Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 -...Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.展开更多
<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is s...<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.</span></span>展开更多
I<span><span style="font-family:Verdana;">ntroduction: Acute thoracic syndrome is the appearance of a new pulmonary </span><span style="font-family:Verdana;">infiltrate</...I<span><span style="font-family:Verdana;">ntroduction: Acute thoracic syndrome is the appearance of a new pulmonary </span><span style="font-family:Verdana;">infiltrate</span><span style="font-family:Verdana;"> on radiology associated with fever, desaturation </span><span style="font-family:Verdana;">or</span><span style="font-family:Verdana;"> respiratory signs. It is the second leading cause of hospitalization and</span></span><span style="font-family:Verdana;"> the first cause of death in sickle cell patients. It is an acute pulmonary complication whose pathophysiological mechanisms are still poorly understood. This study aims to</span><span><span style="font-family:Verdana;"> study the epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary aspe</span></span><span style="font-family:Verdana;">c</span><span><span style="font-family:Verdana;">ts of Acute Chest Syndrome in children at the Pediatrics Department of Donka National Hospital. Method: This is a prospective study of descriptive type for a period of 6 months from February 19 to August 19, </span><span style="font-family:Verdana;">2019</span><span style="font-family:Verdana;"> on patients with sickle cell disease who developed an ATS in the pediatrics department of Donka National Hospital. Epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary data were studied and proportionate data were calculated. Results: The frequency of ATS was 39%. The mean age of our patients was 9.83 years with the extremes of</span></span><span style="font-family:Verdana;"> 4 and 16 years. The age group from 6 to 10 years with a frequ</span><span style="font-family:Verdana;">ency of 66.7% was the most affected. Fever was the main clinical manifestation, followed by hepatome</span><span><span style="font-family:Verdana;">galy. All our patients were homozygous SS and undergoing folic acid prophylaxis. 96% of our patients did not receive any specific vaccine. Antibiotic therapy, hyperhydration </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> analgesics were administered to all our patients. 96% of our patients were transfused with red blood cell concentrate. 96% of our patients were transfused with packed red blood cells. 96% of our patients were transfused with packed red blood cells and 96% of them had a favorable outcome. Conclusion: ATS is an acute co</span></span><span style="font-family:Verdana;">mplication of sickle cell disease responsible for significant mortality and morbidity in the pediatric population. Its treatment is symptomatic and must be started early. Emphasis must be placed on prevention to prevent or limit its occurrence.</span>展开更多
Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with ...Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.展开更多
With the deepening of education digitization and the construction of new medical disciplines,the limitations of traditional medical education models in resource integration,teaching collaboration,and cross-regional de...With the deepening of education digitization and the construction of new medical disciplines,the limitations of traditional medical education models in resource integration,teaching collaboration,and cross-regional development have become increasingly prominent.This article focuses on the innovation of the medical education system in the information age,taking the construction of a clinical virtual teaching and research office in pediatrics as a practical sample,systematically exploring the construction logic and implementation path of a new type of grass-roots teaching organization.The study points out that the virtual teaching and research office forms a“four-in-one”logical framework by reconstructing its target positioning,organizational structure,and operational guarantee mechanism:taking medical-educational collaboration as the core goal,following the principles of cross-domain linkage and resource sharing,establishing a multi-level collaboration network,and achieving sustainable operation through institutional innovation and technological empowerment.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with ...The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with patient safety culture in the emergency department (ED). Until September 2024, the international databases MEDLINE (PubMed and Ovid), Embase and Cochrane, Scopus, Wiley Online Library, Web of Science, Cochrane Central Register of Controlled Trials, EBSCO, ISI, Elsevier, and Google Scholar were searched using the search terms including patient safety culture and MNC. A total of eight articles were reviewed. In the fixed-effect model with low heterogeneity (I^(2) = 0%, P = 1), the mean score of overall MNC was 2.07 (ES, 2.97;95% confidence interval: −2.21-6.35). According to meta-regression analyses, MNC significantly inversely correlated with patient safety culture, age, and work experience (P < 0.01). By improving the working conditions of ED nurses and providing training related to patient safety, the amount of lost nursing care will decrease.展开更多
BACKGROUND Ureteroneocystostomy(UNC)is considered the gold standard for pediatric vesicoureteral reflux(VUR)treatment.While UNC lowers the likelihood of needing additional VUR procedures within 12 months,patients also...BACKGROUND Ureteroneocystostomy(UNC)is considered the gold standard for pediatric vesicoureteral reflux(VUR)treatment.While UNC lowers the likelihood of needing additional VUR procedures within 12 months,patients also have high 30-day and 90-day readmission rates and emergency department(ED)visits.The most common causes of an ED visit following any urologic procedure are urinary tract infections(UTIs)and catheter/drain concerns.Prior studies are limited in identifying predisposing factors to help mitigate complications of UNC and improve patient outcomes.AIM To identify modifiable characteristics at the time of discharge after UNC that predict subsequent unplanned ED visits.METHODS The 2020 American College of Surgeons National Surgical Quality Improvement Program Pediatric data was analyzed for patients undergoing UNC for VUR.A total of 1742 patients were evaluated,with 1495 meeting inclusion criteria.Patients with an ED visit within 30 days following an anti-reflux procedure(n=164)were compared to those who did not return to the ED(n=1331).Basic statistics and logistic regression analysis were performed to find predictive factors associated with postoperative ED visits after UNC.RESULTS Among the 1495 patients,11.0%visited the ED within the 30-day postoperative period.Patients who returned to the ED visit following UNC were more likely to have had a longer mean operative time,surgical site infection,postoperative UTI,postoperative sepsis,history of prior readmission,unplanned reoperation,blood transfusion,or unplanned urinary catheter placement.Multivariate analysis revealed postoperative UTI(P<0.001),superficial surgical site infection(P=0.022),unplanned procedure(P<0.001),unplanned urinary catheter(P<0.001),and prematurity(35-36 weeks gestation)(P=0.004)as independent risk factors for postoperative ED visits.CONCLUSION Utmost caution is needed prior to discharge after UNC to forestall a return to the ED.Postoperative infection remains a primary risk for ED visits in the acute postoperative period.展开更多
Stem cells are pluripotent cells that can divide and differentiate,forming many different types of cells.Stem cells can be obtained from various sources,with embryonic stem cells being the most advantageous as they po...Stem cells are pluripotent cells that can divide and differentiate,forming many different types of cells.Stem cells can be obtained from various sources,with embryonic stem cells being the most advantageous as they possess a broad dividing potential.When the standard treatment proves ineffective,stem cells are typically utilized as a final option.Infections and childhood malignancies are among the significant causes of mortality in the pediatric population.Stem cell therapy has shown a decrease in morbidity and mortality when used in patients with favorable conditions like young age and lack of comorbidities.This review discusses how stem cells are prepared and used in treating pediatric diseases like X-linked agammaglobulinemia,diabetes mellitus,aplastic anemia,infections,and leukemia.Technological advancement has played a significant role in producing more specific stem cells using genetic modification methods like clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9,which produce stem cells that target a particular cell type,e.g.,myocytes and hematopoietic cells,further increasing the effectiveness of the therapy.We address the obstacles faced when conducting research related to stem cells,including ethical and legal issues,which hinder the use of this therapy in some fields.We also indicate recommendations for increasing the efficacy of stem cell therapy in the pediatric population.展开更多
The central nervous system(CNS)does not function in isolation-it engages in continuous molecular dialogue with the vascular and immune systems.Traditionally,the blood-brain barrier(BBB)was portrayed solely as an imper...The central nervous system(CNS)does not function in isolation-it engages in continuous molecular dialogue with the vascular and immune systems.Traditionally,the blood-brain barrier(BBB)was portrayed solely as an impermeable wall,safeguarding the CNS by excluding blood-derived molecules and circulating cells.However,this view has evolved.The BBB is now recognized as a dynamic interface that selectively regulates the exchange of signals,cells.展开更多
Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate...Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.展开更多
Medical history summary:The child has suffered from episodic joint pain in the lower extremities since childhood,with occurrences ranging from 1 to 3 times daily,predominantly during rainy,cold,and humid weather,as we...Medical history summary:The child has suffered from episodic joint pain in the lower extremities since childhood,with occurrences ranging from 1 to 3 times daily,predominantly during rainy,cold,and humid weather,as well as in the afternoons and evenings.Symptoms and signs:The primary manifestation is episodic pain in the distal extremities,predominantly in the lower limbs,knees,and ankles.Occasionally,the pain may ascend to the elbows,wrists,and palms,and may occasionally affect the proximal extremities and waist.Diagnostic methods:Nerve biopsy and related pathological examinations,along with whole exome sequencing,are helpful for diagnosis,particularly the detection of variants in the SCN11A gene.Treatment approaches:(1)Pharmacotherapy:Sodium channel blockers and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can alleviate pain.(2)Neuromodulation techniques:Techniques such as transcranial magnetic stimulation(TMS)and spinal cord stimulation(SCS)can be employed to improve symptoms.(3)Psychotherapy:Cognitive-behavioral therapy(CBT),relaxation training,or psychological counseling can enhance the patient’s coping abilities.Clinical outcome:Pain relief can be achieved with analgesic medication in children,and pain symptoms generally persist until adulthood,gradually diminishing or even disappearing.Patients can reduce the frequency of episodes by staying warm and avoiding cold and damp conditions.展开更多
The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral bloo...The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.展开更多
Emerging evidence suggests that the gut microbiota is closely associated with the pathological manifestations of multiple neurodegenerative diseases via the gut-brain axis,which refers to the crosstalk between the gut...Emerging evidence suggests that the gut microbiota is closely associated with the pathological manifestations of multiple neurodegenerative diseases via the gut-brain axis,which refers to the crosstalk between the gut and the central nervous system.More importantly,mitochondria have been considered prominent mediators of the interplay between the gut microbiota and the brain.Intestinal microbes may modulate mitochondrial function in the central nervous system to affect the progression of neurodegenerative diseases.Mitochondria are essential for meeting the host’s substantial neuronal metabolic demands,maintaining excitability,and facilitating synaptic transmission.Dysfunctional mitochondria are considered critical hallmarks of various neurodegenerative diseases.Therefore,this review provides novel insights into the intricate roles of gut microbiota-mitochondrial crosstalk in the underlying mechanisms during the progression of neurodegeneration,as well as the existing potential therapeutic strategies for neurodegenerative disorders.These suggest intestinal microbiota-mitochondrial interaction play a crucial role in the occurrence and development of neurodegenerative diseases,and targeting this interaction may be a promising therapeutic approach to neurodegenerative diseases.However,this review found that there was relatively little research on the effect of this crosstalk on other neurodegenerative diseases,such as Huntington’s disease and Multiple sclerosis,and the potential therapeutic strategies were translated into clinical trials,which face many challenges in developing personalized treatment plans based on the unique gut microbiota of different individuals.展开更多
Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacte...Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].展开更多
A recently published prospective study marks a breakthrough for congenital olfactory disorders in children.The study provides the first long-term,three-year follow-up data,robustly demonstrating the durable efficacy a...A recently published prospective study marks a breakthrough for congenital olfactory disorders in children.The study provides the first long-term,three-year follow-up data,robustly demonstrating the durable efficacy and safety of autologous nasal epithelial stem cell transplantation.This work reveals immense therapeutic potential for a condition traditionally considered untreatable.However,this milestone achievement also presents new challenges.To translate this pioneering therapy from a single-center success to a global standard,multicenter,controlled clinical trials must be initiated immediately.Only through rigorous validation can we ensure its widespread adoption and ultimately bring hope to millions of children worldwide.展开更多
Hodgkin lymphoma(HL)is a heterogenous lymphoproliferative disorder of B-cell origin and represents one of the most common malignancies in children and young adults.In addition to well-known underlying factors-such as ...Hodgkin lymphoma(HL)is a heterogenous lymphoproliferative disorder of B-cell origin and represents one of the most common malignancies in children and young adults.In addition to well-known underlying factors-such as Epstein-Barr virus infection-the familial aggregation demonstrated in large population studies suggested a genetic predisposition.First-degree relatives of patients with HL have an approximately threefold increased risk of developing the disease compared to the general population.These observations have recently prompted several whole-genome studies in affected families,identifying variants possibly implicated in lymphomagenesis,including alterations in DICER1(a member of the ribonuclease III family),POT1(protection of telomeres 1),KDR(kinase insert domain receptor),KLHDC8B(kelch domain-containing protein 8B),PAX5(paired box protein 5),GATA3(GATA binding protein 3),IRF7(interferon regulatory factor 7),EEF2KMT(eukaryotic elongation factor 2 lysine methyltransferase),and POLR1E(RNA polymerase I subunit E).In this article,we review current insights into the etiopathogenesis and risks of familial HL,and present case reports involving two sisters diagnosed with HL nearly 17 years apart.Recognizing the risk for first-degree relatives may potentially increase awareness of early symptoms among family members of HL patients,leading to earlier diagnosis and better outcomes.Conversely,understanding that the hereditary risk,though higher than in the general population,remains relatively low may provide reassurance for affected families.展开更多
Objectives:Photodynamic therapy(PDT)is a minimally invasive method used in the treatment of various cancers and skin diseases,but it is not widely used in bone cancer,where the current therapy is often not effective a...Objectives:Photodynamic therapy(PDT)is a minimally invasive method used in the treatment of various cancers and skin diseases,but it is not widely used in bone cancer,where the current therapy is often not effective and accompanied by side effects.Alternative and more effective therapies like PDT are needed.In this in-vitro study,the effect of the photosensitizer(PS)chlorin e6(Ce6)on cancerous bone tumor cells using PDT was examined.Methods:A total of 27 tissue specimens from patients with primary bone cancers or bone metastases of different origins were genetically characterized and treated with PDT.Following a 24-h incubation,cell viability was determined,and the effect of PDT on cell migration was analyzed over 48 h.Results:We could demonstrate that the effect on proliferation of PDT in combination with the PS Ce6 was best in cells isolated from primary osteosarcoma and in bone metastases from mammary carcinomas.Besides proliferation,PDT was also effective in inhibiting the migration of these cells.A statistically significant correlation between the PDT effect and CD164 gene expression was detected,indicating that a high expression of this gene could result in a higher effectiveness of the photodynamic treatment.Conclusion:This study analyzes for the first time the effect of PDT in bone cancers and metastases and shows the potential of treating these cancer types with Ce6 PDT.展开更多
Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional ...Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.展开更多
Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,...Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,2013).A major sequela of TBI is long-lasting white matter injury(WMI)which includes traumatic axonal injury and loss of myelination,resulting in cognitive,behavioral,and psychiatric deficits in survivors.展开更多
文摘Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.
文摘<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.</span></span>
文摘I<span><span style="font-family:Verdana;">ntroduction: Acute thoracic syndrome is the appearance of a new pulmonary </span><span style="font-family:Verdana;">infiltrate</span><span style="font-family:Verdana;"> on radiology associated with fever, desaturation </span><span style="font-family:Verdana;">or</span><span style="font-family:Verdana;"> respiratory signs. It is the second leading cause of hospitalization and</span></span><span style="font-family:Verdana;"> the first cause of death in sickle cell patients. It is an acute pulmonary complication whose pathophysiological mechanisms are still poorly understood. This study aims to</span><span><span style="font-family:Verdana;"> study the epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary aspe</span></span><span style="font-family:Verdana;">c</span><span><span style="font-family:Verdana;">ts of Acute Chest Syndrome in children at the Pediatrics Department of Donka National Hospital. Method: This is a prospective study of descriptive type for a period of 6 months from February 19 to August 19, </span><span style="font-family:Verdana;">2019</span><span style="font-family:Verdana;"> on patients with sickle cell disease who developed an ATS in the pediatrics department of Donka National Hospital. Epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary data were studied and proportionate data were calculated. Results: The frequency of ATS was 39%. The mean age of our patients was 9.83 years with the extremes of</span></span><span style="font-family:Verdana;"> 4 and 16 years. The age group from 6 to 10 years with a frequ</span><span style="font-family:Verdana;">ency of 66.7% was the most affected. Fever was the main clinical manifestation, followed by hepatome</span><span><span style="font-family:Verdana;">galy. All our patients were homozygous SS and undergoing folic acid prophylaxis. 96% of our patients did not receive any specific vaccine. Antibiotic therapy, hyperhydration </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> analgesics were administered to all our patients. 96% of our patients were transfused with red blood cell concentrate. 96% of our patients were transfused with packed red blood cells. 96% of our patients were transfused with packed red blood cells and 96% of them had a favorable outcome. Conclusion: ATS is an acute co</span></span><span style="font-family:Verdana;">mplication of sickle cell disease responsible for significant mortality and morbidity in the pediatric population. Its treatment is symptomatic and must be started early. Emphasis must be placed on prevention to prevent or limit its occurrence.</span>
文摘Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.
基金Teaching and Research Project on Education and Teaching of Shanxi Medical University(Project No.:XJ2024030)。
文摘With the deepening of education digitization and the construction of new medical disciplines,the limitations of traditional medical education models in resource integration,teaching collaboration,and cross-regional development have become increasingly prominent.This article focuses on the innovation of the medical education system in the information age,taking the construction of a clinical virtual teaching and research office in pediatrics as a practical sample,systematically exploring the construction logic and implementation path of a new type of grass-roots teaching organization.The study points out that the virtual teaching and research office forms a“four-in-one”logical framework by reconstructing its target positioning,organizational structure,and operational guarantee mechanism:taking medical-educational collaboration as the core goal,following the principles of cross-domain linkage and resource sharing,establishing a multi-level collaboration network,and achieving sustainable operation through institutional innovation and technological empowerment.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
文摘The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with patient safety culture in the emergency department (ED). Until September 2024, the international databases MEDLINE (PubMed and Ovid), Embase and Cochrane, Scopus, Wiley Online Library, Web of Science, Cochrane Central Register of Controlled Trials, EBSCO, ISI, Elsevier, and Google Scholar were searched using the search terms including patient safety culture and MNC. A total of eight articles were reviewed. In the fixed-effect model with low heterogeneity (I^(2) = 0%, P = 1), the mean score of overall MNC was 2.07 (ES, 2.97;95% confidence interval: −2.21-6.35). According to meta-regression analyses, MNC significantly inversely correlated with patient safety culture, age, and work experience (P < 0.01). By improving the working conditions of ED nurses and providing training related to patient safety, the amount of lost nursing care will decrease.
文摘BACKGROUND Ureteroneocystostomy(UNC)is considered the gold standard for pediatric vesicoureteral reflux(VUR)treatment.While UNC lowers the likelihood of needing additional VUR procedures within 12 months,patients also have high 30-day and 90-day readmission rates and emergency department(ED)visits.The most common causes of an ED visit following any urologic procedure are urinary tract infections(UTIs)and catheter/drain concerns.Prior studies are limited in identifying predisposing factors to help mitigate complications of UNC and improve patient outcomes.AIM To identify modifiable characteristics at the time of discharge after UNC that predict subsequent unplanned ED visits.METHODS The 2020 American College of Surgeons National Surgical Quality Improvement Program Pediatric data was analyzed for patients undergoing UNC for VUR.A total of 1742 patients were evaluated,with 1495 meeting inclusion criteria.Patients with an ED visit within 30 days following an anti-reflux procedure(n=164)were compared to those who did not return to the ED(n=1331).Basic statistics and logistic regression analysis were performed to find predictive factors associated with postoperative ED visits after UNC.RESULTS Among the 1495 patients,11.0%visited the ED within the 30-day postoperative period.Patients who returned to the ED visit following UNC were more likely to have had a longer mean operative time,surgical site infection,postoperative UTI,postoperative sepsis,history of prior readmission,unplanned reoperation,blood transfusion,or unplanned urinary catheter placement.Multivariate analysis revealed postoperative UTI(P<0.001),superficial surgical site infection(P=0.022),unplanned procedure(P<0.001),unplanned urinary catheter(P<0.001),and prematurity(35-36 weeks gestation)(P=0.004)as independent risk factors for postoperative ED visits.CONCLUSION Utmost caution is needed prior to discharge after UNC to forestall a return to the ED.Postoperative infection remains a primary risk for ED visits in the acute postoperative period.
文摘Stem cells are pluripotent cells that can divide and differentiate,forming many different types of cells.Stem cells can be obtained from various sources,with embryonic stem cells being the most advantageous as they possess a broad dividing potential.When the standard treatment proves ineffective,stem cells are typically utilized as a final option.Infections and childhood malignancies are among the significant causes of mortality in the pediatric population.Stem cell therapy has shown a decrease in morbidity and mortality when used in patients with favorable conditions like young age and lack of comorbidities.This review discusses how stem cells are prepared and used in treating pediatric diseases like X-linked agammaglobulinemia,diabetes mellitus,aplastic anemia,infections,and leukemia.Technological advancement has played a significant role in producing more specific stem cells using genetic modification methods like clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9,which produce stem cells that target a particular cell type,e.g.,myocytes and hematopoietic cells,further increasing the effectiveness of the therapy.We address the obstacles faced when conducting research related to stem cells,including ethical and legal issues,which hinder the use of this therapy in some fields.We also indicate recommendations for increasing the efficacy of stem cell therapy in the pediatric population.
基金supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under Award Number K02NS110973 and R01NS126498(to MAP).
文摘The central nervous system(CNS)does not function in isolation-it engages in continuous molecular dialogue with the vascular and immune systems.Traditionally,the blood-brain barrier(BBB)was portrayed solely as an impermeable wall,safeguarding the CNS by excluding blood-derived molecules and circulating cells.However,this view has evolved.The BBB is now recognized as a dynamic interface that selectively regulates the exchange of signals,cells.
文摘Clinically differentiating bipolarⅡdisorder(BD-Ⅱ)from major depressive disorder(MDD)remains a significant challenge in modern psychiatry.These two conditions share substantial clinical symptomatology,making accurate diagnosis difficult in routine clinical practice.Misdiagnosis may lead to inappropriate treatment strategies,increased psychological and physical burdens,reduced quality of life,and impaired social functioning.Genetic overlap may partially explain the clinical similarities between MDD and BD-Ⅱ,and biomarkers along with neuroimaging techniques are receiving increasing attention as tools to aid in diagnosis.For example,electroencephalography has been shown to effectively distinguish between unipolar depression and bipolar depression;serum levels of glycogen synthase kinase-3 have also been investigated as a potential tool for differentiating between the two disorders.A comprehensive assessment integrating clinical characteristics,genetic basis research,and multimodal evaluations using neuroimaging and biomarkers through a multidisciplinary approach will help enhance clinicians'ability to distinguish between MDD and BD-Ⅱ.By improving diagnostic accuracy,more personalized and effective treatment strategies can be developed,ultimately improving patients'health outcomes and quality of life.
文摘Medical history summary:The child has suffered from episodic joint pain in the lower extremities since childhood,with occurrences ranging from 1 to 3 times daily,predominantly during rainy,cold,and humid weather,as well as in the afternoons and evenings.Symptoms and signs:The primary manifestation is episodic pain in the distal extremities,predominantly in the lower limbs,knees,and ankles.Occasionally,the pain may ascend to the elbows,wrists,and palms,and may occasionally affect the proximal extremities and waist.Diagnostic methods:Nerve biopsy and related pathological examinations,along with whole exome sequencing,are helpful for diagnosis,particularly the detection of variants in the SCN11A gene.Treatment approaches:(1)Pharmacotherapy:Sodium channel blockers and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can alleviate pain.(2)Neuromodulation techniques:Techniques such as transcranial magnetic stimulation(TMS)and spinal cord stimulation(SCS)can be employed to improve symptoms.(3)Psychotherapy:Cognitive-behavioral therapy(CBT),relaxation training,or psychological counseling can enhance the patient’s coping abilities.Clinical outcome:Pain relief can be achieved with analgesic medication in children,and pain symptoms generally persist until adulthood,gradually diminishing or even disappearing.Patients can reduce the frequency of episodes by staying warm and avoiding cold and damp conditions.
基金supported by Department of Defense grant HT9425-24-1-0030 a grant from the Stanley Medical Research Institute(to SS).
文摘The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.
基金supported by General Program of National Natural Science Foundation of China,No.82370986(to LAW)Shaanxi Provincial NaturalScience Foundation Key Project,No.2023-JC-ZD-56(to SS).
文摘Emerging evidence suggests that the gut microbiota is closely associated with the pathological manifestations of multiple neurodegenerative diseases via the gut-brain axis,which refers to the crosstalk between the gut and the central nervous system.More importantly,mitochondria have been considered prominent mediators of the interplay between the gut microbiota and the brain.Intestinal microbes may modulate mitochondrial function in the central nervous system to affect the progression of neurodegenerative diseases.Mitochondria are essential for meeting the host’s substantial neuronal metabolic demands,maintaining excitability,and facilitating synaptic transmission.Dysfunctional mitochondria are considered critical hallmarks of various neurodegenerative diseases.Therefore,this review provides novel insights into the intricate roles of gut microbiota-mitochondrial crosstalk in the underlying mechanisms during the progression of neurodegeneration,as well as the existing potential therapeutic strategies for neurodegenerative disorders.These suggest intestinal microbiota-mitochondrial interaction play a crucial role in the occurrence and development of neurodegenerative diseases,and targeting this interaction may be a promising therapeutic approach to neurodegenerative diseases.However,this review found that there was relatively little research on the effect of this crosstalk on other neurodegenerative diseases,such as Huntington’s disease and Multiple sclerosis,and the potential therapeutic strategies were translated into clinical trials,which face many challenges in developing personalized treatment plans based on the unique gut microbiota of different individuals.
文摘Urinary tract infections(UTIs)are among the most prevalent pediatric bacterial infections,and undertreated episodes may lead to renal scarring,hypertension,or chronic kidney disease.Multidrug-resistant(MDR)Enterobacterales have been increasingly reported in children,with higher rates in Asian and Middle Eastern settings than in high-income countries[1,2].
文摘A recently published prospective study marks a breakthrough for congenital olfactory disorders in children.The study provides the first long-term,three-year follow-up data,robustly demonstrating the durable efficacy and safety of autologous nasal epithelial stem cell transplantation.This work reveals immense therapeutic potential for a condition traditionally considered untreatable.However,this milestone achievement also presents new challenges.To translate this pioneering therapy from a single-center success to a global standard,multicenter,controlled clinical trials must be initiated immediately.Only through rigorous validation can we ensure its widespread adoption and ultimately bring hope to millions of children worldwide.
文摘Hodgkin lymphoma(HL)is a heterogenous lymphoproliferative disorder of B-cell origin and represents one of the most common malignancies in children and young adults.In addition to well-known underlying factors-such as Epstein-Barr virus infection-the familial aggregation demonstrated in large population studies suggested a genetic predisposition.First-degree relatives of patients with HL have an approximately threefold increased risk of developing the disease compared to the general population.These observations have recently prompted several whole-genome studies in affected families,identifying variants possibly implicated in lymphomagenesis,including alterations in DICER1(a member of the ribonuclease III family),POT1(protection of telomeres 1),KDR(kinase insert domain receptor),KLHDC8B(kelch domain-containing protein 8B),PAX5(paired box protein 5),GATA3(GATA binding protein 3),IRF7(interferon regulatory factor 7),EEF2KMT(eukaryotic elongation factor 2 lysine methyltransferase),and POLR1E(RNA polymerase I subunit E).In this article,we review current insights into the etiopathogenesis and risks of familial HL,and present case reports involving two sisters diagnosed with HL nearly 17 years apart.Recognizing the risk for first-degree relatives may potentially increase awareness of early symptoms among family members of HL patients,leading to earlier diagnosis and better outcomes.Conversely,understanding that the hereditary risk,though higher than in the general population,remains relatively low may provide reassurance for affected families.
文摘Objectives:Photodynamic therapy(PDT)is a minimally invasive method used in the treatment of various cancers and skin diseases,but it is not widely used in bone cancer,where the current therapy is often not effective and accompanied by side effects.Alternative and more effective therapies like PDT are needed.In this in-vitro study,the effect of the photosensitizer(PS)chlorin e6(Ce6)on cancerous bone tumor cells using PDT was examined.Methods:A total of 27 tissue specimens from patients with primary bone cancers or bone metastases of different origins were genetically characterized and treated with PDT.Following a 24-h incubation,cell viability was determined,and the effect of PDT on cell migration was analyzed over 48 h.Results:We could demonstrate that the effect on proliferation of PDT in combination with the PS Ce6 was best in cells isolated from primary osteosarcoma and in bone metastases from mammary carcinomas.Besides proliferation,PDT was also effective in inhibiting the migration of these cells.A statistically significant correlation between the PDT effect and CD164 gene expression was detected,indicating that a high expression of this gene could result in a higher effectiveness of the photodynamic treatment.Conclusion:This study analyzes for the first time the effect of PDT in bone cancers and metastases and shows the potential of treating these cancer types with Ce6 PDT.
文摘Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.
文摘Traumatic brain injury(TBI)is a significant public health issue,affecting approximately 1.7 million people annually in the United States alone,with over 5 million experiencing long-term disabilities(Roozenbeek et al.,2013).A major sequela of TBI is long-lasting white matter injury(WMI)which includes traumatic axonal injury and loss of myelination,resulting in cognitive,behavioral,and psychiatric deficits in survivors.
