BackgroundAdverse childhood experiences （ACEs） are strong predictors of psychopathology across the lifespan， exerting extensive adverse effects on physical and mental health during early development. While ACEs increase the risk of childhood psychopathology， sleep quality and impair cognitive function， the early neurobiological mechanisms mediating ACE-induced cognitive impairment remain unclear. ObjectiveTo explore the association between ACEs exposure and the risk of psychopathology， sleep disorders， and cognitive function， and to examine the mediating role of the putamen volume in the relationship between ACEs and cognitive function from a neurodevelopment perspective. MethodsData were obtained from the Adolescent Brain Cognitive Development （ABCD） study， comprising 10 572 children aged 9 to 10. Participants were categorized into five groups based on the cumulative score of ACEs reported by their parents and the children themselves： no-exposure group （0 types of ACEs）， the one-exposure group， the two-exposure group， the three-exposure group， and the high-risk exposure group （≥ 4 types of ACEs）. Logistic regression analysis was employed to evaluate the association between ACEs and psychopathological symptoms ［T score of the Child Behavior Checklist （CBCL） ≥ 65］. Multiple linear regression analysis was ultilized to analyze the correlations between ACEs and the scores of the Sleep Disturbance Scale for Children （SDSC）， the NIH Toolbox Cognition Battery （NIHTB-CB）， as well as the multiple structures in the cerebral cortex and subcortex. The Bootstrap method was applied to test the mediating effect of the putamen volume between ACEs and neurocognitive function. ResultsAfter adjusting for confounders， ACEs cumulative score was correlated with children's psychopathological symptoms in a dose-response manner. Compared with the no-exposed group， the high-risk exposure group had a 2.08-fold （OR=2.080， 95% CI： 1.401–3.088） increased risk of internalizing problems and a 3.13-fold （OR=3.132， 95% CI： 1.703–5.760） increased risk of externalizing problems， and the risk of conduct problems was 4.68 times that of the no-exposed group （OR=4.681， 95% CI： 2.528–8.669）. ACEs cumulative score positively predicted the total score of SDSC （β=0.080， 95% CI： 0.059–0.102）， with relatively stronger predictive effects on sleep-wake transition disorder （β=0.086， 95% CI： 0.063–0.109） and sleep onset and maintenance disorder （β=0.066， 95% CI： 0.043–0.089）. In terms of neurocognition and brain structure， ACEs cumulative score negatively predicted the overall cognitive composite score （β=-0.025， 95% CI： -0.050–-0.001）， the crystallized cognitive composite score （β=-0.035， 95% CI： -0.060–-0.010）， the volume of the left putamen nucleus （β=-0.025， 95% CI： -0.046– 0.003）， and the volume of the right putamen nucleus （β=-0.023， 95% CI： -0.044– 0.003）. The total putamen volume played a partial mediating role between ACEs and the overall cognitive composite score， the effect value was -0.002 （95% CI： -0.004–-0.001）， accounting for 7.49% of the total effect. ConclusionACEs exposure may increase the risk of psychopathological and sleep disturbances in children and may impair neurocognitive function. Reduced putamen volume may serve a potential neurobiological pathway underlying the impact of ACEs on childhood cognition. ［Funded by National Natural Science Foundation of China-Young Scientists Program （number， 82401763）； Sichuan University West China Hospital Full-time Postdoctoral Research and Development Fund Project （number， 2023HXBH084）］

AIM: To investigate the alterations in corneal aberration and relative refractive power following the reduction of back optic zone diameters(BOZD)of orthokeratology lenses.METHODS: Myopic children aged 8-12 years, deemed suitable and willing to wear orthokeratology lenses, were randomly allocated to wear lenses with a 6.0 mm BOZD or a 5.0 mm BOZD. Data collection included changes in higher-order aberrations, relative refractive power and the treatment zone diameter of the two groups after wearing lenses for 1 d, 1 wk, 1, and 3 mo. The correlation of increase in corneal higher-order aberrations with refractive power was analyzed.RESULTS: The increases in total higher-order aberrations, spherical aberrations and coma aberrations varied over time following lens wear(all P<0.001), and there were no statistically significant differences in the changes of total higher-order aberrations and coma aberrations between the two groups of patients(all P>0.05). A significant difference was observed in the increment of spherical aberrations in the 5 mm range between the two groups of patients, which varied over time(Ftime=40.179, Ptime<0.001; Fgroup=11.948, Pgroup=0.001; Finteraction=3.262, Pinteraction=0.03). A significant difference was observed in the increment of spherical aberrations in the 4 mm range between the two patient groups(Ftime=34.462, Ptime<0.001; Fgroup=13.094, Pgroup<0.001; Finteraction=1.372, Pinteraction=0.25). There was no statistically significant distinction in relative refractive power between the two groups(Fgroup=0.048, Pgroup=0.83; Finteraction=1.208, Pinteraction=0.31); however, relative refractive power changed over time(Ftime=40.030, Ptime<0.001). The difference in treatment zone diameter between the two groups was statistically significant, with changes over time(Ftime=11.212, Ptime<0.001; Fgroup=74.073, Pgroup<0.001; Finteraction=0.312, Pinteraction=0.82). The total higher-order aberrations, spherical aberrations, and coma aberrations in 4, 5 and 6 mm range showed a positive correlation with relative refractive power values(all P<0.001). Statistically significant difference was observed in the axial length between the two groups after wearing lenses for 3, 6 and 12 mo(Ftime=185.398, Ptime<0.001; Fgroup=5.618, Pgroup=0.02; Finteraction=2.315, Pinteraction=0.11).CONCLUSION: Orthokeratology lenses leaded to elevated higher-order aberrations. Orthokeratology lenses with smaller BOZD produced significantly greater spherical aberrations at 4 and 5 mm range and smaller treatment zone diameters. The corneal total higher-order aberration was positively correlated with relative refractive power. Wearing orthokeratology lenses with a smaller BOZD can cause slower axial growth and better myopia control.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Pulse wave analysis plays an important role in the theoretical and clinical studies of both the traditional Chinese medicine and the modern western medicine.In recent years,some researchers raised the opinion of resonance between the harmonics of the pulse wave and the viscera,and applied it to explain the mechanism and the clinical application of the pulse waves,which had a great impact on the related research in the traditional Chinese medicine especially about the pulse diagnosis.To evaluate the feasibility of this opinion,this study summarized the theoretical model and the main arguments of the harmonics-viscera resonance opinion,analyzed the opinion from the aspects of Zang-xiang theory and meridian theory in the traditional Chinese medicine,the anatomy in Western medicine,observations in biology,the resonance phenomenon in physics,and the blood flow study in hemodynamics.Some technical thoughts in the harmonics-viscera resonance opinion that need to be further improved and refined were also identified for further exploration.

Cervical chondrocutaneous branchial remnants (CCBRs) are a rare congenital benign abnormality resulting from branchial arch dysplasia, characterized primarily by the presence of ectopic exophytic cartilaginous tissue in the neck present at birth. In July 2024, a case of CCBRs was treated at Plastic Surgery Hospital, Chinese Academy of Medical Sciences, involving a 7-year-and-10-month-old female patient. At birth, a bean-sized, rod-shaped, firm mass was noted on the left side of her neck, which progressively grew to the size of a corn kernel, measuring approximately 1.0 cm×1.2 cm. No significant local tenderness, redness, swelling, or ulceration was observed. Comprehensive examinations revealed no associated comorbidities. The patient underwent surgical excision of the neck mass. Postoperative pathological examination with hematoxylin-eosin (HE) staining revealed elastic cartilage in the central region of the lesion. The neck incision healed primarily, and no subsequent reappearance of the lesion was observed during the four-month follow-up. This article summarized the diagnostic and therapeutic process of this patient with CCBRs, and through a comprehensive literature review, highlighted that CCBRs represent one of the superficial markers of branchial arch dysplasia, with surgical excision being the primary treatment. Given that branchial arch abnormalities may be associated with structural or functional anomalies in other organs, a thorough systemic evaluation is recommended prior to surgery. Notwithstanding the absence of concomitant malformations detected on initial evaluation, continuous long-term follow-up monitoring is recommended to mitigate the risk of potential diagnoses being overlooked.

Objective:To conduct a systematic review of risk prediction models for enteral feeding intolerance in ICU patients.Methods:Relevant literature was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and Scopus, with search limits from the establishment of the databases up to July 24, 2024. Two researchers independently screened the literature and extracted data, using Prediction model Risk Of Bias ASsessment Tool to evaluate the quality of the included studies.Results:A total of 12 studies were included, which included 20 prediction models. The area under the receiver operating characteristic curve or C-index for these models ranged from 0.70 to 0.94. The overall bias risk of the 12 studies was high, with three studies having good applicability. The bias risk primarily stemmed from issues such as measurement of prediction factors, variable handling, sample size, outcome definition, and model performance evaluation.Conclusions:Existing risk prediction models for enteral feeding intolerance in ICU patients exhibit a high risk of bias. Further validation, optimization, or development of new models is required in the future.

Pulse wave analysis plays an important role in the theoretical and clinical studies of both the traditional Chinese medicine and the modern western medicine.In recent years,some researchers raised the opinion of resonance between the harmonics of the pulse wave and the viscera,and applied it to explain the mechanism and the clinical application of the pulse waves,which had a great impact on the related research in the traditional Chinese medicine especially about the pulse diagnosis.To evaluate the feasibility of this opinion,this study summarized the theoretical model and the main arguments of the harmonics-viscera resonance opinion,analyzed the opinion from the aspects of Zang-xiang theory and meridian theory in the traditional Chinese medicine,the anatomy in Western medicine,observations in biology,the resonance phenomenon in physics,and the blood flow study in hemodynamics.Some technical thoughts in the harmonics-viscera resonance opinion that need to be further improved and refined were also identified for further exploration.

Cervical chondrocutaneous branchial remnants (CCBRs) are a rare congenital benign abnormality resulting from branchial arch dysplasia, characterized primarily by the presence of ectopic exophytic cartilaginous tissue in the neck present at birth. In July 2024, a case of CCBRs was treated at Plastic Surgery Hospital, Chinese Academy of Medical Sciences, involving a 7-year-and-10-month-old female patient. At birth, a bean-sized, rod-shaped, firm mass was noted on the left side of her neck, which progressively grew to the size of a corn kernel, measuring approximately 1.0 cm×1.2 cm. No significant local tenderness, redness, swelling, or ulceration was observed. Comprehensive examinations revealed no associated comorbidities. The patient underwent surgical excision of the neck mass. Postoperative pathological examination with hematoxylin-eosin (HE) staining revealed elastic cartilage in the central region of the lesion. The neck incision healed primarily, and no subsequent reappearance of the lesion was observed during the four-month follow-up. This article summarized the diagnostic and therapeutic process of this patient with CCBRs, and through a comprehensive literature review, highlighted that CCBRs represent one of the superficial markers of branchial arch dysplasia, with surgical excision being the primary treatment. Given that branchial arch abnormalities may be associated with structural or functional anomalies in other organs, a thorough systemic evaluation is recommended prior to surgery. Notwithstanding the absence of concomitant malformations detected on initial evaluation, continuous long-term follow-up monitoring is recommended to mitigate the risk of potential diagnoses being overlooked.

Objective:To conduct a systematic review of risk prediction models for enteral feeding intolerance in ICU patients.Methods:Relevant literature was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, VIP, PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and Scopus, with search limits from the establishment of the databases up to July 24, 2024. Two researchers independently screened the literature and extracted data, using Prediction model Risk Of Bias ASsessment Tool to evaluate the quality of the included studies.Results:A total of 12 studies were included, which included 20 prediction models. The area under the receiver operating characteristic curve or C-index for these models ranged from 0.70 to 0.94. The overall bias risk of the 12 studies was high, with three studies having good applicability. The bias risk primarily stemmed from issues such as measurement of prediction factors, variable handling, sample size, outcome definition, and model performance evaluation.Conclusions:Existing risk prediction models for enteral feeding intolerance in ICU patients exhibit a high risk of bias. Further validation, optimization, or development of new models is required in the future.

Objective In the theories of pulse disgnosis in traditional Chinese medicine(TCM),it is em-phasized that pulse manifestations at the radial artery within the wrist(called Cunkou)signi-fy the physiological and pathological conditions of different internal organs in the human body.However,different opinions exist among researchers about the objectiveness of the pulse diagnosis technique.Some researchers mentioned that no significant differences were observed in pulse manifestations at various Cunkou areas,hence there might be some diffi-culty in evaluating the status of different organs through checking pulse manifestations at Cunkou.This research aims to analyze the pulse response at Cunkou from the aspect of the characteristics of tactile sensing,thus to give a preliminary explanation to the above question. Methods This research utilized the Weber-Fechner law to model the tactile sensing as a dy-namic low-pass signal filter with varying bandwidths under different compression levels dur-ing pulse diagnosis.The model was applied to analyzing the clinical data collected previously by our group.The arterial pressures measured invasively with equipment from 14 patients with aorta coarctation were processed to simulate different pulse manifestations at Cun,Guan,and Chi positions of Cunkou when different compression levels were applied. Results Due to the characteristics of tactile sensing,significant variations were observed in pulse manifestations at different pulse-depths under the application of changing compres-sion levels;while no such changes in pulse manifestations were observed from the employ-ment of transducer only,without tactile sensing involved.The results explained why different understandings on pulse manifestations were formed between direct pulse-taking technique in TCM and modern sphygmography using transducers.The features of pulse manifestations at Cunkou,using direct pulse-taking technique but at different depths,superficial,middle,and deep positions,respectively,predicted by the developed tactile sensing model were in line with those described in TCM pulse theories. Conclusion Based on the developed tactile sensing model,this study preliminarily explains the phenomenon that pulse manifestation at Cunkou changes in response to the compression force applied during TCM pulse-taking.Integrating the tactile sensing model with the study of TCM pulse diagnosis opens a new chapter for visualizing and quantitatively interpreting pulse manifestations.This not only expands the scope of pulse diagnosis study effectively,but also provide a scientific basis for further technical upgrading and optimization of existing pulse di-agnosis equipment.