Based on the view that wind pathogen runs through the entire course of the occurrence and development of nephrotic syndrome， it is proposed that the core pathogenesis of refractory nephrotic syndrome （RNS） in children involves imbalance of the lung， spleen， and kidney， invasion of wind pathogen， and stagnation of turbidity and stasis， and that directing the turbid downward with wind medicinals is the key therapeutic strategy. In clinical practice， according to the distinct pathogenic characteristics of three patterns， including defensive qi insecurity of the lung， yang deficiency with loss of regulation， and binding of turbidity and stasis， three corresponding methods are applied， which are diffusing the lung to consolidate defensive qi， elevating yang to supplement the spleen and kidney， and activating blood to unblock turbidity and stasis. For the pattern of defensive qi insecurity of the lung， wind medicinals are used to penetrate and disperse external pathogens， such as fangfeng （Radix Saposhnikoviae） and mahuang （Herba Ephedrae） for diffusing the lung， dispersing wind， and consolidating defensive qi. For yang deficiency with loss of regulation pattern， wind medicinals are employed to elevate yang and assist transformation， such as shengma （Rhizoma Cimicifugae） and gegen （Radix Puerariae Lobatae） for raising clear yang， warming and activating the spleen and kidney. For binding of turbidity and stasis pattern， wind medicinals with scurrying and collateral‑unblocking properties are used， such as jixueteng （Caulis Spatholobi）， luoshiteng （Caulis Trachelospermi）， and chuanshanlong （Rhizoma Dioscoreae Nipponicae） for dispelling wind， activating blood， resolving stasis， and directing turbidity downward. In all these methods， the core principle is to use wind medicinals to regulate qi movement， open and unblock the sweat pores， and separately eliminate turbid pathogens， thereby providing a theoretical and practical basis for the traditional Chinese medicine diagnosis and treatment of RNS in children.

Based on the view that wind pathogen runs through the entire course of the occurrence and development of nephrotic syndrome， it is proposed that the core pathogenesis of refractory nephrotic syndrome （RNS） in children involves imbalance of the lung， spleen， and kidney， invasion of wind pathogen， and stagnation of turbidity and stasis， and that directing the turbid downward with wind medicinals is the key therapeutic strategy. In clinical practice， according to the distinct pathogenic characteristics of three patterns， including defensive qi insecurity of the lung， yang deficiency with loss of regulation， and binding of turbidity and stasis， three corresponding methods are applied， which are diffusing the lung to consolidate defensive qi， elevating yang to supplement the spleen and kidney， and activating blood to unblock turbidity and stasis. For the pattern of defensive qi insecurity of the lung， wind medicinals are used to penetrate and disperse external pathogens， such as fangfeng （Radix Saposhnikoviae） and mahuang （Herba Ephedrae） for diffusing the lung， dispersing wind， and consolidating defensive qi. For yang deficiency with loss of regulation pattern， wind medicinals are employed to elevate yang and assist transformation， such as shengma （Rhizoma Cimicifugae） and gegen （Radix Puerariae Lobatae） for raising clear yang， warming and activating the spleen and kidney. For binding of turbidity and stasis pattern， wind medicinals with scurrying and collateral‑unblocking properties are used， such as jixueteng （Caulis Spatholobi）， luoshiteng （Caulis Trachelospermi）， and chuanshanlong （Rhizoma Dioscoreae Nipponicae） for dispelling wind， activating blood， resolving stasis， and directing turbidity downward. In all these methods， the core principle is to use wind medicinals to regulate qi movement， open and unblock the sweat pores， and separately eliminate turbid pathogens， thereby providing a theoretical and practical basis for the traditional Chinese medicine diagnosis and treatment of RNS in children.

Objective: To investigate the efficacy of implantable neuromuscular electrical stimulation system on stress urinary incontinence (SUI) model in female rats. Methods: A total of 21 female infertile SD rats were randomly divided into the control，sham stimulation，and stimulation groups，with 7 rats in each group.All rats received vaginal dilation (VD) to simulate postpartum SUI.One week after VD，the control group was given normal feeding，stimulators were implanted in the pelvic floor muscles of the sham stimulation and stimulation groups.The sham stimulation group received normal feeding for 2 weeks，and the stimulation group received pelvic floor electrical stimulation (PFES) for 2 consecutive weeks.The leak point pressure (LPP) of each rat was measured with cystometry before VD (baseline value)，1 week after VD，and 2 weeks after PFES. Results: In the control group and sham stimulation group，LPP increased after 2 weeks of treatment compared with that after 1 week of VD，but it still did not return to the baseline level (P<0.001).In the stimulation group，after 2 consecutive weeks of PFES，LPP increased significantly compared with that 1 week after VD，and returned to the baseline value (P>0.05).There was no significant difference in the LPP baseline values and levels after 1 week of VD among the 3 groups (P>0.05).The LPP in the stimulation group after 2 weeks of PFES was significantly higher than that in the sham stimulation group and stimulation group (P<0.001). Conclusion: The implantable neuromuscular electrical stimulation system is effective in short-term intervention of SUI in female rats，the further studies are needed to confirm the long-term efficacy and safety of the system，the optimal stimulation sites，optimal stimulation parameters，and potential mechanisms of action.

Objective To investigate the association between 8 insulin resistance(IR)surrogate markers and incident atherosclerotic cardiovascular disease(ASCVD)in population with cardiovascular-kidney-metabolic syndrome(CKM)of stages 0-3,and to identify the surrogate marker with the best predictive performance.Methods A study was conducted on 20121 community residents classified as CKM stages 0-3 from the Chengdu cohort of the China Multi-Ethic Cohort.A Cox proportional hazards model was used to calculate hazard ratios(HRs)between each IR surrogate marker and incident ASCVD.Cubic spline regression was employed to explore the dose-response relationships between these markers and incident ASCVD.The relative relationships between different markers and incident ASCVD were examined through the ratio of HRs(RHRs).Time-dependent area under the receiver operating characteristic curve(TDAUC)and Uno's C-statistic were calculated to compare the predictive performance of each marker for incident ASCVD.Based on the PREVENT equation components and the 8 surrogate markers under analysis,random forest feature selection was used to determine the contribution of each marker to accurate prediction.Results During a follow-up period of82 741.93 person-years,1447 incident cases of ASCVD were recorded,with an incidence density of 17.49 per 1000 person-years.Association analyses indicated that the triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL)and the TyG/(TG/HDL)index were not associated with incident ASCVD(P＞0.05).The TyG index combined with obesity measurement parameters emerged as a reliable predictor of ASCVD incidence.The most promising indicator,TyG index with waist-to-height ratio(TyG_WHtR),exhibited an inverted J-shaped association with incident ASCVD(P for nonlinearity=0.045;TDAUC=0.640;C=0.634),while the TyG index with body mass index(TyG_BMI),waist circumference(TyG_WC),and waist-to-hip ratio(TyG_WHR)showed positive linear associations(all P for trend＜0.05),with relatively lower predictive performance(C=0.564,0.588,and 0.598,respectively).Although both the TyG index and the metabolic score for insulin resistance(METS-IR)were associated with increased ASCVD risk(TyG:Q2 vs.Q1,HR=1.23 and Q4 vs.Q1,HR=1.24;METS-IR:P for non-linearity=0.045),they exhibited poor predictive performance for incident ASCVD.Conclusion The TyG index combined with obesity measurement parameters is an ideal IR surrogate marker for predicting incident ASCVD in populations with stages 0-3 CKM.Monitoring these markers will facilitate the prevention and control of cardiovascular diseases in CKM populations.

Objective:To construct a management model of data mining for medical imaging equipment,so as to improve the quality of managing equipment.Methods:A management model of mining data was constructed to manage medical imaging equipment.A total of twenty imaging equipment that were using at Hainan Hospital of the General Hospital of the People's Liberation Army of China from April 2022 to March 2024 were selected.According to different management methods,the conventional management was adopted to manage them during April 2022 to March 2023,and the management model of mining data(model management)was adopted to manage them during April 2023 to March 2024.A self-developed questionnaire was used to conduct a satisfaction survey for imaging physicians,staffs of operating and maintaining equipment,and technicians who using and managing equipment,and patients who received diagnosis and treatment by using equipment.The failure rate and the imaging effect of equipment,the satisfaction scores of the relative staffs who used equipment,and the growth amplitude of operational benefits of equipment between two management methods were compared.Results:A total of 20 failures occurred in imaging equipment that adopted model management.In them,the failure rates of the self-equipment,improper operation and insufficient professional level were respectively 15%,5%and 5%,all of which were lower than those of the conventional management method.The predicted failure rate of model management was 75%,which was higher than that of the conventional management method,and the differences of the above indicators between two methods were statistically significant(x2=6.547,4.392,5.124,6.701,P<0.05).The scores of image clarity,qualification rate,excellent rate,qualification rate of body position,and the total score of imaging effect of adopting model management method were respectively(22.36±2.01),(23.21±1.54),(22.65±1.87),(23.21±1.52)and(91.43±6.77)points,all of which were higher than those of the conventional management method,and the differences were statistically significant(t=10.662,12.727,15.324,16.333,13.742,P<0.05).The satisfaction scores of imaging physicians,staffs of operation and maintenance,technicians and patients who uses management for adopting the model management method were all higher than those of the conventional management method,and the differences were statistically significant(t=13.586,14.249,17.021,11.006,P<0.05).The average values of growth amplitude of cost and benefit of equipment operation of adopting model management method were higher than those of the conventional management method,and the average value of the growth amplitude of the cost of the troubleshooting of model management method was lower than that of the conventional management method,and the differences of them were statistically significant(t=15.057,19.310,18.336,P<0.05).Conclusion:The application of the management model of data mining for medical imaging equipment can provide warning of equipment failures in advance,and reduce the failure rate of equipment,and improve the quality of management and operation of equipment,and enhance the service level of equipment.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

BACKGROUND:With the increasing attention of scholars at home and abroad to children's cervical spine-related diseases,the demand for exploring the anatomical indicators and changes of cervical spine morphology and development in children of different ages is increasing.OBJECTIVE:To explore and analyze the morphological changes of children with different ages and vertebral sequences by measuring the anatomical position indexes of C2-C7 neurocentral synchondrosis in children aged 1-6 years.METHODS:Normal cervical spine CT images were retrospectively collected from 160 children aged 1-6 years at provincial tertiary hospitals.They were divided into six groups according to an age group of 1 year.The raw data of consecutively scanned cervical spine tomography images were imported into Mimics 16.0 software.The positional anatomical indexes of cervical spine segments C2-C7 in coronal and transverse planes were measured and analyzed under the two-dimensional image window by choosing the measurement tools under the toolbar of Measurements.RESULTS AND CONCLUSION:(1)The distance between the two sides of C2-C7 neurocentral synchondrosis and the distance between the left and right sides of neurocentral synchondrosis and the transverse process gradually increased with age.The overall development of vertebrae in each cervical vertebral segment was faster than the ossification of the neurocentral synchondrosis.(2)The cross-sectional angles on both sides of C2-C7 neurocentral synchondrosis gradually increased with age,and the angles between the left and right sides of neurocentral synchondrosis and the anterior and posterior edges of the vertebral body gradually decreased.Both sides of the neurocentral synchondrosis in cervical vertebral segments tended to grow toward the arch site,which mainly promoted the growth and development of the arch.(3)Except for C7,the angle between the coronal planes on both sides of the cervical spine changed little with the descending neurocentral synchondrosis of the cervical spine,and the neurocentral synchondrosis of the cervical spine was more inclined to longitudinal growth and ossification.(4)The neurocentral synchondrosis position changes in C7 were significantly different from those in the rest of the cervical vertebrae.(5)The anatomical indexes of C2-C7 neurocentral synchondrosis position in children have obvious development rules among different ages and vertebral bodies,and these rules are helpful for the clinical diagnosis and treatment of cervical spine diseases in children.

BACKGROUND:With the increasing attention of scholars at home and abroad to children's cervical spine-related diseases,the demand for exploring the anatomical indicators and changes of cervical spine morphology and development in children of different ages is increasing.OBJECTIVE:To explore and analyze the morphological changes of children with different ages and vertebral sequences by measuring the anatomical position indexes of C2-C7 neurocentral synchondrosis in children aged 1-6 years.METHODS:Normal cervical spine CT images were retrospectively collected from 160 children aged 1-6 years at provincial tertiary hospitals.They were divided into six groups according to an age group of 1 year.The raw data of consecutively scanned cervical spine tomography images were imported into Mimics 16.0 software.The positional anatomical indexes of cervical spine segments C2-C7 in coronal and transverse planes were measured and analyzed under the two-dimensional image window by choosing the measurement tools under the toolbar of Measurements.RESULTS AND CONCLUSION:(1)The distance between the two sides of C2-C7 neurocentral synchondrosis and the distance between the left and right sides of neurocentral synchondrosis and the transverse process gradually increased with age.The overall development of vertebrae in each cervical vertebral segment was faster than the ossification of the neurocentral synchondrosis.(2)The cross-sectional angles on both sides of C2-C7 neurocentral synchondrosis gradually increased with age,and the angles between the left and right sides of neurocentral synchondrosis and the anterior and posterior edges of the vertebral body gradually decreased.Both sides of the neurocentral synchondrosis in cervical vertebral segments tended to grow toward the arch site,which mainly promoted the growth and development of the arch.(3)Except for C7,the angle between the coronal planes on both sides of the cervical spine changed little with the descending neurocentral synchondrosis of the cervical spine,and the neurocentral synchondrosis of the cervical spine was more inclined to longitudinal growth and ossification.(4)The neurocentral synchondrosis position changes in C7 were significantly different from those in the rest of the cervical vertebrae.(5)The anatomical indexes of C2-C7 neurocentral synchondrosis position in children have obvious development rules among different ages and vertebral bodies,and these rules are helpful for the clinical diagnosis and treatment of cervical spine diseases in children.

Objective:To construct a management model of data mining for medical imaging equipment,so as to improve the quality of managing equipment.Methods:A management model of mining data was constructed to manage medical imaging equipment.A total of twenty imaging equipment that were using at Hainan Hospital of the General Hospital of the People's Liberation Army of China from April 2022 to March 2024 were selected.According to different management methods,the conventional management was adopted to manage them during April 2022 to March 2023,and the management model of mining data(model management)was adopted to manage them during April 2023 to March 2024.A self-developed questionnaire was used to conduct a satisfaction survey for imaging physicians,staffs of operating and maintaining equipment,and technicians who using and managing equipment,and patients who received diagnosis and treatment by using equipment.The failure rate and the imaging effect of equipment,the satisfaction scores of the relative staffs who used equipment,and the growth amplitude of operational benefits of equipment between two management methods were compared.Results:A total of 20 failures occurred in imaging equipment that adopted model management.In them,the failure rates of the self-equipment,improper operation and insufficient professional level were respectively 15%,5%and 5%,all of which were lower than those of the conventional management method.The predicted failure rate of model management was 75%,which was higher than that of the conventional management method,and the differences of the above indicators between two methods were statistically significant(x2=6.547,4.392,5.124,6.701,P<0.05).The scores of image clarity,qualification rate,excellent rate,qualification rate of body position,and the total score of imaging effect of adopting model management method were respectively(22.36±2.01),(23.21±1.54),(22.65±1.87),(23.21±1.52)and(91.43±6.77)points,all of which were higher than those of the conventional management method,and the differences were statistically significant(t=10.662,12.727,15.324,16.333,13.742,P<0.05).The satisfaction scores of imaging physicians,staffs of operation and maintenance,technicians and patients who uses management for adopting the model management method were all higher than those of the conventional management method,and the differences were statistically significant(t=13.586,14.249,17.021,11.006,P<0.05).The average values of growth amplitude of cost and benefit of equipment operation of adopting model management method were higher than those of the conventional management method,and the average value of the growth amplitude of the cost of the troubleshooting of model management method was lower than that of the conventional management method,and the differences of them were statistically significant(t=15.057,19.310,18.336,P<0.05).Conclusion:The application of the management model of data mining for medical imaging equipment can provide warning of equipment failures in advance,and reduce the failure rate of equipment,and improve the quality of management and operation of equipment,and enhance the service level of equipment.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.