Based on the overall view of communication theory and spoken English language testing system,this paper has conducted a comprehensive and specific observation and research on how examiner non-verbal behavior has affec...Based on the overall view of communication theory and spoken English language testing system,this paper has conducted a comprehensive and specific observation and research on how examiner non-verbal behavior has affected candidate performance.The research has found out that not only examiner behavior including non-verbal behavior but language testing scenario itself is of communicative nature and examiner’s non-verbal behavior indeed promotes examinee’s test performance,which can help to better understand spoken testing system,examiner non-verbal behavior,and testing environment to promote the development of language speaking test and reflect examinee’s real language competence and ability.展开更多
[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to t...[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.展开更多
Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 199...Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 1993.TM typically spares the foveal center,is asymptomatic,and is often detected incidentally during routine ophthalmic examinations.Through literature search,we did not identify racial or regional differences in TM.It predominantly affects children,with an estimated prevalence of 2 per 100000 in individuals under 16 ages[3].While previous reports have focused on pediatric and adult populations,this study presents four cases of TM in preterm infants.展开更多
AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 ...AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included.By exclusion criteria,8460 subjects were screened with 1676 myopia samples and 6784 control samples.Subsequently,baseline characteristics,association analyses,risk stratification analyses,and receive operating characteristic curve(ROC)were used to investigate the associations between covariates and myopia.Then,the causal relationship was explored in depth by MR analysis,and was estimated the reliability by sensitivity analyses and directionality tests.RESULTS:Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates(excluding gender;P<0.05).The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates[model 3:odd ratio(OR)=1.31;95%CI=1.07-1.62;P=0.0133].The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia(P<0.05,OR>1).ROC proved that the model was accurate in its prediction[area under curve(AUC)=0.7].Subsequently,the causal relationship between them was statistically significant(P<0.05)according to the inverse variance weighted(IVW)method in MR.Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders.Forest plot displayed an increasing risk of myopia on asthma(OR>1).The funnel plot demonstrated compliance with Mendel’s second law.Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.CONCLUSION:A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis,which is important implications for public health policy development and clinical practice.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANE...AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANES)were analyzed,a nationally representative U.S.dataset.ERM was identified via retinal imaging based on the presence of cellophane changes.Key predictors included age group,eye surgery history,and refractive error,with additional demographic and health-related covariates.Weighted univariate and multiple logistic regression models were used to assess associations and interaction effects between eye surgery and refractive error.RESULTS:Totally 3925 participants were analyzed.Older age,eye surgery,and refractive errors were significantly associated with ERM.Compared to those under 65y,the odds ratio(OR)for ERM was 3.08 for ages 65–75y(P=0.0014)and 4.76 for ages 75+years(P=0.0069).Eye surgery increased ERM risk(OR=3.48,P=0.0018).Moderate to high hyperopia and myopia were also associated with ERM(OR=2.65 and 1.80,respectively).A significant interaction between refractive error and eye surgery was observed(P<0.0001).Moderate to high myopia was associated with ERM only in those without eye surgery(OR=1.92,P=0.0443).Eye surgery was most strongly associated with ERM in the emmetropic group(OR=3.60,P=0.0027),followed by the moderate to high myopia group(OR=3.01,P=0.0031).CONCLUSION:ERM is significantly associated with aging,eye surgery,and refractive errors.The interaction between eye surgery and refractive error modifies ERM risk and highlights the importance of considering combined effects in clinical risk assessments.These findings may help guide individualized ERM risk assessment that may inform personalized approaches to ERM prevention and management.展开更多
Dear Editor,We present a case of acute zonal occult outer retinopathy(AZOOR)complex in a myopic patient with angioid streaks(ASs).A 19-year-old female has been experiencing visual field defects in her left eye for mor...Dear Editor,We present a case of acute zonal occult outer retinopathy(AZOOR)complex in a myopic patient with angioid streaks(ASs).A 19-year-old female has been experiencing visual field defects in her left eye for more than 3y.She was diagnosed with ASs and choroiditis at a local hospital.She has a seven-year history of bilateral high myopia.A fundus examination confirmed the presence of ASs and myopic fundus changes in both eyes.Multimodal imaging revealed an AZOOR complex in the left eye.展开更多
In China's criminal procedure system,forensic advice is one of the key types of evidence.These advices play an important part in discovering the facts of a case,convictions,and sentencing,and they cannot be ignore...In China's criminal procedure system,forensic advice is one of the key types of evidence.These advices play an important part in discovering the facts of a case,convictions,and sentencing,and they cannot be ignored in assessments of guilt and the death penalty.However,due to broad and flexible criminal laws,in actual litigation,the nonappearance of forensic examiner or mere provision of documentation of advice read in court has become the norm.This has led to the existence in name only of cross-examination rights,which directly damages the legitimate rights and interests of the parties and the objective and impartial rulings of referees.At present,there is no legal clarity in criminal proceedings that examiner should or should not be examined in court.In my opinion,the entire court system should require an appearance in court,which must be a clear mandatory appearance with specific exceptions.The system should guarantee the forensic examiner5 mandatory appearances,which would inevitably improve the rules of evidence.展开更多
Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination...Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.展开更多
Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcom...Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.展开更多
This editorial discusses a case report recently published in the World Journal of Clinical Cases.The report describes the clinical presentation,imaging,diagnosis,and treatment of a patient with tuberous sclerosis comp...This editorial discusses a case report recently published in the World Journal of Clinical Cases.The report describes the clinical presentation,imaging,diagnosis,and treatment of a patient with tuberous sclerosis complex(TSC)combined with primary lymphedema(PLE).Additionally,it retrospectively analyzes the data of 16 previously reported cases of children with TSC combined with PLE to summarize the epidemiology,genetic diagnosis,and current main treatments of these patients.The report also speculates on the pathological and physiological mechanisms underlying TSC combined with PLE.TSC combined with PLE is rare;therefore,the report provides a theoretical basis for understanding the pathophysiological mechanisms and treatment options for patients with TSC and PLE.Comprehensive clinical management of TSC is essential due to the diverse and multiorgan nature of its manifestations,often requiring a multidisciplinary approach for newly diagnosed cases.展开更多
This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a...This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced stage.Two main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial neoplasia.In the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic lesions.Nevertheless,the survival rate still remains poor,and alternative screening methods are under investigation.Endoscopic retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its role.Probably a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early diagnosis.Biomarkers could help to predict and follow the progression of early pancreatic lesions.However,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.展开更多
A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally ...A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.展开更多
Objective:To study the application value and application path of pathological examination in gynecological physical examination.Methods:A total of 1200 patients undergoing gynecological physical examination in X Hospi...Objective:To study the application value and application path of pathological examination in gynecological physical examination.Methods:A total of 1200 patients undergoing gynecological physical examination in X Hospital from January 2024 to December 2024 were selected.All patients received cervical Pap smear examination,and patients with abnormal examination results underwent colposcopic biopsy and HPV infection test for cervical cancer screening.Results:The results of cervical Pap smear showed that a total of 780 patients among 1200 patients showed cervical abnormalities.The Pap smear combined with colposcopy was used for pathological examination to detect cervical cancer lesions in time,and biopsy and HPV infection examination were arranged for high-risk patients to provide data reference for clinical treatment.Conclusions:Pathological examination has a good screening effect in gynecological physical examination.It can detect lesions early and take timely intervention measures,which is helpful to reduce the incidence and mortality of the disease.展开更多
Reducing the resistance of vehicles,ships,aircraft and other means of transport during movement can significantly improve the speed,save energy and reduce emissions.After billions of years of continuous evolution,orga...Reducing the resistance of vehicles,ships,aircraft and other means of transport during movement can significantly improve the speed,save energy and reduce emissions.After billions of years of continuous evolution,organisms in nature have gradually developed the ability to move at high speed to achieve better survival.These evolved organisms provide a perfect template for the human development of drag reduction materials.Revealing the unique physiological structural characteristics of organisms and their relationship with resistance during movement can provide a feasible approach tosolving the problem of reducing friction resistance.Whether flying in the sky,running on the ground,swimming in the water,or even living in the soil,many creatures in various environments have the ability to reduce resistance.Driven by these inspirations,researchers have done a lot of work to explore and imitate these biological epidermis structures to achieve drag reduction.In this paper,the biomimetic drag reduction materials is introduced in detail in the order of drag reduction mechanism,structural characteristics of biological epidermis(including marine animals,flying animals,soil animals and plants),biomimetic preparation methods,performance testing methods and application fields.Finally,the potential of various biomimetic drag reduction materials in engineering application and the problems to be overcome are summarized and prospected.This paper can help readers comprehensively understand the research progress of biomimetic drag reduction materials,and provide reference for further designing the next generation of drag reduction materials.展开更多
Currently,the worldwide prevalence of morbid obesity has increased.1 The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention revealed that the prevalence of obesity in ...Currently,the worldwide prevalence of morbid obesity has increased.1 The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention revealed that the prevalence of obesity in the adult population between 20 and 74 years old had more than doubled from 13.3%to 31.1%from 1960 to 2002.2 Metabolic and bariatric surgery(MBS)is now suggested for patients with a body mass index(BMI)of more than 35 kg/m^(2),comorbidities or no comorbidities.Furthermore,MBS should be offered to people with metabolic disease and a BMI of 30e34.9 kg/m^(2) who have failed to gain a meaningful amount of weight or have failed to keep it off with non-surgical management.However,the BMI cutoff points should be modified for the Asian population.展开更多
As a severe neurological disease,cerebral hemorrhage is dangerous and progresses rapidly,with high disability and fatality rates.Its occurrence seriously harms patients’lives and health,and also causes a heavy social...As a severe neurological disease,cerebral hemorrhage is dangerous and progresses rapidly,with high disability and fatality rates.Its occurrence seriously harms patients’lives and health,and also causes a heavy social burden.Timely diagnosis and treatment of cerebral hemorrhage are essential for improving patients’prognosis.This article reviews the research progress in emergency treatment for patients with cerebral hemorrhage,providing a basis for diagnosis and treatment.展开更多
This study explores the application of Production-Oriented Approach(POA)in teaching German to nursing students in colleges and universities.Focusing on the requirements of the German B1 exam,the study takes the themat...This study explores the application of Production-Oriented Approach(POA)in teaching German to nursing students in colleges and universities.Focusing on the requirements of the German B1 exam,the study takes the thematic unit of“Movement”as an example,and designs the teaching through the links of“drive-enable-evaluate”.The results show that POA effectively improves students’speaking and writing output,but there are still deficiencies in reading and listening.Accordingly,this study has proposed the strategies of“vocabulary in-depth facilitation”and“accurate matching of listening and writing”to optimize the input materials and skills training,achieve the goal of“learning and using”,and provide a practical path for teaching German for Special Purposes.This provides a practical path for the teaching of German for special purposes.展开更多
Objective:To study the application effect of the multi-role positioning service model in hypertensive patients in the health examination center.Methods:A total of 152 hypertensive patients admitted to the hospital’s ...Objective:To study the application effect of the multi-role positioning service model in hypertensive patients in the health examination center.Methods:A total of 152 hypertensive patients admitted to the hospital’s health examination center from January 2024 to January 2025 were selected as the subjects.They were randomly divided into two groups using a random number table method.The control group(76 cases)received conventional physical examination service mode,while the observation group(76 cases)adopted the multi-role positioning service model.The nurse proficiency and physical examination quality were compared between the two groups.Results:The nurse proficiency scores in the observation group were higher than those in the control group(P<0.05).The physical examination quality scores in the observation group were higher than those in the control group(P<0.05).Conclusion:The adoption of the multi-role positioning service model for hypertensive patients in the health examination center can improve nurse proficiency and physical examination quality.展开更多
Marching band(MB)artists are often part of the general student population and not required to complete a preparticipation health screening to identify predisposing medical conditions or risks for injury/illness.Anecdo...Marching band(MB)artists are often part of the general student population and not required to complete a preparticipation health screening to identify predisposing medical conditions or risks for injury/illness.Anecdotally,exertional heat illnesses(EHI)are a concern for MB artists.As more athletic trainers provide MB healthcare,research is needed on EHI occurrence and MB associated EHI risk factors.We utilized an exploratory crosssectional study design to determine EHI risk factors,including previous EHI occurrence,among collegiate MB artists.MB artists(n=1207;age=[19.6±1.3]years)actively participating in their college/university's MB during the 2019 football season completed an online survey to characterize demographics,medical history,medication and supplement use,and nutrition behaviors.Chi-square and binomial logistical regressions assessed associations between categorical variables.Previous EHI was reported by 50.6%of MB artists,with 466(76.3%)experiencing exertional heat exhaustion and 31(5.1%)exertional heat stroke.More females reported exertional heat exhaustion overall(68.2%,p<0.001)and in the previous year(73.3%,p<0.001).Experiencing a previous EHI was significantly associated with having a mood/neurological condition(63.5%,p<0.001),diagnosed(74.3%,p=0.004)or perceived eating disorder(66.7%,p<0.001),and taking prescription medications(59.4%,p<0.001),over-the-counter medications(58.9%,p=0.002),and supplements(55.4%,p=0.037).Half of collegiate MB artists reported experiencing previous EHIs and engaged in behaviors known to increase EHI risk.MB artists should complete pre-participation examinations to identify pre-existing medical conditions and risks for adverse medical events.Healthcare providers working with MB artists should develop policies and procedures to mitigate EHI risks and occurrence.展开更多
文摘Based on the overall view of communication theory and spoken English language testing system,this paper has conducted a comprehensive and specific observation and research on how examiner non-verbal behavior has affected candidate performance.The research has found out that not only examiner behavior including non-verbal behavior but language testing scenario itself is of communicative nature and examiner’s non-verbal behavior indeed promotes examinee’s test performance,which can help to better understand spoken testing system,examiner non-verbal behavior,and testing environment to promote the development of language speaking test and reflect examinee’s real language competence and ability.
文摘[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.
基金Supported by the National Natural Science Foundation of China(No.82070991).
文摘Dear Editor,Torpedo maculopathy(TM),first described by Roseman and Gass in 1992[1],is a rare congenital unilateral retinal pigment epithelium(RPE)abnormality.The term“torpedo maculopathy”was coined by Daily[2]in 1993.TM typically spares the foveal center,is asymptomatic,and is often detected incidentally during routine ophthalmic examinations.Through literature search,we did not identify racial or regional differences in TM.It predominantly affects children,with an estimated prevalence of 2 per 100000 in individuals under 16 ages[3].While previous reports have focused on pediatric and adult populations,this study presents four cases of TM in preterm infants.
基金Supported by the Hainan Provincial Natural Science Foundation of China(No.825RC898)Hainan Province Clinical Medical Center。
文摘AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included.By exclusion criteria,8460 subjects were screened with 1676 myopia samples and 6784 control samples.Subsequently,baseline characteristics,association analyses,risk stratification analyses,and receive operating characteristic curve(ROC)were used to investigate the associations between covariates and myopia.Then,the causal relationship was explored in depth by MR analysis,and was estimated the reliability by sensitivity analyses and directionality tests.RESULTS:Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates(excluding gender;P<0.05).The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates[model 3:odd ratio(OR)=1.31;95%CI=1.07-1.62;P=0.0133].The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia(P<0.05,OR>1).ROC proved that the model was accurate in its prediction[area under curve(AUC)=0.7].Subsequently,the causal relationship between them was statistically significant(P<0.05)according to the inverse variance weighted(IVW)method in MR.Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders.Forest plot displayed an increasing risk of myopia on asthma(OR>1).The funnel plot demonstrated compliance with Mendel’s second law.Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.CONCLUSION:A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis,which is important implications for public health policy development and clinical practice.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
基金Supported by Chengdu Municipal Science and Technology Bureau Key R&D Support Program(No.2023-YF09-00041-SN)。
文摘AIM:To assess risk factors for epiretinal membranes(ERM)and examine their interactions in a nationally representative U.S.dataset.METHODS:Data from the 2005–2008 National Health and Nutrition Examination Survey(NHANES)were analyzed,a nationally representative U.S.dataset.ERM was identified via retinal imaging based on the presence of cellophane changes.Key predictors included age group,eye surgery history,and refractive error,with additional demographic and health-related covariates.Weighted univariate and multiple logistic regression models were used to assess associations and interaction effects between eye surgery and refractive error.RESULTS:Totally 3925 participants were analyzed.Older age,eye surgery,and refractive errors were significantly associated with ERM.Compared to those under 65y,the odds ratio(OR)for ERM was 3.08 for ages 65–75y(P=0.0014)and 4.76 for ages 75+years(P=0.0069).Eye surgery increased ERM risk(OR=3.48,P=0.0018).Moderate to high hyperopia and myopia were also associated with ERM(OR=2.65 and 1.80,respectively).A significant interaction between refractive error and eye surgery was observed(P<0.0001).Moderate to high myopia was associated with ERM only in those without eye surgery(OR=1.92,P=0.0443).Eye surgery was most strongly associated with ERM in the emmetropic group(OR=3.60,P=0.0027),followed by the moderate to high myopia group(OR=3.01,P=0.0031).CONCLUSION:ERM is significantly associated with aging,eye surgery,and refractive errors.The interaction between eye surgery and refractive error modifies ERM risk and highlights the importance of considering combined effects in clinical risk assessments.These findings may help guide individualized ERM risk assessment that may inform personalized approaches to ERM prevention and management.
基金Supported by the National Natural Science Foundation of China(No.82171073).
文摘Dear Editor,We present a case of acute zonal occult outer retinopathy(AZOOR)complex in a myopic patient with angioid streaks(ASs).A 19-year-old female has been experiencing visual field defects in her left eye for more than 3y.She was diagnosed with ASs and choroiditis at a local hospital.She has a seven-year history of bilateral high myopia.A fundus examination confirmed the presence of ASs and myopic fundus changes in both eyes.Multimodal imaging revealed an AZOOR complex in the left eye.
文摘In China's criminal procedure system,forensic advice is one of the key types of evidence.These advices play an important part in discovering the facts of a case,convictions,and sentencing,and they cannot be ignored in assessments of guilt and the death penalty.However,due to broad and flexible criminal laws,in actual litigation,the nonappearance of forensic examiner or mere provision of documentation of advice read in court has become the norm.This has led to the existence in name only of cross-examination rights,which directly damages the legitimate rights and interests of the parties and the objective and impartial rulings of referees.At present,there is no legal clarity in criminal proceedings that examiner should or should not be examined in court.In my opinion,the entire court system should require an appearance in court,which must be a clear mandatory appearance with specific exceptions.The system should guarantee the forensic examiner5 mandatory appearances,which would inevitably improve the rules of evidence.
基金supports by the National Natural Science Foundation of China(Nos.82201135)"2015"Cultivation Program for Reserve Talents for Academic Leaders of Nanjing Stomatological School,Medical School of Nanjing University(No.0223A204).
文摘Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.
文摘Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.
文摘This editorial discusses a case report recently published in the World Journal of Clinical Cases.The report describes the clinical presentation,imaging,diagnosis,and treatment of a patient with tuberous sclerosis complex(TSC)combined with primary lymphedema(PLE).Additionally,it retrospectively analyzes the data of 16 previously reported cases of children with TSC combined with PLE to summarize the epidemiology,genetic diagnosis,and current main treatments of these patients.The report also speculates on the pathological and physiological mechanisms underlying TSC combined with PLE.TSC combined with PLE is rare;therefore,the report provides a theoretical basis for understanding the pathophysiological mechanisms and treatment options for patients with TSC and PLE.Comprehensive clinical management of TSC is essential due to the diverse and multiorgan nature of its manifestations,often requiring a multidisciplinary approach for newly diagnosed cases.
文摘This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced stage.Two main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial neoplasia.In the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic lesions.Nevertheless,the survival rate still remains poor,and alternative screening methods are under investigation.Endoscopic retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its role.Probably a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early diagnosis.Biomarkers could help to predict and follow the progression of early pancreatic lesions.However,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.
文摘A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.
文摘Objective:To study the application value and application path of pathological examination in gynecological physical examination.Methods:A total of 1200 patients undergoing gynecological physical examination in X Hospital from January 2024 to December 2024 were selected.All patients received cervical Pap smear examination,and patients with abnormal examination results underwent colposcopic biopsy and HPV infection test for cervical cancer screening.Results:The results of cervical Pap smear showed that a total of 780 patients among 1200 patients showed cervical abnormalities.The Pap smear combined with colposcopy was used for pathological examination to detect cervical cancer lesions in time,and biopsy and HPV infection examination were arranged for high-risk patients to provide data reference for clinical treatment.Conclusions:Pathological examination has a good screening effect in gynecological physical examination.It can detect lesions early and take timely intervention measures,which is helpful to reduce the incidence and mortality of the disease.
基金the National Natural Science Foundation of China(No.52305236)supported by National Natural Science Foundation of China.
文摘Reducing the resistance of vehicles,ships,aircraft and other means of transport during movement can significantly improve the speed,save energy and reduce emissions.After billions of years of continuous evolution,organisms in nature have gradually developed the ability to move at high speed to achieve better survival.These evolved organisms provide a perfect template for the human development of drag reduction materials.Revealing the unique physiological structural characteristics of organisms and their relationship with resistance during movement can provide a feasible approach tosolving the problem of reducing friction resistance.Whether flying in the sky,running on the ground,swimming in the water,or even living in the soil,many creatures in various environments have the ability to reduce resistance.Driven by these inspirations,researchers have done a lot of work to explore and imitate these biological epidermis structures to achieve drag reduction.In this paper,the biomimetic drag reduction materials is introduced in detail in the order of drag reduction mechanism,structural characteristics of biological epidermis(including marine animals,flying animals,soil animals and plants),biomimetic preparation methods,performance testing methods and application fields.Finally,the potential of various biomimetic drag reduction materials in engineering application and the problems to be overcome are summarized and prospected.This paper can help readers comprehensively understand the research progress of biomimetic drag reduction materials,and provide reference for further designing the next generation of drag reduction materials.
文摘Currently,the worldwide prevalence of morbid obesity has increased.1 The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention revealed that the prevalence of obesity in the adult population between 20 and 74 years old had more than doubled from 13.3%to 31.1%from 1960 to 2002.2 Metabolic and bariatric surgery(MBS)is now suggested for patients with a body mass index(BMI)of more than 35 kg/m^(2),comorbidities or no comorbidities.Furthermore,MBS should be offered to people with metabolic disease and a BMI of 30e34.9 kg/m^(2) who have failed to gain a meaningful amount of weight or have failed to keep it off with non-surgical management.However,the BMI cutoff points should be modified for the Asian population.
文摘As a severe neurological disease,cerebral hemorrhage is dangerous and progresses rapidly,with high disability and fatality rates.Its occurrence seriously harms patients’lives and health,and also causes a heavy social burden.Timely diagnosis and treatment of cerebral hemorrhage are essential for improving patients’prognosis.This article reviews the research progress in emergency treatment for patients with cerebral hemorrhage,providing a basis for diagnosis and treatment.
文摘This study explores the application of Production-Oriented Approach(POA)in teaching German to nursing students in colleges and universities.Focusing on the requirements of the German B1 exam,the study takes the thematic unit of“Movement”as an example,and designs the teaching through the links of“drive-enable-evaluate”.The results show that POA effectively improves students’speaking and writing output,but there are still deficiencies in reading and listening.Accordingly,this study has proposed the strategies of“vocabulary in-depth facilitation”and“accurate matching of listening and writing”to optimize the input materials and skills training,achieve the goal of“learning and using”,and provide a practical path for teaching German for Special Purposes.This provides a practical path for the teaching of German for special purposes.
文摘Objective:To study the application effect of the multi-role positioning service model in hypertensive patients in the health examination center.Methods:A total of 152 hypertensive patients admitted to the hospital’s health examination center from January 2024 to January 2025 were selected as the subjects.They were randomly divided into two groups using a random number table method.The control group(76 cases)received conventional physical examination service mode,while the observation group(76 cases)adopted the multi-role positioning service model.The nurse proficiency and physical examination quality were compared between the two groups.Results:The nurse proficiency scores in the observation group were higher than those in the control group(P<0.05).The physical examination quality scores in the observation group were higher than those in the control group(P<0.05).Conclusion:The adoption of the multi-role positioning service model for hypertensive patients in the health examination center can improve nurse proficiency and physical examination quality.
文摘Marching band(MB)artists are often part of the general student population and not required to complete a preparticipation health screening to identify predisposing medical conditions or risks for injury/illness.Anecdotally,exertional heat illnesses(EHI)are a concern for MB artists.As more athletic trainers provide MB healthcare,research is needed on EHI occurrence and MB associated EHI risk factors.We utilized an exploratory crosssectional study design to determine EHI risk factors,including previous EHI occurrence,among collegiate MB artists.MB artists(n=1207;age=[19.6±1.3]years)actively participating in their college/university's MB during the 2019 football season completed an online survey to characterize demographics,medical history,medication and supplement use,and nutrition behaviors.Chi-square and binomial logistical regressions assessed associations between categorical variables.Previous EHI was reported by 50.6%of MB artists,with 466(76.3%)experiencing exertional heat exhaustion and 31(5.1%)exertional heat stroke.More females reported exertional heat exhaustion overall(68.2%,p<0.001)and in the previous year(73.3%,p<0.001).Experiencing a previous EHI was significantly associated with having a mood/neurological condition(63.5%,p<0.001),diagnosed(74.3%,p=0.004)or perceived eating disorder(66.7%,p<0.001),and taking prescription medications(59.4%,p<0.001),over-the-counter medications(58.9%,p=0.002),and supplements(55.4%,p=0.037).Half of collegiate MB artists reported experiencing previous EHIs and engaged in behaviors known to increase EHI risk.MB artists should complete pre-participation examinations to identify pre-existing medical conditions and risks for adverse medical events.Healthcare providers working with MB artists should develop policies and procedures to mitigate EHI risks and occurrence.
