Objective To evaluate the effect of virtual reality(VR)on cognitive function and quality of life in patients with Parkin-son's disease. Methods A systematic search of CBM,CNKI,Wanfang data,VIP,Cochrane Library,Web of Science,Embase,and PubMed was carried out to identify randomized control trials(RCT)about the effect of VR technology on pa-tients with Parkinson's disease from inception to February 29th,2024.The control group received routine cogni-tive training,balance training or physical therapy,and the experimental group received VR technology.The quali-ty of articles was evaluated using the Cochrane Collaboration's 5.1.0 RCT risk assessment tool for bias.The meta-analysis was performed using Revman5.4.GRADE was used to evaluate the evidence quality of outcome indica-tors. Results A total of 13 literatures involving 426 patients were included.Allocation concealment and blind methods were not described in most literatures,and selective reporting of research results or other biases was unclear.VR tech-nology could improve the Motreal Cognitive Assessment(MoCA)score(MD=1.11,95%CI 0.31 to 1.90,P=0.006),Trail Making Test(TMT)-A score(MD=-6.25,95%CI-11.71 to-0.78,P=0.030)and depression scale score(SMD=-0.56,95%CI-0.95 to 0.18,P=0.004)of patients with Parkinson's disease;however,it did not improve TMT-B score(MD=-6.01,95%CI-28.16 to 16.14,P=0.590),Unified Parkinson's Disease Rat-ing Scale(UPDRS)-Part II score(MD=-2.11,95%CI-4.97 to 0.75,P=0.150)and Parkinson's Disease Ques-tionnaire(PDQ-39)score(MD=-0.92,95%CI-4.03 to 2.19,P=0.560).For quality of evidence,MoCA score,UPDRS-Part II score and PDQ-39 score were low,and depression score and TMT score were moderate. Conclusion VR technology can improve the cognitive function and depression of patients with Parkinson's disease;how-ever,no significant improvement is found in activities of daily living and quality of life.

Objective To evaluate the types and imaging features of early and late complications after liver transplantation.Methods A retro-spective analysis was conducted on the complications imaging data from 124 patients after liver transplantation.The CT and MRI characteristics of these complications was analyzed,categorized based on their occurrence time and type.Results The postoperative complications in the total 124 patients included vascular complication in 85 patients,biliary complication in 78 patients,and parenchy-mal complication in 21 patients.Additionally,the simple and complex complications were exhibited in 43 and 81 patients.Early vas-cular complication accounted for 69.8％,especially 21 cases(91.3％)were with early hepatic artery thrombosis.Bile leakage in 9 cases occurred in the early postoperative period,whereas biliary stenosis in 43 cases and biliary stones in 23 cases were observed in the late postoperative period.All ischemic infarction in 13 cases occurred in the early postoperative period.Among the 10 cases of liver abscess,8 cases were secondary to ischemic necrosis of liver parenchyma,and other 2 cases were secondary to suppurative cholangitis.Addi-tionally,6 cases of liver tumor recurrence were all detected in the late postoperative period.Conclusion The types of complications occurring after liver transplantation vary over time,and CT and MRI can be used to detect and evaluate postoperative complications.

Objective To explore the epidemiological characteristics and cost structure of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in a tertiary comprehensive hospital in Xi'an from 2014 to 2023.Methods The first page information of AECOPD inpatients in a hospital from January 2014 to December 2023 was col-lected(n=6 748),and the distribution of their demographic characteristics and clinical characteristics as well as the composition of hospitalization expenses were retrospectively analyzed,and the structural change degree was used to analyze the structural change of hospitalization expenses in different years.Results AECOPD patients diagnosed and hospitalized accounted for 4.81 ‰ of all hospitalized patients in this institution from 2014-2023,the proportion of AECOPD inpatients showed a continuous downward trend during 10 years(x2=1 083.351,P＜0.001);The distribution of gender,occupation,medical payment meth-ods,and sources of AECOPD inpatients in different years showed statistical differences(P＜0.05);There is a statistical differ-ence in the seasonal distribution of AECOPD inpatients in different years(x2=157.328,P＜0.001);There is a statistical difference in the average length of hospital stay among AECOPD inpatients in different years(x2=83.463,P＜0.001);There were statistically significant differences in the proportion of hospitalizations,admission conditions,comorbidities or complications,history of drug allergies,and readmission plans among AECOPD patients in different years(P＜0.05);There is a statistical difference in the outcomes of hospitalized AECOPD patients in different years(x2=153.367,P＜0.001);The average hospital-ization cost of AECOPD patients gradually increased from 2014-2016,and gradually decreased from 2016-2023(P＜0.01);The hospitalization expenses of AECOPD patients in different years are mainly based on drug expenses and diagnostic expenses;The overall degree of structural change(DSV)of average hospitalization expenses for AECOPD patients from 2014-2022 was 41.62％,with the highest DSV of hospitalization expenses in 2012-2013(22.69％)and the lowest DSV in 2017-2018(4.23％);The proportion of drug expenses in the average hospitalization cost of AECOPD patients continued to decline,while diagnostic expenses,hygiene material expenses,medical service expenses,and nursing expenses showed an overall increasing trend from 2014-2023.Conclusion The proportion and mortality rate of hospitalized AECOPD patients have shown an overall downward trend in the past 10 years;The proportion of hospitalized AECOPD patients in the age group of 70-79 is the highest,mainly distributed in winter;The overall average hospitalization cost over the past 10 years has shown a downward trend,with drug and diagnostic expenses as the main components.Drug expenses have been decreasing year by year,while diagnostic expen-ses have been increasing year by year.This indicates that medical policy reform plays a significant role in optimizing the hospitali-zation cost structure and controlling unreasonable cost growth.

The research on rare diseases in China started relatively late, with scattered research resources and weak data foundation in epidemiology, diagnosis and treatment, and medication, which hinders its research progress. The rare disease data system is the foundation of rare disease research, and the ethical constraint on rare disease data collection is not only the protection of rare disease population, but also the need for the safety and quality of rare disease data. By analyzing and prospecting the current status of the construction of rare disease data systems, including the data of epidemiology, clinical diagnosis and treatment, drug trials, and follow-up to provide reference for the improvement of rare disease data systems. This paper explored the ethical issues to be followed in the process of rare disease data collection from the perspectives of justice, no harm, respect, sharing, and legalization, so as to improve the standardization of rare disease data collection and the understanding of data ethical review.

Objective:To discuss the value of pubo-femoral distance(PFD) in the diagnosis of infants with developmental dysplasia of the hip(DDH).Methods:Nine hundred and thirty-one infants with DDH and normal infants diagnosed by clinical examination and ultrasonography were involved from February 2022 to June 2023 in Beijing Jishuitan Hospital. The ultrasonographic examination included Graf method and pubo-femoral distance measurement. Statistical analysis was made on the measurements of PFD of different types of hips.Results:Among all the hips, 1 359 hips were Graf type Ⅰ, 274 hips were Graf type Ⅱa, 166 hips were Graf type Ⅱb, 31 hips were Graf type Ⅱc, 7 hips were Graf type D, 13 hips were Graf type Ⅲ, and 12 hips were Graf type Ⅳ. The PFD of these hips were (0.34±0.07)cm, (0.35±0.08)cm, (0.35±0.08)cm, (0.51±0.11)cm, (0.67±0.09)cm, (0.95±0.26)cm, (1.27±0.30)cm, respectively. There was no significant difference in PFD between hips of Graf Ⅰ, Graf Ⅱa and Graf Ⅱb ( P>0.05), but there was significant difference in PFD between hips of the other Graf types ( P<0.05). The area under curve(AUC) of the PFD for the diagnosis of stability of the hips in infants was 0.959 with the cut-off value of 0.435 cm, the sensitivity and specificity were 88.9% and 90.4%, respectively. Conclusions:The PFD has great value in the evaluation of the stability of hip joint, and the cut-off value is 0.435 cm.

Compared with traditional drug therapy, nanomedicines exhibit intriguing biological features to increase therapeutic efficiency, reduce toxicity and achieve targeting delivery. This review provides a snapshot of nanomedicines that have been currently launched or in the clinical trials, which manifests a diversified trend in carrier types, applied indications and mechanisms of action. From the perspective of indications, this article presents an overview of the applications of nanomedicines involving the prevention, diagnosis and treatment of various diseases, which include cancer, infections, blood disorders, cardiovascular diseases, immuno-associated diseases and nervous system diseases, etc. Moreover, the review provides some considerations and perspectives in the research and development of nanomedicines to facilitate their translations in clinic.

Objective:To explore the high-frequency ultrasonographic and clinical features of superficial intravascular tumors.Methods:Thirteen superficial intravascular tumor patients who underwent ultrasound examination form Beijing Jishuitan Hospital during 2016-2020 were retrospectively analyzed. The location, anatomic blood vessels, shape, size, boundary, internal echo, blood flow and clinical characteristics of the tumors were analyzed.Results:Among the 13 cases, most of the tumors were oval like or long strip, and a few were round like. All 11 cases of primary intravascular tumors showed hypoechoic mass; 2 cases of intravascular metastasis or recurrence showed solid hypoechoic with hyperechoic mass. Arterial blood flow spectrum was detected in 12 cases. Two patients with glomus tumor showed typical tenderness at the fixed point. Two patients had a history of bone tumors in the upper or lower extremities.Conclusions:High frequency ultrasound can clearly recognize the location of the superficial intravascular tumors, describe the morphological characteristics and sonographic features of the tumor, then help to make a more accurate qualitative diagnosis.

Objective:To determine the prevalence of sarcopenia and explore related influencing factors of sarcopenia in maintenance hemodialysis (MHD) patients.Methods:MHD patients aged ≥18 years old and receiving therapies of ≥3 months from March 2019 to December 2019 in Blood Purification Centre of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively enrolled in this study. General data of the patients were collected. Grip strength was measured by the Jamar dynamometer and the chair stand was measured by a chair of standard height to assess skeletal muscle strength and appendicular skeletal muscle mass was measured by dual energy X-ray absorptiometry. Baseline data between MHD patients with and without myasthenia were compared. Logistic regression analysis method was used to analyze the influencing factors for sarcopenia in MHD patients.Results:A total of 125 MHD patients were enrolled, with 68 males (54.4%), age of (59.4±14.9) years and median dialysis age of 51.0(23.5, 101.0) months. Sarcopenia was diagnosed in 39 cases (31.2%). Compared with MHD patients without sarcopenia, age, tumor necrosis factor-α, von Willebrand factor (vWF) and proportion of using α ketones were higher, and serum carbondioxide combining power (CO 2CP), prealbumin, albumin and proportion of regular exercise were lower in MHD patients with sarcopenia (all P<0.05). Multivariable logistic regression analysis results showed that low CO 2CP ( OR=0.717, 95% CI 0.576-0.892, P=0.003), high vWF ( OR=1.037, 95% CI 1.016-1.058, P<0.001) and no regular exercise ( OR=0.309, 95% CI 0.118-0.810, P=0.017) were independent influencing factors of sarcopenia in MHD patients. Conclusions:The prevalence of sarcopenia in MHD patients is high. Low CO 2CP, high vWF and no regular exercise are independent influencing factors for sarcopenia in MHD patients.

Objective:To measure the pubo-femoral distance of hips of the infants diagnosed with Graf type Ⅰ by high frequency ultrasound.Methods:A total of 1 084 infants(2 168 hips) diagnosed with Graf type Ⅰ by ultrasonography were collected in Beijing Jishuitan Hospital from June 2019 to May 2020. The ultrasonographic examinations included Graf method and pubo-femoral distance measurement. The 95% medical reference value was adopted to confirm range of normal values of the pubo-femoral distance. And the differences of the pubo-femoral distance between different gender, age and bilateral hip were compared.Results:The pubo-femoral distance of hips diagnosed with Graf type Ⅰ was (0.27±0.06)cm, the pubo-femoral distance of males was(0.27±0.06)cm, the pubo-femoral distance of females was (0.27±0.07)cm. The 95% medical reference value was 0.15-0.38 cm. The 95% medical reference value of males was 0.15-0.39 cm, and the 95% medical reference value of females was 0.13-0.41 cm. There were no significant differences between the sexes or between the age(all P>0.05). The difference between the bilateral hip joints from the same infant was statistically significant[(0.274±0.064)cm vs (0.265±0.064)cm, P<0.05]. Conclusions:The 95% medical reference value of hip diagnosed with Graf type Ⅰ is 0.15-0.38 cm.

Objective:To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in treating patients with coronavirus disease 2019 (COVID-19) in the real world.Methods:The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10, 2020 were retrospectively analyzed. According to patient′s antiviral treatment regimens, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), LPV/r plus arbidol combination group (25 patients) and the supportive care group without any antiviral treatment (58 patients). The primary end point was the negative conversion time of nucleic acid of 2019 novel coronavirus (2019-nCoV) by pharyngeal swab.Results:The baseline parameters of 4 groups before treatment was comparable. The negative conversion time of viral nucleic acid was (10.20±3.49), (10.11±4.68), (10.86±4.74), (8.44±3.51) days in LPV/r group, arbidol group, combination group, and supportive care group respectively ( F=2.556, P=0.058). There was also no significant difference in negative conversion rate of 2019-nCoV nucleic acid, the improvement of clinical symptoms, and the improvement of pulmonary infections by CT scan ( P>0.05). However, a statistically significant difference was found in the changing rates from mild/moderate to severe/critical type at day 7 (χ 2=9.311, P=0.017), which were 24%(6/25) in combination group, 16.7%(6/36) in arbidol group, 5.4%(3/56) in LPV/r group and 5.2%(3/58) in supportive care group. Moreover, the incidence of adverse reactions in three antiviral groups was significantly higher than that in supportive care group (χ 2=14.875, P=0.002). Conclusions:Antiviral treatment including LPV/r or arbidol or combination does not shorten the negative conversion time of 2019-nCoV nucleic acid nor improve clinical symptoms. Moreover, these antiviral drugs cause more adverse reactions which should be paid careful attention during the treatment.