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World Journal of Psychiatry 2024年第9期14卷 1404-1410页

作者： Ting Xu Xi Mei Zheng Zhao Yue-Hong Liu Cheng-Ying Zheng department of Psychiatry Affiliated Kangning Hospital of Ningbo UniversityNingbo 315201Zhejiang ProvinceChina

BACKGROUND Perception is frequently impaired in patients with Alzheimer’s disease(AD).Several patients exhibit visual or haptic *** SUMMARY A 71-year-old Chinese man presented with visual and haptic hallucinations he had been experiencing for 2 *** clinical manifestations were the feeling of insects crawling and biting the limbs and *** looked for the insects while itching and scratching,which led to skin breakage on the *** was treated with topical and anti-allergic drugs in several dermatology departments without any significant *** admission,the patient was administered risperidone(0.5 mg)and duloxetine(2 mg/day).One week later,the dose of risperidone was increased to 2 mg/day,and that of duloxetine was increased to 60 mg/*** 2 weeks of treatment,the patient’s sensation of insects crawling and biting disappeared,and his mood *** This patient manifested psychiatric behavioral symptoms caused by AD brain *** was important to re-evaluate the patient’s cognitive-psychological status when the patient repeatedly went to the hospital for ***-up attention to cognitive function and the consideration of perceptual deficits as early manifestations of AD should be considered.

关键词： Perceptual disorders Visual hallucination Haptic hallucination Alzheimer’s disease Anti-psychiatric treatment Case report

Modifiable factors mediating the effects of educational attainment on gestational diabetes mellitus: A two-step Mendelian randomization study

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World Journal of Clinical Cases 2024年第26期12卷 5937-5945页

作者： Ming-Yue Ma Ya-Song Zhao department of Nursing Shengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

BACKGROUND Although there is currently a wealth of evidence to indicate that maternal educational attainment is associated with gestational diabetes mellitus(GDM),the specific modifiable risk factors that mediate the causal relationship between these two variables have yet to be *** To identify the specific modifiable risk factors that mediate the causal relationship between the level of maternal education and *** Mendelian randomization(MR)was conducted using data from genome-wide association studies of European *** initially performed a two-sample MR analysis using data on genetic variants associated with the duration of education as instruments,and subsequently adopted a two-step MR approach using metabolic and lifestyle factors as mediators to examine the mechanisms underlying the relationship between the level of maternal education and risk of developing *** addition,we calculated the proportions of total causal effects mediated by identified metabolic and lifestyle *** A genetically predicted higher educational attainment was found to be associated with a lower risk of developing GDM(OR:0.71,95%CI:0.60-0.84).Among the metabolic factors assessed,four emerged as potential mediators of the education-GDM association,which,ranked by mediated proportions,were as follows:Waist-to-hip-ratio(31.56%,95%CI:12.38%-50.70%),body mass index(19.20%,95%CI:12.03%-26.42%),high-density lipoprotein cholesterol(12.81%,95%CI:8.65%-17.05%),and apolipoprotein A-1(7.70%,95%CI:4.32%-11.05%).These findings proved to be robust to sensitivity *** Our findings indicate a causal relationship between lower levels of maternal education and the risk of developing GDM can be partly explained by adverse metabolic profiles.

关键词： Educational status Gestational diabetes mellitus Metabolism Lifestyle factors Mendelian randomization analysis

Human herpesvirus 7 meningitis in an adolescent with normal immune function:A case report

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World Journal of Clinical Cases 2024年第18期12卷 3636-3643页

作者： Yuan-Yuan Zhen Jing Yang Pei-Yuan Liao department of Pediatrics Qilu Hospital of Shandong University(Qingdao)Qingdao 266035Shandong ProvinceChina

BACKGROUND Human herpesvirus type 7(HHV-7)is a less common herpes virus that usually causes mild,self-limiting ***,in recent years,there have been increasing reports of HHV-7 causing serious central nervous system infections,especially *** pathogenesis and clinical features of HHV-7 meningitis,particularly in adolescents with normal immune function,remain incompletely ***,the purpose of this report is to share a case of HHV-7 meningitis in an immunocompetent adolescent with a view to deepening our understanding of the *** SUMMARY A 12-year-old female was admitted with fever,headache,and vomiting.4 d before admission,the patient developed a fever without obvious induction,with a temperature up to 39.5℃,no convulsions,accompanied by chills,headaches,fatigue,and no muscle *** patient was treated with fever reduction,which could be reduced to 38℃;repeated high fever,accompanied by vomiting 7-8 times;and no abdominal pain or *** patient was diagnosed with"acute suppurative tonsillitis"in a local hospital,and the blood routine was generally *** patient was given symptomatic support treatment such as"ceftriaxone sodium"and antiemetic rehydration for 2 d,and his condition did not *** patient's physical examination showed pharyngeal congestion,bilateral tonsil grade I hypertrophy,regression of purulent secretions,and cervical *** B-ultrasound:Opacity of the vitreous body and edema of the optic disc in both *** coherence tomography examination showed that the macular fovea was generally normal in both eyes,with edema of the optic *** virus monitoring results:*** gave ganciclovir antiviral therapy,dexamethasone anti-inflammatory treatment,mannitol to reduce cranial pressure,omeprazole to protect gastrointestinal mucosa,and calcium and potassium *** This study reports a case of HHV-7 meningitis in an adolescent with normal immune ***

关键词： Human herpesvirus 7 meningitis Immune function Immune deficiency Central system infection Case report

Early diagnostic value of carotid artery ultrasound parameters combined with epicardial adipose layer thickness in coronary heart disease

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World Journal of Clinical Cases 2024年第17期12卷 3004-3011页

作者： Min Xu Zhao-Yang Lu department of Ultrasound Suzhou Ninth People's HospitalSuzhou 215200Jiangsu ProvinceChina

BACKGROUND Coronary heart disease is associated with coronary atherosclerosis indicated by carotid intima-media thickness(CIMT)thickening and altered vascular *** epicardial adipose layer can secrete proinflammatory factors that promote the formation of coronary ***,the epicardial fat layer thickness(EAT)may also predict coronary heart *** To determine the role of common carotid artery ultrasound parameters and EAT in the early diagnosis of coronary artery *** Based on coronary angiography,patients with newly suspected coronary heart disease were divided into case(n=107)and control(n=41)*** carotid ultrasound parameters,including vascular stiffness(β),elastic coefficient(EP),pulse wave conduction velocity(PWV-β),CIMT,and EAT were compared between the case and control groups and among patients with different lesion numbers in the case *** correlation was used to evaluate the early diagnostic value of EAT,common carotid artery elasticity,and CIMT for coronary heart *** EP,β,PWV-β,CIMT,and EAT were significantly higher in the case group compared with the levels in the control group(all P<0.001).In the case group,lesions were detected in one vessel in 34 patients,two vessels in 38 patients,and three vessels in 35 *** the case group,β,EP,PWV-β,CIMT,and EAT levels significantly increased with an increased number of lesions(all P<0.001).EAT positively correlated withβ,EP,PWV-β,and CIMT(all P<0.01).The area under the curve for diagnosing coronary heart disease using EAT combined with CIMT and carotid elasticity was 0.893,and the sensitivity and specificity were 0.890 and *** EAT correlated well with changes in carotid artery elasticity and CIMT in patients with coronary heart *** combination of EAT,carotid artery elasticity,and CIMT facilitates the early diagnosis of coronary heart disease.

关键词： Carotid artery Ultrasound Epicardial adipose layer thickness Coronary heart disease Early diagnosis

Renal Transplant Artery Stenosis: Clinical Manifestations, Diagnosis and Treatment

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Open Journal of Nephrology 2024年第2期14卷 262-274页

作者： Rihab Dkhissi Latifa Driouch Naima Ouzeddoun Loubna Benamar Tarik Bouattar department of Nephrology-Dialysis-Renal Transplantation IbnSina Hospital Mohammed V University Rabat Morocco

Introduction: Renal transplant artery stenosis (RTAS) is a common and early complication of renal transplantation, which can lead to severe post-transplant hypertension, as well as significant morbidity and mortality, particulary graft loss. The aim of this study is to determine the prevalence, clinico-radiological characteristics and evaluate the outcomes of luminal angioplasty as a first-line treatment for RTAS, through the analysis of medical records of 27 kidney transplant patients. Material and Methods: This is a retrospective, single-center, and descriptive study conducted at the Nephrology department of the Ibn-Sina hospital in Rabat, including 27 renal transplant patients with RTAS during the period from 1998 to 2023. All patients with clinically suspected RTAS and confirmed by Doppler ultrasound of the transplanted renal artery were included in the study. Results: The mean age of donors was 48.66 ± 13.55 years, with a female predominance (65%). The donor was deceased in 15% of cases. The mean age of the recipients was 39 ± 16 years with a male-to-female ratio of 4.4. The median onset of RTAS was 3.6 ± 3.4 months after renal transplantation. Seven patients (26%) had high blood pressure (HBP) before their transplantation. Six patients (22%) had hypertriglyceridemia and 7 patients (26%) had pure hypercholesterolemia. The main clinical signs were worsening of preexisting HBP, de novo HBP and acute renal failure (ARF). Stenosis was confirmed by renal Doppler ultrasound in all patients. It was severe in 63%, with a stenosis degree greater than 70%. Six patients underwent angioplasty, resulting in the stabilization of graft function with a nadir of 15 mg/l creatinine and blood pressure control with dual therapy in 5 patients. No graft loss cases were noted. Conclusion: RTAS is a significant vascular complication of renal transplantation that predicts unfavorable outcomes for both the patient and the graft. Early diagnosis is crucial to successfully restore graft f

关键词： RTAS Post Transplant Hypertension Graft Function Luminal Angioplasty

Association between Low Ambient Temperature and the Severity of Acute Ischemic Stroke

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Journal of Clinical and Nursing Research 2024年第5期8卷 83-94页

作者： Xinyi Huang Liming Shu Su Xiao Qiuhong Jiang Shiliang Yang Hualiang Liang Hua Hong Liang Luo department of Critical Care Medicine The Seventh Affiliated Hospital of Sun Yat-sen UniversityShenzhen 518107GuangdongChina department of Neurology The Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510260GuangdongChina The Second Xiangya hospital of Central South University Changsha 410011HunanChina department of Neurology National Key Clinical Department and Key Discipline of NeurologyThe First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080GuangdongChina department of General Practice Shenshan Central HospitalSun Yat-Sen Memorial HospitalSun Yat-Sen UniversityShanweiChina 516600GuangdongChina School of Public Health Sun Yat-sen UniversityGuangzhou 510080GuangdongChina

Objective:To explore the relationships among ambient temperature,ischemic stroke severity,and blood ***:Meteorological data(2005–2015)were collected from the Guangzhou Meteorological Data *** stroke patients from the department of Neurology of the First Affiliated hospital,Sun Yat-sen University were retrospectively evaluated,each winter from 2005 to *** demographics,baseline measurements,and National Institute of Health Stroke Scale(NIHSS)score were ***:Three hundred sixty-two patients were *** median latency from symptom onset to admission was 2 d(IQR:1–3 d).During recruitment,the highest and lowest temperatures were 39℃and 1.3℃,*** was the most common comorbidity(75.1%).NIHSS scores at admission and discharge were higher in the cold-exposed group than in the controls regardless of the average temperature at *** addition,systolic and diastolic blood pressure values at admission were higher in the cold-exposed group than in the *** stratified by hypertensive status,the average and minimum temperatures at admission were negatively associated with systolic and diastolic blood pressure values in hypertensive *** in the average and minimum temperatures at symptom onset were associated with more severe ***:Ischemic stroke patients with symptom onset in winter had higher systolic blood pressure values and more serious neurologic deficits upon admission.

关键词： Low ambient temperature Stroke Blood pressure Severity

Velamentous Cord Insertion: Interest of Antenatal Diagnosis and Review of the Literature

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 234-239页

作者： Karam Harou Aboubacar Sidiki Sidibe Hicham Abdelkhalki Abderaouf Soummani department of Obstetrics and Gynecology Caddi Ayyad University Medical Hospital Med VI Marrakech Morocco

Velamentous insertion of the umbilical cord corresponds to the insertion of the cord directly on amniotic membranes. It is a rare situation whose frequency varies from 0.5% to 1.69% of single pregnancies. It must be diagnosed during the morphological ultrasound of the 2nd trimester, actively looking for the association with a vasa previa, due to the risk of fetal haemorrhagic threat. We report an antenatal diagnosis of velamentous cord insertion and its management with literature review.

关键词： Velamentous Cord Insertion Vasa Previa Antenatal Diagnosis Ultrasound Doppler Benckiser’s Hemorrhage

Mimicking aneurysm in a patient with chronic occlusion of the left middle cerebral artery:A case report

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World Journal of Clinical Cases 2024年第22期12卷 5145-5150页

作者： Sen Yang Rong-Kang Mai department of Neurosurgery The Second Affiliated Hospital of Shenzhen UniversityShenzhen 518000Guangdong ProvinceChina

BACKGROUND With the popularization of various cerebrovascular imaging methods and increased attention to the field,more cerebrovascular diseases are being detected in asymptomatic *** cerebrovascular diseases are typically isolated but occasionally occur simultaneously,causing difficulties in diagnosis and *** changes in the collateral circulation of blood vessels in chronic cerebral artery occlusion patients are slow and dynamic,intercepting morphological development at a specific *** reliance on single imaging tests such as digital subtraction cerebral angiography(DSA)can lead to *** SUMMARY We report a 52-year-old male who was admitted to our department for treatment of an unruptured aneurysm during a follow-up examination for brain trauma after 1 *** tomography(CT)scan was negative,but CT angiography(CTA)revealed a sac-like bulge at the bifurcation of the left middle cerebral *** revealed an unruptured aneurysm with unique scapular *** stump of a middle cerebral artery occlusion was observed during exposure during aneurysm clipping surgery,and the diagnosis of chronic cerebral artery occlusion was confirmed *** case was confusing because of the peculiar morphology of the arterial stump and compensatory angiogenesis due to multiple cerebral artery stenoses observed on preoperative CTA and *** surgery did not cause secondary damage to the patient,and medical treatment for risk factors was continued *** Multiple cerebral arterial stenoses can occur in conjunction with aneurysms or arteriovenous malformations,and their unique morphology can lead to misdiagnosis.

关键词： Chronic occlusion Misdiagnosis Aneurysm Collateral circulation Case report

Diagnostic Value of the Padua Score Combined with Thrombotic Biomarker Tissue Plasminogen Activator Inhibitor-1 (tPAI-1) Detection for the Risk of Deep Vein Thrombosis in Patients with Pulmonary Heart Disease

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Journal of Clinical and Nursing Research 2024年第8期8卷 137-144页

作者： Xiaoyun Zhang Xinlong Xi Wenming Bian Qiang Liu department of Cardiovascular Medicine People’s Hospital of PengzhouPengzhou 611930Sichuan ProvinceChina

This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart *** patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential *** Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable *** data from hospitalized patients with cor pulmonale were retrospectively *** curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT *** showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT *** Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of *** combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT *** combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect *** study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by *** research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.

关键词： Padua prediction score Tissue plasminogen activator inhibitor-1(tPAI-1)detection Deep vein thrombosis(DVT) Pulmonary heart disease(cor pulmonale) Diagnostic accuracy

Study on the Construction and Evaluation System of Clinical Midwifery Teaching Faculty under the New Nursing Model

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Journal of Clinical and Nursing Research 2024年第7期8卷 35-41页

作者： Ying Zhou Xiwei Zhang Lijun Song Yingying Xiao Hua Zhang department of Obstetrics and Gynecology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Objective:To explore the impact of the construction of a clinical midwifery teaching faculty and the development of an evaluation system under the new nursing model on the current teaching ***:From July 2022 to March 2023,10 clinical teaching teachers and 20 midwifery interns from Beijing Anzhen hospital affiliated with Capital Medical University were selected as the subjects of this *** clinical teaching teachers and midwifery interns were divided into an observation group and a control group,with each group including 5 clinical teaching teachers and 10 midwifery *** observation group received daily management and evaluation under the new nursing model,while the control group received management and evaluation under the traditional nursing *** teaching quality evaluation of clinical midwifery teaching teachers by midwifery interns,the exit exam scores of midwifery interns,and the scores of clinical teaching teachers’internship lectures and teaching rounds were compared between the two ***:In the observation group,the scores for teaching attitude,teaching skills,and teaching management in the teaching quality evaluation of clinical midwifery teaching teachers were higher than those in the control *** professional theory scores(91.28±3.64)and overall nursing comprehensive scores(92.56±4.38)of midwifery interns in the observation group were higher than those of midwifery interns in the control group(81.58±2.27 and 80.29±3.33,respectively).The scores for internship lectures(89.32±4.15)and teaching rounds(90.64±5.52)in the observation group were also significantly higher than those in the control group(80.46±3.28 and 81.24±4.38,respectively),and the differences were statistically significant(P<0.05).Conclusion:The management of the clinical midwifery teaching faculty under the new nursing model effectively improved the quality of clinical *** significantly enhanced the teaching effectiveness of clinical teaching t

关键词： Clinical teaching Teaching faculty New nursing model Evaluation system