ObjectiveTo establish a reliable chronic obstructive pulmonary disease (COPD) mouse model based on a self-developed multichannel automatic control system for long-term continuous cigarette smoke exposure in small animals using a novel continuous cigarette smoke exposure method, and to conduct phenotypic evaluation and analysis, thereby providing an animal experimental basis for investigating COPD pathogenesis and prevention strategies. MethodsTwenty male C57BL/6J mice aged 6 weeks were randomly and equally divided into a control group and a model group. The model group (n=10) underwent 6 h of continuous cigarette smoke exposure daily (6 cigarettes per day for 12 consecutive weeks), while the control group (n=10) received no intervention. Body weight was monitored biweekly. Post-exposure, in vivo micro-CT imaging was performed. After euthanasia, serum and bronchoalveolar lavage fluid (BALF) levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were quantified by ELISA. Lung tissues underwent H&E and Masson's trichrome staining to observe changes in lung morphology and inflammatory cell infiltration, and the mean linear intercept (MLI) was calculated, thereby comprehensively evaluating the clinical features of COPD in the mouse model. ResultsCompared with the control group, the model group showed significantly reduced body weight (P<0.01) from the fourth week. Compared with the control group, IL-6 level in the serum and BALF of the model group increased by 27.2% and 140.0%, respectively (P<0.01). TNF-α level in the serum and bronchoalveolar lavage fluid of the model group increased by 16.7% (P<0.01) and 19.3% (P<0.05), respectively. Histopathological examination revealed alveolar wall thinning, septal rupture, emphysematous bullae formation, reduced alveolar count, bronchial wall thickening with lumen narrowing, and inflammatory cell infiltration. MLI was significantly elevated (P<0.01). Masson's staining confirmed collagen deposition and bronchial remodeling. Micro-CT demonstrated localized high-density shadows exhibiting typical features of chronic bronchitis. Conclusion The self-developed device enables long-term continuous smoke exposure, and the successfully established COPD mouse model exhibits pathological features highly consistent with clinical manifestations, offering an efficient and reliable tool for COPD research.

To analyze the clinical and genetic features of oculopharyngodistal myopathy (OPDM) patients and compare the phenotypic differences among various causative genes.

Neuronal intranuclear inclusion disease(NIID) is a rare, chronic progressive neurodegenerative disease predominantly presenting with adult-onset cases in China. This disease exhibits high clinical phenotypic heterogeneity, with neurological manifestations as the predominant symptoms in most patients and prominent involvement of other systems in a minority of cases. Some patients without characteristic early cranial magnetic resonance imaging(MRI) findings are prone to misdiagnosis and missed diagnosis. Herein, we report an adult female patient with NIID characterized by cyclic vomiting. She initially presented with difficult micturition, followed by the onset of cyclic vomiting several years later, without other neurological involve-ments throughout the disease course. Cranial MRI revealed symmetric progressive periventricular white matter lesions in the lateral ventricles. Genetic testing identified abnormal GGC repeat expansion in the NOTCH2NLC gene.Pathological examination of labial gland biopsy showed intranuclear inclusions positive for p62 and ubiquitin. By summarizing the clinical characteristics of this patient, this article aims to deepen clinicians′ understanding of NIID.

Purpose To analyze the ultrasonic manifestations of extrarenal extracranial malignant rhabdoid tumor(EERT)in children to enhance the awareness of its early diagnosis.Materials and Methods Clinical data of 13 children with EERT diagnosed by pathology from the Children's Hospital of Chongqing Medical University were collected retrospectively from January 2014 to March 2024.The ultrasonic manifestations of these cases were summarized and compared with their pathological results.Results Among the 13 children with EERT,10 cases had tumors located in soft tissues of the extremities,and 3 cases had tumors located in the abdomen.The tumors showed irregular shapes and indistinct borders on ultrasonic images,and the average of the maximum diameters of the tumors measured by ultrasound was(10.43±2.57)cm.The interior of the tumors mostly appeared as heterogeneous hypoechoic lesions;9 of the tumors were accompanied by small patchy regions of anechoic areas(cystic degeneration or liquefaction);9 of the tumors were accompanied by strong echoes(calcification);12 of the tumors had relatively abundant blood supply.Conclusion Ultrasonic images of EERT in children have certain characteristics.Mastering the ultrasonic manifestations could assist in the clinical diagnosis and follow-up of this disease.

The diagnosis of obscure gastrointestinal bleeding in children faces many challenges,including the complexity of etiology and the limitations of diagnostic techniques. This article explored current diagnostic strategies,highlighted the importance of multidisciplinary collaboration,and assessed the potential of emerging technologies such as capsule endoscopy and double balloon enteroscopy.While these technologies offer new diagnostics,cost and operational complexity remain barriers to adoption. Future research directions should include improving access to technology and developing integrated diagnostic pathways to optimize the management of obscure gastrointestinal bleeding in children.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective:By using cognitive interviews,the interviewees' cognition and understanding of the inflammatory bowel disease(IBD) self-efficacy scale for adolescents and young adults (IBDSES-A) were evaluated,and the semantic content of IBDSES-A,which was initially translated into Chinese,was tested and revised.Methods:Using purposive sampling,15 IBD patients aged 12-18 were selected from Beijing Children's Hospital,Capital Medical University,between January and February 2025,stratified by age group and disease type.Two rounds of cognitive interviews were conducted.Feedback and suggestions from interviewees were analyzed using a question appraisal system for coding and integration.Based on expert panel discussions,ambiguous items were revised to finalize the Chinese version of the IBDSES-A.Results:In the first round,10 interviewees were interviewed,followed by 5 interviewees in the second round.There were no statistically significant differences ( P>0.05) between the interviewees of two rounds in terms of age,gender,and education level.During the first round of interview,interviewees expressed comprehension difficulties with 76.9% (10/13) of the items.Coding analysis revealed that the primary issue was "clarification",as unclear wording made it difficult for interviewees to fully grasp the intended meaning of certain items.Based on these findings,the expert panel revised 10 of the 13 items in the IBDSES-A.The second round of cognitive interview showed that the interviewees generally understood the revised items，achieving linguistic and semantic consistency with the original scale. Conclusion:The application of cognitive interviews in the translation process of the IBDSES-A helps reduce comprehension biases caused by inappropriate wording，ensuring that the localized version of the scale is more accessible and understandable to the target population.

The efficacy of preoperative neoadjuvant chemoradiotherapy(nCRT)in locally advanced rectal cancer(LARC)is predicted using radiomic features of the target areas in radiotherapy for rectal cancer and an interpretable machine learning model.The clinical data are collected from 290 LARC patients who are divided into effective and ineffective groups based on tumor regression grade.The extracted radiomic features and clinicopathological data are used to develop prediction models.The optimal model is determined based on AUC performance evaluation,and the explanatory analysis is conducted using nomogram and decision curve.A total of 223 patients are included in the study,with 48 in the effective group.There are 156 patients in the training set(34 in the effective group)and 67 patients in the validation set(14 in the effective group).The nomogram model shows the best performance,with AUC of 0.858 in the training set and 0.844 in internal test set,and decision curve analysis demonstrated its superior net clinical benefit across most threshold ranges than other models.Combining radiomics and clinical variables,the nomogram can effectively predict nCRT outcomes and support clinical decision-making.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.