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Objective: This study aimed to investigate the disease characteristics of children admitted to the hospital with high fever on an emergency basis and assess the health needs of their family members. Additionally, it aimed to analyze nursing strategies focusing on the management of chronic internal infections. Method: A total of 526 children with high fever admitted between December 2020 and December 2022 were included in the study. Among them, 368 (69.96%) were aged younger than six years, and the remaining 158 were aged between (6~18 years). The main health needs of family members were assessed using a questionnaire. The children were randomly assigned to control and observation groups, each comprising 263 cases. The control group received routine emergency nursing, while the observation group received advanced chronic nursing strategies focusing on internal infections. The study compared the time taken for temperature normalization, management of depression in children, the occurrence of negative emotions among family members and nurse-patient disputes, nursing quality scores, satisfaction levels, health knowledge mastery rates, and nursing processing ability scores of family members between the two groups. Results: The observation group exhibited significantly shorter time to temperature normalization and better depression management compared to the control group. Additionally, the observation group showed lower occurrences of negative emotions among family members and nurse-patient disputes, higher nursing quality scores and satisfaction levels, and better health knowledge mastery rates and nursing processing ability scores of family members (P < .05). Conclusions: Considering the rapid progression of conditions in emergently hospitalized children with high fever and the susceptibility of family members to various negative emotions, tailored chronic nursing strategies centered on internal infections can significantly enhance clinical diagnosis, reduce nurse-patient disputes, improve nursing quality, and elevate family nursing standards.

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italic>Schisandra chinensis is a traditional Chinese medicine with the functions of reinforcing deficiency, strengthening, and inducing astringency, appliable to treat the chronic cough and deficiency in breath, palpitation, and insomnia, etc. A hybrid mass spectrometry scanning strategy (high-definition data-independent/data-dependent acquisition, HDDIDDA), enabling the ion mobility separation and alternating data-independent acquisition/data-dependent acquisition, was established, which, in combination with in-house library-driven automatic peak annotation workflows facilitated by the UNIFI software, was utilized to systematically characterize the multi-classes of chemical components from S. chinensis. The use of an HSS T3 column (100 mm × 2.1 mm, 1.8 μm), 0.1% formic acid in H2O-acetonitrile as the mobile phase running at the flow rate of 0.3 mL·min-1, and column temperature at 35 ℃, could enable good separation of the S. chinensis components within 42 min. HDDIDDA scan in both the positive and negative ion modes was employed for data acquisition. Based on the automatic peak annotation, reference standards comparison, MS2 data interpretation, and literature analysis, we were able to identify or tentatively characterize 105 compounds in the S. chinensis decoction, involving 56 terpenoids, 42 lignans, five glycosides, one organic acid, and one flavonoid. HDDIDDA scanning can improve the coverage of data acquisition and improve the accuracy of identification, while CCS prediction analysis provides the possibility to distinguish isomers by the ion mobility technology. The results provide reference for the intelligent material basis research of TCM.

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Purpose@#Whether a dilated intrahepatic bile duct (IHBD) has any effect on the prognosis of choledochal cyst (CC) remains controversial. We aimed to summarize the clinical characteristics and prognosis of CC with IHBD dilatation. @*Methods@#One hundred ninety-two children diagnosed with CC were identified, including 127 without IHBD dilatation (group A) and 65 with IHBD dilatation (group B). A retrospective analysis was performed to explore the clinical characteristics and prognosis of CC with IHBD dilatation based on clinical indices, symptoms, and complications. @*Results@#Compared with group A, incidences of jaundice and fever were higher in group B (P = 0.010 and P = 0.033). Preoperative total bilirubin, direct bilirubin, and indirect bilirubin were increased in group B compared to group A (P = 0.005, P < 0.001, and P = 0.014), as were preoperative ALT, AST, γ-GT, and total bile acid (P = 0.006, P = 0.025, P < 0.001, and P = 0.024). The risk of liver fibrosis or cirrhosis was significantly increased for group B compared with group A (P = 0.012) and also occurred earlier in group B (P = 0.006). In the dilated IHBDs, 95.4% (62 of 65) recovered to normal, and more than half of dilated IHBDs (37 of 65) recovered to normal in 1 week. @*Conclusion@#Most IHBDs can recover to normal postoperatively in a short time, and proactive treatment is recommended for CC patients with IHBD dilatation for significant abnormal liver functions.

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Objective To analyze the disease burden of type 2 diabetes mellitus(T2DM)attributable to high body mass index(BMI)in China from 1990 to 2019 in the context of rapid growth in high BMI rates.Methods Data was extracted from GBD 2019,and the disease burden of T2DM attributable to high BMI in China from 1990 to 2019 was analyzed for overall and subgroups defined by age and sex separately and jointly.The joinpoint regression models were used to analyze the trends of standardized death rate and standardized disability-adjusted life year(DALY)rate.Results From 1990 to 2019,the prevalence of T2DM increased from 2928.78 per 100000 to 6328.79 per 100000 in China.The number of T2DM deaths attributed to high BMI increased from 10500 to 47500 and the standardized death rate increased from 1.25 per 100000 to 2.39 per 100000.The attributed DALY increased from 771800 person-years to 3737600 person-years,and the standardized DALY rate increased from 80.21 per 100000 to 181.54 per 100000.Years of life lost(YLL)and years lived with disability(YLD)and their standardized rates also increased.From 1990 to 2019,the annual average percentage change of the standardized death rate and the standardized DALY rate of T2DM attributable to high BMI were 2.28%and 2.81%,respectively,which were statistically significant(P<0.05)and males were both higher than females.The standardized DALY rate and the standardized death rate of males exceeded that of females in 2010 and 2014,respectively.Age-stratified results showed that the burden of T2DM,which is attributed to a high BMI,is even greater in people over 50 years old.The YLD rate attributable to high BMI increased the most among the 15～49 age group,reaching 323.99%.Conclusion From 1990 to 2019,the disease burden of T2DM that can be attributed to high BMI increased significantly in China.It is necessary to strengthen prevention and control efforts,effectively manage population BMI,and adopt key interventions for high-risk groups to reduce the disease burden of T2DM.

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Purpose To summarize the clinical and imaging features of neonatal herpes simplex encephalitis(NHSE).Materials and Methods Clinical and imaging data of 5 NHSE from January 2016 to June 2023 in Beijing Children's Hospital,Capital Medical University were retrospectively collected.All five children underwent MRI examinations,with three of them undergoing enhanced scanning simultaneously.Two children had previously undergone CT scans.The location,density/signal,enhancement characteristics as well as follow-up imaging changes of the lesions were reviewed.Results The main clinical manifestations of NHSE were fever(5 cases)and seizure(4 cases),sometimes accompanied by herpes(2 cases).Imaging examinations in NHSE typically presented with symmetric(1 case)or diffuse/multifocal(4 cases)lesions in bilateral cerebral hemispheres,along with involvement of the bilateral thalamus(5 cases).Early CT scans showed either no abnormalities(1 case)or extensive areas of low density(1 case).MRI examinations usually demonstrated restricted diffusion of acute phase lesions(3 cases)and significant leptomeningeal enhancement in affected areas(3 cases).Intracranial lesions often led to the diffuse atrophy of brain parenchyma and polycystic encephalomalacia(3 cases),indicating a poor prognosis.Conclusion The clinical manifestations of NHSE are nonspecific.Early MRI examinations are of great value for accurate diagnosis and disease evaluation.

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Objective:To analyze high-risk factors for poor neurological prognosis in full-term neonatal purulent meningitis based on clinical and brain MRI features.Methods:This study was a case-control study. The clinical and brain MRI data of 79 neonates with purulent meningitis were retrospectively collected at Beijing Children′s Hospital, Capital Medical University from January 2016 to January 2022. Follow-up assessments including growth and development, as well as neurological sequelae, were conducted over a minimum follow-up period of 6 months. The patients were divided into two groups with good ( n=49) and poor prognosis ( n=30) according to follow-up results. Chi-square tests were used to compare clinical and brain MRI features between the two groups, and a multivariate logistic regression analysis was performed to explore the high-risk factors for poor neurologic prognosis in full-term neonates with purulent meningitis. Results:There were statistically differences between two groups regarding the incidence of seizures, early-onset manifestations, positive cerebrospinal fluid (CSF) culture, CSF white cell counts, and CSF protein concentration ( P<0.05). Statistically differences were also found in the occurrence rates of ependymitis, obvious ventricular dilatation/hydrocephalus, spotty and patchy brain injury/hemorrhage, and destructive lesions within the brain parenchyma ( P<0.05). The results of multivariate logistic regression analysis indicated that seizures ( OR=5.722, 95% CI 1.126-29.072, P=0.035), early-onset neonatal purulent meningitis ( OR=3.657, 95% CI 1.073-12.459, P=0.038), ependymitis ( OR=8.851, 95% CI 1.169-67.017, P=0.035), obvious ventricular dilatation/hydrocephalus ( OR=12.675, 95% CI 1.085-148.110, P=0.043), and destructive lesions within the brain parenchyma ( OR=16.370, 95% CI 1.575-170.175, P=0.019) were independent risk factors for poor prognosis. Conclusions:The occurrence of seizures, early-onset manifestations as well as ependymitis, obvious ventricular dilatation/hydrocephalus, and destructive lesions within the brain parenchyma on MRI are high-risk factors for poor prognosis in the full-term neonate with purulent meningitis.

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Intrahepatic cholangiocarcinoma （ICC） is a relatively rare type of primary liver cancer， and its incidence rate has gradually increased in recent years. Due to its insidious onset and atypical clinical symptoms， most patients are already in the advanced stage of the disease at the time of confirmed diagnosis， and therefore， timely diagnosis and treatment are of great importance. Radical surgical resection is the standard treatment regimen for early-stage ICC patients， while systemic chemotherapy is the basic treatment for patients with advanced ICC and is often combined with interventional treatment， targeted therapy， and immunotherapy. This article reviews the advances in the diagnosis and treatment of ICC.

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Phenylalanine ammonia-lyase (PAL) is the key entry enzyme of plant phenylpropanoid pathway. It plays an important role in the biosynthesis of podophyllotoxin, an anti-tumor lignan that is currently produced from its main natural source Sinopodophyllum hexandrum (Royle) Ying. In this study, we cloned the gene ShPAL encoding phenylalanine ammonia-lyase by RT-PCR from the root of S. hexandrum ecotype inhabited in the Aba' district, Sichuan, based on its public SRA transcriptome data-package. Bioinformatics analyses showed that the ShPAL-encoded protein is composed of 711 amino acids, contains the conserved domains of PAL, and has the signature motif within the active center of aromatic ammonia-lyases. Moreover, ShPAL protein was predicted to have a secondary structure mainly composed of α-helix and random coil, a typical 'seahorse' shape monomer tertiary structure, and a homologous tetramer three-dimensional structure by Swiss-Modelling. The phylogenetic lineage analysis indicated ShPAL was of the highest sequence identity and the shortest evolutionary distance with the PAL of Epimedium sagittatum from the same Berberidaceae family. Subcellular localization experiments showed that ShPAL protein was mainly distributed in the cytoplasm, despite of a minority on the endoplasmic reticulum membrane. Furthermore, ShPAL protein was recombinantly expressed in Escherichia coli and purified by histidine-tag affinity chromatography. Its enzymatic activity was determined up to 20.91 U/mg, with the optimum temperature of 41 ℃ and pH of 9.0. In contrast, the enzyme activity of its F130H mutant decreased by about 23.6%, yet with the same trends of change with temperature and pH, confirming that phenylalanine at this position does affect the substrate specificity of PAL. Both the wild type and the mutant have relatively poor thermostability, but good pH-stability. These results may help to further investigate the regulatory role of PAL in the process of podophyllotoxin biosynthesis and advance the heterologous synthesis of podophyllotoxin to protect the germplasm resource of S. hexandrum. They also demonstrate that ShPAL has a potential application in biochemical industry and biomedicine.

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OBJECTIVE To provide scientific basis for establishing the evaluation index system of professional and specialized drug inspectors in China. METHODS Through the method of literature research， group discussions and behavioral event interview， combined with the practice situation of drug inspection at home and abroad， in accordance with the requirements of Chinese laws and regulations and department rules， the evaluation indexes for drug inspectors were extracted and screened. In addition， the Delphi method was used to conduct correspondence with experts in relevant fields so as to determine the evaluation index system of drug inspectors. RESULTS & CONCLUSIONS Finally， 62 experts completed two rounds of anonymous online questionnaires， including 29 experts in the first round and 33 experts in the second round. The questionnaire recovery rates were 96.67% and 94.29% respectively， and the expert authority coefficients were 0.81 and 0.79， indicating a high level of authority among experts. After expert consultation， evaluation index system for professional and specialized drug inspectors had been constructed， including five first-level indexes （personal characteristics， professional knowledge， professional skills， professional behavior and professional ethics） and their corresponding 27 second-level indexes. The average score of the importance of second-level indexes was 4.224- 4.879， the full score ratio was 81.8%-100%， the coefficient of variation was 0.067-0.177， and Kendall’s W was 0.643 （P＜0.001）. It indicates that this evaluation index system is relatively reliable and is expected to become a management tool for promoting the construction of professional and specialized drug inspector team and ensuring the quality of drug inspection.

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This study was designed to comprehensively characterize and identify the chemical components in traditional Chinese medicine Psoraleae Fructus by establishing an ultra-high performance liquid chromatography/quadrupole time-of-flight mass spectrometry(UHPLC-Q-TOF-MS) method in combination with in-house library. The chromatographic separation conditions(stationary phase, column temperature, mobile phase, and elution gradient) and key MS monitoring parameters(capillary voltage, nozzle voltage, and fragmentor) were sequentially optimized via single-factor experiments. A BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) was finally adopted, with the mobile phase consisting of 0.1% formic acid in water(A) and acetonitrile(B) at the flow rate of 0.4 mL·min~(-1) and column temperature of 30 ℃. Auto MS/MS was utilized for data acquisition in both positive and negative ion modes. By comparison with reference compounds, analysis of the MS~2 fragments, in-house library retrieval and literature research, 83 compounds were identified or tentatively characterized from Psoraleae Fructus, including 58 flavonoids, 11 coumarins, 4 terpenoid phenols, and 10 others. Sixteen of them were identified by comparison with reference compounds, and ten compounds may have not been reported from Psoraleae Fructus. This study achieved a rapid qualitative analysis on the chemical components in Psoraleae Fructus, which provided useful reference for elucidating its material basis and promoting the quality control.

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Objective: To summarize the clinical data and prognosis of children with Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) common genes. Methods: This was a retrospective cohort study.Clinical data of 56 children with Ph-like ALL common gene cases (Ph-like ALL positive group) treated from January 2017 to January 2022 in the First Affiliated Hospital of Zhengzhou University, Henan Children's Hospital, Henan Cancer's Hospital and Henan Provincial People's Hospital were collected, 69 children with other high-risk B cell acute lymphoblastic leukemia (B-ALL) at the same time and the same age were selected as the negative group. The clinical characteristics and prognosis of two groups were analyzed retrospectively. Comparisons between groups were performed using Mann-Whitney U test and χ2 test. Kaplan-Meier method was used for survival curve, Log-Rank test was used for univariate analysis, and the Cox regression model was used for multivariate prognosis analysis. Results: Among 56 Ph-like ALL positive patients, there were 30 males and 26 females, and 15 cases were over 10 years old. There were 69 patients in Ph-like ALL negative group. Compared with the negative group, the children in positive group were older (6.4 (4.2, 11.2) vs. 4.7 (2.8, 8.4) years), and hyperleukocytosis (≥50×109/L) was more common (25% (14/56) vs. 9% (6/69)), the differences were statistically significant (both P<0.05). In the Ph-like ALL positive group, 32 cases were positive for IK6 (1 case was co-expressed with IK6 and EBF1-PDGFRB), 24 cases were IK6-negative, of which 9 cases were CRLF2 positive (including 2 cases with P2RY8-CRLF2, 7 cases with CRLF2 high expression), 5 cases were PDGFRB rearrangement, 4 cases were ABL1 rearrangement, 4 cases were JAK2 rearrangement, 1 case was ABL2 rearrangement and 1 case was EPOR rearrangement. The follow-up time of Ph-like ALL positive group was 22 (12, 40) months, and 32 (20, 45) months for negative group. The 3-year overall survival (OS) rate of positive group was significantly lower than the negative group ((72±7) % vs. (86±5) %, χ2=4.59, P<0.05). Compared with the 24 IK6-negative patients, the 3-year event free survival (EFS) rate of 32 IK6 positive patients was higher, the difference was statistically significant ((88±9) % vs. (65±14) %, χ2=5.37, P<0.05). Multivariate Cox regression analysis showed that the bone marrow minimal residual disease (MRD) not turning negative at the end of first induction (HR=4.12, 95%CI 1.13-15.03) independent prognostic risk factor for patient with Ph-like ALL common genes. Conclusions: Children with Ph-like ALL common genes were older than other high-risk B-ALL patients at diagnosis, with high white blood cells and lower survival rate. The bone marrow MRD not turning negative at the end of first induction were independent prognostic risk factor for children with Ph-like ALL common gene.

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Objective:To investigate the effect of miR-503 targeting CBX2 on drug resistance of breast cancer MDA-MB-231 cells and its potential mechanism.Methods:miR-con group, miR-503 group, si-con group, two groups of si-chromosome homologues (CBX), anti-miR-con group, anti-miR-503 group, miR-503+pcDNA group, miR-503+pcDNA-CBx2 group were set up. Real-time quantitative fluorescence polymerase chain reaction (qRT-PCR) was used to detect the expression levels of miR-503 and CBX2 mRNA. Western blot was used to detect protein expression. Cell activity was detected by MTT assay. The targeted regulatory relationship was detected by double luciferase assay.Results:Compared with normal breast cells HBL-100 (1.02±0.09), the expression level of miR-503 in breast cancer cells MCF-7 (0.41±0.05), MDA-MB-231 (0.25±0.03) and BT474 (0.35±0.04) was significantly decreased. The expression levels of CBX2 mRNA in MCF-7, MDA-MB-231 and BT474 cells were (4.02±0.35), (4.62±0.36) and (3.47±0.33), respectively. The expression levels of CBX2 protein in MCF-7, MDA-MB-231 and BT474 cells were (0.64±0.07), (0.74±0.05) and (0.68±0.06), respectively. The mRNA and protein contents of CBX2 in normal breast cells HPL-100 were (1.01±0.08) and (0.40±0.04), respectively, and the expression of CBX2 in breast cancer cells was significantly higher than that in normal breast cells ( P<0.05). Overexpression of miR-503 (3.64± 0.30) and silting of CBX2 inhibited proliferation, migration and invasion of MDA-MB-231 cells, and inhibited CBX2 (0.26±0.03), cyclin-dependent kinases, CDK) 4 (0.32± 0.03), Cyclin (CCN) D1 (0.58±0.03), matrix metalloproteinases (matrix metalloproteinases), MMP-2 (0.32±0.03) and MMP-9 (0.32±0.04) ( P<0.05). miR-503 targeted the expression of CBX2, and overexpression of CBX2 (0.75±0.03) could reverse the proliferation and drug resistance of miR-503 to MDA-MB-231 breast cancer cells. Conclusion:miR-503 may inhibit the proliferation, migration and invasion of breast cancer cells by down-regulating the expression of CBX2.

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Based on the dual needs of analgesia and anti-inflammation in trauma treatment, this study uses acetaminophen and moxifloxacin hydrochloride as active pharmaceutical ingredients and develops a composite bilayer tablet with a dual-phase drug release system by using binder jet 3D printing technology. Due to the complexity of the 3D printing process, there is an interaction between the various parameters. Through the optimization of the process, the relationship between the key process parameters can be determined more intuitively. In this study, the process of extended-release tablets was optimized to maintain the mechanical properties of the tablets while realizing the regulation of release. The full-factor experimental design of three central points 23 was used to analyze the factors that significantly affect the quality attributes of extended-release tablets and the interaction between factors. The optimal extended-release process parameters were obtained by the response optimizer: the inkjet quantity of the printing ink was 10 (about 13.8 pL), the powder thickness was 180 μm, and the running speed was 360 mm·s-1. The in vitro of release of 3D printed composite bilayer tablets showed that the in vitro of release of 3D printed tablets and commercially available tablets conformed to the Ritger-Peppas release model. The results of porosity showed that the immediate-release layer of the preparation has many pores and large pore size, and the dissolution of the immediate release layer within 15 min was greater than 85%. The internal pore size of the extended release layer is large, but it can still release slowly for up to 8 h, the mechanism may be related to the extended release of HPMC gelation. On the basis of verifying the rationality of the design goal of 3D printed composite bilayer tablets, this study also provides a theoretical basis for the preparation of 3D printing complex preparations.

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Tomato (Solarium lycopersicum) is one of the most popular vegetables worldwide and is a classic model plant for studying fruit development and ripening due to its short growth cycle, clear genetic background and ease of molecular manipulation. This paper used virus-induced gene silencing (VIGS) to construct SlWRKY53b gene-silenced tomato fruits and analyzed the effect of SIWRKY531) gene silencing in the tomato fruit ripening process. We found that transient silencing of SIWRKY531) resulted indelayed in-broken color, higher chlorophyll contents (P<0.05) and reduced carotenoid contents (P<0.05) in tomato fruits, and color difference results indicated that the differences in L *, a * and b * values were consistent with fruit color changes. Further studies showed that genes significantly down-regulated (P<0.01) in SIWRKY531) gene-silenced tomato fruits include the chlorophyll degradation-related genes (AFCl, PAO, PPH, SGR1), carotenoid synthesis-related genes (PSYl, PDS, ZDS), ethylene synthesis pathway-related genes (ACOl, ACS2, NOR, AC03, EA, RIN), and cell wall degradation-related genes (PG, EXP, CELT.). Correlation analysis showed that the expression of SlWRKY53b was negatively correlated with chlorophyll contents and positively correlated with carotenoid contents and the expression of maturation-related genes. These results suggest that inhibition of SIWRKY531) expression at the transcrip-tional level can achieve the effect of delaying tomato fruit ripening, indicating that S1WRKY531) plays arole as a facilitator in the tomato fruit ripening process.

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Abstract@#With the increasing prevalence of overweight and obesity in children, the influence of overweight and obesity on pubertal timing has attracted the attention of scholars. This paper reviewed the correlation and mechanism between childhood obesity and pubertal timing, especially for earlier pubertal timing, and found that the regulation of hypothalamic-pituitary-gonadal axis function by nutrition and metabolic signals might under lie those associations. Obesity in girls was positively correlated with early pubertal timing, while the conclusions in boys were inconsistent. Overweight in boys was related to early pubertal timing, obesity in boys could lead to both earlier and later onset of puberty, which warrents further investigation.

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This study aimed to analyze the impact of traditional Chinese medicine(TCM) on the risk of re-admission for ankylosing spondylitis(AS) patients with dampness-heat syndrome. In this study, a telephone follow-up was conducted on 1 295 AS inpatients, and after screening and exclusions, 1 044 successfully followed-up patients were included. A retrospective cohort study was conducted using propensity score matching(PSM), and a Cox proportional risk model was employed to assess the effect of various factors on the risk of re-admission for AS patients with dampness-heat syndrome. Kaplan-Meier survival curves were used to analyze the effect of TCM intervention time on re-admission. The incidence rate of dampness-heat syndrome in AS patients was found to be 51.3% in this study. After 1∶1 PSM, 385 AS patients with dampness-heat syndrome and 385 AS patients without dampness-heat syndrome were included for analysis. The results indicated that the re-admission rate was higher for patients with dampness-heat syndrome compared with those without dampness-heat syndrome(P<0.05). AS patients with dampness-heat syndrome in the TCM group had a lower admission rate than those in the non-TCM group(P=0.01). The cox proportional risk model demonstrated that TCM was an independent protective factor, as it reduced the risk of re-admission by 35%(HR=0.35, 95%CI[0.26, 0.95], P<0.05). Moreover, the subgroup with high exposure(time to use Chinese medicine >12 months) had a significantly lower risk of re-admission than that with low TCM exposure(time to use Chinese medicine ≤12 months). The re-admission rate for AS patients with dampness-heat syndrome was higher than that without dampness-heat syndrome, and TCM was identified as a protective factor in reducing the risk of re-admission. Furthermore, a longer duration of TCM intervention was associated with a lower risk of re-admission.

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Objective:To evaluate the application of amide proton transfer weighted (APTw) magnetic resonance imaging(MRI) for grading of brainstem glioma (BSG) in children.Methods:Twenty-five children (16 males and 9 females) aged 0.7-12.4(5.6±3.3)years were diagnosed as BSG by surgery or biopsy in Beijing Children′s Hospital from December 2019 to March 2022, including 13 cases of low-grade BSG and 12 cases of high-grade BSG. APTw imaging and conventional MRI were performed on a 3.0 T MRI scanner. The differences in gender distribution, age, conventional MRI appearance, APTw signal intensity and apparent diffusion coefficient (ADC) between children with high and low grade BSG were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of APTw signal intensity in the differential diagnosis of high and low grade BSG, and Youden index was calculated to obtain the optimal diagnostic threshold. Pearson′s correlation coefficient analysis was used to evaluate the correlation between APTw signal intensity and Ki-67 expression.Results:There was no significant difference in age and gender distribution between high-grade and low-grade BSG patients. The maximum diameter of high-grade BSG was significantly larger than that of low-grade BSG [(4.7±0.9) vs. (3.1±1.7)cm; t=-2.94, P=0.007]; the maximum signal intensity of APTw (APTw max) in high-grade BSG was significantly higher than that in low-grade BSG [(4.9±0.6)% vs. (3.0±1.2)%; t=-5.14, P<0.001]; the average signal intensity of APTw (APTw mean) in high-grade BSG was significantly higher than that in low-grade BSG[(3.6±0.4%) vs. (2.7±1.1)%; t=-2.66, P=0.014].The area under the curve(AUC)of APTw max in distinguishing high-and low-grade BSG was 0.897; with 4.07% as the optimal diagnostic threshold of APTw max, the sensitivity for the diagnosis of high-grade BSG was 0.917 and specificity was 0.846. The AUC of APTw mean in distinguishing high-and low-grade BSG was 0.769; with 2.85% as the optimal diagnostic threshold of APTw mean, the sensitivity for the diagnosis of high-grade BSG was 0.917 and specificity was 0.692. There was a positive correlation between the value of APTw max and Ki-67 expression( r=0.453, P=0.023). Conclusion:APTw imaging is helpful to distinguish high-grade and low-grade BSG in children. APTw max value can be used to effectively evaluate the proliferative activity of BSG in children.

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  Objective  Quantitative imaging evaluation was performed on the liver and spleen system lesions of patients with Gaucher disease after treatment. in order to deepen the understanding of Gaucher disease.  Methods  From August 1999 to August 2018, we registered, examined and treated children with Gaucher disease, and conducted quantitative imaging research on 40 children with Gaucher disease who were intensively followed up in Beijing Children's hospital, Capital Medical University until August 2018. At the same time, 34 normal volunteers were matched. All subjects were scanned with magnetic resonance imaging(MRI). The fat fraction(FF), iron content(R2*), standard apparent diffusion coefficient(sADC), slow apparent diffusion coefficient(D), fast apparent diffusion coefficient(D*) and perfusion fraction(f)of the liver and spleen were measured. The quantitative parameter values measured by patients with Gaucher disease and normal subjects were statistically analyzed by independent sample t-tests.  Results  The results showed that there was no significant difference in FF, R2*, sADC, D, D*, f of the liver and spleen, and liver elasticity was also within the normal range. However, the volume of liver and spleen in patients was significantly different from that in normal subjects.  Conclusions  After treatment, the volume of the liver and spleen in patients with Gaucher disease is greater than that of normal people, but other quantitative parameters are within the normal range, indicating that long-term enzyme replacement therapy can delay the progress of liver and spleen diseases to a certain extent. Quantitative imaging has a certain value in the evaluation of Gaucher disease.

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@#AIM: To study the clinical characteristics of vitreous hemorrhage associated with retinal tears, so as to provide suggestions for early intervention and improving the prognosis of patients.<p>METHODS: This was a retrospective study. Totally 105 patients(105 eyes)with vitreous haemorrhage associated with retinal tears treated at our hospital from December 2016 to December 2018 including 54 males and 51 females, of who the clinical characters, therapeutic effcet and prognostic facors were retrospectively analyzed.<p>RESULTS: Among the 105 eyes(151 retinal tears), 82 tears were located in the superotemporal area(54.3%), 28 tears were located in the superonasal area(18.5%), 27 tears were located in the inferior temporal area(17.9%), and 14 tears were located in the inferior nasal area(9.3%). The shape of the retinal tears was mostly horseshoe(77.5%). The diameter of the tear was between 1/8-4 papillary diameter(PD), most commonly is 1 PD. Seventy-six patients(72.4%)had visual acuity better than or equal to their preoperative vision. There was no significant difference in corrected visual acuity pre-and postoperative(<i>P</i>>0.05), and there was no statistically significant improvement in visual acuity between the buckling procedure group and the vitrectomy group(<i>P</i>>0.05).<p>CONCLUSION: Retinal tear is an important cause of vitreous haemorrhage. Retinal tears were mostly located in the superotemporal area with horseshoe shape. A comprehensive understanding of the clinical characteristics of rhegmatogenous vitreous haemorrhage helps to detect tears early and avoid serious complications.Patients had preoperative best corrected visual acuity(BCVA)(LogMAR)less than 1.6 and light perception less than 1 m, have poor postoperative vision, as do patients with retinal detachment involving the macula especially along with proliferative vitreoretinopathy(PVR).

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The recycling of traditional Chinese medicine （TCM） wastes is an important research topic to be solved urgently in the industrialization of TCM resources. Rhei Radix et Rhizoma is a bulk Chinese herb mainly derived from Rheum palmatum，R. tanguticum，and R. officinale. At present，these three medicinal plants have been cultivated on a large scale and widely used in the fields of medicine，health care，food，cosmetics，and veterinary medicine，with an annual demand of more than 5 500 tons（1 ton=1 000 kg）. However，a large number of wastes such as non-medicinal parts and residues produced in the production and deep processing are discarded because there is no effective way of utilization，resulting in serious waste of resources and environmental pollution. The non-medicinal parts contain not only the chemical components and pharmacological effects similar to those of roots and rhizomes but also a variety of amino acids，mineral elements，and conventional nutrients. They have a long history of use，and the content of some resource components is higher than that in roots and rhizomes. In particular，their stems and leaves exhibit great potential to be consumed as food and medicine due to high safety. Besides，the content of anthraquinones in Rhei Radix et Rhizoma residue is high and it possesses good antibacterial activity. It can be seen that the waste from the industrialization of Rhei Radix et Rhizoma has high utilization value. Hence，based on the relevant literature and investigation on the application of producing areas in China and abroad，the paper summarized the utilization status of their medicinal and non-medicinal parts，the waste production in the industrialization，as well as the active substances and utilization ways and put forward the multi-level and multi-path utilization strategy of Rhei Radix et Rhizoma wastes，in order to provide reference for the rational development and application of Rhei Radix et Rhizoma resources and promote the effective utilization and green development of the corresponding wastes.