BACKGROUND Chronic idiopathic uveitis(CIU)and juvenile idiopathic arthritis-associated uveitis(U-JIA)are both vision-threatening conditions that share similar autoimmune mechanisms,but treatment approaches differ sign...BACKGROUND Chronic idiopathic uveitis(CIU)and juvenile idiopathic arthritis-associated uveitis(U-JIA)are both vision-threatening conditions that share similar autoimmune mechanisms,but treatment approaches differ significantly.In managing U-JIA,various treatment options are employed,including biological and non-biological disease-modifying anti-rheumatic drugs.These drugs are effective in clinical trials.Given the lack of established diagnostic and treatment guidelines as well as the limited number of therapeutic options available,patients with CIU frequently do not receive optimal and timely immunosuppression.This study highlighted the necessity for additional research to develop novel diag-nostic techniques,targeted therapies,and enhanced treatment outcomes for young individuals with CIU.AIM To compare the characteristics and outcomes of U-JIA and CIU.METHODS A retrospective cohort study analyzed data from 110 pediatric patients(under 18 years old)with U-JIA and 40 pediatric patients with CIU.Data was collected between 2012 and 2023.The study focused on demographic,clinical,treatment,and outcome variables.RESULTS The median onset age of arthritis was 6.4 years(2.7 years;9.3 years).In 28.2%of cases uveitis preceded the onset of arthritis.In 17.3%of cases it occurred simultan-eously.In 53.6%of cases it followed arthritis.Both groups had similar onset ages,antinuclear antibodies/human leukocyte antigen positivity rates,and ESR levels,with a slight predominance of females(60.9%vs 42.5%,P=0.062),and higher C-reactive protein levels in the U-JIA group.Anterior uveitis was more prevalent in patients with U-JIA(P=0.023),although the frequency of symptomatic,unilateral,and complicated forms did not differ significantly.The use of methotrexate(83.8%vs 96.4%)and biologics(64.7%vs 82.1%)was comparable,as was the rate of remission on methotrexate treatment(70.9%vs 56.5%)and biological therapy(77.8%vs 95%),but a immunosuppressive treatment delay in CIU observed.Patients with CIU were less likely to receive methotrexate[hazard ratio(HR)=0.48,P=0.005]or biological treatment(HR=0.42,P=0.004),but they were more likely to achieve remission with methotrexate(HR=3.70,P=0.001).CONCLUSION Treatment of uveitis is often limited to topical measures,which can delay systemic therapy and affect the outcome.Methotrexate and biological agents effectively manage eye inflammation.It is essential to develop standardized protocols for the diagnosis and management of uveitis,and collaboration between rheumatologists and ophthal-mologists is needed to achieve optimal outcomes in the treatment of CIU.展开更多
BACKGROUND Idiopathic myointimal hyperplasia of the mesenteric veins(IMHMV)is a rare disease characterized by narrowing of the lumen caused by mesenteric vein intimal hyperplasia,resulting in chronic intestinal ischem...BACKGROUND Idiopathic myointimal hyperplasia of the mesenteric veins(IMHMV)is a rare disease characterized by narrowing of the lumen caused by mesenteric vein intimal hyperplasia,resulting in chronic intestinal ischemia.Although the colorectum is the primary site affected by this condition,involvement of the small intestine is even more rare.Recurrence of IMHMV after surgical resection of the affected bowel is uncommon.CASE SUMMARY In this case report,we present a unique instance of IMHMV exclusively occurring in the small intestine.The patient experienced small intestinal perforation,infarction,and obstruction before receiving a clear diagnosis,which was achieved only during the third operation.In this review,we analyzed 84 reported cases to summarize the etiology,clinical manifestations,and diagnostic challenges of IMHMV,with the aim of raising awareness regarding this rare condition among clinicians.CONCLUSION Notably,IMHMV can also affect the small intestine alone.When refractory enteritis with endoscopic findings of nonspecific ischemic changes is encountered,IMHMV should be considered for potential diagnosis.展开更多
BACKGROUND Children with juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)face an elevated risk of severe infection owing to their diseases and the immunosuppressive treatment for disease control.A...BACKGROUND Children with juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)face an elevated risk of severe infection owing to their diseases and the immunosuppressive treatment for disease control.AIM To compare scheduled vaccination coverage and the levels of post-vaccine antibodies against measles,mumps,rubella(MMR)and hepatitis B in pediatric patients with IBD and JIA.METHODS A comparative cohort study included 97 patients with IBD and 170 patients with JIA.Vaccination history was obtained from medical records,while post-vaccination immunity was assessed prospectively by measuring specific IgG antibody titers using enzyme-linked immunosorbent assays(Vector-Best JSC,Russia;IBL International,Germany)during routine visits between January 2022 and April 2023.RESULTS A complete two-dose MMR course had been administered to 66.3%of IBD patients and 55.9%of JIA patients(P=0.121).By contrast,the three-dose hepatitis B schedule was completed in 74.2%of IBD and 100%of JIA patients(P<0.001).Protective level of anti-vaccine antibodies against measles(47.7%vs 57.7%;P=0.168);mumps(75.3%vs 80.0%;P=0.366);rubella(74.4%vs 98.2%;P<0.0001);and hepatitis B(44.8%vs 50.0%;P=0.514)were detected in IBD and JIA patients,respectively.CONCLUSION Patients with IBD and JIA demonstrated different vaccination coverage patterns and levels of anti-vaccine antibodies.Routine baseline serology and timely booster vaccination should be implemented for all pediatric patients receiving chronic immunosuppression.展开更多
Introduction:When conservative treatments fail,botulinum toxin A(BoNT-A)is an option for refractory idiopathic overactive bladder(OAB).This review evaluates the efficacy,safety,and predictive factors for BoNT-A in thi...Introduction:When conservative treatments fail,botulinum toxin A(BoNT-A)is an option for refractory idiopathic overactive bladder(OAB).This review evaluates the efficacy,safety,and predictive factors for BoNT-A in this situation.Material and Methods:A literature search up to January 2025 was performed using PubMed,Google Scholar,and Embase to assess efficacy,safety,and predictors of adverse events(AE)related to BoNT-A.The risk of bias was assessed using the Risk of Bias 2(RoB 2)tool for randomized studies and the Critical Appraisal Skills Programme(CASP)checklist for cohort studies.The quality of the review was evaluated based on the Oxford criteria,following the Strengthening the Assessment of Narrative Review Articles(SANRA)guidelines,and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines for systematic reviews.Results:31 studies were included,involving 5410 patients.BoNT-A improves OAB symptoms even after reinjections.Higher doses do not enhance efficacy but increase AE.AE includes high post-void residual(PVR),clean intermittent self-catheterization(CISC),and Urinary Tract Infection(UTI).Predictors of CISC include age,male gender,hysterectomy,≥3 vaginal deliveries,mixed incontinence,prior mid-urethral sling(MUS),high PVR,low Pressure at Pdet at First Micturition(PIP1)in women,low Bladder Compliance Index(BCI)in men,and high Bladder Outlet Obstruction Index(BOOI).Diabetes and heart failure increase PVR.UTIs are more frequent in women and men with benign prostatic hyperplasia,with CISC increasing the risk fivefold.Severe complications are rare.Predictors of poor response include male gender,high BOOI,low urinary flow,and diabetes.Discussion:BoNT-A is effective for OAB,especially for incontinence.AE is dose-dependent and limits treatment adherence.Their link with poor response remains unclear.Conclusion:BoNT-A effectively treats refractory idiopathic OAB,improving symptoms and quality of life with repeated injections.展开更多
Idiopathic pulmonary fibrosis(IPF)has a poor prognosis if left untreated;therefore,early treatment with pirfenidone is crucial.Lei et al conducted a retrospective analysis to evaluate the effectiveness of early pirfen...Idiopathic pulmonary fibrosis(IPF)has a poor prognosis if left untreated;therefore,early treatment with pirfenidone is crucial.Lei et al conducted a retrospective analysis to evaluate the effectiveness of early pirfenidone treatment on lung function in 113 patients with IPF.In addition to other research,pirfeni-done has demonstrated efficacy in patients at all stages of IPF once correct diagnosis has been made.In advanced IPF,we include the requirement for pirfenidone.Therefore,it is essential to choose an appropriate method of adminis-tration method,such as inhalation.This may circumvent the drawbacks of the high cost and possible adverse effects of this drug.展开更多
BACKGROUND Osteonecrosis of the femoral head(ONFH)is an ischaemic disorder often leading to collapse of the femoral head and severe hip dysfunction.Mesenchymal stem cells(MSCs)have a key role in bone repair,through th...BACKGROUND Osteonecrosis of the femoral head(ONFH)is an ischaemic disorder often leading to collapse of the femoral head and severe hip dysfunction.Mesenchymal stem cells(MSCs)have a key role in bone repair,through their ability to differentiate into osteoblasts and their paracrine regulation of the bone microenvironment.While altered MSCs behaviour has been reported in some secondary forms of ONFH,the proliferative and differentiation programmes of MSCs in human idiopathic ONFH have not been previously characterized.AIM To compare the proliferative capacity,differentiation potential and nuclear factor kappa B(NF-κB)pathway activation of bone marrow MSCs(BM-MSCs)from idiopathic ONFH patients with those from osteoarthritis controls.METHODS Femoral heads were collected during total hip replacement surgeries.Idiopathic ONFH was defined by imaging and histological criteria.Secondary causes were excluded.BM-MSCs were isolated from trabecular bone cylinders and expanded to passage 2 prior characterizations.Proliferation was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay at various seeding densities.Osteogenic potential was assessed by alkaline phosphatase activity,osteogenic gene expression(RUNX2,ALPL,COL1A1 and BGLAP)and Alizarin Red staining.Adipogenesis was quantified by Oil Red O staining.Expression of NF-κB target genes(IL6,NFKBIA,CCL2)was analyzed by quantitative polymerase chain reaction.RESULTS Idiopathic ONFH MSCs exhibited significantly higher proliferation rates than osteoarthritis controls.However,they showed reduced alkaline phosphatase activity and osteogenic gene expression but paradoxically,increased mineralization,suggesting non-canonical mineral deposition mechanisms.These cells also display increased adipogenic differentiation.Importantly,ONFH-MSCs expressed higher,although non-significant levels of certain NF-κB target gene genes,consistent with an activated inflammatory state.CONCLUSION Human BM-MSCs from idiopathic ONFH display a paradoxical phenotype:Hyperproliferative yet osteogenically impaired with greater adipogenesis and activation of NF-κB signalling.This functional compromise and inflammatory bias may underline the failure of bone regeneration in ONFH,highlighting the need for therapies redirecting MSCs fate and modulating the bone marrow niche.展开更多
BACKGROUND Idiopathic portal hypertension(IPH)is a subtype of portal hypertension that arises in the absence of cirrhosis.IPH frequently manifests with clinical features typical of portal hypertension,including spleno...BACKGROUND Idiopathic portal hypertension(IPH)is a subtype of portal hypertension that arises in the absence of cirrhosis.IPH frequently manifests with clinical features typical of portal hypertension,including splenomegaly and esophagogastric fundal varices,along with other associated symptoms.Imaging studies may indicate portal hypertension;however,they typically do not provide evidence of cirrhosis.There are no standardized diagnostic criteria for IPH,and diagnosis is often established by excluding other hepatic diseases.Liver biopsy remains the most reliable approach to verify the diagnosis of IPH.CASE SUMMARY A patient previously diagnosed with“hepatitis B cirrhosis”at an external hospital presented to our facility with gastrointestinal bleeding.Initial assessment revealed minor liver injury,splenomegaly,esophagogastric varices,and portal hypertension.Imaging studies did not indicate cirrhosis and repeated hepatitis B serology tests yielded negative results.After excluding various causes of cirrhosis and other non-cirrhotic etiologies of portal hypertension,liver biopsy confirmed the diagnosis of IPH.The patient was managed with regular endoscopic therapy and long-term carvedilol administration.CONCLUSION Currently,there are no standardized diagnostic criteria for IPH,and its diagnosis is generally established by excluding other conditions.Liver biopsy remains the most reliable method for IPH diagnosis.展开更多
Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with id...Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with idiopathic oligoasthenozoospermia were examined.The first group(n=125)received 100 mg/day of CoQ10 and the second group(n=125)received 200 mg/day of CoQ10 orally for 6 months.Semen parameters,DNA fragmentation index(DFI)and the partner pregnancy rate were analyzed at baseline and after 6 months of treatment.Results:Comparing with baseline data,treatment with CoQ10(100 mg/day or 200 mg/day)resulted in a significant increase in sperm concentration(both P<0.001),a significant improvement in progressive motility and total motile sperm count(P=0.05,P=0.001,respectively).The mean DFI was significantly improved after treatment with CoQ10 at 100 mg/day and at 200 mg/day,after 6 months of treatment(P<0.01).Moreover,CoQ10 significantly improved the partner pregnancy rate.A strongest correlation was found between seminal fluid parameters and DFI(P<0.001).Conclusions:CoQ10 is effective in improving semen parameters,DFI and on the partner pregnancy rate after 6 months with CoQ10 at two doses,with a greater improvement shown in men who took 200 mg/day than in those who took 100 mg/day.展开更多
BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare condition that causes ischaemic colitis,has various clinical manifestations,and may even be asymptomatic,often resulting in clinical misdiagnosis.CASE SUM...BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare condition that causes ischaemic colitis,has various clinical manifestations,and may even be asymptomatic,often resulting in clinical misdiagnosis.CASE SUMMARY We report the case of a 44-year-old woman with chief complaints of abdominal pain,vomiting and decreased defecation.One year prior,the patient was asymptomatic and therefore misdiagnosed with inflammatory bowel disease based on incidental findings on an abdominal computed tomography(CT)scan.The present abdominal CT scan revealed an intestinal obstruction,diffuse thickening of the entire colon wall and calcification of the mesenteric and colonic veins.Colonoscopy revealed multiple ulcerations and extensive dark purple discolouration of the oedematous mucosa.Colonic transit studies suggested a decrease in colonic motility.IMP was considered the underlying cause of her pseudoileus,which was potentially linked to her consumption of Chinese medicinal teas for more than 30 years.The patient underwent conservative medical treatment,and her symptoms gradually improved.She exhibited no signs of ileus or other significant discomfort at the outpatient follow-up one year after the discontinuation of Chinese herbal tea consumption.CONCLUSION IMP can present with symptoms of pseudoileus as initial complication.Clinicians can use CT and colonoscopy for differential diagnoses.展开更多
BACKGROUND Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic(accounting for over 75%)and secondary types(due to malignancies,infections,medications,radiotherapy or...BACKGROUND Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic(accounting for over 75%)and secondary types(due to malignancies,infections,medications,radiotherapy or other conditions).Idiopathic retroperitoneal fibrosis(IRPF)typically affects the abdominal aorta and iliac arteries along with the surrounding retroperitoneal area.This case review aims to summarize the imaging characteristics of IRPF arising from the peritoneal space.CASE SUMMARY An abdominal mass was discovered in a 52-year-old man during a routine physical examination,he had not complained of abdominal pain,distension,nausea,vomiting,diarrhea,fever,and had no significant past medical or family history.Abdominal magnetic resonance imaging revealed a soft tissue mass with poorly defined margins surrounding the duodenum,exhibiting slight to moderate high signal intensity on both T1-weighted and T2-weighted images.Diffusionweighted imaging with aβvalue of 800 mm²/second demonstrated slightly to moderate high signal intensity.Dynamic contrast enhanced images showed uneven enhancement on the arterial phase,with significant enhancement observed on the delayed phase.The mass infiltrated adjacent structures,including the head of the pancreas,the hepatic flexure of the colon,and part of the intestine,raising suspicion for malignant tumors such as sarcoma or lymphoma.However,surgery confirmed the diagnosis of IRPF.The patient underwent routine followup for one year,with no recurrence.CONCLUSION IRPF is a rare condition that presents considerable diagnostic challenges when lesions arise from the peritoneal space.In cases where imaging findings are atypical,a further puncture biopsy may be necessary to confirm the diagnosis.展开更多
BACKGROUND Depression and anxiety are prevalent psychological challenges among patients with adolescent idiopathic scoliosis(AIS),affecting individuals across both sex and age groups.AIM To explore the network structu...BACKGROUND Depression and anxiety are prevalent psychological challenges among patients with adolescent idiopathic scoliosis(AIS),affecting individuals across both sex and age groups.AIM To explore the network structure of depression and anxiety symptoms,with a focus on identifying differences at the symptom level between sex and age subgroups.METHODS A total of 1955 participants diagnosed with AIS aged 10-18 years were assessed using the Patient Health Questionnaire Depression Scale(PHO-9)and the Generalized Anxiety Disorder Scale(GAD-7),and 765 patients exhibiting PHQ-9 or GAD-7 scores ≥ 5 were enrolled in our study. Network analysis and network comparison tests were utilized toconstruct and compare the depression-anxiety symptoms networks among sex and age subgroups.RESULTSThe results revealed GAD3 “Excessive worry” and PHQ2 “Sad mood” were the most significant central symptomsin all subgroups, while “Sad mood” had higher strength than “Excessive worry” in the lower age group. In thenetwork comparisons, the female network exhibited tighter connectivity, especially on GAD6 “Irritability” andGAD2 “Uncontrollable worry”, while only PHQ3 “Sleep” and PHQ9 “Suicidal ideation” had differences at thelocal level in the lower age group.CONCLUSIONSeveral interventions targeting excessive worry and sad mood could reduce the risk of depression and anxietysymptoms in the AIS population. Furthermore, specific anxiety symptoms in females, along with sleep disturbancesand suicidal ideation in the lower age group, should be addressed at an early stage to prevent significantdisruptions in mental health trajectories.展开更多
Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS amo...Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS among children and adolescents.Methods:A cross-sectional study.The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years;Patients within the same age range with ocular trauma were enrolled as the control group.Preoperative chest plain radiographs were used to measure the Cobb angle.Demographic information and clinical data,including diopter,best corrected visual acuity,deviation degree,and binocular function,were analyzed.Results:A significantly higher prevalence of ITS was found in study group compared with control group(12.68%vs 4.18%,P<0.001).Additionally,the mean Cobb angle was lagger in SOP group than that in control group(5.02°±3.87°vs 3.84°±3.09°,P<0.001).Males in SOP group showed a higher prevalence of ITS(12.9%vs 2.87%,P=0.007),but there was no significant difference in females between two groups(12.3%vs 7.69%,P=0.295).Good near stereopsis acuity was significantly associated with high prevalence of thoracic scoliosis(P<0.001).Multivariate logistic regression analysis revealed that a large distant magnitude of deviation(>20 PD)and near stereoacuity were significantly associated with ITS.Conclusions:Patients with SOP have a significantly higher risk of developing idiopathic thoracic scoliosis,especially those with good near stereoscopic and large distant magnitude of deviation.展开更多
The dynamic response characteristics of scoliosis and kyphosis to vibration are currently unclear.The finite element method(FEM)was employed to study the vibration response of patients with idiopathic scoliosis and ky...The dynamic response characteristics of scoliosis and kyphosis to vibration are currently unclear.The finite element method(FEM)was employed to study the vibration response of patients with idiopathic scoliosis and kyphosis.The objective is to analyze the dynamic characteristics of idiopathic scoliosis and kyphosis using FEM.The finite element model of T1—S1 segments was established and verified using the CT scanning images.The established scoliosis and kyphosis models were verified statistically and dynamically.The finite element software Abaqus was utilized to analyze the mode,harmonic response,and transient dynamics of scoliosis and kyphosis.The first four natural frequencies extracted from modal analysis were 1.34,2.26,4.49 and 17.69 Hz respectively.Notably,the first three natural frequencies decreased with the increase of upper body mass.In harmonic response analysis,the frequency corresponding to the maximum amplitude in x direction was the first order natural frequency,and the frequency corresponding to the maximum amplitude in y and z directions was the second order natural frequency.At the same resonance frequency,the amplitude of the thoracic spine was larger relative to that of the lumbar spine.The time domain results of transient analysis showed that the displacement dynamic response of each segment presented cyclic response characteristics over time.Under 2.26 Hz excitation,the dynamic response of the research object appeared as resonance.The higher the degree of spinal deformity,the greater the fundamental frequency.The first three natural modes of scoliosis and kyphosis contain vibration components in the vertical direction.The second order natural frequency was the most harmful to patients with scoliosis and kyphosis.Under cyclic loading,the deformation of the thoracic cone exceeds that of the lumbar cone.展开更多
[Objectives]This meta-analysis evaluated the efficacy of Traditional Chinese Medicine(TCM)manual therapies(Tuina,Daoyin,acupotomology)for idiopathic scoliosis(IS),with dual focus on radiographic outcomes(Cobb angle,ve...[Objectives]This meta-analysis evaluated the efficacy of Traditional Chinese Medicine(TCM)manual therapies(Tuina,Daoyin,acupotomology)for idiopathic scoliosis(IS),with dual focus on radiographic outcomes(Cobb angle,vertebral rotation)and patient-centered metrics(pain,disability,quality of life).[Methods]This study systematically searched PubMed,Cochrane Library,EMBASE,Web of Science,CNKI,Wanfang,and VIP databases(from inception to July 2025)for randomized controlled trials(RCTs)comparing TCM manual therapies against controls(bracing,exercise,sham,or no intervention).Two reviewers independently extracted data and assessed methodological quality using the PEDro scale.Meta-analyses employed random-effects models(Stata 18)to calculate Hedges'g with 95%confidence intervals(CI).Heterogeneity was quantified via I 2 statistics,and subgroup analyses examined intervention types(standalone versus combined)and control groups.[Results]Radiographic outcomes:TCM therapies significantly reduced Cobb angle(Hedges'g=-0.93;95%CI:-1.37,-0.49;p<0.001)and vertebral torsion rotation(VTR;g=-0.71;95%CI:-0.91,-0.51;p<0.001)versus controls;patient-centered outcomes:substantial pain reduction(VAS:g=-1.47;95%CI:-2.64,-0.30;p=0.01)and disability improvement(ODI:g=-1.10;95%CI:-1.57,-0.64;p<0.001)were observed.Quality of life(SRS-22)showed non-significant gains(g=2.01;95%CI:-0.43,4.45;p=0.11).[Conclusions]TCM manual therapies significantly improve spinal alignment and reduce pain/disability in IS patients,particularly when integrated with exercise regimens.While results support their role as complementary interventions,standardization of protocols and long-term efficacy studies are needed for clinical implementation.展开更多
AIM:To characterize a Portuguese population of patients with juvenile idiopathic arthritis(JIA)and to evaluate possible associations between clinical factors and ocular involvement.METHODS:Patients diagnosed with JIA ...AIM:To characterize a Portuguese population of patients with juvenile idiopathic arthritis(JIA)and to evaluate possible associations between clinical factors and ocular involvement.METHODS:Patients diagnosed with JIA in the previous 20y in Hospital Garcia de Orta were included.Data were assessed from Reuma.pt database.Associations between demographic(age and sex),clinical(articular involvement,extra-articular manifestations,biological therapy),laboratory data[anti-nuclear antibodies,anti-cyclic citrullinated peptide(CCP)antibodies,rheumatoid factor,human leukocyte antigen B27(HLA-B27),C-reactive protein,erythrocyte sedimentation rate]and ocular involvement were assessed.Statistical analysis was performed using Chi-square for categorical variables and Mann-Whitney test for continuous variables.RESULTS:Totally 91 patients were included,11(12%)with previous episodes of uveitis.There was a statistically significant preponderance of early age at JIA diagnosis(mean 4.73 vs 9.58y,P=0.008),antinuclear antibodies positivity(P=0.01),and oligoarticular subtype(P=0.04)in the Juvenile idiopathic arthritis-associated uveitis(JIA-U)group.Ocular complications occurred in 36.4%of patients(n=4):cataracts(n=2),band keratopathy(n=1)and posterior synechiae(n=1).The occurrence of complications was corelated with a shorter period between JIA diagnosis and the first JIA-U episode(mean 0.67 vs 4.88y,P=0.012)but not with age at JIA diagnosis or articular involvement.There was erythrocyte sedimentation rate elevation in the 12mo preceding uveitis(mean 40.5 mm/h,range 13-83).CONCLUSION:The occurrence of JIA-U shortly after JIA diagnosis is shown to be a potential risk factor for ocular complications.展开更多
Adolescent idiopathic scoliosis(AIS)is a dynamic progression during growth,which requires long-term collaborations and efforts from clinicians,patients and their families.It would be beneficial to have a precise inter...Adolescent idiopathic scoliosis(AIS)is a dynamic progression during growth,which requires long-term collaborations and efforts from clinicians,patients and their families.It would be beneficial to have a precise intervention based on cross-scale understandings of the etiology,real-time sensing and actuating to enable early detection,screening and personalized treatment.We argue that merging computational intelligence and wearable technologies can bridge the gap between the current trajectory of the techniques applied to AIS and this vision.Wearable technologies such as inertial measurement units(IMUs)and surface electromyography(sEMG)have shown great potential in monitoring spinal curvature and muscle activity in real-time.For instance,IMUs can track the kinematics of the spine during daily activities,while sEMG can detect asymmetric muscle activation patterns that may contribute to scoliosis progression.Computational intelligence,particularly deep learning algorithms,can process these multi-modal data streams to identify early signs of scoliosis and adapt treatment strategies dynamically.By using their combination,we can find potential solutions for a better understanding of the disease,a more effective and intelligent way for treatment and rehabilitation.展开更多
Objective:To investigate the clinical efficacy and safety evaluation of Polyethylene Glycol Recombinant Human Growth Hormone Injection(PEG-rhGH)in the treatment of idiopathic short stature.Methods:A total of 1402 pati...Objective:To investigate the clinical efficacy and safety evaluation of Polyethylene Glycol Recombinant Human Growth Hormone Injection(PEG-rhGH)in the treatment of idiopathic short stature.Methods:A total of 1402 patients were enrolled from March 21,2024 to January 13,2025,including 778 males and 624 females,with ages mainly ranging from 5 to 13 years old.Follow-up visits were completed by 488 patients for the first time,174 patients for the second time,and 81 patients for the third time.All patients were treated with PEG-rhGH(Jin Sai Zeng)as the main therapy after admission.The changes in height information,IGF-1,and thyroid examination results of each patient at the initial diagnosis,6,9,and 12 months after treatment were observed and analyzed.Results:There was no statistical difference between the baseline and the initial diagnosis,as well as the second follow-up visit(P<0.05),while there was a statistical difference between the baseline and the first and third follow-up visits(P>0.05).There was a statistically significant difference in IGF-1 between the initial diagnosis and the first follow-up visit(P<0.05),but no statistical difference between the first,second,and third follow-up visits(P>0.05).Additionally,IGF-1 levels increased with time.There was no statistical difference in TSH between the initial diagnosis and the first,second,and third follow-up visits(P>0.05).There was a statistical difference in free T3 between the initial diagnosis and the first and second follow-up visits(P<0.05),but no statistical difference between the second and third follow-up visits(P>0.05).There was no statistical difference in free T4 between the initial diagnosis and the first and second follow-up visits(P>0.05),but there was a statistical difference between the second and third follow-up visits(P<0.05).Conclusion:PEG-rhGH(Jin Sai Zeng)is significantly effective in improving height and IGF-1 levels in patients with idiopathic short stature.展开更多
Background and Objective:Idiopathic intracranial hypertension(IIH)is a disorder of raised intracranial pressure(ICP)associated with overweight and obesity,with weight loss being the mainstay of management.Diet and lif...Background and Objective:Idiopathic intracranial hypertension(IIH)is a disorder of raised intracranial pressure(ICP)associated with overweight and obesity,with weight loss being the mainstay of management.Diet and lifestyle changes alone are often unsuccessful at achieving meaningful or sustained weight loss.Glucagon-like peptide-1 receptor agonists(GLP-1RA)are a class of medications developed for the treatment of diabetes but are also highly effective for weight reduction.The objective of this narrative review is to present the current evidence for GLP-1RAs in the management of IIH.Methods:Articles were searched for inclusion through OVID using the following terms:[papilledema OR intracranial hypertension OR idiopathic intracranial hypertension OR brain pseudotumor]and[glucagon like peptide 1 OR glucagon like peptide 1 receptor agonist OR semaglutide OR exendin 4 OR liraglutide OR tirzepatide].Titles and abstracts were screened manually for relevance.There were no exclusion criteria for time frame,language,population or article type,although conference abstracts were not included.An illustrative case of a patient with IIH treated with tirzepatide and semaglutide is also presented.Key Content and Findings:GLP-1RAs have demonstrated the potential for significantly greater weight loss in patients with IIH,with a reduced requirement for IIH medications and improved symptoms,compared to conventional weight management.Treatment with GLP-1RAs has also been shown to result in a rapid and persistent reduction in ICP in both rat and human studies.The side effects of GLP-1RAs are generally well-tolerated,with low rates of discontinuation in clinical trials.However,continuous treatment is likely required to avoid weight rebound and symptom recurrence after cessation.Conclusions:Despite highly promising preliminary evidence,further clinical trials are needed to determine the most effective GLP-1RA medications within this class,appropriate dosing regimens and treatment duration.展开更多
Acute pancreatitis during pregnancy is a rare event,and can be associated with high maternal mortality and fetal loss.Gallstone disease is thought to be the most common causative factor of acute pancreatitis,but,in ma...Acute pancreatitis during pregnancy is a rare event,and can be associated with high maternal mortality and fetal loss.Gallstone disease is thought to be the most common causative factor of acute pancreatitis,but,in many cases,the cause remains unclear.We report a case of a 36-year-old woman at 35 wk of gestation,who presented with severe pain confined to the upper abdomen and radiating to the back.The patient was diagnosed with acute idiopathic pancreatitis,which was managed conservatively;she recovered within several days and then delivered a healthy baby.Therefore it is important to consider acute pancreatitis when a pregnant woman presents with upper abdominal pain,nausea and vomiting in order to improve fetal and maternal outcomes for patients with acute pancreatitis.展开更多
Objective To investigate the efficacy and safety of rituximab(RTX) in the treatment of idiopathic membranous nephropathy(IMN) with nephrotic syndrome with a systematic review and meta-analysis.Methods Pub Med, Embase,...Objective To investigate the efficacy and safety of rituximab(RTX) in the treatment of idiopathic membranous nephropathy(IMN) with nephrotic syndrome with a systematic review and meta-analysis.Methods Pub Med, Embase, Cochrane Library and Clinical Trials(December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission(CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated.Results Seven studies involved 120 patients(73% were men) were included in our systematic review and metaanalysis. All were prospective observation cohort studies or matched-cohort studies, mainly came from two medical centers, and one study was multi-centric(four nephrology units in northern Italy). The creatinine clearance was more than 20 ml/(min·1.73 m2) and persistent proteinuria higher than 3.5 g/d for at least 6 months. All patients received treatment previously [44(36.7%) had immunosuppressive treatment]. In 12-and 24-month, 56%(95%CI, 0.47-0.65) and 68%(95%CI, 0.41-0.87) patients could reach remission, while 15%(95%CI, 0.09-0.23) and 20%(95%CI, 0.12-0.32) patients could reach CR. The reduction in proteinuria was gradual and obvious, paralleled with upward trend of serum albumin level and decreasing serum cholesterol level. Renal functions were stable. Relapses happened in 24 months were around 8%. RTX related adverse events were mild and were mostly infusion-related reactions.Conclusions RTX treatment in IMN was efficient, well tolerated and safe. More than 60% patients can reach partial remission or CR in 24 months, and relapse is rare. Adverse events of RTX are mostly infusion-related reactions and generally mild.展开更多
文摘BACKGROUND Chronic idiopathic uveitis(CIU)and juvenile idiopathic arthritis-associated uveitis(U-JIA)are both vision-threatening conditions that share similar autoimmune mechanisms,but treatment approaches differ significantly.In managing U-JIA,various treatment options are employed,including biological and non-biological disease-modifying anti-rheumatic drugs.These drugs are effective in clinical trials.Given the lack of established diagnostic and treatment guidelines as well as the limited number of therapeutic options available,patients with CIU frequently do not receive optimal and timely immunosuppression.This study highlighted the necessity for additional research to develop novel diag-nostic techniques,targeted therapies,and enhanced treatment outcomes for young individuals with CIU.AIM To compare the characteristics and outcomes of U-JIA and CIU.METHODS A retrospective cohort study analyzed data from 110 pediatric patients(under 18 years old)with U-JIA and 40 pediatric patients with CIU.Data was collected between 2012 and 2023.The study focused on demographic,clinical,treatment,and outcome variables.RESULTS The median onset age of arthritis was 6.4 years(2.7 years;9.3 years).In 28.2%of cases uveitis preceded the onset of arthritis.In 17.3%of cases it occurred simultan-eously.In 53.6%of cases it followed arthritis.Both groups had similar onset ages,antinuclear antibodies/human leukocyte antigen positivity rates,and ESR levels,with a slight predominance of females(60.9%vs 42.5%,P=0.062),and higher C-reactive protein levels in the U-JIA group.Anterior uveitis was more prevalent in patients with U-JIA(P=0.023),although the frequency of symptomatic,unilateral,and complicated forms did not differ significantly.The use of methotrexate(83.8%vs 96.4%)and biologics(64.7%vs 82.1%)was comparable,as was the rate of remission on methotrexate treatment(70.9%vs 56.5%)and biological therapy(77.8%vs 95%),but a immunosuppressive treatment delay in CIU observed.Patients with CIU were less likely to receive methotrexate[hazard ratio(HR)=0.48,P=0.005]or biological treatment(HR=0.42,P=0.004),but they were more likely to achieve remission with methotrexate(HR=3.70,P=0.001).CONCLUSION Treatment of uveitis is often limited to topical measures,which can delay systemic therapy and affect the outcome.Methotrexate and biological agents effectively manage eye inflammation.It is essential to develop standardized protocols for the diagnosis and management of uveitis,and collaboration between rheumatologists and ophthal-mologists is needed to achieve optimal outcomes in the treatment of CIU.
基金Supported by the National Natural Science Foundation of China,No.81970493 and No.82270590.
文摘BACKGROUND Idiopathic myointimal hyperplasia of the mesenteric veins(IMHMV)is a rare disease characterized by narrowing of the lumen caused by mesenteric vein intimal hyperplasia,resulting in chronic intestinal ischemia.Although the colorectum is the primary site affected by this condition,involvement of the small intestine is even more rare.Recurrence of IMHMV after surgical resection of the affected bowel is uncommon.CASE SUMMARY In this case report,we present a unique instance of IMHMV exclusively occurring in the small intestine.The patient experienced small intestinal perforation,infarction,and obstruction before receiving a clear diagnosis,which was achieved only during the third operation.In this review,we analyzed 84 reported cases to summarize the etiology,clinical manifestations,and diagnostic challenges of IMHMV,with the aim of raising awareness regarding this rare condition among clinicians.CONCLUSION Notably,IMHMV can also affect the small intestine alone.When refractory enteritis with endoscopic findings of nonspecific ischemic changes is encountered,IMHMV should be considered for potential diagnosis.
文摘BACKGROUND Children with juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)face an elevated risk of severe infection owing to their diseases and the immunosuppressive treatment for disease control.AIM To compare scheduled vaccination coverage and the levels of post-vaccine antibodies against measles,mumps,rubella(MMR)and hepatitis B in pediatric patients with IBD and JIA.METHODS A comparative cohort study included 97 patients with IBD and 170 patients with JIA.Vaccination history was obtained from medical records,while post-vaccination immunity was assessed prospectively by measuring specific IgG antibody titers using enzyme-linked immunosorbent assays(Vector-Best JSC,Russia;IBL International,Germany)during routine visits between January 2022 and April 2023.RESULTS A complete two-dose MMR course had been administered to 66.3%of IBD patients and 55.9%of JIA patients(P=0.121).By contrast,the three-dose hepatitis B schedule was completed in 74.2%of IBD and 100%of JIA patients(P<0.001).Protective level of anti-vaccine antibodies against measles(47.7%vs 57.7%;P=0.168);mumps(75.3%vs 80.0%;P=0.366);rubella(74.4%vs 98.2%;P<0.0001);and hepatitis B(44.8%vs 50.0%;P=0.514)were detected in IBD and JIA patients,respectively.CONCLUSION Patients with IBD and JIA demonstrated different vaccination coverage patterns and levels of anti-vaccine antibodies.Routine baseline serology and timely booster vaccination should be implemented for all pediatric patients receiving chronic immunosuppression.
文摘Introduction:When conservative treatments fail,botulinum toxin A(BoNT-A)is an option for refractory idiopathic overactive bladder(OAB).This review evaluates the efficacy,safety,and predictive factors for BoNT-A in this situation.Material and Methods:A literature search up to January 2025 was performed using PubMed,Google Scholar,and Embase to assess efficacy,safety,and predictors of adverse events(AE)related to BoNT-A.The risk of bias was assessed using the Risk of Bias 2(RoB 2)tool for randomized studies and the Critical Appraisal Skills Programme(CASP)checklist for cohort studies.The quality of the review was evaluated based on the Oxford criteria,following the Strengthening the Assessment of Narrative Review Articles(SANRA)guidelines,and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines for systematic reviews.Results:31 studies were included,involving 5410 patients.BoNT-A improves OAB symptoms even after reinjections.Higher doses do not enhance efficacy but increase AE.AE includes high post-void residual(PVR),clean intermittent self-catheterization(CISC),and Urinary Tract Infection(UTI).Predictors of CISC include age,male gender,hysterectomy,≥3 vaginal deliveries,mixed incontinence,prior mid-urethral sling(MUS),high PVR,low Pressure at Pdet at First Micturition(PIP1)in women,low Bladder Compliance Index(BCI)in men,and high Bladder Outlet Obstruction Index(BOOI).Diabetes and heart failure increase PVR.UTIs are more frequent in women and men with benign prostatic hyperplasia,with CISC increasing the risk fivefold.Severe complications are rare.Predictors of poor response include male gender,high BOOI,low urinary flow,and diabetes.Discussion:BoNT-A is effective for OAB,especially for incontinence.AE is dose-dependent and limits treatment adherence.Their link with poor response remains unclear.Conclusion:BoNT-A effectively treats refractory idiopathic OAB,improving symptoms and quality of life with repeated injections.
文摘Idiopathic pulmonary fibrosis(IPF)has a poor prognosis if left untreated;therefore,early treatment with pirfenidone is crucial.Lei et al conducted a retrospective analysis to evaluate the effectiveness of early pirfenidone treatment on lung function in 113 patients with IPF.In addition to other research,pirfeni-done has demonstrated efficacy in patients at all stages of IPF once correct diagnosis has been made.In advanced IPF,we include the requirement for pirfenidone.Therefore,it is essential to choose an appropriate method of adminis-tration method,such as inhalation.This may circumvent the drawbacks of the high cost and possible adverse effects of this drug.
文摘BACKGROUND Osteonecrosis of the femoral head(ONFH)is an ischaemic disorder often leading to collapse of the femoral head and severe hip dysfunction.Mesenchymal stem cells(MSCs)have a key role in bone repair,through their ability to differentiate into osteoblasts and their paracrine regulation of the bone microenvironment.While altered MSCs behaviour has been reported in some secondary forms of ONFH,the proliferative and differentiation programmes of MSCs in human idiopathic ONFH have not been previously characterized.AIM To compare the proliferative capacity,differentiation potential and nuclear factor kappa B(NF-κB)pathway activation of bone marrow MSCs(BM-MSCs)from idiopathic ONFH patients with those from osteoarthritis controls.METHODS Femoral heads were collected during total hip replacement surgeries.Idiopathic ONFH was defined by imaging and histological criteria.Secondary causes were excluded.BM-MSCs were isolated from trabecular bone cylinders and expanded to passage 2 prior characterizations.Proliferation was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay at various seeding densities.Osteogenic potential was assessed by alkaline phosphatase activity,osteogenic gene expression(RUNX2,ALPL,COL1A1 and BGLAP)and Alizarin Red staining.Adipogenesis was quantified by Oil Red O staining.Expression of NF-κB target genes(IL6,NFKBIA,CCL2)was analyzed by quantitative polymerase chain reaction.RESULTS Idiopathic ONFH MSCs exhibited significantly higher proliferation rates than osteoarthritis controls.However,they showed reduced alkaline phosphatase activity and osteogenic gene expression but paradoxically,increased mineralization,suggesting non-canonical mineral deposition mechanisms.These cells also display increased adipogenic differentiation.Importantly,ONFH-MSCs expressed higher,although non-significant levels of certain NF-κB target gene genes,consistent with an activated inflammatory state.CONCLUSION Human BM-MSCs from idiopathic ONFH display a paradoxical phenotype:Hyperproliferative yet osteogenically impaired with greater adipogenesis and activation of NF-κB signalling.This functional compromise and inflammatory bias may underline the failure of bone regeneration in ONFH,highlighting the need for therapies redirecting MSCs fate and modulating the bone marrow niche.
文摘BACKGROUND Idiopathic portal hypertension(IPH)is a subtype of portal hypertension that arises in the absence of cirrhosis.IPH frequently manifests with clinical features typical of portal hypertension,including splenomegaly and esophagogastric fundal varices,along with other associated symptoms.Imaging studies may indicate portal hypertension;however,they typically do not provide evidence of cirrhosis.There are no standardized diagnostic criteria for IPH,and diagnosis is often established by excluding other hepatic diseases.Liver biopsy remains the most reliable approach to verify the diagnosis of IPH.CASE SUMMARY A patient previously diagnosed with“hepatitis B cirrhosis”at an external hospital presented to our facility with gastrointestinal bleeding.Initial assessment revealed minor liver injury,splenomegaly,esophagogastric varices,and portal hypertension.Imaging studies did not indicate cirrhosis and repeated hepatitis B serology tests yielded negative results.After excluding various causes of cirrhosis and other non-cirrhotic etiologies of portal hypertension,liver biopsy confirmed the diagnosis of IPH.The patient was managed with regular endoscopic therapy and long-term carvedilol administration.CONCLUSION Currently,there are no standardized diagnostic criteria for IPH,and its diagnosis is generally established by excluding other conditions.Liver biopsy remains the most reliable method for IPH diagnosis.
文摘Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with idiopathic oligoasthenozoospermia were examined.The first group(n=125)received 100 mg/day of CoQ10 and the second group(n=125)received 200 mg/day of CoQ10 orally for 6 months.Semen parameters,DNA fragmentation index(DFI)and the partner pregnancy rate were analyzed at baseline and after 6 months of treatment.Results:Comparing with baseline data,treatment with CoQ10(100 mg/day or 200 mg/day)resulted in a significant increase in sperm concentration(both P<0.001),a significant improvement in progressive motility and total motile sperm count(P=0.05,P=0.001,respectively).The mean DFI was significantly improved after treatment with CoQ10 at 100 mg/day and at 200 mg/day,after 6 months of treatment(P<0.01).Moreover,CoQ10 significantly improved the partner pregnancy rate.A strongest correlation was found between seminal fluid parameters and DFI(P<0.001).Conclusions:CoQ10 is effective in improving semen parameters,DFI and on the partner pregnancy rate after 6 months with CoQ10 at two doses,with a greater improvement shown in men who took 200 mg/day than in those who took 100 mg/day.
文摘BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare condition that causes ischaemic colitis,has various clinical manifestations,and may even be asymptomatic,often resulting in clinical misdiagnosis.CASE SUMMARY We report the case of a 44-year-old woman with chief complaints of abdominal pain,vomiting and decreased defecation.One year prior,the patient was asymptomatic and therefore misdiagnosed with inflammatory bowel disease based on incidental findings on an abdominal computed tomography(CT)scan.The present abdominal CT scan revealed an intestinal obstruction,diffuse thickening of the entire colon wall and calcification of the mesenteric and colonic veins.Colonoscopy revealed multiple ulcerations and extensive dark purple discolouration of the oedematous mucosa.Colonic transit studies suggested a decrease in colonic motility.IMP was considered the underlying cause of her pseudoileus,which was potentially linked to her consumption of Chinese medicinal teas for more than 30 years.The patient underwent conservative medical treatment,and her symptoms gradually improved.She exhibited no signs of ileus or other significant discomfort at the outpatient follow-up one year after the discontinuation of Chinese herbal tea consumption.CONCLUSION IMP can present with symptoms of pseudoileus as initial complication.Clinicians can use CT and colonoscopy for differential diagnoses.
文摘BACKGROUND Retroperitoneal fibrosis is a rare fibro-inflammatory condition which can be classified into idiopathic(accounting for over 75%)and secondary types(due to malignancies,infections,medications,radiotherapy or other conditions).Idiopathic retroperitoneal fibrosis(IRPF)typically affects the abdominal aorta and iliac arteries along with the surrounding retroperitoneal area.This case review aims to summarize the imaging characteristics of IRPF arising from the peritoneal space.CASE SUMMARY An abdominal mass was discovered in a 52-year-old man during a routine physical examination,he had not complained of abdominal pain,distension,nausea,vomiting,diarrhea,fever,and had no significant past medical or family history.Abdominal magnetic resonance imaging revealed a soft tissue mass with poorly defined margins surrounding the duodenum,exhibiting slight to moderate high signal intensity on both T1-weighted and T2-weighted images.Diffusionweighted imaging with aβvalue of 800 mm²/second demonstrated slightly to moderate high signal intensity.Dynamic contrast enhanced images showed uneven enhancement on the arterial phase,with significant enhancement observed on the delayed phase.The mass infiltrated adjacent structures,including the head of the pancreas,the hepatic flexure of the colon,and part of the intestine,raising suspicion for malignant tumors such as sarcoma or lymphoma.However,surgery confirmed the diagnosis of IRPF.The patient underwent routine followup for one year,with no recurrence.CONCLUSION IRPF is a rare condition that presents considerable diagnostic challenges when lesions arise from the peritoneal space.In cases where imaging findings are atypical,a further puncture biopsy may be necessary to confirm the diagnosis.
基金Supported by The Sanming Project of Medicine in Shenzhen,No.SZSM202211003Shenzhen-Hong Kong Jointly Funded Project,Shenzhen Science and Technology Program,No.SGDX20230116093645007+1 种基金Shenzhen Second People's Hospital Clinical Project,No.20243357003Shenzhen Medical Research Fund,No.B2303005.
文摘BACKGROUND Depression and anxiety are prevalent psychological challenges among patients with adolescent idiopathic scoliosis(AIS),affecting individuals across both sex and age groups.AIM To explore the network structure of depression and anxiety symptoms,with a focus on identifying differences at the symptom level between sex and age subgroups.METHODS A total of 1955 participants diagnosed with AIS aged 10-18 years were assessed using the Patient Health Questionnaire Depression Scale(PHO-9)and the Generalized Anxiety Disorder Scale(GAD-7),and 765 patients exhibiting PHQ-9 or GAD-7 scores ≥ 5 were enrolled in our study. Network analysis and network comparison tests were utilized toconstruct and compare the depression-anxiety symptoms networks among sex and age subgroups.RESULTSThe results revealed GAD3 “Excessive worry” and PHQ2 “Sad mood” were the most significant central symptomsin all subgroups, while “Sad mood” had higher strength than “Excessive worry” in the lower age group. In thenetwork comparisons, the female network exhibited tighter connectivity, especially on GAD6 “Irritability” andGAD2 “Uncontrollable worry”, while only PHQ3 “Sleep” and PHQ9 “Suicidal ideation” had differences at thelocal level in the lower age group.CONCLUSIONSeveral interventions targeting excessive worry and sad mood could reduce the risk of depression and anxietysymptoms in the AIS population. Furthermore, specific anxiety symptoms in females, along with sleep disturbancesand suicidal ideation in the lower age group, should be addressed at an early stage to prevent significantdisruptions in mental health trajectories.
基金the National Natural Science Foundation of China grant NSFC(82070995).
文摘Objective:Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis(ITS)in children.This study aims to investigate whether superior oblique palsy(SOP)poses a higher risk for developing ITS among children and adolescents.Methods:A cross-sectional study.The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years;Patients within the same age range with ocular trauma were enrolled as the control group.Preoperative chest plain radiographs were used to measure the Cobb angle.Demographic information and clinical data,including diopter,best corrected visual acuity,deviation degree,and binocular function,were analyzed.Results:A significantly higher prevalence of ITS was found in study group compared with control group(12.68%vs 4.18%,P<0.001).Additionally,the mean Cobb angle was lagger in SOP group than that in control group(5.02°±3.87°vs 3.84°±3.09°,P<0.001).Males in SOP group showed a higher prevalence of ITS(12.9%vs 2.87%,P=0.007),but there was no significant difference in females between two groups(12.3%vs 7.69%,P=0.295).Good near stereopsis acuity was significantly associated with high prevalence of thoracic scoliosis(P<0.001).Multivariate logistic regression analysis revealed that a large distant magnitude of deviation(>20 PD)and near stereoacuity were significantly associated with ITS.Conclusions:Patients with SOP have a significantly higher risk of developing idiopathic thoracic scoliosis,especially those with good near stereoscopic and large distant magnitude of deviation.
基金the National Natural Science Foundation of China(No.32260235)。
文摘The dynamic response characteristics of scoliosis and kyphosis to vibration are currently unclear.The finite element method(FEM)was employed to study the vibration response of patients with idiopathic scoliosis and kyphosis.The objective is to analyze the dynamic characteristics of idiopathic scoliosis and kyphosis using FEM.The finite element model of T1—S1 segments was established and verified using the CT scanning images.The established scoliosis and kyphosis models were verified statistically and dynamically.The finite element software Abaqus was utilized to analyze the mode,harmonic response,and transient dynamics of scoliosis and kyphosis.The first four natural frequencies extracted from modal analysis were 1.34,2.26,4.49 and 17.69 Hz respectively.Notably,the first three natural frequencies decreased with the increase of upper body mass.In harmonic response analysis,the frequency corresponding to the maximum amplitude in x direction was the first order natural frequency,and the frequency corresponding to the maximum amplitude in y and z directions was the second order natural frequency.At the same resonance frequency,the amplitude of the thoracic spine was larger relative to that of the lumbar spine.The time domain results of transient analysis showed that the displacement dynamic response of each segment presented cyclic response characteristics over time.Under 2.26 Hz excitation,the dynamic response of the research object appeared as resonance.The higher the degree of spinal deformity,the greater the fundamental frequency.The first three natural modes of scoliosis and kyphosis contain vibration components in the vertical direction.The second order natural frequency was the most harmful to patients with scoliosis and kyphosis.Under cyclic loading,the deformation of the thoracic cone exceeds that of the lumbar cone.
文摘[Objectives]This meta-analysis evaluated the efficacy of Traditional Chinese Medicine(TCM)manual therapies(Tuina,Daoyin,acupotomology)for idiopathic scoliosis(IS),with dual focus on radiographic outcomes(Cobb angle,vertebral rotation)and patient-centered metrics(pain,disability,quality of life).[Methods]This study systematically searched PubMed,Cochrane Library,EMBASE,Web of Science,CNKI,Wanfang,and VIP databases(from inception to July 2025)for randomized controlled trials(RCTs)comparing TCM manual therapies against controls(bracing,exercise,sham,or no intervention).Two reviewers independently extracted data and assessed methodological quality using the PEDro scale.Meta-analyses employed random-effects models(Stata 18)to calculate Hedges'g with 95%confidence intervals(CI).Heterogeneity was quantified via I 2 statistics,and subgroup analyses examined intervention types(standalone versus combined)and control groups.[Results]Radiographic outcomes:TCM therapies significantly reduced Cobb angle(Hedges'g=-0.93;95%CI:-1.37,-0.49;p<0.001)and vertebral torsion rotation(VTR;g=-0.71;95%CI:-0.91,-0.51;p<0.001)versus controls;patient-centered outcomes:substantial pain reduction(VAS:g=-1.47;95%CI:-2.64,-0.30;p=0.01)and disability improvement(ODI:g=-1.10;95%CI:-1.57,-0.64;p<0.001)were observed.Quality of life(SRS-22)showed non-significant gains(g=2.01;95%CI:-0.43,4.45;p=0.11).[Conclusions]TCM manual therapies significantly improve spinal alignment and reduce pain/disability in IS patients,particularly when integrated with exercise regimens.While results support their role as complementary interventions,standardization of protocols and long-term efficacy studies are needed for clinical implementation.
文摘AIM:To characterize a Portuguese population of patients with juvenile idiopathic arthritis(JIA)and to evaluate possible associations between clinical factors and ocular involvement.METHODS:Patients diagnosed with JIA in the previous 20y in Hospital Garcia de Orta were included.Data were assessed from Reuma.pt database.Associations between demographic(age and sex),clinical(articular involvement,extra-articular manifestations,biological therapy),laboratory data[anti-nuclear antibodies,anti-cyclic citrullinated peptide(CCP)antibodies,rheumatoid factor,human leukocyte antigen B27(HLA-B27),C-reactive protein,erythrocyte sedimentation rate]and ocular involvement were assessed.Statistical analysis was performed using Chi-square for categorical variables and Mann-Whitney test for continuous variables.RESULTS:Totally 91 patients were included,11(12%)with previous episodes of uveitis.There was a statistically significant preponderance of early age at JIA diagnosis(mean 4.73 vs 9.58y,P=0.008),antinuclear antibodies positivity(P=0.01),and oligoarticular subtype(P=0.04)in the Juvenile idiopathic arthritis-associated uveitis(JIA-U)group.Ocular complications occurred in 36.4%of patients(n=4):cataracts(n=2),band keratopathy(n=1)and posterior synechiae(n=1).The occurrence of complications was corelated with a shorter period between JIA diagnosis and the first JIA-U episode(mean 0.67 vs 4.88y,P=0.012)but not with age at JIA diagnosis or articular involvement.There was erythrocyte sedimentation rate elevation in the 12mo preceding uveitis(mean 40.5 mm/h,range 13-83).CONCLUSION:The occurrence of JIA-U shortly after JIA diagnosis is shown to be a potential risk factor for ocular complications.
基金by National Natural Science Foundation of China(No.62306083)the Postdoctoral Science Foundation of Heilongjiang Province of China(LBH-Z22175)the Ministry of Industry and Information Technology。
文摘Adolescent idiopathic scoliosis(AIS)is a dynamic progression during growth,which requires long-term collaborations and efforts from clinicians,patients and their families.It would be beneficial to have a precise intervention based on cross-scale understandings of the etiology,real-time sensing and actuating to enable early detection,screening and personalized treatment.We argue that merging computational intelligence and wearable technologies can bridge the gap between the current trajectory of the techniques applied to AIS and this vision.Wearable technologies such as inertial measurement units(IMUs)and surface electromyography(sEMG)have shown great potential in monitoring spinal curvature and muscle activity in real-time.For instance,IMUs can track the kinematics of the spine during daily activities,while sEMG can detect asymmetric muscle activation patterns that may contribute to scoliosis progression.Computational intelligence,particularly deep learning algorithms,can process these multi-modal data streams to identify early signs of scoliosis and adapt treatment strategies dynamically.By using their combination,we can find potential solutions for a better understanding of the disease,a more effective and intelligent way for treatment and rehabilitation.
文摘Objective:To investigate the clinical efficacy and safety evaluation of Polyethylene Glycol Recombinant Human Growth Hormone Injection(PEG-rhGH)in the treatment of idiopathic short stature.Methods:A total of 1402 patients were enrolled from March 21,2024 to January 13,2025,including 778 males and 624 females,with ages mainly ranging from 5 to 13 years old.Follow-up visits were completed by 488 patients for the first time,174 patients for the second time,and 81 patients for the third time.All patients were treated with PEG-rhGH(Jin Sai Zeng)as the main therapy after admission.The changes in height information,IGF-1,and thyroid examination results of each patient at the initial diagnosis,6,9,and 12 months after treatment were observed and analyzed.Results:There was no statistical difference between the baseline and the initial diagnosis,as well as the second follow-up visit(P<0.05),while there was a statistical difference between the baseline and the first and third follow-up visits(P>0.05).There was a statistically significant difference in IGF-1 between the initial diagnosis and the first follow-up visit(P<0.05),but no statistical difference between the first,second,and third follow-up visits(P>0.05).Additionally,IGF-1 levels increased with time.There was no statistical difference in TSH between the initial diagnosis and the first,second,and third follow-up visits(P>0.05).There was a statistical difference in free T3 between the initial diagnosis and the first and second follow-up visits(P<0.05),but no statistical difference between the second and third follow-up visits(P>0.05).There was no statistical difference in free T4 between the initial diagnosis and the first and second follow-up visits(P>0.05),but there was a statistical difference between the second and third follow-up visits(P<0.05).Conclusion:PEG-rhGH(Jin Sai Zeng)is significantly effective in improving height and IGF-1 levels in patients with idiopathic short stature.
文摘Background and Objective:Idiopathic intracranial hypertension(IIH)is a disorder of raised intracranial pressure(ICP)associated with overweight and obesity,with weight loss being the mainstay of management.Diet and lifestyle changes alone are often unsuccessful at achieving meaningful or sustained weight loss.Glucagon-like peptide-1 receptor agonists(GLP-1RA)are a class of medications developed for the treatment of diabetes but are also highly effective for weight reduction.The objective of this narrative review is to present the current evidence for GLP-1RAs in the management of IIH.Methods:Articles were searched for inclusion through OVID using the following terms:[papilledema OR intracranial hypertension OR idiopathic intracranial hypertension OR brain pseudotumor]and[glucagon like peptide 1 OR glucagon like peptide 1 receptor agonist OR semaglutide OR exendin 4 OR liraglutide OR tirzepatide].Titles and abstracts were screened manually for relevance.There were no exclusion criteria for time frame,language,population or article type,although conference abstracts were not included.An illustrative case of a patient with IIH treated with tirzepatide and semaglutide is also presented.Key Content and Findings:GLP-1RAs have demonstrated the potential for significantly greater weight loss in patients with IIH,with a reduced requirement for IIH medications and improved symptoms,compared to conventional weight management.Treatment with GLP-1RAs has also been shown to result in a rapid and persistent reduction in ICP in both rat and human studies.The side effects of GLP-1RAs are generally well-tolerated,with low rates of discontinuation in clinical trials.However,continuous treatment is likely required to avoid weight rebound and symptom recurrence after cessation.Conclusions:Despite highly promising preliminary evidence,further clinical trials are needed to determine the most effective GLP-1RA medications within this class,appropriate dosing regimens and treatment duration.
文摘Acute pancreatitis during pregnancy is a rare event,and can be associated with high maternal mortality and fetal loss.Gallstone disease is thought to be the most common causative factor of acute pancreatitis,but,in many cases,the cause remains unclear.We report a case of a 36-year-old woman at 35 wk of gestation,who presented with severe pain confined to the upper abdomen and radiating to the back.The patient was diagnosed with acute idiopathic pancreatitis,which was managed conservatively;she recovered within several days and then delivered a healthy baby.Therefore it is important to consider acute pancreatitis when a pregnant woman presents with upper abdominal pain,nausea and vomiting in order to improve fetal and maternal outcomes for patients with acute pancreatitis.
基金Supported by the Key Projects in the National Science and Technology Pillar Program during the Twelfth Five-year Plan Period(2011BAI10B03)
文摘Objective To investigate the efficacy and safety of rituximab(RTX) in the treatment of idiopathic membranous nephropathy(IMN) with nephrotic syndrome with a systematic review and meta-analysis.Methods Pub Med, Embase, Cochrane Library and Clinical Trials(December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission(CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated.Results Seven studies involved 120 patients(73% were men) were included in our systematic review and metaanalysis. All were prospective observation cohort studies or matched-cohort studies, mainly came from two medical centers, and one study was multi-centric(four nephrology units in northern Italy). The creatinine clearance was more than 20 ml/(min·1.73 m2) and persistent proteinuria higher than 3.5 g/d for at least 6 months. All patients received treatment previously [44(36.7%) had immunosuppressive treatment]. In 12-and 24-month, 56%(95%CI, 0.47-0.65) and 68%(95%CI, 0.41-0.87) patients could reach remission, while 15%(95%CI, 0.09-0.23) and 20%(95%CI, 0.12-0.32) patients could reach CR. The reduction in proteinuria was gradual and obvious, paralleled with upward trend of serum albumin level and decreasing serum cholesterol level. Renal functions were stable. Relapses happened in 24 months were around 8%. RTX related adverse events were mild and were mostly infusion-related reactions.Conclusions RTX treatment in IMN was efficient, well tolerated and safe. More than 60% patients can reach partial remission or CR in 24 months, and relapse is rare. Adverse events of RTX are mostly infusion-related reactions and generally mild.
