Volume 104 · Issue 19 · 2024

Chronic alcohol-related brain damage (ARBD), previously known as chronic alcoholic encephalopathy, is an important spectrum of chronic brain damage caused by long-term alcohol intake. Its onset and progression are very insidious. Timely and accurate diagnosis and treatment can help improve the clinical prognosis of patients and reduce the disease burden of society. After reviews of the literature and updating of evidence-based evidence, the draft guideline was developed according to the method of Grading of Recommendations, Assessment, Development and Evaluation (GRADE). After repeated discussions and revisions, a guideline on the diagnosis and treatment of chronic alcohol-related brain damage in China was finally established. This guideline compares the definitions of various clinical syndromes of chronic ARBD in different diagnostic classification systems, and grades and recommends various auxiliary examinations, screening tests and diagnostic criteria for the diagnosis of chronic ARBD. In addition, various intervention treatments that can improve the clinical prognosis of chronic ARBD, such as alcohol withdrawal, etiological treatment, correction of nutritional disorders, neural protection treatment, and rehabilitation with nursing comprehensive treatment, were graded and recommended. A total of 28 recommendations were formed to provide reference and guidance for improving the clinical efficacy of chronic ARBD.

To investigate the clinical characteristics and risk factors of delayed diarrhea following irinotecan-based chemotherapies in colorectal cancer patients.

Patients with colorectal cancer undergoing antitumor treatment at Peking University Third Hospital from January 2018 to June 2023 were retrospectively included. All lines of chemotherapies containing irinotecan were analyzed, and related clinical information was collected. According to whether delayed diarrhea occured in the course of the disease, the patients were divided diarrhea group and non-diarrhea group; According to whether delayed diarrhea occurred in the current round of chemotherapy, the patients were divided into chemotherapy group with diarrhea and chemotherapy group without diarrhea, and each round of chemotherapy was regarded as one case data. The incidence and clinical features of delayed diarrhea were analyzed. The multivariate logistic regression model was used to analyze risk factors for the occurrence of delayed diarrhea.

A total of 215 patients were included. There were 104 cases in the diarrhea group, 57 males and 47 females, aged 23 to 83 (58±12) years. There were 111 cases without diarrhea, 73 males and 38 females, aged 32 to 83 (58±10) years. All patients received a total of 271 chemotherapy lines including irinotecan. In the chemotherapy group with delayed diarrhea, there were 118 cases (43.5%), of which 22 cases (18.6%) were severe diarrhea of grade 3 or above. Eighty-seven cases (73.7%) of diarrhea occurred after the first cycle of treatment, with the onset time [M(Q₁, Q₃)] on day 4 (3, 5) after chemotherapy. Delayed diarrhea resulted in 41 cases (34.7%) of delayed chemotherapy or reduced drug dosage. Patients over 65 years old (OR=1.96, 95%CI: 1.13-3.38), at the time of chemotherapy and with three chemotherapeutic drugs (OR=3.48, 95%CI: 1.38-8.82) have a higher risk of diarrhea of any grade, while patients with a previous history of colorectal cancer liver metastasis resection (OR=0.51, 95%CI: 0.27-0.95) have a lower risk of diarrhea of any grade (all P<0.05).

Delayed diarrhea associated with irinotecan has a high incidence in Chinese patients with colorectal cancer, often occurring after initial drug administration, and some patients experienced severe episodes of diarrhea. Patients who are over 65 years old at the time of chemotherapy and whose regimen contains three chemotherapeutic drugs have a higher risk of diarrhea of any grade, while patients with a previous history of colorectal cancer liver metastasis resection have a lower risk of diarrhea of any grade.

To analyze the clinical characteristics and associated factors of neonatal purulent meningitis complicated with brain abscess.

Newborns with purulent meningitis complicated with brain abscess of Zhengzhou University Affiliated Children′s Hospital from January 2010 to January 2023 were retrospectively selected as the case group. Among neonatal meningitis patients without brain abscess, a control group was selected using the 1∶3 nearest neighbor matching method in propensity score matching, with matching factors including onset age≤7 days or>7 days, gestational age, birth weight, and gender. The clinical data of the patients were collected to analyze the differences in pathogen distribution, clinical symptoms and signs, auxiliary examinations, and outcomes between two groups. Multivariate logistic regression model was used to analyze the risk factors of neonatal purulent meningitis complicated with brain abscess.

There were 21 cases in the case group, 9 males and 12 females, aged 4.0-35.0 (18.5±7.5) days; There were 63 cases in the control group, 26 males and 37 females, aged 5.0-41.0 (19.4±9.4) days. There was no statistically significant difference in the positive rates of blood and cerebrospinal fluid pathogens between the case group and the control group [61.9% (13/21) vs 47.6% (30/63), P=0.257]. The proportion of cure or improvement in the case group is lower than that in the control group [33.3% (7/21) vs 88.9% (56/63), P<0.001]. The incidence of multidrug-resistant bacterial infections [47.6% (10/21) vs 12.7% (8/63), P<0.001], convulsion [52.4% (11/21) vs 27.0% (17/63), P=0.033], respiratory failure [57.1% (12/21) vs 14.3% (9/63), P<0.001], and septic shock [52.4% (11/21) vs 3.2% (2/63), P<0.001] in the case group were all higher than those in the control group; C-reactive protein (CRP) and cerebrospinal fluid white blood cell count [M (Q₁, Q₃)] in case group were [70.4 (52.1, 86.4)] mg/L and [1 234 (788, 1 606)]×10⁶/L, respectively, all higher than those in the control group [45.0 (25.7, 57.8)] mg/L, [688 (256, 1 089)]×10⁶/L (all P<0.001). Multivariate logistic regression model analysis revealed that multidrug-resistant bacterial infection (OR=7.094, 95%CI: 1.335-37.705, P=0.022) and septic shock (OR=30.102, 95%CI: 3.101-292.224, P=0.003) were associated factors for neonatal purulent meningitis complicated with brain abscess.

Children with neonatal purulent meningitis complicated with brain abscess have severe infection symptoms and poor prognosis. Multidrug-resistant bacterial infection and septic shock are the related factors of neonatal purulent meningitis complicated with brain abscess.

To explore the effect of closed-loop target-controlled infusion of propofol on anesthesia depth and hemodynamics during fundus surgery in patients with proliferative diabetic retinopathy (PDR) combined with renal failure.

This study was a randomized controlled trial. A total of 70 patients with PDR combined with renal failure who underwent pars plana vitrectomy (PPV) under general anesthesia at Beijing Tongren Hospital Affiliated to Capital Medical University from June 2021 to April 2023 were selected. According to different target-controlled infusion methods of propofol, patients were divided into two groups (n=35) using the random number table method: closed-loop target-controlled infusion group and manual target-controlled infusion group. Both groups of patients underwent total intravenous anesthesia and laryngeal mask ventilation. The target value of bispectral index (BIS) for anesthesia maintenance was set at 45-55. Remifentanil was pumped intravenously and cisatracurium was injected intermittently during the operation. The proportions of time of BIS<40, 40≤BIS≤60 and BIS>60 between the two groups, as well as the differences in mean arterial pressure (MAP), heart rate (HR), BIS value, plasma concentration of propofol, vasoactive drug dosage and incidence of postoperative adverse reactions between the two groups at different time points were compared. Results The proportion of time of 40≤BIS≤60 in the closed-loop target-controlled infusion group was (84.4±2.7)%, which was higher than (65.7±3.8)% in the manual target-controlled infusion group,while the proportions of time of BIS<40 and BIS>60 were (11.2±3.2)% and (4.4±1.4)% respectively, both lower than (28.7±4.8)% and (5.5±1.8)% in the manual target-controlled infusion group (all P<0.05).The MAP in the closed-loop target-controlled infusion group were (79±7) and (77±7) mmHg(1 mmHg=0.133 kPa) at the time of laryngeal mask placement and at the beginning of the operation, which were significantly higher than those in the manual target-controlled infusion group of (74±8) and (72±8) mmHg(both P<0.05). The propofol plasma concentration in the closed-loop target-controlled infusion group were (1.8±0.3) and (1.9±0.5) μg/L, which were lower than those in the manual target-controlled infusion group of (2.5±0.3) and (2.6±0.2) μg/L(both P<0.05).The intraoperative utilization rates of ephedrine and dopamine in the closed-loop target-controlled infusion group were 31.4% (11/35) and 14.3% (5/35), which were lower than those in the manual target-controlled infusion group of 74.3% (26/35) and 37.1% (13/35, both P<0.05). There were no statistically significant differences in the propofol plasma concentration, postoperative pain, nausea, vomiting, hypertension and other adverse reactions between the two groups during recovery (all P>0.05).

Closed-loop target-controlled infusion of propofol can more accurately maintain the depth of general anesthesia and stable hemodynamics during surgery in patients with PDR combined with renal failure.

To evaluate the correlation between visceral fat and lumbar epidural fat (EF) accumulation.

Data of 352 hospitalized patients in the Department of Spine Surgery, Zhongda Hospital Affiliated to Southeast University from July 2020 to July 2023 were retrospectively reviewed, including 164 males and 188 females with a mean age of (65.6±15.1) years. The participants were divided into lumbar EF increased group (increased group, n=130) and non-lumbar EF increased group (normal group, n=222) based on the degree of lumbar EF accumulation. The demographic data, laboratory examinations and imaging indicators (visceral fat and EF-related parameters) of the participants were compared between the two groups. Multivariate logistic regression analysis was performed to assess associated factors for lumbar EF accumulation. The correlation between visceral fat area (VFA) and lumbar EF accumulation was evaluated by Pearson correlation analysis and Jonckheere-Terpstra trend test. The receiver operating characteristic (ROC) curve was further drawn to establish the best cut-off value for VFA to diagnose increased lumbar EF.

The glycated hemoglobin (HbA1c), fasting blood glucose (FBG), VFA, diabetes and hyperlipidemia proportion of increased group were significantly higher than those of normal group (all P<0.05). Multivariate logistic regression analysis showed that the correlates of increased lumbar EF were FBG (OR=1.427, 95%CI:1.043-1.951, P=0.026), VFA (OR=2.212, 95%CI:1.697-2.883, P<0.001) and hyperlipidemia (OR=3.969, 95%CI:1.125-14.005, P=0.032). After adjusting for gender, body mass index, waist circumference, triglycerides, HbA1c, FBG, history of diabetes and hyperlipidemia, the results demonstrated that the incidence of increased lumbar EF elevated with the increase of VFA (OR=3.400, 95%CI:2.363-4.892, P<0.001). Pearson correlation analysis showed that VFA was significantly correlated with lumbar EF-related parameters (all P<0.001). VFA of patients with increased degree of lumbar EF accumulation elevated (J=9.008, P<0.001). The ROC curve showed that the best cut-off values for VFA to diagnose increased lumbar EF were 323.70 cm² for men and 360.46 cm² for women.

Visceral fat is closely associated with increased lumbar EF. VFA is an effective indicator to identify the accumulation of lumbar EF.

To investigate the clinical, imaging and cerebrospinal fluid characteristics of neurobrucellosis (NB) patients with positive oligoclonal bands (OCB).

A total of 23 patients diagnosed with NB from the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2023 were retrospectively analyzed, including 9 males and 14 females, aged 47 (34, 59) years old. NB patients were divided into OCB positive group and OCB negative group according to the results of IgG electrophoresis in serum and cerebrospinal fluid. The clinical, imaging and cerebrospinal fluid characteristics of the two groups were compared.

Cerebrospinal fluid OCB positive in 23 cases of NB accounted for 65.2% (15/23), mainly type Ⅱ(14/15). There were 8 patients in the negative group. The proportion of clinical severe patients (11/15), the proportion of patients with elevated leukocyte in cerebrospinal fluid (15/15), IgG index [M(Q₁, Q₃), 0.97(0.57, 2.11)], and 24 h intrathecal synthesis rate [55.6 (15.3, 232.2) mg/24 h] in OCB positive group were significantly higher than those in the negative group [1/8,5/8, 0.63(0.51, 0.69), 11.6(-1.6, 17.3) mg/24 h, both P<0.05]. There was no significant difference in the course of disease and clinical type between the two groups(both P>0.05). The OCB-positive group showed multiple brain parenchymal lesions in the whole brain (supratentorial combined with supratentorial) (5/15), but no supratentorial parenchymal involvement was found in the OCB-negative group (0/8).

The OCB positive rate in NB patients is 65.2%. Compared with the OCB negative group, the OCB positive patients have more severe clinical symptoms, with more severe intrathecal humoral immune inflammatory reactions of the nervous system, and more likely to have subtentorial brain parenchyma involvement.

To establish and validate a predictive model for postoperative nausea and vomiting (PONV) in patients undergoing lumbar fusion surgery based on LASSO regression.

A total of 582 patients who underwent lumbar fusion surgery at the Second Affiliated Hospital of Wenzhou Medical University between April 2022 and April 2023 were retrospectively included in the modeling group for model establishment and internal validation. Among them, 293 were male and 289 were female, with a median age [M(Q₁, Q₃)] of 65 (56, 70) years. Additionally, 233 patients undergoing lumbar fusion surgery at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2019 to April 2023 were selected as the validation group for external validation. Among them, 118 were male and 115 were female, with a median age of 68 (60, 74) years. Univariate and LASSO regressions were used to screen risk factors. Logistic regression was applied to establish the model and then a nomogram was developed. The area under the curve (AUC) of receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis were adopted to evaluate the performance and clinical applicability of the model.

Four predictive factors were ultimately screened out to construct the model. Female (OR=3.564, 95%CI: 2.142-5.929, P<0.001), non-smoking (OR=7.077, 95%CI: 1.626-30.802, P=0.009), and intraoperative hypotension (OR=2.056, 95%CI: 1.334-3.168, P=0.001) were risk factors for PONV, while intraoperative use of dexamethasone (OR=0.408, 95%CI: 0.218-0.762, P=0.005) was a protective factor. The degree and duration of intraoperative hypotension were further classified based on the cut-off value of ROC curve and clinical experience. Univariate logistic regression analysis showed that mean arterial pressure≤55 mmHg(1 mmHg=0.133 kPa), systolic pressure decrease over 40% of baseline, the longest duration of hypotension>5 min, and the cumulative time of hypotension>10 min increased the risk of PONV by 6.050 times (95%CI: 2.445-14.969, P<0.001), 3.474 times (95%CI: 1.012-11.926, P=0.048), 1.818 times (95%CI: 1.209-2.735, P=0.004), and 1.852 times (95%CI: 1.226-2.796, P=0.003), respectively. The AUC for the established prediction model in the modeling and validation groups were 0.763 (95%CI: 0.719-0.807, P<0.001) and 0.708 (95%CI: 0.627-0.790, P<0.001), respectively. The calibration and decision curves in above two groups demonstrated the model′s consistency and positive net benefit.

The prediction model of PONV after lumbar fusion surgery based on LASSO regression includes female, non-smoking, intraoperative hypotension and dexamethasone,and it is relatively accurate and of clinical application value.

To investigate the molecular mechanism of resolvin D1 (RvD1) in the treatment of systemic lupus erythematosus (SLE) model mice.

Eight-week-old female MRL/lpr mice (Lupus mice model, a total of 12) and ICR mice (healthy control mice, a total of 6) were selected. MRL/lpr mice were randomly divided into phosphate buffered solution (PBS) group and RvD1 group (6 in each group) according to the random number table method. PBS (0.2 ml) and RvD1 (5 μg/kg) were injected into the tail vein respectively, serum anti double stranded DNA (dsDNA) antibody levels, urine protein levels and T follicular helper cell (Tfh) ratio were detected in PBS and RvD1 groups of mice after 8 weeks. After the mice were killed, spleen CD4⁺T cells of PBS group were isolated. CD4⁺T cells were divided into CD4⁺T cells+dimethyl sulfoxide (DMSO) (Group A), CD4⁺T cells+RvD1 (Group B), naive CD4⁺T cells+DMSO (Group C), and naive CD4⁺T cells+RvD1 (Group D) according to random number table method. E26 transcription factor 1 (ETS1) mRNA expression and Tfh ratio and differentiation were detected in each group. CD4⁺T cells or naive CD4⁺T cells were co-cultured with miR-338-3p inhibitors, to detect ETS1 mRNA expression and Tfh differentiation. Splenic CD4⁺T cells of ICR mice were infected with shRNA-circ_0006779 lentivirus or empty lentivirus. miR-338-3p level, ETS1 mRNA expression and Tfh differentiation were detected in each group (The number of sieve holes in cell experiments all is 5).

The expression level of EST1 mRNA on CD4⁺T cells in the spleen of mice in the RvD1 group was higher than that in the PBS group (1.00±0.33 vs 0.34±0.13, P=0.014); The spleen weight, serum anti-dsDNA antibody level, urine protein level, and Tfh cell ratio of RvD1 group were all lower than those of PBS group (all P<0.05). The results of co-culture of RvD1 and CD4⁺T cells in vitro showed that the ETS1 mRNA expression in CD4⁺T cells in Group B was higher than that in Group A (1.00±0.08 vs 0.25±0.05, P<0.001), and the Tfh ratio was lower than that in Group A (16.06%±3.06% vs 21.76%±3.42%, P=0.020); The co-culture results of RvD1 and naive CD4⁺T cells showed that the naive CD4⁺T ETS1 mRNA expression in Group D was higher than that in Group C (1.00±0.25 vs 0.21±0.16, P<0.001), and Tfh differentiation was lower than that in Group C (8.81%±1.01% vs 12.60%±1.86%, P=0.011). Compared with the absence of miR-338-3p inhibitor, miR-338-3p inhibitor can increase the expression of ETS1 mRNA in CD4⁺T cells in PBS group (1.00±0.24 vs 0.10±0.01, P<0.001), and reduce Tfh cell differentiation (9.56%±1.53% vs 13.60%±1.32%, P<0.001); Compared with the empty lentivirus group, shRNA-circ_0006779 lentivirus can increase the miR-338-3p level of CD4⁺T cells (1.00±0.22 vs 1.38±0.21,P=0.002), reduce ETS1 mRNA level (0.76±0.13 vs 1.00±0.14,P=0.005), and improve the differentiation of Tfh cells in ICR group (4.00%±0.65%比1.68%±0.60%,P<0.001).

RvD1 can inhibit Tfh cell differentiation through circ_0006779/miRNA-338-3p/ETS1 axis and treats SLE in mice.

To systematically review the sagittal parameters of the craniovertebral junction (CVJ), introduce the measurement methods and research progress of the parameters, and provide references for their more reasonable use in clinical practice.

A retrieval formula ("atlantoaxial" OR "atlanto-axial" OR "upper cervical" OR "Cranio-vertebral" OR "Occipitocervical" OR "Occipito-cervical" OR "Craniovertebral" OR "craniocervical" OR "cranio-cervical ") AND ("sagittal" OR "alignment") AND (humans[Filter]) AND (english[Filter]) was used to search PubMed for research literature on CVJ sagittal parameters from January 1, 1975 to December 8, 2022, and the literature that met the requirements was systematically reviewed to review the sagittal parameters of the craniovertebral junction.

A total of 7 articles were included, and 9 CVJ sagittal parameters were selected from them. CVJ sagittal parameters can be divided into three categories: anatomical morphological parameters, parameters for assessing skull position, and parameters related to upper cervical curvature. There was a varying degree of correlation between CVJ sagittal parameters and lower cervical and even spinal-pelvic sagittal parameters: the occipital-C₂ angle (O-C₂) had a correlation of r=0.400 with the cervical lordosis angle (C₂-C₇), the C₁-C₂ Cobb angle (C₁-C₂) had a correlation of r=-0.300 with C₂-C₇ and C₁-C₂ had a correlation of r=0.100 with the lumbar lordosis angle (LL) (all P<0.05). O-C₂ and C₁-C₂ have a significant impact on the patient′s postoperative quality of life and pain, swallowing function, and speech function. There are still controversies in the field of the relationship between adolescent idiopathic scoliosis (AIS) and anterior cervical discectomy decompression fusion surgery (ACDF) and O-C₂, and the ideal C₁-C₂ fusion angle.

The morphology of the skull, its position, and the sagittal sequence of the upper cervical spine curvature are extensively correlated. Moreover, the sagittal balance of CVJ is closely linked to the patient′s quality of life.

The child, a 10-year-old male, was admitted to the Department of Hemangioma Surgery of the Third Affiliated Hospital of Zhengzhou University on June 29, 2021 due to "discovery of left thigh and popliteal fossa mass for 2 years", and was in good health. Severe venous malformation of left thigh and popliteal fossa with myositis ossificans was diagnosed. On 3 Jul 2021, "Left thigh and popliteal fossa venous malformation resection + lower extremity vascular exploration + peripheral nerve entrapment release + fascial tissue flap plasty" was performed under general anesthesia. Postoperative routine pathology showed significant hyperplasia of intraadipose blood vessels between skeletal muscles of the popliteal fossa of the left thigh, interspersed with loose areas of mucoid cells rich in blood vessels, local skeletal muscle atrophy with calcinosis, accompanied by chronic inflammation and lymphoid follicular formation. The patients were followed up continuously at 3, 6 months and 1 and 2 years after surgery. There was no recurrence of the lesions, good functional activity, basically symmetrical appearance of both lower limbs, and no obvious thick scar formation in the incision. The diagnosis of this case needs to be distinguished from sarcoma. Therapeutically, it should be considered comprehensively from the aspect of eliminating symptoms and improving limb function. Radical surgery is the first choice for patients with such large-area severe intramuscular venous malformations.

Bariatric surgery is an effective treatment for severe obesity, but postoperative complications of Guillain-Barré syndrome (GBS) are clinically rare. This article reports a case of a 23-year-old male with severe obesity who was seen for "14 years of progressive weight gain". Three months after undergoing sleeve gastrectomy, he developed weakness and hypoesthesia in both lower limbs, and rapidly progressed to difficulty in standing and walking. Electromyography examination revealed multiple movements in both lower limbs, sensory nerve axon damage, and severe proximal end; Peripheral blood anti-GD1A antibody IgG was positive. According to the above symptoms and auxiliary examination results, the patient was diagnosed as acute motor axonal GBS. After 5 days of intravenous infusion of high-dose gamma globulin, the symptoms improved rapidly, and he returned to standing and walking. He could walk slowly on the ground 1 month after discharge. Such cases are rarely reported at home and abroad, and the pathogenesis is still unclear.

The patient was a 24-year-old male with a 20-year history of epilepsy. The clinical seizure was generalized tonic-clonic seizure and was admitted to Peking University International Hospital due to frequent seizures. After admission, the examination was completed. Interseizure EEG showed full-guide synchronous, paroxysmal 3.0-3.5 Hz high-amplitude sharp-slow complex wave activity. The above waveforms were not induced after hyperventilation. Cranial magnetic resonance examination found right frontal lobe malacia, which was considered as focal symptomatic epilepsy after discussion. After resection of frontal lobe malacia, the frequency of postoperative seizures was significantly reduced, and there was no recurrence after treatment with antiepileptic drugs. This case suggests that extensive discharge can also occur in focal lesions, which should be carefully identified by clinical information.

This article summarizes the recent advances in drug treatment of primary malignant bone tumors. The genetic background and carcinogenic mechanism of primary malignant bone tumors are still unclear, and the prognosis of some advanced or recurrent patients remains poor. Neoadjuvant chemotherapy is a major progress in the field of treatment of primary malignant bone tumors, which has significantly improved the survival rate of patients with primary malignant bone tumors. The combination of different chemotherapy drugs has gradually become an effective treatment plan. Immunotherapy, represented by immune checkpoint inhibitors, has gradually occupied an important position in the treatment of primary malignant bone tumors, but its efficacy is often limited due to the low immunogenicity and heterogeneity of primary malignant bone tumors. Enhancing the response of bone tumors to the body's immune system by combined chemotherapy may improve the efficacy of immunotherapy. In addition, some targeted drugs have shown good efficacy in clinical trials, such as gap junction protein 43 half-channel agonist monoclonal antibodies, tyrosine kinase inhibitors, etc.

Nerve damage in pelvic surgery may lead to urinary and stool dysfunction and sexual dysfunction. In order to predict and reduce these problems, a variety of monitoring methods have been developed in recent years, including electrical signal recording and physical measurement of internal organs. In the surgery of colorectal cancer, cervical cancer and prostate cancer, it has been confirmed at home and abroad that intraoperative neuroelectrophysiological monitoring can help to identify and verify the functional integrity of pelvic nerves during operation, improve and alleviate the prognosis, and methodology has been explored to varying degrees. In terms of monitoring equipment, it has also developed from the early neurostimulator combined with electromyographic recorder to special equipment that can integrate recording. Of course, the current research is in the initial stage, and there is no unified instrument and specification for neuroelectrophysiological monitoring technology in pelvic cavity surgery, so further research is needed.

Human cytomegalovirus (CMV), belonging to the herpesvirus family, is one of the most common viruses for intrauterine infections and a common cause of sensorineural hearing loss and intellectual disability in newborns. According to the time of infection, neonatal CMV infection can be divided into congenital infection and postnatal acquired infection. Understanding CMV infection in newborns in different countries or regions and taking targeted preventive measures are crucial for controlling CMV infection in newborns. In response to SARS-CoV-2 infections, many countries have implemented strict interventions such as wearing masks, social distancing, and restricting gatherings and outdoor activities. These controls affect people's lifestyles and may also affect the epidemiology of pathogens. Therefore, analyzing the changes in neonatal CMV infection before and after the SARS-CoV-2 infection pandemic will provide an effective clinical management strategy.

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. Its etiology involves genetic, environmental, bacterial flora and immune factors. Some previous studies have suggested that antibiotic exposure may be associated with an increased risk of IBD, but there is still controversy, especially whether there is a dose-response relationship between the two. A recently published study by the Department of Gastroenterology of Peking University Third Hospital provides the latest evidence on the relationship between antibiotic exposure and the risk of new IBD through systematic reviews and meta-analyses.