Impact of task-oriented training based on acupuncture rehabilitation on upper extremity function and quality of life of patients with early stroke

BACKGROUND Eighty percent of stroke patients develop upper limb dysfunction,especially hand dysfunction,which has a very slow recovery,resulting in economic burden to families and society.AIM To investigate the impact of task-oriented training based on acupuncture therapy on upper extremity function in patients with early stroke.METHODS Patients with early stroke hemiplegia who visited our hospital between January 2021 and October 2022 were divided into a control group and an observation group,each with 50 cases.The control group underwent head acupuncture plus routine upper limb rehabilitation training(acupuncture therapy).In addition to acupuncture and rehabilitation,the observation group underwent upper limb task-oriented training(30 min).Each group underwent treatment 5 d/wk for 4 wk.Upper extremity function was assessed in both groups using the Fugl-Meyer Assessment-Upper Extremity(FMA-UE),Wolf Motor Function Rating Scale(WMFT),modified Barthel Index(MBI),and Canadian Occupational Performance Measure(COPM).Quality of life was evaluated using the Short-Form 36-Item Health Survey(SF-36).Clinical efficacy of the interventions was also evaluated.RESULTS Before intervention,no significant differences were observed in the FMA-UE,MBI,and WMFT scores between the two groups(P>0.05).After intervention,the FMA-UE,WMFT,MBI,COPM-Functional Mobility and Satisfaction,and SF-36 scores increased in both groups(P<0.05),with even higher scores in the observation group(P<0.05).The observation group also obtained a higher total effective rate than the control group(P<0.05).CONCLUSION Task-oriented training based on acupuncture rehabilitation significantly enhanced upper extremity mobility,quality of life,and clinical efficacy in patients with early stroke.

Analysis of alkaline phosphatase and γ-glutamyltransferase after radiofrequency ablation of primary liver cancer: A retrospective study

BACKGROUND Changes in alkaline phosphatase(ALP)andγ-glutamyltransferase(GGT)levels in patients with primary liver cancer(PLC)after radiofrequency ablation(RFA).Hepatocellular carcinoma is a malignant tumor with high incidence worldwide.As a common local treatment,RFA has attracted much attention for its efficacy and influence on liver function.AIM To investigate the effect of serum ALP and GGT levels on the prognosis of patients with PLC treated by RFA.METHODS The preoperative clinical data of 165 patients who were pathologically or clinically diagnosed with PLC and who received RFA in our hospital between October 2018 and June 2023 were collected.The chi-square test was used to compare the data between groups.The Kaplan-Meier method and Cox regression were used to analyze the associ-ations between serum ALP and GGT levels and overall survival,progression-free survival(PFS)and clinical characteristics of patients before treatment.RESULTS The 1-year survival rates of patients with normal(≤135 U/L)and abnormal(>135 U/L)serum ALP before treatment were 91%and 79%,respectively;the 2-year survival rates were 90%and 68%,respectively;and the 5-year survival rates were 35%and 18%,respectively.The difference between the two groups was statistically significant(P=0.01).Before treatment,the 1-year survival rates of patients with normal serum GGT levels(≤45 U/L)and abnormal serum GGT levels(>45 U/L)were 95%and 87%,the 2-year survival rates were 85%and 71%,and the 5-year survival rates were 37%and 21%,respectively.The difference between the two groups was statist-ically significant(P<0.001).Serum ALP[hazard ratio(HR)=1.766,95%confidence interval(95%CI):1.068-2.921,P=0.027]and GGT(HR=2.312,95%CI:1.367-3.912,P=0.002)is closely related to the overall survival of PLC patients after RF ablation and is an independent prognostic factor.The 1-year PFS rates were 72%and 50%,the 2-year PFS rates were 52%and 21%,and the 5-year PFS rates were 14%and 3%,respectively.The difference between the two groups was statistically significant(P<0001).The 1-year PFS rates were 81%and 56%in patients with normal and abnormal serum GGT levels before treatment,respectively;the 2-year PFS rates were 62%and 35%,respectively;and the 5-year PFS rates were 18%and 7%,respectively,with statistical significance between the two groups(P<0.001).The serum ALP concentration(HR=1.653,95%CI:1.001-2.729,P=0.049)and GGT(HR=1.949,95%CI:1.296-2.930,P=0.001)was closely associated with PFS after RFA in patients with PLC.The proportion of male patients with abnormal ALP levels is high,the Child-Pugh grade of liver function is poor,and the incidence of ascites is high.Among GGT-abnormal patients,the Child-Pugh grade of liver function was poor,the tumor stage was late,the proportion of patients with tumors≥5 cm was high,and the incidence of hepatic encephalopathy was high.CONCLUSION Serum ALP and GGT levels before treatment can be used to predict the prognosis of patients with PLC after RFA,and they have certain guiding significance for the long-term survival of patients with PLC after radiofrequency therapy.

Clinical Analysis of 128 Children and Adolescents with Echinococcosis

Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.

Effect of magnetic resonance imaging in liver metastases

This letter to the editor is a commentary on a study titled"Liver metastases:The role of magnetic resonance imaging."Exploring a noninvasive imaging evaluation system for the biological behavior of hepatocellular carcinoma(HCC)is the key to achieving precise diagnosis and treatment and improving prognosis.This review summarizes the role of magnetic resonance imaging in the detection and evaluation of liver metastases,describes its main imaging features,and focuses on the added value of the latest imaging tools(such as T1 weighted in phase imaging,T1 weighted out of phase imaging;diffusion-weighted imaging,T2 weighted imaging).In this study,I investigated the necessity and benefits of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid for HCC diagnostic testing and prognostic evaluation.

Biological function of miRNA-145-5p in angiotensin II induced renal inflammation

Objective:Chronic kidney disease(CKD)is a progressive disorder characterized by intricate structural and functional alterations in the kidneys,attributable to diverse causative factors.Notably,the therapeutic promise of miR-145-5p in addressing renal pathologies has been discerned.This investigation seeks to elucidate the functional role of miR-145-5p in injured kidneys by subjecting human glomerular mesangial cells(HGMCs)to stimulation with Angiotensin II(AngII).Materials and Methods:Cellular viability and the levels of inflammatory mediators were evaluated utilizing Cell Counting Kit-8(CCK-8),quantitative real-time polymerase chain reaction(qRT-PCR),and western blot methodologies,both in the presence of AngII incubation and in scenarios of miR-145p overexpression and downregulation.Furthermore,the cell cycle dynamics were elucidated through Fluorescence-activated Cell Sorting(FACS)analysis.Results:AngII incubation induced an upregulation of miR-145-5p and inflammatory factors including Intercellular Adhesion Molecule 1(ICAM-1),Interleukin 6(IL-6),Interleukin 8(IL-8),and Interleukin 1β(IL-1β).Additionally,it elevated the expression of Cyclin A2,Cyclin D1,and the G2/M cell cycle ratio.Conversely,inhibition of miR-145-5p heightened the levels of inflammatory factors and cell cycle regulators induced by AngII incubation.Reduced expression of miR-145-5p correlated with a downregulation of Interleukin 10(IL-10)expression,concurrently promoting HGMC proliferation under AngII stimulation.Moreover,ectopic miR-145-5p expression demonstrated a reduction in inflammatory factors,cell cyclin regulators,G2/M cell cycle ratio,and overall proliferation.Conclusion:MiR-145-5p exhibited inhibitory effects on the inflammatory response and proliferation induced by Angiotensin II in HGMCs,showcasing its potential as a therapeutic avenue for the treatment of kidney injury.

Risk stratification in gastric cancer lung metastasis: Utilizing an overall survival nomogram and comparing it with previous staging

BACKGROUND Gastric cancer(GC)is prevalent and aggressive,especially when patients have distant lung metastases,which often places patients into advanced stages.By identifying prognostic variables for lung metastasis in GC patients,it may be po-ssible to construct a good prediction model for both overall survival(OS)and the cumulative incidence prediction(CIP)plot of the tumour.AIM To investigate the predictors of GC with lung metastasis(GCLM)to produce nomograms for OS and generate CIP by using cancer-specific survival(CSS)data.METHODS Data from January 2000 to December 2020 involving 1652 patients with GCLM were obtained from the Surveillance,epidemiology,and end results program database.The major observational endpoint was OS;hence,patients were se-parated into training and validation groups.Correlation analysis determined va-rious connections.Univariate and multivariate Cox analyses validated the independent predictive factors.Nomogram distinction and calibration were performed with the time-dependent area under the curve(AUC)and calibration curves.To evaluate the accuracy and clinical usefulness of the nomograms,decision curve analysis(DCA)was performed.The clinical utility of the novel prognostic model was compared to that of the 7th edition of the American Joint Committee on Cancer(AJCC)staging system by utilizing Net Reclassification Improvement(NRI)and Integrated Discrimination Improvement(IDI).Finally,the OS prognostic model and Cox-AJCC risk stratification model modified for the AJCC system were compared.RESULTS For the purpose of creating the OS nomogram,a CIP plot based on CSS was generated.Cox multivariate regression analysis identified eleven significant prognostic factors(P<0.05)related to liver metastasis,bone metastasis,primary site,surgery,regional surgery,treatment sequence,chemotherapy,radiotherapy,positive lymph node count,N staging,and time from diagnosis to treatment.It was clear from the DCA(net benefit>0),time-de-pendent ROC curve(training/validation set AUC>0.7),and calibration curve(reliability slope closer to 45 degrees)results that the OS nomogram demonstrated a high level of predictive efficiency.The OS prediction model(New Model AUC=0.83)also performed much better than the old Cox-AJCC model(AUC difference between the new model and the old model greater than 0)in terms of risk stratification(P<0.0001)and verification using the IDI and NRI.CONCLUSION The OS nomogram for GCLM successfully predicts 1-and 3-year OS.Moreover,this approach can help to ap-propriately classify patients into high-risk and low-risk groups,thereby guiding treatment.

Association of HLA-B*1502 and*1511 Allele with Antiepileptic Drug-induced Stevens-Johnson Syndrome in Central China

Previous studies have demonstrated a strong association between carbamazepine（CBZ）-induced Stevens-Johnson syndrome（SJS） and HLA-B 1502 in Han Chinese. Here, we extended the study of HLA-B 1502 susceptibility to two different antiepileptic drugs, oxcarbazepine（OXC） and phenobabital（PB）. In addition, we genotyped HLA-B 1511 in a case of CBZ-induced SJS with genotype negative for HLA-B 1502. The presence of HLA-B 1502 was determined using polymerase chain reaction with sequence-specific primers（PCR-SSP）. Moreover, we genotyped HLA-B 1502 in 17 cases of antiepileptic drugs（AEDs）-induced cutaneous adverse drug reactions（cADRs）, in comparison with AEDs-tolerant（n=32） and normal controls（n=38） in the central region of China. The data showed that HLA-B 1502 was positive in 5 of 6 cases of AEDs-induced SJS（4 CBZ, 1 OXC and 1 PB）, which was significantly more frequent than AEDs-tolerant（2/32, 18 CBZ, 6 PB and 8 OXC） and normal controls（3/38）. Compared with AEDs-tolerant and normal controls, the OR for patients carrying the HLA-B 1502 with AEDs-induced SJS was 6.25（95% CI： 1.06–36.74） and 4.86（95% CI： 1.01–23.47）. The sensitivity and specificity of HLA-B 1502 for prediction of AEDs-induced SJS were 71.4%. The sensitivity and specificity of HLA-B 1502 for prediction of CBZ-induced SJS were 60% and 94%. HLA-B 1502 was not found in 11 children with maculopapular exanthema（MPE）（n=9） and hypersensitivity syndrome（HSS）（n=2）. However, we also found one case of CBZ-induced SJS who was negative for HLA-B 1502 but carried HLA-B 1511. It was suggested that the association between the CBZ-induced SJS and HLA-B 1502 allele in Han Chinese children can extend to other aromatic AEDs including OXC and PB related SJS. HLA-B 1511 may be a risk factor for some patients with CBZ-induced SJS negative for HLA-B 1502.

Endoscopic ultrasound-measured muscular thickness of the lower esophageal sphincter and long-term prognosis after peroral endoscopic myotomy for achalasia

BACKGROUND People with achalasia typically have a thick lower esophageal muscularis propria(LEMP),and peroral endoscopic myotomy(POEM)has been effective in treating most patients.LEMP thickness may be associated with the outcomes and prognosis after POEM.However,more evidence is needed regarding the relationship between LEMP thickness and patient prognosis after POEM.AIM To assess the association between LEMP thickness,measured using endoscopic ultrasound(EUS),and long-term prognosis,especially relapse,after POEM for achalasia.METHODS All medical records,including EUS data,of patients who underwent POEM to treat achalasia at Shengjing Hospital of China Medical University from January 2012 to September 2018 were retrospectively reviewed.LEMP thickness was measured by EUS,and a thickness of≥3 mm was defined as thickened.The severity of patient symptoms was evaluated using the Eckardt score.Relapse was defined as a 3-point rise in the Eckardt score after a period of clinical remission.The relationship between patient characteristics,muscle thickness,and recurrence was analyzed.RESULTS Eighty-two patients(32 males and 50 females,aged 17-78 years)and 85 POEM procedures were included.In total,76.8%(63/82 patients)of patients had a thickened muscularis propria.Older age and longer disease course were associated with muscularis propria thickening(P<0.05).The mean postoperative follow-up time was 35.4±17.2 mo(range,8-87.5 mo)in 60 patients.Five patients with Eckardt scores>3 refused further management after their symptoms were relieved.The relapse rate was 12.73%(7/55 cases).Five patients,four of whom had muscularis propria thickening,had disease recurrence within 12 mo after the procedure.Achalasia relapsed in one patient who had a thickened muscularis propria after 24 mo and in another patient who did not have a thickened muscularis propria after 30 mo.Patients with recurrence were typically younger and had a shorter disease course(P<0.05).The relapse rate in patients with a non-thickened muscularis propria tended to be higher(18.2%,2/11 patients)than that in patients with a thickened muscularis propria(11.4%,5/44 patients),although no significant difference was found.Age(hazard ratio=0.92;95%confidence interval:0.865-0.979;P<0.05)and being male(hazard ratio=7.173;95%confidence interval:1.277-40.286;P<0.05)were identified as risk factors for symptomatic recurrence by multivariable analysis using the Cox model.CONCLUSION Patients with a thickened muscularis are typically older and have a longer disease course.Younger age and the male sex are associated with increased recurrence.Patients with a thin muscularis propria may be prone to relapse,although further validation is needed.

Effects of Chronotherapy of Benazepril on the Diurnal Profile of RAAS and Clock Genes in the Kidney of 5/6 Nephrectomy Rats

Summary： This study investigated the effects of benazepril administered in the morning or evening on the diurnal variation of renin-angiotensin-aldosterone system （RAAS） and clock genes in the kidney. The male Wistar rat models of 5/6 subtotal nephrectomy （STNx） were established. Animals were ran- domly divided into 4 groups： sham STNx group （control）, STNx group, morning benazepril group （MB） and evening benazepril group （EB）. Benazepril was intragastfically administered at a dose of 10 mg/kg/day at 07：00 and 19：00 in the MB group and EB group respectively for 12 weeks. All the animals were synchronized to the light：dark cycle of 12：12 for 12 weeks. Systolic blood pressure （SBP）, 24-h urinary protein excretion and renal function were measured at 11 weeks. Blood samples and kidneys were collected every 4 h throughout a day to detect the expression pattern of renin activity （RA）, angio- tensin Ⅱ （Ang Ⅱ ） and aldosterone （Aid） by radioimmunoassay （RIA） and the mRNA expression profile of clock genes （bmall, dbp and per2） by real-time PCR at 12 weeks. Our results showed that no signifi- cant differences were noted in the SBP, 24-h urine protein excretion and renal function between the MB and EB groups. There were no significant differences in average Aid and RA content of a day between the MB group and EB group. The expression peak of bmall mRNA was phase-delayed by 4 to 8 h, and the diurnal variation of per2 and dbp mRNA diminished in the MB and EB groups compared with the control and STNx groups. It was concluded when the similar SBP reduction, RAAS inhibition and clock gene profile were achieved with optimal dose of benazepril, morning versus evening dosing of benazepril has the same renoprotection effects.

Solar term peak of onset and death in 1 597 patients with acute ischemic stroke Circular statistical analysis

BACKGROUND： Previously, time data were analyzed by using constituent ratio or relative ratio; however, circular statistical analysis could exactly provide average peak phase of diseases. OBJECTIVE： To investigate the correlation of solar term peak with onset and death of acute ischemic stroke. DESIGN： Retrospective case analysis. SETTINGS： Emergency Department of Foshan Municipal Hospital of Traditional Chinese Medicine; Department of Science and Education, the Second People＇s Hospital of Foshan. PARTICIPANTS： A total of 1 597 patients with acute ischemic stroke were selected from Emergency Room, Department of Neurology, Foshan Municipal Hospital of Traditional Chinese Medicine from 1994 to 2002. There were 875 males and 722 females, and their ages ranged from 33 to 97 years. All cases met the diagnostic criteria of acute cerebral infarction modified by the Second National Cerebrovascular Disease Academic Meeting; meanwhile, they were diagnosed with CT/MRI test. Patients and their relatives provided the confirmed consent. METHODS： Solar term of onset was retrospectively analyzed in 1 597 patients with acute ischemic stroke; among them, solar term of death in 90 cases were analyzed by using circular statistical analysis to calculate peak phase of onset and death of acute ischemic stroke and investigate the correlation of solar term with onset and death of acute ischemic stroke. MAIN OUTCOME MEASURES： Onset and death time of patients with acute ischemic stroke. RESULTS： Solar term of onset in 1 597 patients, especially solar term of death in 90 patients, was not concentrated （P 〉 0.05）, and specific peak phase was not found out. Acute ischemic stroke low attacked from vernal equinox to summer begins, but death caused by acute ischemic stroke high attacked from grain buds to autumn begins. CONCLUSION： Patients with acute ischemic stroke do not have specific solar term peak of onset and death.

Gut microbiome and metabolic-associated fatty liver disease:Current status and potential applications

Metabolic-associated fatty liver disease(MAFLD)is one of the most common chronic liver diseases worldwide.In recent years,the occurrence rate of MAFLD has been on the rise,mainly due to lifestyle changes,high-calorie diets,and imbalanced dietary structures,thereby posing a threat to human health and creating heavy social and economic burdens.With the development of 16S sequencing and integrated multi-omics analysis,the role of the gut microbiota(GM)and its metabolites in MAFLD has been further recognized.The GM plays a role in digestion,energy metabolism,vitamin synthesis,the prevention of pathogenic bacteria colonisation,and immunoregulation.The gut-liver axis is one of the vital links between the GM and the liver.Toxic substances in the intestine can enter the liver through the portal vascular system when the intestinal barrier is severely damaged.The liver also influences the GM in various ways,such as bile acid circulation.The gut-liver axis is essential in maintaining the body’s normal physiological state and plays a role in the onset and prognosis of many diseases,including MAFLD.This article reviews the status of the GM and MAFLD and summarizes the GM characteristics in MAFLD.The relationship between the GM and MAFLD is discussed in terms of bile acid circulation,energy metabolism,micronutrients,and signalling pathways.Current MAFLD treat ments targeting the GM are also listed.

Relationship of the ultrasonic elastography parameter of thyroid carcinoma with the cancer cell growth and neovascularization in lesion tissue

Objective: To study the relationship of the ultrasonic elastography parameter of thyroid carcinoma with the cancer cell growth and neovascularization in lesion tissue. Methods:Patients with thyroid carcinoma who underwent surgical resection and were pathologically diagnosed in Dazhu People's Hospital between March 2015 and June 2017 were chosen as the case group, the patients who received ultrasonic examination and were diagnosed with benign thyroid tumor in Dazhu People's Hospital during the same period were selected as the control group, and the ultrasonic elastography parameter strain ratio as well as the oncogene expression and angiogenesis molecule contents in the thyroid carcinoma tissue and adjacent tissue was determined. Results: DMBT1, CCNG2 and Bax mRNA expression as well as ES protein level in thyroid carcinoma tissue were significantly lower than those in adjacent tissue whereas WIP1 and RET/PTC mRNA expression as well as VEGF, vWF and ANG-1 protein levels were significantly higher than those in adjacent tissue;DMBT1, CCNG2 and Bax mRNA expression as well as ES protein level in thyroid carcinoma tissue with strain ratio ≥3.14 were significantly lower than those in thyroid carcinoma tissue with strain ratio <3.14 whereas WIP1 and RET/PTC mRNA expression as well as VEGF, vWF and ANG-1 protein levels were significantly higher than those in thyroid carcinoma tissue with strain ratio <3.14. Conclusion:The testing threshold 3.14 of ultrasonic elastography parameter stain ratio of thyroid carcinoma can accurately assess the vitality of cancer cell growth and neovascularization in lesion tissue.

Clinical application of combined detection of SARS-CoV-2-specific antibody and nucleic acid

BACKGROUND The global outbreak of human severe acute respiratory syndrome coronavirus(SARS-CoV)-2 infection represents an urgent need for readily available,accurate and rapid diagnostic tests.Nucleic acid testing of respiratory tract specimens for SARS-CoV-2 is the current gold standard for diagnosis of coronavirus disease 2019(COVID-19).However,the diagnostic accuracy of reverse transcription polymerase chain reaction(RT-PCR)tests for detecting SARS-CoV-2 nucleic acid may be lower than optimal.The detection of SARS-CoV-2-specific antibodies should be used as a serological non-invasive tool for the diagnosis and management of SARS-CoV-2 infection.AIM To investigate the diagnostic value of SARS-CoV-2 IgM/IgG and nucleic acid detection in COVID-19.METHODS We retrospectively analyzed 652 suspected COVID-19 patients,and 206 non-COVID-19 patients in Wuhan Integrated TCM and Western Medicine Hospital.Data on SARS-CoV-2 nucleic acid tests and serum antibody tests were collected to investigate the diagnostic value of nucleic acid RT-PCR test kits and immunoglobulin(Ig)M/IgG antibody test kits.The j2 test was used to compare differences between categorical variables.A 95%confidence interval(CI)was provided by the Wilson score method.All analyses were performed with IBM SPSS Statistics version 22.0(IBM Corp.,Armonk,NY,United States).RESULTS Of the 652 suspected COVID-19 patients,237(36.3%)had positive nucleic acid tests,311(47.7%)were positive for IgM,and 592(90.8%)were positive for IgG.There was a significant difference in the positive detection rate between the IgM and IgG test groups(P<0.001).Using the RT-PCR results as a reference,the specificity,sensitivity,and accuracy of IgM/IgG combined tests for SARS-CoV-2 infection were 98.5%,95.8%,and 97.1%,respectively.Of the 415 suspected COVID-19 patients with negative nucleic acid test results,366 had positive IgM/IgG tests with a positive detection rate of 88.2%.CONCLUSION Our data indicate that serological IgM/IgG antibody combined test had high sensitivity and specificity for the diagnosis of SARS-CoV-2 infection,and can be used in combination with RT-PCR for the diagnosis of SARS-CoV-2 infection.

Changes and clinical significance of serum tumor markers in patients with rheumatoid arthritis combined with interstitial lung disease

Objective: To investigate the changes and clinical significance of serum tumor markers in patients with rheumatoid arthritis (RA) combined with interstitial lung disease. Methods:A total of 50 healthy volunteers were chosen as the normal control group, 47 patients with rheumatoid arthritis alone were chosen as the RA group, and 28 patients with rheumatoid arthritis combined with interstitial lung disease were chosen as combined disease group. The differences in the levels of serum tumor markers, RA markers and inflammatory mediators were compared among the three groups, and Pearson test was used to evaluate the correlation of serum tumor marker levels with RA markers and inflammatory mediators in patients with RA combined with interstitial lung disease. Results: Serum tumor markers CA199, CA153 and CEA levels of combined disease group were higher than those of RA group;RA markers RF and GPI levels were higher than those of RA group whereas CCP and AKA levels were not significantly different from those of RA group;inflammatory mediators HMGB1, GM-CSF, IL-6, IL-17 and IL-27 levels were higher than those of RA group. Correlation analysis showed that serum tumor markers CA199, CA153 and CEA levels in patients with RA combined with interstitial lung disease were positively correlated with RF, GPI, HMGB1, GM-CSF, IL-6, IL-17 and IL-27 levels. Conclusion: Serum tumor markers CA199, CA153 and CEA levels abnormally increase in patients with RA combined with interstitial lung disease, and the specific levels were directly correlated with the disease severity.

Use of Ilizarov technique for bilateral knees flexion contracture in Juvenile-onset ankylosing spondylitis: A case report

BACKGROUND Ankylosing spondylitis(AS)is a chronic rheumatic disease that primarily affects the spine and the sacroiliac and peripheral joints.Juvenile-onset AS(JoAS)patients will likely present with peripheral joint symptoms.Knee flexion contracture(KFC)and hip flexion contracture(HFC)are common in these patients due to subchondral bone inflammation.The Ilizarov technique is the most commonly used technique for treating KFC.However,its use to treat JoAS-associated KFC has not been reported.CASE SUMMARY This report presents a case study of a 31-year-old male patient with a squatting gait due to severe bilateral KFC and HFC.The patient had a normal walking pattern until the age of eight,after which he experienced knee and hip pain,leading to the gradual development of KFC and HFC.The patient’s primary complaint was an inability to walk upright.The patient was diagnosed with JoAS and under-went hip dissection and release,limited soft tissue release of the hamstring,and gradual traction using the Ilizarov method.Ultimately,the patient was able to walk upright.CONCLUSION The incidence of squatting gait due to KFC in individuals diagnosed with JoAS was low.Utilizing the Ilizarov technique has proven to be a secure and effective method for managing KFC in JoAS patients.Although the Ilizarov technique cannot substitute for total knee arthroplasty(TKA),its application can delay the need for primary TKA in JoAS patients and alleviate the intricacy and potential complications associated with the procedure.

Changes in neurotransmitter levels,brain structural characteristics,and their correlation with PANSS scores in patients with firstepisode schizophrenia

BACKGROUND In patients with schizophrenia,the brain structure and neurotransmitter levels change,which may be related to the occurrence and progression of this disease.AIM To explore the relationships between changes in neurotransmitters,brain structural characteristics,and the scores of the Positive and Negative Symptom Scale(PANSS)in patients with first-episode schizophrenia.METHODS The case group comprised 97 patients with schizophrenia,who were evaluated using the Canadian Neurological Scale and confirmed by laboratory tests at Ningbo Mental Hospital from January 2020 to July 2022.The control group comprised 100 healthy participants.For all participants,brain structural characteristics were explored by measuring brain dopamine(DA),glutamic acid(Glu),and gamma-aminobutyric acid(GABA)levels,with magnetic resonance imaging.The case group was divided into negative and positive symptom subgroups using PANSS scores for hierarchical analysis.Linear correlation analysis was used to analyze the correlations between neurotransmitters,brain structural character istics,and PANSS scores.RESULTS Patients in the case group had higher levels of DA and lower levels of Glu and GABA,greater vertical and horizontal distances between the corpus callosum and the inferior part of the fornix and larger ventricle area than patients in the control group(P<0.05).Patients with positive schizophrenia symptoms had significantly higher levels of DA,Glu,and GABA than those with negative symptoms(P<0.05).In patients with positive schizophrenia symptoms,PANSS score was significantly positively correlated with DA,vertical and horizontal distances between the corpus callosum and the infrafornix,and ventricular area,and was significantly negatively correlated with Glu and GABA(P<0.05).In patients with negative schizophrenia symptoms,PANSS score was significantly positively correlated with DA,vertical distance between the corpus callosum and the infrafornix,horizontal distance between the corpus callosum and the infrafornix,and ventricular area,and was significantly negatively correlated with Glu and GABA(P<0.05).CONCLUSION In patients with first-episode schizophrenia,DA levels increased,Glu and GABA levels decreased,the thickness of the corpus callosum increased,and these variables were correlated with PANSS scores.

Clinical study of acupuncture combined with surface anesthesia using proparacaine in geriatric cataract phacoemulsification

BACKGROUND During anesthesia administration for cataract surgery,low pH of proparacaine may induce pain or complications such as corneal damage and poor wound healing,with the use of additional drops intraoperatively increasing the risk of complications.Accordingly,there is a clinical need for adjuncts to local anesthesia needs to improve the efficiency of anesthesia and reduce the required amount of intraoperative proparacaine.AIM To identify a method of anesthesia for geriatric cataract phacoemulsification that provides more efficient analgesia and improves clinical efficacy.METHODS A total of 130 geriatric patients with cataracts who attended Hebei Eye Hospital from December 2020 to December 2022 were included in the present study.Patients were divided into the proparacaine surface anesthesia(SA)group(65 cases)and the compound acupuncture-medicine anesthesia group(CAMA group,65 cases).Patients in the CAMA group were provided acupuncture analgesia in addition to SA.Preoperative anxiety[Self-Rating Anxiety Scale(SAS)score and state anxiety inventory(SAI)score],intraoperative stress,vital signs,analgesia,and cooperation,as well as postoperative adverse events,were compared between groups.RESULTS More marked reductions in anxiety were observed among patients in the CAMA group,with corresponding reductions in SAS and SAI scores.During the operation,no change in the secretion of E,NE,or Cor group compared to the preoperative period was observed in the CAMA,which was markedly lower than that in the SA group.Heart rate,blood pressure,and respiratory rate were more stable intraoperatively in the CAMA group.In addition,the incidence of intraoperative pain and the number of additional doses of anesthesia required in the CAMA group were markedly lower than in the SA group.Accordingly,patients in the CAMA group were able to avoid eye movements and eyelid closing leading to greater cooperation with surgeons during surgery.Furthermore,marked reductions in intraoperative adverse effects were observed in the CAMA group,indicating greater overall safety.CONCLUSION Proparacaine SA combined with acupuncture as an analgesic provides improved analgesia with greater safety compared to surface anesthesia with proparacaine during geriatric cataract phacoemulsification.

Multidrug resistant organism infections in patients with COVID-19:risk factors and outcomes

Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.

Assessment of the Respiratory Disease Mortality Risk from Single and Composite Exposures to PM_(2.5)and Ozone—Guangzhou City,Guangdong Province,China,2018-2021

Summary What is already known about this topic?Fine particulate matter(PM_(2.5))and ozone(O_(3))are prevalent pollutants in the atmosphere,which threaten human health,especially the respiratory system.Typically,people are exposed to a mixture of various pollutants in the environment.Thus,the single and combined effects of both pollutants need to be investigated.

Macrophages:Key players in diabetic wound healing

In this editorial,we discuss the article by Wen et al published.Diabetic foot ulcers are prevalent and serious complications of diabetes,significantly impacting patients’quality of life and often leading to disability or death,thereby placing a heavy burden on society.Effective diabetic wound healing is hindered by an imbalance in macrophage polarization;many macrophages fail to transition from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype,which is crucial for tissue remodelling and repair.The wound healing process is both dynamic and complex.Healthy M1 macrophages,which have strong phagocytic abilities,are vital during the inflammatory phase of diabetic wound healing.However,the failure to transition to M2 macrophages during the proliferative phase hinders wound healing.We anticipate the development of new therapies that can repair damaged M1 macrophages during the inflammatory phase and promote M2 macrophage polarization during the proliferative phase,thereby enhancing the overall healing process.