Herpes zoster ophthalmicus(HZO)is caused by the involvement of the ophthalmic division trigeminal nerve after reactivation of varicella-zoster virus(VZV)latent in the trigeminal ganglia, which usually occurs in the elderly and people with low immune function. The clinical manifestations of HZO are complex and diverse, which show not only keratoconjunctivitis and uveitis, but also retinal necrosis, optic neuropathy, and rare central nervous system lesions. Some cases do not have typical skin lesions, which can easily lead to missed diagnosis, misdiagnosis, and mistreatment, seriously affecting People's life quality. This article aimed to evaluate the clinical manifestations of HZO cases reported in the literature in recent years and comprehensively understand their diversity and complexity to better diagnose and treat the disease. This study also aimed to improve the diagnosis and cure rates of the disease, reduce the maximum number of visual damage, and provide more evidence for the precise diagnosis and treatment of HZO.

Objective To explore the dyad coping experience of stress in pregnant women with undifferentiated connective tissue disease and their spouses,providing a basis for developing dyadic coping intervention measures.Methods By purposive sampling,15 pairs of pregnant women and their spouses who visited the outpatient clinic for pregnancy complicated with immune diseases in a matemity hospital in Jiangsu Province from April to August 2023 were selected as the research subjects for semi-structured interviews.Content analysis was conducted using the Colaizzi 7-step method,and an interview outline and integrated themes were developed based on the Developmental Contextual Coping Model.Results 3 themes(coexistence of positive and negative stress experiences;diverse approaches to dyadic coping with stress;growth and challenges following stress adaptation)and 11 subthemes were identified.Conclusion Healthcare professionals should attach importance to the stress coping issues of pregnant women with undifferentiated connective tissue disease and their spouses,take measures to regulate the negative emotions of couples,ensure multi-faceted support,help the couple adopt positive coping strategies,and promote good stress adaptation.

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

The most common subtype of lung cancer is non-small cell lung cancer (NSCLC), which has a poor prognosis and seriously threatens the health of human beings. The multidisciplinary comprehensive treatment model has gradually become the mainstream of NSCLC treatment. Traditional Chinese medicine (TCM) can be used effectively either as an adjunctive therapy or alone throughout the NSCLC therapy, which has a significant impact on survival, quality of life, and reduction of toxicity. Therefore, this paper reviewed the theoretical basis, the latest clinical application, and combined treatment mechanisms in order to explore the advantage stage of TCM treatment and the synergistic therapeutic mechanisms.

Glioblastoma (GBM), characterized by rapid progression, easy recurrence and treatment resistance, is the most aggressive and lethal tumor of the central nervous system. Adenovirus E1A binding protein p300 (p300) serves rich functions as transcriptional coactivator and lysine acetyltransferase. Studies have shown that p300 plays an important role in the occurrence, proliferation, invasion and resistance to chemoradiotherapy of GBM. This paper reviews the structure and function of p300, and systematically expounds its various ways participating in GBM development and its translational perspectives, so as to provide references for GBM study.

OBJECTIVE To explore the anti-respiratory syncytial virus(RSV) pharmacodynamic material basis of Scutellaria Baicalensis. METHODS Network pharmacology method was used to analyze the anti-RSV targets of Scutellaria baicalensis. UPLC-QTOF-MS/MS was used to characterize the consensus components in Scutellaria Baicalensis. A mouse model of RSV pneumonia was established, and the changes of mouse body weight, lung index, lung pathological sections and IL-6 were detected. The gray correlation method was used to analyze the spectrum-effect data of 50 batches of Scutellaria baicalensis samples, and the effective components of Scutellaria baicalensis against RSV pneumonia mice were mined. RESULTS The protein-protein interaction network results determined that the core targets of Scutellaria baicalensis against RSV were AKT1, IL-6, TNF, MAPK3, SRC, HSP90AA1 and PTGS2; overall animal experiment proved that lung index of Scutellaria baicalensis decreased to varying degrees, and the inflammatory factor IL-6 had significant differences; grey correlation analysis showed that the anti-RSV chemical components in Scutellaria baicalensis were mainly flavonoid glycosides.CONCLUSION Using the network pharmacology method to determine the pharmacodynamic target, the gray correlation degree analysis component-target data, the method of mining the pharmacodynamic material basis is feasible, baicalin, wogonin, chrysin-6-C-arabinose-8-C-flavonoid glycoside, chrysin-6-C-arabinose-8-C-arabinoside and chrysin-7-O-glucuronide can be used as Q-Markers of Scutellaria baicalensis for quality evaluation.

Patients with non-small cell lung cancer (NSCLC) are treated in a variety of ways. In addition to radiotherapy, chemotherapy and targeted therapy, breakthroughs have been made in immune checkpoint inhibitors, in particular, programmed cell death 1 (PD-1) and its ligand (PD-L1) inhibitors have achieved survival benefits for NSCLC patients, and some of them have been approved as first-line drugs by the US Food and Drug Administration. Currently, commonly used PD-L1 inhibitors are atezolizumab, durvalumab and avelumab. Combination therapies include combination with chemotherapy, anti-vascular endothelial growth factor drugs, molecular targeted therapy and immunotherapy.

Objective:To identify the risk factors for decrease in regional cerebral oxygen saturation (rScO 2) during one-lung ventilation (OLV) in the patients undergoing thoracic surgery. Methods:A total of 175 patients of both sexes, aged ≥55 yr, with expected operation time≥2 h, scheduled for elective thoracic surgery with OLV, were selected in the Fourth Hospital of Hebei Medical University from August 2017 to September 2018.The rScO 2 was continuously monitored from the beginning of anesthesia induction until removal of tracheal intubation.General anesthesia, general anesthesia combined with epidural block or general anesthesia combined with local nerve block were used.The baseline characteristics, previous medical history and history of anesthesia surgery, type of surgery, method of anesthesia, duration of anesthesia, duration of OLV, duration of surgery, and intraoperative adverse events (hypoxemia, hypotension, bradycardia, etc.) were recorded.According to whether a decrease in rScO 2 occurred during OLV (absolute value of rScO 2 was less than 65% or a decrease of more than 20% of the baseline value), the patients were divided into 2 groups: low rScO 2 group and normal rScO 2 group.Multivariate logistic regression analysis was used to identify the risk factors for decrease in rScO 2 during OLV. Results:One hundred and seven patients developed decrease in rScO 2 during OLV, with an incidence of 61.1%.The results of logistic regression analysis showed that hypoxemia was an independent risk factor for decrease in rScO 2, and general anesthesia combined with epidural block was a protective factor for decrease in rScO 2 during OLV. Conclusion:Hypoxemia is an independent risk factor for decrease in rScO 2 during OLV, while general anesthesia combined with epidural block is a protective factor for decrease in rScO 2 in the patients undergoing thoracic surgery.

Objective To systematically evaluate the effect of early mobilization on the physical function of patients in intensive care unit (ICU). Methods The randomized controlled trials (RCT) about early intervention in ICU patients were retrieved from the Cochrane Library, PubMed, Wed of Science, Medline, CBM, CNKI, VIP, and Wanfang database, all of which were published literatures from the establishment to October 2018. Early activities were carried out in the intervention group, while only routine nursing was carried out in the control group. Outcome measures included the medical research council score (MRC-Score), physical function ICU test (PFIT), independent walking ability, score of quality of life health survey short form (SF-36), incidence of ICU-acquired weakness (ICU-AW) and hospital mortality. Two researchers independently screened the literature, evaluated the quality of the literature and extracted the data. After literature selection, literature quality evaluation and date extraction was performed, and RevMan 5.3 software was used for Meta-analysis. The publication bias was analyzed by funnel plot. Results A total of 13 literatures were included, 10 in English and 3 in Chinese; of the 1 347 patients, 695 in intervention group and 652 in control group. Compared with the control group, the MRC-Score was increased in intervention group [mean difference (MD) = 4.74, 95% confidence interval (95%CI) = 2.30-7.19, P = 0.000 1], independent walking ability was improved [odds ratio (OR) = 2.04, 95%CI =1.39-2.99, P = 0.000 3], the incidence of ICU-AW was decreased (OR = 0.22, 95%CI = 0.14-0.35, P < 0.000 01), and there was no significant difference in PFIT (MD = -0.19, 95%CI = -0.69-0.31, P = 0.46), physical health (PCS) after 6 months (MD = -1.39, 95%CI = -4.18-1.39, P = 0.33) and inpatient mortality (OR = 0.77, 95%CI = 0.53-1.12, P = 0.17) between two groups. It was shown by funnel plot that the publication bias of each literature was relatively small in terms of MRC-Score, PFIT, independent walking ability and SF-36. Conclusion Early mobilization are beneficial for the physical function recovery of ICU patients, which can improve the muscle strength, improve the ability of patients to walk independently, reduce the occurrence of ICU-AW, and do not increase the mortality rate in hospital.

OBJECTIVETo investigate the changes of thrombospondin 1(TSP1) level and von Willebrand factor cleaving protease(ADAMTS13) activity in the patients with hematologic malignancies before and after treatment and to evaluate their clinical significance.

METHODSEighty-two patients with hematologic malignancies were enrolled in this study, among them 20 patients were with acute leukemia, 48 patients were with lymphoma and 14 patients were with multiple myeloma. The plasma samples of 82 patients with hematologic malignancies and 45 healthy controls were collected. The activities of ADAMTS13 were evaluated by residue collagen binding assay(R-CBA), the levels of TSP1 and vWF antigen were measured by enzyme-linked immunosorbent assay(ELISA).

RESULTSThe activity of plasma ADAMTS13 in patients with hematologic malignancies was lower than that of normal controls(P<0.05). The levels of vWF antigen and TSP1 in the patients with hematologic malignancies were higher than those in normal controls(P<0.05). After standard induction chemotherapy, the ADAMTS13 activity of the patients with hematologic malignancies at the complete remission was higher than that before therapy(P<0.05); the vWF antigen level was significantly lower than that in the patients with hematologic malignancies before therapy(P<0.05), but still higher than that in controls(P<0.05). There were 25 infection patients in 82 cases of hematologic malignancies, and the ADAMTS13 activity in the patients with newly diagnosed hematologic malignancies complicated with infection before therapy was obviously lower than that in the patients with hematologic malignancies without infection(P<0.05), the levels of vWF antigen and TSP1 were significantly lower than that in patients without infection (P<0.05). In the process of treatment, 8 patients have been speculated to suffer from thrombus, and the ADAMTS13 activity in the patients with thrombus was obviously lower than that in the patients without thrombus(P<0.05).

CONCLUSIONLow ADAMTS13 activity and high TSP1 level may participate in the progress of hematologic malignancies, the infection and thrombotic events may lead to further reduction of the ADAMTS13 activity. Assaying the level of ADAMTS13 activity in the patients with malignant tumor may be helpful to prevent the infection and thrombosis in the patients with hematologic malignancies.