Objective:To investigate the nutritional risk status of children in PICU and analyze its influencing factors.Methods:From July 2021 to February 2023,all children aged 1 to 18 years admitted to PICU of Beijing Children's Hospital were investigated by using the pediatric Yorkhill Malnutrition Scoring tool(PYMS)and the clinical data questionnaire.Results:A total of 492 children in PICU were enrolled.The first nutritional risk screening results showed that there were 32 cases of no/low nutritional risk(6.5%),76 cases of medium risk(15.4%),and 384 cases of high risk(78.1%).The incidence of medium/high nutritional risk was as high as 93.5%.The PYMS score of nutritional risk in PICU was(2.61±1.42).The results of multiple linear regression analysis showed that weight,fever time before admission,white blood cells,body mass index,primary diagnosis,father's education,and diet before illness were the main influencing factors of nutritional risk of children in PICU(P<0.05).Conclusion:Children in PICU are in a state of high nutritional risk.It is suggested that children in PICU should carry out nutritional screening in a standardized manner,identify children with high nutritional risk and its influencing factors early.To actively conduct nutritional assessment and nutritional intervention could improve the clinical outcome of children in PICU.

AIM To study the chemical constituents from the bark of Toona sinensis(A.Juss.)Roem and their anti-inflammatory activity.METHODS Silica gel,RP-18 reverse phase silica gel and HPLC were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their anti-inflammatory activity were evaluated by RAW264.7 model.RESULTS Sixteen compounds were isolated and identified as(9Z)-18-hydroxyo-ctadec-9-en-4,6-diyn-3-one(1),toonapolyyne C(2),(9S,10E,16R)-octadec-10-ene-12,14-diyne-1,9,16-triol(3),(9S,10E,16R)-9,16-dihydroxyoctadec-10-ene-12,14-diy-n-1-yl acetate(4),toonapolyyne A(5),toonasindiyne B(6),scopoletin(7),sco-parone(8),3-O-acetyl(-)-epicatechin(9),p-ethoxyacetanilide(10),kulonic acid(11),β-sitosterol-3-O-β-D-glucopyranoside(12),vanillic acid(13),cleomiscosin A(14),(-)-isolariciresinol(15),resveratrol(16).The IC50 values of compounds 3-4,6,11-13 for NO were 6.90,10.49,20.03,9.49,18.34,24.36 μmol/L,respectively.CONCLUSION Compound 1 is a new polyacetylene,8-16 are isolated from T.sinensis for the first time.Compounds 3-4,6,11-13 have good anti-inflammatory activity.

In order to explore the effect of PGD2/DP1 receptor pathway on the expression of cyto-kines and injury-related factors in Escherichia coli(E.coli)induced bovine bone marrow derived macrophages,an in vitro model of E.coli induced bovine bone marrow derived macrophages was established.The effects of DP1 receptor agonist on phagocytosis and killing ability,mRNA expres-sion,secretion of pro-inflammatory cytokines(TNF-α,IL-1β)and activation of signaling pathway(MAPK,NF-κB)in cow bone marrow derived macrophages induced by E.coli were examined.The results showed that compared with the E.coli infection group,the phagocytosis and killing ability of BW-245C+E.coli group and 15 d-PGJ2+E.coli group were enhanced(P＜0.01).Compared with the blank control group,mRNA expression was at a higher level(P＜0.001),and the secre-tion of pro-inflammatory cytokines(TNF-α,IL-1β)was significantly increased after adding E.coli solution.The mRNA expression of BW-245C+E.coli group and 15 d-PGJ2+E.coli group were significantly decreased(P＜0.001),and the secretion of pro-inflammatory cytokines(TNF-α,IL-1β)was significantly decreased(P＜0.001).and signaling pathway(MAPK,NF-κB)were sig-nificantly down-regulated(P＜0.001).This study showed that DP1receptor agonist plays an inhib-itory role in the inflammatory response of cow bone marrow-derived macrophages induced by E.coli.This finding provides a potential target for future treatment of cow endometritis,laying the foundation for the development of novel anti-inflammatory treatment strategies.

Objective To explore the predictive value of dose surface histogram(DSH)in image guided radiotherapy(IGRT)for radiotherapy-induced acute radiation proctitis(ARP)in cervical cancer(CCA).Methods Totally 380 patients with CCA IGRT admitted to some hospital from May 2019 to May 2023 were selected prospectively and randomly divided into a control group(n=1 80)and an experimental group(n=200).The patients in the 2 groups were followed up and the incidence rates of ARP were counted,and rectal dose distribution was evaluated using dose volume histogram(DVH)in the control group and DSH in the experimental group.The predictive values of DVH and DSH for ARP were evaluated and compared using ROC curves.Statistical analysis was performed using SPSS 21.0 software.Results The two groups did not have statistically significant difference in the incidence rate of ARP(P＞0.05),while there were significant differences in the evaluation indicators of the rectal dose distribution(P＜0.05).V40,V50,S40 and S50 proved to have low predictive values for grade Ⅰ-Ⅳ ARP with AUC 0.700(P＜0.05);V60 and S60 had moderate predictive values for grade Ⅰ-Ⅳ ARP with AUC greater than 0.700 and less than or equal to 0.900(P＜0.05);V70,V78,S70 and S7s showed high predictive values for grade Ⅰ-Ⅳ ARP with AUC higher than 0.900(P＜0.05).Delong's test results indicated that DVH and DSH had no significant differences in AUC when used to predict gradeⅠ-Ⅳ ARP(allP＞0.05).Conclusion DSH is essentially the same as DVH when used for the prediction of grade Ⅰ-Ⅳ ARP due to CCA IGRT,and thus can be used for the supplementation and optimization of radiotherapy planning systems.[Chinese Medical Equipment Journal,2025,46(3):48-53]

The implementation of the Good Pharmacovigilance Practice(GVP)in 2021 has laid a solid foundation for improving China's pharmacovigilance system,a matter of paramount importance currently emphasized by Marketing Authorization Holders(MAHs).Given the unique organizational structures of corporate groups,establishing a centralized pharmacovigilance system can optimize resource utilization.This paper analyzes the challenges faced by corporate groups in developing such central-ized systems and proposes an organizational framework with defined operational divisions.The findings aim to provide actionable insights for vaccine manufacturers in establishing and refining life cycle pharmacovigilance systems.

Objectives:To analyze the cardiac involvement of patients with Fabry disease(FD)in Anhui region.Methods:This retrospective analysis included 48 previously and currently diagnosed FD patients(25 males)in Anhui region,overall patient and gender specific cardiac involvement was analyzed.Results:The median age of FD patients is 28.0(19.0,46.0)years.The cardiac manifestations of patients with FD were most commonly characterized by palpitations/arrhythmias(13/42 cases)and exertional dyspnea(11/42 cases),electrocardiographic changes were most commonly characterized by T-wave inversion(22/42 cases),ST-segment depression(16/42 cases),and left ventricular hypervoltage(18/42 cases),cardiac structural and functional changes were most common in papillary muscle hypertrophy(29/36 cases),bilateral sign(22/37 cases)and left ventricular hypertrophy(21/46 cases),as well as reduced left ventricular global longitudinal strain(26/39 cases).Neuropathic pain(28/43 cases)was the most common extracardiac manifestation of FD patients.FD patients of different gender differed in age at diagnosis(P=0.018),alpha galactosidase A activity(P<0.001),globotriaosylsphingosine(lyso-GL3)levels(P<0.001),enzyme replacement therapy rate(P=0.043),dyshidrosis(P<0.01),and the incidence of angiokeratoma(P=0.004).Correlation analysis showed that genotype was not correlated with enzyme activity or Lyso-GL-3 levels,whereas the Sokolow-Lyon index was positively correlated with Lyso-GL-3 levels(ρ=0.423,P=0.008),and the Sokolow-Lyon indices(septal thickness:ρ=0.562,P<0.001;left ventricle posterior wall thickness:ρ=0.569,P<0.001)and QRS duration(septal thickness:ρ=0.543,P<0.001;left ventricle posterior wall thickness:ρ=0.557,P<0.001)were positively correlated with left ventricular wall thickness.Conclusions:Cardiac involvement in patients with FD in the Anhui region is characterised by palpitations or arrhythmias,accompanied by nonspecific electrocardiographic changes.Echocardiography frequently reveals papillary muscle hypertrophy.The manifestation of cardiac involvement in patients of different genders is similar.

Objective To explore the clinical efficacy of biplane double-supported screw fixation(BDSF)in the treatment of femoral neck fracture(FNF)and the influencing factors of surgical failure.Methods A total of 360 patients with FNF hospitalized in our hospital from November 2022 to May 2024 were selected as the research objects.According to the random number table method,the patients were divided into the observation group[application of BDSF under the multi-disciplinary treatment(MDT)and green channel mode]and the control group[application of cannulated compression screw(CCS)fixation under the MDT and green channel mode],with 180 cases in each group;According to the failure of surgical treatment or fixation in the observation group,the patients were further divided into the surgical failure group(n=50)and effective surgery group(n=130).The risk factors were analyzed by multivariate Logistic regression.The establishment and fitting of the model were analyzed by Logistic regression.The discrimination,prediction accuracy and clinical value of the model were evaluated by receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)curve,respectively.Results Compared with the control group,the observation group had shorter operation time and hospitalization time(P<0.05),less intraoperative blood loss and fewer intraoperative fluoroscopy times(P<0.05),lower proportion of patients with avascular necrosis of femoral head and fixation failure(P<0.05),and higher Harris hip score 24 months after operation(P<0.05).Garden classification,fracture line location,reduction quality and preoperative traction were the independent influencing factors of surgical failure(P<0.05).The ROC curve analysis showed that the area under the curve(AUC)of the model to predict the risk of surgical failure was 0.867(95%CI:0.751 to 0.946).The calibration curve analysis results showed that the predicted probability of the model was approximately equal to the actual probability,with a Brier value of 0.095.DCA analysis results showed that the threshold probability of the model was 0.1 to 0.9,indicating a high net profit.Conclusion BDSF has a good effect in FNF surgery,which can shorten the operation time and hospitalization time,reduce the number of intraoperative fluoroscopy and bleeding,which is more conducive to hip joint function recovery.Garden classification,fracture line location,reduction quality,and preoperative traction are all the independent influencing factors for surgical failure.

In order to study the effects of prostaglandin D2(PGD2)on cow bone marrow-derived macrophages induced by E.coli,cultured cow bone marrow-derived macrophages were taken as the research object.The effects of endogenous and exogenous PGD2 on the secretion and phagocytosis of E.coli induced proinflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages were ana-lyzed.The results showed that the synthesis of PGD2 in macrophages induced by E.coli is depend-ent on the natural pattern recognition receptors TLR2,TLR4 and NLRP3.Inhibition of endogenous PGD2can down-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in E.coli induced macrophages(P＜0.001),and inhibition of endogenous PGD2 can enhance the kill-ing function of macrophages to a certain extent(P＜0.01).In addition,exogenous PGD2 could up-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages af-ter E.coli stimulation(P＜0.01),and exogenous PGD2 could weaken the killing function of mac-rophages within a certain concentration range(P＜0.01).Results indicated that PGD2 had certain effects on the secretion of cytokines and phagocytosis and killing function of macrophages induced by E.coli.

Objective To analyze the situation of blood lipid and blood routine parameters in patients with pneumoconiosis,and construct a column chart diagnostic model to explore their diagnostic value for pneumo-coniosis.Methods A total of 456 patients with pneumoconiosis admitted to the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College from January 2022 to January 2024 were selected as the pneu-moconiosis group,while 462 healthy subjects exposed to dust during the same period were chosen as the con-trol group.Serum lipids and blood routine parameters related to pneumoconiosis were measured and compared between two groups.Univariate and multivariate Logistic regression analyzes were conducted to examine ser-um lipids and blood routine parameters associated with pneumoconiosis.A risk prediction model was construc-ted using logistic regression in machine learning,and the diagnostic efficacy of the column chart diagnostic model was evaluated by calculating the C-index through receiver operating characteristic(ROC)curve and plotting the model calibration curve based on Hosmer Lemeshow goodness of fit.Decision curve analysis(DCA)was used to assess the clinical practicality of the column chart diagnostic model.Results The levels of serum high-density ester protein cholesterol(HDL-C),cholesterol(TC),red blood cell(RBC),hematocrit(HCT),hemoglobin concentration(HGB),lymphocyte number(LYM),and lymphocyte percentage(LYM％)in the pneumoconiosis group were lower than those in the control group(P＜0.05).The levels of neutrophil-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune inflammation index(SII)were higher than those in the control group(P＜0.05).Multivariate Logistic regression analysis showed that HDL-C,LYM％,PLR,and SII were independent influencing factors for pneumoconiosis(P＜0.05).A column chart diagnostic model for the occurrence of pneumoconiosis was constructed using HDL-C,TC,LYM％,PLR,and SII as diagnostic factors.The ROC curve C-index of the diagnostic model was 0.84(95％CI:0.81-0.86),with sensitivity for diagnosing pneumoconiosis of 75.29％,specificity of 77.51％,posi-tive predictive value of 83.25％,and negative predictive value of 67.88％.Internal validation was conducted on the constructed column chart diagnostic model,with a validation set ROC curve C-index of 0.84(95％CI:0.80-0.87),sensitivity of 80.91％,specificity of 72.62％,positive diagnostic value of 79.46％,and negative diagnostic value of 74.39％.The calibration positive curve slope of the diagnostic model was close to 1,and in the fit test P＞0.05.DCA analysis showed that the diagnostic model had clinical practical value for risk diag-nosis of pneumoconiosis.Conclusion HDL-C,TC,LYM％,PLR and SII are independent influencing factors for pneumoconiosis.A column chart diagnostic model for the occurrence of pneumoconiosis is successfully constructed based on machine learning principles,and it has been verified to have high diagnostic efficiency.

AIM To study the chemical constituents from the bark of Toona sinensis(A.Juss.)Roem and their anti-inflammatory activity.METHODS Silica gel,RP-18 reverse phase silica gel and HPLC were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their anti-inflammatory activity were evaluated by RAW264.7 model.RESULTS Sixteen compounds were isolated and identified as(9Z)-18-hydroxyo-ctadec-9-en-4,6-diyn-3-one(1),toonapolyyne C(2),(9S,10E,16R)-octadec-10-ene-12,14-diyne-1,9,16-triol(3),(9S,10E,16R)-9,16-dihydroxyoctadec-10-ene-12,14-diy-n-1-yl acetate(4),toonapolyyne A(5),toonasindiyne B(6),scopoletin(7),sco-parone(8),3-O-acetyl(-)-epicatechin(9),p-ethoxyacetanilide(10),kulonic acid(11),β-sitosterol-3-O-β-D-glucopyranoside(12),vanillic acid(13),cleomiscosin A(14),(-)-isolariciresinol(15),resveratrol(16).The IC50 values of compounds 3-4,6,11-13 for NO were 6.90,10.49,20.03,9.49,18.34,24.36 μmol/L,respectively.CONCLUSION Compound 1 is a new polyacetylene,8-16 are isolated from T.sinensis for the first time.Compounds 3-4,6,11-13 have good anti-inflammatory activity.