OBJECTIVE T o explore the clinical characteristics and risk factors for plastic bronchitis(PB)in the chil-dren with Mycoplasma pneumoniae pneumonia(MPP).METHODS A retrospective case-control study was con-ducted for the medical data of the children with MPP who hospitalized in pediatrics department of Affiliated Hos-pital of Jining Medical College and underwent bronchoscopy and bronchoalveolar lavage from Jan.2023 to Dec.2024.The enrolled children were divided into the PB group and the non-PB group according to the status of complication with PB.The baseline data,clinical characteristics,laboratory test indexes,imaging features,bron-choscopy findings and treatment outcomes were observed and compared between the two groups of children.RESULTS A total of 734 children with MPP were included in the study,131 of whom were assigned as the PB group,and 603 were assigned as the non-PB group.The children were younger[4.83(1.88,7.00)years],the du-ration of fever was longer,the peak temperature was higher[39.50(39.20,39.80)℃],the percentage of compli-cation with pleural effusion was higher(33.59％),the percentage of extrapulmonary organs involved was higher(27.48％),the levels of white blood cells,neutrophils percentage,C-reactive protein(CRP),lactic dehydrogen-ase(LDH),D-dimer(DD)and alanine aminotransferase(ALT)were higher in the PB group than in the non-PB group,and there were significant differences(P＜0.05).There were significant differences in the percentage of mucosal necrosis under bronchoscopy,number of times of treatments assisted by bronchoscopy and length of hospital stay between the two groups(P＜0.05).CONCLUSIONS The MPP children with PB are characterized by younger rage,longer duration of fever,higher peak temperature,higher percentage of complication with pleural effusion,extrapulmonary organs more likely to be involved,more intensive inflammatory reactions and higher percentage of mucosal necrosis under bronchoscopy.Some of the children need to be treated repeatedly with assis-tance of bronchoscopy,and the length of hospital stay is long.

Objective To analyze the prevalence of dengue fever in Guangzhou based on circuit-qi theory.Methods Data on dengue fever cases in Guangzhou from January 21,2012,to January 19,2024 were collected.And then the incidence of dengue fever was analyzed under the circuit-qi conditions of dominant qi,guest qi,celestial qi,joining of guest qi with dominant qi,and dissimilation of circuit and qi.Results Higher incidence of dengue fever in Guangzhou was presented under the circuit-qi conditions of the fifth qi of the dominant qi in each year,shaoyang minister fire of the guest qi,shaoyin monarch fire of the celestial qi,guest qi restricting dominant qi in the joining of guest qi with dominant qi,shaoyang minister fire(guest qi)joining with yangming dry-metal(dominant qi)in the pattern of guest qi restricting dominant qi.The outbreak of dengue fever under the circuit-qi conditions of dissimilation of circuit and qi showed no statistically significant difference.Conclusion Over the 12-year period from 2012 to 2024,the prevalence of dengue fever in Guangzhou exhibited a 4-5-year cyclical pattern,often with consecutive outbreaks over two years.The prevalence of dengue fever in Guangzhou is associated with the factors of dampness and heat in the theory of five circuits and six qi,while has less relation with dissimilation of circuit and qi.

By collecting inspection results from medical device clinical trials from 2016 to 2023,to analyze and discuss common problems of clinical trials from both in vitro diagnostic reagents and medical devices,and propose the suggested mea-sures taken by participants in the clinical trial,so as to avoid similar problems occur and ensure the quality of clinical trials.

OBJECTIVE T o explore the clinical characteristics and risk factors for plastic bronchitis(PB)in the chil-dren with Mycoplasma pneumoniae pneumonia(MPP).METHODS A retrospective case-control study was con-ducted for the medical data of the children with MPP who hospitalized in pediatrics department of Affiliated Hos-pital of Jining Medical College and underwent bronchoscopy and bronchoalveolar lavage from Jan.2023 to Dec.2024.The enrolled children were divided into the PB group and the non-PB group according to the status of complication with PB.The baseline data,clinical characteristics,laboratory test indexes,imaging features,bron-choscopy findings and treatment outcomes were observed and compared between the two groups of children.RESULTS A total of 734 children with MPP were included in the study,131 of whom were assigned as the PB group,and 603 were assigned as the non-PB group.The children were younger[4.83(1.88,7.00)years],the du-ration of fever was longer,the peak temperature was higher[39.50(39.20,39.80)℃],the percentage of compli-cation with pleural effusion was higher(33.59％),the percentage of extrapulmonary organs involved was higher(27.48％),the levels of white blood cells,neutrophils percentage,C-reactive protein(CRP),lactic dehydrogen-ase(LDH),D-dimer(DD)and alanine aminotransferase(ALT)were higher in the PB group than in the non-PB group,and there were significant differences(P＜0.05).There were significant differences in the percentage of mucosal necrosis under bronchoscopy,number of times of treatments assisted by bronchoscopy and length of hospital stay between the two groups(P＜0.05).CONCLUSIONS The MPP children with PB are characterized by younger rage,longer duration of fever,higher peak temperature,higher percentage of complication with pleural effusion,extrapulmonary organs more likely to be involved,more intensive inflammatory reactions and higher percentage of mucosal necrosis under bronchoscopy.Some of the children need to be treated repeatedly with assis-tance of bronchoscopy,and the length of hospital stay is long.

Objective:To compare the influence of definition methods of different isocenter on postoperative volumetric modulated arc therapy (VMAT) plans for patients with high-grade glioma (HGG),and to explore the feasibility of determining the treatment isocenter at location stage of computed tomography (CT) simulation system (CT-Sim). Methods:A total of 30 HGG patients who received radiotherapy after surgery in Peking University International Hospital from September 1,2021 to December 31,2022 were selected. 4 kinds of methods,which included center of mass (CT-COM) of target region of tumor bed was delineated by CT-Sim location stage,geometric center of target region of treatment plan system (TPS-Geo),whole brain geometric center of treatment plan system (TPS-Head) and center of mass of target region of TPS (TPS-COM),were respectively adopted to definite treatment isocenter for each patient,and they were respectively set as CT-COM group,TPS-Geo group,TPS-Head group and TPS-COM group to design 4 groups of VMAT treatment. The parameters included dose,conformity index (CI),uniformity index (HI) and machine unite (MU) among 4 groups of target region and organ at risk (OAR) were compared. Results:The doses of target region and OAR of four groups were similar,and all of them can meet the requirements of clinical dosimetry and clinical OAR dose limitation,without statistically significant differences (P>0.05). The covered volumes that brain tissues received 10,20,30,40 and 50 Gy doses in CT-COM group,TPS-Geo group and TPS-COM group closed to the maximum dose,the maximum dose of 2％ volume and mean dose (Dmax,D2％,Dmean) of brainstem,bilateral lens,optic chiasm,bilateral optic nerve and pituitary gland. The V10,V20,V30 of brain tissue,and Dmax,D2％,and Dmean of brainstem in TPS-Head group were slightly higher than those in other three groups,and the Dmean of lens,and Dmax,D2％ and Dmean of optic nerve at health side of TPS-Head group were slightly lower than those of other three groups,without statistically significant differences (P>0.05). Conclusion:The four VMAT plans of defining the treatment isocenter can meet the clinical dosimetric requirements,and can determine the isocenter at CT-Sim location stage,which can effectively avoid the occurrence of errors in the reduction of radiotherapy,and increase precision of delivery of radiotherapy dose,and enhance effective utilization rate of equipment.

Objective:To compare the influence of definition methods of different isocenter on postoperative volumetric modulated arc therapy (VMAT) plans for patients with high-grade glioma (HGG),and to explore the feasibility of determining the treatment isocenter at location stage of computed tomography (CT) simulation system (CT-Sim). Methods:A total of 30 HGG patients who received radiotherapy after surgery in Peking University International Hospital from September 1,2021 to December 31,2022 were selected. 4 kinds of methods,which included center of mass (CT-COM) of target region of tumor bed was delineated by CT-Sim location stage,geometric center of target region of treatment plan system (TPS-Geo),whole brain geometric center of treatment plan system (TPS-Head) and center of mass of target region of TPS (TPS-COM),were respectively adopted to definite treatment isocenter for each patient,and they were respectively set as CT-COM group,TPS-Geo group,TPS-Head group and TPS-COM group to design 4 groups of VMAT treatment. The parameters included dose,conformity index (CI),uniformity index (HI) and machine unite (MU) among 4 groups of target region and organ at risk (OAR) were compared. Results:The doses of target region and OAR of four groups were similar,and all of them can meet the requirements of clinical dosimetry and clinical OAR dose limitation,without statistically significant differences (P>0.05). The covered volumes that brain tissues received 10,20,30,40 and 50 Gy doses in CT-COM group,TPS-Geo group and TPS-COM group closed to the maximum dose,the maximum dose of 2％ volume and mean dose (Dmax,D2％,Dmean) of brainstem,bilateral lens,optic chiasm,bilateral optic nerve and pituitary gland. The V10,V20,V30 of brain tissue,and Dmax,D2％,and Dmean of brainstem in TPS-Head group were slightly higher than those in other three groups,and the Dmean of lens,and Dmax,D2％ and Dmean of optic nerve at health side of TPS-Head group were slightly lower than those of other three groups,without statistically significant differences (P>0.05). Conclusion:The four VMAT plans of defining the treatment isocenter can meet the clinical dosimetric requirements,and can determine the isocenter at CT-Sim location stage,which can effectively avoid the occurrence of errors in the reduction of radiotherapy,and increase precision of delivery of radiotherapy dose,and enhance effective utilization rate of equipment.

By collecting inspection results from medical device clinical trials from 2016 to 2023,to analyze and discuss common problems of clinical trials from both in vitro diagnostic reagents and medical devices,and propose the suggested mea-sures taken by participants in the clinical trial,so as to avoid similar problems occur and ensure the quality of clinical trials.

Objective To investigate the protective effect of dapagliflozin on kidney and the expression of AMP-activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)signaling pathway in diabetic nephropathy(DN)rats.Methods A total of 40 SPF Wistar male rats were randomly divided into normal group,model group,low-dose group and high-dose group,with 10 rats in each group.After the DN model was successfully prepared,the rats in normal group were given normal diet + normal saline by gavage,the rats in model group was given high sugar and high fat feed + normal saline by gavage,the rats in low-dose group was given high sugar and high fat feed+1mg/(kg·d)of dapagliflozin by gavage,the rats in high-dose group was given high sugar and high fat feed+10mg/(kg·d)of dapagliflozin by gavage.Rats in each group were continuously gavaged for 12 weeks.Renal function indexes,renal pathological changes,p-AMPK and p-mTOR protein expression,collagen type Ⅰ(COL Ⅰ),collagen type Ⅳ(COL Ⅳ)and fibronectin(FN)of all groups were compared.Results Blood urea nitrogen(BUN),serum creatinine(SCr),24h urinary protein quantity,p-mTOR protein expression,COL Ⅰ,COL Ⅳ and FN levels of rats in model group,low-dose group and high-dose group were significantly higher than those in normal group,and p-AMPK protein expression was significantly lower than that of normal group(P<0.05).BUN,SCr,24h urinary protein quantity,p-mTOR protein expression,COL Ⅰ,COL Ⅳ and FN levels of rats in low-dose group and high-dose group were significantly lower than those in model group,while p-AMPK protein expression was significantly higher than that in model group(P<0.05).BUN,SCr,24h urinary protein quantity,p-mTOR protein expression,COL Ⅰ,COL Ⅳ and FN levels in high-dose group were significantly lower than those in low-dose group,and p-AMPK protein expression was significantly higher than that in low-dose group(P<0.05).Conclusion Dapagliflozin has a good kidney protection effect on DN rats,and its mechanism may be related to the regulation of AMPK/mTOR signaling pathway.

Objective:To compared the changes of macular microvascular architecture in early stage familial exudative vitreoretinopathy (FEVR) patients with inner retinal layer (IRL) persistence and without IRL persistence.Methods:A retrospective clinical study. From 2017 to 2022, 94 patients with stage 1 FEVR with or without IRL residue and 45 age- and sex-matched healthy volunteers with 45 eyes (normal control group) who were confirmed by ophthalmology examination in Hangzhou Hospital of Optometry Affiliated to Wenzhou Medical University and Zhejiang Provincial People's Hospital were included in the study. According to whether there was IRL residue, the patients were divided into IRL group and non-IRL group, with 22 patients (22 eyes) and 72 patients (72 eyes), respectively. Best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) were performed in all eyes. Superficial vessel density (SCP) and deep vessel density (DCP) of whole image, fovea and parafovea, the area and perimeter of fovea avascular area (FAZ), A-circularity index (AI, perimeter/standard circle perimeter with equal area) and vessel density around the 300 μm width of the FAZ (FD), central macular thickness (CMT) on macular 3 mm × 3 mm scan on OCTA were measured.Results:SCP and DCP of whole image ( F=10.774, 4.583) and parafovea ( F=10.433, 3.912), CMT ( F=171.940) in IRL group and non-IRL group on macular 3 mm × 3 mm scan on OCTA were significantly lower than that in normal persons ( P<0.05). There were significant differences among three groups of the area of FAZ ( F=4.315), AI ( F=3.413), FD-300 ( F=13.592) ( P<0.05). BCVA were worst in IRL group ( P<0.05). Conclusions:Blood flow density decreased in macular area of FEVR patients. CMT is significantly thicker than normal population. The FAZ area of the foveal IRL residual eyes is small and irregular, with worse BCVA and lower macular blood density.

Objective:To investigate the prevalence of anxiety and depression in patients undergoing thoracic tumor radiotherapy, preliminarily evaluate the nutritional risk of patients, and analyze the possible influential factors of anxiety and depression and their correlation with nutritional risk, providing a theoretical basis for further formulating a personalized psychological nursing plan for patients undergoing thoracic tumor radiotherapy.Methods:A total of 121 patients who underwent thoracic tumor radiotherapy between April 2019 and March 2020 in Cancer Hospital of The University of Chinese Academy of Sciences were selected for this study. We evaluated patients' psychological statuses using the Hospital Anxiety and Depression Scale and patients' nutritional risk using the Nutrition Risk Screening. We performed univariate analysis, unconditional logistic regression analysis, and contingency analysis to analyze the factors that affected the psychological status of patients undergoing thoracic tumor radiotherapy and correlate patients' psychological status with nutritional risk.Results:Among 121 patients, 99 (81.8%) patients undergoing thoracic tumor radiotherapy would develop or had developed anxiety, and 42 (34.7%) patients were at the boundary of depression or had depression. Correlation analysis revealed that nutritional risk was correlated with the prevalence of anxiety and depression. Logistic regression analysis showed that surgery, first radiotherapy, and nutritional risk were the factors that affected the prevalence of anxiety. Marital status, location of tumors, surgery, first radiotherapy, and nutritional risk affected the prevalence of depression.Conclusion:Patients undergoing thoracic tumor radiotherapy have serious psychological problems. Nutritional risk is positively correlated with the prevalence of anxiety and depression. Surgery and first radiotherapy are the factors that affect the prevalence of anxiety and depression.