ABSTRACT
The etiology of childhood arterial ischemic stroke is complex, and identifying the underlying cause is crucial for optimizing treatment and preventing recurrence. Currently, the classification methods for childhood arterial ischemic stroke are largely based on data from international studies, but a unified consensus have not yet been reached. This paper reviews the existing classification methods and their subtype definitions, and points out some doubts and ambiguities. On this basisi, combined with the data collected by Beijing Children's Hospital on Chinese children with arterial ischemic stroke, a new classification method (COIST) was proposed according to the etiology and pathogenesis, namely: inflammation (I), abnormal vascular structure (S), thrombophilia (T), heart disease (C), other identifiable causes (O), and uncertain causes; and various subtypes are listed. It is hoped that this new classification method can attract the attention and discussion of domestic colleagues, with the aim of further refinement, in order to help clinicians better understand and quickly identify the etiologies of childhood ischemic stroke.
Subject(s)
Ischemic Stroke , Humans , Ischemic Stroke/classification , Ischemic Stroke/etiology , Child , Brain Ischemia/classification , Inflammation , Thrombophilia/classification , Stroke/classificationABSTRACT
Objective: To compare the postoperative analgesic effect of modified superior trunk block and traditional interscalene brachial plexus block in arthroscopic rotator cuff repair. Methods: A total of 40 patients undergoing arthroscopic rotator cuff repair in the Second Affiliated Hospital of Wenzhou Medical University from October to November 2023 were prospectively included, whose American Society of Anesthesiologists (ASA) grade were â -â ¡. They were divided into modified superior trunk block group (group S) and interscalene brachial plexus block group (group I) by random number table according to different nerve block methods, with 20 cases in each group. Local anesthetics was a mixture of 1.33% liposomal bupivacaine and 0.5% levobupivacaine hydrochloride injection in equal volume. Patients in group S were injected 5 ml mixture for ultrasound-guided modified superior trunk block, and patients in group I were injected with 15 ml mixture for ultrasound-guided traditional interscalene block respectively. Both groups underwent superficial cervical plexus block (5 ml mixture). Standardized general anesthesia and standardized postoperative analgesia were followed. The primary outcome measures included 48 h resting numerical rating scale (NRS) scores after surgery and the incidence of hemidiaphragmatic paralysis (HDP) at 30 min after block. The secondary outcome measures included resting NRS scores during the post anesthesia care unit (PACU), 12, 24, and 36 h after surgery, postoperative opioid consumption and satisfaction with analgesia, pulse oxygen saturation (SpO2) at 30 min after block, sensory and motor block duration, and the incidence of perioperative adverse reactions. The non-inferiority cut-off value of resting NRS scores for patients in group S was set as"1 point"at each observation time point after surgery. Results: In group S, one patient was excluded because the target nerve was blocked by the subclavian vein and could not be blocked, nineteen patients [11 males and 8 females, aged (52.2±9.0) years] were eventually included. In group I, there were 7 males and 13 females, aged (55.0±5.1) years. Resting NRS scores of group S and Group I at 48 h after surgery were 0 (0, 0) and 0 (0, 0.8) point, respectively, with no statistical significance (P>0.05). The median difference was 0 (95%CI:0-0) point and the upper 95%CI was 0 point, which was lower than the preset non-inferiority cut-off value"1 point"(non-inferiority P<0.001). The incidence of HDP in group S and group I were 5% (1/19) and 75% (15/20), respectively, with statistically significant (P<0.001). There were no significant differences in resting NRS scores at PACU and 12, 24, 36 h after surgery, opioid dosage, satisfaction with analgesia, SpO2 at 30 min after block, sensory and motor block duration between two groups (all P>0.05). No respiratory adverse events such as hypoxemia and airway spasm occurred in two groups after extubation. One patient in group I showed symptoms of breath shortness when entering PACU, and 3 patients felt uncomfortable due to prolonged numbness and weakness of the blockade limb (>2 days). No nerve block procedures and opioid drugs relative adverse reactions and no neurological complications happened in both groups. Conclusion: Liposomal bupivacaine usage for modified superior trunk block can provide long-term postoperative analgesic effects which is noninferior to traditional interscalene brachial plexus block and causes less HDP in patients undergoing arthroscopic rotator cuff repair.
Subject(s)
Anesthetics, Local , Arthroscopy , Brachial Plexus Block , Bupivacaine , Liposomes , Pain, Postoperative , Humans , Brachial Plexus Block/methods , Bupivacaine/administration & dosage , Anesthetics, Local/administration & dosage , Pain, Postoperative/prevention & control , Rotator Cuff/surgery , Brachial Plexus , Nerve Block/methods , Female , Male , Middle Aged , Analgesia/methodsABSTRACT
Objective: To analyze the sensitivity of cytoplasmic light-chain immunofluorescence with fluorescence in situ hybridization in bone marrow smears (new FISH) for detecting cytogenetic abnormalities in multiple myeloma (MM) . Methods: 42 MM patients admitted to the First Affiliated Hospital of Nanjing Medical University from April 2022 to October 2023 were enrolled. The patients with MM were detected by new FISH and CD138 immunomagnetic bead sorting technology combined with FISH (MACS-FISH) or cytoplasmic immunoglobulin FISH (cIg-FISH) to analyze cytogenetic detection results using combination probes which included 1q21/1p32, p53, IgH, IgH/FGFR3 [t (4;14) ], and IgH/MAF [t (14;16) ]. Results: In 23 patients with MM, the abnormality detection rates of cIg-FISH and new FISH were 95.7% and 100.0%, respectively (P>0.05). The detection rates of 1q21+, 1p32-, p53 deletion, and IgH abnormalities by cIg-FISH and new FISH were consistent, which were 52.2%, 8.7%, 17.4%, and 65.2%, respectively. The results of the two methods further performed with t (4;14) and t (14;16) in patients with IgH abnormalities were identical. The positive rate of t (4;14) was 26.7%, whereas t (14;16) was not detected. In 19 patients with MM, the abnormality detection rates of MACS-FISH and new FISH were 73.7% and 63.2%, respectively (P>0.05). The positivity rate of 1q21+, 1p32- and IgH abnormalities detected by MACS-FISH were slightly higher than those detected by new FISH; however, the differences were not statistically significant (all P values >0.05) . Conclusion: The new FISH method has a higher detection rate of cytogenetic abnormalities in patients with MM and has good consistency with MACS-FISH and cIg-FISH.
Subject(s)
Bone Marrow , Chromosome Aberrations , In Situ Hybridization, Fluorescence , Multiple Myeloma , Humans , Multiple Myeloma/genetics , Multiple Myeloma/diagnosis , In Situ Hybridization, Fluorescence/methods , Immunoglobulin Light Chains/genetics , Male , Cytoplasm/metabolism , Middle Aged , FemaleABSTRACT
Objective: To demonstrate the type of CEBPA gene mutations among patients with acute myeloid leukemia (AML), clinical characteristics, and prognostic effect on patient outcomes. Methods: Demographic data, clinical features, laboratory characteristics, and data about treatment and follow-up of 57 patients with CEBPA mutated AML diagnosed at Peking Union Medical College Hospital between April 2016 and November 2022 were collected and analyzed. Results: In total, 57 patients with CEBPA mutation accounted for 16.1% of all the 353 patients with AML, among which 28 patients had CEBPA-bZIPinf and 29 had CEBPA-other. Compared with the CEBPA-other group, the CEBPA-bZIPinf group was younger (54 vs 64 years, P=0.010), de novo AML was more common (P=0.001), and the level of bone marrow blast was higher (68.0% vs 36.3%, P=0.001). Moreover, 24 patients from the CEBPA-bZIPinf group and 19 from the CEBPA-other group received chemotherapy. The one-course complete remission (CR) rate of the CEBPA-bZIPinf group was significantly higher than that of the CEBPA-other (87.5% vs 47.4%, P=0.010) and CEBPA-wt (87.5% vs 50.3%, P=0.002) groups. After a median follow-up of 11 months, the median OS of the CEBPA-bZIPinf group was significantly longer than that of the CEBPA-wt group (not reached vs 22.1 months, P=0.012) . Conclusion: CEBPA-bZIPinf mutated AML is a unique clinical entity, with a younger age of diagnosis, better response to chemotherapy, and better prognosis.
Subject(s)
CCAAT-Enhancer-Binding Proteins , Leukemia, Myeloid, Acute , Mutation , Humans , Leukemia, Myeloid, Acute/genetics , Leukemia, Myeloid, Acute/diagnosis , CCAAT-Enhancer-Binding Proteins/genetics , Prognosis , Middle Aged , Male , FemaleABSTRACT
Objective: To analyze the trend of dementia mortality rate among individuals aged 60 to 94 years in China from 1982 to 2021. Methods: Utilizing data from the Global Burden of Disease Study 2021, the Joinpoint regression model was employed to analyze the trend in the dementia mortality rate among Chinese older adults from 1982 to 2021. The age-period-cohort analysis method was used to decompose the age effect, period effect and cohort effect of dementia mortality data in Chinese elderly people. Results: From 1982 to 2021, the crude mortality rate of dementia in elderly women aged 60-94 in China (133.67/100 000-214.02/100 000) was higher than that in men (70.92/100 000-119.70/100 000), and the age-standardized mortality rate of dementia in women (230.74/100 000-246.87/100 000) was also higher than that in men (132.88/100 000-140.19/100 000). The age-standardized mortality rate of dementia in both genders showed an N-shaped fluctuation trend. The average annual percent change (AAPC) of dementia mortality rate in elderly males aged 60-94 was 0.07% (95%CI: 0.01%-0.13%), and the AAPC of dementia mortality rate in elderly females was -0.01% (95%CI:-0.08%-0.07%). Age effect analysis showed that from the age of 60, the risk of dementia death in males and females increased with age, especially among elderly people aged 75-94 who experienced a rapid increase in dementia mortality rate. The period effect analysis showed that the overall risk of dementia death in elderly men and women aged 60-94 was decreasing, but it had increased from 2017 to 2021. The cohort effect analysis showed that the risk of dementia death was lower in later birth cohorts. Conclusion: From 1982 to 2021, the dementia mortality rate among Chinese older adults aged 60 to 94 years exhibited fluctuations. Particularly, there has been a notable rebound in recent years. Special attention should be directed towards female seniors and those aged 75 to 94 years.
Subject(s)
Dementia , Humans , Dementia/mortality , Aged , China/epidemiology , Aged, 80 and over , Female , Male , Middle Aged , Cohort Studies , Mortality/trendsABSTRACT
mRNA vaccine technology has made significant progress in recent years, especially with the large-scale application driven by the COVID-19 pandemic. Moderna and Pfizer/BioNTech vaccines have become central tools in the global fight against the virus, demonstrating the potential of the mRNA platform for rapid design, production, and strong immune responses. These vaccines showcase the unique advantages of rapid response and effective protection. At the same time, mRNA technology still faces challenges, such as stability and targeted delivery. Future research will focus on improving the stability and safety of mRNA vaccine and expanding its application to more infectious diseases and cancer treatments. This article reviews platforms of mRNA vaccine, vaccine design, development of delivery system, and the application of mRNA vaccines, in order to enhance the understanding of professionals and accelerate the layout of this technology in vaccine research and application in China.
Subject(s)
COVID-19 Vaccines , COVID-19 , Vaccine Development , Humans , COVID-19/prevention & control , mRNA Vaccines , SARS-CoV-2 , Vaccines, Synthetic , RNA, Messenger/geneticsABSTRACT
PURPOSE: Combining computed diffusion-weighted imaging (DWI) with readout-segmented echo-planar-imaging may shorten acquisition time and improve imaging quality. This study aimed to compare computed vs. acquired DWI qualitatively and quantitatively in visualizing scrotal or testicular lesions. MATERIALS AND METHODS: We retrospectively enrolled 57 consecutive men who underwent scrotal MRI. Four computed DWI sets (cDWI800, cDWI1000, cDWI1200, and cDWI1400) were generated from acquired DWI with two lower b-values (150 and 600 s/mm2). Acquired DWI (DWI800 and DWI1000) and computed DWI were compared through qualitative (susceptibility artifact, signal loss artifact, anatomic clarity, and lesion conspicuity) and quantitative assessment (signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and lesion-to-testicular parenchyma contrast ratio (CR)). RESULTS: Computed DWI was prone to signal loss artifact and slightly lower assessment scores in terms of anatomic clarity and lesion conspicuity, comparing with acquired DWI. The SNR of computed and acquired DWI decreased with increasing b value. Under the same b-values (800 and 1,000 s/mm2), there was no difference in the median SNR and CR between computed and acquired DWI. The median CR of cDWI1400 was significantly higher than that of the other DWI sets excepting cDWI1200 (P=1.000). The median CNR tended to be lower for computed vs. acquired DWI, while no significant difference (P=0.233). CONCLUSIONS: Computed and acquired DWI were nearly equivalent in both qualitative and quantitative evaluations at the b values of 800 and 1,000 s/mm2. Computed DWI could enhance the contrast of scrotal or testicular lesions.
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Objective: To investigate the development of receptive and expressive vocabulary in Mandarin-speaking children with cochlear implants (CI) during the first year after CI activation. Methods: A total of 827 children (411 boys and 416 girls) who were implanted CI before 2.5 years of age from October 2019 to December 2022 in the Department of Auditory Implantation, Shandong Provincial ENT Hospital were included in this study. The Infant Checklist of the Mandarin Early Vocabulary Inventory (EVI) was used to assess the quantity and content of receptive and expressive vocabulary at the time of CI activation and at the 1st, 3rd, 6th, 9th, 12th months post-activation. SPSS 22.0 was used to describe the receptive and expressive vocabulary of CI children at the first year after activation. Results: During the first year after CI activation, CI children's receptive and expressive vocabulary consistently increased with the CI usage. The average number of receptive vocabulary and expressive vocabulary respectively increased from 0 to 178, and from 0 to 97. At the first year of post-activation, the number of receptive and expressive vocabulary of CI children were superior to that of hearing-age matched typical-hearing children, but fell behind of that of chronological age matched typical-hearing children. In terms of lexical categories, receptive and expressive vocabulary was acquired in the following order: nouns, verbs, adjectives, and pronouns. Among the top 50 words that CI children could express, nouns were the most common, then followed by verbs, adjectives, and pronouns. Father's education level can significantly and positively predictethe receptive vocabulary of CI children at the first year post-activation. At the first year after CI activation, the 10th, 25th, 50th, 75th, and 90th percentiles were 113, 149, 178, 202, 223 for the receptive vocabulary, and 9, 37, 97, 148, 188 for expressive vocabulary. Conclusion: For Mandarin speaking children with CI, the receptive and expression vocabulary continuely increased within the first year after CI activation. The ability to grasp receptive vocabulary precedes the ability to express expressive vocabulary. Compared to hearing-age matched typical-hearing children, CI children showed faster rate of the vocabulary growth, and earlier and more frequently verb expression. However, it still larged behind that of chronological age matched hearing normal children. CI children respectively understood and expressed nouns and verbs the first. In children with CI, the first concepts understood and expressed were nouns and verbs. Among the first 50 words expressed, nouns were the most numerous, and the age at which verbs were acquired was earlier than that for hearing-age matched typical-hearing children.
Subject(s)
Cochlear Implantation , Cochlear Implants , Language Development , Vocabulary , Humans , Male , Female , Infant , China , Child, Preschool , LanguageABSTRACT
The global diversity of fungi has been estimated between 2 to 11 million species, of which only about 155 000 have been named. Most fungi are invisible to the unaided eye, but they represent a major component of biodiversity on our planet, and play essential ecological roles, supporting life as we know it. Although approximately 20 000 fungal genera are presently recognised, the ecology of most remains undetermined. Despite all this diversity, the mycological community actively researches some fungal genera more commonly than others. This poses an interesting question: why have some fungal genera impacted mycology and related fields more than others? To address this issue, we conducted a bibliometric analysis to identify the top 100 most cited fungal genera. A thorough database search of the Web of Science, Google Scholar, and PubMed was performed to establish which genera are most cited. The most cited 10 genera are Saccharomyces, Candida, Aspergillus, Fusarium, Penicillium, Trichoderma, Botrytis, Pichia, Cryptococcus and Alternaria. Case studies are presented for the 100 most cited genera with general background, notes on their ecology and economic significance and important research advances. This paper provides a historic overview of scientific research of these genera and the prospect for further research. Citation: Bhunjun CS, Chen YJ, Phukhamsakda C, Boekhout T, Groenewald JZ, McKenzie EHC, Francisco EC, Frisvad JC, Groenewald M, Hurdeal VG, Luangsa-ard J, Perrone G, Visagie CM, Bai FY, Blaszkowski J, Braun U, de Souza FA, de Queiroz MB, Dutta AK, Gonkhom D, Goto BT, Guarnaccia V, Hagen F, Houbraken J, Lachance MA, Li JJ, Luo KY, Magurno F, Mongkolsamrit S, Robert V, Roy N, Tibpromma S, Wanasinghe DN, Wang DQ, Wei DP, Zhao CL, Aiphuk W, Ajayi-Oyetunde O, Arantes TD, Araujo JC, Begerow D, Bakhshi M, Barbosa RN, Behrens FH, Bensch K, Bezerra JDP, Bilanski P, Bradley CA, Bubner B, Burgess TI, Buyck B, Cadez N, Cai L, Calaça FJS, Campbell LJ, Chaverri P, Chen YY, Chethana KWT, Coetzee B, Costa MM, Chen Q, Custódio FA, Dai YC, Damm U, de Azevedo Santiago ALCM, De Miccolis Angelini RM, Dijksterhuis J, Dissanayake AJ, Doilom M, Dong W, Alvarez-Duarte E, Fischer M, Gajanayake AJ, Gené J, Gomdola D, Gomes AAM, Hausner G, He MQ, Hou L, Iturrieta-González I, Jami F, Jankowiak R, Jayawardena RS, Kandemir H, Kiss L, Kobmoo N, Kowalski T, Landi L, Lin CG, Liu JK, Liu XB, Loizides M, Luangharn T, Maharachchikumbura SSN, Makhathini Mkhwanazi GJ, Manawasinghe IS, Marin-Felix Y, McTaggart AR, Moreau PA, Morozova OV, Mostert L, Osiewacz HD, Pem D, Phookamsak R, Pollastro S, Pordel A, Poyntner C, Phillips AJL, Phonemany M, Promputtha I, Rathnayaka AR, Rodrigues AM, Romanazzi G, Rothmann L, Salgado-Salazar C, Sandoval-Denis M, Saupe SJ, Scholler M, Scott P, Shivas RG, Silar P, Souza-Motta CM, Silva-Filho AGS, Spies CFJ, Stchigel AM, Sterflinger K, Summerbell RC, Svetasheva TY, Takamatsu S, Theelen B, Theodoro RC, Thines M, Thongklang N, Torres R, Turchetti B, van den Brule T, Wang XW, Wartchow F, Welti S, Wijesinghe SN, Wu F, Xu R, Yang ZL, Yilmaz N, Yurkov A, Zhao L, Zhao RL, Zhou N, Hyde KD, Crous PW (2024). What are the 100 most cited fungal genera? Studies in Mycology 108: 1-411. doi: 10.3114/sim.2024.108.01.
Subject(s)
Cerebral Infarction , Intracranial Thrombosis , Magnetic Resonance Imaging , Venous Thrombosis , Humans , Male , Female , Middle Aged , Adult , Retrospective Studies , Venous Thrombosis/pathology , Intracranial Thrombosis/pathology , Intracranial Thrombosis/diagnostic imaging , Intracranial Thrombosis/metabolism , Young Adult , Cerebral Infarction/pathology , Cerebral Infarction/diagnostic imaging , Cerebral Infarction/metabolism , Fibrin Fibrinogen Degradation Products/metabolism , Headache/etiology , Cerebral Cortex/pathology , Cerebral Cortex/blood supply , Cerebral Cortex/diagnostic imaging , Diagnosis, Differential , Temporal Lobe/pathology , Temporal Lobe/diagnostic imaging , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/pathology , Seizures/etiology , Brain Edema/pathology , Frontal Lobe/pathology , Frontal Lobe/diagnostic imaging , Frontal Lobe/blood supplySubject(s)
Carcinoma, Renal Cell , Kidney Neoplasms , Humans , Carcinoma, Renal Cell/pathology , Carcinoma, Renal Cell/genetics , Carcinoma, Renal Cell/metabolism , Kidney Neoplasms/pathology , Kidney Neoplasms/genetics , Kidney Neoplasms/metabolism , Male , Middle Aged , Female , Aged , Retrospective Studies , Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics , Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/metabolism , PAX8 Transcription Factor/metabolism , PAX8 Transcription Factor/genetics , PAX2 Transcription Factor/metabolism , PAX2 Transcription Factor/genetics , Racemases and Epimerases/metabolism , Racemases and Epimerases/genetics , Nephrectomy , Follow-Up StudiesABSTRACT
To search for low-energy resonant structures in isospin T=3/2 three-body systems, we have performed the experiments ^{3}H(t,^{3}He)3n and ^{3}He(^{3}He,t)3p at intermediate energies. For the 3n experiment, we have newly developed a thick Ti-^{3}H target that has the largest tritium thickness among targets of this type ever made. The 3n experiment for the first time covered the momentum-transfer region as low as 15 MeV/c, which provides ideal conditions for producing fragile systems. However, in the excitation-energy spectra we obtained, we did not observe any distinct peak structures. This is in sharp contrast to tetraneutron spectra. The distributions of the 3n and 3p spectra are found to be similar, except for the displacement in energy due to Coulomb repulsion. Comparisons with theoretical calculations suggest that three-body correlations exist in the 3n and 3p systems, although not enough to produce a resonant peak.
ABSTRACT
Objective: To summarize the clinical value of fetoscopy in the prenatal diagnosis and treatment of amniotic band syndrome (ABS). Methods: A retrospective analysis was conducted on the clinical data of seven ABS fetuses who underwent prenatal fetoscopic intervention at the Third Affiliated Hospital of Zhengzhou University from December 2020 to August 2023. Literatures related to fetoscopic treatment of ABS were searched in databases including China National Knowledge Infrastructure, Wanfang Data, and PubMed. Clinical data were extracted and the characteristics and intervention effects of fetoscopic surgery in the treatment of ABS were summarized. Results: (1) Preoperative evaluation: the gestational age at diagnosis for the seven ABS fetuses was (19.8±4.4) weeks, and the gestational age at fetoscopic intervention was (22.2±2.8) weeks. The indications for fetoscopic intervention included umbilical cord involvement (3 cases), limb amniotic band with circular constriction (2 cases), and unclear visualization of digits (3 cases). (2) Pregnancy outcomes: among the seven ABS fetuses, four cases underwent selective termination of pregnancy due to severe intrauterine limb amputation, and three cases underwent fetoscopic lysis of amniotic bands. Among the latter three cases, one case experienced intrauterine fetal death (IUFD) two weeks after the procedure, and two cases had good postoperative outcomes. (3) Literature review: a total of 40 cases, including 37 cases from 17 articles and three cases from our institution, were included in the analysis. The indications for fetoscopic surgery included limb amniotic band with circular constriction and involvement of the umbilical cord. The success rate of the surgery was 82% (33/40), and 78% (29/37) of the affected limbs retained good functionality. Premature rupture of membranes was the most common complication, with an incidence rate of 48% (16/33). The average interval from the surgery to membrane rupture was (6.1±5.1) weeks, and the average interval from the surgery to delivery was (10.5±4.1) weeks, with an average gestational age at delivery of (33.7±3.6) weeks. The pregnant women were divided into single Trocar group (27 cases) and double Trocar group (13 cases) based on the surgical approach. The success rates in single Trocar group and double Trocar group were 78% (21/27) and 12/13, respectively, and the difference was not statistically significant (χ2=0.474, P=0.491). The gestational age of delivery in the single Trocar group and double Trocar group was (32.7±3.4) and (35.4±3.2) weeks, respectively, and the difference was statistically significant (t=-2.185, P<0.05). There were no statistically significant differences in the success rate of the surgery, incidence of premature rupture of membranes, interval between surgery and membrane rupture, interval between surgery and delivery, and preterm delivery rate between the two groups (all P>0.05). Conclusions: Fetoscopy could be used for prenatal assessment and intrauterine treatment of ABS. Fetoscopic lysis of amniotic bands may be an effective method for treating ABS, which helps preserve limb function and prevent intrauterine limb amputation and IUFD.
Subject(s)
Amniotic Band Syndrome , Fetoscopy , Pregnancy Outcome , Humans , Amniotic Band Syndrome/diagnosis , Amniotic Band Syndrome/surgery , Fetoscopy/methods , Female , Pregnancy , Retrospective Studies , Umbilical Cord/surgery , Prenatal Diagnosis/methods , Gestational Age , Adult , Ultrasonography, PrenatalABSTRACT
Thrombocytopenia is one of the common complications of cirrhotic patients, which can induce an increasing bleeding risk and closely correlate with bleeding following invasive procedures. Consequently, how to respond to thrombocytopenia is crucial for improving the prognosis of patients with cirrhosis. This article reviews the main mechanisms of cirrhosis concurrent with thrombocytopenia, as well as the corresponding clinical management strategies.
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Liver Cirrhosis , Thrombocytopenia , Humans , Thrombocytopenia/therapy , Thrombocytopenia/etiology , Liver Cirrhosis/complications , Liver Cirrhosis/therapyABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is a common concomitant disease in adults with type 2 diabetes mellitus (T2DM) and prediabetes. Therefore, T2DM/NAFLD patient populations are at high risk for cardiovascular disease. The occurrence and progression of non-alcoholic fatty liver disease-related liver fibrosis and cardiovascular disease have a severe impact on the patient's prognosis and mortality rate. The American Diabetes Association's 2024 "Guidelines for the Standardized Management of Diabetes" put forward recommendations relevant to the screening, evaluation, treatment, and management of NAFLD in T2DM and prediabetic populations, as well as liver fibrosis. The important measures for decelerating liver inflammation and fibrosis progression and the risk of cardiovascular disease are based on improvements in lifestyle methods, weight loss, and blood sugar control.
Subject(s)
Diabetes Mellitus, Type 2 , Non-alcoholic Fatty Liver Disease , Non-alcoholic Fatty Liver Disease/therapy , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/diagnosis , Humans , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/therapy , United States , Prediabetic State/therapy , Prediabetic State/diagnosis , Prediabetic State/complications , Cardiovascular Diseases/prevention & control , Cardiovascular Diseases/etiology , Cardiovascular Diseases/therapy , Liver Cirrhosis/complications , Liver Cirrhosis/therapy , Liver Cirrhosis/diagnosisABSTRACT
Liver biopsy is an important means of clinical diagnosis and treatment of liver diseases, but it is not easily accepted by patients because of its invasiveness. The most commonly employed liver biopsy approaches are percutaneous or transjugular. Endoscopic ultrasound-guided liver biopsy (EUS-LB), a newly emerging transjugular technique, has been widely studied and applied in recent years, but its application in China is less common. The EUS-LB has the advantages of high safety and comfort, simultaneous sampling of both liver lobes, and adequate sampling volume; however, it also has the disadvantages of high requirements for hardware, operators, and cost. This article reviews the clinical application of EUS-LB in accordance with pertinent research findings from recent years and discusses its advantages, disadvantages, and implementation feasibility.
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Endosonography , Liver , Humans , Liver/pathology , Liver/diagnostic imaging , Endosonography/methods , Liver Diseases/pathology , Liver Diseases/diagnostic imaging , Liver Diseases/diagnosisABSTRACT
Brominated flame retardants (BFRs) are a kind of brominated compounds widely used in electronic and electrical appliances, textiles, construction materials and other industrial products to improve the flame retardant property. Because of its strong chemical stability, environmental persistence, long-distance transmission, biological accumulation, the exposure of humans and organisms in the ecosystem is increasing, and its potential biological effects are of great concern. Now BFRs can be detected in breast milk, serum, placenta and cord blood. Studies have shown that exposure to BFRs during pregnancy can lead to adverse birth outcomes such as low birth weight, malformation, gestational age changes and impairment of neurobehavioral development. This article summarizes the pollution and population exposure of three traditional BFRs, polybrominated diphenyl ethers (PBDEs), hexabromocyclododecane (HBCD), and tetrabromobisphenol A (TBBPA), as well as the impact and mechanism of prenatal exposure on offspring birth outcomes and growth and development. It explores the harm of prenatal exposure to BFRs to offspring and proposes preventive measures for occupational populations for reference.
Subject(s)
Flame Retardants , Halogenated Diphenyl Ethers , Hydrocarbons, Brominated , Maternal Exposure , Polybrominated Biphenyls , Prenatal Exposure Delayed Effects , Flame Retardants/toxicity , Pregnancy , Humans , Female , Hydrocarbons, Brominated/toxicity , Halogenated Diphenyl Ethers/toxicity , Maternal Exposure/adverse effects , Polybrominated Biphenyls/toxicityABSTRACT
As an important force in promoting the transformation and upgrading of the national economy, the occupational health of the Internet industry's employees has received widespread attention. This paper examines the current situation of occupational health risks and management in the Internet industry at home and abroad, and on this basis reveals the physical and mental health problems of Internet industry employees. Combining the existing regulations, policies and standard documents at home and abroad, countermeasures are proposed to improve the relevant laws and regulations and their guidelines, implement relevant job design requirements, build a healthy working environment, optimise the work management system and carry out workplace health promotion, in order to provide ideas to accelerate the improvement of occupational health issues in the Internet industry.