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）.

Guided by the theory of "mutual dependence of ascending and descending"， recurrent pediatric cough and asthma are considered to result from the imbalance of the ascending and descending of zang-fu organ qi， which is closely associated with deficiency， phlegm， and blood stasis. In clinical practice， the disease is treated based on differentiation during the initial stage， progression stage， and stable stage. In the initial stage， the pathogenesis is attributed to lung deficiency complicated by external pathogens and liver qi rising to attack the lung； the treatment should focus on restraining the lung and calming the liver， using the self-formulated Longchai Yuchuan Fomulation （龙柴愈喘方）. During the progression stage， the disorder is due to the spleen failing to ascend clear qi and the kidney failing to grasp qi， leading to phlegm formation from deficiency； treatment should focus on tonifying spleen yang， supplementing kidney qi， and resolving phlegm and fluid retention， using a modified combination of Linggui Zhugan Decoction （苓桂术甘汤） and Jinkui Shenqi Pill （金匮肾气丸）. In the stable stage， qi deficiency leads to poor consolidation， with phlegm turbidity and blood stasis； the treatment should aim at tonifying qi， transforming phlegm， and dispelling blood stasis， using a modified version of Guizhi Fuling Pill （桂枝茯苓丸）.

Based on the theory of "spleen functions as wei qi"， this paper believes that the disease mechanism of allergic rhinitis （AR） in children is the nasal dysfunction caused by the loss of spleen's wei qi. The root cause of AR is the failure of splenic transportation as well as its inability to properly distribute nutrients. The inducement of AR is the invasion of pathogenic qi coupled with insecurity of the wei exterior. The key to AR recurrence lies in the deficiency of healthy qi and lingering of pathogenic qi， with pathogenic qi lodging inside the body. The treatment should adhere to the principle of helping the spleen restore wei qi. During the acute phase， the treatment should dispel wind， conso-lidate the wei qi， and relieve stuffy orifices， and the modified Qufeng Tongqiao Decoction （祛风通窍汤） is used. During the remission phase， the treatment should fortify the spleen， raise the clear， and harmonize the wei qi， and the modified Yuhan Decoction （御寒汤） is applied. During the recovery phase， the treatment should reinforce the healthy qi， consolidate the constitution， and strengthen the wei qi， and the modified Huangqi Jianzhong Decoction （黄芪建中汤） is employed.

Based on the "sweat pore-qi and liquid-collaterals" theory， it is considered that the core pathogenesis of pediatric infectious mononucleosis lies in the obstruction of sweat pores， the failure of qi and liquid to disperse， and damage to the collaterals due to pathogenic toxins. Accordingly， the treatment principles proposed include unblocking the sweat pores， regulating qi and liquid， and smoothing the collaterals. In clinical practice， treatment is differentiated according to stages： initial， acute， and late stages. In the initial stage， invasion of warm pathogenic toxins into the lung defense leads to obstruction of the sweat pores， which should be treated by unblocking the sweat pores and expelling pathogens outward. In the acute stage， the obstruction of the sweat pores worsens， leading to the failure of qi and liquid dispersal， resulting in intense heat toxins with accumulation of dampness， phlegm， and blood stasis， which should be treated by promoting qi movement， resolving dampness and phlegm， clearing heat， detoxifying， and dispersing stasis to regulate qi and liquid. In the late stage， residual pathogens remain， with qi and yin deficiency and unsmooth collaterals， which should be treated by unblocking the collaterals， dissipating nodules， tonifying qi， and nourishing yin to smooth the collaterals. This approach may provide new insights for the clinical treatment of pediatric infectious mononucleosis.

Guided by "triple-yang combination of diseases"， it is believed that the core pathogenesis of acute respiratory infection in children is external cold and internal heat， and triple-yang combination， and its transmission can be divided into two forms. First， the taiyang syndrome usually happens earlier， presenting as the exterior cold in taiyang is not yet resolved， and inward penetration of exterior cold transfers into heat， which combines the disease of shaoyang and yangming； second， yangming meridian already has internal heat， then meets with taiyang meridian externally infected with pathogenic qi， both internal and external pathogens accumulated in the two meridians and affected shaoyang meridian. It is proposed that the therapeutic method should release the exterior and clean the interior， and treat the triple-yang at the same time， with self-prescribed Chaige Gaore Formula （柴葛高热方） as the empirical formula for the treatment of acute respiratory infections in children.

Objective: To analyze the change trends in the body shape indicators and proportions of students in Harbin from 2010 to 2024, and to investigate ergonomic compatibility of functional dimensions of school desks and chairs with current student shape indicators, so as to provide a reference for revising furniture standards of desks and chairs. Methods: Between September and November of both 2010 and 2024, a combination of convenience sampling and stratified cluster random sampling was conducted across three districts in Harbin, yielding samples of 6 590 and 6 252 students, respectively. Anthropometric shape indicators cluding height, sitting height, crus length, and thigh length-and their proportional changes were compared over the 15-year period. The 2024 data were compared with current standard functional dimensions of school furniture. The statistical analysis incorporated t-test and Mann-Whitney U- test. Results: From 2010 to 2024, average height increased by 1.8 cm for boys and 1.5 cm for girls; sitting height increased by 1.5 cm for both genders; crus length increased by 0.3 cm for boys and 0.4 cm for girls; and thigh length increased by 0.5 cm for both genders. The ratios of sitting height to height, and sitting height to leg length increased by less than 0.1 . The difference between desk chair height and 1/3 sitting height ranged from 0.4-0.8 cm. Among students matched with size 0 desks and chairs, 22.0% had a desk to chair height difference less than 0, indicating that the desk to chair height difference might be insufficient for taller students. The differences between seat height and fibular height ranged from -1.4 to 1.1 cm; and the differences between seat depth and buttock popliteal length ranged from -9.8 to 3.4 cm. Among obese students, the differences between seat width and 1/2 hip circumference ranged from -20.5 to -8.7 cm, while it ranged from -12.2 to -3.8 cm among non obese students. Conclusion Current furniture standards basically satisfy hygienic requirements; however, in the case of exceptionally tall and obese students, ergonomic accommodations such as adaptive seating allocation or personalized adjustments are recommended to meet hygienic requirements.

Objective:To investigate the clinicopathological and genetic characteristics of malignant transformation of polyostotic fibrous dysplasia (FD) in long bone.Methods:A retrospective analysis of clinical characteristics and morphological features was conducted from 4 cases of malignant transformation of FD diagnosed at Beijing Jishuitan Hospital from January 2016 to December 2023. Hotspot mutations for GNAS gene were tested in 4 cases by Sanger sequencing, in which both FD and malignant tissues were detected in 3 cases respectively.Results:There were 2 female and 2 male patients, aged 46 to 53 years [mean (49±3.2) years], and the course of the disease spanned from 2 months to 36 years. The tumor involved the femur ( n=2), tibia ( n=1) and humerus ( n=1). Three of them were diagnosed with FD before surgery. Single photon emission computed tomography showed multiple increases in bone metabolism, CT showed poorly margin, cortical destruction and soft tissue mass with uneven enhancement. Three cases had both FD and sarcoma components, while the remaining case exhibited exclusively sarcoma. The sarcomas displayed significant morphological variation, with 1 case diagnosed as osteosarcoma and 3 cases classified as low to high grade spindle cell sarcoma. Immunohistochemical results did not provide any indications for clear classification. Sanger sequencing demonstrated GNAS mutations of p.R201H (c.CGT>CAT, n=2) and p.R201C (c.CGT>TGT, n=2). All 4 cases were followed-up for 18 to 76 months, and received chemotherapy after surgery; 2 cases maintained disease-free, one case was diagnosed with invasive breast cancer through a core needle biopsy 3 months after chemotherapy, and another one was found to relapse 18 months after surgery. Conclusions:Some cases of polyostotic FD occur in association with café-au-lait macules and/or endocrine hyperfunctioning in McCune-Albright syndrome (MAS); polyostotic FD and MAS have more malignant potential than monostotic FD, but they are not the risk factors for FD malignancy. GNAS mutations may be involved in the occurrence and development of FD. The histologic types of malignant transformation of polyostotic FD in long bone are diverse, the sarcoma components of FD also present the GNAS mutation, suggesting potential involvement in the pathogenesis of FD malignancy.

Objective:To investigate the clinicopathological and genetic characteristics of malignant transformation of polyostotic fibrous dysplasia (FD) in long bone.Methods:A retrospective analysis of clinical characteristics and morphological features was conducted from 4 cases of malignant transformation of FD diagnosed at Beijing Jishuitan Hospital from January 2016 to December 2023. Hotspot mutations for GNAS gene were tested in 4 cases by Sanger sequencing, in which both FD and malignant tissues were detected in 3 cases respectively.Results:There were 2 female and 2 male patients, aged 46 to 53 years [mean (49±3.2) years], and the course of the disease spanned from 2 months to 36 years. The tumor involved the femur ( n=2), tibia ( n=1) and humerus ( n=1). Three of them were diagnosed with FD before surgery. Single photon emission computed tomography showed multiple increases in bone metabolism, CT showed poorly margin, cortical destruction and soft tissue mass with uneven enhancement. Three cases had both FD and sarcoma components, while the remaining case exhibited exclusively sarcoma. The sarcomas displayed significant morphological variation, with 1 case diagnosed as osteosarcoma and 3 cases classified as low to high grade spindle cell sarcoma. Immunohistochemical results did not provide any indications for clear classification. Sanger sequencing demonstrated GNAS mutations of p.R201H (c.CGT>CAT, n=2) and p.R201C (c.CGT>TGT, n=2). All 4 cases were followed-up for 18 to 76 months, and received chemotherapy after surgery; 2 cases maintained disease-free, one case was diagnosed with invasive breast cancer through a core needle biopsy 3 months after chemotherapy, and another one was found to relapse 18 months after surgery. Conclusions:Some cases of polyostotic FD occur in association with café-au-lait macules and/or endocrine hyperfunctioning in McCune-Albright syndrome (MAS); polyostotic FD and MAS have more malignant potential than monostotic FD, but they are not the risk factors for FD malignancy. GNAS mutations may be involved in the occurrence and development of FD. The histologic types of malignant transformation of polyostotic FD in long bone are diverse, the sarcoma components of FD also present the GNAS mutation, suggesting potential involvement in the pathogenesis of FD malignancy.

Objective: To evaluate the bone repair effect of 3D-printed magnesium (Mg)-loaded polycaprolactone (PCL) scaffolds in a rat skull defect model. Methods: PCL scaffolds mixed with Mg microparticles were prepared by using 3D printing technology, as were pure PCL scaffolds. The surface morphologies of the two scaffolds were observed by scanning electron microscopy (SEM), and the surface elemental composition was analyzed via energy dispersive spectroscopy (EDS). The physical properties of the scaffolds were characterized through contact angle measurements and an electronic universal testing machine. This study has been reviewed and approved by the Ethics Committee. A critical size defect model was established in the skull of 15 Sprague-Dawley (SD) rats, which were divided into the PCL group, PCL-Mg group, and untreated group, with 5 rats in each group. Micro-CT scanning was performed to detect and analyze skull defect healing at 4 and 8 weeks after surgery, and samples from the skull defect area and major organs of the rats were obtained for histological staining at 8 weeks after surgery. Results: The scaffolds had a pore size of (480 ± 25) μm, a fiber diameter of (300 ± 25) μm, and a porosity of approximately 66%. The PCL-Mg scaffolds contained 1.0 At% Mg, indicating successful incorporation of Mg microparticles. The contact angle of the PCL-Mg scaffolds was 68.97° ± 1.39°, indicating improved wettability compared to that of pure PCL scaffolds. Additionally, compared with that of pure PCL scaffolds, the compressive modulus of the PCL-Mg scaffolds was (57.37 ± 8.33) MPa, demonstrating enhanced strength. The PCL-Mg group exhibited the best bone formation behavior in the skull defect area compared with the control group and PCL group at 4 and 8 weeks after surgery. Moreover, quantitative parameters, such as bone volume (BV), bone volume/total volume (BV/TV), bone surface (BS), bone surface/total volume (BS/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N) and bone mineral density (BMD), of skull defects were better than those in the other groups, indicating the best bone regeneration effect. H&E, Goldner, and VG staining revealed more mineralized new bone formation in the PCL-Mg group than in the other groups, and H&E staining of the major organs revealed good biosafety of the material. Conclusion PCL-Mg scaffolds can promote the repair of bone defects and have clinical potential as a new scaffold material for the repair of maxillofacial bone defects.