Mycoplasmal pneumoniae pneumonia(MPP) is one of the most common etiological types of communityacquired pneumonia in childhood. In recent years, the incidence of macrolide-resistant MPP(MRMP) has shown a significantly increasing trend. With the entry of coronavirus disease 2019 into the seasonal epidemic mode, the incidence of MPP in children shows a significant upward trend. Macrolide antibiotics are the preferred anti-infective drugs for children with MPP, with remarkable therapeutic effects. Based on the epidemic trend, occurrence mechanism and key points of early diagnosis of MRMP in children, this paper reviewed the latest progress in the mechanism of action, implementation plan, efficacy and safety of new tetracycline drugs in the treatment of MRMP in children, providing a reference for clinical practice.

B-cell acute lymphoblastic leukemia(B-ALL) ranks first in incidence among newly diagnosed childhood malignancies. Current clinical treatment primarily relies on conventional chemotherapy, which is limited by poor tolerance and suboptimal long-term prognosis. Blinatumomab, a novel immunotherapy drug, targets CD3 and CD19 antigens to activate T-cell-specific killing of leukemia cells. It has demonstrated significant efficacy in relapsed/refractory B-ALL, minimal residual lesion clearance, and bridging hematopoietic stem cell transplantation. However, its clinical application is constrained by adverse reactions such as cytokine release syndrome and neurotoxicity. This review systematically summarized blinatumomab's mechanism of action, clinical application advancements, adverse effects, management strategies, and explored the future research directions, aiming to provide theoretical insights for optimizing precision therapy in B-ALL.

Kawasaki disease(KD) is an acute, self-limiting, multi-system vasculitic syndrome. It is the leading cause of acquired heart disease in children in developed countries. Coronary artery aneurysms are its most serious complication and can trigger long-term cardiovascular events. In recent years, the understanding of the pathogenesis of KD has shifted from the single pathogen hypothesis to an immune-disordered disease caused by microorganisms. Based on the individualized treatment model of KD with risk stratification, this paper systematically reviewed the latest advances in pharmacotherapy for KD, and prospected the future research directions, aiming to provide reference for clinical medication.

Objective To explore the effect and molecular mechanism of catechins in improving age-related macular degeneration(AMD) by targeting and inhibiting oxidative stress mediated by DNA polymerase delta interacting protein(Poldip)2. Methods The possible pharmacological targets of catechins were detected by network pharmacology and molecular docking. Human retinal pigment epithelial cells(ARPE-19) were treated with(300 μM) H2O2 to establish the AMD cell model, which was divided into the normal control group, the AMD group, the AMD＋low-dose catechin group(3 μM), and the AMD＋high-dose catechin group(300 μM). Cell viability was detected using cell counting kit-8, and the levels of reactive oxygen species(ROS), malondialdehyde(MDA), superoxide dismutase(SOD) and glutathione(GSH) were determined. The expression levels of β -galactosidase, Poldip2, NADPH oxidase(NOX)4 and ROS were detected by enzyme-linked immunosorbent assay(ELISA). Results Catechins may alleviate AMD by targeting and inhibiting Poldip2. Different concentrations of catechins promote the proliferation of RPE cells in a dose-dependent manner. Compared with the normal control group, the levels of ROS and MDA in the AMD group cells were significantly increased, while the levels of SOD and GSH were significantly decreased(P＜0.05). Compared with the AMD group, the levels of ROS and MDA in the two groups treated with catechins were significantly decreased, while the levels of SOD and GSH were significantly increased(P＜0.05). The levels of β -galactosidase, Poldip2 and NOX4 in the AMD group cells were significantly increased, while those in the two groups treated with catechins were significantly decreased(P＜0.05). Conclusion Catechins improve AMD by targeting and inhibiting the Poldip2-NOX4-H2O2 pathway, reducing ROS generation, enhancing the antioxidant capacity of retinal pigment epithelial cells, and delaying cellular aging.

Objective To investigate the effect of triple vitamin therapy(folic acid, vitamin B6, and mecobalamin) on cognitive function in patients with white matter lesions and hyperhomocysteinemia. Methods A total of 89 patients with white matter lesions and hyperhomocysteinemia were prospectively enrolled and divided into a cognitive impairment group[Montreal cognitive assessment(MoCA)＜26, n＝66)] and a non-cognitive impairment group(MoCA≥26, n＝23),based on the baseline MoCA scores. All patients received triple vitamin therapy for 12 months. The baseline characteristics between the two groups were compared, the cognitive function changes after treatment were evaluated, and the influencing factors of cognitive improvement (defined as MoCA score increase≥2 points) were analyzed by logistic regression. Results Except for MoCA scores[cognitive impairment group: 20.0(17.0, 23.0)points vs. non-cognitive impairment group: 26.0(26.0, 27.0)points, P＜0.001], there were no statistically significant differences between the two groups in age, gender, education level, vascular risk factors, laboratory indicators, and Fazekas scores(P＞0.05). After 12 months of treatment, serum total homocysteine levels significantly decreased(P＜0.001). The change in MoCA total score from baseline was 1.0(-2.0, 3.0) points(P＝0.126) in the cognitive impairment group and -1.0(-3.0, 1.0) points(P＝0.053) in the non-cognitive impairment group, with a statistically significant difference between the two group(P＝0.020). Subdomain analysis showed that the cognitive impairment group had significant improvements compared to the baseline in visuospatial and executive function(P＜0.001), naming(P＜0.001), attention(P＝0.015), and abstraction(P＝0.013), with changes in visuospatial and executive functio(P＝0.004) and naming(P＝0.017) being significantly superior to those in the non-cognitive impairment group. Multivariate logistic regression analysis showed that baseline MoCA score was an independent predictor of cognitive improvement(odds ratio＝0.76, 95% Wald confidence interval: 0.64-0.87, P＜0.001). Conclusion Triple vitamin therapy for 12 months can improve specific cognitive functions in patients with white matter lesions and hyperhomocysteinemia, especially in patients with baseline cognitive impairment. Visuospatial and executive function, naming, abstraction, and attention have improved significantly. Patients with poorer baseline cognitive function have greater room for improvement.

Objective To observe the adjuvant effect of modified Guizhi Shaoyao Zhimu decoction on patients with knee osteoarthritic synovitis of wind-cold-damp arthralgia syndrome. Methods A total of 102 patients with knee osteoarthritic synovitis of wind-cold-damp arthralgia syndrome who were admitted to our hospital from November 2022 to December 2023 were selected as the research subjects and randomly divided into the control group and the observation group, with 51 cases in each group. The control group received conventional treatment and extracorporeal shock wave therapy, while the observation group was given modified Guizhi Shaoyao Zhimu decoction on the basis of the treatment of the control group. The therapeutic effects, total score of traditional Chinese medicine(TCM) symptoms, western ontario and McMaster universities osteoarthritis index(WOMAC) score, hospital for special surgery knee score(HSS), joint effusion score, synovial thickness score, changes in serum inflammatory factor levels and occurrence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the observation group was higher than that of the control group (94.12% vs. 80.39%, P＜0.05). After treatment, the total score of TCM symptoms, WOMAC score, HSS, joint effusion score and synovial thickness score of the observation group were all better than those of the control group, and the levels of inflammatory factors were all lower than those of the control group, with significant differences (P＜0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (3.92% vs. 5.88%), but there was no significant difference (P＞0.05). Conclusion The modified Guizhi Shaoyao Zhimu decoction has a good effect and is safe and reliable in the adjuvant treatment of patients with knee osteoarthritic synovitis of wind-cold-damp arthralgia syndrome.

Objective To explore the effects of cetirizine combined with montelukast sodium on sleep, quality of life, immunity, inflammatory factors and safety in children with cough variant asthma(CVA). Methods A total of 71 children with CVA admitted to our hospital from December 2022 to October 2024 were selected as the research subjects and randomly divided into the experimental group of 35 cases and the control group of 36 cases. Both groups received basic treatment. The control group was treated with montelukast sodium, and the experimental group was treated with cetirizine on this basis. The treatment course for both groups was one week. The apnea-hypopnea index, the lowest nocturnal blood oxygen saturation, quality of life and inflammatory factors of the two groups before and after treatment were detected, and the occurrence of adverse reactions was statistically analyzed. Results: After treatment, the minimum nocturnal blood oxygen saturation, immunoglobulin(Ig)A, interferon-γ, cluster of differentiation(CD)4＋, CD4＋/CD8＋ in both groups increased compared with those before treatment, and the experimental group was higher than the control group. The differences were significant(P＜0.05). The scores of sleep disorders, physical symptoms, poor mood, daytime functional status and total score in both groups after treatment were lower than those before treatment. The scores in the experimental group were lower than those in the control group, and the differences were significant(P＜0.05). The apnea-hypopnea index, C reactive protein, monocyte chemoattractant protein-1, interleukin(IL)-4, transforming growth factor -β, vascular endothelial growth factor, IgE, IL-13, and CD8＋ in both groups decreased compared with those before treatment, and the experimental group was lower than the control group, with significant differences(P＜0.05). There was no significant difference in the total incidence of abdominal pain and diarrhea, nausea and vomiting, rash and dizziness between the two groups(P＞0.05). Conclusion Cetirizine combined with montelukast sodium in the treatment of children with CVA can improve sleep structure, enhance quality of life and immune function, reduce the levels of inflammatory factors, and has good safety.

Objective To explore the effect of vedolizumab in the treatment of ulcerative colitis(UC) and its mechanism of action on mitochondrial autophagy. Methods A total of 96 patients with UC admitted to our hospital from January 2021 to December 2024 were selected as the research subjects. They were divided into the observation group and the control group by simple sorting random method, with 48 cases in each group. By the end of the study, the two groups had dropped to the observation group with 46 cases and the control group with 45 cases. The control group was treated with mesalazine enteric-coated tablets, while the observation group was added with vedolizumab. The treatment courses for both groups were 8 weeks. After treatment, the clinical efficacy, mitochondrial autophagy, inflammatory factors, intestinal mucosal barrier function and clinical symptom scores of the two groups were compared. Result After treatment, the total effective rate of the observation group was higher than that of the control group(82.61% vs 62.22%, P＜0.05). After treatment, the levels of PTEN-induced putative kinase(PINK)1 and parkinin in both groups were compared with those before treatment(P＜0.05), and those in the observation group were higher than those in the control group(P＜0.05). After treatment, the levels of tumor necrosis factor-α, interleukin(IL)-17 and IL-23 in both groups were lower than those before treatment(P＜0.05), and those in the observation group were lower than those in the control group(P＜0.05). After treatment, the levels of D-lactic acid, diamine oxidase and endothelin in both groups were lower than those before treatment(P＜0.05), and those in the observation group were lower than those in the control group(P＜0.05). By the end of the treatment, the scores of abdominal pain, diarrhea, mucus and bloody stool, and the total score in the observation group were all lower than those in the control group(P＜0.05). Conclusion Vedilizumab treatment has a good effect on UC, which can increase the contents of PINK1 and paraquin in patients and reduce the levels of inflammatory factors.

Objective To explore the clinical value of intravenous thrombolysis with alteplase in the treatment of wake-up stroke(WUS) within the tissue window. Methods Patients with WUS admitted to the neurology department of our hospital from July 2023 to January 2025 were selected and randomly divided into 3 groups, with 36 cases in each group. The control group(C group) received conventional drug treatment, the standard-dose group(B group) received intravenous thrombolysis with 0.9 mg/kg alteplase, and the low-dose group(A group) received intravenous thrombolysis with 0.6 mg /kg alteplase. The National Institutes of Health Stroke Scale(NIHSS) scores, clinical efficacy, bleeding status, coagulation function, platelet count(PLT), outcome status and adverse reactions of each group were compared. Results At 24 hours, 7 days, 14 days and 30 days after treatment, the NIHSS scores of A and B group were lower than those of C group(P＜0.05). The total effective rates of treatment in both A and B group were higher than that in C group(P＜0.05). Before treatment and at 24 hours and 7 days after treatment, there were no significant differences in prothrombin time, activated partial thromboplastin time, fibrinogen and PLT levels among all groups(P＞0.05). At 90 days after treatment, there were no significant differences in the rates of intracranial, digestive tract and urinary system, oral and skin and mucous membrane bleeding among all groups(P＞0.05). The good outcome rate, modified Barthel index score and Montreal Cognitive Assessment Scale score of A and B group were all higher than those of C group(P＜0.05). There was no significant difference in the total incidence of adverse drug reactions among all groups(P＞0.05). Conclusion Intravenous thrombolysis with low-dose alteplase for intratuminal WUS can achieve a similar therapeutic effect to the standard dose, significantly improve neurological function, promote a good outcome, and have a relatively small impact on bleeding.

Objective To explore the efficacy of rituximab as an adjuvant to GDP in the treatment of non-Hodgkin lymphoma(NHL) and its effect on thymidine kinase(TK)-1, recombinant factor related apoptosis ligand(FASL) and platelet-derived growth factor(PDGF)-BB. Methods A total of 210 NHL patients who were treated in our hospital from September 2021 to September 2024 were selected and randomly divided into the observation group and the control group, with 105 cases in each group. The control group was given the GDP regimen, while the observation group was added with rituximab. The clinical efficacy, TK-1, FASL, PDGF-BB, changes of peripheral blood T lymphocyte subsets, cluster of differentiation(CD)8＋, CD4＋ and CD3＋ of the two groups were compared to evaluate the quality of life and occurrence of adverse reactions of the patients. Results A total of 103 cases in the observation group and 101 cases in the control group completed the study. After treatment, the disease control rate of the observation group was higher than that of the control group(72.82% vs. 58.42%, P＜0.05). The levels of TK-1, FASL and PDGF-BB in both groups were lower than those before treatment(P＜0.05), and those in the observation group were lower than those in the control group(P＜0.05). The CD8＋ level in both groups was lower than that before treatment(P＜0.05), and the level in the observation group was lower than that in the control group(P＜0.05). The levels of CD4＋ and CD3＋ were increased before treatment, and the levels in the observation group were higher than those in the control group(P＜0.05). The scores of physical function, emotional function, social function, cognitive function and role function of the two groups of patients were significantly higher, and the observation group was higher than the control group(P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups of patients(P＞0.05). Conclusion Among NHL patients, the rituximab adjuvant GDP regimen has a better therapeutic effect and can effectively improve the levels of TK-1, FASL and PDGF-BB.

Objective To explore the therapeutic effect of cinacalcet combined with renal failure mixture in chronic renal failure(CRF) with secondary hyperparathyroidism(SHPT) and its influence on fibroblast growth factor(FGF)-23, parathyroid hormone(PTH), and 25-hydroxyvitamin D3[25(OH)D3]. Methods Patients with CRF accompanied by SHPT admitted to our hospital from January 2021 to December 2024 were selected for the study and randomly divided into the control group and the experimental group. All patients received hemodialysis treatment three times a week and were treated with calcium carbonate and renal failure mixture. The experimental group was given cinacalcet on the basis of the control group. The clinical efficacy, FGF-23, PTH, 25(OH)D3, blood calcium, blood phosphorus, calcium-phosphorus product, intact PTH(iPTH), thyroid volume and the occurrence of adverse reactions were compared between the two groups. Result After treatment, the total clinical effective rate of the experimental group was higher than that of the control group(84.91% vs. 67.31%), and the difference was significant(P＜0.05). The levels of FGF-23, PTH, 25(OH)D3, blood calcium, blood phosphorus, calcium-phosphorus product, iPTH and thyroid volume in the peripheral blood of the experimental group were all lower than those of the control group(P＜0.05). During the treatment period, there was no statistically significant difference in the occurrence of adverse reactions between the two groups(P＞0.05). Conclusion Cinacalcet combined with renal failure mixture as an adjuvant therapy for CRF with SHPT has a better effect and can help reduce the levels of FGF-23, PTH and 25(OH)D3 in the peripheral blood of patients.

Objective To explore the effect of the Qingre Lishi Jiedu decoction formula as an adjunctive treatment for patients with perianal abscess, and to analyze its influence on inflammatory response and wound healing. Methods Patients with perianal abscess admitted to the anorectal department of our hospital from April 2023 to April 2024 were selected as the research subjects and randomly divided into the control group and the treatment group. Both groups underwent radical resection of perianal abscess. The control group was given potassium permanganate sitz bath combined with conventional anti-infection treatment after the operation, while the treatment group was also treated with fumigation and washing with the Qingre Lishi Jiedu decoction. The treatment course for both groups was 2 weeks. The clinical efficacy, traditional Chinese medicine(TCM) syndrome score, inflammatory factors, growth factors, wound healing indicators, anal function indicators and adverse reactions of the two groups were compared. Results The total effective rate of the treatment group was higher than that of the control group(91.67% vs. 80.00%), and the difference was statistically significant(P＜0.05). After treatment, the TCM syndrome score of the treatment group was lower than that of the control group(P＜0.05)), the levels of serum inflammatory factors were all lower than those of the control group(P＜0.05), and the level of growth factors was higher than that of the control group(P＜0.05). The disappearance time of exudate, edema and wound healing time in the treatment group were shorter than those in the control group(P＜0.05). The levels of wound healing indicators and anal function indicators in the treatment group were lower than those in the control group(P＜0.05). There was no significant difference in the occurrence of adverse reactions between the two groups(P＞0.05). Conclusion The Qingre Lishi Jiedu decoction can assist in alleviating the postoperative inflammatory response in patients with perianal abscess, promoting wound healing and the recovery of anal function.

Objective To explore the effects of Ginkgo biloba leaves combined with Danlong Xingnao formula on cerebral blood flow, metabolism, and serum hypersensitive C-reactive protein(hs-CRP) and homocystine(Hcy) in elderly patients with vascular ischemic dementia. Methods A total of 110 elderly patients with vascular ischemic dementia in the First Affiliated Hospital of Naval Medical University from June 2020 to December 2022 were selected and divided into the observation group and the control group by simple sorting randomization, with 55 cases in each group. The control group was treated with donepezil, while the observation group was additionally treated with Ginkgo biloba leaves combined with Danlong Xingnao formula. The treatment outcomes and adverse reactions of the two groups were compared. Results After treatment, the scores of the mini-mental state examination scale, Hasegawa dementia modified scale, the scores of the dementia pathological behavior assessment scale for behavioral function application and activities of daily living scale in the observation group were higher than those in the control group, while hemorheological indicators such as plasma viscosity, and the levels of serum hs-CRP and Hcy were lower than those in the control group(P＜0.05). The improvement of anterior, middle and posterior arterial blood flow indicators(systolic blood flow velocity, diastolic blood flow velocity, mean blood flow velocity, pulsatile index) and brain metabolic indicators(choline/creatine ratio, lactic acid/creatine ratio) in the observation group was better than that in the control group(P＜0.05). There was no significant difference in adverse reactions(P＞0.05). Conclusion The combination of Ginkgo biloba leaves and Danlong Xingnao formula can improve the hemorheology, serum indicators, cerebral blood flow and metabolism of elderly patients, enhance cognitive and living abilities, and has good safety.

Objective To explore the clinical study of tislelizumab combined with nab-paclitaxel and cisplatin(NabPP) for advanced lung squamous cell carcinoma with high expression of programmed death-ligand(PD-L)1. Methods The clinical data of patients with advanced lung squamous cell carcinoma with high PD-L1 expression who were admitted to our hospital from November 2020 to June 2023 were retrospectively collected. A total of 99 patients who received Nab-PP combined with tislelizumab treatment(the monoclonal antibody group), and 91 patients who received only Nab-PP treatment during the same period(the reference group) were initially included. The propensity score matching method was adopted, and the matching was carried out according to the 1∶1 ratio principle. Eventually, 52 patients in each group were successfully matched. The clinical efficacy, immune indicators, tumor markers, degree of primary lesion remission, functional status, quality of life scores, survival situation and safety between the two groups were compared. Results The objective response rate of the monoclonal antibody group(55.77%) was higher than that of the reference group(32.69%, P＜0.05). After treatment, the levels of CD3＋, CD4＋, CD4＋/CD8＋ and natural killer cells in the monoclonal antibody group were all higher than those in the reference group, while the levels of squamous cell carcinoma antigen, carcinoembryonic antigen, cytokeratin 19 fragment and matrix metalloproteinase 9 were all lower than those in the reference group(P＜0.05). In the monoclonal antibody group, there were 18 cases in stage Ⅲb. Among them, 16 cases(88.9%) eventually underwent radical surgery. Postoperative pathology confirmed 9 cases(56.3%) of major pathological response and 7 cases(43.8%) of pathological complete response. After the treatment, the Karnofsky performance status and the systematic evaluation of pulmonary function - lung score of the monoclonal antibody group were both higher than those of the reference group(P＜0.05). The median progression-free survival and overall survival in the monoclonal antibody group were significantly higher than those in the reference group(χ 2 ＝13.882, 12.323, P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05). Conclusion Tislelizumab combined with the Nab-PP regimen can significantly improve the clinical efficacy of patients with advanced lung squamous cell carcinoma with high PD-L1 expression, prolong survival time, and has a good safety profile. It is suitable for clinical promotion and application.

Peptide drugs, with their high activity, low dosage, few adverse reactions and strong specificity, have shown broad application prospects and potential. However, oral administration is easily destroyed and poorly absorbed. The conventional administration route of peptide drugs is injection, which has poor patient compliance. Nasal administration of peptide drugs can overcome the problems of low bioavailability of oral administration and poor compliance of injection administration, and provide a potential brain-targeted delivery route for some drugs(such as insulin). This article systematically reviewed the marketed nasal peptide preparations and analyzed their advantages in terms of administration convenience and patient compliance compared with injection dosage forms. At the same time, it reviewed the peptide nasal preparations in clinical and preclinical research and discussed strategies to improve the delivery efficiency of peptide drugs.

Premature ovarian failure is characterized by decreased ovarian function before the age of 40, which is mainly manifested by abnormal menstruation, increased gonadotropin, and fluctuating decline in estrogen levels. Based on the theory that "the kidney governs reproduction", traditional Chinese medicine, in combination with the syndrome differentiation of multiple organs such as the liver and spleen, often employs therapeutic methods such as soothing the liver and tonifying the kidney, strengthening the spleen and tonifying the kidney, and tonifying the kidney and promoting blood circulation. This article systematically reviewed the clinical research progress on the treatment of premature ovarian failure from the perspective of kidney therapy in the past three years, explored the therapeutic mechanisms and advantages of different treatment methods, and provided a reference for optimizing clinical treatment plans.