ObjectiveTo develop a classification model based on complete blood count （CBC） parameters combined with clinical factors to predict severe respiratory infections caused by Human adenovirus （HAdV） in pediatric patients. MethodsFrom September 2023 to September 2024， the CBC parameters and related clinical data from pediatric patients diagnosed with HAdV infection were collected. Principal component analysis and random forest models were used to identify potential predictors of severe cases. ResultsA total of 668 pediatric patients were included， with 564 cases assigned to the training cohort and 104 cases to the validation cohort. Severe cases were defined as pneumonia and/or fever lasting ≥5 days （pneumonia or prolonged fever， PorPF）. Principal component analysis and feature importance analysis （Mean Decrease Gini value） identified the monocytosis ratio （PMono）， red blood cell count （RBC）， and platelet count （PLT） as the most critical CBC parameters. Logistic regression analysis revealed that oxygen therapy （OR = 4.367， 95% CI： 1.568–12.161） and increased work of breathing （OR = 3.904， 95% CI： 2.146–7.101） were relative risk factors for PorPF. Meanwhile， higher PMono （OR = 0.696， 95% CI： 0.640–0.757）， RBC （OR = 0.201， 95% CI： 0.124–0.325）， and PLT （OR = 0.990， 95% CI： 0.987–0.994） were protective factors. When PMono was used as a predictive marker for PorPF， the area under the receiver operating characteristic curve （AUC） was 0.648 and 0.705， respectively. A random forest model incorporating four risk factors ［PMono， RBC， PLT， and hematocrit （HCT）］ was constructed to classify PorPF and general cases， achieving AUCs of 0.688 and 0.768， respectively. ConclusionsPMono， RBC， and PLT may serve as characteristic CBC indicators for predicting pneumonia or prolonged fever in children with HAdV infection. A risk factor model built using PMono， RBC， PLT， and HCT offers a relatively simple and accurate approach to predicting severe cases in pediatric HAdV infections.

Secondary metabolites of medicinal plants are extremely important to human health because of their special pharmacological activities or efficacy. They are the main source of drugs, health care products, and cosmetics. As human beings continue to pursue health and longevity, the demand in the pharmaceutical market continues to grow. It becomes especially important to improve the production and quality of secondary metabolites of medicinal plants. Plant secondary metabolites are a kind of adaptation of plants to their environment and are the result of the interaction between plants and biotic and abiotic factors during the long-term evolution process. The production and accumulation of secondary metabolites in medicinal plants are mainly affected by plant genetic factors and environmental factors. Among them, light environment is extremely important for their synthesis. Therefore, light regulation has long been a research focus for many scholars in China and abroad. In this article, we the recent research progress on the effects of light regulation on the secondary metabolites of medicinal plants were reviewed, mainly focusing on the effects of light quality, light intensity and photoperiod, in order to provide theoretical basis and practical guidance for the efficient production of secondary metabolites with important pharmacological activities.

AIM: To examine the effects of blepharoplasty on the ocular surface and refractive state.METHODS:Retrospective study. A total of 70 patients(108 eyes)who underwent blepharoplasty in our ophthalmology department from January 2022 to June 2023 were selected, among which 40 cases(48 eyes)diagnosed with ptosis received levator muscle shortness, and 30(60 eyes)diagnosed with eyelid laxity/single eyelids received blepharoplasty. The ocular surface disease index(OSDI), tear meniscus height(TMH), Schirmer Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL), cylindrical(Cyl), surface regularity index(SRI), surface asymmetry index(SAI), keratometry(Km), and cylindrical(C).RESULTS:There were statistical differences in preoperative and postoperative OSDI, BUT, SⅠt, and FL of patients who received levator resection(all P<0.05), but no differences were found in TMH(P>0.05). At 1 mo postoperatively, OSDI, BUT, SⅠt, and FL were significantly different compared to preoperative values(all P<0.05). There were no significant differences in OSDI, BUT, SⅠt, FL, or TMH of patients received blepharoplasty before and after surgery(all P>0.05). No significant differences were found in Cyl, SRI, SAI, Km, or C in either group before and after surgery(all P>0.05).CONCLUSION:The levator resection has an early impact on the ocular surface of patients with ptosis, and corneal protection measures should be taken early. There was no significant impact on patients undergoing blepharoplasty; there was no significant effect on the refractive status of all patients.

Objective:To explore the potential application of two-dimensional speckle tracking echocardiography (2D-STE) in terms of quantification and evaluating left atrial function in normal fetuses and fetuses with left ventricular outflow tract obstruction (LVOTO).Methods:A total of 32 fetuses diagnosed with LVOTO, who underwent fetal echocardiography at Sir Run Run Shaw Hospital, Zhejiang University College of Medicine between May 2020 to June 2022, were selected as the case group, and 100 pregnant women with normal singleton fetuses between January 2019 to October 2022 were chosen as the control group. The standard basal or apical four-chamber view clips were obtained and were quantitatively analyzed using TomTec-Arena off-line cardiac analysis software to obtain the left atrial strain parameters of the two groups of fetuses including left atrial reservoir phase longitudinal strain(LASr), left atrial ductal phase longitudinal strain(LAScd), left atrial systolic phase longitudinal strain (LASct), as well as the routine obstetric ultrasound measurements and fetal echocardiographic parameters of the two groups: biparietal diameter (BPD), femur length (FL), aortic annulus end-systolic inner diameter (AO), pulmonary annulus end-systolic inner diameter (PA), left atrial end-systolic long length (LAESL), left atrial end-systolic transverse diameter (LAESD), right atrial end-systolic long length (RAESL), right atrial end-systolic transverse diameter (RAESD), left ventricular end-diastolic transverse diameter (LVEDD) and right ventricular diastole end-diastolic transverse diameter (RVEDD). The ratio of right ventricular end-diastolic transverse diameter to left ventricular end-diastolic transverse diameter (RVd/LVd) and the ratio of pulmonary annulus diameter to aortic annulus diameter (PA/AO) were calculated. The differences of strain parameters between the two groups were compared, and the correlation between strain parameters and gestational age, RVd/LVd and other conventional measurement parameters were analyzed. ROC curve was used to compare the specificity and sensitivity of LASr and RVd/LVd in evaluating fetal cardiac dysfunction with LVOTO.Results:There were significant differences in LASr, LAScd, LASct, MAPSE, AO, LAESL, LVEDD, RVd/LVd and PA/AO between the two groups (all P<0.05), there were no significant differences in other parameters (all P>0.05). Correlation analysis showed that LASr was negatively correlated with RVd/LVd in LVOTO group ( rs=-0.394, P=0.025), and LASct was negatively correlated with RVd/LVd ( rs=-0.626, P=0.004). In the control group, LASr was negatively correlated with gestational age, AO and PA ( r/ rs=-0.570, -0.440, -0.493; all P<0.001), and LASct was negatively correlated with gestational age, AO and PA ( r/ rs=-0.601, -0.532, -0.568; all P<0.001). LAScd was positively correlated with gestational age, AO and PA ( r/ rs=0.310, 0.370, 0.314; all P<0.05). There were no significant correlations between the other parameters (all P>0.05). ROC curve analysis showed that the area under the curve(AUC) in LASr evaluation of fetal cardiac dysfunction with LVOTO was 0.890 (0.826, 0.953) and the AUC in RVd/LVd evaluation of fetal cardiac dysfunction with LVOTO was 0.742 (0.637, 0.846), there were significant differences between them( P<0.05). Conclusions:2D-STE is highly feasible and reproducible in assessing fetal left atrial function. Evaluation of fetal left atrial function by 2D-STE provides a new reference index for quantitative analysis of fetal cardiac dysfunction.

Objective:This paper analyzed the current situation and issues of ethical supervision of science and technology projects supported by central financial funds and proposed countermeasures to improve project management.Methods:Considering the practical management experience of a key special project during the 13th Five-Year Plan period, this article investigated ethical supervision issues in various stages including guideline preparation, review and approval, process management, and final acceptance, and proposed four levels of review for ethical oversight according to the characteristics of the research projects and the degree of ethical risks involved.Results:Firstly, lower-risk projects should still be reviewed by the Institutional Ethics Committee, and the project implementation unit should primarily assume responsibility for ethical supervision and follow-up on the review. Second, in addition to the review by the Institutional Ethics Committee, the Project Management Institution should strengthen ethical supervision and take risk control measures at different nodes for sensitive projects and higher ethical risk projects. Third, projects with large ethical controversies and high-risk projects should be reviewed by the National Science and Technology Ethics Committee and a public participation discussion mechanism for major ethical issues should be established. Finally, it is suggested to conduct prospective ethical studies for cutting-edge new technologies and new fields.Conclusions:In the process of managing science and technology program projects, strengthening ethical oversight in the management of science and technology projects should both standardize relevant scientific and technological research activities and not impede the growth of scientific and technological innovation. In view of the differences in ethical risks that may be involved in different projects, hierarchical examination, and supervision measures should be taken to effectively guarantee the smooth implementation of science and technology planning projects.

Objective:To evaluate the predictive value of mechanical power (MP) on the risk of in-hospital mortality in critical ill patients in emergency department.Methods:A total of 105 critical ill patients with invasive mechanical ventilation in the Department of Emergency of Second Affiliated Hospital of Guangzhou Medical University between December 1, 2017 and October 31, 2020 were retrospectively analyzed. Based on the clinical prognosis, the patients were divided into the in-hospital survival group (80 patients) and the in-hospital death group (25 patients). The clinical data and ventilator parameters were recorded, and the MP of the two groups was calculated in order to assess the predictive efficacy of MP on in-hospital death.Results:Compared to the in-hospital death group, the oxygenation index PaO 2/FiO 2 was significantly higher (271 mmHg vs. 217 mmHg, P=0.020) and blood lactate (1.59 mmol/L vs. 2.56 mmol/L, P<0.001) and procalcitonin (0.31 ng/mL vs. 3.55 ng/mL, P=0.028), minute ventilation (7.03 L/min vs.8.32 mmol/L, P=0.013), MP (14.37 J/min vs. 16.12 J/min, P=0.041), SOFA score (5 vs. 8, P=0.001) and APACHE II score (16 vs. 22, P=0.041) were significantly lower in the in-hospital survival group. Multivariate Logistic regression analysis showed that PaO 2/FiO 2( OR=1.015, P=0.044), MP ( OR=1.813, P=0.039) and SOFA score( OR=2.651, P=0.010) were independent risk factors for predicting hospital mortality in patients with mechanical ventilation. The areas under the ROC curves (AUC) were 0.62, 0.63 and 0.75, respectively. Moreover, the MP combined with SOFA score for predicting in-hospital death was significantly higher than that of MP alone (0.77 vs. 0.63, P<0.05). Conclusions:MP is associated with in-hospital death in patients with invasive mechanical ventilation in emergency department. MP combined with SOFA score can enhance its predictive efficacy

Objective:To analyze the current situation of researches on the fear of disease progression at home and abroad, and sort out the research hotspots and development context.Methods:The relevant literature about fear of disease progression published by China National Knowledge Infrastructure (CNKI) and Web of Science core collection database were systematiclly searched, and the search period was from January 1, 2002 to June 24, 2022. CiteSpace 5.8.R3 software was used for visual analysis of relevant literature.Results:A total of 340 articles were retrieved from CNKI and 1 199 articles were retrieved from Web of Science core collection database. The countries and institutions with the highest number of international publications were Germany, Technical University of Munich and The University of Sydney, with close cooperation among authors and poor inter-institutional cooperation. Domestic research focused on the influencing factors of fear of disease progression and its relationship with depression, anxiety, social support and quality of life, while foreign research focused on breast cancer and its survivors, depression, anxiety, quality of life, reliability and validity of the questionnaire and the feasibility of intervention.Conclusions:The number of articles published at home and abroad is generally on the rise. Compared with foreign countries, there is still a certain gap in the research on fear of progression in China. In the future, China should timely pay attention to the development trends and hot frontiers in this field internationally, so as to promote the research and development of fear of disease progression in China.

Objective:To investigate the effect of baseline function movement assessment of ankylosing spondylitis (AS) on treatment outcomes.Methods:The clinical data of 90 patients with AS who met the medical insurance treatment for major disease in Chengdu were collected including clinical symptoms, functional movement screen (FMS) and ankylosing spondylitis disease activity score (ASDAS) after 24 weeks adalimumab treatment. They were divided into the non-treat-to-target group and the non-treat-to target group based on the ASDAS score, t-test or χ2 test was used to compare the differences between the two groups. Logistic regression model was used to analyze the influence of baseline FMS on the outcome of patients reaching the treatment target. Results:① The two groups were different in the FMS [(15.8±2.3) vs (12. 6±2.5), t=6.17, P<0.001], squat [(2.2±0.6) vs (1.7±0.5), t=3.57, P=0.001], hurdle spanning [(2.2±0.7) vs (1.8±0.6), t=2.11, P=0.038], straight lunge [(2.3±0.7) vs (1.7±0.5), t=4.23, P<0.001], shoulder flexibility [(2.5±0.6) vs (2.2±0.8), t=2.21, P=0.037], active straight leg raise [(2.1±0.6) vs (1.8±0.6), t=2.35, P=0.021], spinal stabilization pushups [(2.4±0.7) vs (1.8±0.8), t=3.76, P<0.001], body rotation stability [(2.2±0.7) vs (1.6±0.8), t=3.42, P=0.001] at baseline. ② The two groups were different in ASDAS score [(0.96±0.28) vs (2.19±0.52), t=14.69, P=0.000], FMS [(17.4±1.9) vs (12.7±2.8), t=9.77, P<0.001], deep squat [(2.6±0.5) vs (1.5±0.5), t=9.09, P<0.001], hurdle step [(2.2±0.6) vs (1.8±0.8), t=2.80, P=0.006], straight lunge [(2.6±0.6) vs (1.8±0.9), t=4.85, P<0.001], shoulder flexibility [(2.8±0.4) vs (2.5±0.5), t=2.10, P=0.038], active straight leg raise [(2.2±0.6) vs (1.9±0.8), t=2.46, P=0.016], spinal stability push-ups [(2.8±0.4) vs (1.6±0.7), t=10.36, P<0.001], and body rotation stability [(2.3±0.7) vs (1.6±0.8), t=4.76, P<0.001] at the end of the observation. ③ The cut-off value of the FMS for predicting whether AS patients meet the standard at baseline was 14.25 points (Sensitivity 0.733, specificity 0.800). ④ Logistic regression results showed that in the baseline, FMS series of action tests, squat [ OR (95% CI)=0.155 (0.035, 0.677), P=0.013], straight lunge [ OR (95% CI)=0.375 (0.148, 0.953), P=0.039], spinal stability push-ups [ OR(95% CI)=0.136(0.043, 0.436), P=0.001], and body rotation stability [ OR(95% CI)=0.308 (0.121, 0.780), P=0.013] were the influencing factors of the AS patient's treatment outcome ( P<0.05). Conclusion:The AS patients in the non-treat-to-target group have better FMS tests at baseline and at the end of the study than the non-treat-to-target group. Squats, straight lunges, remember stable push-ups, and body rotation stability are the influencing factors for the treatment outcomes of AS patients at baseline.

Objective:To investigate the effect of functional movement assessment on the recurrence of patients with ankylosing spondylitis (AS) after treat-to-target therapy.Methods:The clinical data of 61 patients with AS in Chengdu were collected including clinical symptoms and AS disease activity (ASDAS). After 24 weeks adalimumab treatment, motor function score of AS patients(ASDAS<1.3) was assessed by functional movement screen (FMS), then adalimumab was discontinued and the rest of the concurrent drugs were continued until the disease relapse or up to 1 year. The data of the two groups were compared using t-test analysis and Cox proportionate hazard model. Results:① The recurrence rate of patients with AS after treat-to-target therapy within 1 year follow-up was 57.4%; ② The recurrence group was younger [(27±7) vs (31±6), t=5.96, P=0.02], the ASADAS value was at the high end when adalimumab was withdrawal [(1.29±0.07) vs (0.87±0.16), t=177.31, P<0.01], and the FMS value was lower after treat-to-target [(12.9±2.7) vs (16.2±1.9), t=29.23, P<0.01], The time to reaching the treatment target was longer [(2.9±1.2) month vs (1.7±0.6) month, t=19.89, P<0.01] than the stable group; ③ The cut-off value of the FMS test of AS patients after treat-to-target therapy was 14.25 (sensitivity was 84.6%, specificity was 80%) . The time to treat-to-target was a risk factor for recurrence ( RR=2.285, P<0.05), and the FMS value after treat-to-target was a protective factor ( RR=0.625, P<0.05). Conclusion:After discontinuing the adalimumab, about half of the patients relapse. The time reaching the treatment target and the FMS value after treat-to-target therapy are the risk factors for disease recurrence.

Objective:To comparative analyze mammographic and clinicopathological findings of ductal carcinoma in situ (DCIS) and DCIS with microinvasion (DCISM), and to investigate the predictive factors for DCISM.Methods:A total of 626 patients with DCISM and DCIS confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University from January 2016 to July 2020 were collected and underwent preoperative mammography. The X-ray findings of DCISM and DCIS patients were classified and diagnosed according to the Breast Imaging Reporting and Data System (BI-RADS) criteria. The differences in clinicopathological and radiographic findings between DCISM and DCIS patients were analyzed using χ 2 test or Fisher exact test. The risk factors of DCISM were evaluated by using univariate and multivariate binary logistic regression analysis. Results:Among the 626 cases, 171 were diagnosed as DCISM, 455 were diagnosed as DCIS. Large diameter (≥2.7 cm), high nuclear grade, comedo type, axillary lymph node metastasis, high Ki67 proliferation index, negativity of estrogen receptor and progesterone receptor were found to be predictors of DCISM in the univariate analysis (all P<0.05). And large diameter (≥2.7 cm)(OR 2.229,95% CI 1.505-3.301, P<0.001), high nuclear grade(OR 1.711,95%CI 1.018-2.875, P=0.043) and axillary lymph node metastasis(OR 4.140,95% CI 1.342-12.773, P=0.013) were found to be independent predictors of DCISM in the multivariate analysis (all P<0.05). Mammographically, the lesion types, the presence and distribution of calcification were statistically significant between DCIS and DCISM patients (χ 2=17.42, 9.65, 9.10, P<0.05). Up to 17.6% (80/455) of DCIS were occult leisions, and DCISM showed more lesions with calcification in mass, asymmetry, and architectural distortion (49.1%, 84/171). Grouped calcifications were usually associated with DCIS (41.5%, 120/289), while regional calcification were commonly found in DCISM (35.9%, 47/131). Conclusions:Lesions with calcification and regional calcification were more likely associated with DCISM on mammography. Large diameter (≥2.7 cm), high nuclear grade and axillary lymph node metastasis were found to be independent predictors of DCISM.