Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients...Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.展开更多
The coronavirus disease 2019(COVID-19)pandemic has been a serious threat to global health for nearly 3 years.In addition to pulmonary complications,liver injury is not uncommon in patients with novel COVID-19.Although...The coronavirus disease 2019(COVID-19)pandemic has been a serious threat to global health for nearly 3 years.In addition to pulmonary complications,liver injury is not uncommon in patients with novel COVID-19.Although the prevalence of liver injury varies widely among COVID-19 patients,its incidence is significantly increased in severe cases.Hence,there is an urgent need to understand liver injury caused by COVID-19.Clinical features of liver injury include detectable liver function abnormalities and liver imaging changes.Liver function tests,computed tomography scans,and ultrasound can help evaluate liver injury.Risk factors for liver injury in patients with COVID-19 include male sex,preexisting liver disease including liver transplantation and chronic liver disease,diabetes,obesity,and hypertension.To date,the mechanism of COVID-19-related liver injury is not fully understood.Its pathophysiological basis can generally be explained by systemic inflammatory response,hypoxic damage,ischemia-reperfusion injury,and drug side effects.In this review,we systematically summarize the existing literature on liver injury caused by COVID-19,including clinical features,underlying mechanisms,and potential risk factors.Finally,we discuss clinical management and provide recommendations for the care of patients with liver injury.展开更多
The management of Helicobacter pylori(H. pylori) infection treatment differs from the common treatment protocol for other infectious diseases. Because culture-or molecular-guided approaches face several practical issu...The management of Helicobacter pylori(H. pylori) infection treatment differs from the common treatment protocol for other infectious diseases. Because culture-or molecular-guided approaches face several practical issues, such as the invasive procedures required to obtain gastric biopsy specimens and the lack of availability of routine laboratory testing in some places, H. pylori treatment includes the administration of two or three empirically selected antibiotics combined with a proton pump inhibitor rather than evidence-based eradication treatment. The efficacy of empirical therapy is decreasing, mostly due to increasing multiple resistance. Multiresistance to levofloxacin, clarithromycin, and metronidazole, which are commonly used in empirical treatments, appears to have increased in many countries. Mutations play a primary role in the antimicrobial resistance of H. pylori, but many different mechanisms can be involved in the development of antibiotic resistance. Determining and understanding these possible mechanisms might allow the development of new methods for the detection of H. pylori and the determination of antimicrobial resistance. A treatment based on the detection of antimicrobial resistance is usually more effective than empirical treatment. Nevertheless, such an approach before treatment is still not recommended in the Maastricht guidelines due to the difficulty associated with the routine application of available cultureor molecular-based susceptibility tests, which are usually administered in cases of treatment failure. The management of first and rescue treatments requires further research due to the steadily increase in antimicrobial resistance.展开更多
This review discusses the pathophysiology,epidemiology,risk factors,classification,clinical evaluation,and current non-operative and operative treatment of hemorrhoids.Hemorrhoids are defined as the symptomatic enlarg...This review discusses the pathophysiology,epidemiology,risk factors,classification,clinical evaluation,and current non-operative and operative treatment of hemorrhoids.Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions.The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement.The abnormal dilatation and distortion of the vascular channel,together with destructive changes in the supporting connective tissue within the anal cushion,is a paramount finding of hemorrhoids.It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development,and could be a potential target for medical treatment.In most instances,hemorrhoids are treated conservatively,using many methods such as lifestyle modification,fiber supplement,suppositorydelivered anti-inflammatory drugs,and administration of venotonic drugs.Non-operative approaches include sclerotherapy and,preferably,rubber band ligation.An operation is indicated when non-operative approaches have failed or complications have occurred.Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy,but postoperative pain is invariable.Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence.The applications and outcomes of each treatment are thoroughly discussed.展开更多
BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the com...BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the comprehensive elucidation of the clinical manifestations of high-dose cantharidin poisoning,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A patient taking 10 g of cantharidin powder orally subsequently developed MODS.The patient was treated with supportive care,fluid hydration and antibiotics,and hemoperfusion and hemofiltration therapy for 24 h and successfully recovered 8 d after hospital admission.Cantharidin poisoning can cause lifethreatening MODS and is rare clinically.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of high-dose cantharidin poisoning resulting in MODS and reviewed the relevant literature to improve the clinical understanding of this rare condition.展开更多
Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management(NOM) is a selective method for liver trauma. The aim of this study was to determine the success rat...Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management(NOM) is a selective method for liver trauma. The aim of this study was to determine the success rate, mortality and morbidity of NOM for isolated liver trauma.Medical records of 81 patients with isolated liver trauma in our unit were analyzed retrospectively. The success rate, mortality and morbidity of NOM were evaluated. In this series, 9 patients with grade IV-V liver injuries underwent emergent operation due to hemodynamic instability; 72 patients, 6 with grade V, 18 grade IV, 29 grade III, 15 grade II and 4 grade I, with hemodynamic stability received NOM. The overall success rate of NOM was 97.2%(70/72). The success rates of NOM in the patients with grade I-III, IV and V liver trauma were100%, 94.4% and 83.3%. The complication rates were 10.0%and 45.5% in the patients who underwent NOM and surgical treatment, respectively. No patient with grade I-II liver trauma had complications. All patients who underwent NOM survived.NOM is the first option for the treatment of liver trauma if the patient is hemodynamically stable. The grade of liver injury and the volume of hemoperitoneum are not suitable criteria for selecting NOM. Hepatic angioembolization associated with the correction of hypothermia, coagulopathy and acidosis is important in the conservative treatment for liver trauma.展开更多
Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a...Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a“depressive disorder”-is a mood disorder that adversely impacts how an individual feels,thinks,and handles daily activities,such as sleeping,eating,or working.To be diagnosed with depression,symptoms must be present most of the time,nearly every day for at least minimum of 2 to 3 weeks.Feeling sad or having low emotional energy may be common among people.For most,however,these feelings are transitory and can be managed by changing daily life routines.But for some,prolonged mood disorders can lead to depression and foster suicidal tendencies.Suicide is a major public health concern.Over 47,000 people died by suicide in the United States in 2017.It is the 10th leading cause of death overall according to NIMH(National Institute of Mental Health).Suicide is complicated and tragic,but it is often preventable.Identifying the warning signs for suicide and how to get help can be a major mitigating factor.In this short communication,we are reviewing the promise and limitations of AI(artificial intelligence)with its integrated tools such as ML(machine learning)and DL(deep learning)for mood analysis as a means for detecting early signs of depression and increased suicidal tendencies for possible suicide risk management.展开更多
Background:The role of the patient’s medication literacy is crucial in ensuring the efficacy of the treatment for nephrotic syndrome(NS).It is imperative to identify and examine instances of inadequate medication lit...Background:The role of the patient’s medication literacy is crucial in ensuring the efficacy of the treatment for nephrotic syndrome(NS).It is imperative to identify and examine instances of inadequate medication literacy in order to effectively manage NS.This study aimed to detect the low medication literacy in Chinese NS children using the 22-item Medication Literacy Scale(MLS-22)and to further analyze its influencing factors.Methods:This study involved consecutive sampling of 157 Chinese children with NS.Interviewer-led questionnaires were used to collect data.Firstly,the MLS-22 was evaluated for reliability and validity.Secondly,the medication literacy level was assessed,and factors related to low scores were examined using a multivariate logistic regression model.Results:MLS-22 proved reliable and valid for detection at a low level in NS children.The tertile was divided into low-level and medium/high-level medication literacy.It was found that the scores of NS children averaged 13.06.Multivariate logistic regression analysis revealed that parents of children with primary NS and congenital NS had lower medication literacy scores,which were related to parents with less than high school education.Conclusions:Healthcare providers should develop tailored strategies to effectively assist Chinese children with limited medication literacy in managing chronic diseases.展开更多
Objective:To describe the major categories of components of an in-house treatment information,management,and planning system(TIMPS■)that were designed and built to optimize the planning process.Methods:The system was...Objective:To describe the major categories of components of an in-house treatment information,management,and planning system(TIMPS■)that were designed and built to optimize the planning process.Methods:The system was designed,from the beginning,to manage the multi-user complex process of planning and delivering external beam treatments with the eventual goal of providing one-day planning,multiple radiation modality optimization,robust optimization,4D planning,daily adaptive treatments,and treatment verification and reconstruction.A Monte Carlo based track repeating algorithm was chosen for dose simulations.The user interface was based on web applications.Results:The first set of released tools included task queuing,followed by resource scheduling calendars and planning aims.Later releases included tools for image registration,manipulating motion profiles and 4D images,segmentation,PET simulation,and portal QA.Currently under testing are plan optimization and biophysical models.Conclusions:The in-house TIMPS first entered clinical service in April of 2017 with new tools added every few months.Since implementation,the time for planning has decreased simultaneously with a reduction of errors.展开更多
With the continuous worsening of theproblems of urban wastes about 60 urbanscientific workers gathered in Guiyang to dis-cuss the present state of the treatment andmanagement of urban wastes and find rela-tive solutio...With the continuous worsening of theproblems of urban wastes about 60 urbanscientific workers gathered in Guiyang to dis-cuss the present state of the treatment andmanagement of urban wastes and find rela-tive solutions to the problems.The“Guiyang Symposium on the Treat-ment and Management of City Wastes”jointly sponsored by the Chinese Urban Sci-entific Research Institute,the Urban Con-struction Department of the Ministry of Ur-展开更多
文摘Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.
基金the National Natural Science Foundation of China,No.81901141the Scientific Research Project of Hunan Provincial Health Commission,No.202204114480.
文摘The coronavirus disease 2019(COVID-19)pandemic has been a serious threat to global health for nearly 3 years.In addition to pulmonary complications,liver injury is not uncommon in patients with novel COVID-19.Although the prevalence of liver injury varies widely among COVID-19 patients,its incidence is significantly increased in severe cases.Hence,there is an urgent need to understand liver injury caused by COVID-19.Clinical features of liver injury include detectable liver function abnormalities and liver imaging changes.Liver function tests,computed tomography scans,and ultrasound can help evaluate liver injury.Risk factors for liver injury in patients with COVID-19 include male sex,preexisting liver disease including liver transplantation and chronic liver disease,diabetes,obesity,and hypertension.To date,the mechanism of COVID-19-related liver injury is not fully understood.Its pathophysiological basis can generally be explained by systemic inflammatory response,hypoxic damage,ischemia-reperfusion injury,and drug side effects.In this review,we systematically summarize the existing literature on liver injury caused by COVID-19,including clinical features,underlying mechanisms,and potential risk factors.Finally,we discuss clinical management and provide recommendations for the care of patients with liver injury.
文摘The management of Helicobacter pylori(H. pylori) infection treatment differs from the common treatment protocol for other infectious diseases. Because culture-or molecular-guided approaches face several practical issues, such as the invasive procedures required to obtain gastric biopsy specimens and the lack of availability of routine laboratory testing in some places, H. pylori treatment includes the administration of two or three empirically selected antibiotics combined with a proton pump inhibitor rather than evidence-based eradication treatment. The efficacy of empirical therapy is decreasing, mostly due to increasing multiple resistance. Multiresistance to levofloxacin, clarithromycin, and metronidazole, which are commonly used in empirical treatments, appears to have increased in many countries. Mutations play a primary role in the antimicrobial resistance of H. pylori, but many different mechanisms can be involved in the development of antibiotic resistance. Determining and understanding these possible mechanisms might allow the development of new methods for the detection of H. pylori and the determination of antimicrobial resistance. A treatment based on the detection of antimicrobial resistance is usually more effective than empirical treatment. Nevertheless, such an approach before treatment is still not recommended in the Maastricht guidelines due to the difficulty associated with the routine application of available cultureor molecular-based susceptibility tests, which are usually administered in cases of treatment failure. The management of first and rescue treatments requires further research due to the steadily increase in antimicrobial resistance.
基金Supported by Faculty of Medicine Siriraj Hospital,Mahidol University,Bangkok,Thailand
文摘This review discusses the pathophysiology,epidemiology,risk factors,classification,clinical evaluation,and current non-operative and operative treatment of hemorrhoids.Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions.The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement.The abnormal dilatation and distortion of the vascular channel,together with destructive changes in the supporting connective tissue within the anal cushion,is a paramount finding of hemorrhoids.It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development,and could be a potential target for medical treatment.In most instances,hemorrhoids are treated conservatively,using many methods such as lifestyle modification,fiber supplement,suppositorydelivered anti-inflammatory drugs,and administration of venotonic drugs.Non-operative approaches include sclerotherapy and,preferably,rubber band ligation.An operation is indicated when non-operative approaches have failed or complications have occurred.Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy,but postoperative pain is invariable.Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence.The applications and outcomes of each treatment are thoroughly discussed.
基金Supported by Jilin Province Science and Technology Agency Project,No.20210101350JCProject of Jilin Provincial Finance Department,No.JLSWSRCZX2023-60Beijing iGandan Foundation Fund for Artificial Liver,No.iGandanF-1082023-RGG025.
文摘BACKGROUND This report delves into the diagnostic and therapeutic journey undertaken by a patient with high-dose cantharidin poisoning and multiorgan dysfunction syndrome(MODS).Particular emphasis is placed on the comprehensive elucidation of the clinical manifestations of high-dose cantharidin poisoning,the intricate path to diagnosis,and the exploration of potential underlying mechanisms.CASE SUMMARY A patient taking 10 g of cantharidin powder orally subsequently developed MODS.The patient was treated with supportive care,fluid hydration and antibiotics,and hemoperfusion and hemofiltration therapy for 24 h and successfully recovered 8 d after hospital admission.Cantharidin poisoning can cause lifethreatening MODS and is rare clinically.This case underscores the challenge in diagnosis and highlights the need for early clinical differentiation to facilitate accurate assessment and prompt intervention.CONCLUSION This article has reported and analyzed the clinical data,diagnosis,treatment,and prognosis of a case of high-dose cantharidin poisoning resulting in MODS and reviewed the relevant literature to improve the clinical understanding of this rare condition.
文摘Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management(NOM) is a selective method for liver trauma. The aim of this study was to determine the success rate, mortality and morbidity of NOM for isolated liver trauma.Medical records of 81 patients with isolated liver trauma in our unit were analyzed retrospectively. The success rate, mortality and morbidity of NOM were evaluated. In this series, 9 patients with grade IV-V liver injuries underwent emergent operation due to hemodynamic instability; 72 patients, 6 with grade V, 18 grade IV, 29 grade III, 15 grade II and 4 grade I, with hemodynamic stability received NOM. The overall success rate of NOM was 97.2%(70/72). The success rates of NOM in the patients with grade I-III, IV and V liver trauma were100%, 94.4% and 83.3%. The complication rates were 10.0%and 45.5% in the patients who underwent NOM and surgical treatment, respectively. No patient with grade I-II liver trauma had complications. All patients who underwent NOM survived.NOM is the first option for the treatment of liver trauma if the patient is hemodynamically stable. The grade of liver injury and the volume of hemoperitoneum are not suitable criteria for selecting NOM. Hepatic angioembolization associated with the correction of hypothermia, coagulopathy and acidosis is important in the conservative treatment for liver trauma.
文摘Mood disorders are often an indication or a sign of depression,and individuals suffering from mood swings may face higher probability and increased suicidal tendencies.Depression-also called“clinical depression”or a“depressive disorder”-is a mood disorder that adversely impacts how an individual feels,thinks,and handles daily activities,such as sleeping,eating,or working.To be diagnosed with depression,symptoms must be present most of the time,nearly every day for at least minimum of 2 to 3 weeks.Feeling sad or having low emotional energy may be common among people.For most,however,these feelings are transitory and can be managed by changing daily life routines.But for some,prolonged mood disorders can lead to depression and foster suicidal tendencies.Suicide is a major public health concern.Over 47,000 people died by suicide in the United States in 2017.It is the 10th leading cause of death overall according to NIMH(National Institute of Mental Health).Suicide is complicated and tragic,but it is often preventable.Identifying the warning signs for suicide and how to get help can be a major mitigating factor.In this short communication,we are reviewing the promise and limitations of AI(artificial intelligence)with its integrated tools such as ML(machine learning)and DL(deep learning)for mood analysis as a means for detecting early signs of depression and increased suicidal tendencies for possible suicide risk management.
文摘Background:The role of the patient’s medication literacy is crucial in ensuring the efficacy of the treatment for nephrotic syndrome(NS).It is imperative to identify and examine instances of inadequate medication literacy in order to effectively manage NS.This study aimed to detect the low medication literacy in Chinese NS children using the 22-item Medication Literacy Scale(MLS-22)and to further analyze its influencing factors.Methods:This study involved consecutive sampling of 157 Chinese children with NS.Interviewer-led questionnaires were used to collect data.Firstly,the MLS-22 was evaluated for reliability and validity.Secondly,the medication literacy level was assessed,and factors related to low scores were examined using a multivariate logistic regression model.Results:MLS-22 proved reliable and valid for detection at a low level in NS children.The tertile was divided into low-level and medium/high-level medication literacy.It was found that the scores of NS children averaged 13.06.Multivariate logistic regression analysis revealed that parents of children with primary NS and congenital NS had lower medication literacy scores,which were related to parents with less than high school education.Conclusions:Healthcare providers should develop tailored strategies to effectively assist Chinese children with limited medication literacy in managing chronic diseases.
文摘Objective:To describe the major categories of components of an in-house treatment information,management,and planning system(TIMPS■)that were designed and built to optimize the planning process.Methods:The system was designed,from the beginning,to manage the multi-user complex process of planning and delivering external beam treatments with the eventual goal of providing one-day planning,multiple radiation modality optimization,robust optimization,4D planning,daily adaptive treatments,and treatment verification and reconstruction.A Monte Carlo based track repeating algorithm was chosen for dose simulations.The user interface was based on web applications.Results:The first set of released tools included task queuing,followed by resource scheduling calendars and planning aims.Later releases included tools for image registration,manipulating motion profiles and 4D images,segmentation,PET simulation,and portal QA.Currently under testing are plan optimization and biophysical models.Conclusions:The in-house TIMPS first entered clinical service in April of 2017 with new tools added every few months.Since implementation,the time for planning has decreased simultaneously with a reduction of errors.
文摘With the continuous worsening of theproblems of urban wastes about 60 urbanscientific workers gathered in Guiyang to dis-cuss the present state of the treatment andmanagement of urban wastes and find rela-tive solutions to the problems.The“Guiyang Symposium on the Treat-ment and Management of City Wastes”jointly sponsored by the Chinese Urban Sci-entific Research Institute,the Urban Con-struction Department of the Ministry of Ur-