （45 times）， and decoctions （9 times） were the principal dosage forms， and administration with wine （70 times） was the most common method. The most frequently used herbal pair was jineijin and roucongrong （Herba Cistanches）， while the core prescription combinations were Tusizi Powder （菟丝子散）， Yangshi Jichang Powder （杨氏鸡肠散）， and Rongxiang Pill （茸香丸）. ConclusionChicken-derived medicinals ， such as jichang and jineijin， are commonly processed by burning or roasting before use in the treatment of enuresis. They are often combined with longgu （Fossilia Ossis Mastodi）， muli （Concha Ostreae）， sangpiaoxiao （Oötheca Mantidis）， roucongrong and rougui （Cortex Cinnamomi） to warm and tonify the kidney qi， arrest enuresis and emission with astringents. Pills and powders are the predominant dosage forms and are commonly administered before meals with wine or salted water.

Objective:To systematically synthesize the real experiences of women who have undergone emergency cesarean sections, providing evidence-based insights to inform the development of personalized care strategies.Methods:A comprehensive literature search was conducted across PubMed, Web of Science, Embase, CINAHL, Cochrane Library, PsycINFO, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative and mixed-methods studies related to the psychological experiences of women who underwent emergency cesarean sections. The search covered all publications up to January 31, 2025. The methodological quality of included studies was appraised using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were integrated using an aggregative synthesis approach.Results:A total of 16 studies were included, from which 78 findings were extracted and grouped into nine new categories. These were further synthesized into three overarching themes: shift in birth plan and emergence of dynamic emotional responses; desire for diversified external support and encouragement; emotional investment and character growth.Conclusions:Women undergoing emergency cesarean sections commonly experience intense negative emotions. It is essential for healthcare providers and family members to pay close attention to the physical and psychological well-being of postpartum women, offer timely emotional support, and help them recover from psychological trauma, thereby promoting maternal mental and physical health.

Objective To investigate the immunomodulatory effect of albumin-bound Paclitaxel combined with Sintilimab on advanced esophageal cancer,and to analyze the survival benefit.Methods A total of 126 patients with advanced esophageal cancer admitted to Rugao People's Hospital from March 2020 to March 2023 were selected,and divided into the observation group(n=63)and the control group(n=63)using a random number table method.The control group was given albumin-bound Paclitaxel,while the observation group was given albumin-bound Paclitaxel combined with Sintilimab.The clinical efficacy,tumor markers[cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC-Ag),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)],immune function indicators(Th1/Th2,Th17/Treg),PD-1/PD-L1 signaling pathway indicators,Karnofsky performance status(KPS)scores,overall survival,and toxic side effects were compared between the two groups.Results The objective remission rate[38.10%(24/63)]and disease control rate[87.30%(55/63)]of the observation group were higher than those of the control group[20.63%(13/63),71.43%(45/63)](P<0.05).After 2 and 4 cycles of treatment,the serum SCC-Ag,CYFRA21-1,CA125 and CEA in the observation group were lower than those in the control group(P<0.05);after 2 and 4 cycles of treatment,compared with the control group,the observation group showed higher Th1/Th2,and lower Th17/Treg,PD-1 and PD-L1(P<0.05).The improvement rate of quality of life,progression free survival and overall survival in the observation group were higher or longer than those in the control group(P<0.05).There was no significant difference in the incidence of abnormal liver dysfunction,nausea and vomiting,decreased hemoglobin and leucopenia between the two groups(P>0.05),but the incidence of rash in the observation group[57.14%(36/63)]was higher than that in the control group[34.92%(22/63)](P<0.05).Conclusion Combination therapy of Sintilimab and albumin-bound Paclitaxel shows significant efficacy in the treatment of advanced esophageal cancer.It can regulate serum tumor marker levels,improve immune function,reduce the activity of the PD-1/PD-L1 signaling pathway to inhibit disease progression,enhance survival benefits,and improve quality of life.However,attention should be paid to the observation of rash reactions during treatment.

Objective:To investigate the alterations in the topological properties of gray matter and white matter dynamic and static functional brain networks in patients with major depressive disorder (MDD) and bipolar depression (BDD) using graph theory analysis, and to evaluate the potential of their combination as biomarkers for differential diagnosis between unipolar and bipolar depression.Methods:From March 2021 to April 2024, inpatients were recruited from the Department of Psychosomatic Medicine, Zhongda Hospital, Southeast University, including 132 patients with MDD, 84 patients with BDD, and 91 healthy controls (HCs). Resting-state structural and functional MRI data were collected, and dynamic and static functional brain networks of gray matter and white matter were constructed. Graph theory analysis was applied to calculate global and nodal network properties, differences in topological attributes among the three groups were compared by One-way analysis of covariance, and Turkey′s post hoc test was used for further pairwise comparison. The network topology attribute indicators with statistically significant inter-group differences were selected using the Least Absolute Shrinkage and Selection Operator regression (LASSO) for feature classification. The diagnostic performance of combined gray and white matter network features for distinguishing MDD from BDD was assessed using receiver operating characteristic (ROC) curves and a random forest model.Results:In the analysis of the static gray matter functional network, both MDD and BDD patients showed abnormal local topological properties. Compared with HCs, the MDD group exhibited abnormal betweenness centrality (BC) in the left inferior frontal gyrus, left precuneus, left ventromedial occipital cortex, right ventromedial occipital cortex, and right anterior thalamus ( t=-3.95-3.62, all P<0.05). The degree centrality (DC) of the left and right anterior thalamus was also abnormal in the MDD group ( t=3.78,4.14, both P<0.001), as was the nodal efficiency (Ne) of the left precuneus and bilateral anterior thalamus ( t=2.37, 3.61, 3.82, all P<0.05). Compared with HCs, the BDD group showed abnormalities in DC and Ne of the left precuneus ( t=-2.76, P=0.014; t=-3.01, P=0.007). In the analysis of the dynamic white matter functional network, both MDD and BDD patients demonstrated abnormal temporal variability of local topological properties. Compared with HCs, the MDD and BDD groups showed reduced BC temporal variability in the left superior corona radiata ( t=-2.39, P=0.047; t=-4.28, P<0.001), and there were significant differences in DC temporal variability in the right posterior limb of the internal capsule and lentiform nucleus ( t=2.65, P=0.021; t=3.49, P=0.001) in MDD group compared with HCs and BBD. The differential diagnosis model combining gray and white matter dynamic and static network topological features achieved an area under the ROC curve of 0.80. Conclusion:Both MDD and BDD exhibit altered topological properties in static gray matter functional networks and dynamic white matter functional networks. The combination of these features may aid in the differential diagnosis of MDD and BDD.

Objective To explore the expression of leukemia inhibitory factor receptor(LIFR)in patients with non-ST-segment elevation myocardial infarction(NSTEMI)and its possible associa-tion with myocardial remodeling.Methods A total of 188 patients with acute myocardial infarc-tion who underwent coronary angiography in our hospital from January 2023 to November 2024 were prospectively enrolled and divided into a control group(94 cases)and an NSTEMI group(94 cases)according to being diagnosed with NSTEMI or not.General clinical data of the patients were collected,and the correlation between serum LIFR level and other indicators was analyzed using linear regression analysis.Results Compared with the control group,the NSTEMI group had significantly higher ratios of smoking history,elevated levels of LIFR,NT-proBNP,cTnⅠ,Cr and UA,increased WBC count,but lower LVEF value[48.94％vs 13.83％,P＜0.01;5.82(4.23,8.11)mmol/L vs 0.97(0.60,1.41)mmol/L,P＜0.01;2.53(1.24,9.71)pg/L vs 0.03(0.02,0.04),P＜0.01;18.57(4.11,250.00)ng/L vs 0.00(0.00,0.00)ng/L,P＜0.01;82.50(68.00,121.25)μmol/L vs 68.50(53.00,88.25)μmol/L,P＜0.01;411.00(349.00,521.25)μmol/L vs 337.00(286.75,406.00)μmol/L,P＜0.01;10.21(8.71,13.09)× 109/L vs 6.22(4.67,7.46)× 109/L,P＜0.01;47.00(38.00,54.00)％vs 59.00(56.00,60.00)％,P＜0.01].Serum LIFR level in the patients was posi-tively correlated with NT-proBNP,cTnⅠ,Cr and WBC count(β=1.403,95％CI:10 597.867-17 327.087,P=0.000;β=0.232,95％CI:114.558-1769.808,P=0.026;β=0.336,95％CI:0.164-0.617,P=0.001).Conclusion LIFR may be involved in the development of myocardial remode-ling and heart failure after myocardial infarction through its role in inflammation.

Objective To investigate the immunomodulatory effect of albumin-bound Paclitaxel combined with Sintilimab on advanced esophageal cancer,and to analyze the survival benefit.Methods A total of 126 patients with advanced esophageal cancer admitted to Rugao People's Hospital from March 2020 to March 2023 were selected,and divided into the observation group(n=63)and the control group(n=63)using a random number table method.The control group was given albumin-bound Paclitaxel,while the observation group was given albumin-bound Paclitaxel combined with Sintilimab.The clinical efficacy,tumor markers[cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC-Ag),carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA)],immune function indicators(Th1/Th2,Th17/Treg),PD-1/PD-L1 signaling pathway indicators,Karnofsky performance status(KPS)scores,overall survival,and toxic side effects were compared between the two groups.Results The objective remission rate[38.10%(24/63)]and disease control rate[87.30%(55/63)]of the observation group were higher than those of the control group[20.63%(13/63),71.43%(45/63)](P<0.05).After 2 and 4 cycles of treatment,the serum SCC-Ag,CYFRA21-1,CA125 and CEA in the observation group were lower than those in the control group(P<0.05);after 2 and 4 cycles of treatment,compared with the control group,the observation group showed higher Th1/Th2,and lower Th17/Treg,PD-1 and PD-L1(P<0.05).The improvement rate of quality of life,progression free survival and overall survival in the observation group were higher or longer than those in the control group(P<0.05).There was no significant difference in the incidence of abnormal liver dysfunction,nausea and vomiting,decreased hemoglobin and leucopenia between the two groups(P>0.05),but the incidence of rash in the observation group[57.14%(36/63)]was higher than that in the control group[34.92%(22/63)](P<0.05).Conclusion Combination therapy of Sintilimab and albumin-bound Paclitaxel shows significant efficacy in the treatment of advanced esophageal cancer.It can regulate serum tumor marker levels,improve immune function,reduce the activity of the PD-1/PD-L1 signaling pathway to inhibit disease progression,enhance survival benefits,and improve quality of life.However,attention should be paid to the observation of rash reactions during treatment.

Objective:To explore the diagnostic value of blood flow parameters of carotid ultrasound combined with serum Sortilin and paraoxonase-1 (PON-1) for stability of carotid atherosclerotic plaque (CAP). Methods:A total of 100 CAP patients who admitted to Rugao Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were selected,and they were divided into a stable plaque group (n=54) and a unstable plaque group (n=46). Enzyme linked immunosorbent assay (ELISA) was adopted to determine the expression levels of serum Sortilin and PON-1 of patients in two groups. Multi factor logistic regression was implemented to analyze the influencing factors on CAP stability. The receiver operating characteristic (ROC) curves were drawn to analyze the diagnostic efficiency of blood flow parameters of carotid ultrasound combined with Sortilin and PON-1 on CAP stability. Results:Compared with the end diastolic blood flow velocity (EDV) and intima-media thickness (IMT) of stable plaque group,unstable plaque group showed increased EDV and IMT,and decreased PSV,and the differences were significant (t=7.536,4.680,5.487,P<0.05),respectively. Compared with stable plaque group,the serum Sortilin level in unstable plaque group significantly increased,while the PON-1 level significantly decreased,and the differences of them were significant (t=8.362,5.581,P<0.05),respectively. Multivariate logistic analysis found that Sortilin was a risk factor that affected CAP stability (OR=3.165,P<0.05),while PON-1 was a protective factor that affected CAP stability (OR=0.765,P<0.05). ROC curve analysis indicated that the area under curve (AUC) values of single Sortilin,PON-1,EDV,IMT,PSV,and the combination of them were respectively 0.788 (95％CI:0.695-0.864),0.814 (95％CI:0.724-0.885),0.847 (95％ CI:0.761-0.911),0.767 (95％ CI:0.672-0.846),0.707 (95％ CI:0.607-0.793) and 0.963 (95％ CI:0.839-0.907). The AUC value of the combination of above 5 indicators was highest,which was better than that of each single indicator,and its sensitivity and specificity were respectively 95.65％ and 83.33％. Conclusion:The EDV,IMT and PSV of blood flow parameters of ultrasound can provide CAP information of morphology and hemodynamics,and serum Sortilin level and PON-1 level can reflect the biological processes of formation and development of CAP. The combined detection of the five indicators can better diagnose CAP stability.