Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preve...Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preventable pregnancy related complications. Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria treatment in Nigeria. This study assessed the prescription pattern of intermittent preventive therapy with Sulphadoxine-Pyrimethamine for pregnant women among doctors practicing in 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Methods: This was a retrospective study using case notes of pregnant women seen at antenatal clinic of 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria from January, 2008 to December, 2008. A total of 336 case notes were reviewed. The findings were precoded, data entry and analysis was done using EPI INFO 2002. Results: A good proportion of the women (82.9%) booked for antenatal clinic within the first and second trimesters of pregnancy. Most commonly prescribed by doctors was the weekly pyrimethamine (daraprim) for malaria prophylaxis in pregnancy (100.0%). Very few doctors prescribed intermittent preventive therapy with sulfadoxine-pyrimethamine, and the few who did prescribed just one dose. Conclusion: The study showed a very low level of prescription of IPTp among doctors practicing at 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. There is a great need for training of these doctors and other health professionals on the recommendations of the current National Antimalarial Treatment Guidelines.展开更多
Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treat...Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.展开更多
Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national ...Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.展开更多
BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and of...BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and often the condition is prolonged,and the patients are prone to anxiety and uneasiness,which may be related to the harshness of the plateau environment,somatic discomfort due to the lack of oxygen,anxiety about the disease,and other factors.AIM To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,sleep disorders,and hypoxia tolerance in patients with high-altitude respiratory diseases.METHODS A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects.The subjects’pre-high-altitude residential altitude was approximately 1700 meters.They were divided into two groups.Both groups were given symptomatic treatment,and the control group implemented conventional nursing intervention,while the research group simultaneously conducted CBT intervention;assessed the degree of health knowledge of the two groups,and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention,respectively.It also observed the length and efficiency of sleep,and detected the level of serum hypoxia inducible factor-1α,erythropoietin(EPO)and clinical intervention before and after intervention.EPO levels,and investigated satisfaction with the clinical intervention.RESULTS The rate of excellent health knowledge in the intervention group was 93.64%,which was higher than that in the control group(74.23%;P<0.05).Before the intervention,there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups(P>0.05),and after the intervention,the scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention(P>0.05),and after the intervention,the scores of the study group were significantly larger than those of the control group(P<0.05).There was no significant difference in serum hypoxia inducible factor-1αand EPO between the two groups before intervention(P>0.05),and both research groups were significantly lower than the control group after intervention(P<0.05).According to the questionnaire survey,the intervention satisfaction of the study group was 95.53%,which was higher than that of the control group(80.14%;P<0.05).CONCLUSION The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients'health knowledge,relieve anxiety,improve sleep quality and hypoxia tolerance,and improve nursing satisfaction.展开更多
This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma pa...This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.展开更多
Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplanta...Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplantation of retinal progenitor cells alone.Bone marrow mesenchymal stem cells regulate and interact with various cells in the retinal microenvironment by secreting neurotrophic factors and extracellular vesicles.Small extracellular vesicles derived from bone marrow mesenchymal stem cells,which offer low immunogenicity,minimal tumorigenic risk,and ease of transportation,have been utilized in the treatment of various neurological diseases.These vesicles exhibit various activities,including anti-inflammatory actions,promotion of tissue repair,and immune regulation.Therefore,novel strategies using human retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles may represent an innovation in stem cell therapy for retinal degeneration.In this study,we developed such an approach utilizing retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles to treat retinal degeneration in Royal College of Surgeons rats,a genetic model of retinal degeneration.Our findings revealed that the combination of bone marrow mesenchymal stem cell-derived small extracellular vesicles and retinal progenitor cells significantly improved visual function in these rats.The addition of bone marrow mesenchymal stem cell-derived small extracellular vesicles as adjuvants to stem cell transplantation with retinal progenitor cells enhanced the survival,migration,and differentiation of the exogenous retinal progenitor cells.Concurrently,these small extracellular vesicles inhibited the activation of regional microglia,promoted the migration of transplanted retinal progenitor cells to the inner nuclear layer of the retina,and facilitated their differentiation into photoreceptors and bipolar cells.These findings suggest that bone marrow mesenchymal stem cell-derived small extracellular vesicles potentiate the therapeutic efficacy of retinal progenitor cells in retinal degeneration by promoting their survival and differentiation.展开更多
Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Tot...Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected.The incidence of hypoglycemia was 1.29%.Among which,317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%.The peak periods of hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic hypoglycemia accounted for 47.01%,The asymptomatic hypoglycemia accounted for 52.98%.The incidence of hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of hypoglycemia,detect and treat asymptomatic hypoglycemia timely and rationally administer antidiabetics to prevent hypoglycemia.展开更多
Objective: To measure the levels of nurse’s knowledge and attitude after the conduct of education session regarding chemotherapy administration and management. Methodology: This research study was conducted at two on...Objective: To measure the levels of nurse’s knowledge and attitude after the conduct of education session regarding chemotherapy administration and management. Methodology: This research study was conducted at two oncology units of tertiary Hospital Rawalpindi. A prepost test intervention study design was used on 35 nurses by using Verity’s tools. Results: The mean scores of knowledge were calculated by Cochran’s Q test showed that knowledge scores have significantly increased with ‘educational training’ (p value < 0.001). The difference in the attitude of the nurses was not found to be statistically significant in repeated measure of ANOVA. Conclusion: The results show that knowledge is the weakest component and attitude is strongest component of oncology nurses ‘competencies in chemotherapy administration.展开更多
On September 20,2017 Hurricane Maria,a category 4 hurricane,made landfall on the eastern coast of Puerto Rico.This was preceded by Hurricane Irma,a category 5 hurricane,which passed just off the coast 13 d prior.The d...On September 20,2017 Hurricane Maria,a category 4 hurricane,made landfall on the eastern coast of Puerto Rico.This was preceded by Hurricane Irma,a category 5 hurricane,which passed just off the coast 13 d prior.The destruction from both Hurricane Irma and Maria precipitated a coordinated federal response which included the Federal Emergency Management Agency(FEMA)and the United States military.The United States Army dispatched the 14^th Combat Support Hospital(CSH)to Humacao,a city on the eastern side of the island where Maria made landfall.The mission of the 14^th CSH was to provide medical humanitarian aid and conduct disaster relief operations in support of the government of Puerto Rico and FEMA.During the 14^th CSH deployment to Puerto Rico,1157 patients were evaluated and treated.Fifty-seven operative cases were performed to include 23 orthopaedic cases.The mean age of the orthopaedic patients treated was 45.7 years(range 13-76 years).The most common operation was irrigation and debridement of open contaminated and/or infected wounds.Patients presented a mean 10.8 d from their initial injury(range 1-40 d).Fractures and infections were the most common diagnoses with the greatest delay in treatment from the initial date of injury.The deployment of the 14^th CSH to Puerto Rico was unique in its use of air transport,language and local customs encountered,as well as deployment to a location outside the continental United States.These factors coupled with the need for rapid deployment of the 14^th CSH provided valuable experience which will undoubtedly enable future success in similar endeavors.展开更多
BACKGROUND Patients affected by Crohn's disease(CD)are more likely to develop gastrointestinal stenosis and often undergo surgery during the duration of disease.AIM To identify the risk factors for gastrointestina...BACKGROUND Patients affected by Crohn's disease(CD)are more likely to develop gastrointestinal stenosis and often undergo surgery during the duration of disease.AIM To identify the risk factors for gastrointestinal stenosis in hospitalized CD patients in China.METHODS The clinical data of CD patients hospitalized at the Seventh Medical Center,Chinese People's Liberation Army General Hospital from January 2010 to December 2018 were included.Patients with gastrointestinal stenosis were compared to those without gastrointestinal stenosis for clinical variables.The risk factors for gastrointestinal stenosis were identified using univariate and multivariable logistic regression analyses.The treatments for patients with gastrointestinal stenosis were analyzed,and the characteristics of different treatment methods were discussed.RESULTS The incidence of gastrointestinal stenosis was 59.02%in the 122 hospitalized CD patients.Age of onset of more than 40 years(odds ratio[OR]=3.072,95%confidence interval[CI]:1.298-7.272,P=0.009)and duration of disease of more than 5 years(OR=2.101,95%CI:1.002-4.406,P=0.048)were associated with the occurrence of gastrointestinal stenosis.Fifteen(20.83%)patients did not undergo surgery and received internal medicine and nutrition treatment.Surgical treatments were performed in 72.22%(52)of cases.The rate of postoperative complications was 15.38%(8 cases),and during a median follow-up period of 46 mo,11.54%(6 cases)underwent reoperation.A total of 29.17%(21 cases)were treated with endoscopic therapy,and during a median follow-up period of 32 mo,76.19%(16 cases)had no surgical event,23.81%(5 cases)failed to avoid surgical treatments,and no serious postoperative complications occurred after endoscopic therapy.CONCLUSION Age of onset of more than 40 years and duration of disease of more than 5 years may be strongly correlated with a higher risk of gastrointestinal stenosis in hospitalized CD patients.Endoscopic therapy for gastrointestinal stenosis is relatively safe and effective,and may help to prevent or delay surgery.展开更多
Background: Female condom (FC) has efficiently challenged the increased risk for sexually transmitted infections (STI)/HIV, unwanted pregnancy and promoted self-protection and autonomy among females. However, despite ...Background: Female condom (FC) has efficiently challenged the increased risk for sexually transmitted infections (STI)/HIV, unwanted pregnancy and promoted self-protection and autonomy among females. However, despite being provided free of charge, the researchers have not observed satisfactory level of demand for FC by the HIV-positive clients at our facility. This study sought to establish the determinants or deterrent factors to the uptake and the use of FC among HIV-infected female clients in an Army hospital, Lagos. Method: A cross-sectional descriptive design was used and 340 interviewees were selected for the survey. Analyses were completed using Epi InfoTM version 7.2.1.0. Association between variables of interests was established using Chi-square. Result: Mean age of the participants was 37.91 ± 8.33 years while the median age was 37. Greater proportion was married (50.5%), business women (55.5%), had at least school certificate (90.1%), and had regular sexual partner (84.4%). Only 69.8% disclosed their status to their sexual partners, while 79.5% in turn were informed of their partners’ HIV status. Being in marital union, younger age and being aware of partner’s HIV status were significantly associated with HIV disclosure (p < 0.001). Contraceptive uptake was 59.8%, while FC use was 5.4%. Most reported limiting factors to FC utilization were non-availability (22.5%) and use of male condom by the partner (13.8%). Conclusion: Suboptimal HIV status disclosure, contraceptive use and very low FC uptake among participants need urgent attention to limit further spread of the virus, STI and prevent unwanted pregnancies.展开更多
<strong>Introduction:</strong> The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored t...<strong>Introduction:</strong> The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. <strong>Methods:</strong> This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. <strong>Results</strong><strong>:</strong> Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. <strong>Conclusion:</strong> In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.展开更多
Introduction: Penile emergencies are multiple and varied, and they can jeopardize the sexual functional prognosis of the patient. The objective of our study was to evaluate the sexual functional prognosis of patients ...Introduction: Penile emergencies are multiple and varied, and they can jeopardize the sexual functional prognosis of the patient. The objective of our study was to evaluate the sexual functional prognosis of patients admitted for penile emergencies. Patients and Methods: We conducted a cross-sectional study from January 1 to 31, 2021, in the urology department of the University Hospital. Variables included sociodemographic, diagnostic, and evolutionary data of sexually active patients admitted for a penile emergency. Results: During this period, 68 patients were admitted for penile emergencies. We included 45 sexually active patients, with a mean age ranging from 34.5 ± 14.1 years with extremes of 16 and 90 years. The most frequent penile emergencies were priapism (62.2%) and penile fracture (22.2%), with a mean time for treatment of 21.4 ± 52.5 hours. The sexual functional prognosis was very satisfactory (normal erection) in 71.1% (n = 32) of patients. Loss of erectile function was observed in 4.4% (n = 2) of cases. Conclusion: Penile emergencies are relatively frequent, dominated by priapism and penile fracture in our context. The sexual functional prognosis is good.展开更多
Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. The aim of this study was to analyze the risk factors associated with the occurrence of diabetic retinopathy (DR) at the National Univer...Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. The aim of this study was to analyze the risk factors associated with the occurrence of diabetic retinopathy (DR) at the National University Hospital Center-Hubert Koutoukou MAGA (CNHU-HKM). Patients and method: this was a descriptive and analytical cross-sectional study with prospective data collection. It was carried out over a three-month period from July 10 to October 10, 2019. It concerned all patients suffering from diabetes mellitus and who consulted in the Endocrinology department during the study period. Results: the frequency of diabetic retinopathy was 30.46% (53/174 patients). A female predominance was observed with a sex ratio (M/F) of 0.57. The main modifiable risk factors were represented by occupation and those that were not modifiable were represented by the presence of old nephropathy, glycated hemoglobin, age of discovery of diabetes and its length of service. Diabetic retinopathy is a serious condition that can ultimately lead to blindness. The frequency of DR remains high in our study.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To ...BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.展开更多
This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy...This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.展开更多
Groundwater overextraction and contamination by heavy metals such as cadmium and arsenic have resultedin ecological degradation and increased risks of renal disease,particularly in water-scarce regions.To address thes...Groundwater overextraction and contamination by heavy metals such as cadmium and arsenic have resultedin ecological degradation and increased risks of renal disease,particularly in water-scarce regions.To address thesechallenges,this review aimed to evaluate the ecological potential of dew water harvesting as a sustainable and safealternative water source.Literature published between 2000 and 2024 was systematically searched in PubMed,Scopus,Web of Science,and Google Scholar using the terms“dew water,”“atmospheric water harvesting,”“groundwaterpollution,”“heavy metals,”“ecosystem restoration,”and“sustainable water systems.”Studies were included if theyfocused on dew water quality,ecological functions,or health-related outcomes,while non-English publications,conference abstracts without full text,and studies not directly addressing dew water were excluded.A total of 46 studiesand 7 official guidelines met the eligibility criteria.Findings indicate that natural dew water generally exhibits a neutralpH(6.5–8.5),negligible concentrations of heavy metals,and relatively high dissolved oxygen content(~9 mg/L).Casestudies from Morocco,Israel,China,and India illustrate its contributions to soil moisture retention,plant survival,biodiversity support,and microclimate regulation.Moreover,dew water produced through the Systemized Dew Process(SDP)consistently complied with WHO(2024)standards for drinking water,showing contaminant levels belowdetection thresholds.In conclusion,dew water harvesting represents a low-impact,climate-resilient,and safe alternativethat mitigates exposure to nephrotoxic pollutants,reduces reliance on overexploited groundwater,and enhances longtermecological restoration and water security in degraded and water-scarce environments.展开更多
Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract and arise from the interstitial cells of Cajal.They predominantly affect individuals between 50 and 70 years o...Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract and arise from the interstitial cells of Cajal.They predominantly affect individuals between 50 and 70 years of age and often carry malignant potential despite being frequently asymptomatic.The stomach and small intestine are the most common locations,while involvement of the esophagus,colon,or rectum is relatively rare.GISTs are often discovered incidentally during endoscopic or radiologic evaluations,and the diagnosis is confirmed through tissue biopsy and immunohistochemical staining,particularly for KIT(CD117),DOG1,and PDGFRA.In the past decade,laparoscopic resection has been considered the standard treatment for localized GISTs smaller than 5 cm.However,recent advances in endoscopic technology have led to a growing role for endoscopic resection as a safe and effective treatment option for selected nonmetastatic GISTs.Endoscopic techniques such as endoscopic submucosal dissection,endoscopic submucosal excavation,submucosal tunneling endoscopic resection,and endoscopic full-thickness resection have demonstrated favorable outcomes,including high complete resection(R0)rates,shorter hospital stays,and quicker recovery compared to traditional surgery.The selection of an appropriate resection method depends on tumor size,location,depth of invasion,and proximity to vital structures.Endoscopic ultrasound has become an essential tool for preprocedural assessment,providing detailed information on tumor characteristics and helping to guide management decisions.While endoscopic resection is a promising minimally invasive approach,it should be performed by skilled endoscopists with appropriate training due to the technical complexity and risk of complications such as bleeding or perforation.This review summarizes recent developments in endoscopic resection of GISTs,with a focus on indications,procedural safety,clinical outcomes,and recommendations for optimal patient selection and procedural planning.展开更多
Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection(ASGS-SMIR)is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery(SMIS)concept.Based on pre...Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection(ASGS-SMIR)is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery(SMIS)concept.Based on previous clinical research results and combined with the ten core treatment principles of SMIS,this guideline systematically elaborates on the indications,contraindications,preoperative evaluation,surgical operation standards,postoperative management,and efficacy evaluation system of ASGS-SMIR.This surgery achieves effective repair of large-area mucosal defects and stenosis prevention in the esophagus through the technical process of“skin flap harvesting,mesh processing,sleeve suture,and stent fixation”.The purpose of this guideline is to promote the standardized and normalized application of this technique and provide guidance for clinical practice.展开更多
文摘Background: Malaria infestation in pregnancy is a major public health concern and ranks amongst the commonest complications of pregnancy in Nigeria. Approximately 50,000 Nigerian women die each year from largely preventable pregnancy related complications. Intermittent preventive therapy for malaria in pregnancy (IPTp) is a key recommendation in the National guideline for malaria treatment in Nigeria. This study assessed the prescription pattern of intermittent preventive therapy with Sulphadoxine-Pyrimethamine for pregnant women among doctors practicing in 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Methods: This was a retrospective study using case notes of pregnant women seen at antenatal clinic of 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria from January, 2008 to December, 2008. A total of 336 case notes were reviewed. The findings were precoded, data entry and analysis was done using EPI INFO 2002. Results: A good proportion of the women (82.9%) booked for antenatal clinic within the first and second trimesters of pregnancy. Most commonly prescribed by doctors was the weekly pyrimethamine (daraprim) for malaria prophylaxis in pregnancy (100.0%). Very few doctors prescribed intermittent preventive therapy with sulfadoxine-pyrimethamine, and the few who did prescribed just one dose. Conclusion: The study showed a very low level of prescription of IPTp among doctors practicing at 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. There is a great need for training of these doctors and other health professionals on the recommendations of the current National Antimalarial Treatment Guidelines.
文摘Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.
文摘Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.
基金Supported by Army Logistics Department Health Bureau Project,No.QJGYXYJZX-012.
文摘BACKGROUND Due to the dry and cold climate,the obvious temperature difference between day and night,and the low oxygen content of the air in the plateau area,people are prone to upper respiratory tract diseases,and often the condition is prolonged,and the patients are prone to anxiety and uneasiness,which may be related to the harshness of the plateau environment,somatic discomfort due to the lack of oxygen,anxiety about the disease,and other factors.AIM To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,sleep disorders,and hypoxia tolerance in patients with high-altitude respiratory diseases.METHODS A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects.The subjects’pre-high-altitude residential altitude was approximately 1700 meters.They were divided into two groups.Both groups were given symptomatic treatment,and the control group implemented conventional nursing intervention,while the research group simultaneously conducted CBT intervention;assessed the degree of health knowledge of the two groups,and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention,respectively.It also observed the length and efficiency of sleep,and detected the level of serum hypoxia inducible factor-1α,erythropoietin(EPO)and clinical intervention before and after intervention.EPO levels,and investigated satisfaction with the clinical intervention.RESULTS The rate of excellent health knowledge in the intervention group was 93.64%,which was higher than that in the control group(74.23%;P<0.05).Before the intervention,there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups(P>0.05),and after the intervention,the scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention(P>0.05),and after the intervention,the scores of the study group were significantly larger than those of the control group(P<0.05).There was no significant difference in serum hypoxia inducible factor-1αand EPO between the two groups before intervention(P>0.05),and both research groups were significantly lower than the control group after intervention(P<0.05).According to the questionnaire survey,the intervention satisfaction of the study group was 95.53%,which was higher than that of the control group(80.14%;P<0.05).CONCLUSION The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients'health knowledge,relieve anxiety,improve sleep quality and hypoxia tolerance,and improve nursing satisfaction.
文摘This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.
基金supported by the National Natural Science Foundation of China,Nos.82271132(to YL),82101167(to BB)the Natural Science Foundation of Chongqing,Nos.CSTB2022NSCQ-MSX0020(to BB),cstc2019jcyj-msxmX0473(to FC).
文摘Our previous study demonstrated that combined transplantation of bone marrow mesenchymal stem cells and retinal progenitor cells in rats has therapeutic effects on retinal degeneration that are superior to transplantation of retinal progenitor cells alone.Bone marrow mesenchymal stem cells regulate and interact with various cells in the retinal microenvironment by secreting neurotrophic factors and extracellular vesicles.Small extracellular vesicles derived from bone marrow mesenchymal stem cells,which offer low immunogenicity,minimal tumorigenic risk,and ease of transportation,have been utilized in the treatment of various neurological diseases.These vesicles exhibit various activities,including anti-inflammatory actions,promotion of tissue repair,and immune regulation.Therefore,novel strategies using human retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles may represent an innovation in stem cell therapy for retinal degeneration.In this study,we developed such an approach utilizing retinal progenitor cells combined with bone marrow mesenchymal stem cell-derived small extracellular vesicles to treat retinal degeneration in Royal College of Surgeons rats,a genetic model of retinal degeneration.Our findings revealed that the combination of bone marrow mesenchymal stem cell-derived small extracellular vesicles and retinal progenitor cells significantly improved visual function in these rats.The addition of bone marrow mesenchymal stem cell-derived small extracellular vesicles as adjuvants to stem cell transplantation with retinal progenitor cells enhanced the survival,migration,and differentiation of the exogenous retinal progenitor cells.Concurrently,these small extracellular vesicles inhibited the activation of regional microglia,promoted the migration of transplanted retinal progenitor cells to the inner nuclear layer of the retina,and facilitated their differentiation into photoreceptors and bipolar cells.These findings suggest that bone marrow mesenchymal stem cell-derived small extracellular vesicles potentiate the therapeutic efficacy of retinal progenitor cells in retinal degeneration by promoting their survival and differentiation.
文摘Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected.The incidence of hypoglycemia was 1.29%.Among which,317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%.The peak periods of hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic hypoglycemia accounted for 47.01%,The asymptomatic hypoglycemia accounted for 52.98%.The incidence of hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of hypoglycemia,detect and treat asymptomatic hypoglycemia timely and rationally administer antidiabetics to prevent hypoglycemia.
文摘Objective: To measure the levels of nurse’s knowledge and attitude after the conduct of education session regarding chemotherapy administration and management. Methodology: This research study was conducted at two oncology units of tertiary Hospital Rawalpindi. A prepost test intervention study design was used on 35 nurses by using Verity’s tools. Results: The mean scores of knowledge were calculated by Cochran’s Q test showed that knowledge scores have significantly increased with ‘educational training’ (p value < 0.001). The difference in the attitude of the nurses was not found to be statistically significant in repeated measure of ANOVA. Conclusion: The results show that knowledge is the weakest component and attitude is strongest component of oncology nurses ‘competencies in chemotherapy administration.
文摘On September 20,2017 Hurricane Maria,a category 4 hurricane,made landfall on the eastern coast of Puerto Rico.This was preceded by Hurricane Irma,a category 5 hurricane,which passed just off the coast 13 d prior.The destruction from both Hurricane Irma and Maria precipitated a coordinated federal response which included the Federal Emergency Management Agency(FEMA)and the United States military.The United States Army dispatched the 14^th Combat Support Hospital(CSH)to Humacao,a city on the eastern side of the island where Maria made landfall.The mission of the 14^th CSH was to provide medical humanitarian aid and conduct disaster relief operations in support of the government of Puerto Rico and FEMA.During the 14^th CSH deployment to Puerto Rico,1157 patients were evaluated and treated.Fifty-seven operative cases were performed to include 23 orthopaedic cases.The mean age of the orthopaedic patients treated was 45.7 years(range 13-76 years).The most common operation was irrigation and debridement of open contaminated and/or infected wounds.Patients presented a mean 10.8 d from their initial injury(range 1-40 d).Fractures and infections were the most common diagnoses with the greatest delay in treatment from the initial date of injury.The deployment of the 14^th CSH to Puerto Rico was unique in its use of air transport,language and local customs encountered,as well as deployment to a location outside the continental United States.These factors coupled with the need for rapid deployment of the 14^th CSH provided valuable experience which will undoubtedly enable future success in similar endeavors.
基金Supported by Capital Health Development Research Fund,No.2018-1-5091National Key R and D Program of China,No.2017YFC0112304.
文摘BACKGROUND Patients affected by Crohn's disease(CD)are more likely to develop gastrointestinal stenosis and often undergo surgery during the duration of disease.AIM To identify the risk factors for gastrointestinal stenosis in hospitalized CD patients in China.METHODS The clinical data of CD patients hospitalized at the Seventh Medical Center,Chinese People's Liberation Army General Hospital from January 2010 to December 2018 were included.Patients with gastrointestinal stenosis were compared to those without gastrointestinal stenosis for clinical variables.The risk factors for gastrointestinal stenosis were identified using univariate and multivariable logistic regression analyses.The treatments for patients with gastrointestinal stenosis were analyzed,and the characteristics of different treatment methods were discussed.RESULTS The incidence of gastrointestinal stenosis was 59.02%in the 122 hospitalized CD patients.Age of onset of more than 40 years(odds ratio[OR]=3.072,95%confidence interval[CI]:1.298-7.272,P=0.009)and duration of disease of more than 5 years(OR=2.101,95%CI:1.002-4.406,P=0.048)were associated with the occurrence of gastrointestinal stenosis.Fifteen(20.83%)patients did not undergo surgery and received internal medicine and nutrition treatment.Surgical treatments were performed in 72.22%(52)of cases.The rate of postoperative complications was 15.38%(8 cases),and during a median follow-up period of 46 mo,11.54%(6 cases)underwent reoperation.A total of 29.17%(21 cases)were treated with endoscopic therapy,and during a median follow-up period of 32 mo,76.19%(16 cases)had no surgical event,23.81%(5 cases)failed to avoid surgical treatments,and no serious postoperative complications occurred after endoscopic therapy.CONCLUSION Age of onset of more than 40 years and duration of disease of more than 5 years may be strongly correlated with a higher risk of gastrointestinal stenosis in hospitalized CD patients.Endoscopic therapy for gastrointestinal stenosis is relatively safe and effective,and may help to prevent or delay surgery.
文摘Background: Female condom (FC) has efficiently challenged the increased risk for sexually transmitted infections (STI)/HIV, unwanted pregnancy and promoted self-protection and autonomy among females. However, despite being provided free of charge, the researchers have not observed satisfactory level of demand for FC by the HIV-positive clients at our facility. This study sought to establish the determinants or deterrent factors to the uptake and the use of FC among HIV-infected female clients in an Army hospital, Lagos. Method: A cross-sectional descriptive design was used and 340 interviewees were selected for the survey. Analyses were completed using Epi InfoTM version 7.2.1.0. Association between variables of interests was established using Chi-square. Result: Mean age of the participants was 37.91 ± 8.33 years while the median age was 37. Greater proportion was married (50.5%), business women (55.5%), had at least school certificate (90.1%), and had regular sexual partner (84.4%). Only 69.8% disclosed their status to their sexual partners, while 79.5% in turn were informed of their partners’ HIV status. Being in marital union, younger age and being aware of partner’s HIV status were significantly associated with HIV disclosure (p < 0.001). Contraceptive uptake was 59.8%, while FC use was 5.4%. Most reported limiting factors to FC utilization were non-availability (22.5%) and use of male condom by the partner (13.8%). Conclusion: Suboptimal HIV status disclosure, contraceptive use and very low FC uptake among participants need urgent attention to limit further spread of the virus, STI and prevent unwanted pregnancies.
文摘<strong>Introduction:</strong> The prevention of mother-to-child transmission (PMTCT) plays a major role in limiting the number of children being infected by HIV. There is dearth of studies that explored the knowledge of HIV transmission and PMTCT among women living with HIV. <strong>Methods:</strong> This was a cross-sectional, descriptive study of HIV-positive mothers receiving medical care at the adult antiretroviral therapy (ART) clinic, 68 Nigeria Army Reference Hospital Yaba. A pre-tested structured questionnaire was used to collect information from the subjects concerning their socio-demographic, knowledge of HIV transmission and mother-to-child transmission of HIV and preventive measures. SPSS v23 was used for data analysis. <strong>Results</strong><strong>:</strong> Out of the 374 participants, 282 (75.4%) were aware that HIV can be transmitted to an unborn baby from the positive mother. Of these, 240 (85.1%) were well-informed that increase mother’s viral load can increase the chances of mother-to-child transmission. 268 (95%) understood that giving of antiretroviral drugs during and after pregnancy can lower transmission risk, while 254 (90.1%) saw the use of breast milk substitutes as another prevention strategy. There was statistically significant association between the respondents’ knowledge of PMTCT and their husbands’/partners’ awareness of their HIV status. <strong>Conclusion:</strong> In conclusion, our study demonstrated a good knowledge of HIV transmission, MTCT and PMTCT among women who were receiving ART in our centre. Disclosure is a significant factor found to be associated with PMTCT knowledge. More studies can also explore if the observations in our study with women living with HIV will be comparable in similar population in different settings.
文摘Introduction: Penile emergencies are multiple and varied, and they can jeopardize the sexual functional prognosis of the patient. The objective of our study was to evaluate the sexual functional prognosis of patients admitted for penile emergencies. Patients and Methods: We conducted a cross-sectional study from January 1 to 31, 2021, in the urology department of the University Hospital. Variables included sociodemographic, diagnostic, and evolutionary data of sexually active patients admitted for a penile emergency. Results: During this period, 68 patients were admitted for penile emergencies. We included 45 sexually active patients, with a mean age ranging from 34.5 ± 14.1 years with extremes of 16 and 90 years. The most frequent penile emergencies were priapism (62.2%) and penile fracture (22.2%), with a mean time for treatment of 21.4 ± 52.5 hours. The sexual functional prognosis was very satisfactory (normal erection) in 71.1% (n = 32) of patients. Loss of erectile function was observed in 4.4% (n = 2) of cases. Conclusion: Penile emergencies are relatively frequent, dominated by priapism and penile fracture in our context. The sexual functional prognosis is good.
文摘Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. The aim of this study was to analyze the risk factors associated with the occurrence of diabetic retinopathy (DR) at the National University Hospital Center-Hubert Koutoukou MAGA (CNHU-HKM). Patients and method: this was a descriptive and analytical cross-sectional study with prospective data collection. It was carried out over a three-month period from July 10 to October 10, 2019. It concerned all patients suffering from diabetes mellitus and who consulted in the Endocrinology department during the study period. Results: the frequency of diabetic retinopathy was 30.46% (53/174 patients). A female predominance was observed with a sex ratio (M/F) of 0.57. The main modifiable risk factors were represented by occupation and those that were not modifiable were represented by the presence of old nephropathy, glycated hemoglobin, age of discovery of diabetes and its length of service. Diabetic retinopathy is a serious condition that can ultimately lead to blindness. The frequency of DR remains high in our study.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
基金Supported by the National Key Research and Development Program of China,No.2022YFC2503600。
文摘BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.
文摘This editorial comments on a study by Zuo et al.The focus is on the efficacy of he-patic arterial infusion chemotherapy combined with camrelizumab and apatinib(the TRIPLET regimen),alongside microwave ablation therapy,in treating advanced hepatocellular carcinoma(HCC).The potential application of this combination therapy for patients with advanced HCC is evaluated.
文摘Groundwater overextraction and contamination by heavy metals such as cadmium and arsenic have resultedin ecological degradation and increased risks of renal disease,particularly in water-scarce regions.To address thesechallenges,this review aimed to evaluate the ecological potential of dew water harvesting as a sustainable and safealternative water source.Literature published between 2000 and 2024 was systematically searched in PubMed,Scopus,Web of Science,and Google Scholar using the terms“dew water,”“atmospheric water harvesting,”“groundwaterpollution,”“heavy metals,”“ecosystem restoration,”and“sustainable water systems.”Studies were included if theyfocused on dew water quality,ecological functions,or health-related outcomes,while non-English publications,conference abstracts without full text,and studies not directly addressing dew water were excluded.A total of 46 studiesand 7 official guidelines met the eligibility criteria.Findings indicate that natural dew water generally exhibits a neutralpH(6.5–8.5),negligible concentrations of heavy metals,and relatively high dissolved oxygen content(~9 mg/L).Casestudies from Morocco,Israel,China,and India illustrate its contributions to soil moisture retention,plant survival,biodiversity support,and microclimate regulation.Moreover,dew water produced through the Systemized Dew Process(SDP)consistently complied with WHO(2024)standards for drinking water,showing contaminant levels belowdetection thresholds.In conclusion,dew water harvesting represents a low-impact,climate-resilient,and safe alternativethat mitigates exposure to nephrotoxic pollutants,reduces reliance on overexploited groundwater,and enhances longtermecological restoration and water security in degraded and water-scarce environments.
文摘Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract and arise from the interstitial cells of Cajal.They predominantly affect individuals between 50 and 70 years of age and often carry malignant potential despite being frequently asymptomatic.The stomach and small intestine are the most common locations,while involvement of the esophagus,colon,or rectum is relatively rare.GISTs are often discovered incidentally during endoscopic or radiologic evaluations,and the diagnosis is confirmed through tissue biopsy and immunohistochemical staining,particularly for KIT(CD117),DOG1,and PDGFRA.In the past decade,laparoscopic resection has been considered the standard treatment for localized GISTs smaller than 5 cm.However,recent advances in endoscopic technology have led to a growing role for endoscopic resection as a safe and effective treatment option for selected nonmetastatic GISTs.Endoscopic techniques such as endoscopic submucosal dissection,endoscopic submucosal excavation,submucosal tunneling endoscopic resection,and endoscopic full-thickness resection have demonstrated favorable outcomes,including high complete resection(R0)rates,shorter hospital stays,and quicker recovery compared to traditional surgery.The selection of an appropriate resection method depends on tumor size,location,depth of invasion,and proximity to vital structures.Endoscopic ultrasound has become an essential tool for preprocedural assessment,providing detailed information on tumor characteristics and helping to guide management decisions.While endoscopic resection is a promising minimally invasive approach,it should be performed by skilled endoscopists with appropriate training due to the technical complexity and risk of complications such as bleeding or perforation.This review summarizes recent developments in endoscopic resection of GISTs,with a focus on indications,procedural safety,clinical outcomes,and recommendations for optimal patient selection and procedural planning.
基金National Key Research and Development Program of China(2022YFC2503600)。
文摘Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection(ASGS-SMIR)is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery(SMIS)concept.Based on previous clinical research results and combined with the ten core treatment principles of SMIS,this guideline systematically elaborates on the indications,contraindications,preoperative evaluation,surgical operation standards,postoperative management,and efficacy evaluation system of ASGS-SMIR.This surgery achieves effective repair of large-area mucosal defects and stenosis prevention in the esophagus through the technical process of“skin flap harvesting,mesh processing,sleeve suture,and stent fixation”.The purpose of this guideline is to promote the standardized and normalized application of this technique and provide guidance for clinical practice.
