Psoriasis arthritis (PsA) is a chronic inflammatory musculoskeletal disease intricately linked to psoriasis (PsO), with a multifaceted etiology encompassing genetic, environmental, and immunological factors. Characterized by complex clinical manifestations, PsA often follows a protracted course with a propensity for relapses, potentially culminating in joint deformity and disability. The condition is further complicated by associated comorbidities such as inflammatory bowel disease, uveitis, cardiovascular disease, and metabolic syndrome, which significantly diminish patients′ quality of life. Early detection and screening of PsA are crucial for its management and prevention of adverse outcomes. However, in China, there is a notable deficiency in the recognition and early diagnosis of PsA, with missed or incorrect diagnoses being relatively common. The consensus comprises four overarching statements and sixteen detailed recommendations, with the overarching goal of enhancing the early diagnosis and treatment of PsA by clinical physicians, thereby improving patient outcomes.

Objective:To observe the effect of WAFF abdominal and pelvic mechanical exercise combined with pelvic floor muscle training during pregnancy on the recovery of pelvic floor muscle function in primiparas after childbirth.Methods:This study was a prospective case-control study,a total of 100 primiparas with a pregnancy of more than 16 weeks who were admitted to Longyan People's Hospital of Fujian from October 2021 to November 2023 were recruited and and randomly divided into control group(n=50)and observation group(n=50).The control group received pelvic floor muscle training,while the observation group received WAFF abdominal and pelvic mechanical exercise on the basis of the control group.The weight gain during pregnancy,mode of delivery,newborn birth weight,duration of second stage of labor,pelvic floor muscle strength,incidence of postpartum pelvic floor organ prolapse,incidence of stress urinary incontinence,pelvic floor electrophysiological indicators,and psychological states[Self rating Anxiety Scale(SAS),Self rating Depression Scale(SDS)]between two groups were compared.Results:The newborn birth weight in the observation group was lighter than that in the control group,the weight gain during pregnancy was less than that in the control group,the duration of second stage of labor was shorter than that in the control group,the number of cases of cesarean section was less than that in the control group,and incidence of postpartum pelvic floor organ prolapse,incidence of stress urinary incontinence were lower than those in the control group(P＜0.05).The pelvic floor muscle strength in the observation group was better than that in the control group at 42 d postpartum(P＜0.05).The fatigue levels of Class Ⅰ and Class Ⅱ muscle fibers in the observation group were lower than those in the control group,while the vaginal dynamic pressure,Class Ⅰ muscle fiber strength,and Class Ⅱ muscle fiber strength were higher than those in the control group(P＜0.05).The SAS and SDS scores in the observation group after intervention were lower than those in the control group(P＜0.05).Conclusion:WAFF abdominal and pelvic mechanical exercise combined with pelvic floor muscle training during pregnancy can effectively improve the pregnancy outcomes of primiparous women,improve pelvic floor electrophysiological indicators and psychological states,and reduce the incidence of postpartum pelvic floor organ prolapse and stress urinary incontinence.

Objective:To investigate the detection and clinical features of human rhinovirus（HRV）infection in children from the Xiamen area.Methods:A retrospective analysis was conducted on children treated at Xiamen Children's Hospital from November 2021 to October 2022.Thirteen types of multiplex respiratory pathogen detection kits were used to screen for 13 common respiratory pathogens. Clinical data of HRV-positive hospitalized children were collected.Results:（1）Among 8 420 children with acute respiratory infections，HRV had the highest detection rate at 20.40%（1 718/8 420），followed by HMPV（10.12%），H3N2（7.46%），HRSV（6.94%），and HPIV（6.59%）.HRV was detected throughout the year，with the highest proportion in May（18.42%）.（2）Out of 1 718 children with HRV infection，863 cases were hospitalized for pneumonia（50.23%，863/1 718）.The median age of hospitalized children was 2.58（1.07，4.20）years old，with 53.77% under 3 years old.（3）The main clinical manifestations of HRV pneumonia were cough（97.68%，843/863），fever（58.05%，501/863），runny nose（57.01%，492/863），nasal congestion（36.96%，319/863），and wheezing（24.33%，210/843）. The HRV pneumonia co-infection group showed statistically significant differences in fever and hospitalization days compared to the single HRV pneumonia infection group（all P<0.05）.（4）Compared to the common pneumonia group，the severe HRV pneumonia group showed statistically significant differences in fever，runny nose，wheezing and hospitalization days the CRP, PCT, LDH levels, and the number of antibiotic applications after hospitalization（all P<0.05）. Conclusion:HRV infection is detected year-round in Xiamen，pneumonia is common，with children under 3 years old being particularly susceptible.It is important to be alert to mixed infections or severe pneumonia.Clinical treatment should avoid unnecessary antibiotic use，actively and provide appropriate treatment.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

The HACEK group microorganisms(Haemophilus parainfluenzae,Aggregatibacter actinomycetem-comitans,Cardiobacterium spp.,Eikenella corrodens,Kingella kingae)belong to Gram-negative bacilli and are members of the normal oropharyngeal microbiota,which can cause invasive opportunistic infection when the host immune barrier is damaged,with infective endocarditis being one of the most serious diseases.HACEK endocarditis is characterized by an insidious course,prolonged delay of diagnosis,and dependence on third-generation cephalo-sporins for treatment.In recent years,with the emergence and development of 16S ribosomal RNA gene sequencing technique,the rapid diagnosis of this disease is expected to be achieved.This paper summarizes the main clinical characteristics and research progress of infective endocarditis caused by HACEK group bacteria,aiming to provide reference for clinical diagnosis and treatment.

The thermal sensitivity of enzymes is a key bottleneck that restricts their practical application,and the development of efficient enzyme stability enhancement technology has important application value.Based on the principle of metal-polyphenol coordination chemistry,this study used tannic acid-ferric ion(TA-FeⅢ)coordination polymer to nano-encapsulate catalase(CAT)and systematically explored its stability enhancement effect.The catalytic activity retention rate of the immobilized enzyme in extreme environments(High temperature,organic solvents,denaturants and pH 3-11)was significantly improved compared with that of the free enzyme,proving that the TA-FeⅢ nanoshell had a significant environmental barrier effect.In the long-term stability test,the immobilized enzyme retained 20％activity after a 30-d storage at room temperature,and its effective activity was prolonged to 8 times that of the free enzyme in the accelerated inactivation test at 37 ℃.In addition,several cyclic catalytic experiments demonstrated that the immobilized enzyme exhibited good reusability,thus broadening its practical application.

Objective To explore the feasibility and corresponding implementation methods of constructing a sample resource bank based on individual-level data of completed clinical trials and using it to construct external controls for drug/device clinical trials.Methods Taking the pre-marketing clinical trial of transcatheter active valve replacement(TAVR)for the treatment of aortic valve stenosis as an example,the individual-level databases of multiple trials were standardized to form a sample bank.The original data of any trial in the sample bank were selected as the experimental group,and the remaining samples were selected as the control group.The potential confounding was handled by using the propensity score matching and stratification methods to clarify the process of constructing external controls based on the sample bank of individual-level data of clinical trials.Results This study included individual-level data of single-group trials of 4 TAVR devices,with a total of 569 subjects(59.2%male).The number of subjects in Trials 1 to 4 was 120,120,163,and 166,respectively.Propensity score matching enabled the matching of 113,117,125,and 147 subjects with comparable or similar characteristics from individual-level data from other trials,respectively,demonstrating a high matching success rate.The PS score distribution plot after stratification showed that the proportions of subjects in the experimental and control groups in strata 1 to 5 in scheme 1 were 4/103,11/103,22/92,32/87,and 51/64,respectively.For all constructed external controlled trials,a certain number of control samples with similar baseline characteristics to the experimental groups were distributed within each propensity score stratum.The results of the simulation test also reflected the potential differences between different devices in the 12-month all-cause mortality rate.Conclusions The sample bank constructed with individual-level data from clinical trials,as a high-quality data source,can serve as a source of external control for single-arm trials in the same field,and as a useful supplement to the external control scenario of real-world evidence to support drug and device development.At the same time,targeted research on research methods and bias control measures in related fields is also needed.

Psoriasis arthritis (PsA) is a chronic inflammatory musculoskeletal disease intricately linked to psoriasis (PsO), with a multifaceted etiology encompassing genetic, environmental, and immunological factors. Characterized by complex clinical manifestations, PsA often follows a protracted course with a propensity for relapses, potentially culminating in joint deformity and disability. The condition is further complicated by associated comorbidities such as inflammatory bowel disease, uveitis, cardiovascular disease, and metabolic syndrome, which significantly diminish patients′ quality of life. Early detection and screening of PsA are crucial for its management and prevention of adverse outcomes. However, in China, there is a notable deficiency in the recognition and early diagnosis of PsA, with missed or incorrect diagnoses being relatively common. The consensus comprises four overarching statements and sixteen detailed recommendations, with the overarching goal of enhancing the early diagnosis and treatment of PsA by clinical physicians, thereby improving patient outcomes.

Objective To assess the prevalence and clinical features of nonalcoholic fatty liver disease(NAFLD)and its risk factors in patients with CHF,so as to provide the reference for early identification of NAFLD.Methods The data from 1120 CHF patients aged 14～89 was collected,including the general demographic information(age,gender,smoking status,height,weight,BMI,etc.),clinical diagnosis and treatment data(blood pressure,NYHA heart function classification,blood biochemical indicators,etc.),and medication use status.SPSS 27.0 was applied to analyze the clinical characteristics of CHF combined with NAFLD,and binary multivariate logistic regression was used to analyze the independent risk factors of CHF combined with NAFLD.Results Among the 1120 patients,634(56.6%)were male and 486(43.4%)were female.The prevalence of CHF patients with NAFLD was 25.0%.The results of univariate analysis showed that the weight of NAFLD patients BMI,systolic blood pressure,diastolic blood pressure,FPG,UA,left room expansion ratio,ALT,CHO,TG,obesity rate,hyperuricemia rate and β-blocker usage rate were all higher than those of non NAFLD patients.The age,BNP,HDL and ACEI/ARB/ARNI usage rate of NAFLD patients were lower than those of non NAFLD patients(all P<0.05).Logistic regression analysis showed that age(OR=0.988),FPG(OR=1.099),overweight(OR=3.497)and obesity(OR=9.193)were independent risk factors for CHF patients with NAFLD.Conclusion NAFLD may be a common complication in CHF patients,especially those who are young,have high FPG,overweight and obese.In the clinical practice,NAFLD screening,evaluation and management should be focused on CHF patients who are young,have high fasting blood sugar,overweight,and obese.

OBJECTIVE: Observational studies have shown inconsistent associations of loneliness or social isolation (SI) with ischemic heart disease (IHD), with unknown mediators. METHODS: Using data from genome-wide association studies of predominantly European ancestry, we performed a bidirectional two-sample Mendelian Randomization (MR) study to estimate causal effects of loneliness ( N = 487,647) and SI traits on IHD ( N = 184,305). SI traits included whether individuals lived alone, participated in various types of social activities, and how often they had contact with friends or family ( N = 459,830 to 461,369). A network MR study was conducted to evaluate the mediating roles of 20 candidate mediators, including metabolic, behavioral and psychological factors. RESULTS: Loneliness increased IHD risk ( OR= 2.129; 95% confidence interval [ CI]: 1.380 to 3.285), mediated by body fat percentage, waist-hip ratio, total cholesterol, and low-density lipoprotein cholesterol. For SI traits, only fewer social activities increased IHD risk ( OR= 1.815; 95% CI: 1.189 to 2.772), mediated by hypertension, high-density lipoprotein cholesterol, triglycerides, fasting insulin, and smoking cessation. No reverse causality of IHD with loneliness and SI was found. CONCLUSION These findings suggested more attention should be paid to individuals who feel lonely and have fewer social activities to prevent IHD, with several mediators as prioritized targets for intervention.
Loneliness/psychology* ; Humans ; Mendelian Randomization Analysis ; Social Isolation ; Myocardial Ischemia/etiology* ; Male ; Female ; Middle Aged ; Genome-Wide Association Study ; Risk Factors ; Aged