ObjectiveTo investigate the mechanism of action of Xiayuxue decoction in inhibiting nonalcoholic fatty liver disease （NAFLD） induced by high-fat diet in mice by regulating nucleotide binding oligomerization domain like receptor containing pyrin domain protein 6 （NLRP6）. MethodsA total of 15 male C57BL/6 mice were randomly divided into low-fat diet （LFD） group， high-fat diet （HFD） group， and Xiayuxue decoction-HFD group （XYXD group）， with 5 mice in each group. Liver function parameters （alanine aminotransferase ［ALT］ and aspartate aminotransferase ［AST］） and blood lipid metabolic indicators （triglycerides ［TG］ and total cholesterol ［TC］） were measured； HE staining and oil red O staining were performed for liver tissue to observe histomorpholoty and lipid droplet deposition； quantitative real-time PCR was used to measure the expression levels of inflammatory factors （tumor necrosis factor-α ［TNF-α］， interleukin-1β ［IL-1β］， interleukin-18 ［IL-18］， and NLRP6） in liver tissue； Western blot was used to measure the protein expression levels of NLRP6， nuclear factor-kappa B （NF-κB）， and NF-κB p65； immunohistochemistry was used to measure the expression of NLRP6 and CD68. Mouse Raw264.7 cells were treated with palmitic acid （PA）， lipopolysaccharide， and serum containing Xiayuxue decoction to observe inflammation. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the LFD group， the HFD group had significant increases in the serum levels of ALT， AST， TC， and TG （all P<0.05）. Liver histopathological examination showed that the HFD group had marked hepatic steatosis and a signficant increase in NAS score （P<0.05）， and quantitative real-time PCR showed significant increases in the inflammatory factors such as IL1β and IL-18 and a significant reduction in the expression of NLRP6 （all P<0.05）. Immunohistochemistry showed that the expression of NLRP6 showed a similar trend as that of the macrophage marker CD68. Western blot showed that after the downregulation of NLRP6 expression， there was a significant increase in phosphorylated NF-κB p65 （P<0.05）. Compared with the HFD group， Xiayuxue decoction effectively improved liver inflammation， upregulated the expression of NLRP6， and downregulated phosphorylated NF-κB p65 in HFD mice （all P<0.05）. After Raw264.7 cells were treated with PA， NLRP6 was downregulated to promote the progression of inflammation （P<0.05）， and treatment with Xiayuxue decoction could upregulate NLRP6 and inhibit inflammation NF-κB （P<0.05）. ConclusionXiayuxue decoction can effectively improve hepatic steatosis and liver inflammation in a mouse model of NAFLD， possibly by regulating NLRP6/NF-κB to alleviate macrophage activation.

Objective:To investigate the clinical characteristics and management status of children with Turner syndrome (TS) in China.Methods:As a cross-sectional study, 1 089 TS patients were included in the database of the National Collaborative Alliance for the Diagnosis and Treatment of Turner Syndrome from August 2019 to November 2023. Clinical characteristics (growth development, sexual development, organ anomalies, etc.), karyotypes, auxiliary examinations, and treatments were collected and analyzed.Results:Among the 1 089 TS cases, 809 were recorded karyotypes. The karyotype distribution was as follows: 45, X in 317 cases (39.2%), X chromosome structural variants (including partial deletions of p or q arm, ring chromosome, and marker chromosome) in 89 cases (11.0%), 45, X/46, XX mosaicism in 158 cases (19.5%), mosaicism with X chromosome structural variants in 209 cases (25.8%), and presence of Y chromosome material in 36 cases (4.4%). Among the 824 TS cases, the age of diagnosis was 9.7(6.4, 12.2) years, with a height standard deviation score (HtSDS) of -3.1±1.2. Five hundred and fifty three cases underwent growth hormone (GH) stimulation test, and 352 cases (63.7%) had GH peak values <10 μg/L and 75.9% (577/760) had low IGF1 levels, with IGF1 SDS ≤-2 accounting for 38.2% (290 cases). Among 471 cases aged ≥8 years, 132 cases (28.0%) showed spontaneous sexual development (mean bone age (11.0±1.7) years), 10 cases had spontaneous menarche (mean bone age (12.0±2.2) years), and 2 cases had regular menstrual cycles. Common physical features included cubitus valgus (311 cases (28.5%)), neck webbing (188 cases (17.2%)), low posterior hairline (185 cases (17.0%)), shield chest (153 cases (14.0%)), high arched palate (127 cases (11.6%)), short fourth metacarpal (43 cases (3.9%)), and spinal abnormalities (38 cases (3.5%)). Congenital cardiovascular and urogenital anomalies occurred in 91 cases (19.4%) and 66 cases (12.0%)respectively. Abdominal ultrasound in 33 cases (7.2%) indicated fatty liver, hepatomegaly, intrahepatic bile duct stones, and splenomegaly. Among 23 cases undergoing oral glucose tolerance test (OGTT) test, 2 were diagnosed with diabetes mellitus and 4 with impaired glucose tolerance. Following diagnosis, 669 cases (80.7%) received rhGH treatment at a chronological age of (9±4) years and bone age of (8.3±3.2) years. Additionally, 112 cases (19.4%) received sex hormone replacement therapy starting at the age of (14±4) years and bone age of (12.6±1.2) years.Conclusions:The karyotypes of 45, X and mosaicism were most common in Chinese children with TS. The clinical manifestations were mainly short stature and gonadal dysplasia. However, a few TS children could be in the normal range of height, and some cases among those aged of ≥8 years old had spontaneous sexual development. Some exhibited physical features, congenital cardiovascular and urogenital anomalies, and dysfunction of the hypothalamic-pituitary-IGF1 axis. Moreover, a few of them developed impaired glucose tolerance and diabetes mellitus. Following diagnosis, most of the patients received rhGH treatment, and a few of them received sex hormone replacement therapy.

Objective:To assess the clinical value of helium-free magnetocardiography(MCG) in the diagnosis of coronary artery disease(CAD).Methods:A total of 213 patients with suspected CAD undergoing MCG in Beijing Anzhen Hospital were enrolled in the study. All patients underwent coronary CT angiography/invasive coronary angiography(CCTA/ICA) within 48 hours after MCG scanning. The parameters of MCG, including magnetic field multipolarization, magnetic field unipolarization, T-wave flattened, change in magnetic field distribution at TT segment, abnormal T-peak amplitude ration of maximum to minimum, significant movement of poles, magnetic field angle deviation and abnormal distribution of positive pole were used for the evaluation of the stenosis of coronary arteries.Results:Among 213 patients, MCG scanning was completed in 193 cases(90.6%), while 20 cases were excluded for various reasons. The CCTA/ICA results were taken as gold standard, the total coincidence rate of MCG with the degree of stenosis was 88.60%(95% CI: 83.25%-92.72%), the sensitivity and specificity of MCG in the diagnosis of CAD was 89.63%(95% CI: 83.21%-94.21%) and 88.23%(95% CI:78.12%-94.78%), respectively; the positive and negative predictive value were 93.80%(95% CI:88.72%-96.68%) and 81.08%(95% CI:72.15%-87.64%), respectively. Conclusion:MCG is highly accurate in the diagnosis of CAD, it may be widely used clinically as an non-invasive method free of radiation or contrast agent.

AIM: To explore the protective effect of fluorofenidone (AKF-PD) on diethylnitrosamine-induced liver injury in rats and its inhibition of the TGF-β1/Smads pathway in hepatocytes. METHODS: Fifty-five male Sprague Dawley (SD) rats were randomly divided into three groups: model group (DEN group, n=20) were gavaged with DEN (10 mg/kg), 5 times for 14 weeks; control group (n=20) were gavaged with saline with the same volume of the model group; treatment group (DEN+AKF-PD Group, n=15), after 4 weeks of modeling, they were gavaged with AKF-PD (500 mg/kg) daily, and stopped at 14 weeks. At the end of experiment, the rats were killed by anesthesia and spinal dislocation. Masson staining was used to observe collagen deposition; primary hepatocytes were extracted and identified, and the levels of α-smooth muscle actin (α-SMA), TGF-β1, Smad3, and Smad7 mRNA, and the expression of Smad3 and Smad7 proteins in hepatocytes were detected. RESULTS: Compared with the control group, Masson staining showed that collagen deposition increased in the DEN group; AKF-PD treatment could significantly improve liver pathological damage and reduce collagen deposition. In addition, compared with the DEN group, the α-SMA, TGF-β1, and Smad3 mRNA levels of the AKF-PD group were significantly reduced, and the Smad7 mRNA level was increased. Moreover, AKF-PD treatment could dependably reduce the expression of Smad3 and increase Smad7. CONCLUSION: AKF-PD can significantly improve liver injury and fibrosis in rats caused by DEN. This effect may be related to the down-regulation of α-SMA, TGF-β1, and Smad3 mRNA levels in hepatocytes and the increase of Smad7 mRNA levels.

This article summarizes the necessity of professional team cooperation in the field of pediatric critical care, the status of domestic and foreign child critical care team cooperation, the role of nurses in team cooperation, team cooperation evaluation tools and so on. This article aims to provide new methods and ideas for the development and cooperation of nursing team building and cooperation in the field of critically ill children in our country, and to improve the team's ability to treat critically ill children.

Objective:To investigate the clinical practice status of neonatal arterial blood gas collection in Class Ⅲ Grade A children's hospitals in China, so as to provide a reference for further standardizing neonatal arterial blood gas collection operating standards.Methods:From July to September 2020, convenience sampling and self-designed Neonatal Arterial Blood Gas Collection Technology Practice Questionnaire were adopted to conduct a cross-sectional survey on the technical operation of 824 nurses of Neonatology Department in 15 ClassⅢ children's hospitals, general hospitals, and maternal and child health hospitals across the country. A total of 824 questionnaires were distributed, 791 were retrieved, and 747 valid questionnaires were collected.Results:The most common site for neonatal arterial blood gas collection was the radial artery, accounting for 98.80% (738/747) , followed by the brachial artery 47.79% (357/747) . The radial artery was often selected below the place where the pulsation was strongest (46.86%, 350/747) , and the most needles were inserted at an angle of 15° to 30°. The brachial artery was often selected below the place where the pulsation was strongest (58.77%, 439/747) , and the most needles were inserted at an angle of 30° to 45°. The more common complications after arterial blood gas collection were bruising, bleeding, and hematoma. A total of 390 (52.21%) nurses received uniform training in arterial blood gas collection in the past year. There was a statistically significant difference in the incidence of needle stick injuries in the collection of nurses of Neonatology Department who received uniform training or not ( P<0.05) . Conclusions:The operating standards for neonatal arterial blood gas collection are not uniform, and it is necessary to standardize the collection process and management. Although the training for nurses has been carried out in clinical practice, the incidence of needle stick injuries among nurses still needs to be further reduced, especially the targeted training of arterial blood gas collection and operation skills. The collection tools should be improved to increase the success rate of arterial blood collection, reduce the occurrence of complications, and ensure the safety of nurses.

Cosmetic and plastic surgery of female external genitalia is a new subject which adopts surgical or non-surgical methods to rectification of vulva and vagina.With the social progress, genitalia plastic surgery has also achieved a dramatic of development, various new technologies has been applied, and women’s genitalia plastic surgery has shown a good prospect. This review focuses on new concepts and techniques of surgery and non-surgical cosmetic surgery of female external genitalia, including the surgical methods, such as mons pubic plasty, clitoral hood plasty, labia minora reduction surgery, labia majora reduction surgery, labia majora augmentation surgery, perineoplasty, vaginoplasty, and non-surgical methods like G-spot augmentation, orgasm shot therapy, photoelectricity-energy based therapy, etc. It could help plastic surgeons and gynecologists to understand the concepts and therapeutics better in this field.

Cosmetic and plastic surgery of female external genitalia is a new subject which adopts surgical or non-surgical methods to rectification of vulva and vagina.With the social progress, genitalia plastic surgery has also achieved a dramatic of development, various new technologies has been applied, and women’s genitalia plastic surgery has shown a good prospect. This review focuses on new concepts and techniques of surgery and non-surgical cosmetic surgery of female external genitalia, including the surgical methods, such as mons pubic plasty, clitoral hood plasty, labia minora reduction surgery, labia majora reduction surgery, labia majora augmentation surgery, perineoplasty, vaginoplasty, and non-surgical methods like G-spot augmentation, orgasm shot therapy, photoelectricity-energy based therapy, etc. It could help plastic surgeons and gynecologists to understand the concepts and therapeutics better in this field.

Objective:To investigate the use of different tools of intravenous infusion and the issues associated with intravenous catheter indwelling in hospitalized children and to provide reference for clinical practices.Methods:Using the convenient sampling method, from July 24th to 31st, 2018, the intravenous infusion treatment of children inpatients in 49 hospitals within the Beijing Children's Hospital Medical Association was selected for investigation. A self-designed Cross-sectional Questionnaire for Children's Intravenous Infusion and a photo of an intravenous infusion tool were used for data collection. Statistical analysis was performed using SPSS 17.0 software.Results:During the data collection period, there were 18 316 hospitalized children in the 49 hospitals, among which there were 14 421 cases of infusions, with the infusions rate of 78.73%. The application rate of indwelling needle was 87.94%. The connector of venous catheter was mainly heparin cap connection (64.23%) . The infusion tools used in 6 398 cases (44.37%) were made by PVC and containing 2-ethyl hexyl phthalate (DEHP) . Aseptic transparent dressing was the main dressing choice. During catheter indwelling, there were some problems such as back-blood in the pipeline or infusion joint, incorrect clamping position of small clips, unclamping, and tube detachment. Indwelling needles had more problems than central venous catheters, including old blood returning in the tube and blood returning in the infusion connector. The difference between the peripheral indwelling needle and the central catheter was statistically significant ( P<0.05) . Conclusions:The rate of intravenous infusion in hospitalized children is relatively high. Although there are various types of intravenous infusion tools, the choice of infusion tools for children was mainly indwelling needle and heparin cap connection, and there were still room for improvement in catheter maintenance.

Objective To analyze the mechanical properties of bone tissue engineering scaffolds with different pore structure and porosity, and improve the mechanical properties of scaffolds by changing pore structure. Methods Square pore, spherical pore and cylindrical pore with different porosities from 55% to 75% were established by SolidWorks software, and the surface-volume ratio of different structures was calculated. The stress distribution and equivalent compression modulus of different scaffolds were obtained by ANSYS Workbench software. According to the stress distribution results, the scaffold with rectangular pore structure and cuboid element structure was improved instead of square pores. Results With the increase of porosity, the surface-volume ratio of the three structures increased. For the same porosity, the surface-volume ratio of square pores and spherical pores was larger, while that of cylindrical pores was the smallest. The modulus and porosity of the three structures were approximately linear. The modulus of the square pore and the cylindrical pore were similar. The stress analysis on the square pore and two improved structures with 60% porosity showed that for the two improve structures, the wall stress on 4 edges parallel to the direction of applied stresses could be reduced by 15%. Conclusions The surface-volume ratio and mechanical property of square pores were more advantageous than spherical pores and cylindrical pores with the same porosity, and the two improved structures could improve the mechanical properties of square pores. The two improved pores enriched the structure of tissue engineering scaffolds. The research findings provide the mechanical references for their clinical application.