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Trust forms the bedrock of the doctor-patient relationship. While establishing trust is a foundational skill for healthcare providers who care for children, there is no systematic approach to teaching this skill set, nor is there formal training during medical school or residency. Traditionally, these skills have been taught by example, in an unstructured and ad hoc manner, with trainees picking it up along the way by observing and modeling their instructors. Here, we define and examine the elements of establishing trust and describe a methodology for establishing trust and managing a child's emotional state during medical encounters. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the clinical efficacy and safety of the combination of thymopeptide enteric-coated tablets and Compound Kuwei Huoxue Formula in the treatment of oral lichen planus (OLP). Using a random number table, the patients were divided into a study group and a control group after registration and enrollment. There was no significant difference in the general data comparison between the two groups (P > 0.05). After treatment, the number of cured patients in the study group was higher than that in the control group, and the number of ineffective cases was lower than that in the control group. The total cure rate in the study group was higher than that in the control group (P < 0.05). The levels of inflammatory factors interleukin-4, interleukin-6, and interferon-γ in the study group. Based on the practical clinical considerations, the treatment regimen of oral immunomodulator-thymopeptide enteric-coated tablets combined with Compound Kuwei Huoxue Formula emphasizes enhancing the immune function of the body and adopting the principle of clearing heat and detoxification in traditional Chinese medicine to achieve the goal of treating the root cause. This comprehensive treatment approach has achieved good clinical efficacy, providing new ideas and methods for the treatment of OLP that are worth promoting. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the research on acupuncture treatment for lumbar disc herniation, most acupuncture treatments are performed under CT guidance or without guidance. The precise control of the target site and the effective acupuncture location are not clear. OBJECTIVE: To observe the clinical effects of acupuncture at Jiaji points under ultrasonic guidance in treating lumbar disc herniation. METHODS: A total of 70 cases of lumbar disc herniation, 36 males and 34 females aged 18-65 years old, were selected from Chinese PLA General Hospital and Third Affiliated Hospital of Beijing University of Chinese Medicine. They were divided into trial group and control group by random number table method, with 35 cases in each group. The control group received acupuncture at Jiaji points. The trial group received acupuncture at Jiaji points under ultrasonic guidance. The patients were treated once on the day of treatment and 4, 7 days after treatment. Visual analog scale score, Oswestry disability index, Japanese Orthopaedic Association score, and MOS 36-Item Short-Form Health Survey (SF-36) were evaluated before and after treatment. RESULTS AND CONCLUSION: (1) Compared with before treatment, the visual analog scale scores of both groups were decreased after treatment (P < 0.01). Compared with the control group, the visual analog scale scores of the trial group were decreased on days 2, 3, 6, 7 of treatment and 1, 2 weeks after the end of treatment (P < 0.05, P < 0.01). (2) Compared with before treatment, Oswestry disability index after treatment was decreased in both groups (P < 0.01). Compared with the control group, Oswestry disability index of the trial group was decreased from days 1 to 7 of treatment and 1, 2 weeks after treatment (P < 0.01). (3) Compared with before treatment, the Japanese Orthopaedic Association scores of both groups were increased after treatment (P < 0.01). Compared with the control group, the Japanese Orthopaedic Association scores of the trial group were increased on days 3, 7 of treatment and 1, 2 weeks after treatment (P < 0.05, P < 0.01). (4) Compared with before treatment, SF-36 scores in both groups were increased after treatment (P < 0.01). There was no significant difference in SF-36 scores between the two groups after treatment (P > 0.05). (5) These results show that acupuncture at Jiaji points has curative effect on lumbar disc herniation, and ultrasonic guidance could improve the clinical curative effect of acupuncture at Jiaji points for lumbar disc herniation. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical observation conducted during the 3rd and 4th years of dental school is an important part of dental students’ clinical education. However, conventional clinical observation is associated with several problems, including the lack of opportunity for all students to assist during surgery. Virtual reality (VR) technologies and devices can be used to demonstrate clinical processes that dental students need to learn through clinical observation. This study aimed to evaluate the effectiveness of teaching dental students the surgical tooth extraction procedure through clinical observation using VR. Methods We recruited third- and fourth-year dental students and divided them into a VR clinical observation group (VR group) and a conventional clinical observation group (control group). The control group visited an outpatient clinic and observed an oral and maxillofacial specialist perform surgical tooth extraction, whereas the VR group watched a 360° video of surgical tooth extraction using a head-mounted display. After observation, both groups were surveyed regarding their satisfaction with the clinical observation and their understanding of the procedure. Results Understanding of the procedure and satisfaction with the observation were significantly higher in the VR group than in the control group (p = 0.001 and p = 0.047, respectively). Compared with conventional clinical observation, VR clinical observation improved learning motivation and medical thinking and judgment skills; however, interaction between professors and students was lacking. Conclusions VR clinical observation using 360° videos might be an effective teaching method for students. However, to allow interaction between professors and students during clinical observations, using it along with conventional clinical observation is necessary.

Introduction Methods Results Conclusion We previously published the outcomes associated with the use of diagnostic laparoscopy to determine peritoneal breach for AASW patients without an immediate indication for laparotomy. Although this pathway was 100% sensitive there was a 54% non‐therapeutic laparotomy rate. Another option that has been extensively reported is the clinical observation algorithm (COA) however, majority of the data originate from high‐volume centres. We hypothesized that a COA would also be a safe option in an Australian setting, and reduce the rate of non‐therapeutic operative intervention in managing AASW.This was a prospective cohort study examining patients with AASW admitted to a level 1 trauma centre in Sydney, Australia, between June 2021 and August 2023. Patient, injury, management and outcome data were collected from electronic medical records and the hospital trauma registry. Data were then analysed to determine the diagnostic accuracy of the COA, complication rates and median hospital length‐of‐stay (LOS).A total of 48 patients presented with AASW. Of these patients, 11 (22.9%) proceeded to immediate laparotomy. Seven patients had a contraindication to COA and underwent diagnostic laparoscopy. Thirty patients were managed with the COA, with three (10%) patients subsequently requiring a laparotomy. Only one patient (3.3%) underwent a non‐therapeutic laparotomy. There were no missed injuries. The COA sensitivity was 100%, specificity 92.7%, PPV 50% and NPV 100%. Patients managed with COA had no complications. Overall median hospital LOS was 1 day (1.0–2.3).A COA is a safe approach for evaluating patients with AASW in an Australian setting with adequate resources. It reduces the rate of non‐therapeutic operative intervention and has acceptable outcomes compared with a diagnostic laparoscopy pathway. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to assess the clinical effectiveness and safety profile of omalizumab as a therapeutic intervention for chronic urticaria (CU). Methods: From March 1, 2023, to September 30, 2023, data on a cohort comprising 96 patients with CU, who underwent treatment with omalizumab at our medical institution's allergy clinic, were systematically compiled. Subsequent to the administration of omalizumab, the therapeutic efficacy was assessed utilizing the 7-day urticaria activity score and the urticaria control test. Results: Based on the statistical analysis, the mean duration of therapeutic intervention was 2.4 ± 1.3 months, with a corresponding mean cumulative dosage of 765 ± 450 mg. Of the subset of 42 patients with CU who were subjected to a follow-up period exceeding 3 months, it was observed that the treatment led to complete symptom remission, and no instances of recurrence were documented. Notably, there were statistically significant differences in the treatment duration and the cumulative dosage between patients who experienced co-morbid conditions and those who did not (p < 0.01, 95% CI: 0.280–1.326; p < 0.01, 95% CI: 0.597–2.997). Furthermore, there were significant differences in the treatment duration and cumulative dosage between patients in the combined allergic rhinitis group and those in the non-combined allergic rhinitis group (p < 0.01, 95% CI: 0.204–1.305; p = 0.01, 95% CI: 0.326–2.860). Conclusion: Omalizumab demonstrates efficacy in the management of CU among Chinese patients by exerting effective symptom control and facilitating the regression of skin lesions. The assessment of its therapeutic efficacy typically requires a 12-week treatment period. Moreover, the co-occurrence of CU with other allergic disorders serves as a pertinent consideration for the adjustment of omalizumab dosing regimens. [ABSTRACT FROM AUTHOR]

Background: Clinical observation conducted during the 3rd and 4th years of dental school is an important part of dental students' clinical education. However, conventional clinical observation is associated with several problems, including the lack of opportunity for all students to assist during surgery. Virtual reality (VR) technologies and devices can be used to demonstrate clinical processes that dental students need to learn through clinical observation. This study aimed to evaluate the effectiveness of teaching dental students the surgical tooth extraction procedure through clinical observation using VR. Methods: We recruited third- and fourth-year dental students and divided them into a VR clinical observation group (VR group) and a conventional clinical observation group (control group). The control group visited an outpatient clinic and observed an oral and maxillofacial specialist perform surgical tooth extraction, whereas the VR group watched a 360° video of surgical tooth extraction using a head-mounted display. After observation, both groups were surveyed regarding their satisfaction with the clinical observation and their understanding of the procedure. Results: Understanding of the procedure and satisfaction with the observation were significantly higher in the VR group than in the control group (p = 0.001 and p = 0.047, respectively). Compared with conventional clinical observation, VR clinical observation improved learning motivation and medical thinking and judgment skills; however, interaction between professors and students was lacking. Conclusions: VR clinical observation using 360° videos might be an effective teaching method for students. However, to allow interaction between professors and students during clinical observations, using it along with conventional clinical observation is necessary. [ABSTRACT FROM AUTHOR]

Abstract Snack products are evolving as new carriers of functional ingredients with nutritional and health-promoting benefits. A blend of whole grains is increasingly being utilized to harness the functional potential of the grain mix. Amaranth, acha, and pearl millet grains flours were optimized using response surface methodology (RSM), to obtain optimum blends (90:5:5 and 47.98:26.68:25.34) with high protein content and low glycemic index. Snack bar products from the blends were labelled MBY and MBZ. A total of 40 diabetic and 10 non-diabetic subjects were recruited. Of the diabetic, about 42% were overweight while 40% were obese, the non-diabetic had normal weights. Each was allowed to consume snacks containing the equivalent of 50 g of carbohydrates. Finger prick was employed to evaluate the postprandial glucose response of snack products while venous blood was evaluated for antioxidant enzymes, carbohydrate-hydrolyzing activities, and insulin using standard methods. Consumption of the multigrain snacks elicited a stable postprandial response (133–141 mg/dL) with 16 and 24% postprandial decline. In addition, snacks had low to intermediate glycemic index (52 and 56) in diabetic and low glycemic index (43 and 45) in non-diabetics; likewise reduced α-amylase/α-glucosidase activities compared to control snacks. Similarly, glutathione level, glutathione peroxidase, superoxide dismutase, and catalase activities in serum from subjects that consumed multigrain snacks were upregulated compared to control and market sample groups. Moreso, snack products promoted a reduction in serum insulin levels in diabetic subjects (45 and 17% for MBY and MBZ respectively). Following the nutraceutical properties displayed by the formulated snack especially MBY, it can be promoted as a functional snack for the management of diabetes while solving the limited snack product choice of diabetes sufferers. Graphical Abstract

Objective: To analyze the clinical effect of Fu's subcutaneous needling (FSN) therapy on treating Knee Osteoarthritis. Methods: The VAS and WOMAC scores were evaluated and compared from 30 patients with knee osteoarthritis before and after FSN therapy. Results: After the first treatment, the patients' VAS scores declined sharply with a marked efficiency of 100%. One-month-following showed that 1 case was cured, 27 cases were effectively improved, among which 67% patients were remarkably effective. 2 cases were ineffective and had recurrence, the total effective rate was 93%. Conclusion: FSN therapy was a safe and effective clinical treatment for knee Osteoarthritis. It worked fast and had immediate beneficial effect. Followingup observation indicated that the long-term effect was also remarkable. FSN was worthy of more clinical applications on knee osteoarthritis patients. [ABSTRACT FROM AUTHOR]

Snack products are evolving as new carriers of functional ingredients with nutritional and health-promoting benefits. A blend of whole grains is increasingly being utilized to harness the functional potential of the grain mix. Amaranth, acha, and pearl millet grains flours were optimized using response surface methodology (RSM), to obtain optimum blends (90:5:5 and 47.98:26.68:25.34) with high protein content and low glycemic index. Snack bar products from the blends were labelled MBY and MBZ. A total of 40 diabetic and 10 non-diabetic subjects were recruited. Of the diabetic, about 42% were overweight while 40% were obese, the non-diabetic had normal weights. Each was allowed to consume snacks containing the equivalent of 50 g of carbohydrates. Finger prick was employed to evaluate the postprandial glucose response of snack products while venous blood was evaluated for antioxidant enzymes, carbohydrate-hydrolyzing activities, and insulin using standard methods. Consumption of the multigrain snacks elicited a stable postprandial response (133–141 mg/dL) with 16 and 24% postprandial decline. In addition, snacks had low to intermediate glycemic index (52 and 56) in diabetic and low glycemic index (43 and 45) in non-diabetics; likewise reduced α-amylase/α-glucosidase activities compared to control snacks. Similarly, glutathione level, glutathione peroxidase, superoxide dismutase, and catalase activities in serum from subjects that consumed multigrain snacks were upregulated compared to control and market sample groups. Moreso, snack products promoted a reduction in serum insulin levels in diabetic subjects (45 and 17% for MBY and MBZ respectively). Following the nutraceutical properties displayed by the formulated snack especially MBY, it can be promoted as a functional snack for the management of diabetes while solving the limited snack product choice of diabetes sufferers. [ABSTRACT FROM AUTHOR]

Background Hepatocellular carcinoma (HCC) is characterized by high morbidity and mortality. Early diagnosis and timely intervention in the precancerous stage can effectively reduce the incidence of HCC, which is of great significance for its prevention and treatment. Modern medical treatment of precancerous lesions of HCC has problems such as difficulties to grasp the timing of intervention and single treatment method, traditional Chinese medicine (TCM) may be a simple and effective new approach to prevent and treat precancerous lesion of HCC. Objective To observe the clinical efficacy and safety of Qizhuhuaji formula in the treatment of precancerous lesion of HCC (liver-depression and spleen-deficiency, phlegm and blood stasis syndrome) . Methods Patients with precancerous lesion of HCC who met the TCM syndrome type "liver-depression and spleen-deficiency, phlegm and blood stasis syndrome" admitted in the hepatology clinic of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Weihai Hospital of Traditional Chinese Medicine and Taian Hospital of Traditional Chinese Medicine from October 2019 to March 2020 were included as the study subjects. General information (gender, age, history of HBV-related cirrhosis, family history of HCC, history of alcohol consumption for more than 10 years), the TCM syndrome score, liver function indicators [alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) ], tumor marker indexes [alpha-fetoprotein (AFP), alpha-fetoprotein variants-L3 (AFP-L3), des-γ-carboxy-prothrombin (DCP) ], imaging indexes (lesion type, lesion nature, lesion length diameter), safety indexes and adverse reactions were collected. The 64 patients who met the inclusion criteria and completed the study were divided into the observation group (n=34) and the control group (n=30) using the random number tables. The patients in the control group were treated with conventional therapy such as antiviral, anti-inflammatory and liver-protective therapy; the observation group was treated with conventional therapy combined with Qizhuhuaji formula. The treatment course was 48 weeks, and the follow-up period was 48 weeks after drug withdrawal. The incidence of HCC and complications in the treatment cycle and follow-up period of the two group were observed, and the differences in the improvement indexes of TCM syndrome (TCM syndrome scores, total effective rate), liver function indicators, tumor marker indexes, imaging indexes (lesion length diameter, lesion stability rate, lesion improvement rate), and safety index (safety rate) between the two groups before and after treatment. Results After treatment, the TCM syndrome scores, ALT, AST, TBIL, GGT, ALP, and AFP-L3 were lower than those before treatment in both groups, and the ALB level was higher than that before treatment (P0.05) in the rates of lesion improvement (35.3%) and lesion stability (50.0%) in the observation group compared with the control group (20.0%, 43.3%). There was no statistically significant difference in the incidence of HCC between the observation group (8.8%) and the control group (16.7%) at the end of the follow-up period (P>0.05) ; the incidence of complications (8.8%) in the observation group was lower than that of the control group (30.0%) (P0.05) in the safety rate between the observation group (94.1%) and the control group (90.0%) . Conclusion The treatment of precancerous lesions of HCC (liver depression and spleen deficiency, phlegm and blood stasis syndrome) with Qizhuhuaji formula has better clinical efficacy and higher safety in improving TCM syndrome, improving liver function, shrinking lesion nodules, reducing the incidence of long-term HCC and complications of liver cirrhosis.

Background: To assist doctors in making better treatment decisions and improve patient prognosis, it is important to determine which therapy modalities are suitable for various forms of idiopathic hypertrophic cranial pachymeningitis (IHCP). All cases were received from the hospital medical record system, and some follow-up information was gathered through telephone follow-up. A total of 26 patients, 14 men and 12 women, with ages ranging from 20 to 73 years and a mean of 47.42 years, were included in the research. Regular types were less likely to recur than irregular and nodular types, focal types were less likely to recur than diffuse types, and corticosteroid-refractory types were more likely to recur than corticosteroid-sensitive types. The extent and shape of the lesion and susceptibility to corticosteroids are potential factors that could influence recurrence. Futhermore, this paper also proposes the fibroblasts as a new therapeutic target which may improve the quality of prognostic survival of patients. [ABSTRACT FROM AUTHOR]

In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis—a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes. [ABSTRACT FROM AUTHOR]

The three-level model (3-LM) tracks transformation in psychoanalytic cases via a focused working group study of detailed clinical material. This Panel was a continuation of a series of programmes on the work of the Clinical Observation Committee held at previous IPA Congresses in Mexico City, Prague, Boston, Buenos Aires, London, and in an Online Congress during the pandemic. In this presentation, panellists summarized how the 3-LM worked, with two summarizing cases presented using this method at their Institute. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the clinical efficacy of modified Shuzao Yinzi in the treatment of chronic glomerulonephritis from the perspective of “ real” diagnosis and treatment. METHODS: A total of 92 patients with chronic glomerulonephritis admitted into hospital from Jan. 2020 to Apr. 2022 were selected and randomly divided into control group and treatment group via random number table method, with 46 cases in each group. The control group was given Benazepril hydrochloride tablets, while the treatment group was given modified Shuzao Yinzi based on the control group. The clinical efficacy, TCM syndrome score, renal function level [blood urea nitrogen (BUN), serum creatinine (SCr), 24 h urine protein quantitation and glomerular filtration rate], routine urine examination [ white blood cell count and red blood cell count in urine] and renal hemodynamic indicators [ peak systolic flow velocity (PSFV), end-diastolic blood flow velocity (EDFV), pulsatility index (PI), resistance index (RI)] of both groups were observed before and after treatment. RESULTS: After treatment, the total effective rate of the treatment group was 93. 48% (43 / 46), which was significantly higher than that of the control group (78. 26%, 36 / 46), with statistically significant difference (P<0. 05). After treatment, the scores of facial and limb edema, lower back stabbing pain, swollen sore throat, indigestion and loss of appetite in both groups were significantly lower than those before treatment, and those of the treatment group were lower than the control group; after treatment, the BUN, SCr and 24 h urine protein quantitation in both groups were lower than those before treatment, the glomerular filtration rate was higher than that before treatment, and those of the treatment group were better than the control group; after treatment, the white blood cell count and red blood cell count in urine in both groups were lower than those before treatment, and those of the treatment group were better than the control group; after treatment, the PSFV and EDFV values in both groups were higher than those before treatment, the PI and RI values were lower than those before treatment, and those of the treatment group were better than the control group, with statistically significant differences (P < 0. 05). CONCLUSIONS: The efficacy of modified Shuzao Yinzi in the treatment of chronic glomerulonephritis is remarkable. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: To probe into the clinical efficacy of modified Shuzao Yinzi in the treatment of chronic glomerulonephritis from the perspective of “ real” diagnosis and treatment. METHODS: A total of 92 patients with chronic glomerulonephritis admitted into hospital from Jan. 2020 to Apr. 2022 were selected and randomly divided into control group and treatment group via random number table method, with 46 cases in each group. The control group was given Benazepril hydrochloride tablets, while the treatment group was given modified Shuzao Yinzi based on the control group. The clinical efficacy, TCM syndrome score, renal function level [blood urea nitrogen (BUN), serum creatinine (SCr), 24 h urine protein quantitation and glomerular filtration rate], routine urine examination [ white blood cell count and red blood cell count in urine] and renal hemodynamic indicators [ peak systolic flow velocity (PSFV), end-diastolic blood flow velocity (EDFV), pulsatility index (PI), resistance index (RI)] of both groups were observed before and after treatment. RESULTS: After treatment, the total effective rate of the treatment group was 93. 48% (43 / 46), which was significantly higher than that of the control group (78. 26%, 36 / 46), with statistically significant difference (P<0. 05). After treatment, the scores of facial and limb edema, lower back stabbing pain, swollen sore throat, indigestion and loss of appetite in both groups were significantly lower than those before treatment, and those of the treatment group were lower than the control group; after treatment, the BUN, SCr and 24 h urine protein quantitation in both groups were lower than those before treatment, the glomerular filtration rate was higher than that before treatment, and those of the treatment group were better than the control group; after treatment, the white blood cell count and red blood cell count in urine in both groups were lower than those before treatment, and those of the treatment group were better than the control group; after treatment, the PSFV and EDFV values in both groups were higher than those before treatment, the PI and RI values were lower than those before treatment, and those of the treatment group were better than the control group, with statistically significant differences ( P < 0. 05 ). CONCLUSIONS: The efficacy of modified Shuzao Yinzi in the treatment of chronic glomerulonephritis is remarkable. [ABSTRACT FROM AUTHOR]

Given the complex of clinical classification in pituitary apoplexy, it is required to carry out detailed observation, timely treatment and comprehensive nursing for patients with pituitary apoplexy. This paper reviewed studies of clinical observation and nursing of patients with pituitary apoplexy, in order to provide reference for establishment and regulation of clinical practice. (垂体危象临床分型复杂, 细致的病情观察、及时救治和有效的综合护理干预十分关键。本研究对垂体危象的临床观察与护理进展进行综述, 旨在为临床制定有效的护理对策和护理指导规范提供参考。)

Abstract Background and purpose The complications of radical surgery for cervical cancer can increase patient suffering and affect their quality of life. This retrospective study assessed the safety of radical hysterectomy (RH) with pelvic lymph node dissection (PLND) by observing the complications of patients with cervical cancer who underwent this procedure in a single centre over 10 years. Our findings may provide experience and evidence for preventing and reducing complications. Methods A total of 2226 cervical cancer patients who met the inclusion criteria were enrolled. All patients underwent RH + PLND. Intraoperative injury to adjacent tissues and short-term and long-term complications were recorded to analyze factors associated with the occurrence of complications. Results Postoperative complications occurred in 34.41% (766/2226) of patients, including 7.68% of patients with injury to adjacent tissues, 31.45% with short-term complications, and 2.96% with long-term complications. Age, tumor size, invasion depth, parametrial invasion, lymph vascular space invasion (LVSI), lymph node metastasis, International Federation of Gynaecology and Obstetrics (FIGO) stage, and surgical procedure were closely associated with the postoperative complications of RH + PLND (P IB2, and who underwent open surgery were more prone to complications.

AIM: To observe the safety and efficacy of stab incision glaucoma surgery(SIGS)in the treatment of adult glaucoma.METHODS: A series of retrospective case studies were carried out from June 2018 to November 2020, the clinical data of 55 cases with 70 eyes of glaucoma treated with SIGS in our hospital were collected. Following up at 6mo after operation, the intraocular pressure(IOP), bleb and postoperative complications were observed.RESULTS: Among the included patients, 30 eyes were performed SIGS alonely, 40 eyes were performed SIGS combined with phacoemulsification. Among them, the operation of 33 eyes(47%)was completely successful, the operation of 28 eyes(40%)was partially successful, and the operation of 9 eyes(13%)were failed. The mean preoperative IOP under medication was 31.82±13.16mmHg, and at 1wk, 1, 3 and 6mo after operation, the mean IOP(14.97±5.25, 17.94±5.24, 18.43±4.74, 17.37±3.36)mmHg were all significantly lower than before operation, and the number of IOP-lowering drugs used at 6mo after operation [0(0, 1)] was significantly lower than before operation [3(2, 3)](P

Objective: To explore the curative effect of buttress plate and traditional internal fixation in the treatment of ankle fracture, so as to provide potential reference for the clinical treatment of this disease. Methods: This is a clinical comparative study. The subjects of this study were one hundred patients with ankle fracture treated in Mindong Hospital Affiliated to Fujian Medical University from January 2019 to December 2021. Enrolled patients were randomly divided into the control group and the experimental group. Patients in the control group were treated with traditional internal fixation, and those in the experimental group were provided with buttress plate. Patients were compared in several aspects such as the comprehensive quality of life assessment questionnaire (GQOLI-74), Baird-Jackson score and postoperative complications. Results: The experimental group showed improved Baird-Jackson score after treatment, significantly higher fracture healing rate than that of the control group three months after treatment. Besides, there was no significant difference in the complications between the two groups, with good prognosis after timely treatment. Conclusion: Internal fixation with buttress plate has obvious advantages in the treatment of ankle fractures, which can effectively improve the quality of life and promote the rapid healing of fractures. It is worthy of clinical promotion and application. [ABSTRACT FROM AUTHOR]

Objectives] To observe the clinical efficacy of warm needling acupuncture of Mongolian medicine in the treatment of lumbar disc herniation (LDH). [Methods] 120 patients with lumbar disc herniation hospitalized in Inner Mongolia International Mongolian Hospital from June 2019 to June 2022 were randomly divided into observation group (n = 60) and control group (n=60). The observation group was treated with warm needling acupuncture of Mongolian medicine, and the control group was treated with common acupuncture of Mongolian medicine, with two weeks as a course of treatment. The pain visual analogue scale (VAS) and Japanese orthopaedic association (JOA) score were observed before and after treatment, and the clinical efficacy was evaluated by the changes of clinical symptoms and signs of Mongolian medicine. [Results] The cure rate of the observation group was 71.7%, which was better than that of the control group (53.3%). The difference in the cure rate between the two groups was statistically significant, X2 -4.302, P -0.038. The total markedly effective rate (cured + markedly effective) of the observation group was 90. 0%, while that of the control group was 83. 3%. There was no significant difference in the total markedly effective rate between the two groups, X2 = 1.154, P= 0.283. The total effective rate (cured + markedly effective + effective) of the observation group was 100%, while that of the control group was 95.0%. There was no significant difference in the total effective rate between the two groups, and the continuous corrected chi-square value was 1.368 and 0.242. After treatment, the degree of low back pain, lower limb pain and dyskinesia were significantly improved in the two groups, the observation group was better than the control group, and the difference was statistically significant (P <0.05). [Conclusions] The warm needling acupuncture of Mongolian medicine was effective in the treatment of lumbar disc herniation, which is worth popularizing. [ABSTRACT FROM AUTHOR]

Abstract Background The growth of frail older patients with extensive care needs in homecare creates a need for competence development. Improvement programmes are essential to fill this knowledge gap. However, the outcomes of such programmes remain unknown. Therefore, the aim of this study is to describe the outcomes of a competence improvement programme for the systematic observation of frail older patients in homecare. Methods This study applied a qualitative mixed-method design. Data were collected in two homecare districts using participant observation, focus group interviews, and individual interviews. Results The analysis revealed five concepts characterising the outcomes of the competence improvement programme: 1) frequency of vital sign measurements, 2) situational awareness, 3) expectations and coping level, 4) activities for sustained improvement, and 5) organisational issues affecting CIP focus. Substantial differences were revealed across the two homecare districts in how homecare professionals enacted new knowledge and routines resulting from the competence improvement programme. The differences were related to the frequency of vital sign measurements, coping levels, and situational awareness, in which successful outcomes were shaped by implementation issues and contextual setting. This involved whether routines and planned activities were set to follow up the improvement programme, or whether organisational issues such as leadership focus, resources, and workforce stability supported the programme. Conclusions This study documents the differences entailed in creating sustainable outcomes of an improvement programme for homecare professionals’ competence in recognising and responding to deteriorating frail older patients. Depending on the implementation process and the homecare context, professionals enact the activities of the improvement programme differently.

Background and purpose: The complications of radical surgery for cervical cancer can increase patient suffering and affect their quality of life. This retrospective study assessed the safety of radical hysterectomy (RH) with pelvic lymph node dissection (PLND) by observing the complications of patients with cervical cancer who underwent this procedure in a single centre over 10 years. Our findings may provide experience and evidence for preventing and reducing complications. Methods: A total of 2226 cervical cancer patients who met the inclusion criteria were enrolled. All patients underwent RH + PLND. Intraoperative injury to adjacent tissues and short-term and long-term complications were recorded to analyze factors associated with the occurrence of complications. Results: Postoperative complications occurred in 34.41% (766/2226) of patients, including 7.68% of patients with injury to adjacent tissues, 31.45% with short-term complications, and 2.96% with long-term complications. Age, tumor size, invasion depth, parametrial invasion, lymph vascular space invasion (LVSI), lymph node metastasis, International Federation of Gynaecology and Obstetrics (FIGO) stage, and surgical procedure were closely associated with the postoperative complications of RH + PLND (P < 0.05). Conclusions: The results of this study showed that RH + PLND for cervical cancer is safe and practical. Patients aged 40–60 years, with tumors ≥ 4 cm, invasion depth ≥ 2/3, parametrial invasion, LVSI, lymph node metastasis, FIGO stage > IB2, and who underwent open surgery were more prone to complications. [ABSTRACT FROM AUTHOR]

Background: Idiopathic longitudinally extensive transverse myelitis is defined as a focal spinal cord lesion that involves three or more segments of the spinal cord as shown by neuroimaging, and results in a profound disability. The clinical picture of a patient with idiopathic longitudinally advanced transverse myelitis is often dramatic and may consist of paraparesis or tetraparesis, sensory disturbances, and pelvic dysfunction. Idiopathic longitudinally advanced transverse myelitis is a common manifestation of the neuromyelitis optica spectrum disorders, but can also occur in various other autoimmune and inflammatory diseases of the CNS, such as multiple sclerosis, sarcoidosis, or Sjogrens syndrome, or in infectious diseases involving the CNS. It is less likely to occur in isolation, as the only manifestation of a demyelinating disease of the nervous system of an unknown etiology (idiopathic myelitis). Clinical case description: The clinical observation presented in the article demonstrates the difficulties of establishing a nosological diagnosis in the case of a monophasic course of TM in the absence of other autoimmune and infectious diseases of the central nervous system. The patient with idiopathic longitudinally distributed TM had no visual disturbances and no antibodies to aquaporin 4 and to myelin oligodendrocyte glycoprotein (MOG-IgG) with twice repeated tests. Conclusion: In this regard, it is important to dynamically monitor the clinical manifestations and MRI signs in patients with an isolated lesion of a demyelinating nature in the form of longitudinally extensive transverse myelitis.

Lysosomal acid lipase deficiency (LAL-D) is a rare, progressive, autosomal recessive disease, which develops due to impaired degradation and subsequent intra-lysosomal accumulation of triglycerides and cholesterol esters causing dyslipidemia. The clinical manifestations of the disease presumably depend on the residual activity of the enzyme, lysosomal acid lipase. A profound deficiency of the enzyme known as Wolman’s disease has an onset in the first 6 months of life. The disease reveals itself by dyspeptic disorders in the form of vomiting and diarrhea, lack of weight gain, hepatosplenomegaly, and adrenal calcification. If the Wolman’s disease is not treated, children die within the first 6 months as a result of exhaustion caused by malabsorption syndrome combined with progressive deterioration of liver and adrenal glands. Partial deficiency of lysosomal acid lipase manifests itself at a later age and is called cholesterol ester storage disease. Its clinical presentations include hepatosplenomegaly, elevated transaminases, hypercholesterolemia, and, in some cases, hypertriglyceridemia. Liver failure is the main cause of death in the natural course of cholesterol ester storage disease. Delayed diagnosis of the disease leads to its progression causing irreversible liver damage. The implementation of mass screening programs with the determination of cholesterol levels in childhood is critical to identifying asymptomatic patients.The article presents a clinical case of a patient aged 3 years. The molecular genetic testing showed a mutation in exon 8 of the LIPA gene: NM_000235.3:c.894G>A synonymous variant in the homozygous state. It was also found that both parents of the girl had this type of mutation in the heterozygous state. The patient was prescribed sebelipase alfa in a dose of 1 mg/kg once every 14 days. The treatment was well tolerated. Due to the early verification of the diagnosis and timely pathogenetic therapy, the prognosis of the course of LAL-D, the duration and quality of life of the child were considered to be favourable.Raising the awareness of doctors along with the introduction of effective screening programs for the timely detection of dyslipidemia in children contributes to timely diagnosis and early initiation of pathogenetic therapy, which can increase the life expectancy of patients with lysosomal acid lipase deficiency and improve their quality of life.

The article considers a clinical case of treatment of one of the variants of myofascial pain syndrome – piriformis syndrome without signs of sciatic nerve neuropathy. The peculiarity of the case is the comorbidity of the opioid syndrome with diabetic sensorimotor polyneuropathy and osteoporosis, which required the appointment of complex therapy. The diagnosis was confirmed by additional research methods: spondylography, MRI of the lumbosacral spine, ultrasound of the piriformis muscle, electroneuromyography. A patient management tactic was chosen based on federal clinical guidelines for the treatment of patients with nonspecific back pain. Treatment included non-medicinal and medicinal methods. In order to relieve pain, dexketoprofen was prescribed 2 ml intramuscularly per 2 ml of 0.5% lidocaine solution – 1 time а day No. 2 – under navigation by ultrasound. Subsequently, the transfer was made to oral administration of 25 mg 3 times а day for 3 days. A step-by-step scheme of prescribing dexketoprofen: its introduction into the piriformis muscle with subsequent transfer to oral administration allowed to significantly reduce the severity of pain after 5 days of treatment. The complex effect on the spasmodic piriformis muscle with the help of a tableted muscle relaxant in combination with postisometric relaxation made it possible to quickly stop the pain syndrome and prevent its chronization. The administration of the preparation of thioctic acid pursued two goals: to improve the metabolism of the spasmodic muscle and restore the energy metabolism of peripheral nerves. As a result of the use of complex, pathogenetically based therapy, a positive effect was achieved.

ObjectiveTo investigate the effectiveness and safety of sacubitril valsartan sodium in the treatment of resistant hypertension (RH).MethodsThis study is a single-center, prospective, randomized controlled study. According to the inclusion and exclusion criteria, patients with RH who met the criteria were screened, and all patients adjusted their drug treatment (valsartan 80 mg, amlodipine 5 mg, and hydrochlorothiazide 12.5 mg). After 4 weeks of drug elution, the random envelope method was used for random grouping. The treatment group took sacubitril valsartan sodium 200 mg, amlodipine 5 mg, hydrochlorothiazide 12.5 mg, and the control group took valsartan 80 mg, amlodipine 5 mg, and hydrochlorothiazide 12.5 mg for 8 weeks. The 24 h ambulatory blood pressure (BP) and the echocardiography index using the office sphygmomanometer were observed in the patients.ResultsA total of 100 patients with RH were included in the two groups, with 50 cases in each group. There were no significant differences in sex, age, or comorbid diseases between the two groups. During the 8-week follow-up, the office BP of the research group were significantly decreased (24.78/17.86 mmHg) compared with those of the control group. In the research group the 24 h average BP, daytime average BP, and nighttime average BP were 144.84/79.82, 147.10/82.06, and 138.67/76.31 mmHg at baseline, and reduced to 128.96/73.32, 131.50/74.94, and 122.11/69.27 mmHg at week 8, which were significantly decreased (P < 0.05 or P < 0.01), and the left ventricular ejection fraction was significantly increased (P < 0.05), compared with the control group.ConclusionSacubitril valsartan sodium can effectively reduce BP and improve cardiac function in RH.

[Objectives] To observe the clinical analgesic effect of Qianghuo Chushi Decoction (QHCSD) on patients with fasciitis, and explore its possible molecular mechanism based on network pharmacology. [Methods] 120 enrolled patients were randomly divided into experimental group and control group, and were separately treated with QHCSD formula granules and Diclofenac Sodium Enteric-coated Tablets for 4 weeks. The patient's pain visual analogue scale (VAS) was used as the curative effect indicator. The molecular action mechanism of QHCSD was predicted based on network pharmacology, the active components of QHCSD were screened using TCMSP database, potential targets were predicted by PharmMapper server, compound-target network and protein interaction network were constructed, and GO-based enrichment analysis and KEGG-based biological pathway enrichment analysis were performed. [Results] After treatment, the pain scores in each group were significantly lower than those before treatment (P <0.01), the score of the experimental group was significantly lower than that of the control group (P<0.01), and the total effective rate of the experimental group was 83.33%, which was significantly higher than that of the control group (78.33%, P <0.05). Based on 108 active components in QHCSD, a compound-target network was constructed. The PPI network contained 155 nodes and 527 interaction relationships, and key nodes included EOS, ESR1, NCOA1, RELA, EGFR, MAPK8, IL-6, etc. The GO pathway mainly involved steroid hormone and its receptor activity, RNA polymerase II transcriptional regulator binding, nuclear receptor activity, protein heterodimerization activity and other pathways. KEGG metabolic pathways included PI3K-Akt signaling pathway, Kaposi's sarcoma-associated herpesvirus (KSHV) infection and other pathways. [Conclusions] QHCSD has a significant analgesic effect on fasciitis, and the PI3K-Akt signaling pathway may be the key pathway for its analgesic effect. [ABSTRACT FROM AUTHOR]

This analysis aimed to identify clinical factors associated with positivity on repeat 68 Ga-PSMA-11 PET/CT after a negative scan in patients with recurrent prostate cancer (PCa) under observation. Methods: This single-center, retrospective analysis included patients who underwent at least 2 68 Ga-PSMA-11 PET/CT scans (PET1 and PET2) at UCLA between October 2016 and June 2021 for recurrent PCa with negative PET1 and no PCa-related treatments between the 2 scans. Using Prostate Cancer Molecular Imaging Standardized Evaluation criteria to define negative and positive scans, the final cohort was divided into PET2-negative (PET2-Neg) and PET2-positive (PET2-Pos). The same PET1 was used twice in the more than 2 PET cases with inclusion criteria fulfilled. Patient characteristics and clinical parameters were compared between the 2 cohorts using Mann-Whitney U test and Fisher exact test. Areas under the curve (AUCs) of the receiver operating characteristic and the Youden index were computed to determine the discrimination ability of statistically significant factors and specific cut points that maximized sensitivity and specificity, respectively. Results: The final analysis included 83 sets of 2 PET/CT scans from 70 patients. Thirty-nine of 83 (47%) sets were PET2-Neg, and 44 of 83 (53%) sets were PET2-Pos. Prostate-specific antigen (PSA) increased from PET1 to PET2 for all 83 (100%) sets of scans. Median PSA at PET1 was 0.4 ng/mL (interquartile range, 0.2-1.0) and at PET2 was 1.6 ng/mL (interquartile range, 0.9-3.8). We found higher serum PSA at PET2 (median, 1.8 vs. 1.1 ng/mL; P = 0.015), absolute PSA difference (median, 1.4 vs. 0.7 ng/mL; P = 0.006), percentage of PSA change (median, +270.4% vs. +150.0%: P = 0.031), and median PSA velocity (0.044 vs. 0.017 ng/mL/wk, P = 0.002) and shorter PSA doubling time (DT; median, 5.1 vs. 8.3 mo; P = 0.006) in the PET2-Pos cohort than in the PET2-Neg cohort. Receiver operating characteristic curves showed cutoffs for PSA at PET2 of 4.80 ng/mL (sensitivity, 34%; specificity, 92%; AUC, 0.66), absolute PSA difference of 0.95 ng/mL (sensitivity, 62%; specificity, 71%; AUC, 0.68), percentage of PSA change of a positive 289.50% (sensitivity, 48%; specificity, 82%; AUC, 0.64), PSA velocity of 0.033 ng/mL/wk (sensitivity, 57%; specificity, 80%; AUC, 0.70), and PSA DT of 7.91 mo (sensitivity, 71%; specificity, 62%; AUC, 0.67). Conclusion: Patients with recurrent PCa under observation after a negative 68 Ga-PSMA-11 PET/CT scan with markedly elevated serum PSA levels and shorter PSA DT are more likely to have positive findings on repeat 68 Ga-PSMA-11 PET/CT., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

This study evaluates the 5-year clinical performance of Class II restorations performed with different bulk-fill restorative materials. In the study, Class II restorations performed with Tetric Bulk-Fill (TBF), Filtek Bulk-Fill (FBF), and Equia Forte Fil (EF) were evaluated. One hundred-nineteen restorations were included in the study. Restorations were assessed during the 6th month, 1st, 2nd, and 5th year. Cochran Q, Pearson chi-square, and Fisher-Freeman-Halton tests were used for statistical analysis. In the 5th year, significant differences were observed in terms of retention, color match, marginal adaptation, marginal discoloration, surface texture, and anatomical form in all materials. There was a significant difference between EF and bulk-fill composites only in terms of retention and anatomical form. EF was significantly less successful than bulk-fill composites with regard to retention and anatomical form, but bulk-fill composites have shown similar clinical performance. EF cannot be an alternative to bulk-fill composites for Class II restorations.

Background: The growth of frail older patients with extensive care needs in homecare creates a need for competence development. Improvement programmes are essential to fill this knowledge gap. However, the outcomes of such programmes remain unknown. Therefore, the aim of this study is to describe the outcomes of a competence improvement programme for the systematic observation of frail older patients in homecare.Methods: This study applied a qualitative mixed-method design. Data were collected in two homecare districts using participant observation, focus group interviews, and individual interviews.Results: The analysis revealed five concepts characterising the outcomes of the competence improvement programme: 1) frequency of vital sign measurements, 2) situational awareness, 3) expectations and coping level, 4) activities for sustained improvement, and 5) organisational issues affecting CIP focus. Substantial differences were revealed across the two homecare districts in how homecare professionals enacted new knowledge and routines resulting from the competence improvement programme. The differences were related to the frequency of vital sign measurements, coping levels, and situational awareness, in which successful outcomes were shaped by implementation issues and contextual setting. This involved whether routines and planned activities were set to follow up the improvement programme, or whether organisational issues such as leadership focus, resources, and workforce stability supported the programme.Conclusions: This study documents the differences entailed in creating sustainable outcomes of an improvement programme for homecare professionals' competence in recognising and responding to deteriorating frail older patients. Depending on the implementation process and the homecare context, professionals enact the activities of the improvement programme differently. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of acupoint catgut embedding on patients with different degrees of spleen deficiency and dampness obstruction type obesity before and after treatment. Methods: Patients who met the inclusion criteria were divided into 30 cases in the mild obesity group and 30 cases in the moderate obesity group. Both groups were treated with the acupoint catgut embedding method once a week for 4 weeks and two consecutive courses of treatment. The changes in body weight, body mass index, waist circumference and hip circumference of the two groups were compared by the method of self-control before and after treatment. Results: (1) After the second course of treatment, the total effective rate of mild obesity group was 86.67%, and the total effective rate of moderate obesity group was 90.00%. There was a significant difference compared with that before treatment (P < 0.05). (2) After treatment, the body weight, body mass index, waist circumference and hip circumference of patients in both groups were lower than before treatment (P < 0.05). Conclusion: acupoint catgut embedding is a safe, effective and economical solution for the treatment of simple obesity due to spleen deficiency and dampness, which can be promoted clinically for its simplicity, time saving, long lasting effect and less rebound. [ABSTRACT FROM AUTHOR]

Objective:To evaluate the long-term curative efficacy and safety of olfactory ensheathing cell (OEC) transplantation by 10 years of follow-up investigation.Methods:A follow-up observation was done on 13 patients with allograft olfactory bulb-derived OEC transplantation from September 2005 to September 2007 at the Second Affiliated Hospital of Xi’an Jiaotong University. After cell purification, amplification, and identification, a 2 × 107/mL cell suspension was prepared for transplantation. In the posterior horn of the spinal cord 0.5 cm distal and proximal to the spinal cord injury zone, 4 needle points were selected to avoid the blood vessels. The needle depth was 3 mm, and the injection volume per point was 10 μL. Postoperatively and at 1 week, 4 weeks, 12 weeks, 24 weeks, 1 year, 3 years, 5 years, and 10 years after the surgery, the patient’s American Spinal Injury Association (ASIA) score, adverse reactions, and other minor observations were assessed.Results:All the patients did not have serious complications. No gliomas or other new organisms formed during the 10-year observation period. Eight of 13 patients had improvement in sensory function, and 5 patients showed improvement in motor function. The ASIA acupuncture, light touch, and exercise scores improved significantly 1 year after the surgery, and this improvement continued until the 10-year follow-up period. Three of 13 patients had improvement in defecation and urination, and 1 patient had improved neuralgia after spinal cord injury.Conclusion:OEC transplantation is safe and effective in treating spinal cord injury. The observation period of OEC transplantation is 1 to 3 years.

To explore the clinical efficacy and safety of azacitidine(AZA) or combined with HAG regimen in the treatment of myelodysplastic syndrome (MDS). The clinical data of 49 patients with MDS in our hospital were retrospectively analyzed. According to different treatment methods, they were divided into supportive treatment group and AZA containing group (AZA or combined with HAG regimen). The clinical efficacy and adverse reactions of the patients were statistically analyzed. In the supportive treatment group, the overall response rate (ORR) was 30.00%, including 0 case complete remission (CR), 1 case of bone marrow complete remission (mCR), 2 cases of partial remission (PR), 3 cases of hematological improvement (HI). The ORR of the AZA containing group was 65.52%, including 8 cases CR, 2 case mCR, 4 cases PR and 5 cases HI. The ORR of monotherapy group was 46.67%, including 2 cases CR, 1 case mCR, 2 cases PR, 2 cases HI. The ORR of combination group was 85.71%, including 6 cases CR, 1 case mCR, 2 cases PR, 3 cases HI. Compared with the supportive treatment group, the complete remission rate and ORR in the group containing AZA were significantly higher than those in the treatment group, and the difference was statistically significant(P<0.05). After receiving AZA containing regimen, the most common adverse reactions were grade III-IV myelosuppression (18/29) and secondary infection (10/29), and the incidence gradually decreased with the increase of treatment courses. Compared with the supportive treatment group, the median Overall survival time and median Progression-free survival time of patients with AZA were significantly longer (P＜0.05). The results of this small sample retrospective case study show that compared with supportive treatment, AZA or combined with HAG regimen has a higher response rate in the treatment of MDS patients, can prolong the overall survival time of patients, and is well tolerated. And combination therapy may have a better effect. [ABSTRACT FROM AUTHOR]

[ Objectives] To explore the e$fect of the extract of Growgx yeast fermentation product on ultraviolet A $ UVA) -induced photo-aging of human skin fibroblasts $ HFF-1) and its specific mechanisms from the level of cell biology, and discussed the application of the Growgx yeast fermentation product extract for skin aging. [Methods] A photo-aging model of HFF-1 ceHs was induced by UVA radiation meter, and it was given different concentrations of Growgx for intervention. The proliferation activity of the HFF-1 ceHs was detected with MTT method, and their migration and invasion ability was measured by scratch test. The SOD, HYP and MDA levels were detected with corresponding kits. After oxygen infusion apparatus assisted facial skin administration, the repair of the skin was observed through the VISIA skin tester. [ Results ] The survival rate of HFF-1 ceHs was reduced significantly by UVA with an iiradiation dose of 10. 8 J/cm2 $ A <0.05), while Growgx significantly increased their survival rate $ A <0.001) and sped up the repair of damaged ceHs. Growgx promoted the production of SOD $ A <0.05), reduced the level of MDA $ A <0.05), and increased the level of HYP $ A <0.05). Growgx effectively inhibited UVA-induced photo-aging of HFF-1 ceHs. The mechanism may be related to accelerating ceH damage repair, up-regulating SOD and HYP expreesion levels, and reducing MDA expreesion level. The clinical observation showed that Growgx effectively improved skin spots and pores, making the skin smoother and more delicate. [Conclusions] Growgx can efectively fight against photo-aging caused by ultraviolet rays, and can significantly improve skin wrinkl$s. [ABSTRACT FROM AUTHOR]

Abstract. The article presents a review of the literature and clinical observation of a newborn with congenital toxoplasmosis. The difficulties of diagnosing the asymptomatic form of congenital toxoplasmosis in the early neonatal period in one of the twins of a newborn are discussed. The authors note that a careful collection of antenatal history (nutritional culture, contact with a feline), analysis of the patient’s physical development, correct interpretation of the clinical manifestation, data from laboratory research methods and clinical alertness for congenital TORCH complex infection will contribute to the early diagnosis of the disease. Timely etiopathogenetic therapy will allow for effective treatment and early prevention of disabling complications in a patient.

Aim. To demonstrate clinical cases of rare stroke type - cerebral venous thrombosis with paroxysmal conditions.Materials and methods. There were retrospectively analyzed medical histories of the three male patients at age of 19, 22 and 47 years old, respectively, diagnosed with venous stroke, and admitted at different time points to the Neurology Department managing acute cerebrovascular accidents.Results. Patients with subacute and acute venous stroke suffered from headache and general discomfort. Depression of consciousness and paroxysmal events were observed during acute stage of the disease. No elevated arterial blood pressure was found. Focal neurological symptoms were observed in one out of three patients manifested as aphasic disorders. Neuro-ophthalmological examination revealed signs of swelling in the optic nerve (papilledema) and retinal artery spasm. Risk factors predisposing to such pathology were revealed in each clinical case.Conclusions. Here we provided with most high-priority risk factors as well as initial clinical manifestations for developing cerebral venous thrombosis as a rather rare pathological condition. However, various issues related to it still remain and require further investigations.

Hematidrosis is a rare disease. Isolated cases are described in the literature, which makes it impossible to study the etiology and pathogenesis of the disease. The most convincing are the assumptions about the role of emotional stress in the clinical manifestations of the disease. The author presents his own 2-year observation of a girl who periodically had bleeding from the nose and ear canal.

The first effects of radiotherapy and antineoplastic chemotherapy happen on the cells of the oral epithelium, which quickly notice proliferation. The size of these effects depends on many factors related to the treatment, the patient, and the tumor. With regard to the patient, this process interferes with their general health status, presence of comorbidities, gender, nutritional status, age, social and psychological factors, in addition to deleterious habits and pre-existing orofacial pathologies. These illnesses in the oral integrity are due to the veracity that radiotherapy and chemotherapy are not capable of destroying tumor cells without normal cells. Oncological treatment can cause adverse reactions in the oral cavity, and it is common, in cancer patients, to antineoplastic treatment, to develop acute or late oral aggravations. [ABSTRACT FROM AUTHOR]

Background. New coronaviral infection (COVID-19) in most cases has less severe course in children than in adults. However, there were reports from the number of European countries and from United States (from March 2020) about children with new disease with signs of Kawasaki disease (KD) and toxic shock syndrome (TSS). So it has received one of the names children’s multisystem inflammatory syndrome (CMIS) associated with COVID-19. The aim of the study is to summarize up-to-date information about this disease.Methods. Information search in PubMed database, CDC (USA) and WHO websites, Search for information in PubMed database, on CDC (USA) and WHO websites, analysis of the medical records of observed patient with CMIS.Results. Clinical and laboratoryinstrumental manifestation and outcomes of CMIS in 120 children from Italy, France, Switzerland, England, USA with similar signs were analyzed. Proposed international diagnostic criteria of the disease in comparison with other phenotypically similar diseases (KD, shock syndrome at KD, TSS of Staphylococcal and Streptococcal etiology, macrophage activation syndrome), clinical observation of patient, algorithm of evaluation and management of patients with CMIS are presented.

Allergic rhinitis (AR) is found in the practice of doctors of various specialties, but making the correct diagnosis and prescribing adequate therapy can take many months and sometimes years. Currently, the problem of AR remains relevant, due to the extreme prevalence of AR, late diagnosis, underestimation of the possible risks of disease progression, complications, and the addition of such a formidable pathology as bronchial asthma. The path of the patient presented in the clinical case is quite typical for many patients with AR and concomitant pathology of nose. A young patient with allergic rhinitis received conservative treatment, and was later operated, but the effect was incomplete and short-lived. Only after 4 years, the patient was first examined by an allergist. Symptoms of AR indicate that the patient has an atopic status that promotes the involvement of various organs and systems in the inflammatory process.To verify the diagnosis and clarify the entire spectrum of “guilty” allergens, a specific allergological examination was carried out, which included skin testing and determination of specific IgE antibodies. The main participants in allergic inflammation are mast cells, eosinophils, lymphocytes, epithelial and endothelial cells. The effect of mediators on vascular endothelial cells and neuroreceptors of the nasal mucosa leads to the formation of allergic inflammation and the onset of clinical symptoms of AR. One of the main mediators released upon repeated contact with an allergen in a sensitized body is histamine, therefore antihistamines are first-line drugs at any stage of AR therapy. In our clinical case, taking into account complaints, medical history, clinical manifestations, results of laboratory (specific, nonspecific) and instrumental methods, the patient needs treatment of the corresponding first stage of therapy based on symptom control. The effectiveness of 2nd generation H1-antihistamines in the management of symptoms such as pruritus, sneezing, and rhinorrhea is due to histamine-mediated development of the early phase of the allergic reaction, which in turn leads to the onset of the late phase and the chronic co Bilastine can be considered as the drug that most fully meets the requirements of ARIA experts for 2nd generation H1-antihistamines : selective blockade of H1 receptors, high antiallergic effect, rapid onset of clinical effect, duration of action 24 hours, lack of tachyphylaxis and good tolerance. The results of the studies and their analysis show that bilastine is the preferred choice for monotherapy of allergic rhinitis.urse of allergic inflammation in the nasal mucosa.

Background: The early recognition of deterioration in frail older patients is a vital competence of homecare professionals, yet there is a gap between competence demands and actual competence. The aim of this study is therefore to describe and analyse the implementation of a competence improvement program for the systematic observation of frail older patients, developed and implemented in two homecare settings in Norway. Methodology: The study applied a descriptive qualitative design consisting of observation, focus group interviews, and individual interviews. Results: Homecare professionals described the competence improvement program differently both within and across the two homecare districts. They gave diverse explanations for the purpose of the program, most of them involving positive expectations towards improving the current observational practice. The content of the competence improvement program was complex and consisted of multiple components, which the participating homecare professionals experienced as demanding. The process of implementing the competence improvement program was influenced by the difficult flow of information, limited available time, and challenges related to simulation. Conclusion: The implementation of a complex competence improvement program for the systematic observation of frail older patients in homecare requires careful planning with regard to content, process, and context.

Background: Subungual splinter hemorrhage (SSH) is a common nail disorder and is difficult to differentiate from other nail diseases because of their similar characteristics. The epidemiological study of SSH is lacking and it is unclear whether SSH needs treatment or not. Aims: The aims of this study were to observe the clinical characteristics of SSH of toenails in Chinese adults and to provide a reference for the diagnosis and prognosis of patients with SSH. Materials and Methods: We collected and followed up 63 SSH patients who were diagnosed through dermoscopic examination. The clinical and dermoscopic characteristics, disease course, and recovery results were recorded. Data sets were analyzed through the use of SPSS 16.0. Literature concerning SSH were reviewed and compared with the results in this study. Results: Sixty-three SSH patients were included with an age range of 17–58 years. Nearly 93.7% of SSH patients occurred in the right, left, or right and left first toenails; 66.7% of SSH patients occurred only in one toenail; there were 60.3% of SSH patients with a clear stimulus causing it and 31.8% of SSH patients with five types of comorbidities. The common characteristics of dermoscopy showed a reddish brown or brown stain with a clear boundary visible under the nail in which the color gradually faded outward from the center, with no blue or white structure. After following up for 24 weeks, the disappearance of hemorrhage was observed in 95.2% of SSH patients. For the recovered SSH patients, data analysis showed no significant difference in the course of SSH in males and females (P = 0.645); the statistical analysis showed that there was no significant correlation (r2 = −0.002) between age and course in recovered SSH patients (P = 0.986). Conclusions: It is unnecessary to do any special treatment during the 1st year. Measures ought to be taken for SSH patients if the course of the disease exceeds more than 1 year.

The article describes four clinical observations of patients with babesiosis detected in the European part of the Russian Federation, two of whom were under the direct supervision of the authors. The analysis of epidemiological data, clinical picture, results of laboratory studies in the dynamics of the disease. Differential diagnosis and treatment are discussed.

Objective: To observe the clinical effect of electroacupuncture "Tongmin point" combined with heat-sensitive moxibustion on knee osteoarthritis and its effect on blood lipid level, polyprotein polysaccharide enzyme-4(a disintegrin and metalloprotease with thrombospondin motifs, ADAMTS-4, matrix metalloproteinase-3(matrix metalloproteinase-3,); and MMPs-3) Impact. Methods: 80 patients were randomly divided into two groups, 40 cases per group, Treatment and control groups, The treatment group was given electroacupuncture combined with heat-sensitive moxibustion, Six times a week, Continuous treatment for 4 weeks; The control group was given intraarticular sodium hyaluronate, Once a week, continuous treatment for 4 weeks. Results: During the treatment period, Visual analogue scale visual analogue scale, VAS) show a downward trend, Intra-group comparisons, Differences were statistically significant (P<0.05); After 2 weeks of treatment ,4 weeks of treatment and 2 weeks of followup, All the scores in the treatment group were lower than those in the control group (P<0.05). After treatment in two groups (The Western Ontario and Mc Master Universities Osteoarthritis Index,) of osteoarthritis index, University of Western Ontario WOMAC) The scores of each item decreased significantly, treatment group was better than the control group (P<0.05). After four weeks of treatment, (Total cholesterol,) Total cholesterol TC, triglycerides (Triglyceride,); and TG, LDL (Low density lipoprotein,); and LDL-C) A decrease in content, High density lipoprotein High density lipoprotein, HDL-C) Increased content, and the improvement was better than that of the control group (P<0.05). After treatment, the ADAMTS-4, MMPs-3 content decreased, Intergroup comparisons, Differences were statistically significant (P<0.05); The effective rate in the treatment group was 87.5%, The control rate was 60%, treatment group was more effective (P<0.05). Conclusions: Electroacupuncture "Tongmin point" combined with heat-sensitive moxibustion can obviously improve the symptoms of knee osteoarthritis patients, Regulate blood lipids, High security, It is worth popularizing in clinic. [ABSTRACT FROM AUTHOR]

Parkinson's disease is a highly disabling, progressive neurodegenerative disease that manifests as a mix of motor and non‐motor signs. Although we are equipped with some symptomatic treatments, especially for the motor signs of the disease, there are still no established disease‐modifying drugs so the disease progresses unchecked. Standard drug discovery programs for disease‐modifying therapies have provided key insights into the pathogenesis of Parkinson's disease but, of the many positive candidates identified in pre‐clinical studies, none has yet translated into a successful clinically efficacious drug. Given the huge cost of drug discovery programs, it is not surprising that much attention has turned toward repurposing strategies. The trialing of an established therapeutic has the advantage of bypassing the need for preclinical safety testing and formulation optimization, thereby cutting both time and costs involved in getting a treatment to the clinic. Additional reduced failure rates for repurposed drugs are also a potential bonus. Many different strategies for drug repurposing are open to researchers in the Parkinson's disease field. Some of these have already proven effective in identifying suitable drugs for clinical trials, lending support to such approaches. In this review, we present a summary of the different strategies for drug repurposing, from large‐scale epidemiological correlation analysis through to single‐gene transcriptional approaches. We provide examples of past or ongoing studies adopting each strategy, where these exist. For strategies that have yet to be applied to Parkinson's disease, their utility is illustrated using examples taken from other disorders.The journey of exenatide shows the potential that repurposing strategies based upon initial epidemiological observations offer for identifying new disease‐modifying therapies for Parkinson's disease. [ABSTRACT FROM AUTHOR]