In order to recognize various metal transfer modes, by the creation of apattern recognition system for metal transfer mode, five kinds of spectrum signal in gas metal arcwelding (MIG, MAG and CO_2) are collected and t...In order to recognize various metal transfer modes, by the creation of apattern recognition system for metal transfer mode, five kinds of spectrum signal in gas metal arcwelding (MIG, MAG and CO_2) are collected and taken as training samples. These samples arepretreated by computer. Several key characteristic parameters of the spectrum signal are creativelyextracted, and a corresponding recognition function and a minimum-distance-classifier areconstructed. The results show that using this method, the pattern recognition of several kinds ofmetal transfer mode for the metal gas arc welding can be done successfully. It has good accuracy andrecognition precision, basis for controlling the metal gas arc welding metal transferautomatically, and relative important parameters in welding process, such as the frequency ofdroplet transfer and the approximate diameter of each droplet, can also be obtained.展开更多
Music Acquiring Device （or MAD, for short） is proposed to identify the origin and acquisition of human language, and is regarded as preceded Chomsky＇s LAD （Language Acquisition Device）. This paper tries to find t...Music Acquiring Device （or MAD, for short） is proposed to identify the origin and acquisition of human language, and is regarded as preceded Chomsky＇s LAD （Language Acquisition Device）. This paper tries to find the answers to two questions. Firstly, what are the main similarities between music and language？ Secondly, in what aspects can music facilitate language similarities （sound, rhythm, and acquisiti structure on？ By literature reviewing, comparison and contrast, three main ） between music and language are discussed, and then three facilitative effects of MAD on language acquisition are illustrated. They are： （1） MAD lays a foundation for language pronunciation acquisition; （2） MAD accelerates the mastery of language rhythm; and （3） MAD promotes language syntax acquisition. This paper will help teachers who like to use music-assistant language teaching method understand more about the positive effects of music on language teaching and acquisition.展开更多
The Horse Dealer's Daughter gradually acquires her love in a tough and unbearable situation after a long dialogue with Doctor Fergusson.By analyzing the linguistic features between Doctor Fergusson and Mabel'd...The Horse Dealer's Daughter gradually acquires her love in a tough and unbearable situation after a long dialogue with Doctor Fergusson.By analyzing the linguistic features between Doctor Fergusson and Mabel'dialogues from the perspective of politeness principle,one conception of which is that politeness is a social behavior in the contact of human beings,the strategies of Mabel's love pursuing and acquiring are gradually revealed.展开更多
BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated w...BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated with autoimmune diseases,cancers, medication use, pregnancy, and the post-partum period. Bullous pemphigoid(BP) is a chronic autoimmune subepidermal blistering disease associatedwith tissue-bound and circulating autoantibodies against BP antigens 180 (BP180)and 230 (BP230). AHA-associated BP has a high mortality rate;hence, the understandingof this disease must improve.CASE SUMMARY A 69-year-old man presented with erythema, blisters, blood blisters, and crustsaccompanied by severe pruritus for more than 20 days, and ecchymosis andswelling on his left upper arm for 3 days. Pathological examination revealed asubepidermal blister that contained eosinophils. Laboratory tests showed that theBP180 autoantibody levels had increased, isolated activated partial thromboplastintime was notably prolonged (115.6 s), and coagulation FⅧ activity wasextremely low (< 1.0%). Furthermore, the FⅧ inhibitor titer had greatlyincreased (59.2 Bethesda units). Therefore, the patient was diagnosed as having BP associated with AHA, prescribed 0.05% topical halometasone cream, and transferred to a higher-level hospitalfor effective treatment;however, he died after 2 days.CONCLUSION AHA associated BP is rare, dangerous, and has a high mortality rate. Therefore, its timely diagnosis and effectivetreatment are necessary.展开更多
Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions r...Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.展开更多
AIM:To investigate the therapeutic effects of botulinum toxin A(BTXA)injection versus strabismus surgery in the treatment of acute acquired comitant esotropia(AACE).METHODS:Patient records of AACE cases treated at Fir...AIM:To investigate the therapeutic effects of botulinum toxin A(BTXA)injection versus strabismus surgery in the treatment of acute acquired comitant esotropia(AACE).METHODS:Patient records of AACE cases treated at First People’s Hospital of Nantong from January 2019 to September 2023 were retrospectively analyzed in this study.Patients were categorized into either strabismus surgery or BTXA injection groups based on treatment modality.Further stratification was performed according to preoperative deviation angles[>35 prism diopters(PD)vs≤35 PD]and age(≥18 years adult group vs<18 years adolescent group).The baseline patient characteristics were collected,deviation angles at multiple timepoints before and after treatment were measured,and stereopsis test results were documented.Through comparative analysis of therapeutic outcomes across subgroups,we systematically evaluated the efficacy of different treatment approaches.RESULTS:A total of 43 AACE patients were included.At the final follow-up,both the surgery and BTXA injection groups showed a statistically significant decrease in deviation angle compared to pretreatment measurements(P<0.001).Significant differences were noted between the two groups in terms of the cure rate of strabismus and the recovery rate of stereopsis(P<0.05).For patients with deviations>35 PD,surgery yielded significantly better outcomes than injection therapy in postoperative angle,success rate,and stereopsis recovery(P<0.05).Similarly,in patients aged≥18 years,surgical treatment was superior to injections in reducing strabismus angle,improving success rates,and restoring stereopsis(P<0.05).CONCLUSION:Both BTXA injection and strabismus surgery demonstrate therapeutic efficacy in AACE.Surgical treatment demonstrated superior efficacy compared to BTXA injection therapy,particularly in patients with deviations>35 PD and those aged≥18 years.For patients with angles≤35 PD or under 18 years,BTXA injection remains a viable treatment option.展开更多
Acquired brain injury(ABI)is an injury that affects the brain structure and function.Traditional ABI treatment strategies,including medications and rehabilitation therapy,exhibit their ability to improve its impairmen...Acquired brain injury(ABI)is an injury that affects the brain structure and function.Traditional ABI treatment strategies,including medications and rehabilitation therapy,exhibit their ability to improve its impairments in cognition,emotion,and physical activity.Recently,near-infrared(NIR)photobiomodulation(PBM)has emerged as a promising physical intervention method for ABI,demonstrating that low-level light therapy can modulate cellular metabolic processes,reduce the in flammation and reactive oxygen species of ABI microenvironments,and promote neural repair and regeneration.Preclinical studies using ABI models have been carried out,revealing the potential of PBM in promoting brain injury recovery although its clinical application is still in its early stages.In this review,we first inspected the possible physical and biological mechanisms of NIR-PBM,and then reported the pathophysiology and physiology of ABI underlying NIR-PBM intervention.Therefore,the potential of NIR-PBM as a therapeutic intervention in ABI was demonstrated and it is also expected that further work can facilitate its clinical applications.展开更多
Acquired hemophilia A(AHA)is a rare blood disorder that can cause life-threatening severe bleeding because of the development of autoantibodies(inhibitors)against factor VIII.AHA is common in elderly patients,and alth...Acquired hemophilia A(AHA)is a rare blood disorder that can cause life-threatening severe bleeding because of the development of autoantibodies(inhibitors)against factor VIII.AHA is common in elderly patients,and although most cases are characterized by subcutaneous or intramuscular bleeding,rare cases of gastrointestinal bleeding have been reported.Controlling gastrointestinal bleeding in patients with AHA is difficult even after multiple endoscopic hemostasis or transcatheter arterial embolization procedures,and these patients are prone to rebleeding.CASE SUMMARY We report the case of a 76-year-old Japanese woman with AHA who presented with repeated bleeding from an esophageal ulcer as the initial symptom.A hemorrhagic ulcer was detected in the lower esophagus,and endoscopic hemostasis using radiofrequency ablation was performed seven times over a month.However,this procedure was unsuccessful,and the patient was transferred to our department.Hypertonic saline-epinephrine injection plus clipping was administered for endoscopic hemostasis,but the treatment response of the patient was poor.After the AHA diagnosis was confirmed,a single dose of a mixture of factors VIIa and X was administered as a bypass hemostatic agent,and the bleeding was successfully controlled.In addition,emicizumab,a bispecific monoclonal antibody that is a substitute for activated factor VIII,was administered,and no further rebleeding was observed.CONCLUSION Multidisciplinary interventions between endoscopists and hematologists are essential to manage rare gastrointestinal bleeding caused by coagulation disorders,such as AHA.展开更多
AIM:To investigate the clinical profile of patients with acquired lacrimal sac mucocele(ALSM)and evaluate the efficacy of endoscopic dacryocystorhinostomy(En-DCR)for this condition.METHODS:En-DCRs were performed on 14...AIM:To investigate the clinical profile of patients with acquired lacrimal sac mucocele(ALSM)and evaluate the efficacy of endoscopic dacryocystorhinostomy(En-DCR)for this condition.METHODS:En-DCRs were performed on 141 patients with ALSM patients from January 2016 to March 2022.The clinical baseline information and magnetic resonance imaging(MRI)images were recorded and summarized.To assess the effectiveness of En-DCR therapy,both anatomical and functional success rate was assessed during a 12mo follow-up.RESULTS:A total of 141 patients,with a mean age of 57.70±14.11y,were enrolled in this study.Majority of the patients were female(n=91;64.54%)and all had unilateral disease.All patients had a previous history of epiphora and purulent secretion,and the duration from lacrimal duct obstruction to mucocele formation ranged from 6 to 120mo.MRI findings consistently revealed an enlarged sac diameter,fluid accumulation separated by a thin rim from adjacent tissues,which is indicative of lacrimal sac mucocele.En-DCR was performed with an anatomical success rate of 93.62%and a functional success rate of 81.56%.CONCLUSION:ALSM is more commonly seen in females and unilaterally.It is essentially a complication of lacrimal duct obstruction.MRI characteristics can be used for precise clinical diagnosis,while En-DCR emerges as an optimal therapy for this condition.Our results provide a comprehensive reference for the diagnosis and treatment of ALSM.展开更多
Type III acute acquired comitant esotropia(AACE)is a special type of binocular coordination disorder with sudden onset characteristics,but its pathogenesis and treatment strategies remain unclear.This article analyzes...Type III acute acquired comitant esotropia(AACE)is a special type of binocular coordination disorder with sudden onset characteristics,but its pathogenesis and treatment strategies remain unclear.This article analyzes the incidence and classification characteristics of Type III AACE,and explores its pathogenesis from multiple perspectives including clinical medicine,neuroscience,and neuro-ophthalmology.It is found that this disease is associated with factors such as decompensation of phoria,dysfunction of the visual center,abnormalities in the physiological and anatomical structure of extraocular muscles,accommodative factors,and disorders of convergence and divergence.The prognosis of Type III AACE is excellent with treatments such as botulinum toxin injection and surgery,and adjunctive therapies like prism adaptation test and visual function training can enhance the management effect.This article provides an in-depth analysis of the pathogenesis and cutting-edge treatment techniques for patients with Type III AACE,which can offer guidance for the subsequent diagnosis and treatment of such patients.展开更多
BACKGROUND Acquired hemophilia A(AHA)is a rare autoimmune bleeding disorder charac-terized by autoantibodies against coagulation factor VIII(FVIII),leading to spon-taneous bleeding in patients without a personal or fa...BACKGROUND Acquired hemophilia A(AHA)is a rare autoimmune bleeding disorder charac-terized by autoantibodies against coagulation factor VIII(FVIII),leading to spon-taneous bleeding in patients without a personal or family history of bleeding disorders.While AHA has been reported in association with various cancers,this case represents,to our knowledge,the first reported instance of AHA following head and neck cancer surgery and subsequent chemoradiotherapy.CASE SUMMARY We present the case of a 65-year-old male with a history of hypopharyngeal squa-mous cell carcinoma(T4bN2cM0,AJCC 8^(th) edition)who developed AHA after extensive surgical resection and chemoradiotherapy.He presented with recurrent hemoptysis and ecchymosis.Coagulation studies showed isolated prolonged activated partial thromboplastin time of 83.8 seconds that did not correct with mixing studies.FVIII activity was<1%,and a Bethesda assay confirmed FVIII inhibitors with a titer of 18.4 Bethesda units.Hemostasis was initially achieved with tranexamic acid and batroxobin.Immunosuppression with prednisone and cyclophosphamide was started;due to gastrointestinal bleeding,rituximab was added.Treatment was later transitioned to azathioprine with prednisone,fol-lowed by tapering.FVIII activity recovered to 188.2%,and the patient remained in remission over six years without AHA or malignancy recurrence.CONCLUSION This case underscores vigilance for AHA after head and neck cancer therapy to enable prompt treatment.展开更多
BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has...BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has emerged as a crucial global health concern due to high mortality rate in children under 5 years,potentially life-threatening complications,and growing challenges in pediatric treatment associated with rising macrolide resistance.Additionally,MPP can be complicated by other bacterial and/or viral pathogens,which may exacerbate disease severity.After the lifting of strict non-pharmaceutical interventions(NPIs)worldwide,the dramatic rise of incidence of MPP in Asia and Europe was observed.AIM To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital,China.METHODS A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study.The blood and respiratory samples were collected within the 24 hours after admission.The hematological parameters,biochemical markers,cytokine profiles were assessed.The respiratory samples were tested for the presence of M.pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction(PCR).The macrolide resistance mutations(A2063G,A2064G in the 23S rRNA gene of M.pneumoniae)were determined by PCR.RESULTS Number of MPP cases has dramatically increased starting August with peak in November.SMPP and general MPP(GMPP)were identified in 264 and 896 of 1160 hospitalized children.The binary logistic regression analysis identified six[C-reactive protein(CRP),lactate dehydrogenase,procalcitonin,erythrocyte sedimentation rate,fibrin and fibrinogen degradation products(FDPs),D-dimer]and four(neutrophils,CRP,FDPs,prothrombin time)predictors of SMPP in age groups 2-5 years and 6-15 years,respectively.Children with SMPP showed significantly higher levels of cytokine interleukin(IL)-17F(2-5 years),and cytokines interferon-gamma,tumor necrosis factoralpha,IL-10(6-13 years).Concomitant viral/bacterial pathogens were determined in 24.3%and 28.0%cases of SMPP and GMPP.Among them,Streptococcus pneumoniae(S.pneumoniae)and Haemophilus influenzae(H.influenzae)were predominant.93.2%cases of MPP were associated with macrolide resistant M.pneumoniae.CONCLUSION Specific MPP epidemiological pattern associated with lifting NPIs was revealed:Increase of hospitalized cases,prevalence of S.pneumoniae and H.influenzae among concomitant pathogens,93.2%of macrolide resistant M.pneumonia.展开更多
Objective Acquired aplastic anemia(aAA)is characterized by an autologous immunological attack against hematopoietic stem and progenitor cells,and immunotolerance disruption is frequent,with reduced T regulatory cells(...Objective Acquired aplastic anemia(aAA)is characterized by an autologous immunological attack against hematopoietic stem and progenitor cells,and immunotolerance disruption is frequent,with reduced T regulatory cells(Tregs)frequencies and increased effector cytotoxic cells.Tregs are reduced in aAA and increase in number after successful immunosuppressive therapies.Methods In this retrospective study,we investigated the frequency of circulating Tregs by multiparametric flow cytometry immunophenotyping in non-severe aAA patients before and after immunosuppressive therapy.The samples were stained with the following antibodies:ECD anti-CD3,PE or PC5 anti-CD4,FITC anti-CD8,and PE anti-CD25,and Tregs were identified by first gating on linear parameters for lymphocyte identification and then for CD3 expression.In CD3+CD4+cells,Tregs were further identified on the basis of CD25 and FOXP3 expression.Results Although the number of Tregs tended to increase after immunosuppressive treatments,their circulating frequency remained lower than that of healthy subjects,regardless of their responsiveness to therapies.Moreover,the relative frequency combined with absolute Treg counts might be more informative in the differential diagnosis of bone marrow failure syndromes.Conclusions The persistent decrease in circulating Tregs could be the result of immunosuppressive agents that could preferentially expand other T-cell subsets.At the same time,an imbalance in immunotolerance might persist,which is also favored by chronic antigen stimulation.展开更多
目的:探讨不同干预措施对ICU获得性衰弱(ICU-AW)的影响,为临床实践提供依据。方法:通过系统评价与荟萃分析,计算机检索PubMed、Embase、ScienceDirect、Web of Science、中国知网等数据库,收集相关主题系统评价,设定纳入标准与排除标准...目的:探讨不同干预措施对ICU获得性衰弱(ICU-AW)的影响,为临床实践提供依据。方法:通过系统评价与荟萃分析,计算机检索PubMed、Embase、ScienceDirect、Web of Science、中国知网等数据库,收集相关主题系统评价,设定纳入标准与排除标准,经文献筛选、信息提取、质量评价、有效性评价及证据图谱制作等步骤进行研究。结果:共纳入35项研究,多数优效及方法学质量较高的干预措施集中在早期运动和神经电生理学检查,17篇早期活动的Meta分析中有11篇显示其能优效改善ICU-AW,8篇神经肌肉电刺激相关文章中有6篇显示其可优效改善。结论:早期运动和神经肌肉电刺激是改善ICU-AW有效的干预措施,但受研究局限性影响,其有效性仍需进一步验证,未来需关注研究热点变化,调整研究方向,深入研究不同干预措施联合应用潜力。展开更多
基金This project is supported by National Natural Science Foundation of China (No.59990470).
文摘In order to recognize various metal transfer modes, by the creation of apattern recognition system for metal transfer mode, five kinds of spectrum signal in gas metal arcwelding (MIG, MAG and CO_2) are collected and taken as training samples. These samples arepretreated by computer. Several key characteristic parameters of the spectrum signal are creativelyextracted, and a corresponding recognition function and a minimum-distance-classifier areconstructed. The results show that using this method, the pattern recognition of several kinds ofmetal transfer mode for the metal gas arc welding can be done successfully. It has good accuracy andrecognition precision, basis for controlling the metal gas arc welding metal transferautomatically, and relative important parameters in welding process, such as the frequency ofdroplet transfer and the approximate diameter of each droplet, can also be obtained.
文摘Music Acquiring Device （or MAD, for short） is proposed to identify the origin and acquisition of human language, and is regarded as preceded Chomsky＇s LAD （Language Acquisition Device）. This paper tries to find the answers to two questions. Firstly, what are the main similarities between music and language？ Secondly, in what aspects can music facilitate language similarities （sound, rhythm, and acquisiti structure on？ By literature reviewing, comparison and contrast, three main ） between music and language are discussed, and then three facilitative effects of MAD on language acquisition are illustrated. They are： （1） MAD lays a foundation for language pronunciation acquisition; （2） MAD accelerates the mastery of language rhythm; and （3） MAD promotes language syntax acquisition. This paper will help teachers who like to use music-assistant language teaching method understand more about the positive effects of music on language teaching and acquisition.
文摘The Horse Dealer's Daughter gradually acquires her love in a tough and unbearable situation after a long dialogue with Doctor Fergusson.By analyzing the linguistic features between Doctor Fergusson and Mabel'dialogues from the perspective of politeness principle,one conception of which is that politeness is a social behavior in the contact of human beings,the strategies of Mabel's love pursuing and acquiring are gradually revealed.
基金Supported by Traditional Chinese Medicine Research Program of Hebei Provincial Administration of Traditional Chinese Medicine,No.2025313 and No.2025448.
文摘BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated with autoimmune diseases,cancers, medication use, pregnancy, and the post-partum period. Bullous pemphigoid(BP) is a chronic autoimmune subepidermal blistering disease associatedwith tissue-bound and circulating autoantibodies against BP antigens 180 (BP180)and 230 (BP230). AHA-associated BP has a high mortality rate;hence, the understandingof this disease must improve.CASE SUMMARY A 69-year-old man presented with erythema, blisters, blood blisters, and crustsaccompanied by severe pruritus for more than 20 days, and ecchymosis andswelling on his left upper arm for 3 days. Pathological examination revealed asubepidermal blister that contained eosinophils. Laboratory tests showed that theBP180 autoantibody levels had increased, isolated activated partial thromboplastintime was notably prolonged (115.6 s), and coagulation FⅧ activity wasextremely low (< 1.0%). Furthermore, the FⅧ inhibitor titer had greatlyincreased (59.2 Bethesda units). Therefore, the patient was diagnosed as having BP associated with AHA, prescribed 0.05% topical halometasone cream, and transferred to a higher-level hospitalfor effective treatment;however, he died after 2 days.CONCLUSION AHA associated BP is rare, dangerous, and has a high mortality rate. Therefore, its timely diagnosis and effectivetreatment are necessary.
文摘Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.
文摘AIM:To investigate the therapeutic effects of botulinum toxin A(BTXA)injection versus strabismus surgery in the treatment of acute acquired comitant esotropia(AACE).METHODS:Patient records of AACE cases treated at First People’s Hospital of Nantong from January 2019 to September 2023 were retrospectively analyzed in this study.Patients were categorized into either strabismus surgery or BTXA injection groups based on treatment modality.Further stratification was performed according to preoperative deviation angles[>35 prism diopters(PD)vs≤35 PD]and age(≥18 years adult group vs<18 years adolescent group).The baseline patient characteristics were collected,deviation angles at multiple timepoints before and after treatment were measured,and stereopsis test results were documented.Through comparative analysis of therapeutic outcomes across subgroups,we systematically evaluated the efficacy of different treatment approaches.RESULTS:A total of 43 AACE patients were included.At the final follow-up,both the surgery and BTXA injection groups showed a statistically significant decrease in deviation angle compared to pretreatment measurements(P<0.001).Significant differences were noted between the two groups in terms of the cure rate of strabismus and the recovery rate of stereopsis(P<0.05).For patients with deviations>35 PD,surgery yielded significantly better outcomes than injection therapy in postoperative angle,success rate,and stereopsis recovery(P<0.05).Similarly,in patients aged≥18 years,surgical treatment was superior to injections in reducing strabismus angle,improving success rates,and restoring stereopsis(P<0.05).CONCLUSION:Both BTXA injection and strabismus surgery demonstrate therapeutic efficacy in AACE.Surgical treatment demonstrated superior efficacy compared to BTXA injection therapy,particularly in patients with deviations>35 PD and those aged≥18 years.For patients with angles≤35 PD or under 18 years,BTXA injection remains a viable treatment option.
基金supported by the University of Macao(MYRG2022-00054-FHS and MYRGGRG2023-00038-FHS-UMDF)the Macao Science and Technology Development Fund(FDCT0048/2021/AGJ and FDCT0020/2019/AMJ)Natural Science Foundation of Guangdong Province(EF017/FHS-YZ/2021/GDSTC).
文摘Acquired brain injury(ABI)is an injury that affects the brain structure and function.Traditional ABI treatment strategies,including medications and rehabilitation therapy,exhibit their ability to improve its impairments in cognition,emotion,and physical activity.Recently,near-infrared(NIR)photobiomodulation(PBM)has emerged as a promising physical intervention method for ABI,demonstrating that low-level light therapy can modulate cellular metabolic processes,reduce the in flammation and reactive oxygen species of ABI microenvironments,and promote neural repair and regeneration.Preclinical studies using ABI models have been carried out,revealing the potential of PBM in promoting brain injury recovery although its clinical application is still in its early stages.In this review,we first inspected the possible physical and biological mechanisms of NIR-PBM,and then reported the pathophysiology and physiology of ABI underlying NIR-PBM intervention.Therefore,the potential of NIR-PBM as a therapeutic intervention in ABI was demonstrated and it is also expected that further work can facilitate its clinical applications.
文摘Acquired hemophilia A(AHA)is a rare blood disorder that can cause life-threatening severe bleeding because of the development of autoantibodies(inhibitors)against factor VIII.AHA is common in elderly patients,and although most cases are characterized by subcutaneous or intramuscular bleeding,rare cases of gastrointestinal bleeding have been reported.Controlling gastrointestinal bleeding in patients with AHA is difficult even after multiple endoscopic hemostasis or transcatheter arterial embolization procedures,and these patients are prone to rebleeding.CASE SUMMARY We report the case of a 76-year-old Japanese woman with AHA who presented with repeated bleeding from an esophageal ulcer as the initial symptom.A hemorrhagic ulcer was detected in the lower esophagus,and endoscopic hemostasis using radiofrequency ablation was performed seven times over a month.However,this procedure was unsuccessful,and the patient was transferred to our department.Hypertonic saline-epinephrine injection plus clipping was administered for endoscopic hemostasis,but the treatment response of the patient was poor.After the AHA diagnosis was confirmed,a single dose of a mixture of factors VIIa and X was administered as a bypass hemostatic agent,and the bleeding was successfully controlled.In addition,emicizumab,a bispecific monoclonal antibody that is a substitute for activated factor VIII,was administered,and no further rebleeding was observed.CONCLUSION Multidisciplinary interventions between endoscopists and hematologists are essential to manage rare gastrointestinal bleeding caused by coagulation disorders,such as AHA.
文摘AIM:To investigate the clinical profile of patients with acquired lacrimal sac mucocele(ALSM)and evaluate the efficacy of endoscopic dacryocystorhinostomy(En-DCR)for this condition.METHODS:En-DCRs were performed on 141 patients with ALSM patients from January 2016 to March 2022.The clinical baseline information and magnetic resonance imaging(MRI)images were recorded and summarized.To assess the effectiveness of En-DCR therapy,both anatomical and functional success rate was assessed during a 12mo follow-up.RESULTS:A total of 141 patients,with a mean age of 57.70±14.11y,were enrolled in this study.Majority of the patients were female(n=91;64.54%)and all had unilateral disease.All patients had a previous history of epiphora and purulent secretion,and the duration from lacrimal duct obstruction to mucocele formation ranged from 6 to 120mo.MRI findings consistently revealed an enlarged sac diameter,fluid accumulation separated by a thin rim from adjacent tissues,which is indicative of lacrimal sac mucocele.En-DCR was performed with an anatomical success rate of 93.62%and a functional success rate of 81.56%.CONCLUSION:ALSM is more commonly seen in females and unilaterally.It is essentially a complication of lacrimal duct obstruction.MRI characteristics can be used for precise clinical diagnosis,while En-DCR emerges as an optimal therapy for this condition.Our results provide a comprehensive reference for the diagnosis and treatment of ALSM.
文摘Type III acute acquired comitant esotropia(AACE)is a special type of binocular coordination disorder with sudden onset characteristics,but its pathogenesis and treatment strategies remain unclear.This article analyzes the incidence and classification characteristics of Type III AACE,and explores its pathogenesis from multiple perspectives including clinical medicine,neuroscience,and neuro-ophthalmology.It is found that this disease is associated with factors such as decompensation of phoria,dysfunction of the visual center,abnormalities in the physiological and anatomical structure of extraocular muscles,accommodative factors,and disorders of convergence and divergence.The prognosis of Type III AACE is excellent with treatments such as botulinum toxin injection and surgery,and adjunctive therapies like prism adaptation test and visual function training can enhance the management effect.This article provides an in-depth analysis of the pathogenesis and cutting-edge treatment techniques for patients with Type III AACE,which can offer guidance for the subsequent diagnosis and treatment of such patients.
文摘BACKGROUND Acquired hemophilia A(AHA)is a rare autoimmune bleeding disorder charac-terized by autoantibodies against coagulation factor VIII(FVIII),leading to spon-taneous bleeding in patients without a personal or family history of bleeding disorders.While AHA has been reported in association with various cancers,this case represents,to our knowledge,the first reported instance of AHA following head and neck cancer surgery and subsequent chemoradiotherapy.CASE SUMMARY We present the case of a 65-year-old male with a history of hypopharyngeal squa-mous cell carcinoma(T4bN2cM0,AJCC 8^(th) edition)who developed AHA after extensive surgical resection and chemoradiotherapy.He presented with recurrent hemoptysis and ecchymosis.Coagulation studies showed isolated prolonged activated partial thromboplastin time of 83.8 seconds that did not correct with mixing studies.FVIII activity was<1%,and a Bethesda assay confirmed FVIII inhibitors with a titer of 18.4 Bethesda units.Hemostasis was initially achieved with tranexamic acid and batroxobin.Immunosuppression with prednisone and cyclophosphamide was started;due to gastrointestinal bleeding,rituximab was added.Treatment was later transitioned to azathioprine with prednisone,fol-lowed by tapering.FVIII activity recovered to 188.2%,and the patient remained in remission over six years without AHA or malignancy recurrence.CONCLUSION This case underscores vigilance for AHA after head and neck cancer therapy to enable prompt treatment.
基金Supported by Baoding Science and Technology Plan Project,No.2272P011Hebei Province Scientific Research Project,No.20241734Hebei Natural Science Foundation Project,No.H2024104011.
文摘BACKGROUND Mycoplasma pneumoniae(M.pneumoniae)is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease.Severe M.pneumoniae pneumonia(SMPP)has emerged as a crucial global health concern due to high mortality rate in children under 5 years,potentially life-threatening complications,and growing challenges in pediatric treatment associated with rising macrolide resistance.Additionally,MPP can be complicated by other bacterial and/or viral pathogens,which may exacerbate disease severity.After the lifting of strict non-pharmaceutical interventions(NPIs)worldwide,the dramatic rise of incidence of MPP in Asia and Europe was observed.AIM To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital,China.METHODS A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study.The blood and respiratory samples were collected within the 24 hours after admission.The hematological parameters,biochemical markers,cytokine profiles were assessed.The respiratory samples were tested for the presence of M.pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction(PCR).The macrolide resistance mutations(A2063G,A2064G in the 23S rRNA gene of M.pneumoniae)were determined by PCR.RESULTS Number of MPP cases has dramatically increased starting August with peak in November.SMPP and general MPP(GMPP)were identified in 264 and 896 of 1160 hospitalized children.The binary logistic regression analysis identified six[C-reactive protein(CRP),lactate dehydrogenase,procalcitonin,erythrocyte sedimentation rate,fibrin and fibrinogen degradation products(FDPs),D-dimer]and four(neutrophils,CRP,FDPs,prothrombin time)predictors of SMPP in age groups 2-5 years and 6-15 years,respectively.Children with SMPP showed significantly higher levels of cytokine interleukin(IL)-17F(2-5 years),and cytokines interferon-gamma,tumor necrosis factoralpha,IL-10(6-13 years).Concomitant viral/bacterial pathogens were determined in 24.3%and 28.0%cases of SMPP and GMPP.Among them,Streptococcus pneumoniae(S.pneumoniae)and Haemophilus influenzae(H.influenzae)were predominant.93.2%cases of MPP were associated with macrolide resistant M.pneumoniae.CONCLUSION Specific MPP epidemiological pattern associated with lifting NPIs was revealed:Increase of hospitalized cases,prevalence of S.pneumoniae and H.influenzae among concomitant pathogens,93.2%of macrolide resistant M.pneumonia.
文摘Objective Acquired aplastic anemia(aAA)is characterized by an autologous immunological attack against hematopoietic stem and progenitor cells,and immunotolerance disruption is frequent,with reduced T regulatory cells(Tregs)frequencies and increased effector cytotoxic cells.Tregs are reduced in aAA and increase in number after successful immunosuppressive therapies.Methods In this retrospective study,we investigated the frequency of circulating Tregs by multiparametric flow cytometry immunophenotyping in non-severe aAA patients before and after immunosuppressive therapy.The samples were stained with the following antibodies:ECD anti-CD3,PE or PC5 anti-CD4,FITC anti-CD8,and PE anti-CD25,and Tregs were identified by first gating on linear parameters for lymphocyte identification and then for CD3 expression.In CD3+CD4+cells,Tregs were further identified on the basis of CD25 and FOXP3 expression.Results Although the number of Tregs tended to increase after immunosuppressive treatments,their circulating frequency remained lower than that of healthy subjects,regardless of their responsiveness to therapies.Moreover,the relative frequency combined with absolute Treg counts might be more informative in the differential diagnosis of bone marrow failure syndromes.Conclusions The persistent decrease in circulating Tregs could be the result of immunosuppressive agents that could preferentially expand other T-cell subsets.At the same time,an imbalance in immunotolerance might persist,which is also favored by chronic antigen stimulation.
文摘目的:探讨不同干预措施对ICU获得性衰弱(ICU-AW)的影响,为临床实践提供依据。方法:通过系统评价与荟萃分析,计算机检索PubMed、Embase、ScienceDirect、Web of Science、中国知网等数据库,收集相关主题系统评价,设定纳入标准与排除标准,经文献筛选、信息提取、质量评价、有效性评价及证据图谱制作等步骤进行研究。结果:共纳入35项研究,多数优效及方法学质量较高的干预措施集中在早期运动和神经电生理学检查,17篇早期活动的Meta分析中有11篇显示其能优效改善ICU-AW,8篇神经肌肉电刺激相关文章中有6篇显示其可优效改善。结论:早期运动和神经肌肉电刺激是改善ICU-AW有效的干预措施,但受研究局限性影响,其有效性仍需进一步验证,未来需关注研究热点变化,调整研究方向,深入研究不同干预措施联合应用潜力。
