Objective:To summarize and analyze the clinical characteristics of pediatric pulmonary hypertension (PH) and the related factors affecting the prognosis，to provide a basis for the early diagnosis and treatment of the disease.Methods:The clinical data of 80 PH children hospitalized in the intensive care department of Children's Hospital of Capital Pediatric Research Institute from January 1,2019 to December 31,2022 were retrospectively analyzed,and general data,clinical symptoms, echocardiography, laboratory examination and treatment indicators were collected. According to survival death groups, multivariate Logistic regression was applied to analyze independent associated risk factors for PH death.Results:（1）Clinical characteristics of childhood PH: more common in infants, the average age of treatment was 0.9(0.3-5.3)years, the male to female ratio was 1.3∶1, and the average time from first symptoms to first diagnosis was 6.5 (2,14) days. The etiology of PH in children was complex, with arterial PH (PAH) (40%), pulmonary disease and(or) hypoxia (33.8%) being the most common. The main clinical manifestations were dyspnea, decreased activity endurance, poor appetite, and positive heart examination. Severe PH accounted for 53.8%, 30% of pulmonary hypertensive crisis.（2）Factors affecting the prognosis of childhood PH: childhood PH mortality was 20.8%, compared with the survival group, ICU length of stay, loss of appetite, decreased urine volume, cardiac function classification, right heart size, main pulmonary artery diameter/ascending aorta diameter ratio(MPAD/MAD), vasoactive inotropic score(VIS), use of invasive ventilator treatment had statistical significance (all P<0.05). A Logistic regression analysis of death-related factors showed that right heart enlargement ( OR=0.193,95% CI 0.040-0.919, P=0.039), higher MPAD/MAD value ( OR =11.883,95% CI 1.347-104.869, P=0.026), and higher VIS score ( OR= 1.029,95% CI 1.003-1.056, P=0.028) were independent risk factors for poor prognosis. Conclusion:（1）Children PH is mainly infants, the causes of PAH and pulmonary diseases, severe PH accounted for 53.8%, 30% of which have pulmonary hypertensive crisis.（2）An enlarged right heart, higher MPAD/MAD values, and higher VIS score are independent risk factors for death in children with PH.

Objective:To explore an effective measurement method for the output power of high-frequency electrosurgical equipment,so as to provide a basis for improving the accuracy of measurement results of output power of this kind of equipment.Methods:Adopt a combined measurement method of voltage method and current method to verify the impedance characteristics of high-frequency resistors of the AJ-60 high-frequency surgical system at 4.2 MHz and 13.56 MHz.Through resistor modification,explore the measurement methods of output power under the two working modes of the system:monopolar pencil vaporization cutting(PV)and bipolar cutting(BC).Measure the power of the two working modes using both voltage method and current method,and analyze the influencing factors of their measurement accuracy.Results:The results of relative deviation between voltage method and current method for the measured power were significantly reduced through refit and comparison experiments.PV mode reduced from 40.58%to 1.11%,and BC mode reduced from 29.48%to 5.37%.In practical operation,the factors included limitation of prober's bandwidth,and mismatch of inputted impedance were important factors that affected the accuracy of measurement.Conclusions:In order to ensure accurate measurement for equipment's output power when operating frequencies exceed 4 MHz,it is essential to use non-inductive load resistance that is accurately calibrated at the specific operating frequency.It has great significance for enhancing the measured accuracy and reliability of output power of electrosurgical equipment with high-frequency.

Tumor-related insomnia is one of the common complications of tumor patients,which is secondary to tumor disease and related to tumor disease itself or tumor treatment.Combined with the unique pathogenesis of"heat-toxicity internal stagnation"of tumor-related insomnia,the important treatment methods are to clear away heat,attack toxicity,regulate qi and supplement healthy qi.This article explained the research status,etiology and pathogenesis,treatment principles of the disease,in order to provide new ideas and methods for the differentiation and treatment of tumor-related insomnia in TCM.

Objective To investigate the predictive value of PCSK9 gene rs562556 polymorphism for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with type 2 diabetes mellitus(T2DM)complicated by acute myocardial infarction(AMI).Methods A total of 97 patients were involved in this study with T2DM complicated by AMI,who underwent PCI at The Third Affiliated Hospital of Qiqihar Medical University between January 2019 and December 2021.Based on MACE occurrence during a 2-year follow-up period,patients were divided into non-MACE group and MACE group(n=57 and 40,respectively).Clinical biochemical parameters,including blood glucose and lipid levels,were recorded.Plasma PCSK9 levels were assessed using enzyme-linked immunosorbent assay.Plasma PCSK9 gene rs562556 polymorphism was detected through sequencing.Kaplan-Meier curve analysis was performed to assess how rs562556 polymorphism impacts MACE incidence post-PCI.Multivariate logistic regression was applied to identify independent MACE-associated risk factors.ROC curve analysis was performed to evaluate the predictive value of rs562556 poly-morphism and key clinical variables for MACE occurrence post-PCI.Results Compared to the non-MACE group,patients in the MACE group exhibited significantly higher age,heart rate,creatinine,NT-proBNP,LDL-C,and plasma PCSK9 levels,along with higher hyper-tension and coronary atherosclerotic heart disease prevalence,and lower diastolic blood pressure(all P＜0.05).In patients with T2DM and AMI,the rs562556 genotype AA of the PCSK9 gene positively correlated with plasma PSCK9 levels(r=0.61,P＜0.000 1).The frequen-cies of the rs562556 genotype AA and allele A were significantly higher in the MACE compared to the non-MACE group(P＜0.05).The AA genotype of the PCSK9 gene rs562556 was associated with an increased risk of MACE during follow-up in patients with T2DM and AMI(P＜0.05).After adjusting for other confounding variables,advanced age,increased NT-proBNP and PCSK9 levels,and the rs562556 AA genotype were identified as independent risk factors for MACE post-PCI in this patient population.Combined analysis of these factors demonstrated superior predictive value for MACE occurrence compared to individual markers.Conclusion The PCSK9 gene rs562556 genotype AA is associated with a significantly increased risk of MACE within two years post-PCI in patients with T2DM and AMI,sug-gesting that it could serve as a promising predictive biomarker for post-PCI MACE in the given population.

Objective To explore the effects of air pressure, humidity, wind, and sunshine on the incidence of cardiovascular and cerebrovascular diseases (CVD) in Guiyang, and to provide reference for the prevention of CVD. Methods Using CVD incidence data from September 2021 to August 2022 in Guiyang City and meteorological data including average air pressure, average humidity, wind, and sunshine during the same period, the effects of meteorological factors on CVD incidence were explored and the importance of each factor was analyzed. Results When air pressure was below 868 hPa, above 887 hPa, or between 877 and 883 hPa, and when air pressure dropped less than 5.3 hPa within 24 hours, there was a higher risk of CVD. When the humidity was above 81%, the wind speed was small (<1.2 m/s) or high (>4m/s), and there was less sunlight (less than 3 hours), the risk of CVD was higher. Low humidity (<60%) was not conducive to the onset of CVD. There were highest risks at lag 5~10 days and 4-25 days for high pressure and low sunlight, respectively. When the relative humidity was saturated, there was an immediate effect. When the wind speed was low and high, the immediate effect and hysteresis effects were significant. Among the above meteorological factors, the impact of 24-hour variation of pressure and high or low atmospheric pressure on the incidence of CVD was the most significant, while the impact of sunlight and humidity was the weakest. The impact of diurnal variations in wind and atmospheric pressure was not clear. Conclusion The impact of air pressure on the incidence of CVD does not exhibit a simple linear relationship. The risk of CVD is high in high humidity, low light, and moderate or strong winds. It is necessary to fully consider changes in meteorological factors for CVD prevention and control.

Objective To investigate the predictive value of PCSK9 gene rs562556 polymorphism for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with type 2 diabetes mellitus(T2DM)complicated by acute myocardial infarction(AMI).Methods A total of 97 patients were involved in this study with T2DM complicated by AMI,who underwent PCI at The Third Affiliated Hospital of Qiqihar Medical University between January 2019 and December 2021.Based on MACE occurrence during a 2-year follow-up period,patients were divided into non-MACE group and MACE group(n=57 and 40,respectively).Clinical biochemical parameters,including blood glucose and lipid levels,were recorded.Plasma PCSK9 levels were assessed using enzyme-linked immunosorbent assay.Plasma PCSK9 gene rs562556 polymorphism was detected through sequencing.Kaplan-Meier curve analysis was performed to assess how rs562556 polymorphism impacts MACE incidence post-PCI.Multivariate logistic regression was applied to identify independent MACE-associated risk factors.ROC curve analysis was performed to evaluate the predictive value of rs562556 poly-morphism and key clinical variables for MACE occurrence post-PCI.Results Compared to the non-MACE group,patients in the MACE group exhibited significantly higher age,heart rate,creatinine,NT-proBNP,LDL-C,and plasma PCSK9 levels,along with higher hyper-tension and coronary atherosclerotic heart disease prevalence,and lower diastolic blood pressure(all P＜0.05).In patients with T2DM and AMI,the rs562556 genotype AA of the PCSK9 gene positively correlated with plasma PSCK9 levels(r=0.61,P＜0.000 1).The frequen-cies of the rs562556 genotype AA and allele A were significantly higher in the MACE compared to the non-MACE group(P＜0.05).The AA genotype of the PCSK9 gene rs562556 was associated with an increased risk of MACE during follow-up in patients with T2DM and AMI(P＜0.05).After adjusting for other confounding variables,advanced age,increased NT-proBNP and PCSK9 levels,and the rs562556 AA genotype were identified as independent risk factors for MACE post-PCI in this patient population.Combined analysis of these factors demonstrated superior predictive value for MACE occurrence compared to individual markers.Conclusion The PCSK9 gene rs562556 genotype AA is associated with a significantly increased risk of MACE within two years post-PCI in patients with T2DM and AMI,sug-gesting that it could serve as a promising predictive biomarker for post-PCI MACE in the given population.

Objective:To investigate the effect of 308-nm light-emitting diode (LED) phototherapy at escalating doses after autologous melanocyte transplantation on the repigmentation in patients with refractory stable vitiligo.Methods:A prospective, randomized, self-controlled trial was conducted. Twelve patients with refractory stable vitiligo (a total of 17 skin lesions) were collected from the Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region from November 2023 to September 2024. Autologous cultured melanocyte transplantation was performed. One week after the inner layer of petrolatum gauze had fallen off, each white patch was bisected by the midline and randomly divided into a test group and a control group; both groups received 308-nm LED light irradiation at an initial dose of 50 mJ/cm 2; then, the test group received a slow (5%) dose escalation, while the control group received a quick (10%) dose escalation. The repigmentation outcomes, clinical efficacy and safety were observed at 1, 3, and 6 months after the start of phototherapy. Results:A total of 12 patients with refractory stable vitiligo were collected, including 3 males and 9 females, aged 5 to 59 (29.4 ± 19.6) years. At 1 month after phototherapy, there was no significant difference in the vitiligo repigmentation area score between the test group and the control group ( P = 0.666) ; at 3 months after phototherapy, the vitiligo repigmentation area score was significantly higher in the test group (54.45 [5.17, 85.50] points) than in the control group (39.75 [4.52, 65.05] points, Z = -2.51, P = 0.012) ; at 6 months after phototherapy, no significant difference in the vitiligo repigmentation area score was observed between the two groups ( P = 0.11). In the test group, the marked response rate increased from 41.18% (7/17) at 1 month to 58.82% (10/17) and 58.82% (10/17) at 3 and 6 months after treatment, respectively; in the control group, it increased from 29.41% (5/17) at 1 month to 35.29% (6/17) and 47.06% (8/17) at 3 and 6 months after treatment, respectively. At 1 month after treatment, the response rate was 58.82% (10/17) in the test group, and 64.71% (11/17) in the control group, which both increased to 70.59% (12/17) at 3 and 6 months after treatment. There were no significant differences in the marked response rates or response rates between the two groups at different time points after treatment (all P > 0.05). The maximum dose of 308-nm LED light was 106.0 (87.0, 152.5) mJ/cm 2 in the test group, and 219.0 (200.5, 268.5) mJ/cm 2 in the control group; the total accumulated dose of 308-nm LED light was 2 101.0 (1 865.0, 2 270.5) mJ/cm 2 in the test group, and 3 411.0 (2 683.5, 4 016.5) mJ/cm 2 in the control group. Blisters occurred in 3 lesions (17.6%) in the control group, while no adverse reactions were observed in the test group. Seven patients (58.3%) preferred the low-dose escalation irradiation protocol in the test group. Conclusion:Autologous melanocyte transplantation combined with 308-nm LED phototherapy initiated at a minimum dose and followed by a 5% dose-escalation irradiation protocol exhibited comparable efficacy but superior safety profiles compared with a conventional 10% dose-escalation irradiation protocol in the treatment of refractory stable vitiligo.

Objective:To investigate the predictive value of refeeding syndrome (RFS) and its influencing factors for 30-day intensive care unit (ICU) readmission in critically ill patients.Methods:A prospective cohort study was conducted. Critically ill patients admitted to the department of critical care medicine, department of respiratory and critical care medicine, and department of neurology at Tianjin Medical University General Hospital from January to April in 2025 were enrolled. Patients were assessed for RFS according to the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria. General information within 24 hours of ICU admission was collected via the electronic medical record system. Treatment details and 30-day ICU readmission status were dynamically recorded. Participants were divided into readmission and non-readmission groups based on whether ICU readmission occurred within 30 days. Intergroup comparisons were performed to identify differences. Multivariate Logistic regression was used to analyze the relationship between RFS and its influencing factors with 30-day ICU readmission. Receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive performance of risk factors.Results:A total of 196 critically ill patients were enrolled, among whom 25 (12.76%) were readmitted to ICU within 30 days and 171 (87.24%) were not. Significant differences were observed in the readmission group compared with the non-readmission group, including significantly higher rates of nasogastric decompression, higher acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, a higher incidence of RFS, and a longer duration of nasogastric decompression. Multivariate Logistic regression analysis showed that RFS was an independent risk factor for 30-day ICU readmission [odds ratio ( OR) = 5.756, 95% confidence interval (95% CI) was 1.603-20.670, P = 0.007]. APACHEⅡ score showed a positive correlation trend with 30-day ICU readmission ( OR = 1.057, 95% CI was 0.991-1.127, P = 0.092). ROC curve analysis showed that the combined prediction model incorporating RFS and APACHEⅡ score had an area under the ROC curve (AUC) of 0.766 (95% CI was 0.668-0.864), with a sensitivity of 88.0% and a specificity of 62.0%, which was significantly superior to a single indicator (the AUC of RFS and APACHEⅡ score was 0.639 and 0.624, respectively). Conclusions:RFS significantly increases the risk of 30-day ICU readmission in critically ill patients. A combined model incorporating RFS and APACHEⅡ score demonstrates good predictive efficacy for 30-day ICU readmission in critically ill patients.

Objective: To explore the association between mediterranean diet (MD) patterns and dental caries among children and adolescents with neurodevelopmental disorders (NDD), so as to provide a basis for developing scientific anti caries strategies related to diet. Methods: From December 2021 to June 2024, a questionnaire survey, a three day 24 hour dietary review survey, oral health examination, physical development measurement and Childhood Autism Rating Scale (CARS) evaluation were conducted involving 147 children and adolescents aged 2-22 years with NDD from nine special education schools and rehabilitation institutions in Tianjin. Group comparisons were carried out using the Mann-Whitney U test, Chi-square test, or Fisher s exact probability method. The correlation between dietary quality and dental caries was analyzed by adopting multiple linear regression analysis and restricted cubic spline. Results: There were 46 children and adolescents (31.3%) in the non dental caries group and 101 children and adolescents (68.7%) in the dental caries group. The number of decayed missing and filled teeth (dmft) was 2.0 (4.0), and the MD score was 4.0 (2.0) points. There were 62 children and adolescents (42.2%) in the low MD scores group and 85 children and adolescents (57.8%) in the high MD scores group. There was no significant difference in MD scores between NDD children in the non dental caries group and those in the dental caries group [nondental caries group:4.0(2.0), dental caries group:4.0(2.0), Z= -0.14, P >0.05]. The MD scores and dmft exhibited increasing and then decreasing trend ( P total =0.02, P non lineary = 0.04 ). Children and adolescents with NDD in the MD high scores group had a lower number of dmft than those in the MD low scores group ( β= -2.00 , 95%CI =-3.39 to -0.62, P <0.05). However, in children and adolescents with NDD and CARS scores ≥30, the above association was insignificant ( β=-0.63, 95%CI=-0.29-0.15, P >0.05). Conclusion Children and adolescents with NDD who have dietary patterns similar to the Mediterranean diet, are found to have fewer dental caries, and this is observed among those with no or mild symptoms of autism spectrum disorder.

Objective:To analyze the clinical characteristics of patients with adverse reactions to facial skin-lightening cosmetics.Methods:A retrospective analysis was conducted on the adverse reaction reports caused by facial skin-lightening cosmetics in the cosmetic adverse reaction reporting system of Yantai city of Shandong province from July 2020 to December 2023. The general information of the patients (such as age, gender), reporting sources, clinical characteristics (types of adverse reactions, skin lesion morphology and subjective symptoms), and channels for purchasing cosmetics were summarized and analyzed.Results:A total of 450 cases of adverse reactions caused by facial skin-lightening cosmetics were identified, predominantly involving females (429 cases, 95.33%). Age distribution was most commonly found from 31 to 40 years (174 cases, 38.67%), followed by 21 to 30 years (130 cases, 28.89%), 41 to 50 years (71 cases. 15.78%), ≥51 years (46 cases, 10.22%), and ≤20 years (29 cases, 6.44%). The main sources of reporting were medical and health institutions (401 cases, 89.11%), followed by cosmetics operators (22 cases, 4.89%), patients (20 cases, 4.44%), business enterprises (3 cases, 0.67%), market supervision and administration bureaus (3 cases, 0.67%), and medical cosmetology hospital (1 case, 0.22%). Cosmetic contact dermatitis was the most common type of cosmetic adverse reaction (416 cases,91.43%), and the common skin lesions included erythema (342 cases,45.00%), papula (166 cases,21.84%), edema and so on. The common symptoms were pruritus (369 cases,49.20% ), burning sensation (158 cases,21.07%) and so on. Online sales was the main purchasing channel (333 cases, 74.01%).Conclusions:The adverse reactions caused by facial skin-lightening cosmetics are mainly found in women, and contact dermatitis is the most common type of cosmetic adverse reaction, predominantly presenting with erythema and manifesting as pruritus.