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Background: Rifampicin-resistant pulmonary tuberculosis (RR-PTB) presents a significant threat to global public health security. China bears a substantial burden of RR-PTB cases globally, with Guizhou Province experiencing particularly alarming trends, marked by a continual increase in patient numbers. Understanding the population characteristics and treatment modalities for RR-PTB is crucial for mitigating morbidity and mortality associated with this disease. Methods: We gathered epidemiological, diagnostic, and treatment data of all RR-PTB cases recorded in Guizhou Province from January 1, 2017 to December 31, 2023. Utilizing composition ratios as the analytical metric, we employed Chi-square tests to examine the spatiotemporal distribution patterns of RR-PTB patients and the evolving trends among different patient classifications over the study period. Results: In our study, 3396 cases of RR-PTB were analyzed, with an average age of 45 years. The number of RR-PTB patients rose significantly from 176 in 2017 to 960 in 2023, peaking notably among individuals aged 23–28 and 44–54, with a rising proportion in the 51–80 age group (P < 0.001). Since 2021, there has been a notable increase in the proportion of female patients. While individuals of Han ethnic group comprised the largest group, their proportion decreased over time (P < 0.001). Conversely, the Miao ethnicity showed an increasing trend (P < 0.05). The majority of patients were farmers, with their proportion showing an upward trajectory (P < 0.001), while students represented 4.33% of the cases. Geographically, most patients were registered in Guiyang and Zunyi, with a declining trend (P < 0.001), yet household addresses primarily clustered in Bijie, Tongren, and Zunyi. The proportion of floating population patients gradually decreased, alongside an increase in newly treated patients and those without prior anti-tuberculosis therapy. Additionally, there was a notable rise in molecular biological diagnostic drug sensitivity (real-time PCR and melting curve analysis) (P < 0.001). However, the cure rate declined, coupled with an increasing proportion of RR-PTB patients lost to follow-up and untreated (P < 0.05). Conclusions: Enhanced surveillance is crucial for detecting tuberculosis patients aged 23–28 and 44–54 years. The distribution of cases varies among nationalities and occupations, potentially influenced by cultural and environmental factors. Regional patterns in RR-PTB incidence suggest tailored prevention and control strategies are necessary. Despite molecular tests advances, challenges persist with low cure rates and high loss to follow-up. Strengthening long-term management, resource allocation, and social support systems for RR-PTB patients is essential. [ABSTRACT FROM AUTHOR]

Purpose: To compare the diagnosis and clinical features of tubulointerstitial nephritis and uveitis syndrome (TINU) before and during the COVID-19 pandemic. Methods: Retrospective chart review. Results: Before the COVID-19 pandemic (March 2017 to March 2019), 1/561 (0.18%) new patient was diagnosed with TINU. During the pandemic (March 2020 to March 2022), 15/581 (2.58%) new patients were diagnosed with TINU. We found a significant increase in TINU cases during the pandemic (P=0.0005). Various posterior segment findings were observed in 2/3 (66.7%) patients before the pandemic and 13/15 (86.7%) patients during the pandemic, including disc edema, chorioretinal scars, disc leakage, and peripheral vascular leakage. Conclusion: This is the first study reporting an increased number of TINU during the COVID-19 pandemic. With most of the American population now exposed to COVID-19, a large multi-center epidemiological study would be helpful to investigate any association of COVID-19 disease or vaccination with TINU in recent years. [ABSTRACT FROM AUTHOR]

Chronic central serous chorioretinopathy (CSCR) is a sight threatening disease that can lead to legal blindness. Verteporfin photodynamic therapy is the main treatment for chronic CSCR, however, there has been a critical worldwide shortage of verteporfin. Other medical treatments have been attempted with variable efficacy. Interferons have shown efficacy in treating uveitis and associated macular edema. We report 2 cases of treatment refractory chronic CSCR successfully treated with subcutaneous injection of interferon alpha with significant anatomical and functional improvement. To our knowledge, this is the first report observing the therapeutic potential of systemic interferon alpha in the treatment of chronic CSCR. A large randomized controlled clinical trial would help to better evaluate the safety and efficacy of systemic PEG-IFNα2a in treating chronic CSCR, and further define the optimal dose, treatment interval and duration. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a common malignancy, and early detection coupled with standardized treatment is crucial for patient survival and recovery. This study aims to scrutinize the current state of breast cancer diagnosis and treatment in Shaanxi province, providing valuable insights into the local practices and outcomes. Methods: We selected 25 hospitals that typically represent the current diagnosis and treatment strategy of breast cancer in Shaanxi (a province in northwest China). The questionnaire comprised sections on fundamental information, outpatient consultations, breast-conserving surgery, neoadjuvant and adjuvant therapy, sentinel lymph node biopsy, breast reconstruction surgery. Results: A total of 6665 breast cancer operations were performed in these 25 hospitals in 2021. The overall proportion of breast-conserving surgery (BCS) is 23.6%. There was a statistically significant positive correlation between the annual volume of breast cancer surgery and the implementation rate of BCS (P = 0.004). A total of 2882 cases of neoadjuvant treatment accounted for 43.24% of breast cancer patients treated with surgery in 2017. Hospitals in Xi'an performed more neoadjuvant therapy for patients with breast cancer compared to other districts (P = 0.008). There was a significantly positive correlation between outpatient visits and the implementation rate of sentinel lymph node biopsy (SLNB) (P = 0.005). 14 hospitals in Shaanxi performed reconstructive surgery. Conclusions: Breast conserving surgery, adjuvant and neoadjuvant therapy and sentinel lymph node biopsy in Shaanxi province have reached the China's average level. Moreover, hospitals in Xi 'an have surpassed this average. However, a disparity is observed in the development of breast reconstruction surgery when compared to top-tier hospitals. [ABSTRACT FROM AUTHOR]

Gestational hypertension (PIH), especially pre-eclampsia (PE), is a common complication of pregnancy. This condition poses significant risks to the health of both the mother and the fetus. Emerging evidence suggests that epigenetic modifications, particularly DNA methylation, may play a role in initiating the earliest pathophysiology of PIH. This article describes the relationship between DNA methylation and placental trophoblast function, genes associated with the placental microenvironment, the placental vascular system, and maternal blood and vascular function, abnormalities of umbilical cord blood and vascular function in the onset and progression of PIH, as well as changes in DNA methylation in the progeny of PIH, in terms of maternal, fetal, and offspring. We also explore the latest research on DNA methylation-based early detection, diagnosis and potential therapeutic strategies for PIH. This will enable the field of DNA methylation research to continue to enhance our understanding of the epigenetic regulation of PIH genes and identify potential therapeutic targets. [ABSTRACT FROM AUTHOR]

Abstract Background Rifampicin-resistant pulmonary tuberculosis (RR-PTB) presents a significant threat to global public health security. China bears a substantial burden of RR-PTB cases globally, with Guizhou Province experiencing particularly alarming trends, marked by a continual increase in patient numbers. Understanding the population characteristics and treatment modalities for RR-PTB is crucial for mitigating morbidity and mortality associated with this disease. Methods We gathered epidemiological, diagnostic, and treatment data of all RR-PTB cases recorded in Guizhou Province from January 1, 2017 to December 31, 2023. Utilizing composition ratios as the analytical metric, we employed Chi-square tests to examine the spatiotemporal distribution patterns of RR-PTB patients and the evolving trends among different patient classifications over the study period. Results In our study, 3396 cases of RR-PTB were analyzed, with an average age of 45 years. The number of RR-PTB patients rose significantly from 176 in 2017 to 960 in 2023, peaking notably among individuals aged 23–28 and 44–54, with a rising proportion in the 51–80 age group (P

卒中是中国居民致死和长期致残的主要原因，传统的治疗药物受限于血脑屏障阻碍、稳定性差、缺乏靶向性、低载药量，治疗效果可能欠理想。纳米材料作为一种新兴的、非侵入性、可实时控制的药物，已被广泛用于卒中的诊疗。纳米药物能够有效提高药物的生物相容性、稳定性、靶向性，并延长药物的半衰期，从而有效改善传统药物的疗效。近年来纳米材料在缺血性卒中诊疗领域取得了一定进展，但仍面临临床转化等挑战。本文主要综述纳米材料在缺血性卒中诊疗中的研究进展和挑战，旨在继续推动纳米材料在卒中诊疗中的研究与应用。 Abstract: Stroke is a major cause of death and long-term disability among residents in China. Traditional therapeutic drugs are limited by the obstruction of the blood-brain barrier, poor stability, lack of targeting, and low drug loading, which may result in suboptimal treatment outcomes. Nanomaterials, as an emerging, non-invasive, and real-time controllable drug delivery system, have been widely used in the diagnosis and treatment of stroke. Nanomedicines can effectively enhance the biocompatibility, stability, and targeting of drugs, as well as prolong their half-life, thereby significantly improving the efficacy of traditional medications. In recent years, there has been some progress in the application of nanomaterials in the field of ischemic stroke diagnosis and treatment, although challenges in clinical translation remain. This article primarily reviews the research progress and challenges of nanomaterials in the diagnosis and treatment of ischemic stroke, aiming to further promote the research and application of nanomaterials in stroke therapy.

Abstract Background Bladder duplication is a rare congenital lower urinary tract anomaly disease characterized by the presence of two bladders, possibly with duplication of the urethra. This disease is rarely reported in cats. The clinical symptoms are commonly occult, with increased difficulty in making a definitive diagnosis, especially if there is no obvious urethral duplication. The diagnosis is typically based on radiographs and ultrasound, with computer tomography serving as a more advanced imaging diagnostic modality. Cases of duplicated bladders with accessory tubular tissues are even scarcer in both human and veterinary medicine. Case presentation A 6-year-old male neutered cat was brought to the hospital because of vomiting and constipation. Cystography revealed increased soft tissue density of a fusiform structure in the lower middle abdomen. The purulent-filled cavitary structure and the accessory tubular structure were removed via surgery, and histopathological examination confirmed a double bladder with attached accessory tubular tissue. After antibiotic treatment, the cat recovered uneventfully. Conclusion This is the first case of bladder duplication in China and the first case of feline bladder duplication with tubular structure attachment in the world. This information will provide a reference for the diagnosis and treatment of similar cases in the future.

Abstract Background Breast cancer is a common malignancy, and early detection coupled with standardized treatment is crucial for patient survival and recovery. This study aims to scrutinize the current state of breast cancer diagnosis and treatment in Shaanxi province, providing valuable insights into the local practices and outcomes. Methods We selected 25 hospitals that typically represent the current diagnosis and treatment strategy of breast cancer in Shaanxi (a province in northwest China). The questionnaire comprised sections on fundamental information, outpatient consultations, breast-conserving surgery, neoadjuvant and adjuvant therapy, sentinel lymph node biopsy, breast reconstruction surgery. Results A total of 6665 breast cancer operations were performed in these 25 hospitals in 2021. The overall proportion of breast-conserving surgery (BCS) is 23.6%. There was a statistically significant positive correlation between the annual volume of breast cancer surgery and the implementation rate of BCS (P = 0.004). A total of 2882 cases of neoadjuvant treatment accounted for 43.24% of breast cancer patients treated with surgery in 2017. Hospitals in Xi’an performed more neoadjuvant therapy for patients with breast cancer compared to other districts (P = 0.008). There was a significantly positive correlation between outpatient visits and the implementation rate of sentinel lymph node biopsy (SLNB) (P = 0.005). 14 hospitals in Shaanxi performed reconstructive surgery. Conclusions Breast conserving surgery, adjuvant and neoadjuvant therapy and sentinel lymph node biopsy in Shaanxi province have reached the China’s average level. Moreover, hospitals in Xi ’an have surpassed this average. However, a disparity is observed in the development of breast reconstruction surgery when compared to top-tier hospitals.

Primary malignant melanoma of the esophagus (PMME) is an extremely rare esophageal malignancy that is often misdiagnosed or overlooked due to its atypical symptoms. We report a case of a 75-year-old male patient who presented with progressive dysphagia. Endoscopic examination revealed a black mass located 25 cm from the incisors. Further imaging studies, including computed tomography (CT) and emission computed tomography (ECT), showed significant thickening of the mid-esophageal wall with localized soft tissue mass formation and heterogeneous enhancement on contrast scans. Multiple lymph nodes around the lesion were visible, leading to an initial misdiagnosis of esophageal cancer. Additionally, metabolic abnormalities in the left scapula suggested possible bone metastasis of the tumor. The final pathological diagnosis was esophageal melanoma. After thorough evaluation of the patient's medical history and additional relevant tests, the primary origin was considered. Diagnosing primary malignant melanoma of the esophagus is a challenging task. This case, through the combination of endoscopic examination, imaging, and pathology, illustrates the characteristics of PMME, providing important insights for clinicians and emphasizing the necessity of comprehensive early evaluation to improve diagnostic accuracy and treatment outcomes.

Abstract Gestational hypertension (PIH), especially pre-eclampsia (PE), is a common complication of pregnancy. This condition poses significant risks to the health of both the mother and the fetus. Emerging evidence suggests that epigenetic modifications, particularly DNA methylation, may play a role in initiating the earliest pathophysiology of PIH. This article describes the relationship between DNA methylation and placental trophoblast function, genes associated with the placental microenvironment, the placental vascular system, and maternal blood and vascular function, abnormalities of umbilical cord blood and vascular function in the onset and progression of PIH, as well as changes in DNA methylation in the progeny of PIH, in terms of maternal, fetal, and offspring. We also explore the latest research on DNA methylation-based early detection, diagnosis and potential therapeutic strategies for PIH. This will enable the field of DNA methylation research to continue to enhance our understanding of the epigenetic regulation of PIH genes and identify potential therapeutic targets.

Post-COVID-19 condition is defined as the presence of symptoms that cannot be explained by other diagnoses, lasting for at least 2 months, occurring three months after a possible or confirmed SARS-CoV-2 infection. It is the result of a complex interplay of biological, psychological, and sociocultural factors, characterized by a high number of affected individuals, complex pathogenesis, diverse symptoms, and a significant need for long-term care. The diagnosis is considered exclusionary and can be classified into six subtypes, including non-severe COVID-19 multiorgan sequelae, pulmonary fibrosis sequelae, myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, post-intensive care syndrome, and medical or clinical sequelae. Based on comprehensive evaluation, treatment and care can be provided through a multidisciplinary approach involving medication, diet, exercise, psychological interventions, patient education, and other methods.

Objective To summarize the clinical features, serological features, blood transfusion protocols and treatment of 3 cases of passenger lymphocyte syndrome(PLS) after ABO-incompatibility liver and renal transplantation in our hospital, in order to provide guidance for comprehensive clinical understanding and recognition of this disease, especially early recognition and treatment. Methods By collecting the basic information of the patients and the time of cross-matching incompatibility of homologous blood after transplantation, observing the skin yellow staining, detecting hemoglobin value and other hemolysis indexes, and blood group serological detection results before and after transfusion, the diagnosis and analysis were performed. The diagnosis and treatment effect of PLS were analyzed by collecting the clinical outcome information after immunization and blood transfusion. Results Three cases of ABO-incompatible liver transplantation showed decreased hemoglobin and hemolysis, incompatible cross-matching of homologous blood, and anti-A and anti-B IgG antibodies were confirmed by serological test. After treatment such as immunosuppression and plasma exchange, blood transfusion was effective, hemolysis was improved, and antibodies gradually disappeared. Conclusion ABO blood group antibody screening, unexpected antibody screening and direct antiglobulin test(DAT)should be performed regularly for ABO-incompatible liver and renal transplantation cases, in order to detect the PLS early. A series of laboratory tests related to PLS should be performed in time to diagnose and adjust the treatment plan, including transfusion strategy, when homologous cross-matching is incompatible.

Abstract Background The Ehlers-Danlos syndromes (EDS) are a group of rare hereditary connective tissue disorders. EDS is clinically and genetically heterogeneous and usually involves multiple systems. There are 14 subtypes of EDS with hallmark features including joint hypermobility, skin hyperextensibility, and tissue fragility. The clinical manifestations and their severity differ among the subtypes, encompassing recurrent joint dislocations, scoliosis, arterial aneurysm and dissection, and organ rupture. Challenges in diagnosis and management arise from the complexity of the disease, which is further complicated by its rarity. The development of clinical guidelines and implementation of coordinated multi-disciplinary team (MDT) approaches have emerged as global priorities. Main body Chinese Multi-Disciplinary Working Group on the Ehlers-Danlos Syndromes was therefore established. Healthcare professionals were recruited from 25 top hospitals across China. The experts are specialized in 24 fields, including genetics, vascular surgery, dermatology, and orthopedics, as well as nursing care, rehabilitation, psychology, and nutrition. Based on GRADE methodology, the Guidelines were written by the Group supervised by methodologists, following a systemic review of all 4453 articles in PubMed published before August 9, 2023, using the search term “Ehlers Danlos”. A coordinated MDT approach for the diagnosis and management of EDS is highly recommended by the Group, along with 29 specific recommendations addressing key clinical questions. In addition to the treatment plan, the Guidelines also emphasize integrating support from nursing care, rehabilitation, psychology, and nutrition. This integration not only facilitates recovery in hospital settings, but most importantly, the transition from an illness-defined life to a more “normalized” life. Conclusion The first guidelines on EDS will shorten the diagnostic odyssey and solve the unmet medical needs of the patients. This article is a synopsis of the full guidelines.

Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources. [ABSTRACT FROM AUTHOR]

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Background: No studies in China have assessed the guideline-concordance level of the first-course of non-small cell lung cancer (NSCLC) diagnosis and treatment and its relationship with survival. This study comprehensively assesses the current status of guideline-concordant diagnosis (GCD) and guideline-concordant treatment (GCT) of NSCLC in China and explores its impact on survival. Methods: First course diagnosis and treatment data for NSCLC patients in Liaoning, China in 2017 and 2018 (n=1828) were used and classified by whether they underwent GCD and GCT according to Chinese Society of Clinical Oncology (CSCO) guidelines. Pearson’s chi-squared test was used to determine unadjusted associations between categorical variables of interest. Logistic models were constructed to identify variables associated with GCD and GCT. Kaplan–Meier analysis and log-rank tests were used to estimate and compare 3-year survival rates. Multivariate Cox proportional risk models were constructed to assess the risk of cancer mortality associated with guidelineconcordant diagnosis and treatment. Results: Of the 1828 patients we studied, 48.1% underwent GCD, and 70.1% underwent GCT. The proportions of patients who underwent both GCD and GCT, GCD alone, GCT alone and neither GCD nor GCT were 36.7%, 11.4%, 33.5% and 18.4%, respectively. Patients in advanced stage and non-oncology hospitals were significantly less likely to undergo GCD and GCT. Compared with those who underwent neither GCD nor GCT, patients who underwent both GCD and GCT, GCD alone and GCT alone had 35.2%, 26.7% and 35.7% higher 3-year survival rates; the adjusted lung cancer mortality risk significantly decreased by 29% (adjusted hazard ratio[aHR], 0.71; 95% CI, 0.53–0.95), 29% (aHR, 0.71; 95% CI, 0.50–1.00) and 32% (aHR, 0.68; 95% CI, 0.51–0.90). Conclusion: The 3-year risk of death is expected to be reduced by 29% if patients with NSCLC undergo both GCD and GCT. There is a need to establish an oncology diagnosis and treatment data management platform in China to monitor, evaluate, and promote the use of clinical practice guidelines in healthcare settings. [ABSTRACT FROM AUTHOR]

Simple Summary: Equine granulocytic anaplasmosis (EGA) is a tick-borne disease affecting horses worldwide, caused by Anaplasma phagocytophilum. The disease ranges from non-specific clinical signs to fatal outcomes. A large number of horses has been tested for serological and molecular surveys concerning EGA, but the number of clinical EGA reports is smaller and mostly as single or case series reports. Therefore, the aim of this paper was to analyze reported cases regarding clinico-pathology, diagnosis, and therapeutic management in equids that developed clinical signs of EGA and were confirmed to be infected with A. phagocytophilum. The variety of clinical and pathological findings and the challenging therapeutic approaches registered strongly suggest that EGA should be included in the differential diagnosis when fever occurs. In addition, the findings emphasize the importance of monitoring EGA to initiate proper medication in order to avoid complications. Equine granulocytic anaplasmosis (EGA) is a tick-borne disease affecting horses worldwide, caused by Anaplasma phagocytophilum. The disease ranges from non-specific clinical signs to fatal outcomes. This paper aimed to analyze EGA cases reported in peer-reviewed journals, particularly on clinico-pathological findings, diagnosis, and therapeutic management. Overall, 189 clinical cases from 31 publications were included in the study. Extensive symptomatology for the EGA cases was reported, of which mostly was fever (90.30%), followed by limb edema (48.51%), anorexia (41.79%), depression (32.84%), icterus (22.39%), ataxia (17.91), tachycardia (16.42%), and lethargy (15.67%). Laboratory tests revealed thrombocytopenia (90.32%), anemia (75%), decreased hematocrit (70.59%), leukopenia (55.88%), lymphopenia (58.14%), and neutropenia (41.67%) as the most common hematological abnormalities. For a subset of tested animals, hyperbilirubinemia (20/29), hyperfibrinogenemia (13/15), and hyponatremia (10/10) were also reported. The diagnosis was established by microscopic identification of morulae (in 153 cases), and/or PCR (120 cases), isolation (1 case), or serology (56 cases). For treatment, oxytetracycline was used in the majority (52.24%) of EGA cases, but recovery without antibiotherapy (10.34%) was also noted. In conclusion, the variety of clinical and pathological findings and the challenging therapeutic approaches reported suggest that EGA should be included in the differential diagnosis when fever occurs. [ABSTRACT FROM AUTHOR]

Phosphorus is widely present in living organisms and nature and exists in a variety of isomers with variable crystal structures. There are several common phosphorus monomers in biomedicine, including red phosphorus (RP), black phosphorus (BLK-P), violet phosphorus (VP), and blue phosphorus (BLU-P). Phosphorus-based semiconductor materials (PSCM) have adjustable band gaps, high photogenerated carrier mobility, and efficient photothermal conversion as well as good biocompatibility and degradability. In addition, phosphorus, an essential element for life-sustaining activities, is present in all cells of the human body, accounting for approximately 1% of the body's total weight. Therefore, phosphorus-based nanomaterials have extensive applications in the biomedical field. This review will clarify the classification, preparation methods, physicochemical properties, mechanisms of action, and applications in biomedicine of phosphorus-based nanomaterials while also offering new ideas for their development in biomedicine. [ABSTRACT FROM AUTHOR]

Diabetic nephropathy (DN) is one of the main complications of diabetes and a major cause of end-stage renal disease, which has a severe impact on the quality of life of patients. Strict control of blood sugar and blood pressure, including the use of renin-angiotensin-aldosterone system inhibitors, can delay the progression of diabetic nephropathy but cannot prevent it from eventually developing into endstage renal disease. In recent years, many studies have shown a close relationship between gut microbiota imbalance and the occurrence and development of DN. This review discusses the latest research findings on the correlation between gut microbiota and microbial metabolites in DN, including the manifestations of the gutmicrobiota and microbialmetabolites in DN patients, the application of the gut microbiota and microbial metabolites in the diagnosis of DN, their role in disease progression, and so on, to elucidate the role of the gut microbiota and microbial metabolites in the occurrence and prevention of DN and provide a theoretical basis and methods for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: The Ehlers-Danlos syndromes (EDS) are a group of rare hereditary connective tissue disorders. EDS is clinically and genetically heterogeneous and usually involves multiple systems. There are 14 subtypes of EDS with hallmark features including joint hypermobility, skin hyperextensibility, and tissue fragility. The clinical manifestations and their severity differ among the subtypes, encompassing recurrent joint dislocations, scoliosis, arterial aneurysm and dissection, and organ rupture. Challenges in diagnosis and management arise from the complexity of the disease, which is further complicated by its rarity. The development of clinical guidelines and implementation of coordinated multi-disciplinary team (MDT) approaches have emerged as global priorities. Main body: Chinese Multi-Disciplinary Working Group on the Ehlers-Danlos Syndromes was therefore established. Healthcare professionals were recruited from 25 top hospitals across China. The experts are specialized in 24 fields, including genetics, vascular surgery, dermatology, and orthopedics, as well as nursing care, rehabilitation, psychology, and nutrition. Based on GRADE methodology, the Guidelines were written by the Group supervised by methodologists, following a systemic review of all 4453 articles in PubMed published before August 9, 2023, using the search term "Ehlers Danlos". A coordinated MDT approach for the diagnosis and management of EDS is highly recommended by the Group, along with 29 specific recommendations addressing key clinical questions. In addition to the treatment plan, the Guidelines also emphasize integrating support from nursing care, rehabilitation, psychology, and nutrition. This integration not only facilitates recovery in hospital settings, but most importantly, the transition from an illness-defined life to a more "normalized" life. Conclusion: The first guidelines on EDS will shorten the diagnostic odyssey and solve the unmet medical needs of the patients. This article is a synopsis of the full guidelines. [ABSTRACT FROM AUTHOR]

Background: Wheat allergy (WA), characterized by immunological responses to wheat proteins, is a gluten-related disorder that has become increasingly recognized in recent years. Bibliometrics involves the quantitative assessment of publications within a specific academic domain. Objectives: We aimed to execute an extensive bibliometric study, focusing on the past 30 years of literature related to wheat allergy. Methods: We searched the Web of Science database on 5th Dec 2023. We used the KEYWORDS: "wheat allergy or wheat anaphylaxis or wheat hypersensitivity," "gliadin allergy or gliadin anaphylaxis or gliadin hypersensitivity," "wheatdependent exercise-induced anaphylaxis," and "baker's asthma" for our search. All items published between 1993 and 2023 were included. The top 100 most cited articles were identified and analyzed. Results: Our study conducted an in-depth bibliometric analysis of the 100 mostcited articles in the field of wheat allergy, published between 2002 and 2019. These articles originated from 20 different countries, predominantly Japan and Germany. The majority of these articles were centered on the pathogenesis and treatment of wheat allergy (WA). The Journal of Allergy and Clinical Immunology (JACI) was the most prolific contributor to this list, publishing 14 articles. The article with the highest citation count was published by Biomed Central (BMC) and garnered 748 citations. The peak citation year was 2015, with a total of 774 citations, while the years 1998, 2001, and 2005 saw the highest publication frequency, each with 7 articles. Conclusion: Our study aims to provide physicians and researchers with a historical perspective for the scientific progress of wheat allergy, and help clinicians effectively obtain useful articles that have a significant impact on the field of wheat allergy. [ABSTRACT FROM AUTHOR]

Bacterial extracellular vesicles (BEVs) are naturally occurring bioactive membrane-bound nanoparticles released by both gram-negative and gram-positive bacterial species, exhibiting a multifaceted role in mediating host-microbe interactions across various physiological conditions. Increasing evidence supports BEVs as essential mediators of cell-to-cell communicaiton, influencing bacterial pathogenicity, disease mechanisms, and modulating the host immune response. However, the extent to which these BEV-mediated actions can be leveraged to predict disease onset, guide treatment strategies, and determine clinical outcomes remains uncertain, particularly in terms of their clinical translation potentials. This review briefly describes BEV biogenesis and their internalisation by recipient cells and summarises methods for isolation and characterization, essential for understanding their composition and cargo. Further, it discusses the potential of biofluid-associated BEVs as biomarkers for various diseases, spanning both cancer and non-cancerous conditions. Following this, we outline the ongoing human clinical trials of using BEVs for vaccine development. In addition to disease diagnostics, this review explores the emerging research of using natural or engineered BEVs as smart nanomaterials for applications in anti-cancer therapy and bone regeneration. This discussion extends to key factors for unlocking the clinical potential of BEVs, such as standardization of BEV isolation and characterisation, as well as other hurdles in translating these findings to the clinical setting. We propose that addressing these hurdles through collaborative research efforts and well-designed clinical trials holds the key to fully harnessing the clinical potential of BEVs. As this field advances, this review suggests that BEV-based nanomedicine has the potential to revolutionize disease management, paving the way for innovative diagnosis, therapeutics, and personalized medicine approaches. Extracellular vesicles (EVs) from both host cells and bacteria serve as multifunctional biomaterials and are emerging in the fields of biomedicine, bioengineering, and biomaterials. However, the majority of current studies focus on host-derived EVs, leaving a gap in comprehensive research on bacteria-derived EVs (BEVs). Although BEVs offer an attractive option as nanomaterials for drug delivery systems, their unique nanostructure and easy-to-modify functions make them a potential method for disease diagnosis and treatment as well as vaccine development. Our work among the pioneering studies investigating the potential of BEVs as natural nanobiomaterials plays a crucial role in both understanding the development of diseases and therapeutic interventions. [Display omitted] [ABSTRACT FROM AUTHOR]

Ischemic heart disease refers to the imbalance between the supply and demand of myocardial blood; it has various causes and results in a class of clinical diseases characterized by myocardial ischemia (MI). In recent years, the incidence of cardiovascular disease has become higher and higher, and the number of patients with ischemic heart disease has also increased year by year. Traditional treatment methods include drug therapy and surgical treatment, both of which have limitations. The former maybe develop risks of drug resistance and has more significant side effects, while the latter may damage blood vessels and risk infection. At this stage, a new cell-free treatment method needs to be explored. Many research results have shown that exosomes from different cell sources can protect the ischemic myocardium via intercellular action methods, such as promoting angiogenesis, inhibiting myocardial fibrosis, apoptosis and pyroptosis, and providing a new basis for the treatment of MI. In this review, we briefly introduce the formation and consequences of myocardial ischemia and the biology of exosomes, and then focus on the role and mechanism of exosomes from different sources in MI. We also discuss the role and mechanism of exosomes pretreated with Chinese and Western medicines on myocardial ischemia. We also discuss the potential of exosomes as diagnostic markers and therapeutic drug for MI.

Scurvy, a rare disease resulting from vitamin C deficiency, can occur in individuals with restrictive eating disorders like anorexia nervosa (AN), leading to severe health complications. This review explores the complex relationship between scurvy and AN, highlighting the overlapping symptoms and challenges in diagnosis and treatment. Vitamin C is essential for collagen synthesis, immune function, and neurotransmitter production, and its deficiency manifests as fatigue, gingival bleeding, joint pain, and perifollicular hemorrhages. AN exacerbates these symptoms through extreme food restriction, causing severe nutritional deficiencies. Analyzing nine case reports, this review reveals that patients with co-occurring AN and scurvy often present with gastrointestinal, psychiatric, and dermatological symptoms. Treatment with vitamin C supplementation typically results in rapid symptom improvement. However, the malnutrition inherent in AN complicates the clinical picture, making timely diagnosis and intervention crucial. This review underscores the importance of a comprehensive, multidisciplinary approach to managing these conditions, emphasizing the need for early recognition and treatment to prevent severe complications. Future research should include a more diverse patient population to enhance understanding of the interplay between AN and scurvy, aiming to improve patient outcomes through tailored treatment strategies.

ABSTRACT Background Primary tracheal carcinoma is an exceptionally rare and life‐threatening disease that presents significant diagnostic and therapeutic challenges. Delayed diagnosis due to misinterpretation of airway obstruction symptoms often leads to poorer prognoses for patients. This study aimed to explore the clinical manifestations and multidisciplinary treatment approaches for primary tracheal carcinoma in Bangladesh, with a focus on recent advancements in diagnosis and treatment. Methods A retrospective observational study was conducted at Bangladesh Specialized Hospital Limited, involving patients aged over 30 who were diagnosed with tracheal carcinoma and underwent multidisiplinary treatment from July 2018 to June 2019. Data were collected through patient interviews and medical record reviews. Descriptive and inferential statistical analyses were performed to examine demographic characteristics, histological variations, tumor locations, clinical signs and symptoms, treatment approaches, and outcomes. Results The study illuminated varied clinical presentations and the successful application of multidisciplinary approaches among the 13 patients. Invasive squamous cell carcinoma and adenoid cystic carcinoma were the predominant histological subtypes. Symptomatology, including dyspnea, cough, and hemoptysis, highlighted the challenge of early detection. Despite the rarity and intricacies associated with primary tracheal carcinoma, the multidisciplinary strategy yielded generally positive outcomes, as evidenced by a 1‐year survival rate of 92.31% and a 5‐year survival rate of 76.92%. Kaplan–Meier survival curves underscored the superior efficacy of surgical interventions over non‐surgical approaches. Conclusion Despite some limitations, this study contributes crucial insights into the nuanced management of primary tracheal carcinoma in the Bangladeshi context. The demonstrated success of the multidisciplinary strategy, especially surgical interventions, accentuates the importance of definitive resection. The lone case of local recurrence emphasizes the necessity for vigilant follow‐up.

Glioma is the most common intracranial malignant tumor, with severe difficulty in treatment and a low patient survival rate. Due to the heterogeneity and invasiveness of tumors, lack of personalized clinical treatment design, and physiological barriers, it is often difficult to accurately distinguish gliomas, which dramatically affects the subsequent diagnosis, imaging treatment, and prognosis. Fortunately, nano-delivery systems have demonstrated unprecedented capabilities in diagnosing and treating gliomas in recent years. They have been modified and surface modified to efficiently traverse BBB/BBTB, target lesion sites, and intelligently release therapeutic or contrast agents, thereby achieving precise imaging and treatment. In this review, we focus on nano-delivery systems. Firstly, we provide an overview of the standard and emerging diagnostic and treatment technologies for glioma in clinical practice. After induction and analysis, we focus on summarizing the delivery methods of drug delivery systems, the design of nanoparticles, and their new advances in glioma imaging and treatment in recent years. Finally, we discussed the prospects and potential challenges of drug-delivery systems in diagnosing and treating glioma.

Abstract Background Primary care physicians often lack resources and training to correctly diagnose and manage chronic insomnia disorder. Tools supporting chronic insomnia diagnosis and management could fill this critical gap. A survey was conducted to understand insomnia disorder diagnosis and treatment practices among primary care physicians, and to evaluate a diagnosis and treatment algorithm on its use, to identify ways to optimize it specifically for these providers. Methods A panel of experts developed an algorithm for diagnosing and treating chronic insomnia disorder, based on current guidelines and experience in clinical practice. An online survey was conducted with primary care physicians from France, Germany, Italy, Spain, and the United Kingdom, who treat chronic insomnia patients, between January and February 2023. A sub-sample of participants provided open-ended feedback on the algorithm and gave suggestions for improvements. Results Overall, 106 primary care physicians completed the survey. Half (52%, 55/106) reported they did not regularly screen for insomnia and half (51%, 54/106) felt they did not have enough time to address patients’ needs in relation to insomnia or trouble sleeping. The majority (87%,92/106) agreed the algorithm would help diagnose chronic insomnia patients and 82% (87/106) agreed the algorithm would help improve their clinical practice in relation to managing chronic insomnia. Suggestions for improvements were making the algorithm easier to read and use. Conclusion The algorithm developed for, and tested by, primary care physicians to diagnose and treat chronic insomnia disorder may offer significant benefits to providers and their patients through ensuring standardization of insomnia diagnosis and management.

Pancreatic cancer is a highly malignant tumor of the digestive tract， and its precision diagnosis and treatment is a major challenge in clinical practice. With the development of science and technology， artificial intelligence has been applied in the early diagnosis， treatment and prognosis prediction of some diseases， which has high clinical value. Medical imaging is a disciplie to evaluate human health， which consists of two relatively independent directions of medical imaging system and medical image processing. Artificial intelligence based on medical imaging plays an important role in the clinical diagnosis and treatment of pancreatic cancer. In this article， research progress in the application of artificial intelligence in precision diagnosis and treatment of pancreatic cancer was reviewed from the aspects of imaging diagnosis， efficacy evaluation， survival prediction and radiogenomics， etc.

Background: Primary care physicians often lack resources and training to correctly diagnose and manage chronic insomnia disorder. Tools supporting chronic insomnia diagnosis and management could fill this critical gap. A survey was conducted to understand insomnia disorder diagnosis and treatment practices among primary care physicians, and to evaluate a diagnosis and treatment algorithm on its use, to identify ways to optimize it specifically for these providers. Methods: A panel of experts developed an algorithm for diagnosing and treating chronic insomnia disorder, based on current guidelines and experience in clinical practice. An online survey was conducted with primary care physicians from France, Germany, Italy, Spain, and the United Kingdom, who treat chronic insomnia patients, between January and February 2023. A sub-sample of participants provided open-ended feedback on the algorithm and gave suggestions for improvements. Results: Overall, 106 primary care physicians completed the survey. Half (52%, 55/106) reported they did not regularly screen for insomnia and half (51%, 54/106) felt they did not have enough time to address patients' needs in relation to insomnia or trouble sleeping. The majority (87%,92/106) agreed the algorithm would help diagnose chronic insomnia patients and 82% (87/106) agreed the algorithm would help improve their clinical practice in relation to managing chronic insomnia. Suggestions for improvements were making the algorithm easier to read and use. Conclusion: The algorithm developed for, and tested by, primary care physicians to diagnose and treat chronic insomnia disorder may offer significant benefits to providers and their patients through ensuring standardization of insomnia diagnosis and management. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to investigate the clinical effects of combining knee extension mechanism (EM) with rearrangement in the treatment of recurrent patellar dislocation (RPD). PATIENTS AND METHODS: Eighty-four patients with RPD admitted to the First Affiliated Hospital of Kunming Medical University were included. In this work, all patients received routine computed tomography (CT) examinations. In addition, the evaluation factors of EM combined with rearrangement therapy in RPD patients were analyzed using logistic regression. RESULTS: Lysholm and Kujula scores, femoral canal width, patellar canal width, patellar tilt angle (PTA), and lateral patellar displacement (LPD) were significantly increased at 1 and 3 years after treatment (p < 0.05). LPA was significantly decreased, while the tibial tuberosity trochlear groove of the femur (TT-TG) demonstrated no considerable differences (p > 0.05). The good rate of the short-term Insall-Salvati index was 78.6%, and that of the long-term Insall-Salvati index was 76.1%. The combination of the knee extension device and rearrangement therapy has a higher rate of short-term and long-term Insall-Salvati index (ISI) excellence. In addition, the range of motion of the knee joint increased significantly, and the Q Angle decreased significantly (p < 0.05). Logistic regression analysis showed that age and ISI were highly correlated with the evaluation of therapeutic effects in patients with RPD. CONCLUSIONS: EM combined with rearrangement in the treatment of RPD had positive short-term and long-term efficacy, high application value, and age, which can be popularized in clinical applications and have positive diagnostic value. [ABSTRACT FROM AUTHOR]

Tumors are characterized by abnormal cell growth, which leads to uncontrolled cell proliferation, invasion of surrounding tissues, and potential metastasis to other parts of the body. Current treatments for tumors include surgery, chemotherapy, radiotherapy, targeted therapy, and biological therapy. However, many tumors are detected at advanced stages, limiting the effectiveness of these treatments. Therefore, there is a need to develop more sensitive and efficient techniques to improve patient survival rates. Surface‐enhanced Raman scattering (SERS) technology is a highly sensitive molecular detection and characterization technique. It can be combined with histomorphology, immunolabeling assays, and molecular hybridization to achieve quantitative diagnosis at morphological, molecular, and genetic levels. SERS offers advantages such as objectivity, reproducibility, and comparability. However, there are challenges to address, including complex substrate or probe preparation, cumbersome data analysis, and signal reproducibility and reliability. To fully utilize the potential of SERS in the biomedical field and for clinical translation, it is important to optimize the technology and develop more sensitive, accurate, and reliable substrate or probe preparation and analysis methods. This review aims to comprehensively explain the mechanism and unique advantages of SERS technology and discuss its current status, challenges, and prospects in tumor‐related research. [ABSTRACT FROM AUTHOR]

Cancer remains one of the primary factors leading to premature death in humans. Conventional therapeutic approaches result in significant harm to normal tissue cells and impede the effective treatment of cancer. In recent years, the benefits of inorganic nanomaterials in cancer research have become increasingly evident, and they are expected to provide new ideas for diagnosing and treating cancer. This study aims to reveal the technological trajectory and important applications of inorganic nanomaterials in cancer diagnosis and treatment better to understand their technological development trends and technical priorities. A patent citation network was constructed to find the milestone patents of inorganic nanomaterials in the field of cancer by main path–derived path analysis, and a citation analysis method based on the PageRank (PR) algorithm was used to identify the high PR value patents of inorganic nanotechnology in cancer. The study found that the overall technological development trajectory of inorganic nanomaterials in cancer is linear, with a focus on enhancing technical aspects such as biological detection and imaging, drug delivery, phototherapy, magnetic hyperthermia, and radiotherapy, progressively enhancing the diagnostic and therapeutic effects, and realizing the integration of diagnosis and treatment. Gold nanomaterials are essential in cancer diagnosis and treatment. Carbon-based nanomaterials, magnetic nanomaterials, upconversion luminescent materials, copper-based nanoparticles, quantum dots, and other inorganic nanomaterials will become significant R&D directions. [ABSTRACT FROM AUTHOR]

BACKGROUND: The problem of intervertebral disc injury and degeneration has been studied in many ways. Many studies have shown that intervertebral disc injury and degeneration is driven by mechanical loading factors. However, the potential relationship between common phenotypes of intervertebral disc injury and degeneration and mechanical loading factors has been rarely summarized. OBJECTIVE: To summarize the types of common structural abnormalities exhibited by intervertebral disc injury and degeneration in the published literature, and sum up the potential links to the types of mechanical loading that lead to these structural abnormalities in in vitro and ex vivo experimental studies. METHODS: Using the terms “intervertebral disc failure, intervertebral disc injury, mechanical load, mechanical factor, load factor, biomechanics” as Chinese and English key words in PubMed, CNKI, and WanFang databases, articles related to intervertebral disc injury degeneration and mechanical load factors were retrieved. Literature screening was performed according to the inclusion and exclusion criteria, and 88 articles were finally included. RESULTS AND CONCLUSION: (1) Common structural abnormalities of intervertebral discs include decreased intervertebral disc height, disc bulge, osteophyte formation, annulus fibrosus tear, intervertebral disc herniation or disc prolapse, endplate damage, Schmorl nodes and intervertebral disc calcification. Intervertebral discs are susceptible to mechanical load types such as compression, bending, axial rotation, and compound loads. (2) The compressive load mainly causes the decrease of the proteoglycan content and the water-binding ability of the intervertebral disc, leading to the decrease or swelling of the intervertebral disc and further damage and degeneration of the intervertebral disc. In addition, the excessive compressive load causes greater damage to the endplate. (3) Bending load and axial rotation load damage the annulus fibrosus more than the endplate, and prolonged or repeated bending loads can cause tearing of the fibrous annulus and herniation or prolapse of the intervertebral disc, while pure axial rotation loads can induce less damage to the intervertebral disc and only cause the tear of the annulus fibrosus. (4) However, when different load types act in combination, it is more likely to result in high stress on the disc and a greater risk of disc injury. (5) Injury and degeneration of the intervertebral disc present progressive structural damage, and early prevention and protection are particularly important in clinical practice. Future tissue engineering research can start with early repair of the intervertebral disc. [ABSTRACT FROM AUTHOR]

Skeletal Class III malocclusion is one type of dentofacial deformity that significantly affects patients' facial aesthetics and oral health. The orthodontic treatment of skeletal Class III malocclusion presents challenges due to uncertainties surrounding mandibular growth patterns and treatment outcomes. In recent years, disease-specific radiographic features have garnered interest from researchers in various fields including orthodontics, for their exceptional performance in enhancing diagnostic precision and treatment effect predictability. The aim of this narrative review is to provide an overview of the valuable radiographic features in the diagnosis and management of skeletal Class III malocclusion. Based on the existing literature, a series of analyses on lateral cephalograms have been concluded to identify the significant variables related to facial type classification, growth prediction, and decision-making for tooth extractions and orthognathic surgery in patients with skeletal Class III malocclusion. Furthermore, we summarize the parameters regarding the inter-maxillary relationship, as well as different anatomical structures including the maxilla, mandible, craniofacial base, and soft tissues from conventional and machine learning statistical models. Several distinct radiographic features for Class III malocclusion have also been preliminarily observed using cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). [ABSTRACT FROM AUTHOR]

Pancreatic cancer is a highly malignant tumor of the digestive tract, and its precision diagnosis and treatment is a major challenge in clinical practice. With the development of science and technology, artificial intelligence has been applied in the early diagnosis, treatment and prognosis prediction of some diseases, which has high clinical value. Medical imaging is a disciplie to evaluate human health, which consists of two relatively independent directions of medical imaging system and medical image processing. Artificial intelligence based on medical imaging plays an important role in the clinical diagnosis and treatment of pancreatic cancer. In this article, research progress in the application of artificial intelligence in precision diagnosis and treatment of pancreatic cancer was reviewed from the aspects of imaging diagnosis, efficacy evaluation, survival prediction and radiogenomics, etc. [ABSTRACT FROM AUTHOR]

Benign prostate hyperplasia (BPH) is the most common benign disease that causes lower urinary tract symptoms (LUTS) in middle-aged and older men, which seriously affects the quality of life of patients. With the deepening of national tiered diagnosis and treatment, primary medical institutions have gradually become the main healthcare provider for BPH patients. Therefore, there is an urgent need to strengthen the screening, diagnosis, treatment, and management capabilities of primary medical institutions for BPH patients. This expert consensus clarifies the diagnosis and treatment process of BPH in primary healthcare institutions, standardizes the management criteria, and establishes a two-way referral mechanism between higher-level hospitals and primary healthcare institutions, providing guideline and reference for grassroots clinical practice. [ABSTRACT FROM AUTHOR]

Vascular dementia (VD) is a prevalent cognitive disorder among the elderly. Its pathological mechanism encompasses neuronal damage, synaptic dysfunction, vascular abnormalities, neuroinflammation, and oxidative stress, among others. In recent years, extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) have garnered significant attention as an emerging therapeutic strategy. Current research indicates that MSC-derived extracellular vesicles (MSC-EVs) play a pivotal role in both the diagnosis and treatment of VD. Thus, this article delves into the recent advancements of MSC-EVs in VD, discussing the mechanisms by which EVs influence the pathophysiological processes of VD. These mechanisms form the theoretical foundation for their neuroprotective effect in VD treatment. Additionally, the article highlights the potential applications of EVs in VD diagnosis. In conclusion, MSC-EVs present a promising innovative treatment strategy for VD. With rigorous research and ongoing innovation, this concept can transition into practical clinical treatment, providing more effective options for VD patients. [ABSTRACT FROM AUTHOR]

Aims: This review examines the Current State of the Integrated Healthcare approach and assesses the impact of integrated care models on patient health outcomes. Methodology: A systematic review using PubMed database and Google Scholar database. Using period 2019-2023 and keywords Clinical Medicine AND Diagnosis AND Treatment AND Integrated Approach and "integrated care" AND "diagnosis and treatment" AND "clinical medicine" AND "multidisciplinary care" were employed to identify relevant studies from PubMed and Google Scholar. Finally, 18 articles were sampled. Results: The systematic literature review on integrated diagnosis and therapy in clinical medicine shows many study designs and sample sizes. RCTs, the gold standard, are included in the review, along with Prospective Cohort Studies, Retrospective Studies, Cross-Sectional Studies, and Post-hoc Analyses. Some studies have large populations and rich datasets, whereas others have smaller samples. These studies provide varied approaches and timeframes for applying the integrated approach in clinical practice and discuss integrated healthcare approaches that use multidisciplinary teams, innovative technologies, and targeted interventions to treat chronic disorders and multi-morbidities. Integrated healthcare enhances patient outcomes, adherence to recommendations, and quality of life, emphasizing the need for tailored care in modern medicine. Scientific Novelty: Exploring a complex, integrated clinical medicine diagnosis and treatment approach to find patient care solutions. Conclusion: Clinical medicine's integrated diagnosis and treatment strategy is dynamic and promising. It can improve patient care, lower healthcare costs, and improve the quality of life for people with diverse health issues. [ABSTRACT FROM AUTHOR]

Abstract Sepsis is a life‐threatening organ dysfunction syndrome caused by the host's dysregulated response to infection. The leading causes of death in critically ill patients are sepsis‐associated encephalopathy (SAE), respiratory dysfunction, circulatory dysfunction, and other multi‐organ dysfunctions. SAE is among the most common serious complications of sepsis and is associated with a poor prognosis and long‐term cognitive dysfunction. Its clinical manifestations vary, and there are still no unified diagnostic criteria. The incidence of SAE varies from 9% to 71% in critically ill patients due to therapeutic interventions such as sedation, mechanical ventilation, and muscle relaxants. Advances in medical technology have significantly increased the survival rate of patients with sepsis, but up to 21% now experience long‐term sequelae or cognitive impairment. The lack of specific early diagnostic and treatment methods leads to increased SAE‐associated mortality and complications in patients, which also impose heavy economic burdens. This article reviews the pathogenesis and diagnostic methods of SAE and progress in its treatment, aiming to reduce the mortality and hospitalization lengths of patients with SAE and improve their survival rate and quality of life through early detection, diagnosis, and effective treatment.

Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources.

Recently，the incidence of ureteral calculi has been increased，and the treatment methods have been constantly updated. Nowadays，minimally invasive treatment has become a trend，mainly including extracorporeal shockwave lithotripsy（ESWL），ureteroscopic lithotripsy（URL），percutaneous nephrolithotripsis（PCNL）and laparoscopic lithotripsis. Noncontrast computed tomography（NCCT），as a common noninvasive diagnostic technique for clinical surgical diseases，has high specificity and sensitivity for the identification of ureteral calculi. In addition to definite diagnosis，the use of ureteral wall thickness（UWT）measurement to predict the matching degree of ureteral calculi treatment and prognosis has received widespread attention. Existing literature has suggested that UWT can predict the efficacy of ureteral stone incarceration and treatment plan. However，most studies are limited to the prediction of single treatment mode by UWT. In this article，literature review related to UWT was performed，aiming to provide reference for the prediction of ureteral stone incarceration and the selection of clinical treatment regimen.

AIM: To explore the clinical features, diagnosis and treatment experience and the distribution characteristics of pathogenic microorganisms of primary canaliculitis, and provide reference for its diagnosis and treatment. METHODS: Retrospective clinical study. A total of 119 cases(120 eyes)diagnosed as primary canaliculitis in the department of ophthalmology of Wuxi No.2 People's Hospital from June 2019 to February 2023 were included. The treatment methods were mainly divided into conservative treatment(removing canaliculus stones through lacrimal punctum combined with injecting antibiotic eye ointment into the tube)and surgical treatment. The inspection methods of pathogenic microorganisms included secretion smear microscopy and microbial culture.RESULTS: Primary canaliculitis was more common in middle-aged and older female, mainly manifested by long-term red eye and increased secretion; however, the majority was not accompanied by tearing. Totally, 118 cases(99.2%)had monocular disease, while 63 cases(63 eyes; 52.5%)had inferior lacrimal canaliculus disease. Laboratory examination: Among 119 cases(120 eyes), 4 cases(4 eyes)did not undergo laboratory examination, and the other 115 cases(116 eyes)were as follows: Gram staining microscopy of secretion smear showed that Actinomyces were detected in 102 cases(103 eyes; 88.8%), while no fungus was detected; Microbial culture: 85 cases(86 eyes; 74.1%)were positive for bacterial culture. A total of 111 bacterial strains were cultured, which contained 26 types of bacteria. Among them, 32 strains were aerobic(28.8%); 26 strains were anaerobic(23.4%); and 53 strains were facultative anaerobic(47.7%). The most common bacteria were streptococcus(20 strains), staphylococcus(13 strains), Propionibacterium(10 strains), and capnocytophaga(10 strains). Only 4 cases(4 eyes; 3.4%)of microbial cultures were positive for Actinomyces. Fungus was negative in all microbial cultures. Treatment: Of the 119 cases(120 eyes), 114 cases(115 eyes; 95.8%)were cured by conservative treatment of removing lacrimal canaliculus stones through lacrimal punctum and intracanalicular ointment infiltration(IOI), while 5 cases(5 eyes)were not effective in conservative treatment; however, all of them were cured after surgical treatment, and the cure rate for primary canaliculitis was 100.0%.CONCLUSION: The incidence of primary canaliculitis is low, and it is prevalent in middle-aged and older female. Single lacrimal canaliculus is more common, which could be missed and misdiagnosed in clinic. Actinomyces is the major pathogen observed mostly in mixed infections, with heterogeneous strains, mainly anaerobic or facultative anaerobic bacteria. Streptococcus and Staphylococcus are the most common whereas fungal canaliculitis is rare. The cure rate of primary canaliculitis is high after diagnosis, and IOI method is recommended as the initial treatment of canaliculitis.

Chest tightness variant asthma (CTVA) is an atypical form of asthma, characterized by chest tightness as the primary symptom, without the typical asthma symptoms， such as recurrent wheezing and shortness of breath. Since it was first reported and named internationally in 2013, CTVA has gradually been recognized by clinical physicians in China and has undergone extensive clinical practice. As for diagnosis of CTVA ，doctors should integrate symptoms of chest tightness and objective evidence of variable airflow restriction, exclude chest tightness caused by other diseases, and find effective results of asthma treatment in patients. The treatment principle of CTVA is similar to that of typical asthma. An appropriate initial treatment level should be selected based on the patient's chest tightness attack, and the stepwise treatment plan should be followed for upgrade and downgrade treatment. Based on clinical diagnosis and treatment practices, this article systematically introduces the diagnostic criteria, diagnostic procedures, management evaluation, and treatment plans of CTVA,which is to help clinical physicians in standardizing the diagnosis and treatment of CTVA.

With the popularity of low⁃dose computed tomography (LDCT) in physical examination and the widespread concern of people about lung diseases after COVID⁃19 outbreak, the detection rate of pulmonary nodules in the population has increased year by year. The clinical cases of early lung cancer and multiple primary lung cancer are increasing, and the necessity of personalized treatment tailored to the diverse detection of pulmonary nodules is highlighted in the diagnosis and treatment process of pulmonary nodules. However, chest CT and traditional bronchoscopy not only have insufficient accuracy in preoperative localization of pulmonary nodules and the diagnosis of benign and malignant pulmonary nodules, but also have significant limitations in the diagnosis and treatment of patients who cannot undergo surgery. The emergence of electromagnetic navigation bronchoscopy （ENB） has greatly solved this problem and further improves the diagnosis and treatment process of pulmonary nodules. ENB is a new technology that relies on electromagnetic positioning technology to locate, biopsy, and minimally invasive treatment of pulmonary nodules through bronchoscopy. In this review, we mainly summarize the application and latest progress of ENB in the diagnosis and treatment of pulmonary nodules. [ABSTRACT FROM AUTHOR]

Recently, the incidence of ureteral calculi has been increased, and the treatment methods have been constantly updated. Nowadays, minimally invasive treatment has become a trend, mainly including extracorporeal shockwave lithotripsy （ESWL）, ureteroscopic lithotripsy (URL), percutaneous nephrolithotripsis (PCNL) and laparoscopic lithotripsis. Noncontrast computed tomography （NCCT）, as a common noninvasive diagnostic technique for clinical surgical diseases, has high specificity and sensitivity for the identification of ureteral calculi. In addition to definite diagnosis, the use of ureteral wall thickness （UWT） measurement to predict the matching degree of ureteral calculi treatment and prognosis has received widespread attention. Existing literature has suggested that UWT can predict the efficacy of ureteral stone incarceration and treatment plan. However, most studies are limited to the prediction of single treatment mode by UWT. In this article, literature review related to UWT was performed, aiming to provide reference for the prediction of ureteral stone incarceration and the selection of clinical treatment regimen. [ABSTRACT FROM AUTHOR]