Objective To compare the efficacy of omalizumab analogue(SYN008)with omalizumab original drug(Xolair^®)in allergic asthma mice model, providing a basis for the clinical application of SYN008. Methods Forty healthy BALB/c mice were divided into four groups, with 10 mice in each. Group I was the control group and asthma was induced by intraperitoneal injection of ovalbumin(OVA)-aluminium hydroxide in groups Ⅱ-Ⅳ. Mice in groups Ⅲ and Ⅳ were treated with Xolair^®(200 μg/each)and SYN008(200 μg/each)intraperitoneally, respectively. The levels of IgE in serum and T helper 2 cell(Th2)cytokines in broncho alveolar lavage fluid(BALF)were detected in each group; lung tissues were observed by hematoxylin-eosin(HE)staining, peroxynitrite-schiff(PAS)staining and Massons trichrome(Masson)staining. For the expression of transforming growth factor beta 1(TGF-β1), phosphorylated Smad family member 3(P-smad3)/Smad family member 3(Smad3), collagen Ⅲ(COL3)and mucin 5AC(MUC5AC), lung tissues were examined by quantitative real-time PCR(RT-qPCR), enzyme linked immunosorbent assay(ELISA), western blotting(WB)and immunohistochemistry. Results The levels of IgE in serum and interleukin-4(IL-4), IL-5 and IL-13 in BALF were significantly increased in the group Ⅱ compared with those in the control group(all P<0.001). The levels of IgE in serum and IL-4/5/13 in BALF in groups Ⅲ and Ⅳ were significantly decreased compared with those in the group Ⅱ(P<0.001, P<0.05, P<0.01, P<0.05; P<0.001, P<0.05, P<0.05, P<0.05). HE, PAS and Masson staining confirmed that Xolair^® and SYN008 could effectively reduce inflammatory cell aggregation, airway cuprocyte chemotaxis and collagen deposition in mice with asthma. Xolair^® and SYN008 could attenuate airway remodeling by inhibiting TGF-β1, P-smad3/Smad3, COL3 and MUC5AC in lung tissues, with no reach statistical significance between the two groups in all the assays. Conclusion SYN008 improves allergic asthma in mice and is consistent with the efficacy of Xolair^®, which is expected to be clinically significant for allergic asthma in the future.

Objective To investigate the clinical efficacy and influencing factors of tigecycline in the treatment of infectious diseases. Methods A total of 746 medical records of patients treated with tigecycline in Shandong Provincial Hospital Affiliated to Shandong First Medical University during January 2017 and December 2020 were retrospectively collected, and the clinical data of patients were analyzed to evaluate the clinical efficacy and factors. Results This study included 726 valid cases. Respiratory infection(65.43%)and complicated intra-abdominal infection(cIAI)(27.13%)were the main infections. The clinical effective rate was 65.70%, and the incidence of adverse reactions was 4.68%. Logistic regression analysis showed that the risk factors for the failure of tigecycline treatment were malignant solid tumor(OR=1.931, 95%CI: 1.161-3.214, P=0.011), respiratory system infection(OR=1.704, 95%CI: 1.096-2.649, P=0.018), septic shock(OR=2.784, 95%CI: 1.766-4.389, P<0.001), mechanical ventilation(OR=1.809, 95%CI: 1.143-2.862, P=0.011)and continuous renal replacement therapy(CRRT)(OR=1.886, 95%CI: 1.136-3.129, P=0.014), while the protective factors were admission to ICU(OR=0.518, 95%CI: 0.309-0.870, P=0.013)and long duration(OR=0.952, 95%CI: 0.919-0.985, P=0.005). Conclusion Tigecycline is mainly used for the treatment of severe and complex infections caused by multidrug-resistant bacteria. Patients with malignant solid tumor, respiratory system infection, septic shock, mechanical ventilation and CRRT have higher risk of tigecycline treatment failure, which should be paid attention to during the treatment.

Objective To analyse short-term efficacy and safety of anticoagulant therapy in elderly patients with corona virus disease 2019. Methods The study included corona virus disease 2019 patients aged ≥ 80 years who were admitted to Qilu Hospital of Shandong University between December 2022 and August 2023. They were divided into anticoagulant and non-anticoagulant groups according to whether they received anticoagulant therapy. The bleeding events and clinical outcomes during hospitalisation were observed in the two groups. Results A total of 254 patients with an average age of 85 years were divided into the anticoagulant group(n=183)and the non-anticoagulant group(n=71). Compared with the non-anticoagulant group, there were more severe(45.90% vs. 30.99%, P<0.001)and critically ill(16.39% vs. 4.22%, P<0.001)patients in the anticoagulant group. Binary Logistic analysis showed that anticoagulant therapy(OR=9.224, 95%CI: 3.435-24.769)and non-steroidal anti-inflammatory drugs(OR=3.619, 95%CI: 1.696-7.723)were independent risk factors for bleeding events during hospitalisation. There were 33 deaths, of which, 32(96.97%)patients were classified as critically ill. After propensity score matching(PSM)to balance baseline characteristics, the incidence of bleeding events in the anticoagulant group was significantly higher than that in the non-anticoagulant group(40.85% vs. 8.45%, P<0.001). There was no significant difference in in-hospital mortality between the two groups(4.22% vs. 4.22%, P>0.999). Conclusion Anticoagulant therapy does not reduce mortality in elderly patients with corona virus disease 2019 but result in more bleeding events.

Objective To explore the relationship between lung adenocarcinoma with EGFR sensitizing mutation and bullous pemphigoid, as well as the benefit of almonertinib. Methods Clinical data from a case of lung adenocarcinoma complicated with bullous pemphigoid was collected. Pathological and molecular diagnosis was confirmed through histopathological examination and next-generation sequencing genetic testing. Literature review was then conducted to summarize and analyze the diseases pathogenesis and treatment options. Results The diagnosis of metastatic lung adenocarcinoma with bullous pemphigoid was established through imaging and histopathology examination. Next-generation sequencing revealed a sensitizing mutation of exon 19 deletion in the EGFR gene. The patient was treated with almonertinib with regular chest CT evaluations. The anti-tumor treatment efficacy was assessed to be partial response, and the skin lesions continued to improve with no significant adverse reactions. Conclusion Targeted therapies can be considered in patients with EGFR-mutant metastatic lung adenocarcinoma complicated by bullous pemphigoid and almonertinib demonstrates good efficacy and safety.

The clinical manifestations of chronic rhinosinusitis(CRS)are chronic nasal congestion, runny nose, and loss of sense of smell, which seriously affect the patients quality of life. The pathogenesis of CRS is highly heterogeneous, and the phenotype associated with nasal polyps is chronic rhinosinusitis with nasal polyps(CRSwNP). Clinical trials of various biological agents targeting intrinsic biomarkers have been conducted to address the limited efficacy of traditional treatment drugs and postoperative recurrence in patients with CRSwNP. In recent years, clinical research for the treatment of CRSwNP in China has flourished, and self-developed varieties of domestic enterprises continue to emerge, bringing new choices for CRSwNP patients, especially those with severe and refractory CRSwNP. By summarizing the current status and development trends of clinical research for the treatment of CRSwNP in China, this study aims to provide information and reference for the research and development of drugs for treating CRSwNP.

Diabetes mellitus is a global public health problem, which leads to enormous human suffering. The prevalence of type 2 diabetes mellitus(T2DM)remains rising in China. Meanwhile, the awareness and control rate of diabetes have increased, but they are still at a low level. Dipeptidyl peptidase-4(DPP-4)inhibitors are novel oral antihyperglycemic agents. The unique mechanism of DPP-4 inhibitors satisfy different clinical demands. However, the molecular structure, clinical application and safety information of available DPP-4 inhibitors are different. We focus specially on the different clinical pharmaceutical characters, efficacy, safety and application on special population of DPP-4 inhibitors, which aims to provide the best drugs for individual patients.

Objective To construct a network of depressive disorders and multiple psycho-behavioural problems in adolescents, so as to identify core symptoms and infer potential causal associations. Methods A total of 320 adolescents diagnosed with depressive disorders were assessed using the childrens depression inventory, the young internet addiction scale, the social avoidance and distress questionnaire, and the pittsburgh sleep quality index. Undirected network analysis was used to identify the most relevant connections between symptoms. Bayesian network analysis was used to estimate a directed acyclic graph and infer the likely direction of causal associations. Results The network analysis revealed that withdrawal & social problems and negative mood were central symptoms in adolescent depressive disorders and psycho-behavioural problems. Sleep disorders were recognized as having the highest bridging effect between symptoms. The strongest associations were found between depressive symptoms, particularly anhedonia and sleep disturbances. In the Bayesian network model, negative mood serves as a pivotal symptom, significantly influencing a range of psycho-behavioural problems. Symptoms such as ineffectiveness and interpersonal problems were more reactive, positioned at the networks periphery, and influenced by other central symptoms. Conclusion Negative mood is a key symptom in adolescent depressive disorders and psycho-behavioural problems, and it can easily trigger various psychological and behavioural problems in adolescents. Targeting negative mood in interventions may help mitigate the development of these related issues.

Objective To investigate the effects of 25-hydroxyvitamin D ［25(OH)D］, insulin-like growth factor I(IGF-I), and anxiety and depression symptoms on non-suicidal self-injury(NSSI)in outpatient adolescents with psychiatric disorders. Methods A total of 234 outpatient adolescents with psychiatric disorders were selected for observation. They were divided into two groups based on the presence of NSSI: a non-NSSI group(86 cases)and an NSSI group(148 cases). The patients were assessed using the Hamilton Depression Rating Scale(HAMD)and the Hamilton Anxiety Rating Scale(HAMA). Serum levels of 25(OH)D and IGF-I were measured. Differences in variables between the two groups were compared. Binary Logistic regression was used to determine the risk factors for NSSI, and receiver operating characteristic(ROC)curve analysis was conducted to estimate the optimal cut-off values. Results The HAMA and HAMD scores in the NSSI group were significantly higher than those in the non-NSSI group(P<0.001), and the 25(OH)D levels were significantly lower in the NSSI group(P=0.001). Regression analysis revealed that the severity of depression symptoms(OR=1.186, 95%CI=1.089-1.292, P<0.001)and 25(OH)D levels(OR=0.921, 95%CI=0.857-0.990, P=0.026)were the influencing factors for NSSI in outpatient adolescents with psychiatric disorders. ROC analysis indicated that 25(OH)D level ≤13.06 ng/mL and HAMD score ≥18.50 were the best cut-off values for the diagnosis of NSSI. Conclusion The levels of 25(OH)D and the severity of depression symptoms are the influencing factors for NSSI in outpatient adolescents with psychiatric disorders. Combined testing of these factors demonstrates good diagnostic predictive value.

Objective To examine the mediating effects of social avoidance and academic defeat on the relationship between adolescent depressive disorder and internet addiction. Methods A total of 463 adolescents diagnosed with a diagnosis of depressive disorder, who sought outpatient and inpatient treatment in mental facilities between May 2021 and October 2022 were assessed using Childrens Depression Inventory, Social Avoidance and Distress Scale, Defeat Scale, and Internet Addiction Test. The mediating effect analysis was performed using SPSS 26.0 with the PROCESS v4.1 macro, using the bias-corrected non-parametric percentile bootstrap method for mediation testing. Results Significant positive correlations were found between internet addiction, depression severity, social avoidance, and academic defeat. Social avoidance and academic defeat played parallel mediating roles in the relationship between depressive severity and internet addiction, with mediation effects of 0.136(95%CI: 0.028-0.243)and 0.276(95%CI: 0.079-0.475), respectively. Conclusion The severity of depression in adolescents with depressive disorder not only directly influences internet addiction, but also indirectly affects it through the mediating roles of social avoidance and academic defeat. Future clinical practice should implement interventions targeting social avoidance and academic defeat to reduce the risk of internet addiction in adolescents with depressive disorder.

Objective To explore a better surgical treatment for secondary hyperparathyroidism(SHPT), so as to provide evidence-based basis for clinical treatment, and further improve the quality of life and prognosis of patients. Methods The clinical data of 75 patients with SHPT admitted to the Department of Thyroid and Breast Surgery, the 960th Hospital of PLA Joint Logistics Support Force from December 2021 to February 2023 were retrospectively analyzed. According to the condition, the patients were divided into total parathyroidectomy(TPTX)group(n=35)and total parathyroidectomy with autotransplantation(tPTX+AT)group(n=40). The changes of parathyroid hormone, serum calcium and serum phosphorus were monitored before operation and 1 day, 1 month, 3 months, 6 months and 1 year after operation. The time and amount of intravenous calcium supplement(calcium gluconate)during hospitalization, perioperative complications and recurrence were evaluated and analyzed in the two groups. Meanwhile, before and after operation(6 months, 1 year)bone formation markers, i.e. N-terminal propeptide of type Ⅰ collagen, bone resorption markers, i.e. β cross-linked C-telopeptide of type I collagen, spinal bone mineral density and bone mineral density of the left femoral neck T value scores were compared. The MOS 36-item short-form health survey(SF-36)was used to evaluate the quality of life of patients before and after operation(6 months,1 year). Results There was no significant difference in baseline data between the two groups(P>0.05). There was no statistically significant difference in the number of parathyroid glands removed and the situation of combined thyroid surgery between the two groups(P>0.05). There was no statistically significant difference in calcium supplementation time and amount during hospitalization between the two groups(P>0.05). There was no statistically significant difference in the incidence of recurrent hyperparathyroidism(RHPT)and the incidence of hypocalcemia 1 year after surgery between the two groups(P>0.05). There was a statistically significant difference in the incidence of permanent hypoparathyroidism between the two groups(P<0.01). The levels of blood calcium, phosphorus, and parathyroid hormone parathyroid hormone in both groups on the 1 day, 1 month, 3 months, 6 months, and 1 year after surgery were significantly lower than those before surgery(P<0.05). The blood calcium level was the lowest 1 month after surgery, gradually increased 3 months after surgery, and tended to be stable and basically close to the normal value 1 year after surgery. In the TPTX group, parathyroid hormone dropped sharply after surgery and showed no significant change from 1 day to 1 year after surgery. In the tPTX+AT group, parathyroid hormone also dropped sharply after surgery. There was no significant change from 1 day to 1 month after surgery. Compared to 1 month after surgery, the increase in parathyroid hormone 3 months after surgery was statistically significant(P<0.05). Compared to 1 day and 1 month after surgery the increase in parathyroid hormone 6 months and 1 year after surgery was statistically significant(P<0.05). The levels of N-terminal propeptide of type Ⅰ collagen and β cross-linked C-telopeptide of type I collagen in both groups at 6 months and 1 year after surgery were significantly lower than those before surgery(P<0.05). N-terminal propeptide of type Ⅰ collagen continued to decline at 1 year after surgery compared to 6 months after surgery(P<0.05). There was no significant difference in the degree of decline of β cross-linked C-telopeptide of type I collagen between 1 year after surgery and 6 months after surgery(P>0.05). The T-scores of spinal and left femoral neck bone mineral density in both groups at 6 months and 1 year after surgery were significantly higher than those before surgery(P<0.05). The spinal bone mineral density gradually approached the normal value at 6 months after surgery. There was no significant change between 1 year and 6 months after surgery(P>0.05). The left femoral neck bone mineral density continued to increase at 1 year after surgery compared to 6 months after surgery(P<0.05). There was no statistically significant difference in N-terminal propeptide of type Ⅰ collagen, β cross-linked C-telopeptide of type I collagen, spinal bone mineral density, and left femoral neck bone mineral density between the two groups(P>0.05). SF-36 scale analysis revealed the scores of physical function, role physical, body pain, general health, vitality, social function, role emotional and mental health in the TPTX group and tPTX+AT group after surgery(6 months, 1 year)were significantly higher than those before surgery(P<0.05), but there was no significant improvement at 1 year after operation compared with 6 months after operation(P>0.05), and there was no significant difference between the two groups(P>0.05). Conclusion TPTX and tPTX+AT have good effects on controlling the levels of serum calcium, phosphorus and other biochemical indicators, improving the quality of life, and improving bone metabolism disorders in patients with SHPT. The incidence of permanent hypoparathyroidism in the tPTX+AT group is lower than that in the TPTX group. tPTX+AT may be a better choice for the treatment of secondary hyperparathyroidism.

Objective To investigate the clinical features and anesthetic concerns of pulmonary dissemination in juvenile-onset recurrent respiratory papillomatosis(JORRP). Methods We retrospectively analysed the clinical medical records of 120 children with JORRP who attended Beijing Tongren Hospital, Capital Medical University, from 1 June 2022 to 31 December 2023, defined those who showed special signs on lung CT as pulmonary dissemination, and compared the differences in clinical features and general anesthetic concerns between the pulmonary dissemination group and the no-dissemination group. Results The incidence of JORRP pulmonary dissemination in this study was 15.8%(19/120), with imaging findings of scattered nodules of variable size and round cavities in the lungs. The age of initial surgery in the pulmonary dissemination group was younger than that in the no-dissemination group ［1.4(0.9-2.4)years vs. 2.7(1.7-4.7)years］, and the total number of surgeries was greater than that in the no-dissemination group ［32.0(19.0-46.0)times vs. 13.0(4.0-24.0)times］. The tracheotomy rate, the tracheal dissemination rate and the incidence of atypical hyperplasia in the pulmonary dissemination group were significantly higher than those in the no-dissemination group(78.9% vs. 10.9%, 100.0% vs. 11.9%, 68.4% vs. 27.7%). The differences in the incidence of preoperative pneumonia, duration of surgery, duration of general anesthesia, duration of recovery from anesthesia, and ICU retention rate were statistically significant(P<0.05). Multifactorial Logistic regression analysis showed that age at first presentation ≤2.5 years, tracheotomy, atypical hyperplasia and higher number of operations(OR>1, P<0.05)were risk factors for pulmonary dissemination. Multivariate Logistic regression analysis showed that age at onset≤2.5 years, tracheotomy, atypical hyperplasia and frequent surgery(OR>1, P<0.05)were risk factors for pulmonary dissemination. Conclusion Compared to general JORRP patients, JORRP patients with pulmonary dissemination have a younger initial age of surgery, more surgeries, a higher tracheotomy rate, a higher incidence of preoperative pneumonia, a longer operation and general anaesthesia time, a higher ICU observation rate and a poorer prognosis. Children with JORRP who have a history of tracheotomy and atypical hyperplasia with an initial age of onset ≤2.5 years should be alert for pulmonary dissemination of the papilloma and undergo regular lung CT screening.

Objective To review the early treatment and diagnositic modalities of 3 patients with Brucella periprosthetic joint infection and to review the relevant literature. Method The clinical data of the three patients with brucella periprosthetic joint infection were analysed, and the relevant literature was reviewed. Results The diagnosis of these three patients was confirmed by joint fluid or tissue culture. The serological tests of these patients were also positive. One patient was diagnosed with mixed infection and the pathogenic bacteria of the infection was Finegoldia magna. Symptoms were resolved after antibiotics alone, debridement antibiotics and implant retention(DAIR)or two-stage revision arthroplasty. Conclusion Cultures of synovial fluid and intraoperative periprosthetic tissue represent the routine method for diagnosing periprosthetic joint infection caused by brucella. Brucella serology test is helpful in the diagnosis. Antibiotics alone or debridement antibiotics and implant retention(DAIR)has been effective and should be considered first in patients without loosening of brucella-induced periprosthetic joint infection. Two-stage revision arthroplasty should be considered for patients in whom the pathogenic bacteria cannot be identified piror to surgery.

Objective To investigate the expression and function of protease activated receptor-2(PAR-2)in human corneal epithelial cells(HCECs)stimulated with Aspergillus fumigatus(A. fumigatus). Methods 75% ethanol-killed A. fumigatus stimulated HCECs, and PAR-2 mRNA and protein expressions were tested by RT-qPCR and Western blotting. HCECs were stimulated with 75% ethanol-killed A. fumigatus with or without pretreatment of FSLLRY-NH₂, PCR, Western blotting, and ELISA tested the expressions of IL-1β, TNF-α and p-p38. Results In HCECs, PAR-2 mRNA and protein expressions were significantly increased by A. fumigatus. A. fumigatus upregulated IL-1β, TNF-α and p-p38 expressions levels. FSLLRY-NH₂ significantly inhibited IL-1β, TNF-α and p-p38 expressions compared with infected control. Conclusion A. fumigates stimulation increases PAR-2 expression and upregulates cytokine expression levels though the PAR-2/p-p38 pathway.

Objective To investigate the difference and consistency of corneal keratometry and astigmatism measured by IOL Master700 and Pentacam in cataract patients. Methods A total of 115 cataract patients(203 eyes)were selected from June 2023 to October 2023. Corneal keratometry and astigmatism of the anterior corneal surface, posterior corneal surface and total cornea of cataract patients were measured by IOL Master700 and Pentacam, respectively. Differences, correlations and agreement between the two instruments were analysed. Results Significant differences were found in Ks, Kf and Km of the posterior corneal surface between IOL Master700 and Pentacam(P<0.05), while no significant differences were found in other parameters. Pearson correlation analysis showed a strong correlation between the two instruments in the measurement of Ks, Kf, Km and △k. The correlations for Ks, Kf and Km were more significant than those for △k(P<0.001). Bland-Altman analysis showed strong agreement between the anterior corneal surface Ks, Kf and Km measured by the two instruments, but poor agreement between the posterior corneal surface Ks, Kf and Km. Conclusion Firstly, the IOL Master700 and Pentacam show moderate differences and strong consistency in anterior corneal surface keratometry. Secondly, there are minimal differences and significant consistency in the measurement of total corneal keratometry. However, significant differences and poor consistency are observed in the posterior corneal surface keratometry. Although the differences in astigmatism measurements for the anterior corneal surface, posterior corneal surface and total cornea are minimal between two devices, the consistency is poor. Overall, measurement data from the IOL Master700 and Pentacam should not be used interchangeably in clinical practice, but can be cross-referenced. A comprehensive analysis of the measurement results is recommended for clinical decision making.

Objective To assess the current status of professional cognition and identity among undergraduate students majoring in preventive medicine and to analyze the influencing factors. Methods Using a self-administered questionnaire, we surveyed 507 undergraduates from the 2016 to 2020 cohorts in the School of Public Health at a certain university in Shandong Province. Results A total of 495 valid questionnaires were received(146 male and 349 female), giving a valid response rate of 97.63%. Only 22.02% of the students voluntarily chose preventive medicine as their first choice, while a large proportion were second choice or adjusted admissions. The average major transfer-out rate across all grades was 24.58%. Both interest in the major(χ2=10.581, P=0.001)and satisfaction with the major(χ2=6.509, P=0.011)increased significantly with grade level. There was a statistically significant difference in professional cognition scores across grades(F=24.136, P<0.001), with higher grades having higher cognition scores. However, there was no significant difference in professional identity scores across grades. The differences in professional cognition or identity scores between genders were not statistically significant. Professional cognition scores significantly positively impacted the professional identity scores(B=0.398, P<0.001). Conclusion Grade level is an important factor influencing professional cognition among preventive medicine undergraduates. Professional cognition has a significant positive effect on professional identity. These findings may inform educational reforms in preventive medicine undergraduate programs.

Airway inflammatory diseases, including allergic rhinitis, chronic sinusitis, asthma, and chronic obstructive pulmonary disease(COPD), are characterized by airway inflammation and airway hyperresponsiveness. Recently, metabolomics has emerged as a key tool for studying airway inflammatory diseases. Advances in analytical techniques are enhancing its sensitivity, accuracy, and throughput, offering deeper insights into metabolic changes in conditions like allergic rhinitis, asthma, and COPD. This review outlines advancements in metabolomics research on airway inflammatory diseases, and identifys metabolic pathways and products linked to inflammation and oxidative stress through analyses of blood, sputum, urine feces, and exhaled air condensate. It aims to guide precision medicine, enhance understanding of disease mechanisms, identify biomarkers, evaluate treatment efficacy, and develop new therapies.