AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(...AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.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
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
The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presu...The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.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
BACKGROUND Thyroid cancer is a common malignancy,often found in women.It is the second most common malignant tumor,second only to breast cancer,and it most frequently occurs as papillary thyroid carcinoma(PTC),represe...BACKGROUND Thyroid cancer is a common malignancy,often found in women.It is the second most common malignant tumor,second only to breast cancer,and it most frequently occurs as papillary thyroid carcinoma(PTC),representing over 90%of cases.PTC frequently presents with lymph node metastases,though in rare cases,patients may experience dysphagia,dyspnea,or hoarseness.In PTC and other differentiated thyroid cancers,direct invasion into major local veins is uncommon,and simultaneous involvement of the vagus nerve is even rarer.Herein,we report a case involving a 50-year-old male patient with a complete invasion of the vagus nerve and the internal jugular vein.CASE SUMMARY A 50-year-old male discovered a mass on the left side of his neck one year ago.Initially,the mass was approximately 3 cm,but it gradually grew to approximately 6.5 cm in the past month and caused hoarseness.There is no family history of note.On physical examination,a firm,non-tender mass approximately 6.5 cm in diameter was palpated along the lateral border of the left sternocleidomastoid muscle.The mass was irregular in shape,immobile,and did not move with swallowing.The patient has a 5-year history of hypertension with hypokalemia controlled with oral antihypertensive medications(nifedipine and spironolactone).His blood pressure has been maintained between 165-185/112-132 mmHg,and he often reports dizziness.Upon hospitalization,he was diagnosed with primary hyperaldosteronism.Ultrasound-guided fine needle aspiration biopsy of the left neck mass was performed,and the pathology report confirmed a diagnosis of PTC,with a clinical diagnosis of left-sided metastatic PTC.CONCLUSION The postoperative survival rate for PTC patients is generally good.If clinical signs suggest PTC with recurrent laryngeal nerve involvement,fiberoptic laryngoscopy should be conducted to assess the vocal cords,and intraoperative nerve monitoring is crucial.Preoperative evaluation of the involvement of major neck blood vessels is necessary.Therefore,surgeons should examine signs of large vein damage,as vascular resection and repair or reconstruction are often required.Surgery should be the first choice for differentiated thyroid cancer and radioactive iodine treatment(I-131)should be administered to patients with extrathyroidal invasion or metastasis following total thyroidectomy,followed by TSH suppression therapy.展开更多
BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for...BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.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:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This st...Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This study investigated the current state and predictors of such participation during this critical period.Methods:A cross-sectional study was conducted among older adults discharged from two tertiary hospitals in Fujian,China(October-December 2023).Data were collected using a general information questionnaire,a self-developed behavior scale,the Health Literacy Management Scale,General Self-Efficacy Scale,Facilitation of Patient Involvement Scale,and Family Support Scale.Analyses included ANOVA,Pearson correlation,and multiple stepwise regression.Results:Among 302 valid responses,the mean score for participation in medication safety behaviors was 68.59±11.62,indicating a moderate level.Health literacy,self-efficacy,healthcare worker support,and family support were positively correlated with participation(all P<0.01).Multiple regression identified daily medication frequency,health literacy,self-efficacy,and healthcare worker support as significant predictors,explaining 18.3%of the variance.Conclusion:Participation in medication safety among older chronic disease patients during care transitions requires improvement.Enhancing health literacy,self-efficacy,and healthcare worker support,while considering medication frequency,can promote patient involvement and medication safety.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
BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection(TBAD),significantly impacting long-term survival.Accurate ...BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection(TBAD),significantly impacting long-term survival.Accurate risk prediction is essential for optimized clinical management.AIM To develop and validate a logistic regression-based risk prediction model for aortic adverse remodeling following TEVAR in patients with TBAD.METHODS This retrospective observational cohort study analyzed 140 TBAD patients undergoing TEVAR at a tertiary center(2019–2024).Based on European guidelines,patients were categorized into adverse remodeling(aortic growth rate>2.9 mm/year,n=45)and favorable remodeling groups(n=95).Comprehensive variables(clinical/imaging/surgical)were analyzed using multivariable logistic regression to develop a predictive model.Model performance was assessed via receiver operating characteristic-area under the curve(AUC)and Hosmer-Lemeshow tests.RESULTS Multivariable analysis identified several strong independent predictors of negative aortic remodeling.Larger false lumen diameter at the primary entry tear[odds ratio(OR):1.561,95%CI:1.197–2.035;P=0.001]and patency of the false lumen(OR:5.639,95%CI:4.372-8.181;P=0.004)were significant risk factors.False lumen involvement extending to the thoracoabdominal aorta was identified as the strongest predictor,significantly increasing the risk of adverse remodeling(OR:11.751,95%CI:9.841-15.612;P=0.001).Conversely,false lumen involvement confined to the thoracic aorta demonstrated a significant protective effect(OR:0.925,95%CI:0.614–0.831;P=0.015).The prediction model exhibited excellent discrimination(AUC=0.968)and calibration(Hosmer-Lemeshow P=0.824).CONCLUSION This validated risk prediction model identifies aortic adverse remodeling with high accuracy using routinely available clinical parameters.False lumen involvement thoracoabdominal aorta is the strongest predictor(11.751-fold increased risk).The tool enables preoperative risk stratification to guide tailored TEVAR strategies and improve long-term outcomes.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
A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally ...A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.展开更多
文摘AIM:To report and analyze cases of sterile intraocular inflammation(IOI)following intravitreal faricimab injections in patients treated for neovascular age-related macular degeneration(nAMD)and diabetic macular edema(DME).METHODS:This double-center case series included nine eyes of six patients who developed uveitis after faricimab therapy.Comprehensive clinical evaluation was performed,including slit-lamp examination,intraocular pressure(IOP)measurement,fluorescein and indocyanine green angiography(ICGA),and laboratory tests.Inflammatory responses were treated with topical or systemic corticosteroids,and patients were monitored for visual acuity and inflammatory activity.RESULTS:The incidence of IOI was 0.8%per patient(Innsbruck)and 0.23%(Czechia),with inflammation typically occurring between the third and sixth injection(mean interval:10d post-injection).Inflammator y presentations ranged from anterior uveitis to posterior segment involvement.One notable case demonstrated novel choroidal hypofluorescent lesions on angiography,suggesting deeper ocular involvement.The mean patient age was 76y;five of six affected patients were female.All cases responded to local and systemic corticosteroids,with full recovery of initial visual acuity.CONCLUSION:Sterile IOI after faricimab appears to be a rare but relevant adverse event.Although the incidence falls within expected ranges for anti-vascular endothelial growth factor(anti-VEGF)agents,the observed choroidal involvement represents a potentially new safety signal.Prompt diagnosis and corticosteroid therapy are effective in all cases.Our findings support the need for vigilant post-marketing surveillance and further studies to better understand the underlying mechanisms and risk factors of faricimab-associated inflammation.
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.
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.
基金Supported by the National Natural Science Foundation of China(No.82271063No.82471054)Central Guidance for Local Scientific and Technological Development Funding Projects(No.2024ZY01057).
文摘The immune system is involved in many age-related pathological changes,also plays an important role in tissue regeneration after injury.But no immune involvement has been discussed regarding cataract since it is presumed that lens has no source of immune cells as an avascular zone.Latest research has challenged the longstanding view of the lens as an immune-privileged tissue,revealing the presence of resident immune cells and active immune responses within the lens.Thus,we summarized the immune involvement in maintaining lens homeostasis,which may be a deleterious role in the induction of lens opacification if inappropriately activated.Furthermore,bioengineer-based immunomodulatory therapies to fine-tune the micro immune environment within lens may be future strategies for in situ lens regeneration,as a novel treatment for cataract.
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.
基金Supported by Sichuan Provincial Health and Health Commission Science and Technology Project(First Batch)Collaborative University-City Project,No.24WXXT06.
文摘BACKGROUND Thyroid cancer is a common malignancy,often found in women.It is the second most common malignant tumor,second only to breast cancer,and it most frequently occurs as papillary thyroid carcinoma(PTC),representing over 90%of cases.PTC frequently presents with lymph node metastases,though in rare cases,patients may experience dysphagia,dyspnea,or hoarseness.In PTC and other differentiated thyroid cancers,direct invasion into major local veins is uncommon,and simultaneous involvement of the vagus nerve is even rarer.Herein,we report a case involving a 50-year-old male patient with a complete invasion of the vagus nerve and the internal jugular vein.CASE SUMMARY A 50-year-old male discovered a mass on the left side of his neck one year ago.Initially,the mass was approximately 3 cm,but it gradually grew to approximately 6.5 cm in the past month and caused hoarseness.There is no family history of note.On physical examination,a firm,non-tender mass approximately 6.5 cm in diameter was palpated along the lateral border of the left sternocleidomastoid muscle.The mass was irregular in shape,immobile,and did not move with swallowing.The patient has a 5-year history of hypertension with hypokalemia controlled with oral antihypertensive medications(nifedipine and spironolactone).His blood pressure has been maintained between 165-185/112-132 mmHg,and he often reports dizziness.Upon hospitalization,he was diagnosed with primary hyperaldosteronism.Ultrasound-guided fine needle aspiration biopsy of the left neck mass was performed,and the pathology report confirmed a diagnosis of PTC,with a clinical diagnosis of left-sided metastatic PTC.CONCLUSION The postoperative survival rate for PTC patients is generally good.If clinical signs suggest PTC with recurrent laryngeal nerve involvement,fiberoptic laryngoscopy should be conducted to assess the vocal cords,and intraoperative nerve monitoring is crucial.Preoperative evaluation of the involvement of major neck blood vessels is necessary.Therefore,surgeons should examine signs of large vein damage,as vascular resection and repair or reconstruction are often required.Surgery should be the first choice for differentiated thyroid cancer and radioactive iodine treatment(I-131)should be administered to patients with extrathyroidal invasion or metastasis following total thyroidectomy,followed by TSH suppression therapy.
基金supported by the National High Level Hospital Clinical Research Funding(No.2024-GSP-TJ-15&No.2023-GSP-QN-17)the Chinese Society of Cardiology’s Foundation(CSCF2023B03).
文摘BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.
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.
基金supported by the Natural Science Foundation of Fujian Province,China(Grant No.2023J01133509)by The Key Projects on Civil Affairs Policy and Theory Research in Fujian Province(Grant No.FMZD202402).
文摘Background:Patient participation is crucial for medication safety among older adults with chronic diseases transitioning from hospital to home,yet evidence on its levels and influencing factors remains limited.This study investigated the current state and predictors of such participation during this critical period.Methods:A cross-sectional study was conducted among older adults discharged from two tertiary hospitals in Fujian,China(October-December 2023).Data were collected using a general information questionnaire,a self-developed behavior scale,the Health Literacy Management Scale,General Self-Efficacy Scale,Facilitation of Patient Involvement Scale,and Family Support Scale.Analyses included ANOVA,Pearson correlation,and multiple stepwise regression.Results:Among 302 valid responses,the mean score for participation in medication safety behaviors was 68.59±11.62,indicating a moderate level.Health literacy,self-efficacy,healthcare worker support,and family support were positively correlated with participation(all P<0.01).Multiple regression identified daily medication frequency,health literacy,self-efficacy,and healthcare worker support as significant predictors,explaining 18.3%of the variance.Conclusion:Participation in medication safety among older chronic disease patients during care transitions requires improvement.Enhancing health literacy,self-efficacy,and healthcare worker support,while considering medication frequency,can promote patient involvement and medication safety.
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.
基金Supported by Zhangjiajie"Xiao He(Young Talent)"Project,No.2024XHRC03Jishou University School-Level Research Project.
文摘BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection(TBAD),significantly impacting long-term survival.Accurate risk prediction is essential for optimized clinical management.AIM To develop and validate a logistic regression-based risk prediction model for aortic adverse remodeling following TEVAR in patients with TBAD.METHODS This retrospective observational cohort study analyzed 140 TBAD patients undergoing TEVAR at a tertiary center(2019–2024).Based on European guidelines,patients were categorized into adverse remodeling(aortic growth rate>2.9 mm/year,n=45)and favorable remodeling groups(n=95).Comprehensive variables(clinical/imaging/surgical)were analyzed using multivariable logistic regression to develop a predictive model.Model performance was assessed via receiver operating characteristic-area under the curve(AUC)and Hosmer-Lemeshow tests.RESULTS Multivariable analysis identified several strong independent predictors of negative aortic remodeling.Larger false lumen diameter at the primary entry tear[odds ratio(OR):1.561,95%CI:1.197–2.035;P=0.001]and patency of the false lumen(OR:5.639,95%CI:4.372-8.181;P=0.004)were significant risk factors.False lumen involvement extending to the thoracoabdominal aorta was identified as the strongest predictor,significantly increasing the risk of adverse remodeling(OR:11.751,95%CI:9.841-15.612;P=0.001).Conversely,false lumen involvement confined to the thoracic aorta demonstrated a significant protective effect(OR:0.925,95%CI:0.614–0.831;P=0.015).The prediction model exhibited excellent discrimination(AUC=0.968)and calibration(Hosmer-Lemeshow P=0.824).CONCLUSION This validated risk prediction model identifies aortic adverse remodeling with high accuracy using routinely available clinical parameters.False lumen involvement thoracoabdominal aorta is the strongest predictor(11.751-fold increased risk).The tool enables preoperative risk stratification to guide tailored TEVAR strategies and improve long-term outcomes.
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A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.
