Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic a...Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic adhesiolysis is the primary treatment for IUA;however,studies specifically addressing its efficacy in tuberculosisinduced IUA remain scarce.This study aims to evaluate the therapeutic outcomes of hysteroscopic adhesiolysis for IUA caused by endometrial tuberculosis.Methods:This retrospective cohort study included patients diagnosed with tuberculosisinduced IUA who underwent hysteroscopic adhesiolysis at the Third Xiangya Hospital of Central South University between May 2014 and October 2022.Clinical data including age,medical history,adhesion severity,surgical treatment,and reproductive outcomes were analyzed.Results:Among 39 patients identified,2 were lost to follow-up.A total of 37 patients were included,with a follow-up duration ranging from 6 months to 9 years.Hypomenorrhea was reported in 24(64.9%)patients,secondary amenorrhea in 10(27.0%)patients,and normal menstruation in 3(8.1%)patients.Most patients presented with primary infertility(59.5%),and only 2(5.4%)had secondary infertility.The median American Fertility Society(AFS)score at initial assessment was 10(range,8−12);8(21.6%)patients had moderate IUA,and 29(78.4%)had severe IUA.A total of 86 surgical procedures were performed across 37 patients,with 27 patients undergoing 2 or more surgeries.Postoperatively,25(67.6%)patients achieved normalization of the uterine cavity,while 12(32.4%)still had a reduced cavity.Only 7(18.9%)patients had a grossly normal endometrium at the final surgery,all of whom had moderate adhesions at the initial procedure.Menstrual flow returned to normal in 12(32.4%)patients,while 25(67.6%)continued to experience hypomenorrhea.Of 29 patients who attempted in vitro fertilization and embryo transfer(IVF-ET),only 6(20.7%)conceived.Among these,4(13.8%)delivered at term via cesarean section;one case was complicated by postpartum hemorrhage due to uterine atony and another by placental adhesion.Conclusion:Endometrial tuberculosis can lead to severe IUA.Hysteroscopic adhesiolysis facilitates cavity restoration and improvement of menstrual conditions,but the overall reproductive outcomes remain suboptimal.展开更多
Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of pregnancy.GDM is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,...Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of pregnancy.GDM is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,and neurological disorders.Recent investigations have focused on the correlation of genetic factors such asβ-cell function and insulin secretary genes(transcription factor 7 like 2,potassium voltage-gated channel subfamily q member 1,adipo-nectin etc.)on maternal metabolism during gestation leading to GDM.Epigenetic alterations like DNA methylation,histone modification,and miRNA expression can influence gene expression and play a dominant role in feto-maternal meta-bolic pathways.Interactions between genes and environment,resulting in differ-ential gene expression patterns may lead to GDM.Researchers suggested that GDM women are more susceptible to insulin resistance,which alters intrauterine surroundings,resulting hyperglycemia and hyperinsulinemia.Epigenetic modi-fications in genes affecting neuroendocrine activities,and metabolism,increase the risk of obesity and type 2 diabetes in offspring.There is currently no treatment or effective preventive method for GDM,since the molecular processes of insulin resistance are not well understood.The present review was undertaken to un-derstand the pathophysiology of GDM and its effects on adverse neonatal out-comes.In addition,the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.展开更多
BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time ...BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.展开更多
BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical...BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.展开更多
Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or force...Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.展开更多
This study investigates the effects of AI-mediated communication (AMC) on trust-building and negotiation outcomes in professional remote collaboration settings. Through a mixed-methods approach combining experimental ...This study investigates the effects of AI-mediated communication (AMC) on trust-building and negotiation outcomes in professional remote collaboration settings. Through a mixed-methods approach combining experimental design and qualitative analysis (N = 120), we examine how AI intermediaries influence communication dynamics, relationship building, and decision-making processes. Results indicate that while AMC initially creates barriers to trust formation, it ultimately leads to enhanced communication outcomes and stronger professional relationships when implemented with appropriate transparency and support. The study revealed a 31% improvement in cross-cultural understanding and a 24% increase in negotiation satisfaction rates when using AI-mediated channels with proper transparency measures. These findings contribute to the theoretical understanding of technology-mediated communication and practical applications for organizations implementing AI communication tools.展开更多
This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic vitrectomy.Specifically,they synthesized current knowledge and evaluated the efficacy of various ...This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic vitrectomy.Specifically,they synthesized current knowledge and evaluated the efficacy of various adjunctive therapies in improving the outcomes of diabetic retinopathy and managing associated complications.Herein,we highlight the key roles of pharmacological adjuvants in optimizing surgical techniques,minimizing intraoperative challenges,and enhancing postoperative recovery.We further discuss the potential implications of this approach for clinical practice and future research directions in this evolving field.Overall,this editorial underscores the importance of incorporating pharmacological adjuvants into standard diabetic vitrectomy care to improve surgical outcomes and thus patients’quality of life.展开更多
Chinese President Xi Jinping calls for honoring history to preserve peace,as the country commemorates the 80th anniversary of its hard-won victory in WWII.
BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with si...BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.展开更多
“The blood-washed film will never lie.”When that line was spoken in Dead to Rights,the cinema seemed frozen in a deeper silence than I had ever experienced.It pierced the air with a truth that could not be softened,...“The blood-washed film will never lie.”When that line was spoken in Dead to Rights,the cinema seemed frozen in a deeper silence than I had ever experienced.It pierced the air with a truth that could not be softened,and I felt my chest tighten as if the words had been spoken directly to me.At that moment,I was not merely a spectator of a film,but a witness called to remember.The trembling voice of the actor,the stark finality of the line-it overwhelmed me with an emotion too heavy for words,a blend of grief,anger,and responsibility.展开更多
Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 an...Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.展开更多
Over 70 years ago,China proposed the Five Principles of Peaceful Coexistence,which were first embraced by countries such as Myanmar and gradually gained traction across Asia.The Five Principles eventually became widel...Over 70 years ago,China proposed the Five Principles of Peaceful Coexistence,which were first embraced by countries such as Myanmar and gradually gained traction across Asia.The Five Principles eventually became widely recognized norms in international relations and foundational principles of international law,contributing significantly to the post-World War II international order.Decades on,the Five Principles have not faded into history.Rather,they have demonstrated renewed relevance in today’s complex global landscape.展开更多
Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was e...Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was employed, involving 60 pregnant women with GDM who were purposively selected and randomly allocated into experimental and control groups, each comprising 30 participants. The experimental group received comprehensive nursing interventions and pregnancy monitoring, while the control group received standard nursing care. Data collection was conducted using demographic questionnaires, pregnancy indicators, and maternal-infant outcome measurement tools. The collected data were analyzed using Microsoft Excel and the Statistical Package for Social Sciences (SPSS). Results: The findings indicated significant improvements in fasting blood glucose, postprandial blood glucose, amniotic fluid index, and neonatal birth weight in the experimental group compared to the control group. However, no statistically significant differences were observed in body mass index (BMI) or pregnancy weight gain. Comprehensive nursing interventions were associated with a significant reduction in maternal complications, including polyhydramnios, postpartum hemorrhage, and preeclampsia, as well as neonatal complications such as neonatal pneumonia, macrosomia, and hypoglycemia. Conclusion: Comprehensive nursing interventions have a positive impact on maternal and neonatal outcomes in pregnant women with GDM.展开更多
The African continent habituated with volatile conflicts and protracted violence,be it intra-state or inter-state is also acquainted with multi-ethnic tensions breeding different militias.The trend,although not new,is...The African continent habituated with volatile conflicts and protracted violence,be it intra-state or inter-state is also acquainted with multi-ethnic tensions breeding different militias.The trend,although not new,is the expanding phenomenon of Jihadism and general terrorism.Some of these and other forms of conflicts summarize the geopolitics of Africa’s Great Lakes Region(AGLR).The bloodbath wherein the subregion engrosses itself is not solely guided by political considerations.Both endogenous and exogenous capitalist economic profit have stirred the system while ethnic politics and politics on ethnic leanings have amplified the scenario.The endeavors of both the international community and regional blocs appear deficient-a consequence of the frailty of the UN system and general multilateralism.Peace is possible for AGLR when humanity is placed over the tidal wave of capitalist profit,patriotism over toxic ethnicity and respect is accorded to international jurisprudence emblemed by the bona fide principle of pacta sunt Servanda,without neglecting the capacity of the youth and peace education.展开更多
BACKGROUND Outcomes of early breast cancer in African women are currently not well defined.AIM To analyze survival outcomes and prognostic factors in Moroccan women with operable breast cancer treated with multimodal ...BACKGROUND Outcomes of early breast cancer in African women are currently not well defined.AIM To analyze survival outcomes and prognostic factors in Moroccan women with operable breast cancer treated with multimodal therapies.METHODS We retrospectively analyzed the data of a large cohort of 400 patients diagnosed with nonmetastatic breast cancer who completed surgery,chemotherapy,and radiotherapy at the National Institute of Oncology in Rabat,from January 2001 to December 2003.RESULTS The mean age at diagnosis was 45 years(range:22-91 years).Surgery was performed in all cases:Mastectomy in 86%and breast-conserving surgery in 14%.Most tumors(>87%)were classified as pathologic T2 stage or higher,and axillary lymph nodes were involved in 75.5%of cases.Ninety-five percent of patients completed six cycles of adjuvant chemotherapy,and all received radiotherapy.At a median follow-up of 74.5 months,the 5-year overall survival(OS)was 82.1%[95%confidence interval(CI):78.1-86.3],and the 5-year disease-free survival was 78.1%(95%CI:73.8-82.6).In univariate analysis,negative nodal status[pN-vs pN+,hazard ratio(HR)=0.34,95%CI:0.16-0.75;P=0.007]and lower American Joint Committee on Cancer(AJCC)stage(Ⅰ-ⅡvsⅢ,HR=0.29,95%CI:0.16-0.52;P<0.001)were significantly associated with better OS.In multivariate analysis,AJCC stageⅠ-Ⅱvs stageⅢremained the strongest predictor of improved OS(HR=0.32,95%CI:0.15-0.67;P=0.002),followed by treatment with anthracyclines vs cyclophosphamide,methotrexate,fluorouracil(CMF;HR=0.58,95%CI:0.35-0.94;P=0.027).CONCLUSION Moroccan women with early breast cancer exhibited more aggressive disease compared to women in high-income countries.AJCC stageⅢwas the strongest predictor of poorer OS,followed by chemotherapy regimen(CMF vs anthracycline).A multimodal treatment approach,including surgery,systemic therapy,and radiotherapy,is essential to improve breast cancer outcomes.展开更多
Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data dat...Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.展开更多
This editorial discusses a recent article published by Li et al in 2024,which highlights a critical yet underexplored dimension of chronic wound care:The impact of psychological factors such as depression and anxiety ...This editorial discusses a recent article published by Li et al in 2024,which highlights a critical yet underexplored dimension of chronic wound care:The impact of psychological factors such as depression and anxiety on treatment outcomes.With the increasing prevalence of chronic wounds in China,driven by population aging,traffic accidents,and chronic diseases,chronic wounds have emerged as a significant public health concern.They not only pose serious threats to individual health but also impose considerable social and economic burdens on healthcare systems.Against this backdrop,the study by Li et al aimed to explore how psychological distress affects the management and recovery of patients with chronic wounds.In their research,chronic wound patients were meticulously evaluated for depression and anxiety using validated psychological assessment scales and blood biomarkers.The findings reveal a stark reality:Individuals with severe depression and anxiety exhibit markedly lower treatment adherence,slower recovery rates,and diminished post-treatment quality of life.These psychological challenges hinder patients’active engagement with their care plans and may directly impede physiological healing processes.Importantly,the study underscored that factors such as wound size,anxiety,and depression significantly influence therapeutic outcomes in chronic wound patients.This insight calls for a more holistic approach to wound care,where addressing psychological well-being becomes an integral component of treatment protocols.As such,the study highlighted the necessity of early identification and targeted intervention for depression and anxiety in chronic wound patients. By prioritizing psychological support alongside medicaltreatment, healthcare providers can enhance therapeutic efficacy and improve patients’ long-term quality of life.This integrative approach can not only optimize clinical outcomes but also alleviate the broader societal andeconomic impact of chronic wounds.展开更多
Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision ...Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision of care,outcomes,or patient population.We aimed to elucidate potential differences in demographics,outcomes,and minimally invasive surgery utilization for SCP performed by urology and gynecology.Methods:In our retrospective analysis,sacrocolpopexies were identified using the American College of Surgeons National Surgical Quality Improvement Project database from 2006–2020.Pearson’s chi-square test was performed to test trends in the utilization of MIS in five-year blocks.Frailty was calculated using the NSQIP modified frailty index and the revised surgical Risk Analysis Index.Univariate analysis was performed using Student’s t-test and Pearson’s chi-square to compare operative parameters,frailty,demographics,and outcomes.Results:We identified 8944 sacrocolpopexies.Gynecology performed 81%of cases while urology performed the remaining 19%(p<0.001).Between the specialties,there were no significant differences in outcomes,minor or major complications,or 30-day reoperations/hospital readmissions/mortality.However,urologists tended to care for patients who were older(65 vs.61 years,p<0.001)and frailer by both frailty indices(p<0.001).Conclusion:Case distributions have remained stable,with gynecologists four-fold more sacrocolpopexies,in keeping with the larger number of practicing gynecologists vs.urologists.There was no difference in 30-day outcomes between both specialties.However,urologists operated on older,more frail patients.展开更多
On September 3,2025,heads turned to Beijing for a grand military parade marking the 80th anniversary of the victory in the Chinese People’s War of Resistance Against Japanese Aggression and the World Anti-Fascist War...On September 3,2025,heads turned to Beijing for a grand military parade marking the 80th anniversary of the victory in the Chinese People’s War of Resistance Against Japanese Aggression and the World Anti-Fascist War.Such events often highlight military strength,but this commemoration sought to project a deeper message:remembrance of sacrifice,recognition of the immense costs of conflict,and a renewed commitment to peace.展开更多
BACKGROUND:Sepsis may increase the risk of long-term cardiovascular outcomes.This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.METHODS:We c...BACKGROUND:Sepsis may increase the risk of long-term cardiovascular outcomes.This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.METHODS:We conducted a comprehensive systematic search of MEDLINE,EMBASE,the Cochrane Library,Wanfang,and CNKI from database inception through May 2025,without language restrictions.The primary outcome was a composite of myocardial infarction,stroke,congestive heart failure,or cardiovascular death.To evaluate the association between sepsis survivors and cardiovascular outcomes,we calculated cumulative incidence rates and hazard ratios(HRs)with corresponding 95%confi dence intervals(95%CIs).RESULTS:Twenty-fi ve observational studies comprising 7,525,271 participants were included.The pooled cumulative incidence of major cardiovascular events was 9.0%(95%CI:6.1%-11.9%),myocardial infarction 2.4%(95%CI:1.6%-3.1%),stroke 4.9%(95%CI:3.8%-6.1%),and congestive heart failure 8.6%(95%CI:4.6%-12.6%).Compared with non-sepsis controls,sepsis survivors had a signifi cantly higher risk of major cardiovascular events(HR:1.54;95%CI:1.32-1.79),myocardial infarction(HR:1.41;95%CI:1.29-1.54),stroke(HR:1.45;95%CI:1.32-1.60),and congestive heart failure(HR:1.51;95%CI:1.46-1.56).Risk factors associated with increased cardiovascular events in sepsis survivors included age≤45 years,male,hyperlipidemia,and multiple comorbidities.CONCLUSION:Adult sepsis survivors may face significantly increased risks of long-term cardiovascular outcomes.Both common cardiovascular risk factors and sepsis-related pathophysiological changes contribute to this association.展开更多
基金supported by the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hosipital of Central South University,China(YX202112).
文摘Objective:Endometrial tuberculosis,which commonly affects women of reproductive age,is a significant cause of intrauterine adhesions(IUA),potentially leading to hypomenorrhea,amenorrhea,and infertility.Hysteroscopic adhesiolysis is the primary treatment for IUA;however,studies specifically addressing its efficacy in tuberculosisinduced IUA remain scarce.This study aims to evaluate the therapeutic outcomes of hysteroscopic adhesiolysis for IUA caused by endometrial tuberculosis.Methods:This retrospective cohort study included patients diagnosed with tuberculosisinduced IUA who underwent hysteroscopic adhesiolysis at the Third Xiangya Hospital of Central South University between May 2014 and October 2022.Clinical data including age,medical history,adhesion severity,surgical treatment,and reproductive outcomes were analyzed.Results:Among 39 patients identified,2 were lost to follow-up.A total of 37 patients were included,with a follow-up duration ranging from 6 months to 9 years.Hypomenorrhea was reported in 24(64.9%)patients,secondary amenorrhea in 10(27.0%)patients,and normal menstruation in 3(8.1%)patients.Most patients presented with primary infertility(59.5%),and only 2(5.4%)had secondary infertility.The median American Fertility Society(AFS)score at initial assessment was 10(range,8−12);8(21.6%)patients had moderate IUA,and 29(78.4%)had severe IUA.A total of 86 surgical procedures were performed across 37 patients,with 27 patients undergoing 2 or more surgeries.Postoperatively,25(67.6%)patients achieved normalization of the uterine cavity,while 12(32.4%)still had a reduced cavity.Only 7(18.9%)patients had a grossly normal endometrium at the final surgery,all of whom had moderate adhesions at the initial procedure.Menstrual flow returned to normal in 12(32.4%)patients,while 25(67.6%)continued to experience hypomenorrhea.Of 29 patients who attempted in vitro fertilization and embryo transfer(IVF-ET),only 6(20.7%)conceived.Among these,4(13.8%)delivered at term via cesarean section;one case was complicated by postpartum hemorrhage due to uterine atony and another by placental adhesion.Conclusion:Endometrial tuberculosis can lead to severe IUA.Hysteroscopic adhesiolysis facilitates cavity restoration and improvement of menstrual conditions,but the overall reproductive outcomes remain suboptimal.
基金Supported by Maulana Azad National Fellowship,University Grants Commission,New Delhi,and Department of Biotechnology,New Delhi,No.AS[82-27/2019(SA III)]DBT-BUILDER-University of Lucknow Interdisciplinary Life Science Programme for Advance Research and Education(Level II),No.TG(BT/INF/22/SP47623/2022).
文摘Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of pregnancy.GDM is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,and neurological disorders.Recent investigations have focused on the correlation of genetic factors such asβ-cell function and insulin secretary genes(transcription factor 7 like 2,potassium voltage-gated channel subfamily q member 1,adipo-nectin etc.)on maternal metabolism during gestation leading to GDM.Epigenetic alterations like DNA methylation,histone modification,and miRNA expression can influence gene expression and play a dominant role in feto-maternal meta-bolic pathways.Interactions between genes and environment,resulting in differ-ential gene expression patterns may lead to GDM.Researchers suggested that GDM women are more susceptible to insulin resistance,which alters intrauterine surroundings,resulting hyperglycemia and hyperinsulinemia.Epigenetic modi-fications in genes affecting neuroendocrine activities,and metabolism,increase the risk of obesity and type 2 diabetes in offspring.There is currently no treatment or effective preventive method for GDM,since the molecular processes of insulin resistance are not well understood.The present review was undertaken to un-derstand the pathophysiology of GDM and its effects on adverse neonatal out-comes.In addition,the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.
文摘BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.
文摘BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.
文摘Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.
文摘This study investigates the effects of AI-mediated communication (AMC) on trust-building and negotiation outcomes in professional remote collaboration settings. Through a mixed-methods approach combining experimental design and qualitative analysis (N = 120), we examine how AI intermediaries influence communication dynamics, relationship building, and decision-making processes. Results indicate that while AMC initially creates barriers to trust formation, it ultimately leads to enhanced communication outcomes and stronger professional relationships when implemented with appropriate transparency and support. The study revealed a 31% improvement in cross-cultural understanding and a 24% increase in negotiation satisfaction rates when using AI-mediated channels with proper transparency measures. These findings contribute to the theoretical understanding of technology-mediated communication and practical applications for organizations implementing AI communication tools.
文摘This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic vitrectomy.Specifically,they synthesized current knowledge and evaluated the efficacy of various adjunctive therapies in improving the outcomes of diabetic retinopathy and managing associated complications.Herein,we highlight the key roles of pharmacological adjuvants in optimizing surgical techniques,minimizing intraoperative challenges,and enhancing postoperative recovery.We further discuss the potential implications of this approach for clinical practice and future research directions in this evolving field.Overall,this editorial underscores the importance of incorporating pharmacological adjuvants into standard diabetic vitrectomy care to improve surgical outcomes and thus patients’quality of life.
文摘Chinese President Xi Jinping calls for honoring history to preserve peace,as the country commemorates the 80th anniversary of its hard-won victory in WWII.
文摘BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.
文摘“The blood-washed film will never lie.”When that line was spoken in Dead to Rights,the cinema seemed frozen in a deeper silence than I had ever experienced.It pierced the air with a truth that could not be softened,and I felt my chest tighten as if the words had been spoken directly to me.At that moment,I was not merely a spectator of a film,but a witness called to remember.The trembling voice of the actor,the stark finality of the line-it overwhelmed me with an emotion too heavy for words,a blend of grief,anger,and responsibility.
文摘Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.
基金phased achievement of the Yunnan Provincial Philosophy and Social Sciences Innovation Team project titled Research on Ethnic Issues and Their Impact in Northern Myanmar(No.2025CX09).
文摘Over 70 years ago,China proposed the Five Principles of Peaceful Coexistence,which were first embraced by countries such as Myanmar and gradually gained traction across Asia.The Five Principles eventually became widely recognized norms in international relations and foundational principles of international law,contributing significantly to the post-World War II international order.Decades on,the Five Principles have not faded into history.Rather,they have demonstrated renewed relevance in today’s complex global landscape.
文摘Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was employed, involving 60 pregnant women with GDM who were purposively selected and randomly allocated into experimental and control groups, each comprising 30 participants. The experimental group received comprehensive nursing interventions and pregnancy monitoring, while the control group received standard nursing care. Data collection was conducted using demographic questionnaires, pregnancy indicators, and maternal-infant outcome measurement tools. The collected data were analyzed using Microsoft Excel and the Statistical Package for Social Sciences (SPSS). Results: The findings indicated significant improvements in fasting blood glucose, postprandial blood glucose, amniotic fluid index, and neonatal birth weight in the experimental group compared to the control group. However, no statistically significant differences were observed in body mass index (BMI) or pregnancy weight gain. Comprehensive nursing interventions were associated with a significant reduction in maternal complications, including polyhydramnios, postpartum hemorrhage, and preeclampsia, as well as neonatal complications such as neonatal pneumonia, macrosomia, and hypoglycemia. Conclusion: Comprehensive nursing interventions have a positive impact on maternal and neonatal outcomes in pregnant women with GDM.
文摘The African continent habituated with volatile conflicts and protracted violence,be it intra-state or inter-state is also acquainted with multi-ethnic tensions breeding different militias.The trend,although not new,is the expanding phenomenon of Jihadism and general terrorism.Some of these and other forms of conflicts summarize the geopolitics of Africa’s Great Lakes Region(AGLR).The bloodbath wherein the subregion engrosses itself is not solely guided by political considerations.Both endogenous and exogenous capitalist economic profit have stirred the system while ethnic politics and politics on ethnic leanings have amplified the scenario.The endeavors of both the international community and regional blocs appear deficient-a consequence of the frailty of the UN system and general multilateralism.Peace is possible for AGLR when humanity is placed over the tidal wave of capitalist profit,patriotism over toxic ethnicity and respect is accorded to international jurisprudence emblemed by the bona fide principle of pacta sunt Servanda,without neglecting the capacity of the youth and peace education.
文摘BACKGROUND Outcomes of early breast cancer in African women are currently not well defined.AIM To analyze survival outcomes and prognostic factors in Moroccan women with operable breast cancer treated with multimodal therapies.METHODS We retrospectively analyzed the data of a large cohort of 400 patients diagnosed with nonmetastatic breast cancer who completed surgery,chemotherapy,and radiotherapy at the National Institute of Oncology in Rabat,from January 2001 to December 2003.RESULTS The mean age at diagnosis was 45 years(range:22-91 years).Surgery was performed in all cases:Mastectomy in 86%and breast-conserving surgery in 14%.Most tumors(>87%)were classified as pathologic T2 stage or higher,and axillary lymph nodes were involved in 75.5%of cases.Ninety-five percent of patients completed six cycles of adjuvant chemotherapy,and all received radiotherapy.At a median follow-up of 74.5 months,the 5-year overall survival(OS)was 82.1%[95%confidence interval(CI):78.1-86.3],and the 5-year disease-free survival was 78.1%(95%CI:73.8-82.6).In univariate analysis,negative nodal status[pN-vs pN+,hazard ratio(HR)=0.34,95%CI:0.16-0.75;P=0.007]and lower American Joint Committee on Cancer(AJCC)stage(Ⅰ-ⅡvsⅢ,HR=0.29,95%CI:0.16-0.52;P<0.001)were significantly associated with better OS.In multivariate analysis,AJCC stageⅠ-Ⅱvs stageⅢremained the strongest predictor of improved OS(HR=0.32,95%CI:0.15-0.67;P=0.002),followed by treatment with anthracyclines vs cyclophosphamide,methotrexate,fluorouracil(CMF;HR=0.58,95%CI:0.35-0.94;P=0.027).CONCLUSION Moroccan women with early breast cancer exhibited more aggressive disease compared to women in high-income countries.AJCC stageⅢwas the strongest predictor of poorer OS,followed by chemotherapy regimen(CMF vs anthracycline).A multimodal treatment approach,including surgery,systemic therapy,and radiotherapy,is essential to improve breast cancer outcomes.
文摘Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.
基金Supported by Research Project of Nantong Health and Health Commission,No.MS2023041 and No.MA2021017Science and Technology Program of Nantong City,No.Key03 and No.JCZ2022040+1 种基金Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,and No.KD2022KYJJZD022Nantong Young Medical Expert,No.46.
文摘This editorial discusses a recent article published by Li et al in 2024,which highlights a critical yet underexplored dimension of chronic wound care:The impact of psychological factors such as depression and anxiety on treatment outcomes.With the increasing prevalence of chronic wounds in China,driven by population aging,traffic accidents,and chronic diseases,chronic wounds have emerged as a significant public health concern.They not only pose serious threats to individual health but also impose considerable social and economic burdens on healthcare systems.Against this backdrop,the study by Li et al aimed to explore how psychological distress affects the management and recovery of patients with chronic wounds.In their research,chronic wound patients were meticulously evaluated for depression and anxiety using validated psychological assessment scales and blood biomarkers.The findings reveal a stark reality:Individuals with severe depression and anxiety exhibit markedly lower treatment adherence,slower recovery rates,and diminished post-treatment quality of life.These psychological challenges hinder patients’active engagement with their care plans and may directly impede physiological healing processes.Importantly,the study underscored that factors such as wound size,anxiety,and depression significantly influence therapeutic outcomes in chronic wound patients.This insight calls for a more holistic approach to wound care,where addressing psychological well-being becomes an integral component of treatment protocols.As such,the study highlighted the necessity of early identification and targeted intervention for depression and anxiety in chronic wound patients. By prioritizing psychological support alongside medicaltreatment, healthcare providers can enhance therapeutic efficacy and improve patients’ long-term quality of life.This integrative approach can not only optimize clinical outcomes but also alleviate the broader societal andeconomic impact of chronic wounds.
文摘Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision of care,outcomes,or patient population.We aimed to elucidate potential differences in demographics,outcomes,and minimally invasive surgery utilization for SCP performed by urology and gynecology.Methods:In our retrospective analysis,sacrocolpopexies were identified using the American College of Surgeons National Surgical Quality Improvement Project database from 2006–2020.Pearson’s chi-square test was performed to test trends in the utilization of MIS in five-year blocks.Frailty was calculated using the NSQIP modified frailty index and the revised surgical Risk Analysis Index.Univariate analysis was performed using Student’s t-test and Pearson’s chi-square to compare operative parameters,frailty,demographics,and outcomes.Results:We identified 8944 sacrocolpopexies.Gynecology performed 81%of cases while urology performed the remaining 19%(p<0.001).Between the specialties,there were no significant differences in outcomes,minor or major complications,or 30-day reoperations/hospital readmissions/mortality.However,urologists tended to care for patients who were older(65 vs.61 years,p<0.001)and frailer by both frailty indices(p<0.001).Conclusion:Case distributions have remained stable,with gynecologists four-fold more sacrocolpopexies,in keeping with the larger number of practicing gynecologists vs.urologists.There was no difference in 30-day outcomes between both specialties.However,urologists operated on older,more frail patients.
文摘On September 3,2025,heads turned to Beijing for a grand military parade marking the 80th anniversary of the victory in the Chinese People’s War of Resistance Against Japanese Aggression and the World Anti-Fascist War.Such events often highlight military strength,but this commemoration sought to project a deeper message:remembrance of sacrifice,recognition of the immense costs of conflict,and a renewed commitment to peace.
基金supported by Zhejiang Province Medical and Health Science and Technology Plan Project(2022KY241)Hangzhou Health Science and Technology Plan Project(ZD20230017).
文摘BACKGROUND:Sepsis may increase the risk of long-term cardiovascular outcomes.This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.METHODS:We conducted a comprehensive systematic search of MEDLINE,EMBASE,the Cochrane Library,Wanfang,and CNKI from database inception through May 2025,without language restrictions.The primary outcome was a composite of myocardial infarction,stroke,congestive heart failure,or cardiovascular death.To evaluate the association between sepsis survivors and cardiovascular outcomes,we calculated cumulative incidence rates and hazard ratios(HRs)with corresponding 95%confi dence intervals(95%CIs).RESULTS:Twenty-fi ve observational studies comprising 7,525,271 participants were included.The pooled cumulative incidence of major cardiovascular events was 9.0%(95%CI:6.1%-11.9%),myocardial infarction 2.4%(95%CI:1.6%-3.1%),stroke 4.9%(95%CI:3.8%-6.1%),and congestive heart failure 8.6%(95%CI:4.6%-12.6%).Compared with non-sepsis controls,sepsis survivors had a signifi cantly higher risk of major cardiovascular events(HR:1.54;95%CI:1.32-1.79),myocardial infarction(HR:1.41;95%CI:1.29-1.54),stroke(HR:1.45;95%CI:1.32-1.60),and congestive heart failure(HR:1.51;95%CI:1.46-1.56).Risk factors associated with increased cardiovascular events in sepsis survivors included age≤45 years,male,hyperlipidemia,and multiple comorbidities.CONCLUSION:Adult sepsis survivors may face significantly increased risks of long-term cardiovascular outcomes.Both common cardiovascular risk factors and sepsis-related pathophysiological changes contribute to this association.
