In the context of Western medicine,Xin(心heart),Gan(肝liver),Pi(脾spleen),Fei(肺lung),and Shen(肾kidney)are five specific organs,while in ancient Chinese medicine,they are five kinds of Zang Xiang(藏象visceral manifes...In the context of Western medicine,Xin(心heart),Gan(肝liver),Pi(脾spleen),Fei(肺lung),and Shen(肾kidney)are five specific organs,while in ancient Chinese medicine,they are five kinds of Zang Xiang(藏象visceral manifestation),often referred to as Wu Zang(五藏five zang-organs),representing five interrelated structural-functional systems.There are both differences and connections between visceral manifestations and organs,which are reflected in the theories of Wu Zang.The specific connotation of Wu Zang are determined by the specific context in which they are located.With the accumulation of practice,the Wu Zang of the human body structures and functions,as well as the relationship between the Wu Zang have been in constant development and change.The encounter of Chinese and Western medicine in the 19th century dramatically changed the connotation of Wu Zang,from emphasizing visceral manifestations and neglecting substance to an organs-oriented perspective.This article examines how the encounter of Chinese and Western medicine in China influenced Chinese medicine.By analyzing three key aspects:(1)the interpretation of Wu Zang in pre-16th century texts;(2)the evolution and dissemination of Western medicine during the Ming and Qing dynasties;(3)the shifting conceptualization of Wu Zang in late Qing medical literature—the study elucidates the transformative impact of this cross-cultural medical encounter on the theory and practice of Chinese medicine.展开更多
Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous ma...Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous manifestations that may hold diagnostic and prognostic significance. Patients with BMES have reported localized erythema, dermal thickening, and induration overlying the affected joints, which are hypothesized to reflect microvascular compromise and inflammatory processes within the bone and adjacent soft tissues. Dermatologic signs are likely linked to regional hyperemia, venous stasis, and cytokine-mediated inflammation, paralleling the pathophysiological mechanisms underlying intraosseous edema. Elevated intraosseous pressure in BMES may disrupt local perfusion, resulting in ischemia-reperfusion injury and subsequent vascular leakage, which manifests in visible cutaneous changes. Pro-inflammatory mediators, such as interleukin-1β and vascular endothelial growth factor (VEGF), central to BMES pathogenesis, may exacerbate endothelial activation, and dermal involvement. Histopathologic studies of affected skin have revealed perivascular lymphocytic infiltration and increased dermal vascularity, further supporting the theory of a shared ischemic and inflammatory pathway between bone and skin. Although MRI remains the gold standard for BMES diagnosis, recognition of these cutaneous manifestations could expedite orthopedic referral and intervention, especially in cases where imaging is delayed or symptoms are ambiguous. Current treatment options, including bisphosphonates, prostacyclin analogs, and offloading of weight bearing, may benefit from integration with dermatologic strategies to alleviate localized cutaneous symptoms and improve patient comfort. Evaluating the molecular and vascular links between BMES and its cutaneous manifestations provides an opportunity to refine diagnostic protocols and therapeutic approaches, offering a comprehensive understanding of the systemic interplay between dermal and skeletal pathophysiology, and optimizing clinical outcomes for patients affected by BMES.展开更多
Adult Still's Disease(ASD)is a systemic inflammatory disorder of unknown etiology,thought to be triggered by infectious agents in genetically susceptible individuals,resulting in aberrant cytokine production inclu...Adult Still's Disease(ASD)is a systemic inflammatory disorder of unknown etiology,thought to be triggered by infectious agents in genetically susceptible individuals,resulting in aberrant cytokine production including interleukin(IL)−1,IL-6,AND IL-18.The disease severity varies and may include macrophage activation syndrome(mas),a potentially life-threatening complication.It is associated with seronegative chronic polyarthritis,predominantly affecting young individuals.It is a rare condition with a complex diagnosis due to its overlapping clinical features with more common diseases.展开更多
Pigs have emerged as valuable large-animal models for cardiac xenotransplantation;however,the temporal dynamics of myocardial development in this species remains insufficiently defined.This study analyzed gene express...Pigs have emerged as valuable large-animal models for cardiac xenotransplantation;however,the temporal dynamics of myocardial development in this species remains insufficiently defined.This study analyzed gene expression patterns across four key developmental stages(neonatal,juvenile,sexual maturity,and adulthood)to delineate the molecular mechanisms driving porcine myocardial development.Increases in heart weight were accompanied by proportional expansion of myocardial fiber area and chamber size,reflecting coordinated structural development.Transcriptomic profiling of myocardial tissue by RNA sequencing(RNA-seq)identified 2189 differentially expressed genes(DEGs)across stage comparisons.Short time-series expression miner(STEM)analysis classified these DEGs into four major expression clusters enriched in pathways associated with myocardial development,immune responses,cell proliferation,and metabolic processes.Among 359 DEGs conserved across all developmental stages,six candidate genes were strongly associated with myocardial development.Reverse transcription-quantitative real-time polymerase chain reaction(RT-qPCR)confirmed a significant correlation between the expression of these candidate genes and myocardial development in porcine tissue.These findings establish a transcriptomic framework for porcine myocardial maturation and provide a molecular basis for advancing cardiac xenotransplantation.展开更多
BACKGROUND Celiac disease(CD)is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals.It is more commonly diagnosed in children presenting typical clinical signs and symptom...BACKGROUND Celiac disease(CD)is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals.It is more commonly diagnosed in children presenting typical clinical signs and symptoms but most of the CD patients diagnosed in the developed world are silent cases with no prominent gastrointestinal features.Thus,there are silent forms of the disease in which oral manifestations are the first sign.In the pediatric population oral health can affect growth and self-esteem and have a negative impact in their life quality.AIM To assess the prevalence and types of oral manifestations in pediatric patients with CD.METHODS We performed a comprehensive literature search in PubMed,Scielo,Cochrane Library and Lilacs databases from 2014-2024.Three independent researchers screened and extracted the information,applying the eligibility criteria and bias was assessed using Joanna Briggs Institute tools.RESULTS Of the initial 241 articles,14 studies fulfilled the proposed objectives and were included in the review.The main oral manifestations found were recurrent aphthous stomatitis and enamel defects.Additionally,delayed tooth eruption,angular cheilitis,glossodynia and xerostomia were also reported.CONCLUSION Assessing oral manifestations is crucial,especially in underdiagnosed cases of children with CD.Recognizing these signs helps pediatricians or general practitioners identify them during routine exams,enabling early diagnosis and treatment to prevent negative impacts on the child’s and family’s quality of life.展开更多
BACKGROUND Hepatitis B virus(HBV)primarily causes hepatic inflammation and has various clinical manifestations.However,extrahepatic reactions,ranging from localized or systemic inflammation,may occur in some cases.Her...BACKGROUND Hepatitis B virus(HBV)primarily causes hepatic inflammation and has various clinical manifestations.However,extrahepatic reactions,ranging from localized or systemic inflammation,may occur in some cases.Here,we report a case of an acute exacerbation of chronic HBV infection with atypical extrahepatic mani-festation confined to the skin and mucosa despite nucleotide analog treatment,which was fully recovered on systemic steroid treatment.CASE SUMMARY A 53-year-old woman visited a clinic due to worsening skin rash and mucosal inflammation.She was receiving antiviral therapy due to a recent acute exacer-bation of chronic HBV infection.While liver function was improving with anti-viral treatment,skin rash and mucosal inflammatory lesions gradually worsened.Thus,blood tests and skin biopsy were performed to determine the cause.Despite a thorough review of serum markers and skin biopsy results,a concrete diagnosis revealing other etiology apart from the acute phase of HBV infection could not be established.The cutaneous lesions were considered a rare immunologic extrahe-patic manifestation of HBV,warranting systemic steroid treatment.Afterward,both skin and mucosal lesions rapidly improved,and the patient was discharged without any sequelae.CONCLUSION Clinicians should recognize mucocutaneous manifestations of chronic HBV,as systemic steroids may yield favorable outcomes.展开更多
Objective The clinical features,disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries.To reduce misdiagnosis and improve visual function,the clinical character...Objective The clinical features,disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries.To reduce misdiagnosis and improve visual function,the clinical characteristics,management and visual outcomes of 13 cases of ocular toxoplasmosis(OT)were described.Methods This retrospective study included 14 eyes of 13 patients who were diagnosed with OT in Hubei,China.The clinical characteristics,course of treatment and outcomes are presented.There were 7 males and 6 females.Results The main form of OT was retinochoroiditis with vitritis or anterior uveitis.Next-generation sequencing was applied to 3 eyes,and positive results were found in those eyes.Thirteen patients were positive for Toxoplasma gondii IgG antibodies,and 3 of them were also positive for IgM T.gondii antibodies.One patient with acquired immune deficiency syndrome was diagnosed with coinfection with OT and cytomegalovirus,as evidenced by an aqueous humor etiological test.Three patients were misdiagnosed with noninfectious uveitis.Recurrence occurred in 3 eyes during the follow-up periods.One patient who received vitreous implantation of Ozurdex therapy at another hospital before referral relapsed.One patient who received sulfadiazine,azithromycin and glucocorticoid therapy relapsed.One patient who received sulfadiazine therapy experienced relapse.Patients who received clindamycin and sulfadiazine or who received clindamycin only did not experience recurrence during the follow-up period.The best corrected visual acuity was improved in 6 eyes after inflammation resolved.Conclusions Primary active retinochoroiditis is the main form of OT in Hubei,China.Timely correct diagnosis on the basis of ocular characteristics and aetiological test results and effective treatment should be adopted to prevent poor visual outcomes and recurrence.展开更多
From the perspective of Xiang thinking(象思维imagery thinking),the application of Wu Xing(五行five elements)in traditional Chinese medicine(TCM)provides a reasonable cognitive model.Wu Xing with the earth in the cent...From the perspective of Xiang thinking(象思维imagery thinking),the application of Wu Xing(五行five elements)in traditional Chinese medicine(TCM)provides a reasonable cognitive model.Wu Xing with the earth in the center(中土五行)helps TCM establish extensive connections between the human body and the universe,while Wu Xing in the generating and conquering cycles(生克五行)incorporates everything into a systematic thinking framework through complex dialectical relationships,becoming an ideal cognitive tool for TCM diagnosis and treatment.In essence,Wu Xing represents an upgrade of yin-yang dialectical thinking into a two-dimensional Xiang thinking diagram,possessing powerful explanatory capabilities.When faced with complex life systems,Wu Xing provides TCM with a theoretical framework,and TCM,in turn,offers a practical application for Wu Xing.展开更多
Autoimmune diseases frequently present with ophthalmological manifestations,posing significant diagnostic and therapeutic challenges.This review delved into the complex interplay between autoimmunity and ocular health...Autoimmune diseases frequently present with ophthalmological manifestations,posing significant diagnostic and therapeutic challenges.This review delved into the complex interplay between autoimmunity and ocular health,highlighting common manifestations such as uveitis,keratitis,and optic neuritis.We explored advanced diagnostic tools and techniques to improve early detection and accurate diagnosis.Additionally,the review addressed current therapeutic strategies,emphasizing the need for tailored treatments to manage ocular symptoms effectively while minimizing systemic side effects.By overcoming these challenges we aimed to enhance patient outcomes and quality of life for those affected by autoimmune-related eye diseases.展开更多
Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment ...Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.展开更多
BACKGROUND Common variable immunodeficiency(CVID)is a primary antibody immunodeficiency disorder characterized by diminished IgG levels.Despite ongoing research,the precise pathogenesis of CVID remains unclear.Genetic...BACKGROUND Common variable immunodeficiency(CVID)is a primary antibody immunodeficiency disorder characterized by diminished IgG levels.Despite ongoing research,the precise pathogenesis of CVID remains unclear.Genetic factors account for only 10%-20%of cases,with an estimated incidence of 1 in 10000 to 1 in 100000,affecting individuals across all age groups.CASE SUMMARY We report the case of a 32-year-old man with CVID who presented with a chief complaint of“recurrent diarrhea and significant weight loss over the past 2 years”.Laboratory tests on admission showed fat droplets in stool,while other parameters were within normal ranges.Gastroscopy revealed a smooth gastric mucosa without bile retention or signs of Helicobacter pylori infection;however,the mucosa of the descending segment of the duodenum appeared rough.Further evaluation of the small intestine using computed tomography indicated no abnormalities.Finally,the whole-small bowel double-balloon enteroscopy(DBE)was performed,which revealed various phenotypic changes in the small intestinal mucosa.The patient was diagnosed with CVID,which improved after immunoglobulin therapy,with favorable follow-up outcomes.CONCLUSION Non-infectious enteropathy in CVID is rare.Therefore,DBE is essential for diagnosing small intestinal involvement in such cases.展开更多
基金financed by the grant from The MUST Faculty Research Grants(FRG-25-031-FC)and Fundação Macao.
文摘In the context of Western medicine,Xin(心heart),Gan(肝liver),Pi(脾spleen),Fei(肺lung),and Shen(肾kidney)are five specific organs,while in ancient Chinese medicine,they are five kinds of Zang Xiang(藏象visceral manifestation),often referred to as Wu Zang(五藏five zang-organs),representing five interrelated structural-functional systems.There are both differences and connections between visceral manifestations and organs,which are reflected in the theories of Wu Zang.The specific connotation of Wu Zang are determined by the specific context in which they are located.With the accumulation of practice,the Wu Zang of the human body structures and functions,as well as the relationship between the Wu Zang have been in constant development and change.The encounter of Chinese and Western medicine in the 19th century dramatically changed the connotation of Wu Zang,from emphasizing visceral manifestations and neglecting substance to an organs-oriented perspective.This article examines how the encounter of Chinese and Western medicine in China influenced Chinese medicine.By analyzing three key aspects:(1)the interpretation of Wu Zang in pre-16th century texts;(2)the evolution and dissemination of Western medicine during the Ming and Qing dynasties;(3)the shifting conceptualization of Wu Zang in late Qing medical literature—the study elucidates the transformative impact of this cross-cultural medical encounter on the theory and practice of Chinese medicine.
文摘Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous manifestations that may hold diagnostic and prognostic significance. Patients with BMES have reported localized erythema, dermal thickening, and induration overlying the affected joints, which are hypothesized to reflect microvascular compromise and inflammatory processes within the bone and adjacent soft tissues. Dermatologic signs are likely linked to regional hyperemia, venous stasis, and cytokine-mediated inflammation, paralleling the pathophysiological mechanisms underlying intraosseous edema. Elevated intraosseous pressure in BMES may disrupt local perfusion, resulting in ischemia-reperfusion injury and subsequent vascular leakage, which manifests in visible cutaneous changes. Pro-inflammatory mediators, such as interleukin-1β and vascular endothelial growth factor (VEGF), central to BMES pathogenesis, may exacerbate endothelial activation, and dermal involvement. Histopathologic studies of affected skin have revealed perivascular lymphocytic infiltration and increased dermal vascularity, further supporting the theory of a shared ischemic and inflammatory pathway between bone and skin. Although MRI remains the gold standard for BMES diagnosis, recognition of these cutaneous manifestations could expedite orthopedic referral and intervention, especially in cases where imaging is delayed or symptoms are ambiguous. Current treatment options, including bisphosphonates, prostacyclin analogs, and offloading of weight bearing, may benefit from integration with dermatologic strategies to alleviate localized cutaneous symptoms and improve patient comfort. Evaluating the molecular and vascular links between BMES and its cutaneous manifestations provides an opportunity to refine diagnostic protocols and therapeutic approaches, offering a comprehensive understanding of the systemic interplay between dermal and skeletal pathophysiology, and optimizing clinical outcomes for patients affected by BMES.
文摘Adult Still's Disease(ASD)is a systemic inflammatory disorder of unknown etiology,thought to be triggered by infectious agents in genetically susceptible individuals,resulting in aberrant cytokine production including interleukin(IL)−1,IL-6,AND IL-18.The disease severity varies and may include macrophage activation syndrome(mas),a potentially life-threatening complication.It is associated with seronegative chronic polyarthritis,predominantly affecting young individuals.It is a rare condition with a complex diagnosis due to its overlapping clinical features with more common diseases.
基金supported by the National Natural Science Foundation of China(32222079 to L.J.and 32202621 to D.D.W.)。
文摘Pigs have emerged as valuable large-animal models for cardiac xenotransplantation;however,the temporal dynamics of myocardial development in this species remains insufficiently defined.This study analyzed gene expression patterns across four key developmental stages(neonatal,juvenile,sexual maturity,and adulthood)to delineate the molecular mechanisms driving porcine myocardial development.Increases in heart weight were accompanied by proportional expansion of myocardial fiber area and chamber size,reflecting coordinated structural development.Transcriptomic profiling of myocardial tissue by RNA sequencing(RNA-seq)identified 2189 differentially expressed genes(DEGs)across stage comparisons.Short time-series expression miner(STEM)analysis classified these DEGs into four major expression clusters enriched in pathways associated with myocardial development,immune responses,cell proliferation,and metabolic processes.Among 359 DEGs conserved across all developmental stages,six candidate genes were strongly associated with myocardial development.Reverse transcription-quantitative real-time polymerase chain reaction(RT-qPCR)confirmed a significant correlation between the expression of these candidate genes and myocardial development in porcine tissue.These findings establish a transcriptomic framework for porcine myocardial maturation and provide a molecular basis for advancing cardiac xenotransplantation.
文摘BACKGROUND Celiac disease(CD)is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals.It is more commonly diagnosed in children presenting typical clinical signs and symptoms but most of the CD patients diagnosed in the developed world are silent cases with no prominent gastrointestinal features.Thus,there are silent forms of the disease in which oral manifestations are the first sign.In the pediatric population oral health can affect growth and self-esteem and have a negative impact in their life quality.AIM To assess the prevalence and types of oral manifestations in pediatric patients with CD.METHODS We performed a comprehensive literature search in PubMed,Scielo,Cochrane Library and Lilacs databases from 2014-2024.Three independent researchers screened and extracted the information,applying the eligibility criteria and bias was assessed using Joanna Briggs Institute tools.RESULTS Of the initial 241 articles,14 studies fulfilled the proposed objectives and were included in the review.The main oral manifestations found were recurrent aphthous stomatitis and enamel defects.Additionally,delayed tooth eruption,angular cheilitis,glossodynia and xerostomia were also reported.CONCLUSION Assessing oral manifestations is crucial,especially in underdiagnosed cases of children with CD.Recognizing these signs helps pediatricians or general practitioners identify them during routine exams,enabling early diagnosis and treatment to prevent negative impacts on the child’s and family’s quality of life.
基金Supported by Chonnam National University Hospital Biomedical Research Institute,No.BCRE23215.
文摘BACKGROUND Hepatitis B virus(HBV)primarily causes hepatic inflammation and has various clinical manifestations.However,extrahepatic reactions,ranging from localized or systemic inflammation,may occur in some cases.Here,we report a case of an acute exacerbation of chronic HBV infection with atypical extrahepatic mani-festation confined to the skin and mucosa despite nucleotide analog treatment,which was fully recovered on systemic steroid treatment.CASE SUMMARY A 53-year-old woman visited a clinic due to worsening skin rash and mucosal inflammation.She was receiving antiviral therapy due to a recent acute exacer-bation of chronic HBV infection.While liver function was improving with anti-viral treatment,skin rash and mucosal inflammatory lesions gradually worsened.Thus,blood tests and skin biopsy were performed to determine the cause.Despite a thorough review of serum markers and skin biopsy results,a concrete diagnosis revealing other etiology apart from the acute phase of HBV infection could not be established.The cutaneous lesions were considered a rare immunologic extrahe-patic manifestation of HBV,warranting systemic steroid treatment.Afterward,both skin and mucosal lesions rapidly improved,and the patient was discharged without any sequelae.CONCLUSION Clinicians should recognize mucocutaneous manifestations of chronic HBV,as systemic steroids may yield favorable outcomes.
基金Hubei Natural Science Foundation of China(No.2022CFB296).
文摘Objective The clinical features,disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries.To reduce misdiagnosis and improve visual function,the clinical characteristics,management and visual outcomes of 13 cases of ocular toxoplasmosis(OT)were described.Methods This retrospective study included 14 eyes of 13 patients who were diagnosed with OT in Hubei,China.The clinical characteristics,course of treatment and outcomes are presented.There were 7 males and 6 females.Results The main form of OT was retinochoroiditis with vitritis or anterior uveitis.Next-generation sequencing was applied to 3 eyes,and positive results were found in those eyes.Thirteen patients were positive for Toxoplasma gondii IgG antibodies,and 3 of them were also positive for IgM T.gondii antibodies.One patient with acquired immune deficiency syndrome was diagnosed with coinfection with OT and cytomegalovirus,as evidenced by an aqueous humor etiological test.Three patients were misdiagnosed with noninfectious uveitis.Recurrence occurred in 3 eyes during the follow-up periods.One patient who received vitreous implantation of Ozurdex therapy at another hospital before referral relapsed.One patient who received sulfadiazine,azithromycin and glucocorticoid therapy relapsed.One patient who received sulfadiazine therapy experienced relapse.Patients who received clindamycin and sulfadiazine or who received clindamycin only did not experience recurrence during the follow-up period.The best corrected visual acuity was improved in 6 eyes after inflammation resolved.Conclusions Primary active retinochoroiditis is the main form of OT in Hubei,China.Timely correct diagnosis on the basis of ocular characteristics and aetiological test results and effective treatment should be adopted to prevent poor visual outcomes and recurrence.
文摘From the perspective of Xiang thinking(象思维imagery thinking),the application of Wu Xing(五行five elements)in traditional Chinese medicine(TCM)provides a reasonable cognitive model.Wu Xing with the earth in the center(中土五行)helps TCM establish extensive connections between the human body and the universe,while Wu Xing in the generating and conquering cycles(生克五行)incorporates everything into a systematic thinking framework through complex dialectical relationships,becoming an ideal cognitive tool for TCM diagnosis and treatment.In essence,Wu Xing represents an upgrade of yin-yang dialectical thinking into a two-dimensional Xiang thinking diagram,possessing powerful explanatory capabilities.When faced with complex life systems,Wu Xing provides TCM with a theoretical framework,and TCM,in turn,offers a practical application for Wu Xing.
文摘Autoimmune diseases frequently present with ophthalmological manifestations,posing significant diagnostic and therapeutic challenges.This review delved into the complex interplay between autoimmunity and ocular health,highlighting common manifestations such as uveitis,keratitis,and optic neuritis.We explored advanced diagnostic tools and techniques to improve early detection and accurate diagnosis.Additionally,the review addressed current therapeutic strategies,emphasizing the need for tailored treatments to manage ocular symptoms effectively while minimizing systemic side effects.By overcoming these challenges we aimed to enhance patient outcomes and quality of life for those affected by autoimmune-related eye diseases.
基金Supported by the Central Guiding Local Science and Technology Development Fund Project,No.YDZX2022091。
文摘Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.
基金Supported by National Natural Science Foundation of China,No.82360120Ten Thousand Doctor Plan in Yunnan Province,No.YNWRMY-2018-020Yunnan Provincial Key Laboratory of Clinical Virology,No.202205AG070053-07.
文摘BACKGROUND Common variable immunodeficiency(CVID)is a primary antibody immunodeficiency disorder characterized by diminished IgG levels.Despite ongoing research,the precise pathogenesis of CVID remains unclear.Genetic factors account for only 10%-20%of cases,with an estimated incidence of 1 in 10000 to 1 in 100000,affecting individuals across all age groups.CASE SUMMARY We report the case of a 32-year-old man with CVID who presented with a chief complaint of“recurrent diarrhea and significant weight loss over the past 2 years”.Laboratory tests on admission showed fat droplets in stool,while other parameters were within normal ranges.Gastroscopy revealed a smooth gastric mucosa without bile retention or signs of Helicobacter pylori infection;however,the mucosa of the descending segment of the duodenum appeared rough.Further evaluation of the small intestine using computed tomography indicated no abnormalities.Finally,the whole-small bowel double-balloon enteroscopy(DBE)was performed,which revealed various phenotypic changes in the small intestinal mucosa.The patient was diagnosed with CVID,which improved after immunoglobulin therapy,with favorable follow-up outcomes.CONCLUSION Non-infectious enteropathy in CVID is rare.Therefore,DBE is essential for diagnosing small intestinal involvement in such cases.
