Objective:To analyze the clinical characteristics of children with head and neck rhabdomyosarcoma (RMS) and to summarize the mid-long term efficacy of Beijing Children′s Hospital Rhabdomyosarcoma 2006 (BCH-RMS-2006) regimen and China Children′s Cancer Group Rhabdomyosarcoma 2016 (CCCG-RMS-2016) regimen.Methods:A retrospective cohort study. Clinical data of 137 children with newly diagnosed head and neck RMS at Beijing Children′s Hospital, Capital Medical University from March 2013 to December 2021 were collected. Clinical characteristic of patients at disease onset and the therapeutic effects of patients treated with the BCH-RMS-2006 and CCCG-RMS-2016 regimens were compared. The treatments and outcomes of patients with recurrence were also summarized. Survival analysis was performed by Kaplan-Meier method, and Log-Rank test was used for comparison of survival rates between groups.Results:Among 137 patients, there were 80 males (58.4%) and 57 females (41.6%), the age of disease onset was 59 (34, 97) months. The primary site in the orbital, non-orbital non-parameningeal, and parameningeal area were 10 (7.3%), 47 (34.3%), and 80 (58.4%), respectively. Of all patients, 32 cases (23.4%) were treated with the BCH-RMS-2006 regimen and 105 (76.6%) cases were treated with the CCCG-RMS-2016 regimen. The follow-up time for the whole patients was 46 (20, 72) months, and the 5-year progression free survival (PFS) and overall survival (OS) rates for the whole children were (60.4±4.4)% and (69.3±4.0)%, respectively. The 5-year OS rate was higher in the CCCG-RMS-2016 group than in BCH-RMS-2006 group ((73.0±4.5)% vs. (56.6±4.4)%, χ2=4.57, P=0.029). For the parameningeal group, the 5-year OS rate was higher in the CCCG-RMS-2016 group (61 cases) than in BCH-RMS-2006 group (19 cases) ((57.3±7.6)% vs. (32.7±11.8)%, χ2=4.64, P=0.031). For the group with meningeal invasion risk factors, the 5-year OS rate was higher in the CCCG-RMS-2016 group (54 cases) than in BCH-RMS-2006 group (15 cases) ((57.7±7.7)% vs. (30.0±12.3)%, χ2=4.76, P=0.029). Among the 10 cases of orbital RMS, there was no recurrence. In the non-orbital non-parameningeal RMS group (47 cases), there were 13 (27.6%) recurrences, after re-treatment, 7 cases survived. In the parameningeal RMS group (80 cases), there were 40 (50.0%) recurrences, with only 7 cases surviving after re-treatment. Conclusions:The overall prognosis for patients with orbital and non-orbital non-parameningeal RMS is good. However, children with parameningeal RMS have a high recurrence rate, and the effectiveness of re-treatment after recurrence is poor. Compared with the BCH-RMS-2006 regimen, the CCCG-RMS-2016 regimen can improve the treatment efficacy of RMS in the meningeal region.

Objective:To compare the efficacy of fractional CO 2 laser combined with topical delivery of fluorouracil versus compound betamethasone injections in the treatment of vitiligo. Methods:Clinical data were collected from 94 patients with localized, non-segmental, and stable vitiligo, who received fractional CO 2 laser combined with drug delivery at the Cosmetological Center, Xijing Hospital, Air Force Medical University from October 2018 to May 2023, and were retrospectively analyzed. Among them, there were 40 cases in the fractional CO 2 laser combined with fluorouracil injection group, and 54 cases in the fractional CO 2 laser combined with compound betamethasone injection group. All the patients received the above treatment once a month for 5 sessions. A 4-level grading scale was used to evaluate the pigmentation improvement, and the clinical efficacy and safety of the two therapeutic regimens were compared. Comparisons between groups were performed using chi-square test, Fisher′s exact test, and t test. Results:In the fractional CO 2 laser combined with fluorouracil injection group, there were 22 males and 18 females, their ages were 21.95 ± 12.88 years, and the disease duration was 25.46 ± 11.42 months; in the fractional CO 2 laser combined with compound betamethasone injection group, there were 36 males and 18 females, their ages were 22.26 ± 8.79 years, and the disease duration was 26.51 ± 12.81 months. One month after the first treatment, no significant difference was observed in the efficacy between the two groups ( χ2 = 1.39, P = 0.238). One month after the fifth treatment, 2 (5.0%) patients showed an excellent response, 4 (10.0%) showed a good response, 12 (30.0%) showed a mild response, and 22 (55.0%) showed a poor response in the fractional CO 2 laser combined with fluorouracil injection group; in the fractional CO 2 laser combined with compound betamethasone injection group, 8 (14.8%) patients showed a good response, 8 (14.8%) showed a mild response, and 38 (70.4%) showed a poor response; there was no significant difference in the efficacy between the two groups after 5 sessions of treatment ( χ2 = 2.35, P = 0.125). After either 1 or 5 sessions of treatment, there were no significant differences in the efficacy for lesions on the face and neck, trunk and limbs, hands and feet between the two therapeutic regimens (all P > 0.05). Comparisons of the efficacy for skin lesions on different body sites showed that one session of the fractional CO 2 laser combined with fluorouracil injection was more effective for the treatment of skin lesions on the face and neck compared with those on the hands and feet ( P = 0.039) ; after 5 sessions of treatment, the two therapeutic regimens both showed better efficacy for facial skin lesions compared with hand and foot skin lesions ( P = 0.005, 0.049). There was no significant difference in the occurrence of adverse reactions such as pigmentation, infection and scarring between the two groups. Conclusion:The fractional CO 2 laser combined with topical delivery of fluorouracil and compound betamethasone injections showed similar efficacy and safety in the treatment of vitiligo, and both can be used as treatment options for vitiligo.

Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Objective To evaluate the effect of manual massage on complications after endoscopic foam sclerotherapy injection for the treatment of internal hemorrhoids.Methods Consecutive 113 patients with grade Ⅰinternal hemorrhoids were prospectively enrolled and completed endoscopic foam sclerotherapy.The patients were randomly divided into a massage group(n=65)and a control group(n=68).Massage group performed manual perianal massage,Visual analogue scale(VAS)was used to evaluate perianal pain.The postoperative bleeding,short-term and long-term efficacy were also compared.Results The median VAS of 24 h postoperation was 1.0(0.0,3.0)in massage group,which was significantly lower than 2.0(1.0,4.0)in control group,the difference was statistically significant(P=0.014).The no bleeding rate of one week postoperation was 84.6％in massage group,which was significantly higher than 64.7％in control group,the difference was statistically significant(P=0.009).After 12 weeks,6 months and 12 months of follow-up,there were no significant differences in cure rate and remission rate between the two groups(P＞0.05).Conclusion Manual massage after endoscopic sclerosing agent injection is beneficial to relieve postoperative pain of grade Ⅰ internal hemorrhoids and reduce bleeding.

Objective To investigate the efficacy and safety of edaravone dexborneol combined with alteplase in the treatment of acute ischemic stroke （AIS）. Methods The data were collected from 124 patients with AIS who were admitted to our hospital from November 2020 to April 2022. The patients were randomly divided into experimental group （intravenous thrombolysis with alteplase + treatment with edaravone dexborneol） and control group （intravenous thrombolysis with alteplase）， and the two groups were compared for efficacy. Results The overall response rate in the experimental group was significantly higher than that in the control group （82.3% vs 64.5%， P < 0.05）. The National Institutes of Health Stroke Scale scores at different stages after thrombolysis were significantly lower in the experimental group （5.40 ± 3.82， 4.14 ± 3.44， and 0.57 ± 0.99） than in the control group （P < 0.05）. No adverse drug reactions were observed in the two groups during the treatment. Conclusion Edaravone dexborneol combined with alteplase has definite clinical efficacy in the treatment of AIS.

Objective　To investigate the prognosis and influencing factors of intravascular interventional therapy for posterior circulation infarction. Method　For selecting our department admitted in October 2019 and October 2017-two years hospitalized with a total of 42 cases of clinically diagnosed patients with posterior circulation infarction，patient gender，age，on admission，the main symptoms and signs，pathogenic factors，pathogenesis time interval，when to see a doctor to vascular disease opening time，lesion blood vessel parts，collateral compensatory，operation method choice and recanalization，vascular interventional treatment and postoperative 7 days before the NIHSS score，GCS score，mRS score when discharged from hospital，postoperative complications and prognosis of 90 days. According to the improved Rankin score of patients with 90-day prognosis，the patients were divided into a good prognosis group （mRS score <4 points） and a poor prognosis group （mRS score ≥ 4 points），and statistical analysis was conducted. Results　（1） For posterior circulation infarction，multiple interventional therapies were used to treat the lesion vessel opening rate of 71.4%，the 3-month mortality rate of posterior circulation infarction was 28.6%. And the good prognosis rate was 50%. （2）Univariate analysis suggested a statistically significant difference in the prognosis of patients with smoking P<0.01）. （3）Logistic regression analysis showed that after adjusting for cerebrovascular risk factors such as smoking，lower basilar artery occlusion was associated with poor prognosis. （4）Good intraoperative lesion vessels （Ⅱb level or Ⅲ level） and is related to good prognosis. Conclusion　Endovascular interventional therapy is an efficient and rapid method for posterior circulation infarction to open blood vessels. Good recanalization of diseased blood vessels during operation is positively correlated with good prognosis，while smoking and lower basilar artery occlusion are correlated with poor prognosis.

Objective: The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state. Methods: A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO_{2 peak}%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO_{2 peak}% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re-revascularization, re-infarction and all-cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance. Results: The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0)% vs. (65.0±8.2)%, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization (OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[(7.7±3.6)years vs. (5.0±2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI (OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re-revascularization and re-infarction between the two groups within 24 months after PCI between the groups. Conclusions Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.

Objective The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state. Methods A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO2 peak%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO2 peak% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re?revascularization, re?infarction and all?cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance. Results The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0) % vs. (65.0±8.2) %, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization ( OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[ (7.7 ± 3.6)years vs. (5.0 ± 2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI ( OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re?revascularization and re?infarction between the two groups within 24 months after PCI between the groups. Conclusions Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.

Objective To explore the clinical application of transvaginal ultrasonography in the diagnosis of intrauterine adhesions .Methods 95 patients with suspected intrauterine adhesions were selected as the study subjects.All patients were treated with vaginal two -dimensional,three-dimensional ultrasound,and the results and hysteroscopy results were compared .The sensitivity,specificity,positive predictive value ,negative predictive value and accuracy of two -dimensional and three -dimensional ultrasonography were analyzed .Results Of 95 cases with suspected intrauterine adhesions ,vaginal two -dimensional ultrasound diagnosed 54 cases of intrauterine adhesions , including 30 cases of mild adhesion ,18 cases of moderate adhesion ,6 cases of severe adhesion ,22 cases of missed diagnosis or misdiagnosis.Compared with hysteroscopy ,the difference was statistically significant (χ2 =12.213,P=0.007).Three -dimensional ultrasound diagnosed intrauterine adhesions in 63 cases,including 20 cases of mild adhesion ,35 cases of moderate adhesion ,8 cases of severe adhesion ,only 7 cases of missed diagnosis or misdiagnosis . Compared with hysteroscopy ,the difference was not statistically significant (χ2 =0.630,P=0.889),suggested that the diagnosis of vaginal three -dimensional ultrasound and hysteroscopy results was consistent , and vginal three -dimensional ultrasound was superior than two -dimensional ultrasound , the difference was statistically significant (χ2 =8.848,P=0.003).The sensitivity of transvaginal two -dimensional ultrasonography in diagnosis of intrauterine adhesions was 67.65％,which of three-dimensional ultrasound was 89.71％,there was statistically significant differ-ence between the two groups (χ2 =9.861,P=0.002).The specificity of two-dimensional ultrasound was 70.37％, which of three-dimensional ultrasound was 92.59％,there was significant difference between the two groups (χ2 =4.418,P=0.036).The positive predictive value of two -dimensional ultrasound was 85.19％,which of three -dimensional ultrasound was 96.83％,there was statistically significant difference between the two groups (χ2 =5.040, P=0.025).The negative predictive value of two -dimensional ultrasound was 46.34％,which of three-dimensional ultrasound was 78.13％, there was statistically significant difference between the two groups (χ2 =7.583, P =0.006).The diagnostic accuracy of two -dimensional ultrasound was 68.42％,which of three -dimensional ultra-sound was 90.53％,there was statistically significant difference between the two groups (χ2 =14.228,P=0.000). Conclusion Transvaginal three-dimensional ultrasound in diagnosis of intrauterine adhesions is more accurate than two-dimensional ultrasound , and the result is consistent with hysteroscopy .Transvaginal three -dimensional ultra-sound can be used as the preferred method of intrauterine adhesions .

Objective To evaluate the efficacy of alendronate sodium combined with dietary and exercise intervention in postmenopausal osteoporosis. Methods 88 postmenopausal osteoporosis patients were enrolled and treated with alendronate sodium and Vitamin D combined with dietary and exercise intervention for 12 months. Bone mineral density (BMD) of lumber spine and femur neck were measured before and after the treatment. Results Medication combined with dietary and exercise intervention significantly increased bone mineral density of postmenopausal osteoporosis patients, and the serum levels of bone alkaline phosphatase (BLAP), alkaline phosphatase (AKP) and tartrate resistant acid phosphatase (TRACP) were significantly higher than those pre-treatment, with significant differences (P<0.05). Conclusion Compared to simple medication treatment, medication combined with dietary and exercise intervention is more effective to enhance medication efficacy and BMD level.