Objective To understand the cognitive influencing factors affecting the use of epinephrine by medical staff for the treatment of serve allergic reactions and the current state of research at home and abroad. Methods Using searching terms such as “adrenaline” “anaphylactic shock”“severe anaphylactic reaction”“allergic reaction”“epinephine”“anaphylaxis”in Chinese and English. Literature review was performed from China National Knowledge Infrastructure （CNKI）， Wanfang Data， Chongqing VIP Database， PubMed， Web of Science. The retrieval time is from the inception of the databases to July 20， 2024. Literature contents were extracted and analyzed. Results A total of nine articles were retrieved， and eight international studies showed that there were differences in the correct use of adrenaline in patients with severe allergic reactions among medical staff of different professions， levels of hospitals， ages， and years of service. Through targeted training and education， the correct use rate of adrenaline by medical staff in the treatment of severe allergic reactions could be significantly improved. Only one Chinese study suggested that clinicians and nurses had severe cognitive deficiencies in the proper use of adrenaline. Conclusion Medical staff have varying degrees of cognitive insufficiency of correct use of adrenaline for the treatment of severe allergic reactions， which is influenced by multiple factors.

Mycoplasma pneumoniae pneumonia （MPP） is a common cause of community-acquired pneumonia in children aged 5 and older in China. Although most affected children have favorable clinical prognosis， some cases can escalate into severe MPP due to risk factors such as pathogen resistance or co-infections， etc. These severe cases significantly jeopardize the lives of children and may lead to diverse long-term sequelae. In response to this challenge， the Children’s Medical Center of the Third Affiliated Hospital of Sun Yat-sen University， integrating current guidelines， expert consensus， and its extensive clinical experience， has devised the “412” cluster treatment strategy. This comprehensive approach encompasses treatments for anti-infection， anti-inflammatory storm， anticoagulation and antioxidant stress. Additionally， it seamlessly integrates traditional Chinese medicine with western therapies， featuring bundled respiratory management and follow-up care. This strategy provides a valuable reference for the diagnosis and treatment of severe MPP in children.

Objective To investigate whether nitrazepam can increase the accuracy of RigiScan measurement of nocturnal penile tumescence and rigidity （NPTR） by improving the sleep quality of patients. Methods All participants received NPTR measurement for two consecutive nights. In Trial 1， 125 normal volunteers were randomly assigned into the control group （n = 68） and experimental group （n = 57）. They took either a placebo or 10 mg of nitrazepam before NPTR testing on the second night to observe the effect of nitrazepam on nocturnal penile erections in the normal population. In Trial 2， 128 patients with erectile dysfunction were randomly assigned into the control group （n = 64） and experimental group （n = 64）. They took either a placebo or 10 mg of nitrazepam before NPTR testing to observe the effect of nitrazepam on NPTR detection parameters including effective erection times （EEE）， total erection duration （TED）， erection duration with erection rigidity≥60% （D60）， average erection rigidity （AER）， average erection tumescence circumference （AET）， rigidity activity unit （RAU） and tumescence activity unit （TAU） at the tip and base of the penis and the normal erection rates. Results In Trial 1， there were no statistically significant differences in NPTR parameters and normal rates between two groups on the second night （all P > 0.05）. The Richards-Campbell Sleep Questionnaire （RCSQ） score in the experimental group was higher than that in the control group （P < 0.001）. In Trial 2， NPTR parameters （D60_tip， D60_base， AER_base， RAU_tip， TAU_tip） on the first night were lower compared to those on the second night in the control group （all P < 0.05）， and there were no significant differences in normal erection rates （67.2% vs. 78.1%， P = 0.065）. Except for AET_tip （7.85（6.83，8.98） cm vs. 8.10（7.50，8.90） cm， P = 0.014）， there were no statistically significant differences in NPTR parameters and normal erection rates between two nights in the experimental group （all P > 0.05）. In comparison between two groups， the parameters on the first night （EEE， D60_tip， RAU_tip and TAU_tip）and those on the second night （EEE， D60_tip， D60_base， TED， RAU_tip， RAU_base， TAU_tip and TAU_base） in the experimental group were lower than those in the control group （all P < 0.05）. No significant difference was observed in the normal erection rates on the first night between two groups （67.2% vs. 65.6%， P = 0.852）， and the normal erection rate on the second night in the experimental group was lower than that in the control group （78.1% vs. 57.8%， P = 0.014）. In the experimental group， the RCSQ scores on two nights were higher compared to those in the control group， and the RCSQ scores on the first night were lower than those on the second night in both groups （both P < 0.05）. Conclusions NPTR measurement yields the first night effect. Nitrazepam can significantly inhibit the nocturnal penile erection. Improving sleep quality cannot eliminate the first night effect， whereas increase the false negative rate of NPTR measurement. Nitrazepam should be avoided in the NPTR measurement for patients with normal sleep， whereas it can be given for patients with sleep disorders or sleep difficulty after full consideration of the advantages and disadvantages.

Objective To identify hub genes associated with ferroptosis in the progression of diabetic nephropathy （DN） through bioinformatics analysis， offering novel insights into DN treatment. Methods Differentially expressed genes （DEGs） in DN were screened using RNA sequencing dataset GSE142025， and Gene Ontology （GO） and Gene Set Enrichment Analysis （GSEA） were utilized for functional annotation. Subsequently， the Weighted Gene Co-expression Network Analysis （WGCNA）was conducted to pinpoint key genes. Venn diagrams aided in identifying hub genes among ferroptosis-related genes （FRGs） common to DEGs and key genes. ROC curves were employed to assess the clinical diagnostic potential of these hub genes. Immunohistochemistry （IHC）was conducted to detect the expression levels of hub genes in DN patients and normal kidney tissues. Results 1 916 DEGs were identified between the DN and control （NC） groups. GO enrichment analysis revealed that DEGs were mainly involved in inflammation-related biological processes. GSEA analysis found significant enrichment in processes related to iron ion binding. Among 12 co-expression modules constructed by WGCNA， grey60， turquoise， and grey modules showed the highest correlation with DN. 188 key genes were selected from 3 modules based on the screening criteria， among which 2 were FRGs shared by DEGs， namely ceruloplasmin （CP） gene and lipocalin-2 （LCN2） gene. ROC curves confirmed high clinical diagnostic value of these two genes. IHC results showed upregulated expression of both two genes in DN patient samples （both P < 0.05）， consistent with the findings of bioinformatics analysis. Conclusion CP and LCN2 could be involved in the progression of DN by inhibiting ferroptosis， serving as promising biomarkers and treatment targets for DN.

Objective To investigate the key issues of clinical diagnosis and treatment of Zinner syndrome and reduce the misdiagnosis rate. Methods Clinical data of 1 case of Zinner syndrome were retrospectively analyzed. Zinner syndrome cases presenting hematuria， frequent urination and dysuria as initial manifestations were retrieved from PubMed， CNKI， Wanfang Data and Chongqing VIP until November 2022 by using the searching words of Zinner syndrome， renal agenesis and seminal vesicle cyst. Clinical characteristics， developmental characteristics and treatment methods were summarized. Results The 46-year-old male patient was admitted to the hospital because of “bladder space-occupying lesion for more than 8 years， hematuria with dysuria for 1 week”， and was diagnosed with Zinner syndrome by imaging examination. He successfully underwent “transurethral cystoscopy + transrectal pelvic mass puncture biopsy”， and was discharged from the hospital at postoperative 2 d. The patient was advised to continually receive anti-infection treatment after discharge. According to literature review， 16 cases of Zinner syndrome presenting with hematuria， dysuria and other urinary symptoms as the first manifestations were collected. All patients developed abnormalities in the urinary system by imaging examination. Surgical resection and puncture biopsy were the main treatment methods. Among 8 patients receiving follow-up， 7 cases did not recur， and 1 suspected recurrent case underwent puncture biopsy. Conclusions Zinner syndrome is mainly manifested with imaging characteristics of unilateral seminal vesicle cyst， ipsilateral renal agenesis and ipsilateral ejaculatory duct obstruction triad. Ultrasound， CT scan， and MRI are important diagnostic tools for Zinner syndrome. Laparoscopic seminal vesicle cystectomy can reduce the risk of recurrence.

Objective To analyze the factors influencing poor recovery of renal function in patients with severe unilateral hydronephrosis after relief of obstruction， providing evidence for predicting the recovery of renal function. Methods Clinical data of 55 patients with severe unilateral hydronephrosis and glomerular filtration rate （GFR） < 10 mL/min admitted to Tungwah Hospital from 2015 to 2022 were retrospectively analyzed. All patients underwent percutaneous nephrostomy for temporary relief of the obstruction. Based on the recovery of renal function， all patients were divided into the recovery group and non-recovery group， and the factors influencing renal function recovery after nephrostomy were collected and analyzed. Results Among 55 patients treated with percutaneous nephrostomy for severe hydronephrosis， renal function was recovered in 30 cases （54.5%）， and poor recovery in 25 cases （45.5%）. Univariate analysis showed no significant differences in terms of gender， side， body mass index （BMI）， history of diabetes mellitus， history of hypertension， pre-nephrostomy GFR， and urinary pH of the affected kidney between the recovery and non-recovery groups （all P > 0.05）. However， there were significant differences in age， renal parenchymal thickness， ratio of GFR of the affected kidney to total GFR， presence of renal infection， and post-nephrostomy urinary output of the affected kidney between two groups （all P < 0.05）. Further multivariate logistic regression analysis showed that a pre-nephrostomy ratio of GFR of the affected kidney to total GFR （OR=0.24， 95%CI 0.06-0.98） and a post-nephrostomy urinary output of the affected kidney （OR=0.04， 95%CI 0.01-0.25） were the independent influencing factors of poor recovery of renal function after nephrostomy. Conclusions Partial patients with severe unilateral hydronephrosis and a GFR <10 mL/min can obtain renal function recovery after temporary relief of obstruction via percutaneous nephrostomy. The pre-nephrostomy ratio of GFR of the affected kidney to total GFR <10% and post-nephrostomy urinary output of the affected kidney <400 mL/day are the independent influencing factors for poor recovery of renal function， which can guide clinicians in predicting renal outcome.

Autism research is evolving from a medical paradigm， which emphasizes deficits and interventions， to a neurodiversity paradigm that values autism as an integral part of human diversity. Historically， the medical paradigm’s focus on “rescue” efforts has distanced researchers from the autistic community， often failing to address the community’s real needs. In contrast， the neurodiversity paradigm advocates a comprehensive understanding of autism and the adoption of participatory research practices. This shift encourages active collaboration between researchers and autistic individuals， fostering inclusive knowledge production that is both meaningful and impactful for the autistic community. However， achieving this collaborative approach requires dismantling social barriers， such as power imbalances， that hinders effective partnership. This article explores the principles and practice of a neurodiversity-aligned participatory research approach and proposes a co-production framework designed to support researchers and the autistic community in advancing autism research that is relevant， respectful， and responsive.

The incidence of allergic diseases is gradually increasing， and multi-system allergic diseases often co-occur in the same patient. It is very important to conduct comprehensive diagnosis and treatment with high quality， high efficiency， reasonable and standardized. The multi-disciplinary diagnosis and treatment provides a new way to solve the complicated and difficult comorbidities of allergic comorbidity and multimorbidity， which is an effective supplement to the traditional diagnosis and treatment mode， and is also the development trend of the diagnosis and treatment of allergic diseases. At present， the multi-disciplinary treatment of allergic comorbidity and multimorbidity is still in the exploratory stage at home and abroad， and has not yet formed a mature system or a operation mode. Based on the clinical exploration and practical experience of allergic disease expert team of the Third Affiliated Hospital of Sun Yat-sen University， this paper expounds the construction and implementation of the multi-disciplinary treatment system for allergic comorbidity and multimorbidity from the aspects of implementation objectives， organizational structure， basic requirements， operation mode， procedure， system guarantee， quality control and so on. Establishing a standardized， mature and perfect multi-disciplinary treatment system for allergic comorbidity and multimorbidity and ensuring its effective operation and implementation will help to improve the level of multi-disciplinary diagnosis and treatment for allergic comorbidity and multimorbidity.

Objective To evaluate the rehabilitation effect of innovative mirror therapy （MT） on the upper limb function and daily living activity ability of stroke patients. Methods Sixty patients with impaired hand function after stroke were enrolled and divided into the intervention （n = 30） and control groups （n = 30） according to the random number table method. Patients in the intervention group received conventional rehabilitation training combined with innovative MT， and those in the control group received conventional rehabilitation training and conventional MT. Before treatment and 4 weeks after treatment， the Fugl-Meyer Assessment Scale for the upper limb （FMA-UE）， the Fugl-Meyer Assessment Scale for the wrist and fingers （FMA-WH）， and the modified Barthel Index （MBI） were evaluated to compare the rehabilitation effects between two groups. Results After 4 weeks of treatment， the FMA-UE， FMA-WH， and MBI scores of patients in two groups were higher than those before treatment （all P < 0.05）. The FMA-UE， FMA-WH， and MBI scores in the intervention group were higher than those in the control group （50.00 （25.75， 57.25） vs.24.00 （9.75， 51.50）， 12.00（1.75， 14.75） vs. 0（0， 12.50）， 24.50（13.00， 28.75） vs.13.00（4.75， 21.00）， all P < 0.05）. The differences before and after treatment of FMA-UE， FMA-WH and MBI scores in the intervention group were all higher than those in the control group （all P < 0.05）. Conclusion Compared with traditional MT， innovative MT yields higher efficacy in improving the upper limb function and enhancing daily living capability of patients with impaired hand function after stroke.

Bronchial asthma is a common chronic inflammatory disease of the lung， which can cause great health problems and socioeconomic burden. In recent decades， the prevalence of asthma in China has been increasing， and multiple factors have synergistically affected the progress of asthma. More and more studies have found that lipid metabolism disorders play an important role in the development of asthma. High density lipoprotein （HDL） has the functions of reverse cholesterol transport （RCT）， regulation of inflammation and anti-oxidation， and is also involved in the regulation of the immune system and lipid metabolism. Previous studies have shown that serum HDL is associated with the occurrence of asthma. The level of HDL in patients with severe asthma and acute exacerbation of asthma is low.

Obesity， as a global health issue， presents significant challenges in its treatment and management， particularly the phenomenon of weight regain. This not only undermines the effectiveness of weight loss efforts but may also have further impacts on the physical and mental health of patients. This article delves into the issue of weight regain during the treatment of obesity， analyzing its definition， prevalence， and health implications. It elucidates the biological mechanisms of weight regain from aspects such as the body weight set-point theory， metabolic adaptation， immune cell phenotypic changes， lipid metabolism， and appetite regulation. A comprehensive management strategy is proposed， including lifestyle adjustments， continuous pharmacological treatment， surgical intervention， and multidisciplinary collaboration， aiming to achieve long-term weight control in obese patients. The study emphasizes the continuity and individualization of weight management， providing scientific guidance for clinical practice.

The severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） is still spreading widely around the world， and it is estimated that there are more than 760 million confirmed cases of SARS-CoV-2 infection （COVID-19）. Although most of the infected patients can be cured， there are still many patients who experience persistent clinical symptoms such as dizziness， fatigue， weakness， coughing and chest pain， etc. at two to three months or even longer after being infected with SARS-CoV-2. Internationally， this type of discomforts is referred to as long COVID. The emergence of long COVID has brought a new crisis to people’s health， which not only affects the quality of life and work of patients， but also brings great pressure on the health care of the society. Continuously exploring the impact of long COVID and its underlying mechanism， developing health management strategies for long COVID， and better prevention and treatment of long COVID are still the focus of research worldwide. The article introduces the definition of long COVID and reviews recent research progress in its underlying mechanism， common systemic clinical manifestations， risk factors， and health management of long COVID， aiming to provide more ideas for deepening clinicians’ understanding of long COVID.

Ferroptosis suppressor protein 1 （FSP1） is a key suppressor in the process of ferroptosis， which can prevent cell death and has important biological functions and potential value in clinical application. In this article， the discovery background， gene localization and structural characteristics of FSP1， as well as its dual role in inhibiting ferroptosis and promoting apoptosis were explicitly discussed. In clinical researches， FSP1 inhibitors， such as iFSP1 and icFSP1， have been developed. Subsequently， the regulatory mechanisms of FSP1 expression， its association with tumor immune escape， and its potential as a monitoring indicator for tumor prognosis and therapeutic response will be investigated.

The “Enhanced perceptual functioning model” and the “Veridical mapping model” have been proposed to explain the presence and nature of special abilities in autism. Here， we propose an important update to these two models， by combining them with autistic idiosyncratic language development. The “special abilities” of individuals with autism are achieved by redirecting language analyzers toward structured， yet socially unbiased material， which explains how these special skills extend language processing to materials beyond language. Calendar calculation serves as a test of this theory， in which language analyzers are redirected to calendars， a possible consequence of non-social learning. Non-social learning itself results from the bifurcation caused by the absence of social bias in overall information processing. The longitudinal and operational properties of calendar calculation are analogous to the language learning and processing characteristics of neurotypical populations. Combining the “hijacking” of human language analyzer and directing it towards non-communicative， language-like material provides a concise explanation for the common features of most autistic special abilities and integrates and enriches the “Veridical mapping model”.

Objective To investigate the median effective dose （ED₅₀） of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine under opioid-free anesthesia （OFA）. Methods Adult patients aged 18-59 years with body mass index （BMI）<30 kg/m² and ASA grade Ⅰ or Ⅱ were selected for endotracheal intubation general anesthesia. Dixon sequential method was adopted. The initial dose of esketamine was 0.5 mg/kg， and the dose of the next patient was determined according to the tracheal intubation response. The ratio of adjacent doses was 1:1.1. The ED₅₀ and 95% confidence interval （CI） of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine OFA were calculated. Results A total of 29 patients were included for statistical analysis. Tracheal intubation reaction was positive in 15 cases （positive group） and negative in 14 cases （negative group）. In the positive group， 3 cases had cough reaction during tracheal intubation. The ED₅₀ of esketamine for inhibiting tracheal intubation response during the induction of dexmedetomidine combined with lidocaine OFA was 0.448 mg/kg， and the corresponding 95%CI was 0.421-0.476 mg/kg. Conclusion In the OFA of esketamine combined with dexmedetomidine and lidocaine， 0.448 mg/kg of esketamine results in 50% of the maximum response intensity for inhibiting tracheal intubation response.

Genetic variation is one of the important factors leading to the incidence and development of cancer. Copy number variation is an important source of genetic diversity， which can be expressed as gene amplification or deletion in structure， and is related to the occurrence and development of different tumors. High-throughput sequencing and gene chip technology can be adopted to detect the variation of copy number， and provide relevant information about tumor molecular characteristics， prognosis and treatment， which is conducive to more accurate diagnosis and treatment decisions for patients in clinical practice. Ovarian cancer is one of the female reproductive system diseases with the highest mortality rate. Understanding its pathogenesis is of significance for improving the survival rate of ovarian cancer. At present， the specific role and mechanism of copy number variation in ovarian cancer are still unclear. In this article， relevant copy number variation in ovarian cancer was reviewed based on the existing research results， aiming to provide novel ideas and methods for the prevention， diagnosis and treatment of ovarian cancer.

Cytokines are small molecular proteins released by activated immune cells or non-immune cells. Cytokines can play a wide range of biological roles in immune regulation and the incidence and progression of immune diseases by selectively binding with specific signals and activating the downstream immune signal transduction pathway. Encouraging efficacy has been achieved in the application of antibody-based cytokines or cytokine receptor monoclonal antibodies in the treatment of related immune diseases. Nevertheless， the high cost of administration based on monoclonal antibodies makes it unaffordable for patients. Aptamers， also known as chemical antibodies， are oligonucleotide fragments synthesized in vitro and obtained by artificial screening， which can specifically bind to multiple target molecules with high affinity. Compared with antibodies， aptamers have the advantages of low cost， low immunogenicity and convenient modification. Hence， the potential application prospect of functionalized aptamers in targeted therapy of immune diseases has attracted more and more attention from researchers. In this article， chemical modification of specific aptamers related to 8 types of cytokine aptamers （IL-1α， IL-6， IL-17， TNF-α， TGF-β， IFN-γ， MCP-1 and IP-10） which play critical roles in immune regulation was reviewed， the research progress in their application in the treatment for immune and immune-related diseases was summarized， and the potential application of aptamer drugs in precise targeted therapy for specific immune diseases was briefly predicted.

Pulmonary fibrosis （PF） is a chronic progressive lung disease that poses a serious health risk. It is mainly characterized by abnormal fibrosis and scarring of lung tissues， resulting in the gradual replacement of alveoli with fibrous tissues and ultimately respiratory failure， posing a serious threat to human health. To date， the treatment of PF has been a formidable challenge. However， in recent years， with the rise of precision medicine concepts and emerging therapies， the understanding and treatment strategies of PF have been ever advanced. This article provides a comprehensive review of recent research advances in PF within the field of precision medicine， from the perspectives of both molecular biology and genetics， as well as emerging therapeutic strategies， aiming to reveal the potential for tapping into emerging therapeutic strategies using molecular biological tools such as high-throughput bioinformatics technology and analysis. In-depth understanding of these advances can help to better elucidate the pathophysiological processes of PF and provide novel ideas and strategies for future clinical practice， thereby improving patients’ clinical prognosis and quality of life.

Atherosclerosis is a common vascular disease， which is characterized by lipid deposition and related inflammatory reactions. Vulnerable atherosclerotic plaque is the main pathological cause of acute cardiovascular events. Therefore， early detection and timely interventional treatment of vulnerable plaques are of clinical significance. Although a variety of clinical methods have been developed for the diagnosis and treatment of vulnerable plaques， the acute clinical events caused by vulnerable plaques frequently occur. Nanoparticles have shown huge potential in this regard. Nanoparticles are widely applied in imaging because their unique optical properties can efficiently label tissues and cells to detect the state of disease. Metal nanoparticles can achieve high-resolution imaging， which can also be used as drug delivery carriers to improve therapeutic effect. In this article， recent research progress in the use of nanoparticles in targeted diagnosis of vulnerable atherosclerotic plaques was reviewed， and the future development of nanoparticles in related fields and the challenges and opportunities for clinical transformation were also illustrated.

Fractional exhaled nitric oxide （FeNO） is a biomarker of type 2 inflammation， and produced by nitric oxide synthase （NOS） expressed on the airway epithelial cells， with the substrates of L-arginine and oxygen. Type 2 cytokines such as interleukin （IL）-4 and IL-13 can up-regulate inducible NOS， which results in the abundant production of NO. NO plays an important role in the pathogenesis of bronchial asthma， and is closely associated with the airway inflammation and remodeling， reduction of lung function and eosinophil infiltration， etc. The technique of FeNO test is applied in the clinical diagnosis of asthma， predicting the response to steroids and evaluating the compliance of asthmatic patients. In recent years， it also plays a guiding role in choosing the optimal biologics for individual therapy for patients of asthma. As a non-invasive， convenient， and economical method， the role of FeNO in the diagnosis and treatment of asthma will be better understood and applied.

The long-term survival rate of patients with hepatocellular carcinoma （HCC） is poor， and drug efficacy is an important factor affecting clinical prognosis. N6-methyladenosine （m⁶A） modification is the most abundant modification in eukaryotic RNA， which can affect the occurrence and development of HCC and drug efficacy by regulating cancer-related biological functions. However， the role of m⁶A modification in HCC drug treatment has not been fully elucidated. Therefore， the biological functions of different regulatory members of the m⁶A modification process （methyltransferase， demethyltransferase and binding protein） in HCC drug treatment were illustrated， proposing that regulatory members of the m⁶A modification process can be used as biomarkers for HCC prognosis evaluation and have the potential to become therapeutic targets and providing novel insights for HCC precision medicine.

Persons with prototypical autism often present unique strengths that traditional intelligence assessments overlook， together with absence of oral language at the preschool age. Here， we propose a strengths-based approach in understanding and engaging with non-verbal autistic children. It emphasizes recognizing unique intellectual abilities often masked by communication challenges and conventional understanding of repetitive behaviors. By observing these children’s interests in structured objects， patterns， and screens， caregivers and clinicians can gain insights into their cognitive potential. We then present methods to leverage autistic strengths to support wellbeing of the families， including using “lateral tutorship” —a non-intrusive， side-by-side engagement method—as a way to connect with autistic children， respecting and utilizing their intrinsic learning style.

Pancreatic schwannoma is an extremely rare neurogenic tumor， lacking of specific clinical manifestations and imaging signs. It is difficult to make a definite diagnosis before operation， and it is frequently misdiagnosed with other benign and malignant tumors of the pancreas. In this article， the diagnosis and treatment of a patient with pancreatic schwannoma were reported. The 44-year-old female patient was admitted to the hospital because of pancreatic mass found by physical examination for 5 days. Abdominal enhanced CT scan showed pancreatic body mass， approximately 6.4 cm×5.4 cm in size. The patient underwent middle pancreatectomy and distal pancreatic stump jejunum Roux-en-Y anastomosis. Postoperative pathological report was consistent with pancreatic epithelioid schwannoma. During the follow-up of 2 years， no tumor recurrence or metastasis was found. This case provides clinical reference for clinicians to diagnose and treat pancreatic schwannoma.

Chronic nasal inflammation， such as rhinitis and sinusitis， is a common chronic disease that affects people’s quality of life for a long period of time. Its pathogenesis and mechanism are still unclear. The establishment of animal models is an effective approach to explore the pathogenesis， among which the establishment of mouse models of chronic nasal inflammation has been rapidly developed in recent years. The aim of this review is to summarize the research status of chronic rhinosinusitis and allergic rhinitis modeling in mice at home and abroad， especially the progress in eosinophilic chronic rhinosinusitis mouse models， which plays an important role in the development of new drugs to prevent and control chronic nasal inflammation or further elucidation of its pathogenesis.

Objective To understand the distribution of allergens in different altitude areas of Yunnan Province and evaluate the impact of meteorological factors on the sensitization rate of allergens， providing a theoretical basis for formulating reasonable allergen screening programs in different regions of Yunnan Province. Methods A retrospective analysis was conducted in children with allergic rhinitis （AR） admitted to Department of Otolaryngology of Kunming Children’s Hospital from January 2022 to December 2023， and their permanent places of residence were Xishuangbanna prefecture， Dehong prefecture， Honghe prefecture， Zhaotong， Kunming， Dali prefecture， and Diqing prefecture. Skin prick tests （SPT） were performed， and the positive results of SPT and demographic data were analyzed. At the same time， the relationship between altitudes and meteorological factors and allergens was analyzed by considering the altitudes of these seven regions and meteorological data （average temperature， average annual relative humidity， average annual wind speed， and average annual precipitation） during the same period. Results A total of 8， 175 data sets were collected. Under different meteorological and altitude conditions， the positive rate of SPT for dust mites and partial pollen allergens showed significant differences （all P < 0.05）， and dust mites remained the main allergen even at high altitudes. The positive rate of dust mite SPT was positively correlated with the average annual temperature and negatively correlated with the altitude （both P <0.05）； the positive rate of pollen SPT was negatively correlated with the average annual relative humidity （P < 0.05）； the positive rate of dust mite SPT was increased with age （P < 0.05）. Conclusion The distribution of allergens in different meteorological and altitude areas of Yunnan Province may vary， and personalized diagnosis， treatment， prevention programs need to be formulated.

Objective To evaluate the application value of the MRI-based three-dimensional （3D） reconstruction of pelvic autonomous nerves and surrounding organs in laparoscopic D3 radical resection for rectal cancer. Methods Fifty-six patients with rectal cancer were randomly divided into the reconstruction and control groups. In the reconstruction group， surgical plans were formulated based on preoperative MRI 3D reconstruction. In the control group， conventional surgical plans were formulated. Intraoperative and postoperative functional recovery-related indicators were compared between two groups. Results The 3D reconstruction model provided individualized visualization of the distribution relationship between the pelvic autonomous nerves and surrounding organs. Compared to the control group， patients in the reconstruction group had significantly shorter operation time （（143.7±13.3）min vs. （151.5±12.1） min， P = 0.040）， less blood loss （（31.3±12.1） mL vs. （39.4±11.6） mL， P = 0.024））， improved IPSS score （（6.0±1.3） vs. （7.9±2.6）， P = 0.003）， and shorter duration of urinary catheter removal （2.0（2.0， 2.0）d vs. 3.5（3.0， 4.0）d， P < 0.001）. Conclusions MRI-based 3D reconstruction of pelvic autonomous nerves provides a more precise visualization of the anatomical position of the pelvic autonomous nerves and surrounding organs， ultimately improving the efficiency and safety of D3 resection. It offers important reference for surgeons in formulating precise and individualized surgical plans.

Adult-onset latent autoimmune diabetes （LADA） represents an autoimmune form of diabetes that emerges in the adult population. Frequently， individuals with LADA are initially misdiagnosed as type 1 or type 2 diabetes mellitus. Nonstandard management of LADA patients can impede efforts to preserve the remaining functionality of pancreatic islet beta-cells，elevate the risk of early complications of diabetes and increase the mortality rate. This review offers a comprehensive examination of various biomarkers， encompassing genetic factors， transcriptional profiles， proteins， metabolomic markers， and inflammatory indices， which may be employed to forecast the onset of LADA， aiming to facilitate prompt recognition and diagnosis of LADA， thereby retarding the progressive deterioration of pancreatic islet beta-cell function.

This review provides an overview of the evolution and perceptions of the concept of autism within Western and Chinese contexts， as well as the perceptions of various groups toward official and related terminology. It emphasize the importance of language in constructing social cognition and values of autism， offering a guide to the translation， interpretation and usage of autism-related languages in Chinese. The discourse in the West surrounding “person-first language” and “identity-first language” reflects divergent perspectives on identity within the autistic community. In the Chinese context， the discourse on autism is largely led by professionals， with societal understanding of autism often shaped by medical and charity perspectives. Different Chinese users construct and perceive autism-related terms in diverse ways. The medical terms “孤独症” （gūdú zhèng） and “自闭症” （zìbì zhèng） carry stigmatizing connotations， especially “zìbì zhèng，” which， due to its negative association with self-imposed isolation， is often linked with negative labels such as “dangers” or “burdens.” Terms like “星星的孩子” （xīngxīng de háizi） and “闭娃” （bì wá）， despite their popularity， are criticized by the autistic community for their romanticized and demeaning connotations， and for overlooking adult autistic individuals. The term “孤独症谱系障碍” （gūdú zhèng pǔxì zhàng’ài） is preferred for its lesser stigmatizing implications. Autistic individuals prefer neutral and non-pathologizing expressions. This review calls for discussions of autism in the Chinese context to focus on individual experiences， respect their subjectivity， reflect on potential ableist tendencies， and promote the concept of neurodiversity， to foster a more comprehensive and inclusive societal understanding and acceptance of autistic people.

Objective To systematically review the progress in the application of artificial intelligence in the field of pediatric otolaryngology-head and neck surgery at home and abroad， aiming to provide reference for the development and clinical practice in the future. Methods Literature related to the application of artificial intelligence in otolaryngology，head and neck surgery were searched from PubMed， Web of Science and Embase databases in June 2024， regardless of the research type， publication date and language restrictions. Subsequently， using the National Heart， Lung， and Blood Institute Study Quality Assessment Tools （NHI-SQAT） and the Oxford 2011 Levels of Evidence （LOE）， tables were designed to assess the quality of the articles and select authentic and effective literature. Literature content was extracted， and a systematic review of current status and future prospects of artificial intelligence in this field was conducted. Results After preliminary screening of abstracts and titles， full-text reading， supplementary retrieval， and exclusion of literature that did not meet quality standards， a total of 38 articles were finally included. Artificial intelligence has been widely used in the diagnosis and treatment of pediatric otolaryngological diseases in various forms. Significant clinical effects have been achieved through methods such as machine learning and big data processing， enabling surgical assistance and the establishment of diagnostic and treatment models. In recent research， the diagnosis and treatment of pediatric otitis media， assessment of pediatric hearing loss， preoperative planning and postoperative guidance， and telemedicine are becoming the main directions of exploration and application of artificial intelligence. Conclusions Application of artificial intelligence in pediatric otolaryngology head and neck surgery at home and abroad has been gradually extended in recent years. As the use of artificial intelligence in assisted diagnosis and treatment has been gradually accepted by the medical community， the application platform for artificial intelligence will become diversified in the future.

In clinical practice， the application of surface disinfectants for skin disinfection is a prerequisite for venipuncture. Chlorhexidine， a widely recognized disinfectant， is frequently employed for this purpose. However， during intravenous infusions， minute quantities of chlorhexidine can be inadvertently introduced into the bloodstream via the puncture needle， potentially precipitating immediate-type （type ） hypersensitivity reactions. Regrettably， these reactions are often erroneously attributed to administered medications， such as antibiotics， which can result in both misdiagnosis and underdiagnosis. This article details a case of an allergic reaction that occurred subsequent to multiple intravenous infusions and was ultimately identified as chlorhexidine-induced after antibiotic allergy was ruled out. The objective of this report is to deepen the clinical physcians’ comprehension of chlorhexidine-induced allergies in the context of infusion-related allergic reactions， thereby offering a valuable reference for accurate diagnosis and effective treatment strategies.

Objective To identify lactylation-related molecular subtypes， construct a prognostic model， and predict immunotherapy efficacy in ovarian cancer （OC）. Methods The prognostic significance of lactylation-related genes （LRGs） was analyzed using data from TCGA-OV， GSE63885， and GSE26193 datasets. Unsupervised clustering identified four distinct lactylation-related clusters （LRGClusters）. Differential expression and Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses were performed for these clusters. Using univariate Cox regression analysis （P < 0.0001）， five prognostic-related genes （PRGs） were identified. The expression levels of these PRGs in normal ovarian tissues， as well as early and advanced-stage ovarian cancer tissues were validated via RT-qPCR. Based on the five PRGs， a second round of unsupervised clustering was conducted to identify two gene clusters （geneClusters）， and a prognostic scoring system， termed LactyScore， was developed. Immune cell infiltration， immunotherapy response， and drug sensitivity analyses were then performed based on LactyScore stratification. Results Four LRGClusters and two geneClusters were identified. Five differentially expressed genes including COL16A1， SPEN， AHDC1， LUZP1， and SDF2L1 were significantly associated with prognosis of OC patients. RT-qPCR indicated that SPEN， COL16A1， AHDC1， and LUZP1 were the potential risk factors for poor prognosis， whereas SDF2L1 might serve as a protective factor. Based on these PRGs， the LactyScore prognostic scoring system was established. Survival analysis revealed that patients in the high LactyScore group exhibited significantly better overall survival compared to those in the low LactyScore group. Moreover， patients with a high LactyScore showed increased immune evasion potential and lower response rates to immunotherapy. Conclusions Five prognostic genes including COL16A1， SPEN， AHDC1， LUZP1， and SDF2L1 are associated with OC and these genes demonstrate their potential as biomarkers for OC. Furthermore， the development of the robust LactyScore system offers an accurate tool for predicting OC prognosis and immunotherapy responsiveness， providing insights for personalized therapeutic strategies.

Objective To evaluate the diagnostic value of total serum immunoglobulin E （IgE） levels， eosinophil （EOS） count and percentage in the diagnosis of allergic rhinitis （AR）， and to construct a diagnostic model for preliminary diagnosis of AR by combining total serum IgE and EOS. Methods Clinical data of 305 AR patients and 256 non-AR patients admitted to Department of Otolaryngology at the First Affiliated Hospital of Chongqing Medical University from April 2023 to April 2024 were retrospectively analyzed. The general information， total serum IgE level， EOS count and percentage were compared between two groups. Binary logistic regression analysis was used to screen for suitable indicators to construct the predictive model， and the receiver operating characteristic （ROC） curve was plotted. The area under the ROC curve （AUC） was used to determine the predictive value of this model. Clinical data from 216 patients with and without AR admitted to Department of Otolaryngology at the First Affiliated Hospital of Chongqing Medical University from June 2019 to June 2022 were collected for external validation. Stratification analysis was performed according to age [adolescent group （≤ 18 years old）， youth group （19-45 years old）， middle-aged group （46-60 years old）， and elderly group （> 60 years old）]， respectively. Results The percentage of EOS and total serum IgE level were the influencing factors of AR in the overall and all age groups. The combined diagnostic model for all patients was： Logit P = -4.174+6.856EOS count+ 0.048total serum IgE. Diagnostic model in adolescent group was： Logit P = -4.472+0.637EOS percentage+0.034total serum IgE； youth group： Logit P = -4.491+0.372EOS percentage+0.068total serum IgE； middle-aged group： Logit P = -4.759+5.768EOS count+ 0.062total serum IgE； elderly group： Logit P = -4.888+0.855EOS percentage+0.028total serum IgE， respectively. Hosmer-Lemeshow goodness-of-fit test， ROC curve analysis and external validation all indicated that this model had high diagnostic value. Conclusion The combination of total serum IgE levels and EOS count demonstrates good diagnostic value for AR in different age groups， which can be used to guide preliminary diagnosis of AR.

Objective To investigate the correlation between Glasgow score and blood inflammatory markers before treatment with the efficacy of nasopharyngeal carcinoma. Methods Cases from the two clinical centers were divided into training set and validation set， and the clinical characteristics of the two groups were compared to be balanced. To search the independent prognostic risk factors of nasopharyngeal carcinoma and then the prognostic index of each patient was calculated， and the patients were divided into high-risk， intermediate-risk and low-risk groups. Further validation in the validation set. Results Cox multivariate analysis of the training set showed that age >50， T3-T4， N2-N3， GPS score of 1-2， NLR>2.5， and LMR≤2.35 before treatment were poor prognostic factors affecting the 5-year disease-specific survival rate of patients with nasopharyngeal carcinoma. Conclusion The combination of GPS， NLR， LMR and age， TNM staging may provide a new way for the prognosis evaluation of patients with nasopharyngeal carcinoma before treatment.

Objective To investigate the role of ultrasound-guided volume resuscitation in the treatment of severe trauma. Methods Sixty patients with severe trauma requiring surgical intervention were included and randomly assigned into the ultrasound-guided volume resuscitation group （group U， n = 30） and the empirical treatment group （group C， n = 30） using the random number table method. All patients underwent general anesthesia induction， central venous catheterization and subsequent surgery. In group U， ultrasound examination was conducted for assessing the inferior vena cava （IVC）， aortic root peak velocity variation （ΔV_peak） and time integral variation of aortic root velocity （ΔVTI） upon arrival at the operating room， after general anesthesia induction， at the end of operation and upon resuscitation， respectively. Fluid resuscitation therapy in group U was guided based on these results. In group C， patients were subjected to fluid resuscitation based on heart rate （HR）， mean arterial pressure （MAP）， central venous pressure （CVP）， fluid load test and blood gas analysis results， etc. Radial artery blood samples were collected from all patients immediately upon arrival at the OR （T₀）， at 1 h （T₁）， 2 h （T₂）， 4 h （T₃）， 6 h （T₄）， and 24 h （T₅） post-arrival， and lactate levels along with other blood gas analysis results were recorded accordingly. Additionally， the total amount of crystalloids and colloids administered from 0-<1 h，1-<2 h， 2-<4 h， 4-6 h， and 0-6 h since arrival were documented. The operation time， anesthesia duration， postoperative recovery time， extubation time， blood loss volume， urine output， duration of hypotension， duration of elevated lactate levels， length of hospital stay， ICU transfer rate， 28-d mortality rate， and the total amount of norepinephrine use were recorded. Results Compared with T₀， lactate levels in group U exhibited an increase at T₁ and T₂， and followed by a return to normal levels at T₄. In group C， an elevation in lactate levels was demonstrated at T_1~T₃， which subsequently decreased to normal levels at T₅. Patients in group U displayed lower lactate levels at both T₂ and T₃ than those in group C. Additionally， patients in group U exhibited reduced overall usage of norepinephrine and a shorter duration of elevated lactate levels. Moreover， patients in group U received a higher volume of crystalloid fluids during the initial hour （0-<1 h）， and lesser amounts during 2-<4 h and 4-6 h as well as overall within 0-6 h， respectively. Furthermore， compared to the group C， there was less administration of colloid fluids during 2-<4 h and overall within 0-6 h in group U （all P < 0.05）. However， no statistically significant differences were observed in the operation time， anesthesia duration， postoperative recovery time， extubation time， length of hospital stay， intraoperative blood loss， transfusion volume， oxygenation index， urine output or duration of hypotension between two groups （all P > 0.05）. Conclusion Ultrasound-guided volume resuscitation can be safely employed in severe trauma patients， which can reduce the total amount of transfusion， decrease the total dosage of vasoactive medications， and shorten the duration of elevated lactate levels.

Objective To evaluate the impact of atypical sensory response patterns on the development of initiating joint attention （IJA） abilities in toddlers， further exploring the early developmental mechanisms of autism spectrum disorder （ASD）. Methods Forty infants at 12 months of age were followed up and divided into three groups at 24 months of age： ASD， developmental differences （D/D）， and typical development （TD） groups. The Toddler Sensory Profile Second Edition （TSP-2） was used to assess the degree of atypical sensory response patterns. Interactive videos were coded to evaluate IJA abilities. Linear regression analysis was employed to assess the relationship between sensory responsiveness and IJA abilities. Results The sensory seeking and registration scores at 12 months of age and the sensory seeking score at 24 months of age in ASD toddlers were negatively correlated with IJA frequency （r_s = -0.735， P = 0.015； r_s = -0.635， P = 0.048； r_s = -0.680， P = 0.030）， while the sensory sensitivity and avoiding scores at 12 months were positively correlated with the development of IJA frequency（r_p= 0.674， P = 0.047； r_p= 0.818， P = 0.007）. Conclusions Higher levels of sensory seeking and registration in ASD toddlers will affect their current IJA abilities. However， higher levels of sensory sensitivity and avoiding predict a better developmental trend in IJA abilities.

Objective To investigate the clinical features and risk factors of sepsis-induced cardiomyopathy in children with sepsis， aiming to provide reference for enhancing the diagnosis and treatment levels of clinicians. Methods Clinical data of children with sepsis were retrospectively analyzed. All patients were divided into the sepsis-induced cardiomyopathy group and non-sepsis-induced cardiomyopathy group according to whether sepsis-induced cardiomyopathy occurred.Clinical characteristics and outcomes were compared between two groups. The risk factors of sepsis-induced cardiomyopathy were analyzed. Results Three hundred and ninty-eight children with sepsis were included in this study， and the incidence of sepsis-induced cardiomyopathy was 15.58%（62/398）. The age of children in the sepsis-induced cardiomyopathy group was 49 （18， 108） months， older than 19 （6， 52） months in the non-sepsis-induced cardiomyopathy group. The incidence of septic shock in the sepsis-induced cardiomyopathy group was 83.87%（52/62）， which was higher than 42.56% （143/336） in the non-sepsis-induced cardiomyopathy group. The mortality rate in the sepsis-induced cardiomyopathy group was 29.03% （18/62）， significantly higher than 14.58% （49/336） in the non-sepsis-induced cardiomyopathy group. All differences were statistically significant （all P < 0.05）.Multivariate Logistic regression analysis showed that the influence of age on sepsis-induced cardiomyopathy was statistically significant （OR=1.010， 95%CI 1.003-1.017， P = 0.006）. The higher the lactic acid level， the higher the risk of sepsis-induced cardiomyopathy， with statistical significance （OR=1.163， 95%CI 1.034-1.308， P = 0.012）. The higher the cTnI level， the higher the risk of sepsis-induced cardiomyopathy， with statistical significance （OR=9.929， 95%CI 4.651-21.197， P < 0.001）. Conclusions Compared with children with non-sepsis-induced cardiomyopathy， children with sepsis-induced cardiomyopathy are more prone to septic shock and have higher mortality. Age， lactic acid and cTnI levels are the independent influencing factors for sepsis-induced cardiomyopathy in children.

With the increasing maturity of neonatal intensive care technology， the survival rate of premature infants has been increased significantly. At the same time， the incidence of brain injury has also been elevated year by year， and most of the affected children are complicated with early clinical manifestations and long-term sequelae of nervous system injury. Therefore， finding a simple and effective diagnostic method to improve the quality of life of premature infants has become a key problem to be solved urgently in the current field. In recent years， more and more biological markers of brain injury have been studied and applied to the early diagnosis and prognosis assessment of brain injury in premature infants. This article reviews the domestic and international research progress on these biological markers， aiming to provide reference for the early diagnosis and prognosis assessment of brain injury in premature infants.

Objective To explore the differences of etiology of recurrent implantation failure （RIF） and recurrent pregnancy loss （RPL）. Methods Patients with RIF （n = 315） and patients with RPL （n = 376） admitted to the Reproductive Center of the First Affiliated Hospital of Sun Yat-sen University from June 2018 to June 2021 were included. General and etiological data were collected to compare the differences in baseline data and etiological composition. Relative risk factors of the etiology of these two conditions were identified by multivariate regression analysis. Results Univariate analysis showed a significantly higher proportion of chronic endometritis， endometrial polyps， endometriosis， endometriosis complicated with polyps， diminished ovarian reserve and a significantly lower proportion of unexplained cause in the RIF group than in the RPL group （all P <0.05）. Multivariate logistic regression analysis showed that the incidence of chronic endometritis （OR=3.044， 95%CI 1.849-5.011， P < 0.001）， endometrial polyps （OR=3.769， 95%CI 1.670-8.510， P < 0.001）， endometriosis （OR=3.812， 95%CI 2.131-6.819， P < 0.001） and diminished ovarian reserve （OR=2.175， 95%CI 1.285-3.683， P = 0.004） in the RIF group was significantly higher than that in the RPL group. The proportion of patients with lower anti-Mullerian hormone levels （OR=0.917， 95%CI 0.864-0.973， P = 0.004） in the RIF group was higher compared with that in the RPL group. Conclusion Chronic endometritis， endometrial polyps， endometriosis， decreased anti-Mullerian hormone level and diminished ovarian reserve are more common in RIF patients， and the screening and monitoring of the above lesions should be strengthened in the subsequent practice of assisted reproduction.

Short-lasting unilateral neuralgiform headache attacks is a rare type of primary headache， which is usually accompanied by ipsilateral conjunctival congestion and （or） lacrimation and other autonomic symptoms during episodes， and generally presents a chronic course. Most patients repeatedly seek medical attention due to ineffective diagnosis and treatment， causing great suffering and severely affecting their quality of life. Currently， in clinical practice， short-lasting unilateral neuralgiform headache attacks has not been sufficiently recognized. Due to its rarity， there is a lack of related research in China， hence there is an urgent need to improve clinicians'awareness and diagnostic and treatment level to reduce the rate of misdiagnosis. This article reviews the research progress in the epidemiology， pathophysiological mechanisms， clinical characteristics， diagnosis and treatment of short-lasting unilateral neuralgiform headache attacks， aiming to provide a more comprehensive reference for clinicians， thereby improving the effective diagnosis and treatment rate， helping patients to get rid of pain as soon as possible， and improving the quality of life. At the same time， it also calls for researchers at home and abroad to increase their research efforts on short-lasting unilateral neuralgiform headache attacks to provide more theoretical basis for clinical treatment.

Objective To investigate the effect of Shewanella algae （S.algae） on the occurrence and development of colorectal adenoma and its regulatory effect on the immune microenvironment in mice. Methods Twenty-four mice were divided into three groups： control group， azoxymethane （AOM）/ dextran sodium sulfate （DSS） group， AOM/DSS+S.algae group. The survival status and colorectal adenoma of mice were compared among three groups. Colorectal tissues in the AOM/DSS group and AOM/DSS+S.algae group were collected for high-throughput RNA-seq. Gene set enrichment analysis （GSEA）and cell-type identification by estimating relative subsets of RNA transcripts （CIBERSORT） were used to analyze the changes of immune-related pathways， immune cells and immune factors. Results Compared with the AOM/DSS group， the body weight （P < 0.05） and survival rate were decreased， the hematochezia was aggravated， the survival status was worsened，the colorectal length was shortened （all P < 0.05）， and the average number and size of adenomas were significantly increased （both P < 0.05） in the AOM/DSS+S.algae group. Compared with the AOM/DSS group， the inflammatory responses were significantly enhanced in AOM/DSS+S.algae group （P < 0.05）. The production of pro-inflammatory cytokines including interleukin （IL）-2， IL-6， IL-12， IL-17， interferon （IFN）， tumor necrosis factor （TNF） （all P < 0.05） and IL-1β showed an upward trend in the AOM/DSS+S.algae group， while the production of anti-inflammatory cytokines including IL-4， IL-10， IL-13 （all P < 0.05） and transforming growth factor β showed an inhibitory trend. Both naive B cells and plasma cells （both P < 0.05） were increased in AOM/DSS+S.algae group， and the nuclear factor -κB （NF-κB） signaling pathway was activated. Conclusion S.algae may form a tumor-promoting immune microenvironment by activating immune signals， such as activation of B cells and activation of the NF-κB pathway， and then promote the development of colorectal adenoma.

Objective To evaluate the effect of intrauterine hyperglycemia exposure on inflammatory cytokine levels in neonatal umbilical cord blood and the incidence of allergic diseases in infants. Methods 112 pregnant women and their infants were enrolled. According to the glucose levels during pregnancy， all women were divided into the intrauterine hyperglycemia exposure （n = 55） and non-intrauterine hyperglycemia exposure groups （n = 57）. The levels of inflammatory cytokines in the umbilical cord blood were compared between two groups. During 1-year follow-up， the incidence of allergic diseases such as atopic dermatitis and wheezing in infants was compared between two groups. The impact of intrauterine hyperglycemia on neonatal immunity and infant allergic diseases was evaluated. Results There were no significant differences in the levels of IL-1β， IL-2， IL-6， IL-8， IL-10， IL-12 and TNF-α between two groups （all P > 0.05）. In the intrauterine hyperglycemia exposure group， the IL-4 level in the umbilical cord blood was （30.180±8.648） pg/mL， significantly higher than （22.500±10.100） in the non-intrauterine hyperglycemia exposure group （P < 0.05）. In the intrauterine hyperglycemia exposure group， the incidence of allergic diseases was 34.7%， higher compared with 24.0% in the non-intrauterine hyperglycemia exposure group during 1-year follow-up. However， there was no significant difference between two groups （P > 0.05）. Conclusion Intrauterine hyperglycemia exposure exerts certain effect on the IL-4 level in the neonatal cord blood， which may provide evidence for early intervention of allergic diseases.

Objective To evaluate the efficacy of repetitive facilitative exercise combined with low-frequency acupoint electrical stimulation therapy in the recovery of patients with upper limb motor dysfunction after stroke. Methods Sixty-two patients with upper limb motor dysfunction after stroke were divided into the observation group （n =31） and control group （n =31）. Patients in the control group were treated with conventional rehabilitation training combined with low-frequency acupoint electrical stimulation in Department of Neurology， and those in the observation group were treated with repetitive facilitative exercise besides the interventions in the control group. The efficacy of the two groups was evaluated by Fugl-Meyer Motor Assessment （FMA） scale， Modified Ashworth scale （MAS） and Modified Barthel Index （MBI） scale before treatment and at 2 weeks after treatment， respectively. Results The FMA scores after treatment were significantly higher than pre-treatment scores in two groups， the FMA scores in the observation group were significantly higher than those in the control group， and the difference of the FMA scores between pre- and post-treatment in the observation group was significantly larger compared with that in the control group （all P <0.05）. After treatment， the MAS grade was decreased compared with that before treatment in two groups， and the degree of grade decrease in the observation group was greater than that in the control group （all P <0.05）. The MBI scores after treatment were higher than those before treatment in two groups， the MBI scores in the observation group were higher than those in the control group， and the difference of the MBI scores between pre- and post-treatment in the observation group was larger than that in the control group （all P <0.05）. Conclusion Repetitive facilitative exercise combined with low-frequency acupoint electrical stimulation therapy yields high efficacy in the recovery of upper limb motor function， mitigation of muscular spasm and improvement of daily living capability after stroke.

Circular RNAs （circRNA） are a class of multifunctional non-coding RNAs with a covalently ring structure， playing a variety of biological roles within cells. Chronic myelogenous leukemia （CML） is a myeloproliferative disorder originating from hematopoietic stem cells and progenitor cells. Although the current research on circRNA in CML is not yet comprehensive， evidence has shown that circRNA plays a significant role in the onset and progression of CML. This review summarizes the involvement of circRNA in CML， particularly focusing on its contribution to tyrosine kinase inhibitors （TKIs） resistance， and discusses the potential utility of circRNA for diagnosing and assessing prognosis in CML. The objective is to provide researchers with an up-to-date overview of the role of circRNA in CML and offer references for future research endeavors.

Objective To investigate the efficacy and safety of 4-week cluster immunotherapy with house dust mite extracts in patients allergic to house dust mites. Methods From August 2022 to May 2024， 80 patients with house dust mite-induced allergic rhinitis， complicated with or without asthma， were recruited from multiple centers （including Peking Union Medical College， et al） to undergo 4-week dose-escalation subcutaneous cluster immunotherapy with house dust mites. Patient symptoms， medication use， quality of life， asthma control test （ACT） results， as well as local and systemic adverse reactions were recorded at 0， 1， 6， and 12 months， respectively. Results Significant differences were observed in the daily total symptom scores （P < 0.001）， daily nasal scores （P < 0.001）， daily ocular scores （P = 0.009）， and total symptom and medication scores （P = 0.003） across different time points during cluster immunotherapy， respectively. Significant differences were also found in the activity RQLQ （P < 0.001）， sleep RQLQ （P = 0.002）， non-eye/nose symptom RQLQ （P = 0.032）， practical problems RQLQ （P < 0.001）， nasal symptom RQLQ （P < 0.001）， emotional RQLQ （P = 0.011）， total RQLQ （P < 0.001）， and children’s ACT scores （P < 0.001）， respectively. The longer the time， the lower the score. During the dose-escalation period， 22 patients （27.5%） experienced local adverse reactions， and 5 patients （6.3%） experienced systemic adverse reactions. A total of 35 （3.6%） injections resulted in adverse reactions， including 27 （2.8%） injections with local reactions and 8 （0.8%） injections with systemic reactions. Conclusion Four-week cluster immunotherapy with house dust mites shows significant efficacy in patients allergic to house dust mites.

Urinary tract infection is the most common infectious complication after kidney transplantation. To further reduce the incidence of urinary tract infection after kidney transplantation， improve the diagnosis and treatment level of urinary tract infection after kidney transplantation in China， prevent the development of bacterial drug resistance and ensure the safety and effectiveness of drug use， Branch of Organ Transplantation of Chinese Medical Association organized experts in the fields of kidney transplantation and infectious diseases to consider clinical status of urinary tract infection after kidney transplantation in China， refer to “Diagnosis and Treatment of Urological and Andrological Diseases in China （2022 edition）” and “Urinary Tract Infection in Solid Organ Transplant Recipients in American Society of Transplantation Practical Guidelines for Infectious Diseases （2019 edition） ”， and formulate “Guidelines for Clinical Diagnosis and Treatment of Urinary Tract Infection in Kidney Transplant Recipients in China” from the perspectives of clinical classification and definition， epidemiology and etiology， diagnosis and treatment of urinary tract infection after kidney transplantation， respectively.

Dermatophytosis is distributed worldwide， with a global prevalence of 20%-25%， while allergic diseases have a high prevalence of 10%-45% in the global population. In recent years， research on the correlation between dermatophytosis and allergic diseases such as allergic rhinitis， atopic dermatitis， and asthma has been reported successively， highlighting a previously overlooked relationship between dermatophytes and allergic diseases. This review summarizes the research progress on fungal allergens， the correlation between dermatophytosis and allergic diseases， as well as the mechanisms of interaction， aiming to provide insights for the clinical diagnosis and treatment of dermatophytosis and allergic diseases.

Objective To evaluate the predictive value for serum albumin-globulin ratio （A/G） for the risk of Kawasaki disease （KD） in febrile children. Methods In this single-center retrospective cohort study， the big-data platform of a certain third-tier A-level hospital was employed. Clinical and laboratory data of 432 febrile children aged 0-16 were collected. The children were divided into 4 groups based on the quartiles and median of their serum A/G ratios. The correlation between the A/G and the risk of KD was analyzed. Results The total incidence rate of KD in 432 children with fever was 14.4% （62/432）.A significant negative correlation was observed between the A/G and the risk of KD. For each increase of 0.1 in the A/G， the risk of KD was decreased by 18% （OR=0.82， 95% CI 0.76-0.88， P < 0.001）. Subgroup analysis showed a consistent negative correlation between the A/G and KD risk across different ages， genders， and biochemical markers. Conclusions A/G may be a useful biomarker for assessing the risk of KD in febrile children. As the A/G increases， the risk of KD is gradually decreased. This finding has potential clinical application value for early diagnosis and risk assessment of KD.

Objective To investigate the clinical characteristics of vasculitis caused by Mycobacterium tuberculosis infection （tuberculosis infection） and to deepen clinical professionals' understanding of this condition. Methods Clinical data of two children diagnosed with vasculitis caused by tuberculosis infection were retrospectively analyzed. Relevant studies were searched and reviewed from CNKI， Wanfang Database and PubMed by using the keywords of “vasculitis” “tuberculosis infection” and “child”. Results Two children were admitted to hospital due to recurrent fever complicated with local pain. Vascular ultrasound indicated diffuse thickening or abnormal echoes on the walls of the corresponding vessels. The purified protein derivative （PPD） test and the tuberculosis infection T-cell spot test （T-SPOT） yielded positive results. Chest CT scan suggested pulmonary inflammation， and the diagnosis of tuberculosis infection complicated with vasculitis was confirmed. After anti-tuberculosis treatment， the vascular lesions were cured. According to literature review， vasculitis caused by tuberculosis infection is mainly manifested as aortic dilation or aneurysm， and can also involve the retina and cerebral vessels， etc. Anti-tuberculosis treatment is effective for such vascular lesions. Conclusions Tuberculosis infection can cause vascular lesions， and affect the arteries and veins of different sizes. In clinical practice， for patients with prolonged fever accompanied by local pain， tuberculosis related examination and vascular ultrasound examinations should be conducted to prevent missed diagnosis and misdiagnoses.

Objective To explore the application value of 80 kV deep learning image reconstruction （DLIR） algorithm in coronary CT angiography （CCTA）. Methods Sixty patients who underwent CCTA were divided into two groups based on the scanning protocols： 100 kV group （Group A， n = 30） and 80 kV group （Group B， n = 30）. In Group A， 60% ASIR-V （A-AV60） and DLIR high-level reconstruction （A-DLIR） was adopted. In Group B， DLIR high-level reconstruction （B-DLIR） was employed. The CT volumetric dose index （CTDIvol） and the dose length product （DLP） were recorded in both groups， and the effective dose （ED） was calculated. Regions of interest （ROI） were placed in the aortic root （AR）， left anterior descending coronary artery （LAD）， left circumflex coronary artery （LCX）， right coronary artery （RCA）， and the same-layer pectoral fat area. The CT values and noise values of each ROI were recorded. Signal-to-noise ratio （SNR） and contrast-to-noise ratio （CNR） were calculated. Subjective evaluation was performed on the original axis， curved planar reconstruction （CPR）， volume rendering （VR）， and maximum intensity projection （MIP） reconstructions after the second-generation freeze technology （Snapshot Freeze 2， SSF-2）， and the images in two groups were subject to subjective image quality evaluation. Results The ED in Group B was reduced by 45.14% compared to that in Group A. The CT values for AR， LAD， LCX， and RCA in the B-DLIR were higher than those in the A-AV60 and A-DLIR groups， and the differences were statistically significant （all P < 0.001）. The noise values for AR， LAD and LCX were similar， whereas statistical significance was observed in RCA between the A-DLIR and B-DLIR groups （P < 0.05）. The noise values in the A-DLIR and B-DLIR groups were smaller than that in the A-AV60 group， and the differences were statistically significant （both P < 0.001）. The SNR and CNR for AR， LAD， LCX and RCA were similar between the A-DLIR and B-DLIR groups， which were higher than those in the A-AV60 group （all P < 0.05）. The average subjective evaluation score of image quality in the B-DLIR group was higher than that in the A-AV60 group （P < 0.05）， whereas lower than that in the A-DLIR group （P < 0.05）. There were no significant differences in clarity， artifact and small branch visibility between the A-DLIR and B-DLIR groups （all P > 0.05）. Conclusions During CCTA， the 80 kV DLIR algorithm contributes to yielding high-quality images， further improves the diagnostic efficiency and reduces the irradiation dose.

Atopic dermatitis （AD） is a common chronic inflammatory skin disease characterized by dry skin， recurrent itching， and eczema-like lesions， which can significantly reduce the quality of life. In recent years， the global prevalence of AD has been increasing， with a particularly marked rise in China. Research has shown that air pollutants can damage the skin barrier through mechanisms like oxidative stress， thereby increasing the risk of AD. Various exposure factors， including diet and allergens， also significantly influence the onset and progression of AD through different mechanisms. Furthermore， psychological factors such as anxiety and stress can exacerbate AD through neuroendocrine regulation. Obesity is closely associated with AD， particularly among children and adolescents. Given the diversity of factors and mechanisms influencing AD， a comprehensive approach to primary prevention that considers multiple factors is warranted.