Objective: To construct an evaluation index system of cervical cancer prevention and control literacy, so as to provide an assessment tool for cervical cancer prevention and control literacy. Methods: The preliminary framework for cervical cancer prevention and control literacy was designed based on literature review. Twenty-one experts with both theoretical and practical experience in cervical cancer prevention and control were invited to participate in two rounds of Delphi consultation. The weights of indicators were determined by the percentage weighting method and product method, and the response rate, authority level, opinion concentration degree, and coordination degree of experts were evaluated. Results: Twenty-one experts participated in the consultation, including 3 males and 18 females. There were 11 experts with a doctor's degree, 7 with a master's degree and 3 with a bachelor's degree. All of them had senior professional titles and had more than 10 years of working experience. The recovery rates of the two rounds of consultations were 100.00% and 95.24%, the authority coefficients were 0.963 and 0.948, and Kendall's coefficients of concordance were 0.175 and 0.148 (both P<0.05), respectively. The final cervical cancer prevention and control literacy evaluation index system included 3 primary indicators (basic knowledge and concepts: 0.334; healthy lifestyle and behaviors: 0.338; basic skills: 0.328), 12 secondary indicators, with "capability to accurately acquire, comprehend, evaluate and apply health information" having the highest weight (0.166), and 51 tertiary indicators, with "HPV vaccination" (0.086), "consulting on relevant issues" (0.082), and "expressing personal perspectives" (0.080) having relatively higher weights. Conclusion The evaluation index system of cervical cancer prevention and control literacy serves as a valid assessment tool for women of appropriate age, providing the reference for developing targeted health education to enhance cervical cancer prevention and control literacy.

Cardiac arrest (CA) is a critical condition in the field of cardiovascular medicine. Despite successful resuscitation, patients continue to have a high mortality rate, largely due to post CA syndrome (PCAS). However, the injury and pathophysiological mechanisms underlying PCAS remain unclear. Experimental animal models are valuable tools for exploring the etiology, pathogenesis, and potential interventions for CA and PCAS. Current CA animal models include electrical induction of ventricular fibrillation (VF), myocardial infarction, high potassium, asphyxia, and hemorrhagic shock. Although these models do not fully replicate the complexity of clinical CA, the mechanistic insights they provide remain highly relevant, including post-CA brain injury (PCABI), post-CA myocardial dysfunction (PAMD), systemic ischaemia/reperfusion injury (IRI), and the persistent precipitating pathology. Summarizing the methods of establishing CA models, the challenges encountered in the modeling process, and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.
Animals ; Disease Models, Animal ; Post-Cardiac Arrest Syndrome/physiopathology* ; Heart Arrest/physiopathology* ; Humans ; Ventricular Fibrillation/complications*

Objective:To investigate the effect of early protein supplementation on the clinical outcomes of elderly ICU patients with critically ill.Methods:The study was a post-hoc analysis of a multicenter, cluster randomized controlled trial (NEED trial), which aimed to evaluate the impact of feeding protocol on nutritional implementation and outcomes in ICU patients. It was planned to include elderly patients aged ≥70 years from the NEED trial, and patients who had not started nutritional therapy by the Day 3 after enrolment, stayed in the ICU less than 7 days, missing the primary outcome were excluded. The primary outcome of this study was 28-day mortality of enrolment. Patients were categorized into Q1 (<0.6 g/kg/d), Q2 (0.6-0.83 g/kg/d), and Q3 (≥0.83 g/kg/d) groups according to the tertiles of protein supply. The log-rank test was used to compare the Kaplan-Meier survival curves for 28-day mortality. The associations between different protein groups and 28-day mortality were tested by Cox proportional hazards regression models. Subgroup analysis was conducted in patients with high (mNUTRIC score≥5) nutritional risk or patients with baseline acute kidney injury.Results:A total of 789 elderly (≥70 years) patients was included in the study, with a mean protein amount of 0.69 (0.53, 0.91) g/(kg·d) during days 3-7 after ICU admission, and mean protein amounts in the Q1 low-protein group, the Q2 medium-protein group, and the Q3 high-protein group were 0.46 (0.36, 0.53), 0.69 (0.63, 0.76), and 1.03 (0.91, 1.23) g/(kg·d), respectively. The results showed that the medium protein group associated with lower 28-day mortality compared to the high protein group, and the association between the medium protein group and lower 28-day mortality still held after controlling for possible confounders by Cox multivariate regression analysis. In the high-nutritional risk subgroup (mNUTRIC≥5), a significant association was also found between the medium protein group and lower 28-day mortality.Conclusions:Early high protein supply are not beneficial for elderly ICU patients by this large sample size post-hoc analysis, and medium protein supply associate with lower 28-day mortality compared with the high protein group. This study may provide a theoretical basis for the optimal dose of early protein supply in elderly ICU patients, as well as a reference for clinical implementation.

Exogenous lipoid pneumonia is an inflammatory response to the lungs caused by inhaled lipid substances, which is prone to secondary bacterial infection, resulting in the formation of local abscesses, which can be life-threatening in severe cases. This paper reports a case of a 55-year-old patient with diesel aspiration, secondary to Klebsiella pneumoniae (ESBL positive) and Candida glabrata infection resulting in lung abscess formation. He was treated with a variety of antibacterial drugs for anti-infection, non-invasive ventilator ventilation, bronchoalveolar lavage, glucocorticoids, phlegm and other medical treatments. Finally, he underwent middle lobectomy for improvement and was discharged from the hospital, and he recovered well with regular follow-up.

Exogenous lipoid pneumonia is an inflammatory response to the lungs caused by inhaled lipid substances, which is prone to secondary bacterial infection, resulting in the formation of local abscesses, which can be life-threatening in severe cases. This paper reports a case of a 55-year-old patient with diesel aspiration, secondary to Klebsiella pneumoniae (ESBL positive) and Candida glabrata infection resulting in lung abscess formation. He was treated with a variety of antibacterial drugs for anti-infection, non-invasive ventilator ventilation, bronchoalveolar lavage, glucocorticoids, phlegm and other medical treatments. Finally, he underwent middle lobectomy for improvement and was discharged from the hospital, and he recovered well with regular follow-up.

Objective:To evaluate the efficacy and safety of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) for rectal cancer with lateral lymph node metastasis (LLNM).Methods:From January 2016 to December 2022, 103 rectal cancer patients with LLNM were enrolled. The patients were divided into SIB-IMRT group (52 cases) and conventional chemoradiotherapy (CRT) group (51 cases) using the random number table method. The dose was 50 Gy for the pelvis with 60 Gy of SIB-IMRT for the LLNM in the SIB-IMRT group. The dose was 50 Gy for the pelvis in the CRT group. The primary endpoint was the lateral recurrence rate. The efficacy and adverse reactions of the two groups were compared.Results:The adverse reactions and surgical complications after neoadjuvant radiotherapy were comparable between the two groups. The response rates of LLNM treatment were 76.9% and 56.9%, respectively, in the two groups ( χ2=4.69, P=0.03). The SIB-IMRT group and CRT group had a local recurrence rate of 7.7% and 25.5% ( χ2=5.92, P=0.015), respectively, and a lateral recurrence rate of 3.8% and 23.5% ( χ2=8.49, P=0.004), respectively. Univariate analysis showed that the SIB-IMRT, short axis of lateral lymph nodes <5 mm after radiotherapy, and negative result in the postoperative lymph node pathological examination were factors associated with lateral recurrence. Multivariable regression analysis demonstrated that the SIB-IMRT ( HR=6.42, 95% CI: 1.40-29.49) and short axis of lateral lymph nodes <5 mm after radiotherapy ( HR=0.17, 95% CI: 0.04-0.66) were independent factors associated with lateral recurrence. The two groups had a 3-year disease-free survival of 73.25% and 62.6% ( P>0.05), respectively, and a 3-year overall survival of 87% and 82.5% ( P>0.05), respectively. Conclusions:The SIB-IMRT is safe and effective for rectal cancer with LLNM. The short axis of lateral lymph nodes <5 mm after neoadjuvant radiotherapy and SIB-IMRT is an independent risk factor for lateral recurrence.

Objective:To analyze the difference of maternal and neonatal outcomes for the living infant of surgically and spontaneously reduced dichorionic pregnancies following assisted reproductive technology (ART).Methods:We used a retrospective cohort study to analyze the clinical data of 11 050 fresh/frozen-thawed double embryos transfer with singleton live birth cycles in the Center for Reproductive Medicine of Jiangxi Maternal and Child Health Hospital from March 2014 to October 2021, including 226 cases in the surgical reduction group, 1 506 cases in the spontaneous reduction group, and 9 318 cases of singleton pregnancy in control group. The basic clinical data, maternal and fetal complications and birth outcomes of the three groups were compared by univariate analysis. Multivariate logistic regression was used to analyze the factors affecting maternal and infant outcomes.Results:The rate of premature rupture of membranes in the natural fetal reduction group, the surgical reduction group and control group was 1.4% (21/1 506), 1.3% (3/226) and 0.6% (56/9 318), respectively, with a significant difference among the three groups ( P=0.003). The differences of the risk of preterm birth, very premature birth, low birth weight, very low birth weight, and small for gestational age among the surgical fetal reduction group [17.3% (39/226), 4.0% (9/226), 15.5% (35/226), 3.1% (7/226), 9.3% (21/226)], the natural fetal reduction group [11.6% (175/1 506), 1.9% (28/1 506), 8.6% (129/1 506), 1.3% (20/1 506), 9.1% (137/1 506)] and control group [7.7% (721/9 318), 0.9% (86/9 318), 3.9% (367/9 318), 0.5% (45/9 318), 6.0% (560/9 318)] were statistically significant (all P<0.001). Compared with the spontaneous reduction group, the surgical reduction group had a higher risk of premature birth [(a OR=2.37, 95% CI: 1.64-3.42, P<0.001) vs. (a OR=1.54, 95% CI: 1.29-1.84, P<0.001)], very preterm birth [(a OR=4.26, 95% CI: 2.02-8.97, P=0.001) vs. (a OR=1.95, 95% CI: 1.26-3.01, P=0.003)], low birth weight [(a OR=4.35, 95% CI: 2.94-6.44, P<0.001) vs. (a OR=2.26, 95% CI: 1.83-2.79, P<0.001)] and small-for-gestational age[(a OR=1.82, 95% CI: 1.14-2.92, P=0.013) vs. (a OR=1.60, 95% CI: 1.31-1.95, P<0.001)]. There was no statistical difference in birth defect rate among the three groups ( P>0.05). Conclusion:The risk of maternal and fetal complications and birth defects for the living singletons of surgically and spontaneously reduced dichorionic diamniotic pregnancies were similar to those singleton pregnancies following ART, but the proportion of premature rupture of membranes is higher, and the risk of premature birth and low birth weight of surgical reduction were higher than that of spontaneous reduction. Surgical reduction is not recommended to use as a rescue measure of dichorionic twins conceived by ART.

Objective:To analyze the difference of maternal and neonatal outcomes for the living infant of surgically and spontaneously reduced dichorionic pregnancies following assisted reproductive technology (ART).Methods:We used a retrospective cohort study to analyze the clinical data of 11 050 fresh/frozen-thawed double embryos transfer with singleton live birth cycles in the Center for Reproductive Medicine of Jiangxi Maternal and Child Health Hospital from March 2014 to October 2021, including 226 cases in the surgical reduction group, 1 506 cases in the spontaneous reduction group, and 9 318 cases of singleton pregnancy in control group. The basic clinical data, maternal and fetal complications and birth outcomes of the three groups were compared by univariate analysis. Multivariate logistic regression was used to analyze the factors affecting maternal and infant outcomes.Results:The rate of premature rupture of membranes in the natural fetal reduction group, the surgical reduction group and control group was 1.4% (21/1 506), 1.3% (3/226) and 0.6% (56/9 318), respectively, with a significant difference among the three groups ( P=0.003). The differences of the risk of preterm birth, very premature birth, low birth weight, very low birth weight, and small for gestational age among the surgical fetal reduction group [17.3% (39/226), 4.0% (9/226), 15.5% (35/226), 3.1% (7/226), 9.3% (21/226)], the natural fetal reduction group [11.6% (175/1 506), 1.9% (28/1 506), 8.6% (129/1 506), 1.3% (20/1 506), 9.1% (137/1 506)] and control group [7.7% (721/9 318), 0.9% (86/9 318), 3.9% (367/9 318), 0.5% (45/9 318), 6.0% (560/9 318)] were statistically significant (all P<0.001). Compared with the spontaneous reduction group, the surgical reduction group had a higher risk of premature birth [(a OR=2.37, 95% CI: 1.64-3.42, P<0.001) vs. (a OR=1.54, 95% CI: 1.29-1.84, P<0.001)], very preterm birth [(a OR=4.26, 95% CI: 2.02-8.97, P=0.001) vs. (a OR=1.95, 95% CI: 1.26-3.01, P=0.003)], low birth weight [(a OR=4.35, 95% CI: 2.94-6.44, P<0.001) vs. (a OR=2.26, 95% CI: 1.83-2.79, P<0.001)] and small-for-gestational age[(a OR=1.82, 95% CI: 1.14-2.92, P=0.013) vs. (a OR=1.60, 95% CI: 1.31-1.95, P<0.001)]. There was no statistical difference in birth defect rate among the three groups ( P>0.05). Conclusion:The risk of maternal and fetal complications and birth defects for the living singletons of surgically and spontaneously reduced dichorionic diamniotic pregnancies were similar to those singleton pregnancies following ART, but the proportion of premature rupture of membranes is higher, and the risk of premature birth and low birth weight of surgical reduction were higher than that of spontaneous reduction. Surgical reduction is not recommended to use as a rescue measure of dichorionic twins conceived by ART.

Objective : To analyze the risk factors for endophthalmitis requiring evisceration or enucleation. Methods : The charts of 121 eyes of 121 inpatients with endophthalmitis were retrospectively reviewed , and the group that required evisceration or enucleation (24 patients) with those that received salvaging therapies (97 patients) were compared. Age , sex , medication history , past medical history , clinical manifestation , Leukocyte counts and treatment progression were retrospectively analyzed. Results : Twenty four eyes( 19. 8% )underwent enucleation or evisceration. The proportion of corneal ulcerative endophthalmitis ( 33. 3% ) and endogenous endophthalmitis (25. 0% ) in evisceration or enucleation group was greater than that in the salvaging group ( 1. 0% , 4. 1% ) (P < 0. 001) . The group of eviscerated or enucleated eyes was older (P < 0. 05] , had poorer initial visual acuity [(2. 9 ± 0. 2) LogMAR vs (2. 3 ± 0. 5) LogMAR , P < 0. 001] , had longer duration before intervention ( 15. 8 d vs 4. 6 d , P < 0. 05) , and had more Leukocyte counts [( 12. 8 ± 5. 6) × 109/L vs (9. 1 ± 3. 3) × 109/L , P < 0. 005 ] . With Logistic regression analysis , corneal ulcer, endogenous endophthalmitis , initial vision , leukocyte counts , duration before intervention were the risk factor for evisceration or enucleation ( OR = 343. 283 , OR = 22. 608 , OR = 1 920. 384 , OR = 1. 341 , OR = 1. 167 ) . Conclusion The most common cause of evisceration or enucleation caused by infectious endophthalmitis are infections from corneal ulcer and from endogenous source. The risk factors for endophthalmitis requiring evisceration or enucleation would be considered to be corneal ulcer endophthalmitis , endogenous endophthalmitis , initial vision , leukocyte counts , and duration before intervention.

Essential tremor (ET) is a common movement disorder. It is characterized by a distinctive 4-12 Hz action tremor typically affecting bilateral upper limbs. Existing drugs for ET mainly include β-blockers, anticonvulsants, benzodiazepines, etc. However, the efficacy of existing drugs is limited. With the development of the medical research, some progress has been made in the treatment of ET. The review will explore the recent advances in the treatment of ET,such as new drugs, surgical treatment, repetitive transcranial magnetic stimulation, rehabilitation treatment, etc., in order to provide clinical application prospects.