Acute compartment syndrome(ACoS)involves a complex pathological process in which rising pressures within an enclosed muscle space ultimately result in anoxia and cell death.The most common etiologies include long bone...Acute compartment syndrome(ACoS)involves a complex pathological process in which rising pressures within an enclosed muscle space ultimately result in anoxia and cell death.The most common etiologies include long bone fractures,crush injuries,and burns.[1,2]While rare,ACoS can also occur in atraumatic settings following periods of prolonged limb compression,such as intoxication.[3]Atraumatic ACoS is easily overlooked,resulting in diagnostic delay and poor patient outcomes.Prompt recognition and surgical management is essential to prevent critical sequelae.展开更多
Amyotrophic lateral sclerosis(ALS)is a neuromuscular condition resulting from the progressive degeneration of motor neurons in the cortex,brainstem,and spinal cord.While the typical clinical phenotype of ALS involves ...Amyotrophic lateral sclerosis(ALS)is a neuromuscular condition resulting from the progressive degeneration of motor neurons in the cortex,brainstem,and spinal cord.While the typical clinical phenotype of ALS involves both upper and lower motor neurons,human and animal studies over the years have highlighted the potential spread to other motor and non-motor regions,expanding the phenotype of ALS.Although superoxide dismutase 1(SOD1)mutations represent a minority of ALS cases,the SOD1 gene remains a milestone in ALS research as it represents the first genetic target for personalized therapies.Despite numerous single case reports or case series exhibiting extramotor symptoms in patients with ALS mutations in SOD1(SOD1-ALS),no studies have comprehensively explored the full spectrum of extramotor neurological manifestations in this subpopulation.In this narrative review,we analyze and discuss the available literature on extrapyramidal and non-motor features during SOD1-ALS.The multifaceted expression of SOD1 could deepen our understanding of the pathogenic mechanisms,pointing towards a multidisciplinary approach for affected patients in light of new therapeutic strategies for SOD1-ALS.展开更多
Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives ...Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.展开更多
An African student in Hangzhou is furthering the cause of intercultural dialogue through community involvement.During the 19th Asian Games held in east China’s Hangzhou,McCleary Gondo,a 27-year-old Zimbabwean student...An African student in Hangzhou is furthering the cause of intercultural dialogue through community involvement.During the 19th Asian Games held in east China’s Hangzhou,McCleary Gondo,a 27-year-old Zimbabwean student living in Hangzhou,Zhejiang Province,caught people’s attention.展开更多
Objective:Pediatric patients undergoing day surgery often experience significant anxiety,which can negatively impact both the child and their parents.Addressing this anxiety is crucial to ensure a smooth surgical expe...Objective:Pediatric patients undergoing day surgery often experience significant anxiety,which can negatively impact both the child and their parents.Addressing this anxiety is crucial to ensure a smooth surgical experience and recovery.This mini review aims to evaluate the impact of preoperative anxiety in children,identify contributing factors,and explore effective strategies to manage this anxiety during day surgery.Methods:A literature review was conducted,focusing on studies that assess anxiety levels in pediatric patients before day surgery and the interventions designed to alleviate this anxiety.The review included both psychological and procedural strategies.Results:Preoperative anxiety in children can be influenced by a variety of factors,including age,previous medical experiences,parental anxiety,and the hospital environment.Untreated anxiety may lead to increased postoperative pain,behavioral changes,and extended recovery times.Several strategies,including psychological preparation,family centered approaches,and the involvement of child life specialists,have been shown to effectively reduce anxiety.Conclusions:Managing anxiety in pediatric day surgery is vital to improving both surgical outcomes and the overall experience for children and their families.Healthcare professionals can play a key role in reducing anxiety through targeted interventions and supportive care.展开更多
Small cell lung cancer(SCLC), which accounts for about one-sixth of all lung cancer cases, is the most aggressive subtype, with a high propensity for brain involvement[1]. The role of prophylactic cranial irradiation(...Small cell lung cancer(SCLC), which accounts for about one-sixth of all lung cancer cases, is the most aggressive subtype, with a high propensity for brain involvement[1]. The role of prophylactic cranial irradiation(PCI) in reducing intracranial relapse and improving survival has been a subject of intense debate for decades.展开更多
BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esoph...BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esophagus.Most related papers have been case reports,and no comprehensive studies have been conducted;thus,the actual clinical situation has remained unknown for a long time.AIM To elucidate the actual clinical situation of esophageal involvement of MCL presenting with MLP,including its prognosis.METHODS From January 2001 to December 2021,among MCL patients whose gastrointestinal lesions were histopathologically confirmed by endoscopic biopsy at our center,6 patients with MLP in the esophagus were selected.We retro-spectively examined the clinical features of these patients,including their prognosis.RESULTS In all patients,multiple lesions were present in the gastrointestinal tract other than the esophagus and in the lymph nodes throughout the body,and most patients also had lesions involving the bone marrow or spleen.Most of the treatments include chemotherapy,with a 50%survival period of less than 2 years and a 5-year survival rate of approximately 30%,indicating a poor prognosis.CONCLUSION Patients with esophageal involvement of the MCL who presented with MLP had a large tumor burden and poor survival.展开更多
BACKGROUND Submucosal tumors arise from the subepithelial layer anywhere along the gastr-ointestinal tract,most commonly in the stomach.A wide range of lesions,from benign to malignant,may present as gastric submucosa...BACKGROUND Submucosal tumors arise from the subepithelial layer anywhere along the gastr-ointestinal tract,most commonly in the stomach.A wide range of lesions,from benign to malignant,may present as gastric submucosal tumors.However,the gastric involvement of Crohn’s disease(CD)is generally not considered in the differential diagnosis of such lesions.CASE SUMMARY A 23-year-old male patient presented with a gastric subepithelial tumor.The medical history included CD.Diagnostic workup revealed a 3-cm mucosal lesion with a central ulceration on the posterior wall of the distal antrum.The patient underwent laparoscopic wedge resection of stomach,and the postoperative course was uneventful.Histopathological analysis confirmed a diagnosis of gastric CD presenting as a subepithelial tumor.CONCLUSION Despite its rarity,upper gastrointestinal CD can present as a gastric subepithelial tumor,warranting consideration in young patients with CD.展开更多
Objective:To compare the diagnostic value of 99mTc-MDP SPECT/CT and MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.Methods:A retrospective analysis was conducted on the imaging data of 78 t...Objective:To compare the diagnostic value of 99mTc-MDP SPECT/CT and MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.Methods:A retrospective analysis was conducted on the imaging data of 78 thoracic wall and rib lesions from 66 patients,a total of 32 males and 34 females,aged(53.2±5.6)years old with pathologically confirmed lung adenocarcinoma who underwent both 99mTc-MDP SPECT/CT and MSCT examinations from March 2017 to September 2023.The diagnostic efficacy of the two imaging modalities was compared using pathological confirmation or clinical follow-up as the gold standard.Results:Pathological confirmation or clinical follow-up revealed 74 lesions with thoracic wall bone involvement in lung adenocarcinoma(20 lesions confirmed by surgical pathology and 54 lesions confirmed by clinical follow-up)and 4 lesions without thoracic wall or rib involvement(2 lesions confirmed by surgical pathology and 2 lesions confirmed by clinical follow-up).The diagnostic sensitivity,specificity,and accuracy of 99mTc-MDP SPECT/CT were 97.3%,50.0%,and 94.9%,respectively.Its diagnostic sensitivity and accuracy were higher than those of MSCT(72.3%and 74.4%,respectively),with statistically significant differences(P<0.05).The specificity of 99mTc-MDP SPECT/CT was lower than that of MSCT(100.0%),but the difference was not statistically significant(P<0.05).There were no statistically significant differences in the positive predictive value and negative predictive value between 99mTc-MDP SPECT/CT and MSCT(P>0.05).99mTc-MDP SPECT/CT examination revised the MSCT tumor staging in 14 patients[21.2%(14/66)]with lung adenocarcinoma.Conclusion:99mTc-MDP SPECT/CT imaging demonstrates superior diagnostic efficacy compared to MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.It offers more accurate tumor staging than MSCT,and an accurate diagnosis aids in clinical treatment decision-making.展开更多
BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the deve...BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care,thereby improving outcomes for infants and their families.AIM To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit(NICU).METHODS A literature search was conducted using the PubMed,MEDLINE,and Cochrane Library for systematic reviews databases,with the following search terms:“parental presence neonatology”,“couplet care”,“zero separation neonatal care”,“family integrated care”,“couplet care intervention”,“mother-child separation”,“parents newborn togetherness”,“mother-baby care”,“closeness and separation NICU”,“mother-infant interaction NICU”,“kangaroo care”,“dyad mother-infant”,and“newborn integrated care”.The database search for this literature review began on December 10,2024,with the final search conducted on April 10,2025.RESULTS The literature search yielded 281 articles,out of which 23 were selected for a detailed review.The factors associated with parental presence in NUs were grouped into five main categories:Parents’socio-demographic and cultural traits;the physical layout and care model of the NUs;the quality of parents’relationships with the healthcare staff;their active involvement in neonatal care;and the newborn’s health status.CONCLUSION The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.展开更多
Schisandrin B(Sch B),the major lignans isolated from Schisandra chinensis,exerts high arntioxidant activities.However,it is unknown whether SchB protects neural cell against Aβinduced cellular apoptosis.This study ai...Schisandrin B(Sch B),the major lignans isolated from Schisandra chinensis,exerts high arntioxidant activities.However,it is unknown whether SchB protects neural cell against Aβinduced cellular apoptosis.This study aims to investigate the neuroprotective action of SchB on cellular model of AD,and revealed the underlying mechanisms.展开更多
Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially av...Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.展开更多
The massive vector bosons Z o, W ± and the scalar Higgs-boson H o assumed in weak interaction theory, but also the six quarks required in strong interactions are well understood in an alternative quantum field th...The massive vector bosons Z o, W ± and the scalar Higgs-boson H o assumed in weak interaction theory, but also the six quarks required in strong interactions are well understood in an alternative quantum field theory of fermions and bosons: Z o and W ± as well as all quark-antiquark states (here only the tt¯state is discussed) are described by bound states with scalar coupling between their massless constituents and have a structure similar to leptons. However, the scalar Higgs-boson H o corresponds to a state with vector coupling between the elementary constituents. Similar scalar states are expected also in the mass region of the mesons ω (0.782 GeV) - Υ ( 9.46 GeV). The underlying calculations can be run on line using the Web-address https://h2909473.stratoserver.net.展开更多
Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely un...Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.展开更多
BACKGROUND: Early identification of patients requiring ventilator support will be beneficial for the outcomes of botulism. The present study aimed to establish a new scoring system to predict mechanical ventilation(MV...BACKGROUND: Early identification of patients requiring ventilator support will be beneficial for the outcomes of botulism. The present study aimed to establish a new scoring system to predict mechanical ventilation(MV) for botulism patients.METHODS: A single-center retrospective study was conducted to identify risk factors associated with MV in botulism patients from 2007 to 2022. Univariate analysis and multivariate logistic regression analysis were used to screen out risk factors for constructing a prognostic scoring system. The area under the receiver operating characteristic(ROC) curve was calculated.RESULTS: A total of 153 patients with botulism(66 males and 87 females, with an average age of 43 years) were included. Of these, 49 patients(32.0%) required MV, including 21(13.7%) with invasive ventilation and 28(18.3%) with non-invasive ventilation. Multivariate analysis revealed that botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement were independent risk factors for MV. These risk factors were incorporated into a multivariate logistic regression analysis to establish a prognostic scoring system. Each risk factor was scored by allocating a weight based on its regression coefficient and rounded to whole numbers for practical utilization([botulinum toxin type A: 1], [pneumonia: 2], [incubation period ≤1 day: 2], [hypoxia <90%: 2], [severity of muscle involvement: grade Ⅱ, 3;gradeⅢ, 7;grade IV, 11]). The scoring system achieved an area under the ROC curve of 0.82(95% CI 0.75–0.89, P<0.001). At the optimal threshold of 9, the scoring system achieved a sensitivity of 83.7% and a specificity of 70.2%.CONCLUSION: Our study identified botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement as independent risk factors for MV in botulism patients. A score ≥9 in our scoring system is associated with a higher likelihood of requiring MV in botulism patients. This scoring system needs to be validated externally before it can be applied in clinical settings.展开更多
Background:The emergence of dengue fever has prompted significant public health responses,highlighting the need for a comprehensive understanding of One Health in addressing vector-borne diseases.China's experienc...Background:The emergence of dengue fever has prompted significant public health responses,highlighting the need for a comprehensive understanding of One Health in addressing vector-borne diseases.China's experience in dengue control and prevention programs offers valuable insights into the successful integration of multidisciplinary strategies.Aims:The review aims to:(1)systematically analyze lessons from China's dengue control and prevention programs,focusing on the integration of these efforts with the One Health approach;(2)underscore the reasons of optimizing the dengue control and prevention program;(3)highlight the alignment of China's dengue control strategies with the One Health framework;(4)contribute to global efforts in combating dengue,providing scientific evidence and strategic recommendations for other regions facing similar challenges.Results:Through a comprehensive literature review and expert interviews,this study found China's approach to dengue control and prevention implemented through a hierarchical system led by the government,with collaborative efforts across multiple departments.This multi-sectoral collaboration mechanism enables the technical interventions well executed by health and disease control institutions,optimizing the integration of multiple costeffeteness approaches,such as case management,early detection and outbreak response,reducing local transmission,and minimizing severe cases and fatalities.It was found that community participation and public health education have played a vital role in raising awareness,promoting personal protective measures,and enhancing the overall effectiveness of control efforts.The implementation of these integrated interventions has resulted in reduced dengue cases and improved capacity of outbreak response.China's dengue control strategies under the One Health framework,with focus on interdisciplinary collaboration,incorporated environmental and ecological interventions,which reduced mosquito breeding sites and improved sanitation.The findings of the review underscore the need for continuous improvement in early warning systems,scientific research,and the adoption of the One Health approach to address emerging challenges posed by climate change and the cross-border spread of infectious diseases.Conclusion:China's dengue control and prevention programs provide a compelling case study for the effective application of the One Health approach.By systematically analyzing the integration of multidisciplinary strategies,this review reveals valuable lessons on optimizing public health responses to vector-borne diseases.The alignment of these strategies with One Health principles not only enhances the effectiveness of dengue control efforts in China but also offers a framework that can be adapted by other regions facing similar challenges.Ultimately,the insights gained from this analysis contribute to the global fight against dengue,emphasizing the need for collaborative and holistic approaches in public health initiatives.展开更多
Objectives:Inpatient falls are a major patient safety issue in acute care hospitals.Multifactorial inhospital fall prevention programs have shown reductions in falls and related risks.One common element of successful ...Objectives:Inpatient falls are a major patient safety issue in acute care hospitals.Multifactorial inhospital fall prevention programs have shown reductions in falls and related risks.One common element of successful programs is active patient involvement.This study objective was to explore patients’and nurses’experiences with a structured intervention to foster patient involvement.Methods:This study was conducted between September 2020 and April 2021 in a university hospital neurological ward.The studied intervention consisted of a falls information leaflet,and a structured nurse-patient conversation about fall risk-reduction activities.Nurses were trained to deliver the intervention and supported throughout the study.Nurses’and patients’experiences regarding personal involvement,satisfaction,and confidence were surveyed and analyzed quantitatively and qualitatively.Results:Fifty-six patients recruited by ward nurses received the intervention.After receiving the intervention,patients reported high levels of satisfaction with the in-hospital fall prevention conversation.Twenty-one nurses indicated that they would use the leaflet and communication aid.Twenty-one nurses commented on intervention facilitators and barriers.More specific facilitators included their shared perception that“handing out the leaflet to patients was not problematic”and that the leaflet was seen as“applicable in many patient situations.”Their comments indicated two particularly prominent barriers to conducting the intervention in clinical practice:1)“finding the time for the implementation in the daily clinical routine and workload”and 2)“environmental factors like a noisy and busy atmosphere on the ward.”Conclusions:This study provides insights into a patient involvement intervention featuring a structured nurse-patient discussion about fall risks.The accompanying information leaflet and communication guide require adaptations to facilitate sustainable implementation into the hospital’s fall prevention program,but proved useful.展开更多
The cellular prion protein(PrPC),a cell surface glycoprotein of 209 amino acids,has been considerably studied over the decades mainly due to its critical involvement in transmissible spongiform encephalopathies,or pri...The cellular prion protein(PrPC),a cell surface glycoprotein of 209 amino acids,has been considerably studied over the decades mainly due to its critical involvement in transmissible spongiform encephalopathies,or prion diseases.Indeed,it is the misfolding and aggregation of PrPC into pathological assemblies-named PrPSc-that constitute prions,the agents causing these unusual neurodegenerative diseases affecting humans and animals(Prusiner,1982).Furthermore,increasing evidence support its relevance also in other neurodegenerative diseases(NDDs),such as Alzheimer’s and Parkinson’s diseases(Corbett et al.,2020).展开更多
文摘Acute compartment syndrome(ACoS)involves a complex pathological process in which rising pressures within an enclosed muscle space ultimately result in anoxia and cell death.The most common etiologies include long bone fractures,crush injuries,and burns.[1,2]While rare,ACoS can also occur in atraumatic settings following periods of prolonged limb compression,such as intoxication.[3]Atraumatic ACoS is easily overlooked,resulting in diagnostic delay and poor patient outcomes.Prompt recognition and surgical management is essential to prevent critical sequelae.
文摘Amyotrophic lateral sclerosis(ALS)is a neuromuscular condition resulting from the progressive degeneration of motor neurons in the cortex,brainstem,and spinal cord.While the typical clinical phenotype of ALS involves both upper and lower motor neurons,human and animal studies over the years have highlighted the potential spread to other motor and non-motor regions,expanding the phenotype of ALS.Although superoxide dismutase 1(SOD1)mutations represent a minority of ALS cases,the SOD1 gene remains a milestone in ALS research as it represents the first genetic target for personalized therapies.Despite numerous single case reports or case series exhibiting extramotor symptoms in patients with ALS mutations in SOD1(SOD1-ALS),no studies have comprehensively explored the full spectrum of extramotor neurological manifestations in this subpopulation.In this narrative review,we analyze and discuss the available literature on extrapyramidal and non-motor features during SOD1-ALS.The multifaceted expression of SOD1 could deepen our understanding of the pathogenic mechanisms,pointing towards a multidisciplinary approach for affected patients in light of new therapeutic strategies for SOD1-ALS.
基金supported by the National Natural Science Foundation of China,Nos.82071426,81873784Clinical Cohort Construction Program of Peking University Third Hospital,No.BYSYDL2019002(all to DF)。
文摘Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.
文摘An African student in Hangzhou is furthering the cause of intercultural dialogue through community involvement.During the 19th Asian Games held in east China’s Hangzhou,McCleary Gondo,a 27-year-old Zimbabwean student living in Hangzhou,Zhejiang Province,caught people’s attention.
文摘Objective:Pediatric patients undergoing day surgery often experience significant anxiety,which can negatively impact both the child and their parents.Addressing this anxiety is crucial to ensure a smooth surgical experience and recovery.This mini review aims to evaluate the impact of preoperative anxiety in children,identify contributing factors,and explore effective strategies to manage this anxiety during day surgery.Methods:A literature review was conducted,focusing on studies that assess anxiety levels in pediatric patients before day surgery and the interventions designed to alleviate this anxiety.The review included both psychological and procedural strategies.Results:Preoperative anxiety in children can be influenced by a variety of factors,including age,previous medical experiences,parental anxiety,and the hospital environment.Untreated anxiety may lead to increased postoperative pain,behavioral changes,and extended recovery times.Several strategies,including psychological preparation,family centered approaches,and the involvement of child life specialists,have been shown to effectively reduce anxiety.Conclusions:Managing anxiety in pediatric day surgery is vital to improving both surgical outcomes and the overall experience for children and their families.Healthcare professionals can play a key role in reducing anxiety through targeted interventions and supportive care.
文摘Small cell lung cancer(SCLC), which accounts for about one-sixth of all lung cancer cases, is the most aggressive subtype, with a high propensity for brain involvement[1]. The role of prophylactic cranial irradiation(PCI) in reducing intracranial relapse and improving survival has been a subject of intense debate for decades.
文摘BACKGROUND In addition to nodal lesions,over 30%of mantle cell lymphomas(MCLs)also have gastrointestinal involvement,characteristically presenting as multiple lymphomatous polyposis(MLP),which rarely involve the esophagus.Most related papers have been case reports,and no comprehensive studies have been conducted;thus,the actual clinical situation has remained unknown for a long time.AIM To elucidate the actual clinical situation of esophageal involvement of MCL presenting with MLP,including its prognosis.METHODS From January 2001 to December 2021,among MCL patients whose gastrointestinal lesions were histopathologically confirmed by endoscopic biopsy at our center,6 patients with MLP in the esophagus were selected.We retro-spectively examined the clinical features of these patients,including their prognosis.RESULTS In all patients,multiple lesions were present in the gastrointestinal tract other than the esophagus and in the lymph nodes throughout the body,and most patients also had lesions involving the bone marrow or spleen.Most of the treatments include chemotherapy,with a 50%survival period of less than 2 years and a 5-year survival rate of approximately 30%,indicating a poor prognosis.CONCLUSION Patients with esophageal involvement of the MCL who presented with MLP had a large tumor burden and poor survival.
文摘BACKGROUND Submucosal tumors arise from the subepithelial layer anywhere along the gastr-ointestinal tract,most commonly in the stomach.A wide range of lesions,from benign to malignant,may present as gastric submucosal tumors.However,the gastric involvement of Crohn’s disease(CD)is generally not considered in the differential diagnosis of such lesions.CASE SUMMARY A 23-year-old male patient presented with a gastric subepithelial tumor.The medical history included CD.Diagnostic workup revealed a 3-cm mucosal lesion with a central ulceration on the posterior wall of the distal antrum.The patient underwent laparoscopic wedge resection of stomach,and the postoperative course was uneventful.Histopathological analysis confirmed a diagnosis of gastric CD presenting as a subepithelial tumor.CONCLUSION Despite its rarity,upper gastrointestinal CD can present as a gastric subepithelial tumor,warranting consideration in young patients with CD.
文摘Objective:To compare the diagnostic value of 99mTc-MDP SPECT/CT and MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.Methods:A retrospective analysis was conducted on the imaging data of 78 thoracic wall and rib lesions from 66 patients,a total of 32 males and 34 females,aged(53.2±5.6)years old with pathologically confirmed lung adenocarcinoma who underwent both 99mTc-MDP SPECT/CT and MSCT examinations from March 2017 to September 2023.The diagnostic efficacy of the two imaging modalities was compared using pathological confirmation or clinical follow-up as the gold standard.Results:Pathological confirmation or clinical follow-up revealed 74 lesions with thoracic wall bone involvement in lung adenocarcinoma(20 lesions confirmed by surgical pathology and 54 lesions confirmed by clinical follow-up)and 4 lesions without thoracic wall or rib involvement(2 lesions confirmed by surgical pathology and 2 lesions confirmed by clinical follow-up).The diagnostic sensitivity,specificity,and accuracy of 99mTc-MDP SPECT/CT were 97.3%,50.0%,and 94.9%,respectively.Its diagnostic sensitivity and accuracy were higher than those of MSCT(72.3%and 74.4%,respectively),with statistically significant differences(P<0.05).The specificity of 99mTc-MDP SPECT/CT was lower than that of MSCT(100.0%),but the difference was not statistically significant(P<0.05).There were no statistically significant differences in the positive predictive value and negative predictive value between 99mTc-MDP SPECT/CT and MSCT(P>0.05).99mTc-MDP SPECT/CT examination revised the MSCT tumor staging in 14 patients[21.2%(14/66)]with lung adenocarcinoma.Conclusion:99mTc-MDP SPECT/CT imaging demonstrates superior diagnostic efficacy compared to MSCT in detecting thoracic wall and rib involvement in lung adenocarcinoma.It offers more accurate tumor staging than MSCT,and an accurate diagnosis aids in clinical treatment decision-making.
文摘BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care,thereby improving outcomes for infants and their families.AIM To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit(NICU).METHODS A literature search was conducted using the PubMed,MEDLINE,and Cochrane Library for systematic reviews databases,with the following search terms:“parental presence neonatology”,“couplet care”,“zero separation neonatal care”,“family integrated care”,“couplet care intervention”,“mother-child separation”,“parents newborn togetherness”,“mother-baby care”,“closeness and separation NICU”,“mother-infant interaction NICU”,“kangaroo care”,“dyad mother-infant”,and“newborn integrated care”.The database search for this literature review began on December 10,2024,with the final search conducted on April 10,2025.RESULTS The literature search yielded 281 articles,out of which 23 were selected for a detailed review.The factors associated with parental presence in NUs were grouped into five main categories:Parents’socio-demographic and cultural traits;the physical layout and care model of the NUs;the quality of parents’relationships with the healthcare staff;their active involvement in neonatal care;and the newborn’s health status.CONCLUSION The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.
文摘Schisandrin B(Sch B),the major lignans isolated from Schisandra chinensis,exerts high arntioxidant activities.However,it is unknown whether SchB protects neural cell against Aβinduced cellular apoptosis.This study aims to investigate the neuroprotective action of SchB on cellular model of AD,and revealed the underlying mechanisms.
基金supported by the Sponsored by Tianjin Health Research Project(Grant No.TJWJ2023ZD003)the Chinese Society of Clinical Oncology Beijing Xisike Clinical Oncology Research Foundation(Grant Nos.Y-NCJH202201-0027 and Y-2022YMJN/MS-0001).
文摘Because human immunodeficiency virus(HIV)-associated Burkitt lymphoma(BL)has a poor prognosis new therapeutic approaches need to be developed1.Axicabtagene ciloleucel(axi-cel)is an anti-CD19 CAR-T cell commercially available FDA-approved product for patients with relapsed or refractory(R/R)large B-cell lymphoma(LBCL).However,axi-cel has not been approved by the FDA for use in patients with R/R BL.
文摘The massive vector bosons Z o, W ± and the scalar Higgs-boson H o assumed in weak interaction theory, but also the six quarks required in strong interactions are well understood in an alternative quantum field theory of fermions and bosons: Z o and W ± as well as all quark-antiquark states (here only the tt¯state is discussed) are described by bound states with scalar coupling between their massless constituents and have a structure similar to leptons. However, the scalar Higgs-boson H o corresponds to a state with vector coupling between the elementary constituents. Similar scalar states are expected also in the mass region of the mesons ω (0.782 GeV) - Υ ( 9.46 GeV). The underlying calculations can be run on line using the Web-address https://h2909473.stratoserver.net.
基金The study was partly funded by the National Natural Science Foundation of China(82371490)the National Key R&D Program of China(2022YFC2503900,2022YFC2503901)+1 种基金Beijing Hundred,Thousand and Ten Thousand Talents Project(2017-CXYF-09)Beijing Health System Leading Talent Grant(2022-02-10).
文摘Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.
基金funded by the Medical Science Research Project of Hebei Provincial Health and Health Commission(20221073).
文摘BACKGROUND: Early identification of patients requiring ventilator support will be beneficial for the outcomes of botulism. The present study aimed to establish a new scoring system to predict mechanical ventilation(MV) for botulism patients.METHODS: A single-center retrospective study was conducted to identify risk factors associated with MV in botulism patients from 2007 to 2022. Univariate analysis and multivariate logistic regression analysis were used to screen out risk factors for constructing a prognostic scoring system. The area under the receiver operating characteristic(ROC) curve was calculated.RESULTS: A total of 153 patients with botulism(66 males and 87 females, with an average age of 43 years) were included. Of these, 49 patients(32.0%) required MV, including 21(13.7%) with invasive ventilation and 28(18.3%) with non-invasive ventilation. Multivariate analysis revealed that botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement were independent risk factors for MV. These risk factors were incorporated into a multivariate logistic regression analysis to establish a prognostic scoring system. Each risk factor was scored by allocating a weight based on its regression coefficient and rounded to whole numbers for practical utilization([botulinum toxin type A: 1], [pneumonia: 2], [incubation period ≤1 day: 2], [hypoxia <90%: 2], [severity of muscle involvement: grade Ⅱ, 3;gradeⅢ, 7;grade IV, 11]). The scoring system achieved an area under the ROC curve of 0.82(95% CI 0.75–0.89, P<0.001). At the optimal threshold of 9, the scoring system achieved a sensitivity of 83.7% and a specificity of 70.2%.CONCLUSION: Our study identified botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement as independent risk factors for MV in botulism patients. A score ≥9 in our scoring system is associated with a higher likelihood of requiring MV in botulism patients. This scoring system needs to be validated externally before it can be applied in clinical settings.
基金supported by the National Parasitic Resources Center,the Ministry of Science and Technology fund(grant number NPRC-2019-194-30)the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(grant number 21410750200)+3 种基金Hainan Province Health Technology Innovation Joint Project(grant number WSJK2024MS226)the Three-Year Public Health Action Plan(No.2023-2025)of Shanghai(grant numbers GWVI-11.1-12,GWVI-11.2-XD33)Science&Technology Fundamental Resources Investigation Program(grant numbers 2022FY100900,2022FY100904)Shenzhen Medical Research Fund(grant number B2404002).
文摘Background:The emergence of dengue fever has prompted significant public health responses,highlighting the need for a comprehensive understanding of One Health in addressing vector-borne diseases.China's experience in dengue control and prevention programs offers valuable insights into the successful integration of multidisciplinary strategies.Aims:The review aims to:(1)systematically analyze lessons from China's dengue control and prevention programs,focusing on the integration of these efforts with the One Health approach;(2)underscore the reasons of optimizing the dengue control and prevention program;(3)highlight the alignment of China's dengue control strategies with the One Health framework;(4)contribute to global efforts in combating dengue,providing scientific evidence and strategic recommendations for other regions facing similar challenges.Results:Through a comprehensive literature review and expert interviews,this study found China's approach to dengue control and prevention implemented through a hierarchical system led by the government,with collaborative efforts across multiple departments.This multi-sectoral collaboration mechanism enables the technical interventions well executed by health and disease control institutions,optimizing the integration of multiple costeffeteness approaches,such as case management,early detection and outbreak response,reducing local transmission,and minimizing severe cases and fatalities.It was found that community participation and public health education have played a vital role in raising awareness,promoting personal protective measures,and enhancing the overall effectiveness of control efforts.The implementation of these integrated interventions has resulted in reduced dengue cases and improved capacity of outbreak response.China's dengue control strategies under the One Health framework,with focus on interdisciplinary collaboration,incorporated environmental and ecological interventions,which reduced mosquito breeding sites and improved sanitation.The findings of the review underscore the need for continuous improvement in early warning systems,scientific research,and the adoption of the One Health approach to address emerging challenges posed by climate change and the cross-border spread of infectious diseases.Conclusion:China's dengue control and prevention programs provide a compelling case study for the effective application of the One Health approach.By systematically analyzing the integration of multidisciplinary strategies,this review reveals valuable lessons on optimizing public health responses to vector-borne diseases.The alignment of these strategies with One Health principles not only enhances the effectiveness of dengue control efforts in China but also offers a framework that can be adapted by other regions facing similar challenges.Ultimately,the insights gained from this analysis contribute to the global fight against dengue,emphasizing the need for collaborative and holistic approaches in public health initiatives.
文摘Objectives:Inpatient falls are a major patient safety issue in acute care hospitals.Multifactorial inhospital fall prevention programs have shown reductions in falls and related risks.One common element of successful programs is active patient involvement.This study objective was to explore patients’and nurses’experiences with a structured intervention to foster patient involvement.Methods:This study was conducted between September 2020 and April 2021 in a university hospital neurological ward.The studied intervention consisted of a falls information leaflet,and a structured nurse-patient conversation about fall risk-reduction activities.Nurses were trained to deliver the intervention and supported throughout the study.Nurses’and patients’experiences regarding personal involvement,satisfaction,and confidence were surveyed and analyzed quantitatively and qualitatively.Results:Fifty-six patients recruited by ward nurses received the intervention.After receiving the intervention,patients reported high levels of satisfaction with the in-hospital fall prevention conversation.Twenty-one nurses indicated that they would use the leaflet and communication aid.Twenty-one nurses commented on intervention facilitators and barriers.More specific facilitators included their shared perception that“handing out the leaflet to patients was not problematic”and that the leaflet was seen as“applicable in many patient situations.”Their comments indicated two particularly prominent barriers to conducting the intervention in clinical practice:1)“finding the time for the implementation in the daily clinical routine and workload”and 2)“environmental factors like a noisy and busy atmosphere on the ward.”Conclusions:This study provides insights into a patient involvement intervention featuring a structured nurse-patient discussion about fall risks.The accompanying information leaflet and communication guide require adaptations to facilitate sustainable implementation into the hospital’s fall prevention program,but proved useful.
基金supported by the Ministero della Salute(grant No.RF-2016-02364498,to NR).
文摘The cellular prion protein(PrPC),a cell surface glycoprotein of 209 amino acids,has been considerably studied over the decades mainly due to its critical involvement in transmissible spongiform encephalopathies,or prion diseases.Indeed,it is the misfolding and aggregation of PrPC into pathological assemblies-named PrPSc-that constitute prions,the agents causing these unusual neurodegenerative diseases affecting humans and animals(Prusiner,1982).Furthermore,increasing evidence support its relevance also in other neurodegenerative diseases(NDDs),such as Alzheimer’s and Parkinson’s diseases(Corbett et al.,2020).
