Objective:To explore the clinical characteristics and predictive factors for plastic bronchitis (PB) in children with severe Mycoplasma pneumoniae pneumonia (SMPP). Methods:A retrospective cohort enrolled children with a clinical diagnosis of SMPP who were treated at the Department of Respiratory Medicine of Tianjin Children′s Hospital Machang District from January 1, 2018, to October 31, 2023. According to the bronchoscopy and pathological examination results, the patients were divided into 142 cases in the PB group and 274 cases in the non-PB group. The clinical manifestations, laboratory data, imaging findings, and treatments were analyzed.Mann-Whitney U test and Chi-square test were used to analyze the differences between the two groups, and multivariate Logistic regression was used to analyze the risk factors. The receiver operating characteristic (ROC) curve was used to explore the predictive value of PB in SMPP. Results:Among 416 SMPP children, there were 197 males and 219 females; PB group 142 cases, non-PB group 274 cases, the age of disease onset was (6.9±2.9) years and (6.6±2.8) years in the PB group and the non-PB group respectively. The incidence of wheezing symptoms, hypoxemia, heat peak >40 ℃, the duration of fever, neutrophil-lymphocyte ratio, mean platelet volume, C-reactive protein, procalcitonin, interleukin-6, alanine transaminase, aspartate aminotransferase and ferritin were higher in the PB group (16 cases (11.3%) vs. 15 cases (5.5%), 14 cases (9.9%) vs. 12 cases (4.4%), 57 cases (40.1%) vs. 67 cases (24.5%), 10 (8, 12) vs. 9 (8, 12) d, 6.1 (4.1, 13.1)×10 9vs. 5.0 (3.7, 6.8)×10 9/L, 10.2 (9.6, 10.8) vs. 9.4 (8.9, 10.1) fl, 33.4 (16.0, 67.5) vs. 23.0 (10.4, 56.1) mg/L, 0.24 (0.12, 0.48) vs. 0.16 (0.09, 0.31) μg/L, 39.9 (25.1, 81.4) vs. 31.3 (18.3, 59.3) ng/L, 16.0 (12.0, 29.0) vs. 14.0 (10.0, 24.3) U/L, 38.5 (28.0, 52.5) vs. 33.0 (25.0, 44.0) U/L, 233 (136, 488) vs. 156 (110, 293) μg/L, χ2=4.55, 4.79, 11.00, Z=2.25, 4.00, 6.64, 2.76, 2.98, 3.09, 2.22, 2.62, 4.18, all P<0.05). Multivariate Logistic regression analysis showed that the dyspnea ( OR=2.97, 95% CI 1.35-6.55, P=0.007), the diminution of respiration ( OR=2.40, 95% CI 1.27-4.52, P=0.006), neutrophil-lymphocyte ratio (NLR) ( OR=2.07, 95% CI 1.71-2.51, P<0.001), lactate dehydrogenase (LDH) ( OR=1.01, 95% CI 1.00-1.01, P<0.001), mean platelet volume/platelet count (MPV/PLT) ( OR=1.39, 95% CI 1.13-1.71, P=0.002), pleural effusion ( OR=2.23, 95% CI 1.21-4.13, P=0.011),≥2/3 lobe consolidation ( OR=1.84, 95% CI 1.04-3.00, P=0.039) and atelectasis ( OR=1.98, 95% CI 1.02-3.48, P=0.044) were independent predictors of PB in children with SMPP. ROC curve analysis showed that the cut-off values for NLR, LDH and MPV/PLT in the diagnosis of PB were 2.79 (sensitivity 0.89, specificity 0.69, area under the curve (AUC)=0.86, P<0.001), 474 U/L (sensitivity 0.63, specificity 0.65, AUC=0.70, P=0.003) and 0.04 (sensitivity 0.75, specificity 0.53, AUC=0.68, P=0.005) respectively. Children in the PB group had longer hospital stays and corticosteroid treatment course than those in the non-PB group, the proportion of children in the PB group who received bronchoscopy treatment twice or more was higher (9 (8, 12) vs. 8 (6, 10) d, 7 (5, 8) vs. 6 (5, 7) d, 128 cases (90.1%) vs. 218 cases (79.6%), 106 cases (74.7%) vs. 54 cases (19.7%), Z=6.70, 5.06, χ2=7.48, 119.27, all P<0.05). Conclusions:The dyspnea, respiration diminution, NLR level elevation (>2.79) and pleural effusion were predictive factors for PB in children with SMPP. This provides a basis for the early identification of PB in children with SMPP.

Objective To study the mechanical response of tibial prostheses and the distal tibial cancellous bone after implantation of radial and axial functionally graded materials(FGM)into the ankle joint.Methods Three FGM were used:titanium alloy-bioactive glass composite FGM(FGM-Ⅰ),titanium(Ti)alloy-ideal bone elastic composite FGM(FGM-Ⅱ),and Ti alloy-hydroxylapatite composite FGM(FGM-Ⅲ).A three-dimensional finite element model of total ankle arthroplasty(TAA)was established,and the simulation software ABAQUS was used for secondary development based on Fortra.By changing the volume fraction,the mechanical properties of the FGM tibial prosthesis can be adjusted both axially and radially.The stress distributions of the tibial prosthesis and cancellous bone after FGM axial and radial tibial component implantation in the standing position were analyzed.Results Compared with Ti alloy tibial prosthesis,three kinds of FGM could effectively reduce the stress concentration on the tibial prosthesis,and the overall effect of FGM-Ⅲ tibial prosthesis was better than that of FGM-Ⅰ and FGM-Ⅱ tibial prosthesis;the radial distribution of FGM could effectively reduce the maximum von Mises stress of the prosthesis.For the tibial cancellous bone,the three types of FGM radial tibial prostheses and FGM-Ⅲ axial tibial prostheses could effectively increase the distal stress,thus,relieving the stress shielding on the cancellous bone;the FGM-Ⅲ radial tibial prosthesis was the most effective in improving the stress level of the cancellous bone.Conclusions FGM-Ⅲ radial ankle prosthesis can effectively reduce the stress concentration phenomenon and the stress shielding effect on the prosthesis to prolong its life,with potential application prospects.

Objective To construct a curriculum system for higher vocational education in speech-language-hearing rehabilitation based on the World Health Organization rehabilitation competency framework(RCF),to align with international standards. Methods Based on RCF,curriculum theory and principles of vocational education psychology,a curriculum system and its content for higher vocational education in speech-language-hearing rehabilitation were developed.The curric-ulum content and core competencies were analyzed in detail across four levels:basic courses,specialized basic courses,specialized core courses and practical training courses. Results From the perspective of the seven competency domains of RCF,the theoretical and practical significance of con-structing a speech-language-hearing higher vocational education curriculum system based on RCF was systemati-cally elaborated.The study emphasized the importance of establishing competency-oriented higher vocational re-habilitation education for developing students'professional competence,adapting to job requirements,and pro-moting career development.A curriculum content system for speech-language-hearing rehabilitation higher voca-tional education based on RCF was systematically constructed,encompassing basic courses,professional cours-es,and practical training courses.The course names,main content and competency objectives at each level were analyzed in detail. Conclusion It is important to develop the course system of higher vocational education of speech-language-hearing reha-bilitation based on RCF.By comparing with international standards,the curriculum is optimized,focusing on im-proving students'vocational competence and promoting the international development.The curriculum system covers key areas such as core values,beliefs,practice and professionalism,integrates basic,core and practical training courses to achieve a competence-oriented curriculum system for higher vocational speech-language-hear-ing rehabilitation education.

【Objective】 To evaluate the safety and efficacy of the collection of peripheral blood stem cells (PBSCs) in pediatric patients with thalassemia major (TM) weighing 20 kg or less. 【Methods】 PBSCs collection data of 170 pediatric patients with TM weighing 20 kg or less from January 2013 to December 2020 in our center were reviewed. Safety was assessed by the occurrence of adverse events during apheresis procedures, and efficacy was evaluated by the number of CD34+ cells collected. 【Results】 A total of 171 PBSCs procedures were performed on 170 patients with TM weighing 20 kg or less, with a median age of (4.98±1.53) years and a median weight of (17.30±2.18) kg. The probability of collecting at least 1×10⁶ CD34+ cells/kg during a single course of apheresis was 99.41% (169/170), with a median (5.88±4.23) ×10⁶ CD34+ cells collected per kg of weight of the recipient. A minimum pre-apheresis hemoglobin (Hb) of 60 g/L in patients with TM weighing 20 kg or less was safe and feasible. The most common adverse event of G-CSF mobilization in TM patients is bone pain, with the incidence of 7.65% (13/170), which was higher than that of healthy children donors in our center. The most common adverse events during the collection were pain at the puncture site of the femoral vein (6.47%, 11/170) and low pressure of the fluid (2.92%, 5/170). And no serious complications related to PBSCs mobilization, central venous catheter(CVC)placement or the apheresis procedure occurred. 【Conclusion】 PBSCs collection by COM.TEC blood cell separator in children weighing 20 kg or less is safe and efficacious.

PURPOSE: The maximum width between the mesial and distal labial transitional line angles, described as “esthetic width” herein, could significantly influence the visual perception of the teeth and smile. This study aimed to conduct biometric research on esthetic width and to explore whether regular distribution exists in the esthetic width of human teeth. MATERIALS AND METHODS: A total of 4,264 maxillary and mandibular anterior teeth were measured using the Geomagic studio software program. The proportions of maxillary to mandibular homonymous teeth and proportions between the adjacent teeth were calculated. Bilateral symmetry and the correlation between the esthetic and mesiodistal widths were both accounted for during the measurement procedures. RESULTS: The mean esthetic widths were 6.773 ± 0.518 mm and 4.329 ± 0.331 mm for maxillary and mandibular central incisors, respectively, 5.451 ± 0.487 mm and 5.008 ± 0.351 mm for maxillary and mandibular lateral incisors, respectively, and 3.340 ± 0.353 mm and 5.958 ± 0.415 mm for maxillary and mandibular canines, respectively. Except for the mandibular canines, no significant difference in esthetic width was found among homonymous teeth from the same jaw. A high linear correlation was found between the esthetic and mesiodistal widths of the same tooth, except for the maxillary canines. Esthetic width proportions among different tooth categories showed some regular patterns, which were similar to those of the mesiodistal width. CONCLUSION Esthetic width is regularly distributed among the teeth in the Chinese population. This could provide an important reference for anterior dental restorations and dimension recovery in esthetic reconstruction of anterior teeth.

Objective To explore the potential mechanism of Erchen decoction in the treatment of obese polycystic ovary syndrome and obese infertility, in order to provide theoretical basis for “treating different diseases with same method”. Methods The active ingredients and targets of Erchen decoction were obtained from TCMSP database, and the targets of obese polycystic ovary syndromes and obese infertility were obtained from GeneCard database. Active ingredient-target network was constructed by Cytoscape 3.7.1, and protein-protein interaction network and core target were obtained from STRING. GO and KEGG enrichment analysis were performed by Cytoscape 3.7.1 and online software. Results 125 ingredients and 218 targets of Erchen decoction were obtained. There were 2 783 target genes for obese infertility and 2 962 target genes for obese polycystic ovary syndrome. Erchen decoction has a total of 117 target genes in the treatment of obese infertility and obese polycystic ovary syndromes, which proves the principle of “treating different diseases with same method”. Potential active ingredients include quercetin, kaempferol, naringin, baicalin and formononetin. PPI showed that STAT3, JUN, AKT1, MAPK3, MAPK1, MAPK14, IL-6 and FOS were the core targets of “treating different diseases with same method”. Molecular docking results showed that quercetin, kaempferol, etc. had good binding ability with JUN. GO and KEGG enrichment analysis showed that AGE-RAGE signaling pathway, IL-17 signaling pathway and endocrine resistance might be the key pathways for the “treating different diseases with same method” of Erchen decoction. Conclusion Erchen decoction treating "different diseases with same method" involves same targets and same pathways, which can provide reference for future experimental research.

[Objective] To systematically study the characteristics of the key syndromes of systemic lupus erythematosus(SLE),summarize its clinical efficacy,and explore the mechanism of traditional Chinese medicine(TCM).[Methods] The main clinical syndrome features of SLE are heat-toxicity,blood stasis and Yin-deficiency.Compared with glucocorticoids(GCs) alone,combination with JP can significantly improve the clinical efficacy and reduce the glucocorticoid treat consumption effectively.[Results]Our results showed that in MRL/LPR model mice,JP could restore the balance between TH17 and regulatory T cells through CaMK4 signaling pathway,and the interaction between T cells and B cells.JP could promote DNA methylation,inhibit the over-activated lymphocytes,improve the prognosis of SLE and prevent renal damage.JP could up-regulate the concentration of eicosapentaenoic acid (EPA) and the level of glycine,phenylalanine and tryptophan dramatically.Furthermore,JP could reduce the abundance of pathogenic bacteria(such as Parabacteroides) and increase the abundance of beneficial bacteria (such as Odoribacter and Ruminococcus) by regulating gastrointestinal function,which was not found in GCs treated subjects.JP can also obviously reduce the expression of TLR7,TLR9 and IL-6 in intestinal mucosa,showing the effect of multi-target therapy on SLE.[Conclusion] The most common clinical syndromes of SLE are heat-toxicity,blood stasis and Yin-deficiency.JP can effectively control the progress of SLE and exert its clinical function from different aspects.Our research laid the scientific basis for the popularization and application of TCM in clinical treatment of SLE.

OBJECTIVE:To establish a method for simultaneous determination of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate in Xiaoer huadu powder.METHODS:HPLC method was adopted.The separation was performed on Waters SunFireTM-C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 238 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:The linear ranges of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate were 8.808-88.08 μg/mL(r=0.999 8),1.778-17.78 μg/mL(r=0.999 6),2.533-25.33 μg/mL(r=0.999 9),respectively.LOQ were 4.404,0.889,2.533 μg/mL;LOD were 1.101,0.445,1.267 μg/mL.RSDs of precision,stability and reproducibility tests were all lower than 2％.The recoveries were 95.08％-99.61％ (RSD=1.77％,n =9),96.93％-99.94％ (RSD=0.92％,n=9),98.33％-102.05％ (RSD=1.27％,n=9).CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for simultaneous determination of paeoniflorin,berberine hydrochloride and ammonium glycyrrhizinate in Xiaoer huadu powder.

OBJECTIVE:To establish a method for content determination of bavachin and bakuchiol in Psoralea corylifolia.METHODS:HPLC method was adopted.The determination was performed on Shim-Pack VP-ODS column with mobile phase consisted of acetonitrile-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 246 nm,the column temperature was 30 ℃,and the sample size was 10 μL.RESULTS:The linear ranges of bavachin and bakuchiol were 48.9-489 ng(r=0.999 8),784-7 840 ng(r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 2.0％.Average recoveries ranged 95.30％-99.63％ (RSD=1.45％,n=9),96.89％-100.82％ (RSD=1.36％,n=9).CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for the simultaneous determination of bavachin and bakuchiol in P corylifolia.

OBJECTIVE:To establish a method for simultaneous determination of sodium danshensu,protocatechuic aldehyde,salvianolic acid B and phellodendrine hydrochloride in Shenbai shuxin granules.METHODS:HPLC method was adopted.The separation was performed on Waters sunfire-C18 column with mobile phase consisted of acetonitrile-0.05 ％ trifluoroacetic acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 288 nm,and the column temperature was 30 ℃.The sample size was 5 μL.RESULTS:The linear ranges of sodium danshensu,protocatechuic aldehyde,salvianolic acid B and phellodendrine hydrochloride were 0.040 01-1.600 46 μg(r=0.999 9),0.013 84-0.553 7 μg(r=0.999 9),0.049 32-1.972 94 μg(r=0.999 6),0.014 46-0.578 6 μg(r=0.999 8).The limits of quantitation were 7.68,2.66,4.74,1.38 ng,and the limits of detection were 1.92,0.66,2.36,0.69 ng,respectively.RSDs of precision,stability and reproducibility tests were all lower than 2％.The recoveries were 98.846％-100.762％ (RSD=0.77％,n=6),96.632％-99.463％ (RSD=0.98％,n=6),98.541％-100.432％ (RSD=0.82 ％,n =6),98.607 ％-101.521％ (RSD =1.11％,n =6),respectively.CONCLUSIONS:The method is simple,accurate and precise.It can be used for 4 components in Shenbai shuxin granules.