As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatri...As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation...BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics.The complex anatomy of this region,with its proximity to critical structures,demands a thorough understanding of assessment and management principles.This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma,with particular emphasis on early recognition of critical injuries,airway management strategies,and special population considerations.METHODS:A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases,which focused on maxillofacial trauma management in emergency settings.Articles were selected based on relevance to clinical practice,methodological quality,and current management guidelines.The review synthesized evidence from multiple study types,including original research,systematic reviews,and clinical practice guidelines,to provide practical guidance for emergency physicians.RESULTS:Initial assessment following Advanced Trauma Life Support(ATLS)principles is crucial,with airway management being a primary concern due to the risk of dynamic obstruction.Critical time-sensitive emergencies include orbital compartment syndrome,trapdoor fractures(in pediatric patients),and facial nerve injuries.Computed tomography(CT)imaging remains the gold standard for diagnosis.Special considerations are required for pediatric patients,who present unique anatomical challenges and injury patterns,and for elderly patients,who often have complex medical comorbidities and increased complication risks.Management strategies range from conservative treatment to urgent surgical intervention,with decisions based on the injury pattern and associated complications.CONCLUSION:Emergency physicians must maintain a structured yet fl exible approach to maxillofacial trauma,focusing on early recognition of critical injuries,appropriate airway management,and timely specialist consultation.Understanding injury patterns and their potential complications allows for eff ective risk stratifi cation and treatment planning,ultimately improving patient outcomes.展开更多
BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and...BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.展开更多
Knee osteoarthritis(KOA)represents one of the most common causes of chronic pain.The high prevalence and disability rates of KOA impose a severe burden on both individuals and society.In contrast to cutaneous pain,KOA...Knee osteoarthritis(KOA)represents one of the most common causes of chronic pain.The high prevalence and disability rates of KOA impose a severe burden on both individuals and society.In contrast to cutaneous pain,KOA-induced joint pain is characterized as a deep tissue pain that potentially involves distinct subgroups of peripheral sensory neurons and central processing mechanisms.Furthermore,KOA pain is closely related to locomotion activity.Impaired sensorimotor integration and pain mutually reinforce each other in KOA,forming a vicious cycle that exacerbates disease progression.In this review,we highlight the key differences between KOA pain and cutaneous pain,and the latter has been extensively studied in the pain field.We hope to offer new insights into the central mechanisms and development of new treatment strategies for KOA based on the interactions between impaired sensorimotor integration and chronic joint pain.展开更多
Synapses are key structures involved in transmitting information in the nervous system,and their functions rely on the regulation of various lipids.Lipids play important roles in synapse formation,neurotransmitter rel...Synapses are key structures involved in transmitting information in the nervous system,and their functions rely on the regulation of various lipids.Lipids play important roles in synapse formation,neurotransmitter release,and signal transmission,and dysregulation of lipid metabolism is closely associated with various neurodegenerative diseases.The complex roles of lipids in synaptic function and neurological diseases have recently garnered increasing attention,but their specific mechanisms remain to be fully understood.This review aims to explore how lipids regulate synaptic activity in the central nervous system,focusing on their roles in synapse formation,neurotransmitter release,and signal transmission.Additionally,it discusses the mechanisms by which glial cells modulate synaptic function through lipid regulation.This review shows that within the central nervous system,lipids are essential components of the cell membrane bilayer,playing critical roles in synaptic structure and function.They regulate presynaptic vesicular trafficking,postsynaptic signaling pathways,and glial-neuronal interactions.Cholesterol maintains membrane fluidity and promotes the formation of lipid rafts.Glycerophospholipids contribute to the structural integrity of synaptic membranes and are involved in the release of synaptic vesicles.Sphingolipids interact with synaptic receptors through various mechanisms to regulate their activity and are also involved in cellular processes such as inflammation and apoptosis.Fatty acids are vital for energy metabolism and the synthesis of signaling molecules.Abnormalities in lipid metabolism may lead to impairments in synaptic function,affecting information transmission between neurons and the overall health of the nervous system.Therapeutic strategies targeting lipid metabolism,particularly through cholesterol modulation,show promise for treating these conditions.In neurodegenerative diseases such as Alzheimer’s disease,Parkinson disease,and amyotrophic lateral sclerosis,dysregulation of lipid metabolism is closely linked to synaptic dysfunction.Therefore,lipids are not only key molecules in neural regeneration and synaptic repair but may also contribute to neurodegenerative pathology when metabolic dysregulation occurs.Further research is needed to elucidate the specific mechanisms linking lipid metabolism to synaptic dysfunction and to develop targeted lipid therapies for neurological diseases.展开更多
<p> <span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Objective:</span></b></span><span><span><span style="font-...<p> <span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Objective:</span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> To learn the epidemiological, clinical, paraclinical, therapeutical aspects and prognosis of haemorrhage of the third trimester during pregnancy. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">It is about a transversal</span><b> </b><span style="font-family:Verdana;">and descriptive</span><b> </b><span style="font-family:Verdana;">study,</span><b> </b><span style="font-family:Verdana;">realized at the department of obstetrics and gynaecology from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to June 30</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020. Was included in the study any pregnant patient showing the third trimester bleeding (</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">≥</span><span><span style="font-family:Verdana;">28 Weeks gestation) received for bleeding during our study period and has been taken in charge in our department. The parameters stu</span><span style="font-family:Verdana;">died were on the socio-demographic characteristics, the clinical and para c</span><span style="font-family:Verdana;">linical aspects, the noted diagnosis, the therapeutic aspects, maternal and perinatal prognosis. The information w</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> collected from an inquiry document, the clinical files, the register of delivery room and childbirth, surgery protocols. The type and the analysis of the data were done by the softwares Word, Excel 2013 and Epi Info version 7.2.3. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We registered 2159 deliveries and 105 cases of third trimester bleeding, so a frequency of 4.86%. The average age was 30.14</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">± 6.57 [16</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">49</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">years old] and the average parity was 3 [0</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">10]. Married women represented 87.62% of all. They were in a bad condition in 41.90% of cases. Fetal heart-sound w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> absent in 65.76% of cases. The diagnosis checked w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> abruptio placenta, placenta previa and the uterus rupture. A blood transfusion of concentrated red blood cells Isogroup and Isorhesus was performed to 45.72% of cases. Caesarean section was performed in 54.29% of cases. Complications were observed in 74.28% of cases. The maternal lethality rate was 13.33% with a perinatal mortality of 74.77%. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The third trimester bleeding</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> frequent in developing countries because of poor obstetric coverage in this countr</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">y</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. The perinatal prognosis is often bad because of late diagnosis, difficult access to Health Center with adequate technical platforms, miss of blood products and miss of qualified staff to take in charge th</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">se emergencies.</span></span></span> </p>展开更多
VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a ra...VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a rare condition that was not reported until 2020.[2]Since then,interest among dermatologists,hematologists,and rheumatologists with published works has increased,[3]but none of them reported in the emergency setting,nor have any cases arisen following COVID-19 infection.展开更多
In 2012,we published the first special issue on the mechanisms of pain and itch in Neuroscience Bulletin[1],covering peripheral[2,3],central[4],and glial[5]mechanisms.In 2018,the second special issue expanded on these...In 2012,we published the first special issue on the mechanisms of pain and itch in Neuroscience Bulletin[1],covering peripheral[2,3],central[4],and glial[5]mechanisms.In 2018,the second special issue expanded on these topics[6],featuring single-cell profiling and in vivo Ca2+imaging of primary sensory neurons[7,8],and illustrating how nociceptors regulate pain,itch,and infection[9].It also highlighted spinal neurocircuits of pain[10]and itch[11],glial contributions[12],sex differences[13],and supraspinal mechanisms underlying pain and empathy[14,15].Over the past seven years,significant advances have been made in neuroglial and neuroimmune interactions and supraspinal circuits.Thus,this third special issue—comprising one review,eleven original articles,and one research highlight[16,17,18,19,20,21,22,23,24,25,26,27,28]—timely summarizes recent progress in pain and itch research.展开更多
Diffuse large B-cell lymphoma(DLBCL),the most common subtype of non-Hodgkin’s lymphoma(NHL)worldwide,accounts for 39% and 44% of nodal and extranodal NHL cases in China,respectively1.Standard first-line treatment for...Diffuse large B-cell lymphoma(DLBCL),the most common subtype of non-Hodgkin’s lymphoma(NHL)worldwide,accounts for 39% and 44% of nodal and extranodal NHL cases in China,respectively1.Standard first-line treatment for DLBCL is chemo-immunotherapy with rituximab,cyclophos-phamide,doxorubicin,vincristine,and prednisone,which cures 50%-60% of patients2.展开更多
Noncohesive particle clusters are identified and tracked in turbulent flows to determine the breakdown and time evolution of cluster statistics and their implications for interscale mass transfer,which has connections...Noncohesive particle clusters are identified and tracked in turbulent flows to determine the breakdown and time evolution of cluster statistics and their implications for interscale mass transfer,which has connections to the classical turbulent energy cascade and its mass cascade counterpart running in parallel.In particular,the formation and dynamics of sediment and larvae clusters are of interest to coral larvae settlement in coastal regions and particularly the resilience of green-gray coastal protection solutions.Analogous cluster behavior is relevant to cloud microphysics and precipitation initiation,radiation transport and light transmission through colloids and suspensions,heat and mass transfer in particle-laden flows,and viral and pollutant transmission.Following a comparison between various clustering techniques,we adopt a density-based cluster identification algorithm based on its simplicity and efficiency,where particles are clustered based on the number of neighboring particles in their individual spheres of influence.We establish parallels with lattice-based percolation theory,as evident in the power-law scaling of the cluster size distribution near the percolation threshold.The degree of discontinuity of the phase transition associated with this percolation threshold is observed to broaden with larger Stokes numbers and thereby large-scale clustering.The sensitivity of our findings to the employed clustering algorithm is discussed.A novel cluster tracking algorithm is deployed to determine the interscale transfer rate along the particle-number phase-space dimension via accounting of cluster breakup and merger events,extending previous work on the bubble breakup cascade beneath surface breaking waves.Our findings shed light on the interaction between particle clusters and their carrier turbulent flows,with an eye toward transport models incorporating cluster characteristics and dynamics.展开更多
Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.展开更多
Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and manag...Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.展开更多
The cure rate for chronic neurodegenerative diseases remains low,creating an urgent need for improved intervention methods.Recent studies have shown that enhancing mitochondrial function can mitigate the effects of th...The cure rate for chronic neurodegenerative diseases remains low,creating an urgent need for improved intervention methods.Recent studies have shown that enhancing mitochondrial function can mitigate the effects of these diseases.This paper comprehensively reviews the relationship between mitochondrial dysfunction and chronic neurodegenerative diseases,aiming to uncover the potential use of targeted mitochondrial interventions as viable therapeutic options.We detail five targeted mitochondrial intervention strategies for chronic neurodegenerative diseases that act by promoting mitophagy,inhibiting mitochondrial fission,enhancing mitochondrial biogenesis,applying mitochondria-targeting antioxidants,and transplanting mitochondria.Each method has unique advantages and potential limitations,making them suitable for various therapeutic situations.Therapies that promote mitophagy or inhibit mitochondrial fission could be particularly effective in slowing disease progression,especially in the early stages.In contrast,those that enhance mitochondrial biogenesis and apply mitochondria-targeting antioxidants may offer great benefits during the middle stages of the disease by improving cellular antioxidant capacity and energy metabolism.Mitochondrial transplantation,while still experimental,holds great promise for restoring the function of damaged cells.Future research should focus on exploring the mechanisms and effects of these intervention strategies,particularly regarding their safety and efficacy in clinical settings.Additionally,the development of innovative mitochondria-targeting approaches,such as gene editing and nanotechnology,may provide new solutions for treating chronic neurodegenerative diseases.Implementing combined therapeutic strategies that integrate multiple intervention methods could also enhance treatment outcomes.展开更多
Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientati...Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.展开更多
This paper presents an Eulerian-Lagrangian algorithm for direct numerical simulation(DNS)of particle-laden flows.The algorithm is applicable to perform simulations of dilute suspensions of small inertial particles in ...This paper presents an Eulerian-Lagrangian algorithm for direct numerical simulation(DNS)of particle-laden flows.The algorithm is applicable to perform simulations of dilute suspensions of small inertial particles in turbulent carrier flow.The Eulerian framework numerically resolves turbulent carrier flow using a parallelized,finite-volume DNS solver on a staggered Cartesian grid.Particles are tracked using a point-particle method utilizing a Lagrangian particle tracking(LPT)algorithm.The proposed Eulerian-Lagrangian algorithm is validated using an inertial particle-laden turbulent channel flow for different Stokes number cases.The particle concentration profiles and higher-order statistics of the carrier and dispersed phases agree well with the benchmark results.We investigated the effect of fluid velocity interpolation and numerical integration schemes of particle tracking algorithms on particle dispersion statistics.The suitability of fluid velocity interpolation schemes for predicting the particle dispersion statistics is discussed in the framework of the particle tracking algorithm coupled to the finite-volume solver.In addition,we present parallelization strategies implemented in the algorithm and evaluate their parallel performance.展开更多
BACKGROUND Chronic kidney disease(CKD)contributes significantly to emergency department(ED)presentations in low-and middle-income countries.These patients frequently have multiple comorbidities and face high in-hospit...BACKGROUND Chronic kidney disease(CKD)contributes significantly to emergency department(ED)presentations in low-and middle-income countries.These patients frequently have multiple comorbidities and face high in-hospital mortality.However,limited data exist on early predictors of mortality at ED admission.Identifying key clinical and laboratory features associated with adverse outcomes may support timely risk stratification and targeted interventions for acutely ill CKD patients.AIM To identify baseline predictors of in-hospital mortality in adult Indian patients with CKD admitted to the ED.METHODS This retrospective study was conducted from January 2021 to December 2022 at the Acute Care and Emergency Medicine Unit of the Postgraduate Institute of Medical Education and Research,Chandigarh,India.CKD was diagnosed and staged following the Kidney Disease:Improving Global Outcomes guidelines.Data were extracted from medical records using a structured form.All consecutive patients aged≥18 years were included.Independent mortality predictors were identified using multivariate Cox regression analysis.RESULTS Among 354 patients(mean age 49 years;58%males),60.5%had CKD stage 5,and 41.2%were on maintenance dialysis.Hypertension(74.9%)and diabetes(46.0%)were common comorbidities.Diabetic kidney disease was the primary etiology in 35.6%,while 43.2%had unknown causes.Infection(63.0%)was the most frequent cause for ED admission.In-hospital mortality was 29.1%(n=103).Independent mortality predictors were Glasgow coma scale(GCS)<15[hazard ratio(HR):1.822,P=0.017],hyperglycemia(HR:1.641,P=0.020),and low albumin(HR:1.270,P=0.028).Advanced age,Charlson comorbidity Index,quick Sequential Organ Failure Assessment,and neutrophilia were significant in univariate but not multivariate analysis.CKD stage,dialysis dependency,cardiovascular disease,and neutrophil-lymphocyte ratio were not predictive.CONCLUSION A low GCS,hyperglycemia,and low albumin levels at admission independently predict in-hospital mortality in CKD patients presenting to the ED,warranting early recognition and targeted interventions.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
Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital...Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital in our African regions. This study aimed to investigate the knowledge and perception of uterine fibroids among women who came to the gynecology-obstetrics department of the Regional Hospital Center (CHR) Tsévié. Methodology: It was a cross-sectional descriptive study, with data collection conducted from May 7th to 20th, 2024, using systematic sampling. The study included all women present in the Gynecology-Obstetrics Department of CHR Tsévié during the study period who willingly and informedly consented to participate in the survey. Results: 362 women participated in the study. Among them, 36.8% had a secondary level, and 72.9% were Christians. About 97.5% had heard of uterine fibroids. In 63.5% of cases, their entourage was the principal source of information. The diagnostic methods mentioned by the women were ultrasound in 94.6% of cases, while prayers and occultism were also cited in 28% and 33.3% of cases, respectively. While 91.9% of the women considered the hospital, the place for treatment, some indicated that treatment would require plant-based approaches (46.8%) and prayers (26%). The cost of treatment was an obstacle for 85.4% of women, and 61.3% expressed fear of dying during surgery. There was a statistically significant relationship between treatment choice and religion. Conclusion: The majority of women had heard of uterine fibroids but had incorrect information about the treatment.展开更多
文摘As a critical department ensuring the sterility of hospital instruments,the Sterile Supply Center(SSC)directly impacts the sterility status of clinical instruments through its sterilization qualification rate.Geriatric patients,due to physiological decline and compromised immune function,constitute a high-risk group for hospital-acquired infections,with more stringent requirements for instrument sterility.This paper analyzes the current status and influencing factors of sterilization qualification rates in SSCs,explores the mechanistic association between sterilization qualification rates and infections in geriatric departments,and proposes targeted strategies to improve sterilization qualification rates.It highlights the pivotal role of SSC instrument sterilization in infection prevention and control for geriatric patients,providing theoretical basis and practical guidance for optimizing SSC management,reducing infection rates in geriatric departments,and ensuring the safety of elderly patients’medical care.These findings aim to enhance overall infection management standards in hospitals.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
文摘BACKGROUND:Maxillofacial trauma represents a significant challenge in emergency medicine,requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics.The complex anatomy of this region,with its proximity to critical structures,demands a thorough understanding of assessment and management principles.This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma,with particular emphasis on early recognition of critical injuries,airway management strategies,and special population considerations.METHODS:A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases,which focused on maxillofacial trauma management in emergency settings.Articles were selected based on relevance to clinical practice,methodological quality,and current management guidelines.The review synthesized evidence from multiple study types,including original research,systematic reviews,and clinical practice guidelines,to provide practical guidance for emergency physicians.RESULTS:Initial assessment following Advanced Trauma Life Support(ATLS)principles is crucial,with airway management being a primary concern due to the risk of dynamic obstruction.Critical time-sensitive emergencies include orbital compartment syndrome,trapdoor fractures(in pediatric patients),and facial nerve injuries.Computed tomography(CT)imaging remains the gold standard for diagnosis.Special considerations are required for pediatric patients,who present unique anatomical challenges and injury patterns,and for elderly patients,who often have complex medical comorbidities and increased complication risks.Management strategies range from conservative treatment to urgent surgical intervention,with decisions based on the injury pattern and associated complications.CONCLUSION:Emergency physicians must maintain a structured yet fl exible approach to maxillofacial trauma,focusing on early recognition of critical injuries,appropriate airway management,and timely specialist consultation.Understanding injury patterns and their potential complications allows for eff ective risk stratifi cation and treatment planning,ultimately improving patient outcomes.
文摘BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.
基金supported by the Natural Science Foundation of Beijing Municipality(No.F252065)the National Natural Science Foundation of China(No.32271190,32571323)the STI 2030 Major Project(No.2021ZD0203202)。
文摘Knee osteoarthritis(KOA)represents one of the most common causes of chronic pain.The high prevalence and disability rates of KOA impose a severe burden on both individuals and society.In contrast to cutaneous pain,KOA-induced joint pain is characterized as a deep tissue pain that potentially involves distinct subgroups of peripheral sensory neurons and central processing mechanisms.Furthermore,KOA pain is closely related to locomotion activity.Impaired sensorimotor integration and pain mutually reinforce each other in KOA,forming a vicious cycle that exacerbates disease progression.In this review,we highlight the key differences between KOA pain and cutaneous pain,and the latter has been extensively studied in the pain field.We hope to offer new insights into the central mechanisms and development of new treatment strategies for KOA based on the interactions between impaired sensorimotor integration and chronic joint pain.
基金supported by the National Natural Science Foundation of China,No.82201568(to QQ)Capital’s Funds for Health Improvement and Research,No.2024-2-1031(to QQ)Beijing Nova Program,No.20240484566(to QQ).
文摘Synapses are key structures involved in transmitting information in the nervous system,and their functions rely on the regulation of various lipids.Lipids play important roles in synapse formation,neurotransmitter release,and signal transmission,and dysregulation of lipid metabolism is closely associated with various neurodegenerative diseases.The complex roles of lipids in synaptic function and neurological diseases have recently garnered increasing attention,but their specific mechanisms remain to be fully understood.This review aims to explore how lipids regulate synaptic activity in the central nervous system,focusing on their roles in synapse formation,neurotransmitter release,and signal transmission.Additionally,it discusses the mechanisms by which glial cells modulate synaptic function through lipid regulation.This review shows that within the central nervous system,lipids are essential components of the cell membrane bilayer,playing critical roles in synaptic structure and function.They regulate presynaptic vesicular trafficking,postsynaptic signaling pathways,and glial-neuronal interactions.Cholesterol maintains membrane fluidity and promotes the formation of lipid rafts.Glycerophospholipids contribute to the structural integrity of synaptic membranes and are involved in the release of synaptic vesicles.Sphingolipids interact with synaptic receptors through various mechanisms to regulate their activity and are also involved in cellular processes such as inflammation and apoptosis.Fatty acids are vital for energy metabolism and the synthesis of signaling molecules.Abnormalities in lipid metabolism may lead to impairments in synaptic function,affecting information transmission between neurons and the overall health of the nervous system.Therapeutic strategies targeting lipid metabolism,particularly through cholesterol modulation,show promise for treating these conditions.In neurodegenerative diseases such as Alzheimer’s disease,Parkinson disease,and amyotrophic lateral sclerosis,dysregulation of lipid metabolism is closely linked to synaptic dysfunction.Therefore,lipids are not only key molecules in neural regeneration and synaptic repair but may also contribute to neurodegenerative pathology when metabolic dysregulation occurs.Further research is needed to elucidate the specific mechanisms linking lipid metabolism to synaptic dysfunction and to develop targeted lipid therapies for neurological diseases.
文摘<p> <span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Objective:</span></b></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> To learn the epidemiological, clinical, paraclinical, therapeutical aspects and prognosis of haemorrhage of the third trimester during pregnancy. </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:Verdana;">It is about a transversal</span><b> </b><span style="font-family:Verdana;">and descriptive</span><b> </b><span style="font-family:Verdana;">study,</span><b> </b><span style="font-family:Verdana;">realized at the department of obstetrics and gynaecology from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to June 30</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020. Was included in the study any pregnant patient showing the third trimester bleeding (</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">≥</span><span><span style="font-family:Verdana;">28 Weeks gestation) received for bleeding during our study period and has been taken in charge in our department. The parameters stu</span><span style="font-family:Verdana;">died were on the socio-demographic characteristics, the clinical and para c</span><span style="font-family:Verdana;">linical aspects, the noted diagnosis, the therapeutic aspects, maternal and perinatal prognosis. The information w</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> collected from an inquiry document, the clinical files, the register of delivery room and childbirth, surgery protocols. The type and the analysis of the data were done by the softwares Word, Excel 2013 and Epi Info version 7.2.3. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We registered 2159 deliveries and 105 cases of third trimester bleeding, so a frequency of 4.86%. The average age was 30.14</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">± 6.57 [16</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">49</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">years old] and the average parity was 3 [0</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">10]. Married women represented 87.62% of all. They were in a bad condition in 41.90% of cases. Fetal heart-sound w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> absent in 65.76% of cases. The diagnosis checked w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">as</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> abruptio placenta, placenta previa and the uterus rupture. A blood transfusion of concentrated red blood cells Isogroup and Isorhesus was performed to 45.72% of cases. Caesarean section was performed in 54.29% of cases. Complications were observed in 74.28% of cases. The maternal lethality rate was 13.33% with a perinatal mortality of 74.77%. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The third trimester bleeding</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> frequent in developing countries because of poor obstetric coverage in this countr</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">y</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. The perinatal prognosis is often bad because of late diagnosis, difficult access to Health Center with adequate technical platforms, miss of blood products and miss of qualified staff to take in charge th</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">se emergencies.</span></span></span> </p>
基金National High Level Hospital Clinical Research Funding(Scientific Research Seed Fund of Peking University First Hospital).
文摘VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a rare condition that was not reported until 2020.[2]Since then,interest among dermatologists,hematologists,and rheumatologists with published works has increased,[3]but none of them reported in the emergency setting,nor have any cases arisen following COVID-19 infection.
文摘In 2012,we published the first special issue on the mechanisms of pain and itch in Neuroscience Bulletin[1],covering peripheral[2,3],central[4],and glial[5]mechanisms.In 2018,the second special issue expanded on these topics[6],featuring single-cell profiling and in vivo Ca2+imaging of primary sensory neurons[7,8],and illustrating how nociceptors regulate pain,itch,and infection[9].It also highlighted spinal neurocircuits of pain[10]and itch[11],glial contributions[12],sex differences[13],and supraspinal mechanisms underlying pain and empathy[14,15].Over the past seven years,significant advances have been made in neuroglial and neuroimmune interactions and supraspinal circuits.Thus,this third special issue—comprising one review,eleven original articles,and one research highlight[16,17,18,19,20,21,22,23,24,25,26,27,28]—timely summarizes recent progress in pain and itch research.
基金sponsored by Shanghai Roche Pharmaceuticals Ltd.
文摘Diffuse large B-cell lymphoma(DLBCL),the most common subtype of non-Hodgkin’s lymphoma(NHL)worldwide,accounts for 39% and 44% of nodal and extranodal NHL cases in China,respectively1.Standard first-line treatment for DLBCL is chemo-immunotherapy with rituximab,cyclophos-phamide,doxorubicin,vincristine,and prednisone,which cures 50%-60% of patients2.
文摘Noncohesive particle clusters are identified and tracked in turbulent flows to determine the breakdown and time evolution of cluster statistics and their implications for interscale mass transfer,which has connections to the classical turbulent energy cascade and its mass cascade counterpart running in parallel.In particular,the formation and dynamics of sediment and larvae clusters are of interest to coral larvae settlement in coastal regions and particularly the resilience of green-gray coastal protection solutions.Analogous cluster behavior is relevant to cloud microphysics and precipitation initiation,radiation transport and light transmission through colloids and suspensions,heat and mass transfer in particle-laden flows,and viral and pollutant transmission.Following a comparison between various clustering techniques,we adopt a density-based cluster identification algorithm based on its simplicity and efficiency,where particles are clustered based on the number of neighboring particles in their individual spheres of influence.We establish parallels with lattice-based percolation theory,as evident in the power-law scaling of the cluster size distribution near the percolation threshold.The degree of discontinuity of the phase transition associated with this percolation threshold is observed to broaden with larger Stokes numbers and thereby large-scale clustering.The sensitivity of our findings to the employed clustering algorithm is discussed.A novel cluster tracking algorithm is deployed to determine the interscale transfer rate along the particle-number phase-space dimension via accounting of cluster breakup and merger events,extending previous work on the bubble breakup cascade beneath surface breaking waves.Our findings shed light on the interaction between particle clusters and their carrier turbulent flows,with an eye toward transport models incorporating cluster characteristics and dynamics.
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
文摘Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.
基金partly supported by the Yan’an University Qin Chuanyuan“Scientist+Engineer”Team Special Fund,No.2023KXJ-012(to YL)Yan’an University Transformation of Scientific and Technological Achievements Fund,No.2023CGZH-001(to YL)+2 种基金College Students Innovation and Entrepreneurship Training Program,Nos.D2023158,202410719056(to XS,JM)Yan’an University Production and Cultivation Project,No.CXY202001(to YL)Kweichow Moutai Hospital Research and Talent Development Fund Project,No.MTyk2022-25(to XO)。
文摘The cure rate for chronic neurodegenerative diseases remains low,creating an urgent need for improved intervention methods.Recent studies have shown that enhancing mitochondrial function can mitigate the effects of these diseases.This paper comprehensively reviews the relationship between mitochondrial dysfunction and chronic neurodegenerative diseases,aiming to uncover the potential use of targeted mitochondrial interventions as viable therapeutic options.We detail five targeted mitochondrial intervention strategies for chronic neurodegenerative diseases that act by promoting mitophagy,inhibiting mitochondrial fission,enhancing mitochondrial biogenesis,applying mitochondria-targeting antioxidants,and transplanting mitochondria.Each method has unique advantages and potential limitations,making them suitable for various therapeutic situations.Therapies that promote mitophagy or inhibit mitochondrial fission could be particularly effective in slowing disease progression,especially in the early stages.In contrast,those that enhance mitochondrial biogenesis and apply mitochondria-targeting antioxidants may offer great benefits during the middle stages of the disease by improving cellular antioxidant capacity and energy metabolism.Mitochondrial transplantation,while still experimental,holds great promise for restoring the function of damaged cells.Future research should focus on exploring the mechanisms and effects of these intervention strategies,particularly regarding their safety and efficacy in clinical settings.Additionally,the development of innovative mitochondria-targeting approaches,such as gene editing and nanotechnology,may provide new solutions for treating chronic neurodegenerative diseases.Implementing combined therapeutic strategies that integrate multiple intervention methods could also enhance treatment outcomes.
文摘Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.
基金supported by the P.G.Senapathy Center for Computing Resources at IIT Madrasfunding provided by the Ministry of Education,Government of Indiasupported by the National Natural Science Foundation of China(Grant Nos.12388101,12472224 and 92252104).
文摘This paper presents an Eulerian-Lagrangian algorithm for direct numerical simulation(DNS)of particle-laden flows.The algorithm is applicable to perform simulations of dilute suspensions of small inertial particles in turbulent carrier flow.The Eulerian framework numerically resolves turbulent carrier flow using a parallelized,finite-volume DNS solver on a staggered Cartesian grid.Particles are tracked using a point-particle method utilizing a Lagrangian particle tracking(LPT)algorithm.The proposed Eulerian-Lagrangian algorithm is validated using an inertial particle-laden turbulent channel flow for different Stokes number cases.The particle concentration profiles and higher-order statistics of the carrier and dispersed phases agree well with the benchmark results.We investigated the effect of fluid velocity interpolation and numerical integration schemes of particle tracking algorithms on particle dispersion statistics.The suitability of fluid velocity interpolation schemes for predicting the particle dispersion statistics is discussed in the framework of the particle tracking algorithm coupled to the finite-volume solver.In addition,we present parallelization strategies implemented in the algorithm and evaluate their parallel performance.
文摘BACKGROUND Chronic kidney disease(CKD)contributes significantly to emergency department(ED)presentations in low-and middle-income countries.These patients frequently have multiple comorbidities and face high in-hospital mortality.However,limited data exist on early predictors of mortality at ED admission.Identifying key clinical and laboratory features associated with adverse outcomes may support timely risk stratification and targeted interventions for acutely ill CKD patients.AIM To identify baseline predictors of in-hospital mortality in adult Indian patients with CKD admitted to the ED.METHODS This retrospective study was conducted from January 2021 to December 2022 at the Acute Care and Emergency Medicine Unit of the Postgraduate Institute of Medical Education and Research,Chandigarh,India.CKD was diagnosed and staged following the Kidney Disease:Improving Global Outcomes guidelines.Data were extracted from medical records using a structured form.All consecutive patients aged≥18 years were included.Independent mortality predictors were identified using multivariate Cox regression analysis.RESULTS Among 354 patients(mean age 49 years;58%males),60.5%had CKD stage 5,and 41.2%were on maintenance dialysis.Hypertension(74.9%)and diabetes(46.0%)were common comorbidities.Diabetic kidney disease was the primary etiology in 35.6%,while 43.2%had unknown causes.Infection(63.0%)was the most frequent cause for ED admission.In-hospital mortality was 29.1%(n=103).Independent mortality predictors were Glasgow coma scale(GCS)<15[hazard ratio(HR):1.822,P=0.017],hyperglycemia(HR:1.641,P=0.020),and low albumin(HR:1.270,P=0.028).Advanced age,Charlson comorbidity Index,quick Sequential Organ Failure Assessment,and neutrophilia were significant in univariate but not multivariate analysis.CKD stage,dialysis dependency,cardiovascular disease,and neutrophil-lymphocyte ratio were not predictive.CONCLUSION A low GCS,hyperglycemia,and low albumin levels at admission independently predict in-hospital mortality in CKD patients presenting to the ED,warranting early recognition and targeted interventions.
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.
文摘Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital in our African regions. This study aimed to investigate the knowledge and perception of uterine fibroids among women who came to the gynecology-obstetrics department of the Regional Hospital Center (CHR) Tsévié. Methodology: It was a cross-sectional descriptive study, with data collection conducted from May 7th to 20th, 2024, using systematic sampling. The study included all women present in the Gynecology-Obstetrics Department of CHR Tsévié during the study period who willingly and informedly consented to participate in the survey. Results: 362 women participated in the study. Among them, 36.8% had a secondary level, and 72.9% were Christians. About 97.5% had heard of uterine fibroids. In 63.5% of cases, their entourage was the principal source of information. The diagnostic methods mentioned by the women were ultrasound in 94.6% of cases, while prayers and occultism were also cited in 28% and 33.3% of cases, respectively. While 91.9% of the women considered the hospital, the place for treatment, some indicated that treatment would require plant-based approaches (46.8%) and prayers (26%). The cost of treatment was an obstacle for 85.4% of women, and 61.3% expressed fear of dying during surgery. There was a statistically significant relationship between treatment choice and religion. Conclusion: The majority of women had heard of uterine fibroids but had incorrect information about the treatment.
