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Stercoral perforation of the cecum:A case report

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1189-1194页

作者： Hung-Chun Yu Ta-Wei Pu Jung-Cheng Kang Chao-Yang Chen Je-Ming Hu Ruei-Yu Su Department of Surgery Taichung Armed Forces General HospitalTaichung 411228Taiwan Department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan Department of Pathology and Laboratory Medicine Taoyuan Armed Forces General HospitalTaoyuan 325Taiwan

BACKGROUND With less than 90 reported cases to date,stercoral perforation of the colon is a rare *** ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall,which is caused by the presence of a stercoraceous *** underscore this urgent surgical situation concerning clinical presentation,surgical treatment,and results,we present the case of a 66-year-old man with a stercoral *** SUMMARY A 66-year-old man with a history of hypertension,hyperlipidemia,and gout presented at the emergency department with lower abdominal pain and a low-grade fever lasting for a few *** computed tomography indicated a suspected bezoar(approximately 7.6 cm)in the dilated cecum,accompanied by pericolic fat stranding,mild proximal dilatation of the ileum,pneumoperitoneum,and minimal ***,feculent peritonitis with isolated cecal perforation were ***,a right hemicolectomy with peritoneal lavage was performed.A histopathological examination supported the intraoperative *** In stercoral perforations,a diagnosis should be diligently pursued,especially in older adults,and prompt surgical intervention should be implemented.

关键词： Acute abdomen Colectomy Peritoneal lavage Pneumoperitoneum Bezoars Case report

Study on blood pressure rhythm in hypertensive patients with Yin deficiency syndrome and a random forest model for predicting hypertension with Yin deficiency syndrome

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Journal of Traditional Chinese Medicine 2024年第3期44卷 564-571页

作者： ZHOU Ying LI Ping LUAN Jianwei SHEN Rui WU Yinglan XU Qiwen WANG Xinyue ZHU Yao XU Xiangru LIU Zitian JIANG Yuning ZHONG Yong HE Yun JIANG Weimin Department of Cardiology the Affiliated Hospital of Nanjing University of Chinese MedicineJiangsu Province Hospital of Traditional Chinese MedicineNanjing 210029China Department of Health Management Centre Jinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210002China emergency Department Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai 200032China Department of general Internal Medicine the Affiliated Hospital of Nanjing University of Chinese MedicineJiangsu Province Hospital of Traditional Chinese MedicineNanjing 210029China

OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting ***: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher t

关键词： hypertension Yin deficiency syndrome random forest blood pressure rhythm blood pressure variability

Landslide hazard susceptibility evaluation based on SBAS-InSAR technology and SSA-BP neural network algorithm:A case study of Baihetan Reservoir Area

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Journal of Mountain Science 2024年第3期21卷 952-972页

作者： GUO Junqi XI Wenfei YANG Zhiquan SHI Zhengtao HUANG Guangcai YANG Zhengrong YANG Dongqing Faculty of Geography Yunnan Normal UniversityKunming 650500China Key Laboratory of Early Rapid Identification Prevention and Control of Geological Diseases in Traffic Corridor of High Intensity Earthquake Mountainous Area of Yunnan ProvinceKunming 650093China Faculty of Public Safety and emergency Management Kunming University of Science and TechnologyKunming 650093China Key Laboratory of Geological Disaster Risk Prevention and Control and emergency Disaster Reduction of Ministry of emergency Management of the People’s Republic of China Kunming University of Science and TechnologyKunming 650093China Guizhou Geological Survey Institute Guiyang 550081China College of Big Data and Intelligent Engineering Southwest Forestry UniversityKunming 650224China

Landslide hazard susceptibility evaluation takes on critical significance in early warning and disaster prevention and *** order to solve the problems of poor effectiveness of landslide data and complex calculation of weights for multiple evaluation factors in the existing landslide susceptibility evaluation models,in this study,a method of landslide hazard susceptibility evaluation is proposed by combining SBAS-InSAR(Small Baseline Subsets-Interferometric Synthetic Aperture Radar)and SSA-BP(Sparrow Search Algorithm-Back Propagation)neural network *** SBAS-InSAR technology is adopted to identify potential landslide hazards in the study area,update the cataloging data of landslide hazards,and 11 evaluation factors are chosen for constructing the SSA-BP model for training and *** Reservoir area is selected as a case study for *** indicated by the results,the application of SBAS-InSAR technology,combined with both ascending and descending orbit data,effectively addresses the incomplete identification of landslide hazards caused by geometric distortion of single orbit SAR data(e.g.,shadow,overlay,and perspective contraction)in deep canyon areas,thereby enabling the acquisition of up-to-date landslide hazard ***,in comparison to the conventional BP(Back Propagation)algorithm,the accuracy of the model constructed by the SSA-BP algorithm exhibits a significant increase,with mean squared error and mean absolute error reduced by 0.0142 and 0.0607,***,during the process of susceptibility evaluation,the SSA-BP model effectively circumvents the issue of considerable manual interventions in calculating the weight of evaluation *** area under the curve of this model reaches 0.909,surpassing BP(0.835),random forest(0.792),and the information value method(0.699).The risk of landslide occurrence in the Baihetan Reservoir area is positively correlated with slope,surface temperature,and deformation ra

关键词： Baihetan SBAS-InSAR SSA-BP Landslide hazard susceptibility evaluation

High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

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World Journal of Psychiatry 2024年第7期14卷 1027-1033页

作者： Hong-Ru Li Yu Guo emergency Intensive Care Unit The Fourth Affiliated Hospital of Soochow University(Suzhou Dushu Lake Hospital)Suzhou 215000Jiangsu ProvinceChina

BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other *** with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate *** To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of *** general data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU *** were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the *** Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU *** results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient *** logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU *** Patients

关键词： Critical illness Delirium Risk factor Intensive care unit Emotional nursing Pain nursing

Effects of oral probiotics on inflammation and intestinal function in adult patients after appendectomy:Randomized controlled trial

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1371-1376页

作者： Ke Lan Ke-Rui Zeng Fu-Rui Zhong Sheng-Jin Tu Jin-Long Luo Shi-Long Shu Xue-Feng Peng Hua Yang Kai Lu Department of general Surgery Zigong Fourth People's HospitalZigong 643000Sichuan ProvinceChina

BACKGROUND Appendectomy is an acute abdominal surgery that is often accompanied by severe abdominal *** probiotics are one of the postoperative treatments for rapid ***,there is a lack of prospective studies on this topic after *** To investigate whether the postoperative probiotics can modulate the inflammatory response and restore intestinal function in patients following *** This was a prospective,randomized trial.A total of 60 emergency patients were randomly divided into a control group(n=30)and a probiotic group(n=30).Patients in the control group started to drink some water the first day after surgery,and those in the probiotic group were given water supplemented with Bacillus licheniformis capsules for 5 consecutive days *** indices of inflammation and postoperative conditions were recorded,and the data were analyzed with RStudio 4.3.2 *** A total of 60 participants were *** with those in the control group,the C-reactive protein(CRP),interleukin 6 and procalcitonin(PCT)levels were significantly lower in the probiotic group at 2 d after surgery(P=2.224e-05,P=0.037,and P=0.002,respectively,all P<0.05).This trend persisted at day 5 post-surgery,with CRP and PCT levels remaining significantly lower in the probiotic group(P=0.001 and P=0.043,both P<0.05).Furthermore,probiotics0.028,both P<0.05).CONCLUSION Postoperative oral administration of probiotics may modulate the gut microbiota,benefit the recovery of the early inflammatory response,and subsequently enhance recovery after appendectomy.

关键词： Probiotics Gut microbiota Appendectomy Inflammatory markers Intestinal function Enhanced recovery after surgery Postsurgical infections

Knockdown of ATRX enhances radiosensitivity in glioblastoma

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中华神经外科杂志(英文) 2024年第3期10卷 1-10页

作者： Zhao Yue Chen Yifei Liu Ruoyu Liu Minghang You Na Zhao Kai Zhang Jiashu Xu Bainan Medical School of Chinese PLA Beijing China Department of emergency Medicine Hainan Hospital of Chinese PLA General Hospital Sanya Hainan China Department of Neurosurgery The First Medical Center Chinese PLA General Hospital Beijing China Center of Cognition and Brain Science Beijing Institute of Basic Medical Sciences Beijing China

Background Glioblastoma are highly malignant type of primary brain tumors. Treatment for glioblastoma multiforme (GBM) generally involves surgery combined with chemotherapy and radiotherapy. However, the development of tumoral chemo- and radioresistance induces complexities in clinical practice. Multiple signaling pathways are known to be involved in radiation-induced cell survival. However, the role of alpha-thalassemia X-linked mutant retardation syndrome (ATRX), a chromatin remodeling protein, in GBM radioresistance remains *** In the present study, the ATRX mutation rate in patients with glioma was obtained from The Cancer Genome Atlas, while its expression analyzed using bioinformatics. Datasets were also obtained from the Gene Expression Omnibus, and ATRX expression levels following irradiation of GBM were determined. The effects of ATRX on radiosensitivity were investigated using a knockdown *** The present study demonstrated that the ATRX mutation rate in patients with GBM was significantly lower than that in patients with low-grade glioma, and that patients harboring an ATRX mutation exhibited a prolonged survival, compared with to those harboring the wild-type gene. Single-cell RNA sequencing demonstrated that ATRX counts increased 2 days after irradiation, with ATRX expression levels also increasing in U-251MG radioresistant cells. Moreover, the results of in vitro irradiation assays revealed that ATRX expression was increased in U-251MG cells, while ATRX knockdown was associated with increased levels of *** High ATRX expression levels in primary GBM may contribute to high levels of radioresistance. Thus ATRX is a potential target for overcoming the radioresistance in GBM.

关键词： Glioblastoma ATRX Radiosensitivity Knockdown

Comparison of the pathological characteristics of uninjured skin tissues of diabetic rodents and diabetic patients

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中华内分泌外科杂志（中英文） 2024年第3期18卷 339-345页

作者： Du Juan Liu Ying Zhu Anfeng Song Dongming Qu Shiguang Yuan Zhixin emergency Critical and Translational Medicine LaboratoryJilin Province People’s HospitalChangchun 130021China emergency Medicine Department of general Hospital of Northern Theater Command Laboratory of Rescue Center of Severe Wound and Trauma PLAShenyang 110016China Department of Pathology the Centre Hospital of ChangchunChangchun 130021China Department of emergency Surgery Jilin Province People’s HospitalChangchun 130021China

Objective To study uninjured diabetic skin structure and compare the pathological characteristics of skin tissue from mouse and rat models of diabetes mellitus(DM)and humans with *** Establishing the DM C57BL/6J mice skin tissue models and db/db mice skin tissue models,as well as DM rat skin tissue *** tissues were collected from the animal models and DM *** biopsy specimens were stained with hematoxylin and eosin(HE)staining,Masson trichrome staining and periodic acid-Schiff(PAS)***(1)Skin from mice with streptozotocin(STZ)-induced DM was thinner and had less hair than skin from control *** epidermis had abnormal keratinization and dermal collagen and elastin fibers were dense and significantly atrophied.(2)Compared with the control group,skin tissue from db/db mice was thinner and had less *** was no aberrant keratinization in the epidermis,and dermal collagen and elastin fibres were loose.(3)Skin tissue from rats with STZ-induced DM was significantly thinner than control *** epidermis had mildly abnormal keratinization,and the dermis layer was atrophied and partly *** focal lipofuscin was deposited.(4)Whole skin tissue from patients with diabetes was significantly thinner than skin from subjects without *** epidermis had mild hyper keratinization,and the dermal elastin fibers were atrophied,loose,irregular,and showed focal mucoid *** Uninjured DM skin tissues were thinner and more irregular than normal *** changes in rat DM skin were most like those seen in the skin of patients with DM.

关键词： Diabetes mellitus Skin Human Mouse Rat

Severe acute kidney injury due to oxalate crystal induced severe interstitial nephritis:A case report

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World Journal of Nephrology 2024年第2期13卷 24-30页

作者： Maulik K Lathiya Praveen Errabelli Sasmit Roy Neeharik Mareedu Department of emergency Medicine Mayo Clinic Health SystemEau ClaireWI 54703United States Department of Nephrology Mayo Clinic Health SystemEau ClaireWI 54703United States Department of Nephrology Centra Lynchburg General HospitalLynchburgVA 24551United States Department of Nephrology UPMC Western MarylandCumberlandMD 21502United States

BACKGROUND Acute kidney injury(AKI)due to interstitial nephritis is a known condition primarily attributed to various *** medication-induced interstitial nephritis is common,occurrences due to non-pharmacological factors are *** report presents a case of severe AKI triggered by intratubular oxalate crystal deposition,leading to interstitial *** aim is to outline the case and its management,emphasizing the significance of recognizing uncommon causes of interstitial *** SUMMARY A 71-year-old female presented with stroke-like symptoms,including weakness,speech difficulties,and cognitive *** hypertension had been managed with hydrochlorothiazide(HCTZ)for over two *** admis-sion,severe hypokalemia and AKI were noted,prompting discontinuation of HCTZ and initiation of prednisolone for acute interstitial *** investigations,including kidney biopsy,confirmed severe acute interstitial nephritis with oxalate crystal deposits as the underlying *** treatment,initial renal function showed minimal ***,with prednisolone therapy and supportive measures,her condition gradually improved,high-lighting the importance of comprehensive *** This case underscores the importance of a thorough diagnostic approach in identifying and addressing uncommon causes of interstitial *** occurrence of interstitial nephritis due to oxalate crystal deposition,especially without typical risk factors,emphasizes the need for vigilance in clinical practice.

关键词： Acute kidney injury Interstitial nephritis Oxalate crystal Hydrochlorothiazide Hypokalemia Case report

Study on myocardial infarction based on nationwide inpatient sample database:a bibliometric analysis from 2000 to 2022

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emergency and Critical Care Medicine 2024年第1期4卷 22-27页

作者： Tianyi Zhang Xue Yang Qian Zhuang Yuhua Liu Huajuan Bai Jianchao Liu Zhouheng Ye Institution of Hospital Management Department of Medical Innovation and ResearchChinese PLA General HospitalBeijingChina Outpatient Department The Second Medical Center and National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina Department of Special Operations Medicine The Sixth Medical CenterChinese PLA General HospitalBeijingChina.

Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent *** influence of the National Inpatient Sample(NIS),the largest collection of administrative healthcare data across the United States,on the field of MI has not been well *** study aimed to quantify the contribution of NIS to MI research using bibliometric ***:We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to *** indicators,such as the number of publications,citations,and Hirsch index(H-index),were summarized by years,authors,organizations,and *** and CiteSpace software were used to analyze the keywords and trends of the hot ***:A total of 342 articles on MI based on NIS were included.A significant growth in outputs related to MI using the NIS from 2000 to 2020 was *** publications were mainly from the United *** Mayo Clinic was the most prolific institution and had the most citations and the highest *** American Journal of Cardiology ranked first among journals with the highest number of publications,citations,and *** and healthcare management are the main focuses of this *** risks and care are receiving increased ***:This study suggests that NIS significantly contributes to high-quality output in MI *** efforts are needed to improve the impact of knowledge gained from the NIS on MI.

关键词： Administrative healthcare database Bibliometrics Big data Myocardial infarction National Inpatient Sample