ObjectiveTo observe the clinical efficacy and safety of Modified Guomin Decoction （加味过敏煎， MGD） in patients with mild to moderate atopic dermatitis （AD） of the traditional Chinese medicine （TCM） pattern of heart fire and spleen deficiency， and to explore its possible mechanisms. MethodsIn this randomized， double-blind， placebo-controlled study， 72 patients with mild to moderate AD and the TCM pattern of heart fire and spleen deficiency were randomly divided into a treatment group and a control group， with 36 cases in each group. The treatment group received oral MGD granules combined with topical vitamin E emulsion， while the control group received oral placebo granules combined with topical vitamin E treatment. Both groups were treated twice daily for 4 weeks. Clinical efficacy， TCM syndrome scores， Visual Analogue Scale （VAS） for pruritus， Dermatology Life Quality Index （DLQI） scores， Scoring Atopic Dermatitis （SCORAD） and serum biomarkers， including interleukin-33 （IL-33）， interleukin-1β （IL-1β）， immunoglobulin E （IgE）， and tumor necrosis factor-α （TNF-α） were compared before and after treatment. Safety indexes was also assessed. ResultsThe total clinical effective rates were 77.78% （28/36） in the treatment group and 38.89% （14/36） in the control group， with cure rates of 19.44% （7/36） and 2.78% （1/36）， respectively. The treatment group showed significantly better clinical outcomes compared to the control group （P＜0.05）. The treatment group exhibited significant reductions in total TCM syndrome scores， including erythema， edema， papules， scaling， lichenification， pruritus， irritability， insomnia， abdominal distension， and fatigue scores， as well as reductions in VAS， DLQI， SCORAD， and serum IgE and IL-33 levels （P＜0.05 or P＜0.01）. Compared to the control group， the treatment group had significantly better improvements in all indicators except for insomnia （P＜0.05）. No adverse events occurred in either group. ConclusionMGD is effective and safe in treating mild to moderate AD patients with heart fire and spleen deficiency pattern. It significantly alleviates pruritus， improves TCM syndromes and quality of life， and enhances clinical efficacy， possibly through modulation of immune responses.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective:To investigate the association between prenatal environmental factors and attention defi-cit hyperactivity disorder(ADHD)and its symptom severity in children.Methods:Based on the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)diagnosis criteria,1 156 children with ADHD and 289 normal control children were included in this study.ADHD diagnoses were established using the Clinical Diag-nostic Interview Scale,core symptoms were assessed with the ADHD Rating Scale,and information on prenatal ex-posures were collected via self-developed questionnaires.Results:Maternal stress during pregnancy was associated with increased risk factor of ADHD in children(OR=1.22,P＜0.01).Among children with ADHD,preconception paternal alcohol consumption was positively associated with hyperactivity/impulsivity symptoms(β=0.08,P＜0.05),and maternal smoking during pregnancy was positively associated with total symptoms(β=0.07-0.09,P＜0.05).Conclusion:Maternal stress during pregnancy may increase the risk factor of ADHD in children.Both pre-conception paternal alcohol consumption and maternal smoking during pregnancy may be associated with increased ADHD symptom severity in children.

Objective:To investigate the characteristics and clinical effects of laparoscopic pneumovesical Cohen and laparoscopic Lich-Gregoir ureteral replantations for the treatment of primary obstructive megaloureter (POM) in children.Methods:A randomized controlled study was conducted.The clinical data of 51 children with unilateral POM admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2023 were collected.Random number table method was used in the selection of surgical methods.They were divided into the laparoscopic pneumovesical Cohen ureteral replantation group (group A, 22 cases) and the laparoscopic Lich-Gregoir ureteral replantation group (group B, 29 cases) according to the surgical method.The anterior-posterior diameter(APD), maximum ureteral diameter and differential renal function parameters on the affected side were measured by color Doppler ultrasound of the urinary system, and compared between and within the two groups before and after surgery.The operation time, blood loss and postoperative intubation time were compared between the two groups.The incidence of postoperative complications such as reflux, bladder spasm, urinary retention and urinary tract infection was recorded.The independent and paired sample t-tests were used for statistical analysis. Results:The operation time and hematuria duration of group B [(125.7±14.2) min, (1.5±0.6) d] were significantly shorter than those of group A [(142.6±14.7) min, (2.8±0.7) d] (all P<0.05). The APD, maximum ureteral diameter, and differential renal function on the affected side of group A were (21.7±7.9) mm, (11.6±3.2) mm, and (28.2±4.9)% before surgery, and (10.3±4.5) mm, (6.0±2.0) mm and (43.8±4.4)% after surgery, respectively.The APD, maximum ureteral diameter, and differential renal function on the affected side of group B were (21.1±5.6) mm, (11.3±4.6) mm, and (30.2±5.5)% before surgery, and (10.2±4.5) mm, (6.6±2.0) mm, and (42.4±5.2)% after surgery, respectively.There was no statistically significant difference in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the two groups of children (all P>0.05). However, there were statistically significant differences in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the same group of children (all P<0.01). No significant difference was found in intraoperative blood loss, postoperative intubation time, and postoperative complications between the two groups (all P>0.05). Conclusions:Both surgical methods are effective in the treatment of POM in children.Laparoscopic Lich-Gregoir ureteral replantation has advantages of less operation time compared with laparoscopic pneumovesical Cohen ureteral replantation.

Objective:To evaluate the clinical efficacy of methylation sensitive-high resolution melting curve (MS-HRM) detection of IFN-induced protein 44-like (IFI44L) gene methylation in the diagnosis of systemic lupus erythematosus (SLE), as well as the relationship between IFI44L gene markers and the early onset of SLE.Methods:From February 2020 to September 2022, the MS-HRM was used to detect the methylation level of the IFI44L gene in peripheral blood mononuclear cells of 602 SLE patients and 524 other autoimmune disease patients (excluding SLE) from Beijing Peking Union Medical College Hospital, Guangdong Provincial People′s Hospital, and Shenzhen People′s Hospital, totaling 1 126 patients. Compared with the 2012 SLICC criteria, the suspected cases were followed up for 6 months until the onset and clinical diagnosis of SLE were confirmed. The measurement data of normal distribution were expressed as mean±SD, and the consistency analysis was performed using the Kappa consistency test. The clinical diagnostic efficacy indicators were calculated using the receiver operating characteristic (ROC) curve. Results:RR (95% CI) of early suspected cases was 17.06 (9.43, 30.82). The results of IFI44L gene methylation level were in good agreement with the 2012 SLICC criteria, and the sensitivity, specificity and total coincidence rate were 90.53%, 92.56% and 91.47%, respectively. The Kappa value (95% CI) was 0.829(0.796, 0.862) ( P<0.001). The diagnostic efficiency of IFI44L gene methylation level ( Kappa value 0.817) was superior to anti-nuclear antibody, anti-SM antibody and anti-dsDNA antibody ( Kappa value 0.418, 0.216 and 0.440, respectively). The Kappa values (95% CI) of methylation between MS-HRM and pyrosequencing was 0.861(0.806, 0.916), P<0.001. Conclusion:The hypomethylation of IFI44L gene methylation level detected by MS-HRM is closely related to the occurrence and development of SLE, and its diagnostic performance is better than that of three autoantibodies in SLE diagnosis, which can be used for the early diagnosis of SLE.

This article summarizes the nursing experience of a patient with cold agglutinin syndrome who experienced 2 sudden cardiac arrests.The nursing key points included:balancing the contradiction between hypothermia rewarming and head therapeutic hypothermia,thereby optimizing the temperature management strategy;controlling the entire process to ensure the safety of blood transfusion;conducting dynamic assessment and monitoring of coagulation function,preventing both bleeding and thrombosis;timing of nutritional therapy and progressive feeding at the right time;multidisciplinary collaboration was implemented to carry out a rehabilitation activity plan during continuous renal replacement therapy;preventing ICU delirium.With comprehensive treatment and meticulous nursing care provided by the multidisciplinary team,the patient was discharged in good condition after 22 days of hospitalization,and has resumed his daily working life after 3 months of follow-up.

Objective To analyze the status of 2 649 suspected pertussis patients in Xi'an and the changes in laboratory diagnostic indi-cators.Methods 2 649 patients with suspected pertussis who visited the Second Affiliated Hospital of Xi'an Jiaotong University from June 2023 to May 2025 were collected as the research subjects.Nasopharyngeal swabs were collected from the patients,and pertussis nucleic acid was detected by polymerase chain reaction(PCR)-fluorescence probe method.Laboratory diagnostic indicators were an-alyzed.Results Among the 2 649 samples tested,250 were positive for pertussis nucleic acid,with a positive detection rate of 9.44%.The detection rate in male patients was 9.37%(127/1 356),and in female patients was 9.51%(123/1 293),with difference no was statis-tically significant between the two groups(χ2=0.019,P=0.894).There was a statistically significant difference in the positive detection rate among different age groups(χ2=46.473,P<0.05),with the highest positive detection rate in the 7～19 age group(14.98%).The prevalence of pertussis showed a seasonal characteristic with a peak from April to September.21.2%(53/250)of the positive patients were mixed infections.In the 1～14 age group,the white blood cell count(WBC),lymphocyte percentage(LYMP%),and lymphocyte count(LYMP#)in the pertussis infection group were higher than those in the Mycoplasma pneumoniae(MP)infection group(t=10.179,5.819,8.614)and the Respiratory syncytial virus(RSV)infection group(t=16.570,2.618,7.185),and the differences were statistically significant(all P<0.01),respectively.In the＞14 age group,the LYMP%and LYMP#in the pertussis infection group were higher than those in the MP infection group(t=3.275,2.319)and the RSV infection group(t=2.401,4.617),and the differences were statistically significant(all P<0.05),respectively.Conclusion The pertussis infection status in Xi'an area from 2023 to 2025 shows significant char-acteristics in terms of age,season and laboratory test results.It is necessary to further improve the pertussis surveillance system in this area,optimize the clinical diagnosis and treatment process and strengthen the vaccination work of pertussis vaccine.

Villitis of unknown etiology (VUE) occurs in up to 15% of term placentas. Patients with VUE exhibit increased incidence of gestational diabetes mellitus, gestational hypertension, and preeclampsia, with demonstrated recurrence risk. VUE contributes to various adverse pregnancy outcomes. Its pathogenesis involves abnormal maternal immune responses against fetal allografts and may relate to unidentified microbial infections. Currently, VUE diagnosis relies exclusively on placental pathological examination. Clinical management remains primarily symptomatic, though immunomodulatory therapies show potential. This review summarizes recent advances in VUE epidemiology, pathogenesis, clinical significance, pathological features, and preventive strategies, aiming to enhance clinical understanding of this condition.

This article summarizes the nursing experience of a patient with cold agglutinin syndrome who experienced 2 sudden cardiac arrests.The nursing key points included:balancing the contradiction between hypothermia rewarming and head therapeutic hypothermia,thereby optimizing the temperature management strategy;controlling the entire process to ensure the safety of blood transfusion;conducting dynamic assessment and monitoring of coagulation function,preventing both bleeding and thrombosis;timing of nutritional therapy and progressive feeding at the right time;multidisciplinary collaboration was implemented to carry out a rehabilitation activity plan during continuous renal replacement therapy;preventing ICU delirium.With comprehensive treatment and meticulous nursing care provided by the multidisciplinary team,the patient was discharged in good condition after 22 days of hospitalization,and has resumed his daily working life after 3 months of follow-up.