Objective:To discuss the clinical efficacy of recombinant human growth hormone(rhGH)in the treatment of the pediatric patients with growth hormone deficiency(GHD)and idiopathic short stature(ISS),and to clarify its clinical application value in the pediatric patients with short stature of different etiologies.Methods:The clinical data of 132 children with short stature who treated with rhGH from January 2018 to January 2023 were collected.They were divided into GHD group(n=70)and ISS group(n=62)based on different etiologies.The bone age,target height(TH),body mass index(BMI),height standard deviation score(HtSDS),changes in height standard deviation scores(ΔHtSDS)before treatment and 6 months after treatment,and growth velocity(GV)of the pediatric patients were calculated.Propensity score matching(PSM)and inverse probability of treatment weighting(IPTW)were used to balance the confounding factors between the pediatric patients in two groups and the efficacy and safety of the pediatric patients in two groups were evaluated.Results:There were significant differences in whether children were full-term,bone age,bone age maturity,and TH of the pediatric patients between two groups(P<0.05).Compared with before treatment,the height and HtSDS of the pediatric patients in both GHD and ISS groups were significantly increased after treated for 6 months(P<0.05).Before matched by PSM,there were significant differences in full-term,bone age,bone age maturity,and TH of the pediatric patients between two groups(P<0.05).After matched by PSM,there were no significant differences in gender,region,term birth status,mode of delivery,feeding method,age,bone age,height,BMI,TH,and pretreatment HtSDS of the pediatric patients between two groups(P>0.05);the standardized mean difference(SMD)differences of covariates except for region were<0.2.After weighted by IPTW,there were no significant differences in gender,region,term birth status,mode of delivery,feeding method,age,bone age,height,BMI,TH,and pretreatment HtSDS of the pediatric patients between two groups(P>0.05);all SMD of covariates except for term birth status were<0.2.Before balancing covariates,after meatched by PSM matching,and after weighted by IPTW weighting compared with GHD group,the GV and ΔHtSDS of the pediatric patients in ISS group were slightly increased,but the difference was not significant(P>0.05).In terms of adverse reactions,2 cases(2.68%)of fasting hyperglycemia and 7 cases(10.00%)of hypothyroidism occurred in GHD group;3 cases(4.84%)of fasting hyperglycemia and 2 cases(3.23%)of hypothyroidism occurred in ISS group.Conclusion:rhGH can promote the height increase in the patients with GHD and ISS,and there is no significant difference in the height-increasing efficacy between GHD and ISS children.The incidence of adverse reactions is relatively low during treatment,indicating good overall safety.

OBJECTIVE To evaluate the short-term efficacy of single-session microwave ablation for benign thyroid nodule.METHODS Patients with benign thyroid nodules treated by microwave ablation between June 2019 and December 2022 at the Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,were included for analysis.Thyroid function was tested 1 month after treatment,and ultrasound and thyroid function were performed 3 months,6 months and 1 year after treatment.Volume reduction rates(VRR)of nodules were calculated.Data of the last follow-up within 1 year were included for analysis.Variables including gender,age,whether Hashimoto's thyroiditis was present,longitudinal diameter of nodules,solid volume of nodules were included for univariate and multivariate analysis.RESULTS A total of 151 patients with 163 nodules were included.The perioperative complication rate was 1.99%(3/151).The VRR at half year after treatment was(79.58±17.70)%,and the success rate at half year after treatment was 93.43%(128/137).The VRR of at 1year after treatment was(81.24±24.29)%.The 1-year treatment success rate was 92.77%(77/83).Univariate and multivariate analysis showed that nodular solid volume and age were independent factors affecting VRR after ablation.Regression coefficient of age and solid volume was 0.34(P<0.05)and-0.47(P<0.05),respectively.For every 1 cm3 increase in solid volume,1-year VRR(%)decreased by 0.47.Regression equation:1-year VRR=68.92+0.34×age-0.47×solid volume.Serum FT4 gradually decreased and the thyroid stimulating hormone(TSH)gradually increased within 6 months after ablation,and the differences were statistically significant(P<0.05).After 6 months,serum FT4 gradually recovered to the normal level and TSH gradually recovered.However,TSH still did not reach the preoperative level one year after ablation.FT3 decreased gradually after treatment,but there was no significant difference between the values at each time point(P=0.40).After the ablation of thyroid nodule,the mean value of thyroid function index fluctuated,but all of them were within the normal reference range.CONCLUSION Microwave ablation is a safe and effective treatment method for benign thyroid nodules,with an overall success rate of over 90%.Solid nodule volume and age are independent factors affecting the microwave ablation effect of benign thyroid nodules.

Objective To investigate the effect of adenotonsillectomy on immune function and sleep structure in children with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 94 children with OSAHS treated at Children's Hospital Affiliated to Zhengzhou University from November 2020 to June 2022 were selected as the observation group,and another 80 healthy children who underwent physical examinations at the same hospital during the same period were selected as the control group.Children in the observation group underwent bilateral tonsillectomy combined with endoscopic adenoidectomy.Changes in the sleep structure of children in the observation group were detected before surgery and at discharge by using a multi-channel sleep monitoring system.Venous blood samples were collected from children in the observation group before surgery,one month after surgery,and six months after surgery,while venous blood samples of children in the control group were collected on the day of physical examination.The serum levels of IgA,IgG and IgM were measured by using immunoturbidimetry,the percentages of CD3+,CD4+and CD8+in the plasma were measured by using flow cytometry,and the CD4+/CD8+ratio was calculated.Results Compared with before surgery,the proportion of non-rapid eye movement sleep(NREM)1,apnea-hypopnea index and obstructive apnea-hypopnea index of children in the observation group decreased at discharge,the proportions of NREM2,NREM3 and rapid eye movement sleep(REM),sleep efficiency and the lowest oxygen saturation increased,and REM time extended(P＜0.05).The preoperative serum levels of IgA,IgG and IgM in the observation group were significantly higher than those in the control group(P＜0.05).One month after surgery,the serum levels of IgA,IgG and IgM in the observation group were significantly lower than those in the control group(P＜0.05).There was no statistically significant difference in the serum levels of IgA,IgG and IgM between the observation group and the control group at six months after surgery(P＞0.05).One and six months after surgery,the serum levels of IgA,IgG and IgM in the observation group were significantly lower than those before surgery(P＜0.05),and the serum levels of IgA,IgG and IgM at six months after surgery were significantly higher than those one month after surgery(P＜0.05).The preoperative CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly lower than those in the control group,while the CD8+percentage was significantly higher than that in the control group(P＜0.05).One month after surgery,the CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly lower than those in the control group,while the CD8+percentage was significantly higher than that in the control group(P＜0.05).There was no statistically significant difference in the CD3+,CD4+and CD8+percentages and the CD4+/CD8+ratio between the observation group and the control group at six months after surgery(P＞0.05).One month after surgery,the CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly lower than those before surgery,while the CD8+percentage was significantly higher than that before surgery(P＜0.05);six months after surgery,the CD3+and CD4+percentages and the CD4+/CD8+ratio in the observation group were significantly higher than those before surgery,while the CD8+percentage was significantly lower than that before surgery(P＜0.05).The CD3+and CD4+percentages and the CD4+/CD8+ratio at six months after surgery were significantly higher than those at one month after surgery,while the CD8+percentage was significantly lower than that at one month after surgery in the observation group(P＜0.05).Conclusion Adenotonsillectomy can effectively prolong the REM time of OSAHS children and improve their sleep efficiency,sleep structure and the immune regulation function of the body.The immune function of the body decreases briefly after adenotonsillectomy,and then gradually returns to the normal level.

AIM:To investigate the effect of polycomb group ring finger 3(PCGF3)on the viability and apop-tosis of OSCC cells and its potential mechanism.METHODS:The data were downloaded from the online public database to predict the expression of PCGF3 in OSCC and its relationship with pathological stage survival rate.Fifty pairs of OSCC tissues and adjacent tissues were selected to analyze the relationship between the expression of PCGF3 and the survival rate of patients.The expression level of PCGF3 in the specimens was detected by IHC,and the extracted cancer and adja-cent tissues were homogenized to analyze its mRNA expression.The mRNA and protein expression levels of PCGF3 in the cells were analyzed by RT-qPCR and Western blot experiments,and the protein expressions of PCGF3,p-PI3K,p-AKT,cyclin D1 and cleaved caspase-3(cl-caspase-3)were further analyzed.In addition,the effects of PCGF3 on cell viability and apoptosis were also detected.Finally,subcutaneous tumor models in nude mice were constructed to verify the above experiments.RESULTS:PCGF3 was highly expressed in OSCC and was closely related to pathological stage,pathologi-cal grade,and survival rate of patients.PCGF3 was highly expressed in OSCC tissues and cell lines in the network online databases.Western blot results showed that the expressions of PCGF3,p-PI3K,p-AKT,cyclin D1 and cl-caspase-3 were decreased and increased respectively after knocking down or overexpressing PCGF3 in OSCC cells.And cell viability and apoptosis were affected.The volume and weight of tumors in sh-PCGF3 group were lower than those in sh-NC group,and HE results showed that the nuclear atypotype of tumor cells in sh-PCGF3 group was less than that in sh-NC group.CON-CLUSION:PCGF3 can significantly affect the viability and apoptosis of OSCC cells,and its potential mechanism is to ac-tivate the PI3K/AKT signaling pathway to participate in the proliferation and apoptosis of OSCC cells.

Objective:To summarize the best evidence for the management of fatigue-related symptom clusters in HIV/AIDS patients.Methods:According to the "6S" model, clinical decisions, guidelines, expert consensus, systematic reviews, Meta-analysis, evidence summary, and randomized controlled trials on the management of fatigue-related symptom clusters of HIV/AIDS patients were searched from top to bottom in BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center Database, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Medlive, Joint United Nations Programme on HIV/AIDS, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, WanFang data, China Biology Medicine disc and other databases and websites. The search period was from January 1, 2017, to July 30, 2023. Two researchers independently used corresponding quality evaluation tools to evaluate the methodological quality of the included literature. They extracted and summarized the best evidence for the management of fatigue-related symptom clusters in HIV/AIDS patients.Results:A total of 20 articles were included, including seven clinical decisions, three guidelines, two evidence summaries, one expert consensus, three systematic reviews, and four randomized controlled trials. Thirty-four pieces of evidence were summarized from four aspects: fatigue management, frailty management, sexual dysfunction management, and sleep disorder management.Conclusions:This study summarizes the best evidence for the management of fatigue-related symptom clusters in HIV/AIDS patients. Medical and nursing staff must select and apply the evidence in a targeted manner based on clinical situations.

Purpose: This study aims to evaluate the efficacy and safety of a new combination treatment of vinorelbine and pyrotinib in human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) and provide higher level evidence for clinical practice. Materials and Methods: This was a prospective, single-arm, phase 2 trial conducted at three institutions in China. Patients with HER2-positive MBC, who had previously been treated with trastuzumab plus a taxane or trastuzumab plus pertuzumab combined with a chemotherapeutic agent, were enrolled between March 2020 and December 2021. All patients received pyrotinib 400 mg orally once daily plus vinorelbine 25 mg/m2 intravenously or 60-80 mg/m2 orally on day 1 and day 8 of 21-day cycle. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival, and safety. Results: A total of 39 patients were enrolled. All patients had been pretreated with trastuzumab and 23.1% (n=9) of them had accepted trastuzumab plus pertuzumab. The median follow-up time was 16.3 months (95% confidence interval [CI], 5.3 to 27.2), and the median PFS was 6.4 months (95% CI, 4.0 to 8.8). The ORR was 43.6% (95% CI, 27.8% to 60.4%) and the DCR was 84.6% (95% CI, 69.5% to 94.1%). The median PFS of patients with versus without prior pertuzumab treatment was 4.6 and 8.3 months (p=0.017). The most common grade 3/4 adverse events were diarrhea (28.2%), neutrophil count decreased (15.4%), white blood cell count decreased (7.7%), vomiting (5.1%), and anemia (2.6%). Conclusion Pyrotinib plus vinorelbine showed promising efficacy and tolerable toxicity as second-line treatment in patients with HER2-positive MBC.

Objective:To compare the clinical utility of 18F-prostate specific membrane antigen (PSMA)-1007 and 18F-FDG PET/CT imaging in newly diagnosed hepatocellular carcinoma (HCC). Methods:From April 2022 to July 2022, 17 patients (14 males, 3 females, age 36-73(54.4±10.1) years) with newly diagnosed HCC who underwent 18F-FDG and 18F-PSMA-1007 PET/CT imaging within 3 d in the First Affiliated Hospital of Zhengzhou University were prospectively enrolled. ROIs were drawn from normal liver tissue (L), abdominal aorta (A), right gluteus medius (M), and SUV max of these regions were compared with the SUV max of primary tumor (T). Wilcoxon rank sum test and Kruskal-Wallis rank sum test were used to analyze the data. Results:18F-FDG PT/CT, 18F-PSMA-1007 PET/CT and enhanced MRI detected 1(0, 2), 2(1, 5) and 2(1, 4) tumor lesions of the liver in each patient respectively ( H=7.10, P=0.029), and 18F-PSMA-1007 detected more lesions than 18F-FDG ( P=0.024). Although SUV max of 18F-PSMA-1007 in HCC was significantly higher than that of 18F-FDG (25.7(17.1, 45.1) vs 6.3(2.9, 12.4); z=3.39, P=0.001), there was no significant difference of T/L ratio between 18F-PSMA-1007 and 18F-FDG PET/CT imaging (2.7(2.1, 4.7) vs 1.6(1.0, 4.5); z=0.52, P=0.602). T/A and T/M ratios were significantly higher in 18F-PSMA-1007 PET/CT imaging than those in 18F-FDG PET/CT imaging ( z values: 3.15, 3.53, P values: 0.002, <0.001). 18F-PSMA-1007 PET/CT imaging found high uptake foci in the liver and ribs in 2 cases, which were pathologically confirmed as bone metastasis of HCC, while those lesions were not found by 18F-FDG imaging. Conclusion:Compared with 18F-FDG, 18F-PSMA-1007 PET/CT demonstrates higher tumor uptake, more intrahepatic tumors foci and distant bone metastases.

ObjectiveTo explore the potential suitable distribution area and spatial production area of high-quality medicinal materials of Miao medicine Laportea bulbifera. MethodBased on 200 distribution spots of L. bulbifera and 120 ecological factors, the maximum entropy model（MaxEnt） and ArcGIS software were applied to predict the potential suitable areas. The content of rutin, kaempferol-3-O-rutinoside, and quercitrin from 33 batches of L. bulbifera in Guizhou province was determined by high-performance liquid chromatography (HPLC). Combined with the previous content data of total polysaccharides and total flavonoids, the correlation between the main pharmacodynamic components of L. bulbifera and ecological factors was analyzed. Eventually, the quality regionalization of L. bulbifera was exhibited by the collocated Cokriging in ArcGIS. ResultThe optimum distribution areas of L. bulbifera were Yunnan, Guizhou, Sichuan, Hunan, and Hubei provinces in China, and the high and medium suitable areas accounted for 59.48% of the total distribution areas. October precipitation, slope, min temperature of the coldest month, altitude, solar radiation intensity in June, and April precipitation were the main ecological factors affecting the growth and distribution of L. bulbifera. Temperature, radiation intensity, precipitation, and soil composition and properties had great effects on the accumulation of secondary metabolites in L. bulbifera. The results showed that the high-quality areas of L. bulbifera mainly included Leishan county, Kaili city, Qingzhen city, Pingba district, Huishui county, Longli county, Kaiyang county, and Jiangkou county in Guizhou province. ConclusionL. bulbifera is widely distributed in China， but the suitable distribution areas are mainly concentrated in southwest China and part of central China. The planting bases of L. bulbifera can be selected in parts of cities and counties in southeast and central Guizhou province. In this study， the potential suitable growing areas and the optimum planting areas of L. bulbifera in Guizhou were predicted， which could provide scientific references for the cultivation and the site selection of large-scale planting for L. bulbifera.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Patient experience is an important window for modern hospital management and medical service quality, and also an important point for humanistic hospital construction. Improving patient experience is of great significance for constructing harmonious doctor-patient relationship and improving patients’ satisfaction and sense of gain. Based on the perspective of patient experience improvement, this paper analyzed the core value of "patient demand first" of Mayo Clinic and the operational experience of Cleveland Medical Center Patient Experience Office, and applied them to the cultivation of humanistic hospital culture in the First Affiliated Hospital of Xi’an Jiaotong University. Based on the concept of "strengthening patient demand orientation", with the goal of "building a high-quality patient service system and significantly improving patient satisfaction", through building education platforms for medical ethics and medical humanism, exploring the medical humanism dissemination mode for medical staff, and carrying out the humanism literacy cultivation practice in the training camp for improving hospital service efficiency, the humanistic cultural atmosphere of the hospital has been further enhanced, and the patient satisfaction has been steadily improved. It provides reference for the cultivation of humanistic literacy and the construction of new culture in public hospitals in the context of high-quality development.