The lung collaterals form a network that branches from the lung meridian, traversing the lung system and extending across the body′s surface. Lung collateral disease refers to the structural alterations or dysfunction in these collaterals caused by external or internal pathogens. Research into the structural and physiological functions of children′s lung collaterals, as well as the pathogenesis and syndrome differentiation for treating lung collateral diseases in children, holds significant value in guiding the prevention and treatment of pediatric respiratory conditions. Drawing on the theory of collateral disease, the clinical insights of both historical and contemporary physicians, and modern research findings—while considering the unique physiological and pathological characteristics of children′s respiratory systems—this study provides a foundational summary of the morphology and spatial distribution of children′s lung collaterals. The characteristics of these collaterals are highlighted as thin, sparse, short, narrow, brittle, and tender. From this structural understanding, the unique physiological functions of children′s lung collaterals are analyzed. The study further explores the interactions between pathogenic factors and lung collaterals, elucidating the pathogenesis and progression of children′s lung collateral diseases. It proposes treatment principles centered on "seeking treatment in the collaterals and employing the method of unblocking collaterals, "which align with the unique features of pediatric lung collaterals. Common treatment approaches, and relevant prescriptions for managing these diseases are summarized. This paper lays the foundation for a theoretical system encompassing the structure, function, pathogenesis, and syndrome differentiation for treating children′s lung collateral diseases. It offers valuable insights for the clinical diagnosis and management of pediatric respiratory diseases linked to collateral dysfunction and serves as a reference for the systematic development of a broader theoretical framework for children′s collateral diseases.

ObjectiveTo obtain the epidemiological characteristics of re-positive cases infected with SARS-CoV-2 in Pudong New Area from March to July 2022, including clinical manifestations, duration of a negative nucleic acid conversion after tested for re-positive, and length of time from the discharge of the initial infection to the most recent re-positivity, so as to provide a scientific basis for the prevention and control of COVID-19. MethodsA questionnaire survey was conducted among the re-positive cases infected with SARS-CoV-2 after discharged from hospital/quarantine facility in Pudong New Area, and descriptive epidemiological methods were used for characteristics analysis. ResultsA total of 2 422 re-positive cases met the inclusive and exclusive criteria, with males accounting for 61.02%. The age distribution mainly fell between 18 and <60 years old, accounting for 62.39%. Clinical manifestations were predominantly asymptomatic (72.15%), followed by cough (12.03%) and sore throat (6.58%). Among the stratified randomized sample of 416 individuals, there were statistically significant differences in symptoms (χ²=262.667, P<0.001), clinical typing (χ²=12.996, P=0.001), and duration of a negative nucleic acid conversion (χ²=142.578, P<0.001) between the initial positive and re-positive instances. Besides, statistically significant differences in symptoms (χ²=13.696, P=0.016) and self-perception of the severity of re-infection (χ²=7.923, P=0.048) between the initial and re-positive cases were observed by different genders. ConclusionAmong re-positive cases, males experienced milder symptoms compared to females, and the self-perception of symptoms during re-positivity is milder than that in the initial positive infection. The length of time for negative nucleic acid conversion during the initial positive period is shorter than that during the re-positive period.

OBJECTIVE: To evaluate the effect of biodegradable magnesium alloy materials in promoting tendon-bone healing during rotator cuff tear repair and to investigate their potential underlying biological mechanisms. METHODS: Forty-eight 8-week-old Sprague Dawley rats were taken and randomly divided into groups A, B, and C. Rotator cuff tear models were created and repaired using magnesium alloy sutures in group A and Vicryl Plus 4-0 absorbable sutures in group B, while only subcutaneous incisions and sutures were performed in group C. Organ samples of groups A and B were taken for HE staining at 1 and 2 weeks after operation to evaluate the safety of magnesium alloy, and specimens from the supraspinatus tendon and proximal humerus were harvested at 2, 4, 8, and 12 weeks after operation. The specimens were observed macroscopically at 4 and 12 weeks after operation. Biomechanical tests were performed at 4, 8, and 12 weeks to test the ultimate load and stiffness of the healing sites in groups A and B. At 2, 4, and 12 weeks, the specimens were subjected to the following tests: Micro-CT to evaluate the formation of bone tunnels in groups A and B, HE staining and Masson staining to observe the regeneration of fibrocartilage at the tendon-bone interface after decalcification and sectioning, and Goldner trichrome staining to evaluate the calcification. Immunohistochemical staining was performed to detect the expressions of angiogenic factors, including vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2), as well as osteogenic factors at the tendon-bone interface. Additionally, immunofluorescence staining was used to examine the expressions of Arginase 1 and Integrin beta-2 to assess M1 and M2 macrophage polarization at the tendon-bone interface. The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in tendon-bone healing was further analyzed using real-time fluorescence quantitative PCR. RESULTS: Analysis of visceral sections revealed that magnesium ions released during the degradation of magnesium alloys did not cause significant toxic effects on organs such as the heart, liver, spleen, lungs, and kidneys, indicating good biosafety. Histological analysis further demonstrated that fibrocartilage regeneration at the tendon-bone interface in group A occurred earlier, and the amount of fibrocartilage was significantly greater compared to group B, suggesting a positive effect of magnesium alloy material on tendon-bone interface repair. Additionally, Micro-CT analysis results revealed that bone tunnel formation occurred more rapidly in group A compared to group B, further supporting the beneficial effect of magnesium alloy on bone healing. Biomechanical testing showed that the ultimate load in group A was consistently higher than in group B, and the stiffness of group A was also greater than that of group B at 4 weeks, indicating stronger tissue-carrying capacity following tendon-bone interface repair and highlighting the potential of magnesium alloy in enhancing tendon-bone healing. Immunohistochemical staining results indicated that the expressions of VEGF and BMP-2 were significantly upregulated during the early stages of healing, suggesting that magnesium alloy effectively promoted angiogenesis and bone formation, thereby accelerating the tendon-bone healing process. Immunofluorescence staining further revealed that magnesium ions exerted significant anti-inflammatory effects by regulating macrophage polarization, promoting their shift toward the M2 phenotype. Real-time fluorescence quantitative PCR results demonstrated that magnesium ions could facilitate tendon-bone healing by modulating the PI3K/AKT signaling pathway. CONCLUSION Biodegradable magnesium alloy material accelerated fibrocartilage regeneration and calcification at the tendon-bone interface in rat rotator cuff tear repair by regulating the PI3K/AKT signaling pathway, thereby significantly enhancing tendon-bone healing.
Animals ; Rotator Cuff Injuries/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction ; Wound Healing/drug effects* ; Alloys/pharmacology* ; Rats ; Proto-Oncogene Proteins c-akt/metabolism* ; Rotator Cuff/metabolism* ; Macrophages/metabolism* ; Magnesium/pharmacology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Biocompatible Materials ; Bone Morphogenetic Protein 2/metabolism*

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

By reconstructing the integrated Chinese and western medicine diagnostic and treatment system， the "Two Reconstructions" theoretical framework establishes a standardized pathway of "classification-staging-syndrome differentiation"， which improves the accuracy of disease identification and strengthens the capacity for full-course intervention； in addition， by reconstructing the modern materia medica system， it innovatively integrates the traditional properties and efficacy of Chinese herbal medicinals with modern pharmacological mechanisms， forming a "state-target co-regulation" precise medication model， and builds a dose-effect theoretical system for prescriptions and medicinals， thereby enhancing both the targeting accuracy and dosage precision of therapeutic interventions. The "Two Reconstructions" theorecitcal framework is a key strategy for enhancing clinical efficacy. It can precisely identify "states" and "targets" for directed intervention， shift the focus of prevention and treatment earlier to enable full-cycle management， establish standardized paradigms for reproducible and evaluable efficacy， and expand the scope of clinical practice to address conditions without typical syndromes and critical illnesses. As a systematic pathway for innovation in TCM， this theoretical framework provides valuable insights and references for promoting the high-quality development of integrative Chinese and western medicine.

Hepatic fibrosis is a pathological process of chronic liver injury. Without timely intervention and treatment， liver fibrosis may eventually lead to liver cirrhosis and cancer. Janus kinase （JAK）/signal transducer and activator of transcription （STAT） signaling pathway is closely associated with the occurrence and development of liver fibrosis. Based on this， this paper summarized and analyzed the mechanism and effects of active ingredients and compounds of traditional Chinese medicine improving liver fibrosis based on JAK/STAT signaling pathway. It is found that the active ingredients and compounds of traditional Chinese medicine that promote blood circulation and remove blood stasis （ingredients such as ethanol extract of Euonymus alatus and paclitaxel， as well as compounds such as Ershiwuwei songshi pill and Ganfukang）， clear away heat and toxic material （ingredients such as betulinic acid， total flavonoids from Persicaria perfoliata， as well as compounds such as Pianzaihuang and Kehuang capsules）， and sooth the liver and promote qi circulation （ingredients such as fraxetin and cucurbitacin B， as well as compounds such as Chaihu shugan powder and Xiaochaihu decoction） can all relieve liver fibrosis by inhibiting the activity of the JAK/STAT signaling pathway， reducing inflammatory reactions， and inhibiting the proliferation of hepatic stellate cells.

Objective To evaluate the value of red cell volume distribution width(RDW)in the prognosis of patients with cardiac arrest(CA).Methods Clinical data of 146 CA patients admitted to intensive care unit(ICU)of Huzhou Central Hospital from January 2018 to October 2022 were retrospectively analyzed,and the patients were divided into survival group and death group according to the prognosis during ICU stay.The clinical data of two groups were compared,and the risk factors affecting the prognosis of CA patients were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of RDW in CA patients.The survival curve was plotted by Kaplan-Meier method.Results A total of 146 CA patients were included in the analysis,among which 49 patients survived and 97 patients died,the mortality rate of CA patients in ICU was 66.44%.The scores of acute physiology and chronic health evaluation Ⅱ,RDW,blood sodium and alanine aminotransferase in death group were significantly higher than those in survival group,the time of cardiopulmonary resuscitation was significantly longer than that in survival group,and the length of ICU stay was significantly shorter than that in survival group(P<0.05).Multivariate Logistic regression analysis showed that RDW and time of cardiopulmonary resuscitation were independent risk factors for predicting death during ICU stay in CA patients(P<0.05).ROC curve results showed that RDW predicted death in CA patients with the area under curve of 0.742,the best cut-off value was 13.95%,the sensitivity was 59.8%,and the specificity was 85.7%.Patients with low RDW had significantly higher one-year cumulative survival rate than those with high RDW(χ2=18.757,P<0.001).Conclusion RDW was an independent risk factor for predicting death during ICU stay in CA patients.

ObjectiveTo investigate the correlation between genetic polymorphism of heat shock proteins 70 (HSP70) and susceptibility to occupational noise-induced hearing loss (ONIHL). Methods A total of 229 ONIHL workers were selected as the case group and 229 healthy workers with similar age, years of noise exposure, and noise exposure levels were selected as the control group using the case-control study method. Occupational health examinations were conducted on both groups, and peripheral blood of individuals was collected for DNA extraction. The genotypes of three single nucleotide polymorphisms of the HSP70 were detected using the MassArray system. Results The allele frequency distribution of HSP70 rs2227956, rs1043618, and rs1061581 in the control group was in Hardy-Weinberg equilibrium (all P>0.05). The genotype and allele frequency distribution of rs2227956 was significantly different between the two groups (all P<0.05), while no significant difference was found for rs1043618 and rs1061581 (all P>0.05). After adjusting for age, years of noise exposure, individual noise exposure level, smoking, and drinking, individuals with AG and AG+GG genotypes of rs2227956 had a higher risk of ONIHL than those with AA genotype (all P<0.05). The risk of ONIHL was higher in individuals with G allele of rs2227956 than in those with A allele (P<0.05). No correlation was found between rs1043618 and rs1061581 polymorphisms and the risk of ONIHL (all P>0.05). Conclusion The rs2227956 polymorphism of the HSP70 gene is correlated with susceptibility to ONIHL in noise-exposed workers, and the G allele is a risk factor for ONIHL in this population.

Objective To investigate the relationship between circKIF4A expression and clinicopathologic features and prognosis of thyroid cancer patients.Methods A total of 120 patients diagnosed with thyroid cancer in our hospital from April 2016 to April 2017 were selected by random sampling method.Cancer tissues and adjacent tissues were taken during surgery and divided into thyroid cancer group and adjacent cancer group according to surgical pathologic detection.The relative expression level of circKIF4A in thyroid cancer group and paracancer group was detected by qRT-PCR,and the relationship between circKIF4A expression and clini-copathological features of thyroid cancer was analyzed.Kaplan-Meier survival curve was used to analyze the relationship between circKIF4A expression and prognosis of thyroid cancer patients.Cox regression analysis was performed to analyze the factors influencing the poor prognosis of patients with thyroid cancer 5 years af-ter surgery.Results The relative expression level of circKIF4A in thyroid cancer group was higher than that in paracancer group,and the difference was statistically significant(P＜0.05).The expression of circKIF4A was correlated with the degree of capsule invasion,lymph node metastasis and differentiation(P＜0.05).Kap-lan-Meier survival curve analysis showed that the 5-year cumulative survival rate of patients with high cir-cKIF4A expression was lower than those with low circKIF4A expression,and the difference was statistically significant(x2=11.368,P=0.001).Multivariate analysis showed that envelope invasion,degree of differenti-ation,lymph node metastasis and circKIF4A expression level were the influencing factors for poor prognosis of thyroid cancer patients at 5 years after surgery(P＜0.05).Conclusion circKIF4A is highly expressed in thy-roid cancer tissues,which is related to the clinicopathological features and 5-year postoperative survival of thy-roid cancer patients,and may be used as a potential prognostic marker for thyroid cancer.

Objective:To investigate the clinical effect of helium-oxygen mechanical ventilation on inflammation of the diseased lung segment and diaphragm function in patients with acute respiratory distress syndrome (ARDS) caused by pneumonia who suffered difficulty weaning from mechanical ventilation.Methods:A prospective controlled study was conducted. A total of 40 patients with ARDS caused by pneumonia and requiring tracheal intubation with difficulty weaning from mechanical ventilation, admitted to the department of critical care medicine in Pingtan Branch of Fujian Medical University Union Hospital from October 2020 to December 2021 were enrolled. Patients were divided into nitrogen oxygen ventilation group and helium-oxygen ventilation group according to random number table, with 20 cases in each group. The nitrogen oxygen ventilation group was given 60% nitrogen and 40% oxygen ventilation treatment, and the helium-oxygen ventilation group was given 60% helium and 40% oxygen ventilation treatment. Peak airway pressure (Ppeak), plateau airway pressure (Pplat), tidal volume (V T), minute ventilation volume (MV) and pulse oxygen saturation (SpO 2) were collected at 0, 1, 2, 3 hours after ventilation treatment. At the same time, the concentrations of inflammatory factors interleukin-6 (IL-6) and C-reactive protein (CRP) in epithelial lining fluid in patients with diseased lung segments were measured before and after ventilation treatment for 3 hours, and the diaphragmatic excursion and the diaphragmatic thickening fraction were measured before and after ventilation treatment for 3 hours. Results:There were no significant differences in gender, age, oxygenation index, serum CRP, serum procalcitonin (PCT), body temperature, serum creatinine (SCr), alanine aminotransferase (ALT), fasting blood glucose (FPG), hemoglobin (Hb), and basic heart and lung diseases between the two groups. Under the condition that V T and SpO 2 are relatively unchanged, the airway pressure in helium-oxygen ventilation group decreased significantly after 1 hour of ventilation [Ppeak (cmH 2O, 1 cmH 2O≈0.098 kPa): 22.80±4.47 vs. 28.00±5.07, Pplat (cmH 2O): 19.15±3.90 vs. 23.20±3.81, both P < 0.05], and the airway pressure in the nitrogen oxygen ventilation group increased significantly after 1 hour [Ppeak (cmH 2O): 22.35±2.13 vs. 19.75±1.94, Pplat (cmH 2O): 18.50±1.70 vs. 16.50±1.88, both P < 0.05]. There were no significant differences in CRP and IL-6 levels in epithelial lining fluid in the diseased lung segment before and after ventilation in the nitrogen oxygen ventilation group, while the levels of these indexes in the helium-oxygen ventilation group after ventilation were significantly lower than those before ventilation, and significantly lower than those in the nitrogen oxygen ventilation group [CRP (mg/L): 10.15 (6.39, 15.84) vs. 16.10 (11.63, 18.66), IL-6 (μg/L): 1.15 (0.78, 1.86) vs. 2.67 (1.67, 4.85), both P < 0.05]. There were no statistically significant differences in the diaphragmatic excursion and the diaphragmatic thickening fraction before and after ventilation in the nitrogen oxygen ventilation group, while the above indexes in the helium-oxygen ventilation group were significantly higher than those before ventilation, and were significantly higher than those in the nitrogen oxygen ventilation group [diaphragmatic excursion (cm): 1.93 (1.69, 2.20) vs. 1.34 (1.22, 1.83), diaphragmatic thickening fraction: (48.22±8.61)% vs. (33.29±11.04)%, both P < 0.05]. Conclusion:Helium-oxygen ventilation can reduce the airway pressure of patients with mechanical ventilation, alleviate the inflammatory response of lung segment, improve the function of respiratory muscle, and is expected to be an important treatment for severe lung rehabilitation.