Objective To analyze the research status and trend of scarlet fever literature in China, and to provide reference for subsequent research. Methods Three major Chinese databases, CNKI, Wanfang, and VIP, as well as Web of Science English database, were used to search for literature related to scarlet fever from 2000 to 2023. Citespace6.2.R2 software was used to statistically analyze the number of publications, authors, institutions and journals, co-cited literature, keyword clustering, and other literature characteristics of the literature. Results From 2000 to 2023, a total of 1 011 Chinese literature were included in the three major Chinese databases. Since 2011, the number of publications had gradually increased, but in recent years, the number of publications had decreased. The organization with the most publications was the Shenyang Center for Disease Control and Prevention. The cluster analysis of key words mainly formed 9 cluster tags, and the high-frequency keywords mainly included epidemic characteristics, epidemiology, incidence rate, etc. A total of 84 English literature were included in the WOS database, with an overall upward trend in publication volume. The institution with the most publications was the China Center for Disease Control and Prevention, and the most frequently cited journal was ^“LANCET INFECT DIS^”.《Resurgence of scarlet fever in China: a 13-year population-based surveillance study》 was the most cited journal. After keyword cluster analysis, 9 cluster labels were mainly formed, and the keywords were mainly outbreak，Hong Kong, and Group A streptococcus. Conclusion Compared with the English literature, which mainly focuses on spatiotemporal aggregation, etiology and strain resistance, Chinese literature focuses more on epidemic surveillance, clinical features and quality nursing.

ObjectiveTo explore the possible mechanism of Danggui Sini Granules （当归四逆颗粒） in treatment of coronary heart disease with cold congealing and blood stasis syndrome. MethodsFifty SD rats were randomly divided into a blank group， a model group， a Danshen Pill （丹参滴丸） group， and a low- and high-dosage Danggui Sini Granules group， with 10 rats in each group. Except for the blank group， the rat model of coronary heart disease with cold congealing and blood stasis syndrome was established by repeated cold stimulation at low temperature combined with intraperitoneal injection of posterior pituitary hormone in all other groups. In the 6th week of modelling， 0.073 g·kg^-1·d^-1 of compound Danshen Pill was given to the Danshen Pill group， 20.2 and 40.4 g·kg^-1·d^-1 of Danggui Sini Granules were given to the low- and high-dose Danggui Sini Granules groups， respectively， and 0.2 ml/10 g of sterile water was given to the blank group and the model group， all for 2 consecutive weeks. The general conditions of the rats were recorded， and the body mass was compared weekly. At the end of the intervention， electrocardiogram， blood rheological indexes， including whole blood low-cut viscosity， whole blood high-cut viscosity， erythrocyte aggregation index， and cardiac index were detected to evaluate the effect of the medication， and HE staining was used to observe the myocardial histopathological changes， TUNEL staining to detect the apoptotic situation of cardiomyocytes， and ELISA to detect the serum thyroid-stimulating hormone （TSH）， free triiodothyronine （FT₃）， free tetraiodothyronine （FT₄） levels and thromboxane B₂ （TXB₂）， 6-keto-prostaglandin F1α （6-Keto-PGF_1α）， endothelin 1 （ET-1）， and nitric oxide （NO） levels. ResultsCompared with the blank group at the same time point， the body mass of rats in the remaining groups decreased at all time points （P＜0.05 or P＜0.01）； compared with the model group at the same time point， the body mass of rats in high-dose Danggui Sini Granules group and Danshen Pill group increased at the 6th and 7th weeks （P＜0.05 or P＜0.01）. In the blank group， the S-T segment of the electrocardiogram was close to the isoelectric line， the myocardial structure was regular， the fibres were closely arranged， and the nuclei of the cells were intact and neatly aligned； in the model group， the S-T segment of the electrocardiogram significantly elevated， and the arrangement of the myocardial fibres was obviously disordered， with myocardial cells appearing to be swollen， necrotic， and infiltrated by inflammatory cells， and the apoptosis-positive cells of the cardiac muscle cells obviously increased； in each of the medication groups， the electrocardiogram had a lowered S-T segment， and myocardial fibres were aligned， myocyte structure and morphology were improved， inflammatory cells reduced， and the number of apoptosis-positive cells significantly reduced. Compared with the blank group， the cardiac index， whole blood high cut viscosity， whole blood low cut viscosity， erythrocyte aggregation index increased in the model group， and the serum levels of TSH， FT₃， FT₄， NO， 6-Keto-PGF_1α significantly reduced， and the levels of ET-1 and TXB₂ significantly increased （P＜0.05 or P＜0.01）. Compared with the model group， the levels of cardiac index， whole blood high cut viscosity， whole blood low cut viscosity， erythrocyte aggregation index， ET-1 and TXB₂ significantly decreased and the levels of NO and 6-Keto-PGF_1α significantly increased in each medication group， and the serum levels of TSH， FT₃， and FT₄ elevated in the high-dose Danggui Sini Granules group and Danshen Pill group （P＜0.05 or P＜0.01）. The serum TSH level of rats in the low-dose Danggui Sini Granules group was lower than that in Danshen Pill group and the high-dose Danggui Sini Granules group （P＜0.01）. ConclusionDanggui Sini Granules have the effect of alleviating myocardial injury in coronary heart disease with cold congealing and blood stasis syndrome， and its mechanism may be related to reducing myocardial cell apoptosis， improving energy metabolism， and regulating the level of vasoactive factors.

Objective To explore the feasibility and short-term clinical efficacy of single segment thora-columbar tuberculosis treated with one-stage posterior approach lamina-sparing decompression.Methods A total of 11 patients with single segment thoracolumbar tuberculosis who underwent one-stage posterior ap-proach preservation of vertebral plate lesion removal,bone graft fusion,and internal fixation treatment in this hospital from September 2021 to June 2022 were selected.C-reactive protein(CRP)and erythrocyte sedimen-tation rate(ESR)were monitored to evaluate tuberculosis bacteremia and activity control,visual analogue scale(VAS)score and Oswestry disability index(ODI)were followed up to evaluate the improvement of clin-ical function,and the American Spinal Injury Association(ASIA)injury scale was used to evaluate neurologi-cal function,and the correction of kyphosis was followed up.Results All 11 patients were fully followed up.The average surgical duration is(270.91±45.98)minutes,and the average surgical bleeding is(522.72± 194.11)mL.During the follow-up period,none of the 11 patients experienced tuberculosis recurrence,and all 11 patients achieved bone graft fusion.The fusion time was 6-9 months after surgery with an average of(7.36±1.12)months.Two patients with preoperative nerve damage recovered after surgery.During the fol-low-up period,11 patients did not experience any complications related to surgery.The average CRP,ESR,ODI score,and VAS score of postoperative patients decreased compared to preoperative levels,and further de-creased at 12 months after surgery;The patient's kyphosis caused by thoracolumbar tuberculosis was correc-ted,and no obvious angle loss was found at the last follow-up(P＞0.05).Conclusion One-stage posterior ap-proach lamina-sparing decompression is a safe and effective method for treating single segment thoracolumbar tuberculosis.

Objective To explore the expression and clinical significance of tissue inhibitor of matrix metal-loproteinases(TIMP)-1 and pentraxin-3(PTX3)in the serum of patients with obstructive sleep apnea-hypop-nea syndrome(OSAHS).Methods A total of 120 patients with OSAHS admitted to the hospital from 2021 to 2022 were selected as the study group,and another 114 healthy people who underwent the physical exami-nation in the same period were selected as the control group.The severity of OSAHS was determined accord-ing to the apnea-hypopnea index(AHI)and the minimum oxygen saturation(LSpO2),and the patients were divided into mild group(66 cases)and the moderate-severe group(54 cases).Serum TIMP-1 and PTX3 levels were measured by enzyme-linked immunosorbent assay.Pearson method was used to analyze the correlation between serum TIMP-1,PTX3 and AHI,LSpO2.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum TIMP-1 and PTX3 on the severity of disease in patients with OSAHS.Logistic regression was used to analyze the factors influencing the severity of the disease in OSAHS patients.Results Serum TIMP-1,PTX3 and AHI levels in the study group were higher than those in the control group,and LSpO2 level was lower than that in the control group(P<0.05).The body mass index(BMI),the proportion of hypertension history,the proportion of coronary heart disease history,the levels of total choles-terol,triglycerides,low-density lipoprotein cholesterol,TIMP-1,PTX3 and AHI in the moderate-severe group were significantly higher than those in the mild group,and the high density lipoprotein cholesterol,LSpO2 lev-el was significantly lower than that in the mild group(P<0.05).Pearson method results showed that serum TIMP-1,PTX3 levels were positively correlated with AHI(r=0.428,0.392,P<0.05),and serum TIMP-1,PTX3 levels were negatively correlated with LSpO2(r=-0.645,-5.836,P<0.05).The results of the ROC curve showed that the area under the curve(AUC)of serum TIMP-1 and PTX3 alone predicted the severity of the patients'disease was 0.813 and 0.777,with cut-off values were 2.47 μg/L and 7.23 ng/L,with the sensi-tivity of 70.37%and 77.78%and the specificity of 77.27%and 72.23%,respectively.The AUC for predic-ting the severity of patients'disease by combining the two was 0.866,which was significantly higher than those of serum TIMP-1(Z=2.067,P=0.039)and PTX3 alone(Z=2.331,P=0.020).Logistic regression a-nalysis showed that TIMP-1,PTX3,history of hypertension,and history of coronary artery disease,AHI and LSpO2 were influential factors for severity of disease in patients with OSAHS(P<0.05).Conclusion TIMP-1 and PTX3 are both up-regulated in the serum of OSAHS patients and closely related to the severity of the disease,and they are the influential factors in the severity of OSAHS patients.

Objective: To explore the performance of machine learning prediction models in forecasting student absenteeism due to respiratory symptoms caused by air pollution in short term, aiming to provide a methodological reference for early warning systems of school diseases. Methods: Utilizing data from shortterm sequences of student absenteeism due to respiratory symptoms in Jiangsu Province from September 2019 to October 2022, the study integrated average concentrations of atmospheric pollutants. A univariate distributed lag nonlinear model was employed to select optimal lag variables for the pollutants. An extreme gradient boosting(XGBoost) algorithm model was developed to predict the frequency of absenteeism due to respiratory symptoms and compared with the seasonal autoregressive integrated moving average with exogenous factors(SARIMAX) model. Results: Between 2019 and 2022, an average of 9 709 students per day in Jiangsu Province were absent due to respiratory symptoms. The daily average air quality index (AQI) was 76.96,with mass concentrations of PM2.5, PM10, NO2, and O3 averaging at 35.75, 61.13, 28.89, 104.81 μg/m3, respectively. Granger causality tests indicated that AQI, PM2.5, PM10, NO2, and O3 were significant predictors of absenteeism frequency due to respirutory symptoms(F=1.46,1.79,1.67,3.41,2.18,P<0.01). The singleday lag effects of PM2.5, PM10, NO2, and O3 reached their peak relative risk (RR) values at lag4, lag0, lag0, lag4 respectively. When integrating these optimal lag variables for the pollutants, the XGBoost model demonstrated superior predictive performance to the SARIMAX model, reducing the mean absolute error (MAE) from 2.251 to 0.475, mean absolute percentage error (MAPE) from 0.429 to 0.080, and root mean square error (RMSE) from 2.582 to 0.713; at the P75 percentile alert threshold, the sensitivity improved from 0.086 to 0.694 and specificity from 0.979 to 0.988, with the Youden index increasing from 0.065 to 0.682. Conclusions The XGBoost model exhibits robust predictive performance and effective early warning capabilities for shortterm sequences of student absenteeism due to respiratory symptoms caused by air pollution. Schools could timely adopt this model to preemptively detect and control disease outbreaks, thereby enhancing school health management.

Objective To establish a machine learning radiomics model that can accurately predict MRI enhancement patterns of glioma based on T2 fluid attenuated inversion recovery(T2-FLAIR)images for optimizing the workflow of magnetic resonance imaging(MRI)examinations of glioma patients.Methods We retrospectively collected preoperative MR T2-FLAIR images from 385 patients with pathologically confirmed glioma,who were divided into enhancing and non-enhancing groups according to the enhancement pattern.Predictive radiomics models were established using Gaussian Process,Linear Regression,Linear Regression-Least absolute shrinkage and selection operator,Support Vector Machine,Linear Discriminant Analysis or Naive Bayes as the classifiers in the training cohort(n=201)and tested both in the internal(n=85)and external validation cohorts(n=99).The receiver-operating characteristic curve was used to assess the predictive performance of the models.Results The predictive model constructed based on 15 radiomics features using Gaussian Process as the classifier had the best predictive performance in both the training cohort and the internal validation cohort,with areas under the curve(AUC)of 0.88(95%CI:0.81-0.94)and 0.80(95%CI:0.71-0.88),respectively.In the external validation cohort,the model showed an AUC of 0.81(95%CI:0.71-0.90)with sensitivity,specificity,positive predictive value and negative predictive value of 0.98,0.61,0.76 and 0.96,respectively.Conclusion The T2-FLAIR-based machine learning radiomics model can accurately predict the enhancement pattern of gliomas on MRI.

Objective To establish a machine learning radiomics model that can accurately predict MRI enhancement patterns of glioma based on T2 fluid attenuated inversion recovery(T2-FLAIR)images for optimizing the workflow of magnetic resonance imaging(MRI)examinations of glioma patients.Methods We retrospectively collected preoperative MR T2-FLAIR images from 385 patients with pathologically confirmed glioma,who were divided into enhancing and non-enhancing groups according to the enhancement pattern.Predictive radiomics models were established using Gaussian Process,Linear Regression,Linear Regression-Least absolute shrinkage and selection operator,Support Vector Machine,Linear Discriminant Analysis or Naive Bayes as the classifiers in the training cohort(n=201)and tested both in the internal(n=85)and external validation cohorts(n=99).The receiver-operating characteristic curve was used to assess the predictive performance of the models.Results The predictive model constructed based on 15 radiomics features using Gaussian Process as the classifier had the best predictive performance in both the training cohort and the internal validation cohort,with areas under the curve(AUC)of 0.88(95%CI:0.81-0.94)and 0.80(95%CI:0.71-0.88),respectively.In the external validation cohort,the model showed an AUC of 0.81(95%CI:0.71-0.90)with sensitivity,specificity,positive predictive value and negative predictive value of 0.98,0.61,0.76 and 0.96,respectively.Conclusion The T2-FLAIR-based machine learning radiomics model can accurately predict the enhancement pattern of gliomas on MRI.

Objective To explore the clinicopathological and immunohistochemical features of nephrogenic adenoma(NA).Methods Clinical data of NA patients diagnosed in the Department of Pathology,Zhongshan Hospital,Fudan University from July 2016 to October 2022 were collected and analyzed to explore their clinicopathological features.Results A total of 13 NA cases were enrolled.There were 11 males and 2 females.Organs involved:ureter(n=7),bladder(n=5),bladder and ureter(n=1),renal pelvis(n=2).NA patients performed as ureteral stenosis(6/7),rough bladder wall(3/5),and renal pelvis polyp(2/2).The typical microscopical features of NA were tubular(13/13)and papillary(4/13)structures,covered with cuboidal or columnar epithelium(13/13),or a mixed hobnail-spike eosinophilic epithelium(12/13);the interstitium was loose,containing varied amounts of vasculature and inflammatory cells(13/13).Immunohistochemistry revealed specific expressions of CK7,PAX-8,CK19 and CK8.Conclusions NA is a rare neoplasm of the urinary system with unique histological features.NA has the risk of misdiagnosis and over-treatment,and the potential of recurrence and malignant conversion.The diagnosis of NA depends on pathology,and the immunohistochemistry can be helpful for its pathological diagnosis.

Objective:To investigate the current situation and influence factors of prehospital thrombolysis treatment for ST segment elevation myocardial infarction (STEMI) in China, to analyze the main factors affecting prehospital thrombolysis implementation, and optimize the pre-hospital thrombolysis strategy for STEMI to reduce mortality.Methods:A multicenter cross-sectional survey was conducted. 21 cities from six major geographical regions in China were selected by using convenient sampling method. An anonymous online electronic questionnaire was used to investigate the current situation and influence factors of prehospital emergency physicians and grassroots physicians implementing prehospital thrombolysis treatment for STEMI patients. Chi-square test was used to analyze the differences in count data between groups, and multivariate logistic regression was used to analyze the factors affecting prehospital thrombolysis in STEMI.Results:A total of 5 163 prehospital emergency physicians and physicians from grassroots township health centers/community health service centers or village clinics participated in this survey. Among them, 3208 (62.13%) have never implemtent thrombolysis, and 1 955 (37.87%) have did it before. The results of the multivariate logistic regression analysis indicated that physicians with 5-10 years of experience ( OR=1.41, 95% CI: 1.18-1.69, P<0.01), 11-20 years of experience ( OR=1.25, 95% CI: 1.03-1.52, P=0.02), those working in village clinics ( OR=1.30, 95% CI: 1.05-1.61, P=0.02), those in pre-hospital emergency medical institutions/departments ( OR=3.19, 95% CI: 2.80-3.64, P<0.01), those whose units are equipped with remote ECG transmission capabilities ( OR=1.72, 95% CI: 1.50-1.96, P<0.01), or ECG AI-assisted diagnostic tools ( OR=1.31, 95% CI: 1.15-1.49, P<0.01), and those who believe that thrombolysis is highly effective and should be widely adopted ( OR=2.55, 95% CI: 2.09-3.12, P<0.01) or consider it somewhat effective but warranting caution ( OR=2.11, 95% CI: 1.73-2.59, P<0.001), were more likely to make pre-hospital thrombolysis decisions for STEMI patients. To improve the current situation of pre-hospital thrombolysis for STEMI, the top four measures prioritized by pre-hospital emergency and grassroots physicians were enhancing the rescue capabilities of primary care doctors (92.22%), strengthening guidance from higherlevel hospitals (84.99%), increasing support for information technology (83.37%), and improving public health education (74.75%). Conclusions:The implementation rate of prehospital thrombolysis for STEMI in China still needs to be improved. Optimizing the prehospital thrombolysis strategy for STEMI, strengthening the allocation of basic medical resources and information technology support, and improving the referral mechanism are conducive to the implementation of prehospital thrombolysis for STEMI.

Different sagittal and vertical malocclusions exhibit different characteristics in the growth,development,and final morphol-ogy of the temporomandibular joint.Different skeletal malocclusions affect the spatial and morphological characteristics of the final tem-poromandibular joint through different growth and development mechanisms.These mechanisms have important guiding significance for determining the etiology and guiding treatment plans of maxillofacial malocclusion in children and adolescents in clinical practice.This article summarized and analyzed morphological differences of the temporomandibular joint fossa and condyle in different sagittal and ver-tical malocclusions,as well as the relative position of the condyle in the fossa.It is found that there is a connection between different maxillofacial malocclusions and the characteristics of the temporomandibular joint,with the vertical direction having a more significant impact on the temporomandibular joint than the sagittal direction;the impact of vertical malocclusion on the temporomandibular joint is mainly reflected in the shape of the joint fossa and the position of the condyle in the fossa.The joint fossa of hyperdivergent malocclu-sion is often relatively low and flat,with the condyle located in the anterior upper position of the fossa.The joint fossa of hypodivergent is relatively narrow and deep,and the condyle is relatively backward and lower in the joint fossa.The possible mechanisms were also elaborated,providing reference for clinicians'comprehensive diagnosis and treatment.