Objective To explore the correlation between eosinophils(EOS),interleukin-17A(IL-17A),tumor necrosis factor α(TNF-α)and vascular endothelial growth factor(VEGF)in peripheral blood and my-coplasma pneumoniae infection with wheezing in children.Methods A total of 98 children with mycoplasma pneumoniae infection diagnosed and treated in the hospital from January 2022 to May 2023 were selected as the study group.The study group was divided into wheezing group(32 cases)and non-wheezing group(66 ca-ses)according to whether they were accompanied by wheezing,and 30 children with lobar pneumonia without wheezing who were examined by fiberoptic bronchoscopy during the same period were selected as the control group.The levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood of different groups were compared,and the correlation between the four indexes and mycoplasma pneumoniae infection with wheezing in children was analyzed.Results The levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood of the study group were significantly higher than those of the control group,and the differences were statistically significant(P＜0.05).The differences in the levels of EOS,IL-17A,TNF-α and VEGF in the peripheral blood of the three groups were statistically significant(P＜0.05).Specifically,the levels of EOS,IL-17A,TNF-α and VEGF in the wheezing group were significantly higher than those in the non-wheezing group and the control group,and the differences were statistically significant(P＜0.05),and the levels of EOS,IL-17A,TNF-α and VEGF in the non-wheezing group were significantly higher than those in the control group,and the differences were sta-tistically significant(P＜0.05).Pearson correlation analysis showed that the levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood were positively correlated with mycoplasma pneumoniae infection with wheez-ing in children(P＜0.05).Using wheezing as a state variable and plotting the receiver operating characteristic(ROC)curve,it was found that the area under the curve of peripheral blood EOS,IL-17A,TNF-α and VEGF for distinguishing mycoplasma pneumoniae infection with wheezing in children was 0.658,0.960,0.948,and 0.937.Conclusion Peripheral blood EOS,IL-17A,TNF-α,The level of VEGF is positively correlated with Mycoplasma pneumoniae infection with wheezing in children,which could be used for clinical differentiation of mycoplasma pneumoniae infection with wheezing in children.

Objective:To explore the changes of large-scale functional brain networks and network topological properties in patients with major depressive disorder (MDD) whose diagnosis had not changed after 5 years of follow-up.Methods:Totally 521 cases of hospitalized MDD patients were recruited from January 2012 to August 2018, and another 204 cases of gender- and age-matched healthy controls were recruited. All participants completed resting-state functional magnetic resonance scanning and clinical assessment. Their diagnosis were reviewed 5 years after discharge.A total of 258 participants whose diagnosis had not changed were counted into the MDD group for analysis. The differences in large-scale brain network connectivity between the two groups were analyzed by constructing a whole-brain functional network, on the basis of which the altered topological properties of the sensorimotor network (SMN), visual network (VN) and default mode network (DMN) were further analyzed between the two groups.The SPSS 24.0 software was used for data analysis and the independent sample t-test and χ2 test were used for the data comparison of the two groups. Results:Compared with the healthy controls, the MDD group had significantly decreased network clustering, mainly involving the SMN, VN and DMN (edge P<0.001, cluster P<0.05). The MDD group had decreased functional connectivity(FC) strength within the SMN, VN and DMN networks, the FC strength between the SMN and VN networks, between the frontoparietal network (FPN) and the DAN networks were decreased(all P<0.05, FDR corrected). Graph-theory analysis showed that local efficiency, clustering coefficient, and normalized shortest path length were decreased in the MDD group, node efficiency was decreased in the left ventral medial prefrontal cortex and the middle of the bilateral insula, node centrality was decreased in the middle of the bilateral insula and occipital lobe, and the betweenness was decreased in the middle of the right insula (all P<0.05, FDR corrected). Conclusion:MDD exhibits abnormal network functional connectivity, disruption of network topological properties, diminished optimal information processing, and to some extent reflects the severity of depressive symptoms. The decreased ability of information transfer flow in the insula plays an important role for the functional abnormality of the network.

Background/Aims: To evaluate the causal correlation between complement components and non-viral liver diseases and their potential use as druggable targets. Methods: We conducted Mendelian randomization (MR) to assess the causal role of circulating complements in the risk of non-viral liver diseases. A complement-centric protein interaction network was constructed to explore biological functions and identify potential therapeutic options. Results: In the MR analysis, genetically predicted levels of complement C1q C chain (C1QC) were positively associated with the risk of autoimmune hepatitis (odds ratio 1.125, 95% confidence interval 1.018–1.244), while complement factor H-related protein 5 (CFHR5) was positively associated with the risk of primary sclerosing cholangitis (PSC;1.193, 1.048– 1.357). On the other hand, CFHR1 (0.621, 0.497–0.776) and CFHR2 (0.824, 0.703–0.965) were inversely associated with the risk of alcohol-related cirrhosis. There were also significant inverse associations between C8 gamma chain (C8G) and PSC (0.832, 0.707–0.979), as well as the risk of metabolic dysfunction-associated steatotic liver disease (1.167, 1.036–1.314). Additionally, C1S (0.111, 0.018–0.672), C7 (1.631, 1.190–2.236), and CFHR2 (1.279, 1.059–1.546) were significantly associated with the risk of hepatocellular carcinoma. Proteins from the complement regulatory networks and various liver diseaserelated proteins share common biological processes. Furthermore, potential therapeutic drugs for various liver diseases were identified through drug repurposing based on the complement regulatory network. Conclusions Our study suggests that certain complement components, including C1S, C1QC, CFHR1, CFHR2, CFHR5, C7, and C8G, might play a role in non-viral liver diseases and could be potential targets for drug development.

In recent years, the number of people living in short-term and long-term period in high-altitude has been continuously increasing, with over 81.6 million people living in areas with an altitude of ≥ 2, [KG*9]500 meters. In China, there are over 10 million people who frequently reside at high altitudes, and over 20 million people enter the plateau every year. The unique plateau climate has triggered a series of plateau related diseases, among which high altitude cerebral edema (HACE) is one of the most serious diseases. If patients are not treated promptly and appropriately, they may die from cerebral hernia within 24 hours. However, the exact mechanism of the development of HACE is not fully understood, which makes the clinical prevention and treatment of HACE challenging. Mesenchymal stem cells (MSC) and their exosomes (MSC-Exos) have the ability to repair damaged tissues and cells, resist oxidative stress, inhibit inflammatory reactions, and regulate autophagy, which may potentially become new drugs for preventing and treating HACE. This article elucidated the pathogenesis of high altitude brain edema and the potential roles of MSC and MSC-Exos based on relevant literatureat home and abroad, providing a theoretical basis for the prevention and treatment of HACE by MSC and MSC-Exos.

Objective To investigate the expression of serum soluble myeloid cell trigger receptor 1(sTREM-1), interleukin-21(IL-21), 25 (OH) vitamin D[25(OH)D]in children with inflammatory bowel disease and their relations. Methods A total of 107 children with inflammatory bowel disease were selected as research objects and included in observation group. At the same time, 53 healthy people were selected as control group. The patients in the observation group were divided into active stage group (n=54) and remission stage group (n=53) according to disease activity. The expression of sTREM-1, IL-21, 25(OH)D were compared between the observation group and the control group and between active stage group and remission stage group. Kendall's tau-b method was used to analyze the correlations of sTREM-1, IL-21 and 25(OH)D with inflammatory bowel disease activity. Receiver operating characteristic (ROC) curve model was used to analyze the area under the curve (AUC) value, sensitivity and specificity of sTREM-1, IL-21 and 25(OH)D in the diagnosis and prediction of inflammatory bowel disease (IBD). Results The serum levels of sTREM-1 and IL-21 in the observation group were higher than those in the control group, but level was lower than that in the control group (P < 0.05). The serum levels of sTREM-1 and IL-21 levels in the active stage group were higher than those in the remission stage group, but 25(OH)D level was lower than that in the remission stage group (P < 0.05). Kendall′s tau-b correlation analysis showed that sTREM-1 and IL-21 were positively correlated with inflammatory bowel disease activity (r=0.460, 0.484; P < 0.05). 25(OH)D was negatively correlated with inflammatory bowel disease activity (r=-0.434, P < 0.05). ROC curve analysis showed that the AUC values of sTREM-1, IL-21, 25(OH)Dand their combination in the diagnosis of inflammatory bowel disease were 0.791, 0.852, 0.808, 0.862, respectively(P < 0.05), and the sensitivities were 74.80%, 81.30%, 75.50% and 81.30%, respectively. The specificities were 75.50%, 75.50%, 81.30% and 79.20%, respectively. The AUC values of sTREM-1, IL-21, 25(OH)D and their combination in predicting the active phase of inflammatory bowel disease were 0.821, 0.840, 0.799, 0.840, respectively (P < 0.05), the sensitivities were 79.60%, 75.90%, 77.40% and 87.00%, respectively, and the specificities were 79.20%, 75.50%, 83.30% and 79.20%, respectively. Conclusion Serum levels of sTREM-1, IL-21, 25(OH)D are closely related to the occurrence and development of inflammatory bowel disease. Dynamic monitoring of their levels is helpful to provide an important reference for clinical diagnosis of inflammatory bowel disease and evaluation of disease progression in children.

BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.

BackgroundSuicide is one of the serious public health problems worldwide. The relationship between suicide and neutrophil-to-lymphocyte ratio （NLR） may vary in different regions and different age. It is necessary to further investigate the relationship between NLR and suicidal ideation in Chinese children and adolescents with depression. ObjectiveTo explore the correlation between NLR and suicidal ideation in children and adolescents with depression， so as to provide clues for exploring the biomarkers of suicide. MethodsA retrospective analysis of 536 children and adolescents with depression who were hospitalized in the Third People's Hospital of Fuyang from January 2020 to December 2022 and met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） was performed. Patients were divided into two groups according to whether they reported suicidal ideation. Demographic data， discharge diagnosis， Hamilton Depression Scale-17 item （HAMD-17） score and hematological test data （neutrophil counts， lymphocyte counts） on the second day were collected from medical records. Receiver operating characteristic （ROC） curve was used to determine the optimal cut-off point of NLR for predicting suicidal ideation in children and adolescents with depression， and binary Logistic regression was used to analyze the risk factors for suicidal ideation. ResultsAmong the 536 patients， 429 cases （80.04%） had no suicidal ideation， and 107 cases （19.96%） had suicidal ideation. Compared with patients without suicidal ideation， the HAMD-17 score ［（25.28±8.86） vs. （21.21±8.46）， F=19.400， P<0.01］， neutrophil level ［（3.85±1.68）×10⁹/L vs. （3.15±1.14）×10⁹/L， Z=4.073， P<0.01］， and NLR level ［（1.96±1.50） vs. （1.52±0.71）， Z=3.532， P<0.01］ in the suicidal ideation patients were significantly higher. The optimal critical NLR value determined by the ROC curve was 1.52 （59.80% sensitivity， 58.50% specificity）， with an area under the curve of 0.610. Logistic regression analysis showed that the risk of suicidal ideation was 1.94 times higher in those with high NLR than in the low NLR after controlling for age， sex， age at onset， duration of illness， and HAMD-17 score （OR=1.940， 95% CI： 1.251~3.009， P=0.003）. ConclusionNLR may be a risk factor and potential biomarker influencing suicidal ideation in the children and adolescents with first-episode depression. ［Funded by Scientific Research Project of Fuyang Municipal Health Commission （number， FY2020xg14）］

Objective:To explore the application effect of case-based learning (CBL), teaching mode combined with 3D printing in clinical teaching of sacral tumors.Methods:A total of 108 undergraduate interns and standardized residency training students who studied in our hospital from 2017 to 2018 were divided into the CBL teaching group ( n = 53) and the CBL combined with 3D printing teaching group ( n = 55) according to their study time. The combined teaching group used computer tomography (CT) data to reconstruct and print out a 3D model of sacral tumors based on CBL, and performed preoperative teaching on the invasion of the surrounding tissues of the tumor. The scores of the students in the two groups were evaluated respectively, and the students were surveyed by self-identification questionnaire (learning interest, self-learning ability, teamwork ability, comprehensive analysis ability and clinical thinking ability). The t-test (one-sided) was used for comparison between groups using stata 14.0. Results:The score of CBL teaching group (75.90±6.70) was lower than that of CBL combined with 3D printing teaching group (83.60±7.40). In terms of critical thinking ability evaluation, self-learning ability, learning interest, comprehensive analysis ability and clinical thinking ability, the CBL combined 3D printing teaching group was superior to the CBL teaching group, and the difference was statistically significant ( P<0.001). In terms of teamwork ability, there was no statistical difference between the two groups. Conclusion:The CBL teaching mode combined with 3D printing can improve academic performance, students' learning interest and clinical thinking ability of sacral tumors in the teaching of undergraduate interns and standardized residency training students.

Objective : Viral load is becoming more and more important in prevention of HIV/AIDS. Understanding the baseline of viral load before treatment in newly reported HIV/AIDS patients can provide a basis for AIDS prevention. Methods : The viral load of newly reported HIV/AIDS patients in Jiangsu province in 2019 was detected by fluorescence quantitative PCR , the differences of viral load under different demographic characteristics were compared , and the factors of high viral load were analyzed. Results : he mean viral load of 3098 newly reported HIV/AIDS patients in Jiangsu province was 4. 33 ± 1. 05 log/mL , and the proportion of patients with viral load < 5000 copies/mL was 20. 85% (646/3 098) . There were statistically significant differences in viral load among different genders (P < 0. 05) , and male patients had higher viral load. The difference of viral load between HIV⁃infected and AIDS patients was statistically significant (P < 0. 05) , and the viral load value of AIDS patients diagnosed with disease status was relatively high. Unmarried and married spouses were more likely to have higher viral load than divorced or widowed spouses. Higher baseline viral load level was associated with higher rates of virologic failure after antiviral therapy. Conclusion The overall viral load of HIV infected /AIDS patients is high , but there is a certain proportion of low viral load , suggesting that follow⁃up of low viral load should be strengthened in AIDS prevention and treatment. Strengthen interventions aimed at men and unmarried or married people with spouses to reduce the risk of transmission.