BACKGROUND Rare liver tumors(RLTs)have an extremely low likelihood of forming,and some have been recorded only in isolated cases.The lack of normal clinical symptoms in RLTs makes preoperative diagnosis extremely chal...BACKGROUND Rare liver tumors(RLTs)have an extremely low likelihood of forming,and some have been recorded only in isolated cases.The lack of normal clinical symptoms in RLTs makes preoperative diagnosis extremely challenging,which results in frequent misinterpretation.The present case report helps enhance our ability to recognize and treat uncommon liver tumor disorders.CASE SUMMARY We describe four distinct examples of rare liver tumor diseases.These cases were all true cases with no conventional clinical signs or imaging findings.In all patients,hepatic occupancy was discovered on physical examination,which raised the preoperative suspicion of hepatic cancer.All tumors were surgically removed,and postoperative histology and immunohistochemistry were performed to confirm the diagnosis.The first patient had primary hepatic fibrosarcoma.The second case involved a primary hepatic neuroendocrine tumors.These two patients had malignant liver tumors,and both had extremely satisfactory surgical outcomes.The third case involved focal hepatic steatosis,and the fourth case involved a single necrotic nodule in the liver.These two patients had benign liver tumors,but they had already undergone surgery and did not require any postoperative care.CONCLUSION The number of patients with RLTs is small,and the clinical and imaging results are vague.Preoperative diagnosis is challenging,and patients are sometimes mistakenly diagnosed with liver cancer,which leads to unnecessary surgical therapy in certain individuals.展开更多
Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dy...Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dysfunction in the brain.In this study,we enrolled 357 patients with mild intracerebral hemorrhage(ICH)from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission,neurological function prognosis at 3 months,and 1-year stroke recurrence.Patients were divided into groups based on Fazekas scale scores:no LA(n=83),mild LA(n=64),moderate LA(n=98)and severe LA(n=112).More severe LA,larger hematoma volume,and higher blood glucose level at admission were associated with more severe neurological deficit.More severe LA,older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months.In addition,moderate-to-severe LA,admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence.These findings suggest that LA severity may be a potential marker of individual ICH vulnerability,which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH.Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols.This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University(approval No.12)on March 10,2011.展开更多
BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ systems.We report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute panc...BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ systems.We report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute pancreatitis.No such case has been previously reported.CASE SUMMARY A 29-year-old woman did not pay much attention to a fever 4 d prior.During this time,she experienced anorexia and only drank a small amount of water every day.She did not present with abdominal distension,postprandial nausea,vomiting,cough or expectoration.After physical and laboratory examinations,the patient was diagnosed with hypothyroidism.During the course of the disease,hypothyroidism was generally accompanied by constantly increased pancreatic amylase and trypsin.After admission,the possible etiology of the patient was excluded and the concentrations of pancreatic lipase and amylase in serum were>2000U/L(reference range 23-300 U/L)and 410 U/L(reference range 30-110 U/L),respectively.So we highly suspected that it may be acute pancreatitis.Interestingly,she never developed any complications associated with acute pancreatitis despite high levels of serum pancreatic amylase and trypsin,and she reported no symptoms of abdominal pain.Serum amylase and lipase decreased gradually after active thyroxine supplementation,and the patient was discharged from the hospital after active treatment.CONCLUSION This case suggests that clinicians should pay attention to hypothyroidism with elevated pancreatic amylase and trypsin,even if no complications of acute pancreatitis are reported.展开更多
This report analyzes the existing problems in terminology referring to clinical symptoms of traditional Chinese medicine(TCM)from the viewpoint of data sharing and elaborates the necessity of establishing a standard d...This report analyzes the existing problems in terminology referring to clinical symptoms of traditional Chinese medicine(TCM)from the viewpoint of data sharing and elaborates the necessity of establishing a standard directory of clinical data elements of TCM.We evaluated the principles and methods of data element extraction according to the status quo of the clinical information system and characteristics of symptoms for TCM and consequently proposed a three-layer model for optimal extraction.展开更多
Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-...Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.展开更多
Objective: the experiment will be hembide injection for patients with severe sepsis to further compare the coagulation index of patients and relieve clinical symptoms. Methods: sepsis patients admitted from January 20...Objective: the experiment will be hembide injection for patients with severe sepsis to further compare the coagulation index of patients and relieve clinical symptoms. Methods: sepsis patients admitted from January 2021 to December 2,2021 were selected for clinical review and divided into 2 groups of 78 patients, namely observation group (n=39) and control group (n=39).The control group was conventional supportive treatment, and the observation group was treated with habidide injection to compare the treatment results. Results: in terms of treatment, the coagulation results in the observation group were better than the control group, with statistical significance (P <0.05).In addition, on the WBC count, the posttreatment observation group was (10.22 ± 3.01) 109 / L · L-1), the controls were (13.44 ± 2.91) 109 / L · L-1), and on the platelet index was (187.44 ± 47.31) 109 / L and (118.23 ± 50.65) 109 / L with significant differences (P <0.05).Meanwhile, in both the APACHEII and cTnI indicators, the observation group scored lower than the control group, and the difference was statistically significant (P <0.05).After 7 days of treatment, the number of MODS in the observed group was lower. Conclusion: blood-net injection can correct coagulation disorder and prevent disease deterioration. It improves the prognosis and deserves application.展开更多
Objective: to explore the improvement of clinical symptoms of patients with chronic renal failure treated by traditional Chinese medicine nursing technology. Method: from July 2019 to July 2020 as the time period for ...Objective: to explore the improvement of clinical symptoms of patients with chronic renal failure treated by traditional Chinese medicine nursing technology. Method: from July 2019 to July 2020 as the time period for the implementation of the study, 74 patients with chronic renal failure in our hospital were selected, and the grouping method was random number table method, 37 cases for each. The reference group received basic nursing intervention, and the experimental group received traditional Chinese medicine nursing technology. The scores of quality of life, sleep status, complications and clinical effects were calculated. Results: there was no significant difference between the quality of life scores and sleep status scores of the two groups before the intervention (p > 0.05). After the intervention, the data of the reference group was used as a reference. The quality of life score and sleep status score of the experimental group were better, and the differences between the groups were significant (p < 0.05);taking the experimental group data as a reference, the reference group had more complications and lower clinical effects, and there was a comparison of data between groups Statistically significant (p < 0.05). Conclusion: the traditional Chinese medicine nursing technology treatment for patients with chronic renal failure can improve the quality of life of patients and improve the insomnia symptoms, which is of high safety and has significant clinical application value.展开更多
Objective: this paper mainly studies the patients with chronic obstructive emphysema, observes the symptoms of this type of patients during their illness, and treats the selected patients in different ways, and analyz...Objective: this paper mainly studies the patients with chronic obstructive emphysema, observes the symptoms of this type of patients during their illness, and treats the selected patients in different ways, and analyzes the final therapeutic effect. Methods: this article mainly selected 62 patients with chronic obstructive emphysema from May 2020 to September 2021. In order to better compare and analyze the treatment results, all patients were divided into two groups for comparison. Firstly, 31 patients were randomly selected as the X group in this study, and their conditions were relatively serious. The remaining 31 patients were taken as the Y group of this study, and their condition was relatively mild. During the treatment of all patients, medical staff should choose the appropriate treatment method for patients according to the severity of their condition, and compare and analyze the final treatment effects of different patients. Results: after observing and studying the selected patients with the above methods, it was found that the symptoms of patients during the illness were complicated, and the complications of patients with different conditions were different. However, after choosing a scientific and reasonable treatment method for patients according to different patients conditions, the patients conditions were obviously improved, and the overall cure rate and satisfaction were improved correspondingly. There are obvious differences between the final research data of the two groups, which can provide reliable data support for this study. Conclusion: from the above research methods and research process, it is found that the symptoms of patients with different diseases are different, and the probability of pulmonary bullae in the course of patients onset is relatively large. However, for some patients with serious illness, long-term illness will lead to respiratory and heart failure, aggravate the changes of patients condition, and increase the mortality of patients. Therefore, in the process of treating this type of patient, we should accurately judge the patients condition, and combine the judgment results to treat the patient, so as to improve the effect of treatment for the patient.展开更多
Objective:to evaluate the value of TCM syndrome differentiation in patients with AIDS complicated with pulmonary infection by observing the curative effect in the course of combined TCM treatment. Methods: 35 PATIENTS...Objective:to evaluate the value of TCM syndrome differentiation in patients with AIDS complicated with pulmonary infection by observing the curative effect in the course of combined TCM treatment. Methods: 35 PATIENTS with AIDS complicated with pulmonary infection in our hospital from April 2016 to April 2021 were selected. The patients treated with western medicine alone were listed as the reference group, and the patients treated with Western medicine combined with TCM syndrome differentiation were listed as the experimental group. 18 cases were included in the experimental group and 17 cases were included in the reference group. The two groups were compared in the quality of clinical outcomes. Results:the effective rate of the experimental group was 88.89%, which exceeded 64.71% in the reference group. There was a significant difference between the two groups (P<0.05). Moreover, the quality of life score in the experimental group was higher than that in the reference group, and there was a significant difference (P<0.05). Conclusion: in the clinical treatment of AIDS complicated with pulmonary infection, the timely combination of TCM syndrome differentiation treatment can effectively improve the symptoms of patients, shorten the hospitalization period, improve the quality of life after treatment, so it is worthy of clinical application.展开更多
Objective To explore anxiety and impulsivity in adult female patients with anorexia nervosa(AN),and the relationship with different dimensions of the core clinical symptoms.Methods From June 2014 to October 2022,96 pa...Objective To explore anxiety and impulsivity in adult female patients with anorexia nervosa(AN),and the relationship with different dimensions of the core clinical symptoms.Methods From June 2014 to October 2022,96 patients with AN,from both outpatient clinics andinpatienttwards,wereenrolled from Peking UniversitySixthHospital.Additionally,51 control participants were recruited from the community.Statetrait Anxiety Inventory(STAI)and Barratt Impulsiveness Scale(BIS-11))were used to evaluate the anxiety and impulsivityofeachggroup.TheEatingDisorder Inventory-1(EDI-1)was used to assess clinical and other psychological characteristics of ED.Correlation and regression analysis were employedtoexplore the relationship between anxiety,impulsivity,and core clinical symptoms of eating disorders.Results(1)The total EDI-1 score for the AN group((233.7±48.4)vs.(184.2±30.4),t=7.58,P<0.001)and scores in 7 subscales(Drive for Thinness:t=5.25,P<0.001;Bulimia:t=6.05,P<0.001;Ineffectiveness:t=7.91,P<0.001;Perfectionism:t=3.05,P=0.003;Interpersonal Distrust:t=5.50,P<0.001;Interoceptive Awareness:t=7.00,P<0.001;Maturity Fears:t=2.46,P=0.015)were significantly higher than the control group.(2)The AN group had significantly higher levels of state anxiety(t=8.60,P<0.001),trait anxiety(t=7.40,P<0.001),total impulsivity(t=3.55,P<0.001),attentional impulsiveness(t=2.43,P=0.017)and motor impulsiveness(t=4.29,P<0.001)compared to the control group.(3)Correlation analysis showed that state anxiety,trait anxiety,attentional impulsiveness,motor impulsiveness,and non-planning impulsiveness were positively correlated with the drive for thinness(r=0.522,0.577,0.272,0.387,0.209,allP<0.05);State anxiety,trait anxiety,attentional impulsiveness,motor impulsiveness,and non-planning impulsiveness were also positively correlated with bulimia(r=0.402,0.471,0.304,0.514,0.466,all P<0.01);Attentional impulsiveness,state anxiety,and trait anxiety were positively correlated with body dissatisfaction(r=0.333,0.448,0.409,all P<0.01).Further ridge regression analysis indicated that trait anxiety in AN patients was an influencing factor of the drive for thinness(t=3.13,P=0.002),state anxiety was an influencing factor of body dissatisfaction(t=1.99,P=0.050),and motor impulsiveness and non-planning impulsiveness were the influencing factors of bulimia(t=2.92,2.79,all P<005).Conclusion Patients with anorexia nervosa have higher anxiety and impulsivity,and the levels of anxiety and impulsivity in different dimensions are related to the core clinical symptoms of AN patients.展开更多
The concept of the brain cognitive reserve is derived from the well-acknowledged notion that the degree of brain damage does not always match the severity of clinical symptoms and neurological/cognitive outcomes.It ha...The concept of the brain cognitive reserve is derived from the well-acknowledged notion that the degree of brain damage does not always match the severity of clinical symptoms and neurological/cognitive outcomes.It has been suggested that the size of the brain(brain reserve) and the extent of neural connections acquired through life(neural reserve) set a threshold beyond which noticeable impairments occur.In contrast,cognitive reserve refers to the brain's ability to adapt and reo rganize stru cturally and functionally to resist damage and maintain function,including neural reserve and brain maintenance,resilience,and compensation(Verkhratsky and Zorec,2024).展开更多
Alzheimer’s disease(AD)is a slow,progressive neurodegenerative disease with clinical symptoms that typically emerge in the elderly,leading to deterioration of cognitive functions over time.Memory loss is the primary ...Alzheimer’s disease(AD)is a slow,progressive neurodegenerative disease with clinical symptoms that typically emerge in the elderly,leading to deterioration of cognitive functions over time.Memory loss is the primary symptom,eventually leading to significant declines in executive and cognitive functions,along with psychiatric and behavioral changes,and alterations in personality.展开更多
Hypoxic pulmonary hypertension(HPH)is a pathophysiological state characterized by diverse clinical symptoms resulting from structural and functional changes in pulmonary vessels induced by hypoxic stimuli,leading to i...Hypoxic pulmonary hypertension(HPH)is a pathophysiological state characterized by diverse clinical symptoms resulting from structural and functional changes in pulmonary vessels induced by hypoxic stimuli,leading to increased pulmonary artery pressure.展开更多
Spreading COVID-19 disease caused by coronavirus 2 causes tremendous health challenges worldwide. Owing to a high transmission rate, fast-spreading disease, asymptomatic carriers, and high infectivity, we observe a pa...Spreading COVID-19 disease caused by coronavirus 2 causes tremendous health challenges worldwide. Owing to a high transmission rate, fast-spreading disease, asymptomatic carriers, and high infectivity, we observe a pandemic status that we follow today. Although there are different reports of case fatality rates around the globe, the primary determinant of mortality is age. Symptoms of COVID-19 disease vary from asymptomatic individuals to severe acute respiratory distress syndrome (ARDS) and death. The most common complication of COVID-19 is ARDS. Hyperinflammation due to excessive immune response to coronavirus is the leading cause of severe symptoms seen in the course of COVID-19. The virus enters cells utilizing the S1 subunit through the ACE2 receptor. The innate immune response is the primary immune reaction to virus entry. RNA viruses, including corona-virus, replicate in the cytoplasm, assemble, and then exit by exocytosis. Some suggest that SARS-Cov2 uses cell-cell fusion to infect adjacent cells. Different sensors detect the virus particles in the endosomal compartment and cytoplasm, and infected cells induce an immune response to surrounding cells. As a result, the production of cytokines and chemokines such as interferons (INFs) will be augmented. Since coronavirus uses different means to evade the immune system, it is difficult for immune cells to “sense” them;thus, the coronavirus response is not adequate. It has been showing that even a sufficient level of immunoglobulin response couldn’t neutralize virus replication. Therefore, the innate immune response is unable to eradicate SARS-Cov2, causes overexpression of cytokines and chemokines that cannot eliminate the virus. Diminished INFs secretion and apoptosis of regulatory T cells (Treg) are the leading cause of dysregulated immune response in a cytokine storm. Inflammatory cells attack infected and uninfected cells, causing more inflammation and apoptosis of endothelial and epithelial cells. In the end, organ failure occurs due to immune cells’ overactivity, cell proliferation, hemorrhage, microthrombi, and remodeling of tissue cells. This review discusses the immune response and pathomechanisms of the associated symptoms in COVID-19.展开更多
Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. H...Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.展开更多
BACKGROUND Bladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness.The bladder is characterized by four distinct forms of neuroendocrine tumors.Among them,large-cell neuroendocrine carcinoma ...BACKGROUND Bladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness.The bladder is characterized by four distinct forms of neuroendocrine tumors.Among them,large-cell neuroendocrine carcinoma is the least prevalent,but has the highest level of aggressiveness.The 5-year survival rate for large-cell neuroendocrine carcinoma of the bladder is exceedingly poor.To date,only a few dozen cases have been reported.CASE SUMMARY Here,we report the case of a 65-year-old man with large-cell neuroendocrine carcinoma of the bladder.The patient presented to the Department of Urology at our hospital due to the presence of painless hematuria without any identifiable etiology.During hospitalization,abdominal computed tomography revealed the presence of an irregular mass on the right anterior wall of the bladder.A cystoscopic non-radical resection of the bladder lesion was performed.The postoperative pathological examination revealed large-cell neuroendocrine bladder cancer.Previous reports on cases of large-cell neuroendocrine carcinoma cases were retrieved from PubMed,and the present paper discusses the currently recognized best diagnostic and treatment options for large-cell neuroendocrine carcinoma based on the latest research progress.CONCLUSION Large-cell neuroendocrine carcinoma of the bladder is an uncommon malignancy with a highly unfavorable prognosis.Despite ongoing efforts to prolong patient survival through multidisciplinary therapy,the prognosis remains unfavorable.Large-cell neuroendocrine carcinoma continues to be a subject of uncertainty.展开更多
Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chin...Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chinese Medicine (TCM) syndrome aims to reflect the characteristics of diseases and is the basic principle of TCM treatment of diseases. This study aimed to summarize the distribution pattern of TCM syndromes in patients with hyperlipidemia. Methods: The frequency, characteristics and distribution of all TCM syndromes of 1012 patients with hyperlipidemia were analyzed. Results: The main disease types determined by frequency of 1012 patients included hypertriglyceridemia combined with hypo high-density lipoprotein cholesterolemia (19.76%), hypo high-density lipoprotein cholesterolemia (18.58%), hypercholesterolemia (16.50%), mixed hyperlipidemia (16.40%), and hypertriglyceridemia (15.12%). The distribution of TCM syndromes, in order of frequency, was as follows: Qi-deficiency and blood stasis syndrome (23.52%), liver depression and spleen deficiency (9.88%), syndrome of qi stagnation and blood stasis (9.29%), phlegm stasis syndrome (7.41%), and syndrome of yang deficiency of spleen and kidney (6.92%). Conclusion: Qi-deficiency and blood stasis syndrome and liver depression and spleen deficiency are the most common TCM syndromes in patients with hyperlipidemia.展开更多
Objective:This study aimed to analyze the epidemiological characteristics and clinical symptoms of mpox cases with and without human immunodeficiency virus(HIV)reported in China in 2023,providing evidence for coordina...Objective:This study aimed to analyze the epidemiological characteristics and clinical symptoms of mpox cases with and without human immunodeficiency virus(HIV)reported in China in 2023,providing evidence for coordinated prevention and control strategies for both infections.Method:All confirmed mpox cases reported in 2023 were extracted from China’s Information System for Disease Control and Prevention.Data were collected from the surveillance system and epidemiological investigations.Statistical analyses were performed using SPSS 24.0,with group comparisons conducted using t-tests and chi-square tests.Results:Among 1,712 confirmed mpox cases in China during 2023,802(46.8%)were people with human immunodeficiency virus(PWH).Of the 1,702 male cases,97.3%of PWH and 91.1%of those without HIV self-identified as men who have sex with men(MSM).Age distribution showed 79.4%of PWH and 87.6%of those without HIV were under 40 years old,while 64.2%of PWH and 71.3%of those without HIV were reported from eastern regions.Cardinal symptoms at diagnosis occurred at similar rates between those with and without HIV,including rash(90.9%vs.93.4%),fever(52.5%vs.53.8%),and lymphadenopathy(23.8%vs.25.4%).Among coinfected cases,individuals diagnosed with HIV after mpox or within one year before mpox demonstrated higher rates of immunodeficiency and lower rates of HIV viral suppression.Conclusion:Male mpox cases with HIV was more likely to be MSM,older,and reported from central and western regions compared to those without HIV.No significant differences were observed in cardinal symptom occurrence between groups.These findings emphasize the importance of implementing integrated prevention strategies targeting both HIV and mpox,particularly among key populations.展开更多
Alzheimer’s disease(AD)is a degenerative neurological disease that primarily affects the elderly.Drug therapy is the main strategy for AD treatment,but current treatments suffer from poor efficacy and a number of sid...Alzheimer’s disease(AD)is a degenerative neurological disease that primarily affects the elderly.Drug therapy is the main strategy for AD treatment,but current treatments suffer from poor efficacy and a number of side effects.Non-drug therapy is attracting more attention and may be a better strategy for treatment of AD.Hypoxia is one of the important factors that contribute to the pathogenesis of AD.Multiple cellular processes synergistically promote hypoxia,including aging,hypertension,diabetes,hypoxia/obstructive sleep apnea,obesity,and traumatic brain injury.Increasing evidence has shown that hypoxia may affect multiple pathological aspects of AD,such as amyloid-beta metabolism,tau phosphorylation,autophagy,neuroinflammation,oxidative stress,endoplasmic reticulum stress,and mitochondrial and synaptic dysfunction.Treatments targeting hypoxia may delay or mitigate the progression of AD.Numerous studies have shown that oxygen therapy could improve the risk factors and clinical symptoms of AD.Increasing evidence also suggests that oxygen therapy may improve many pathological aspects of AD including amyloid-beta metabolism,tau phosphorylation,neuroinflammation,neuronal apoptosis,oxidative stress,neurotrophic factors,mitochondrial function,cerebral blood volume,and protein synthesis.In this review,we summarized the effects of oxygen therapy on AD pathogenesis and the mechanisms underlying these alterations.We expect that this review can benefit future clinical applications and therapy strategies on oxygen therapy for AD.展开更多
The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagno...The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.展开更多
文摘BACKGROUND Rare liver tumors(RLTs)have an extremely low likelihood of forming,and some have been recorded only in isolated cases.The lack of normal clinical symptoms in RLTs makes preoperative diagnosis extremely challenging,which results in frequent misinterpretation.The present case report helps enhance our ability to recognize and treat uncommon liver tumor disorders.CASE SUMMARY We describe four distinct examples of rare liver tumor diseases.These cases were all true cases with no conventional clinical signs or imaging findings.In all patients,hepatic occupancy was discovered on physical examination,which raised the preoperative suspicion of hepatic cancer.All tumors were surgically removed,and postoperative histology and immunohistochemistry were performed to confirm the diagnosis.The first patient had primary hepatic fibrosarcoma.The second case involved a primary hepatic neuroendocrine tumors.These two patients had malignant liver tumors,and both had extremely satisfactory surgical outcomes.The third case involved focal hepatic steatosis,and the fourth case involved a single necrotic nodule in the liver.These two patients had benign liver tumors,but they had already undergone surgery and did not require any postoperative care.CONCLUSION The number of patients with RLTs is small,and the clinical and imaging results are vague.Preoperative diagnosis is challenging,and patients are sometimes mistakenly diagnosed with liver cancer,which leads to unnecessary surgical therapy in certain individuals.
基金supported by the National Natural Science Foundation of China,Nos.81771281(to FXS),81471177(to FXS)the Natural Science Foundation of Shanghai of China,No.20ZR1434200(to YF)。
文摘Leukoaraiosis(LA)results from ischemic injury in small cerebral vessels,which may be attributable to decreased vascular density,reduced cerebrovascular angiogenesis,decreased cerebral blood flow,or microcirculatory dysfunction in the brain.In this study,we enrolled 357 patients with mild intracerebral hemorrhage(ICH)from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission,neurological function prognosis at 3 months,and 1-year stroke recurrence.Patients were divided into groups based on Fazekas scale scores:no LA(n=83),mild LA(n=64),moderate LA(n=98)and severe LA(n=112).More severe LA,larger hematoma volume,and higher blood glucose level at admission were associated with more severe neurological deficit.More severe LA,older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months.In addition,moderate-to-severe LA,admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence.These findings suggest that LA severity may be a potential marker of individual ICH vulnerability,which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH.Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols.This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University(approval No.12)on March 10,2011.
基金Supported by Shanghai Shenkang Hospital Development Center,No.SHDC12016109.
文摘BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ systems.We report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute pancreatitis.No such case has been previously reported.CASE SUMMARY A 29-year-old woman did not pay much attention to a fever 4 d prior.During this time,she experienced anorexia and only drank a small amount of water every day.She did not present with abdominal distension,postprandial nausea,vomiting,cough or expectoration.After physical and laboratory examinations,the patient was diagnosed with hypothyroidism.During the course of the disease,hypothyroidism was generally accompanied by constantly increased pancreatic amylase and trypsin.After admission,the possible etiology of the patient was excluded and the concentrations of pancreatic lipase and amylase in serum were>2000U/L(reference range 23-300 U/L)and 410 U/L(reference range 30-110 U/L),respectively.So we highly suspected that it may be acute pancreatitis.Interestingly,she never developed any complications associated with acute pancreatitis despite high levels of serum pancreatic amylase and trypsin,and she reported no symptoms of abdominal pain.Serum amylase and lipase decreased gradually after active thyroxine supplementation,and the patient was discharged from the hospital after active treatment.CONCLUSION This case suggests that clinicians should pay attention to hypothyroidism with elevated pancreatic amylase and trypsin,even if no complications of acute pancreatitis are reported.
基金funding support from the Innovation Platform Open Fund Project of Hunan Provincial Universities (No. 13K076)National Key Discipline Open Fund Project of TCM diagnostics in Hunan University of Chinese Medicine (2015zyzd18)
文摘This report analyzes the existing problems in terminology referring to clinical symptoms of traditional Chinese medicine(TCM)from the viewpoint of data sharing and elaborates the necessity of establishing a standard directory of clinical data elements of TCM.We evaluated the principles and methods of data element extraction according to the status quo of the clinical information system and characteristics of symptoms for TCM and consequently proposed a three-layer model for optimal extraction.
基金Fund project no.:2020-SW(reserved)-52Kunming Health Commission 1000 project reserved candidates:Study on the diagnostic value of BALF solution acer sequencing and culturing in difficult and severe respiratory infections.
文摘Objective:To explore the effects of bronchoscopy alveolar lavage in the treatment of severe pneumonia caused by multiple drug bacterial infection.Methods:A total of 84 patients with severe pneumonia infected by multi-drug resistant bacteria were randomly selected from Kunming Second People's Hospital,which is our hospital from January 2019 to December 2020 for this research.They were divided into a reference group and a study group using a digital table method,with 42 cases in each group.The reference group was given the routine treatment,the research group performed bronchoscopy alveolar lavage on this basis to observe the curative effect.Results:Before treatment,there was no significant difference in serum factor indexes and blood gas analysis indexes between the two groups of patients,P>0.05.After treatment,the time of fever,cough,moist rales disappearing and infection control time in the study group were shorter than those in the reference group,P<0.05.Serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)levels were lower than the reference group,and the arterial partial pressure of oxygen(PO2)and oxygen saturation(SO2)were both lower than the reference group,P<0.05.The effective rate of the treatment in the study group was higher than that in the reference group,P<0.05.Conclusion:Bronchoscopic alveolar lavage treatment can effectively improve the clinical symptoms of patients with severe pneumonia caused by multi-drug resistant bacterial infection,and the effects are significant.
文摘Objective: the experiment will be hembide injection for patients with severe sepsis to further compare the coagulation index of patients and relieve clinical symptoms. Methods: sepsis patients admitted from January 2021 to December 2,2021 were selected for clinical review and divided into 2 groups of 78 patients, namely observation group (n=39) and control group (n=39).The control group was conventional supportive treatment, and the observation group was treated with habidide injection to compare the treatment results. Results: in terms of treatment, the coagulation results in the observation group were better than the control group, with statistical significance (P <0.05).In addition, on the WBC count, the posttreatment observation group was (10.22 ± 3.01) 109 / L · L-1), the controls were (13.44 ± 2.91) 109 / L · L-1), and on the platelet index was (187.44 ± 47.31) 109 / L and (118.23 ± 50.65) 109 / L with significant differences (P <0.05).Meanwhile, in both the APACHEII and cTnI indicators, the observation group scored lower than the control group, and the difference was statistically significant (P <0.05).After 7 days of treatment, the number of MODS in the observed group was lower. Conclusion: blood-net injection can correct coagulation disorder and prevent disease deterioration. It improves the prognosis and deserves application.
文摘Objective: to explore the improvement of clinical symptoms of patients with chronic renal failure treated by traditional Chinese medicine nursing technology. Method: from July 2019 to July 2020 as the time period for the implementation of the study, 74 patients with chronic renal failure in our hospital were selected, and the grouping method was random number table method, 37 cases for each. The reference group received basic nursing intervention, and the experimental group received traditional Chinese medicine nursing technology. The scores of quality of life, sleep status, complications and clinical effects were calculated. Results: there was no significant difference between the quality of life scores and sleep status scores of the two groups before the intervention (p > 0.05). After the intervention, the data of the reference group was used as a reference. The quality of life score and sleep status score of the experimental group were better, and the differences between the groups were significant (p < 0.05);taking the experimental group data as a reference, the reference group had more complications and lower clinical effects, and there was a comparison of data between groups Statistically significant (p < 0.05). Conclusion: the traditional Chinese medicine nursing technology treatment for patients with chronic renal failure can improve the quality of life of patients and improve the insomnia symptoms, which is of high safety and has significant clinical application value.
文摘Objective: this paper mainly studies the patients with chronic obstructive emphysema, observes the symptoms of this type of patients during their illness, and treats the selected patients in different ways, and analyzes the final therapeutic effect. Methods: this article mainly selected 62 patients with chronic obstructive emphysema from May 2020 to September 2021. In order to better compare and analyze the treatment results, all patients were divided into two groups for comparison. Firstly, 31 patients were randomly selected as the X group in this study, and their conditions were relatively serious. The remaining 31 patients were taken as the Y group of this study, and their condition was relatively mild. During the treatment of all patients, medical staff should choose the appropriate treatment method for patients according to the severity of their condition, and compare and analyze the final treatment effects of different patients. Results: after observing and studying the selected patients with the above methods, it was found that the symptoms of patients during the illness were complicated, and the complications of patients with different conditions were different. However, after choosing a scientific and reasonable treatment method for patients according to different patients conditions, the patients conditions were obviously improved, and the overall cure rate and satisfaction were improved correspondingly. There are obvious differences between the final research data of the two groups, which can provide reliable data support for this study. Conclusion: from the above research methods and research process, it is found that the symptoms of patients with different diseases are different, and the probability of pulmonary bullae in the course of patients onset is relatively large. However, for some patients with serious illness, long-term illness will lead to respiratory and heart failure, aggravate the changes of patients condition, and increase the mortality of patients. Therefore, in the process of treating this type of patient, we should accurately judge the patients condition, and combine the judgment results to treat the patient, so as to improve the effect of treatment for the patient.
文摘Objective:to evaluate the value of TCM syndrome differentiation in patients with AIDS complicated with pulmonary infection by observing the curative effect in the course of combined TCM treatment. Methods: 35 PATIENTS with AIDS complicated with pulmonary infection in our hospital from April 2016 to April 2021 were selected. The patients treated with western medicine alone were listed as the reference group, and the patients treated with Western medicine combined with TCM syndrome differentiation were listed as the experimental group. 18 cases were included in the experimental group and 17 cases were included in the reference group. The two groups were compared in the quality of clinical outcomes. Results:the effective rate of the experimental group was 88.89%, which exceeded 64.71% in the reference group. There was a significant difference between the two groups (P<0.05). Moreover, the quality of life score in the experimental group was higher than that in the reference group, and there was a significant difference (P<0.05). Conclusion: in the clinical treatment of AIDS complicated with pulmonary infection, the timely combination of TCM syndrome differentiation treatment can effectively improve the symptoms of patients, shorten the hospitalization period, improve the quality of life after treatment, so it is worthy of clinical application.
文摘Objective To explore anxiety and impulsivity in adult female patients with anorexia nervosa(AN),and the relationship with different dimensions of the core clinical symptoms.Methods From June 2014 to October 2022,96 patients with AN,from both outpatient clinics andinpatienttwards,wereenrolled from Peking UniversitySixthHospital.Additionally,51 control participants were recruited from the community.Statetrait Anxiety Inventory(STAI)and Barratt Impulsiveness Scale(BIS-11))were used to evaluate the anxiety and impulsivityofeachggroup.TheEatingDisorder Inventory-1(EDI-1)was used to assess clinical and other psychological characteristics of ED.Correlation and regression analysis were employedtoexplore the relationship between anxiety,impulsivity,and core clinical symptoms of eating disorders.Results(1)The total EDI-1 score for the AN group((233.7±48.4)vs.(184.2±30.4),t=7.58,P<0.001)and scores in 7 subscales(Drive for Thinness:t=5.25,P<0.001;Bulimia:t=6.05,P<0.001;Ineffectiveness:t=7.91,P<0.001;Perfectionism:t=3.05,P=0.003;Interpersonal Distrust:t=5.50,P<0.001;Interoceptive Awareness:t=7.00,P<0.001;Maturity Fears:t=2.46,P=0.015)were significantly higher than the control group.(2)The AN group had significantly higher levels of state anxiety(t=8.60,P<0.001),trait anxiety(t=7.40,P<0.001),total impulsivity(t=3.55,P<0.001),attentional impulsiveness(t=2.43,P=0.017)and motor impulsiveness(t=4.29,P<0.001)compared to the control group.(3)Correlation analysis showed that state anxiety,trait anxiety,attentional impulsiveness,motor impulsiveness,and non-planning impulsiveness were positively correlated with the drive for thinness(r=0.522,0.577,0.272,0.387,0.209,allP<0.05);State anxiety,trait anxiety,attentional impulsiveness,motor impulsiveness,and non-planning impulsiveness were also positively correlated with bulimia(r=0.402,0.471,0.304,0.514,0.466,all P<0.01);Attentional impulsiveness,state anxiety,and trait anxiety were positively correlated with body dissatisfaction(r=0.333,0.448,0.409,all P<0.01).Further ridge regression analysis indicated that trait anxiety in AN patients was an influencing factor of the drive for thinness(t=3.13,P=0.002),state anxiety was an influencing factor of body dissatisfaction(t=1.99,P=0.050),and motor impulsiveness and non-planning impulsiveness were the influencing factors of bulimia(t=2.92,2.79,all P<005).Conclusion Patients with anorexia nervosa have higher anxiety and impulsivity,and the levels of anxiety and impulsivity in different dimensions are related to the core clinical symptoms of AN patients.
文摘The concept of the brain cognitive reserve is derived from the well-acknowledged notion that the degree of brain damage does not always match the severity of clinical symptoms and neurological/cognitive outcomes.It has been suggested that the size of the brain(brain reserve) and the extent of neural connections acquired through life(neural reserve) set a threshold beyond which noticeable impairments occur.In contrast,cognitive reserve refers to the brain's ability to adapt and reo rganize stru cturally and functionally to resist damage and maintain function,including neural reserve and brain maintenance,resilience,and compensation(Verkhratsky and Zorec,2024).
基金supported by the National Natural Science Foundation of China(82120108010 and 81930028).
文摘Alzheimer’s disease(AD)is a slow,progressive neurodegenerative disease with clinical symptoms that typically emerge in the elderly,leading to deterioration of cognitive functions over time.Memory loss is the primary symptom,eventually leading to significant declines in executive and cognitive functions,along with psychiatric and behavioral changes,and alterations in personality.
基金supported by General Program of the Natural Science Foundation of Hebei Province(No.H2024110033,China).
文摘Hypoxic pulmonary hypertension(HPH)is a pathophysiological state characterized by diverse clinical symptoms resulting from structural and functional changes in pulmonary vessels induced by hypoxic stimuli,leading to increased pulmonary artery pressure.
文摘Spreading COVID-19 disease caused by coronavirus 2 causes tremendous health challenges worldwide. Owing to a high transmission rate, fast-spreading disease, asymptomatic carriers, and high infectivity, we observe a pandemic status that we follow today. Although there are different reports of case fatality rates around the globe, the primary determinant of mortality is age. Symptoms of COVID-19 disease vary from asymptomatic individuals to severe acute respiratory distress syndrome (ARDS) and death. The most common complication of COVID-19 is ARDS. Hyperinflammation due to excessive immune response to coronavirus is the leading cause of severe symptoms seen in the course of COVID-19. The virus enters cells utilizing the S1 subunit through the ACE2 receptor. The innate immune response is the primary immune reaction to virus entry. RNA viruses, including corona-virus, replicate in the cytoplasm, assemble, and then exit by exocytosis. Some suggest that SARS-Cov2 uses cell-cell fusion to infect adjacent cells. Different sensors detect the virus particles in the endosomal compartment and cytoplasm, and infected cells induce an immune response to surrounding cells. As a result, the production of cytokines and chemokines such as interferons (INFs) will be augmented. Since coronavirus uses different means to evade the immune system, it is difficult for immune cells to “sense” them;thus, the coronavirus response is not adequate. It has been showing that even a sufficient level of immunoglobulin response couldn’t neutralize virus replication. Therefore, the innate immune response is unable to eradicate SARS-Cov2, causes overexpression of cytokines and chemokines that cannot eliminate the virus. Diminished INFs secretion and apoptosis of regulatory T cells (Treg) are the leading cause of dysregulated immune response in a cytokine storm. Inflammatory cells attack infected and uninfected cells, causing more inflammation and apoptosis of endothelial and epithelial cells. In the end, organ failure occurs due to immune cells’ overactivity, cell proliferation, hemorrhage, microthrombi, and remodeling of tissue cells. This review discusses the immune response and pathomechanisms of the associated symptoms in COVID-19.
文摘Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.
文摘BACKGROUND Bladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness.The bladder is characterized by four distinct forms of neuroendocrine tumors.Among them,large-cell neuroendocrine carcinoma is the least prevalent,but has the highest level of aggressiveness.The 5-year survival rate for large-cell neuroendocrine carcinoma of the bladder is exceedingly poor.To date,only a few dozen cases have been reported.CASE SUMMARY Here,we report the case of a 65-year-old man with large-cell neuroendocrine carcinoma of the bladder.The patient presented to the Department of Urology at our hospital due to the presence of painless hematuria without any identifiable etiology.During hospitalization,abdominal computed tomography revealed the presence of an irregular mass on the right anterior wall of the bladder.A cystoscopic non-radical resection of the bladder lesion was performed.The postoperative pathological examination revealed large-cell neuroendocrine bladder cancer.Previous reports on cases of large-cell neuroendocrine carcinoma cases were retrieved from PubMed,and the present paper discusses the currently recognized best diagnostic and treatment options for large-cell neuroendocrine carcinoma based on the latest research progress.CONCLUSION Large-cell neuroendocrine carcinoma of the bladder is an uncommon malignancy with a highly unfavorable prognosis.Despite ongoing efforts to prolong patient survival through multidisciplinary therapy,the prognosis remains unfavorable.Large-cell neuroendocrine carcinoma continues to be a subject of uncertainty.
文摘Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chinese Medicine (TCM) syndrome aims to reflect the characteristics of diseases and is the basic principle of TCM treatment of diseases. This study aimed to summarize the distribution pattern of TCM syndromes in patients with hyperlipidemia. Methods: The frequency, characteristics and distribution of all TCM syndromes of 1012 patients with hyperlipidemia were analyzed. Results: The main disease types determined by frequency of 1012 patients included hypertriglyceridemia combined with hypo high-density lipoprotein cholesterolemia (19.76%), hypo high-density lipoprotein cholesterolemia (18.58%), hypercholesterolemia (16.50%), mixed hyperlipidemia (16.40%), and hypertriglyceridemia (15.12%). The distribution of TCM syndromes, in order of frequency, was as follows: Qi-deficiency and blood stasis syndrome (23.52%), liver depression and spleen deficiency (9.88%), syndrome of qi stagnation and blood stasis (9.29%), phlegm stasis syndrome (7.41%), and syndrome of yang deficiency of spleen and kidney (6.92%). Conclusion: Qi-deficiency and blood stasis syndrome and liver depression and spleen deficiency are the most common TCM syndromes in patients with hyperlipidemia.
基金National Key Research and Development Program of China(2024YFC2309501).
文摘Objective:This study aimed to analyze the epidemiological characteristics and clinical symptoms of mpox cases with and without human immunodeficiency virus(HIV)reported in China in 2023,providing evidence for coordinated prevention and control strategies for both infections.Method:All confirmed mpox cases reported in 2023 were extracted from China’s Information System for Disease Control and Prevention.Data were collected from the surveillance system and epidemiological investigations.Statistical analyses were performed using SPSS 24.0,with group comparisons conducted using t-tests and chi-square tests.Results:Among 1,712 confirmed mpox cases in China during 2023,802(46.8%)were people with human immunodeficiency virus(PWH).Of the 1,702 male cases,97.3%of PWH and 91.1%of those without HIV self-identified as men who have sex with men(MSM).Age distribution showed 79.4%of PWH and 87.6%of those without HIV were under 40 years old,while 64.2%of PWH and 71.3%of those without HIV were reported from eastern regions.Cardinal symptoms at diagnosis occurred at similar rates between those with and without HIV,including rash(90.9%vs.93.4%),fever(52.5%vs.53.8%),and lymphadenopathy(23.8%vs.25.4%).Among coinfected cases,individuals diagnosed with HIV after mpox or within one year before mpox demonstrated higher rates of immunodeficiency and lower rates of HIV viral suppression.Conclusion:Male mpox cases with HIV was more likely to be MSM,older,and reported from central and western regions compared to those without HIV.No significant differences were observed in cardinal symptom occurrence between groups.These findings emphasize the importance of implementing integrated prevention strategies targeting both HIV and mpox,particularly among key populations.
基金supported by the Key Research and Development Support Project of Chengdu Science and Technology Bureau, No. 2019-YF05-00655-SN (to WDL)the Key Project of the Medical Science Department, University of Electronic Science and Technology of China, No. ZYGX2020ZB035 (to WDL)
文摘Alzheimer’s disease(AD)is a degenerative neurological disease that primarily affects the elderly.Drug therapy is the main strategy for AD treatment,but current treatments suffer from poor efficacy and a number of side effects.Non-drug therapy is attracting more attention and may be a better strategy for treatment of AD.Hypoxia is one of the important factors that contribute to the pathogenesis of AD.Multiple cellular processes synergistically promote hypoxia,including aging,hypertension,diabetes,hypoxia/obstructive sleep apnea,obesity,and traumatic brain injury.Increasing evidence has shown that hypoxia may affect multiple pathological aspects of AD,such as amyloid-beta metabolism,tau phosphorylation,autophagy,neuroinflammation,oxidative stress,endoplasmic reticulum stress,and mitochondrial and synaptic dysfunction.Treatments targeting hypoxia may delay or mitigate the progression of AD.Numerous studies have shown that oxygen therapy could improve the risk factors and clinical symptoms of AD.Increasing evidence also suggests that oxygen therapy may improve many pathological aspects of AD including amyloid-beta metabolism,tau phosphorylation,neuroinflammation,neuronal apoptosis,oxidative stress,neurotrophic factors,mitochondrial function,cerebral blood volume,and protein synthesis.In this review,we summarized the effects of oxygen therapy on AD pathogenesis and the mechanisms underlying these alterations.We expect that this review can benefit future clinical applications and therapy strategies on oxygen therapy for AD.
基金supported by the National Natural Science Foundation of China,No.30560042,81160161 and 81360198(all to RSX)grants from the Education Department of Jiangxi Province,No.GJJ13198 and GJJ170021(both to RSX)+3 种基金grants from Jiangxi Provincial Department of Science and Technology,No.2014-47,20142BBG70062,and 20171BAB215022(all to RSX)a grant from Health and Family Planning Commission of Jiangxi Province,No.20181019(to RSX)a grant from Jiangxi Provincial Department of Science and Technology Gan Po Elite 555,No.2015108(to RSX)the Innovation Fund Designated for Graduate Students of Jiangxi Province,No.YC2016-B027 and YC2015-S097(both to RSX)。
文摘The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.
