Objective: To identify early clinical predictors associated with dysphagia and delayed swallowing recovery in patients with traumatic brain injury (TBI). Methods: In this retrospective study, we enrolled adult TBI patients admitted to the rehabilitation unit of a tertiary medical center between June 2019 and June 2023. Data on baseline characteristics, neurological status, imaging findings, and rehabilitation-related variables were collected. Swallowing function was assessed using two indicators: (1) nasogastric (NG) tube retention and (2) the Functional Oral Intake Scale (FOIS) scores at 1, 4, and 12 weeks post-injury. Regression analyses were conducted to identify predictors associated with dysphagia and swallowing recovery. Results: A total of 160 patients were included. At 1 week post-injury, longer intensive care unit (ICU) stay, poor initial sitting balance and use of sedative medication in ICU were associated with NG tube retention. At 4 weeks, lower initial Rancho Los Amigos Scale (RLAS) scores, immobility-related complications, longer hospitalization, and temporal lobe hematomas were associated with persistent NG tube dependence. By 12 weeks, older age, delayed ability to follow commands, and poor initial sitting balance remained associated with NG tube retention. FOIS outcomes were also associated with older age, delayed time to follow commands, impaired initial sitting balance, prolonged ICU stay, temporal lobe hematomas, lower initial RLAS scores, immobility-related complications, prolonged endotracheal tube placement and extended hospital stays. Conclusion Impaired cognitive status, poor physical function, immobility-related complications, and temporal lobe hematomas were key factors associated with dysphagia and delayed oral intake in individuals with TBI.

Objectives: . The prognostic value of the pretreatment albumin-to-alkaline phosphatase ratio (AAPR) in head and neck cancer (HNC) remains uncertain. This meta-analysis aimed to evaluate the predictive role of AAPR for survival outcomes in patients with HNC. Methods: . A comprehensive search of the Cochrane Library, PubMed, and Embase databases was conducted to identify relevant studies published up to July 30, 2024. We included studies on AAPR and survival outcomes in HNC patients. Results: . Eight studies comprising 1,737 HNC patients were analyzed using random-effects models. Lower AAPR values were significantly correlated with worse overall survival (hazard ratio [HR], 2.08), progression-free survival (HR, 2.00), and disease-free survival (HR, 2.18). Sensitivity analyses confirmed the robustness of these results, with no significant publication bias detected. Conclusion . Our findings suggest that pretreatment AAPR could serve as a valuable and cost-effective prognostic indicator in HNC, potentially aiding clinicians in risk stratification and treatment decision-making. However, additional validation studies are warranted to confirm its clinical applicability.

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

On August 24 2024, Xiaoshan District Center for Disease Control and Prevention, Hangzhou City, received a report of two cases of varicella infection among staff in the intensive care unit (ICU) of a hospital in its jurisdiction. The center immediately organized personnel to conduct an epidemiological investigation of the cases and their close contacts. The index case was a patient admitted to the ICU who had large areas of red rash and pustules on the chest, back, and right axilla. This case was diagnosed with herpes zoster by a dermatology consultation within the hospital. The other nine secondary cases were all nursing staff in the ICU, who were clinically diagnosed with varicella between August 21 and September 1, with an attack rate of 14.06%. All secondary varicella cases had a history of contact with the herpes zoster case and no history of varicella infection. Their varicella vaccination history was unknown. Based on the results of the on-site epidemiological and sanitary investigations, it was determined that this was an outbreak of varicella in the hospital caused by a herpes zoster case. After the last case was diagnosed, no new cases were reported within the longest incubation period (21 days), and the outbreak was declared over on September 21. Close contact with the herpes zoster case was likely the main cause of the outbreak. This highlights the need for early identification and isolation of suspected herpes zoster cases in hospitals in the future, as well as enhanced protective measures to prevent nosocomial infections.

Circadian rhythm refers to the 24-hour periodic changes in behavior, physiology, and molecular processes in the human body. Disruptions to the circadian rhythm not only affect mental health but are also associated with various metabolic disorders, including the regulation of bone and muscle metabolism. Research has shown that work-related musculoskeletal disorders (WMSDs) are influenced not only by workload but also by circadian rhythm factors, such as shift work. This review examined the relationships between circadian rhythm-related antecedents, outcomes, and WMSDs, exploring their shared metabolic markers and mechanisms. It provided a systematic overview of the intrinsic connection between circadian rhythm disruptions and WMSDs. While current studies highlight the impact of circadian rhythm disturbances on musculoskeletal disorders, further investigation is required to address the confounding factors involved. Future research should integrate chronobiology with both subjective and objective data to explore the pathway from environmental factors to intermediate phenotypes to diseases, ultimately providing a more comprehensive understanding of the network mechanisms underlying WMSDs.

OBJECTIVE: Evaluate the clinical application effect of low-field infant MRI. METHODS: Using literature review, expert consultation, and two rounds of Delphi to determine the evaluation index system. Then retrospectively analyze and compare the data of low-field infant MRI and high-field MRI from January 2023 to December 2024. RESULTS: There is a certain gap between low-field infant MRI and high-field MRI in terms of signal-to-noise ratio, image uniformity, software system reliability, scanning time, user interface friendliness and image result consistency. However, there was no difference in terms of spatial resolution and image quality. The noise, hardware system reliability, mean time between failure and the rate of examination completed without sedation are better than that of high-field MRI. CONCLUSION Low-field infant MRI meets needs of clinical diagnostic and has stable performance. It can be used as a routine screening tool for brain diseases near the bed.
Magnetic Resonance Imaging/methods* ; Humans ; Infant ; Retrospective Studies ; Signal-To-Noise Ratio ; Reproducibility of Results ; Brain Diseases/diagnostic imaging* ; Brain/diagnostic imaging* ; Software

Coronavirus disease 2019 (COVID-19) is a multi-system disease that can lead to various severe complications. Acute limb ischemia (ALI) has been increasingly recognized as a COVID-19-associated complication that often predicts a poor prognosis. However, the pathophysiology and molecular mechanisms underlying COVID-19-associated ALI remain poorly understood. Hypercoagulability and thrombosis are considered important mechanisms, but we also emphasize the roles of vasospasm, hypoxia, and acidosis in the pathogenesis of the disease. The angiotensin-converting enzyme 2 (ACE2) pathway, inflammation, and platelet activation may be important molecular mechanisms underlying these pathological changes induced by COVID-19. Furthermore, we discuss the hypotheses of risk factors for COVID-19-associated ALI from genetic, age, and gender perspectives based on our analysis of molecular mechanisms. Additionally, we summarize therapeutic approaches such as use of the interleukin-6 (IL-6) blocker tocilizumab, calcium channel blockers, and angiotensin-converting enzyme inhibitors, providing insights for the future treatment of coronavirus-associated limb ischemic diseases.
Humans ; COVID-19/physiopathology* ; Ischemia/etiology* ; SARS-CoV-2 ; Extremities/blood supply* ; Risk Factors ; Interleukin-6/antagonists & inhibitors* ; Acute Disease ; Angiotensin-Converting Enzyme 2

Objective To analyze the research literature on fire needling therapy published on China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),and China Science and Technology Journal Database(VIP)in the last 20 years,and to explore the current status and the hotspots of the research,thus to summarize and analyze the spectrum of the dominant diseases and technological transformations of fire needling therapy.Methods CiteSpace and VOSviewer were applied to analyze the keywords,authors and institutions,to draw the scientific knowledge map,and to summarize the disease spectrum.Results A total of 4 226 literature were included,from 2000 to 2023,the number of publications on fire needling therapy research showed an increasing trend,with each of the four periods showing its own characteristics of the times.The"filiform fire needling"and"pricking of fire needling"were widely used as acupuncture tools and acupuncture techniques in the studies,the emergence of high-frequency disease keywords such as"shingles""vitiligo"and"acne"indicates that research on the treatment of skin diseases with fire needling has attracted much attention.The disease spectrum of fire needling therapy was enlarged,involving a total of 356 diseases distributed in 20 disease systems.Conclusion Skin diseases and arthralgia became the dominant diseases of fire needling therapy,the rise of research hot words such as"acne vulgaris""vitiligo""stroke""chronic eczema""filiform fire needling"and"Lingnan fire needling"indicates that fire needling therapy is developing towards research standardization,theoretical diversification and disease diversification.

Objective:To explore the mediating effect of illness acceptance between self-compassion and rehabilitation motivation in stroke patients with partial disability.Methods:By convenience sampling method, stroke patients who attended the neurology outpatient clinic of Xinxiang Central Hospital from February to December 2024 were selected as the research subjects. The General Information Questionnaire, Self-Compassion Scale (SCS), Chinese version of Acceptance of Illness Scale (AIS-CHI), and Stroke Rehabilitation Motivation Scale (SRMS) were used for the survey. Pearson correlation analysis was applied to analyze the relationships among self-compassion, illness acceptance, and rehabilitation motivation. AMOS 21.0 software was used to establish a structural equation model and verify the mediating effect.Results:A total of 300 questionnaires were distributed, and 289 valid ones were recovered, with an effective recovery rate of 96.33%. Among the 289 stroke patients with partial disability, the total score of SCS was (65.73±5.50), the total score of AIS-CHI was (17.46±5.62), and the total score of SRMS was (77.18±10.97). Pairwise positive correlations were found between self-compassion, illness acceptance, and rehabilitation motivation (all P<0.05). Self-compassion had a direct positive effect on rehabilitation motivation ( β=0.328, P<0.01) and a direct positive effect on illness acceptance ( β=0.439, P<0.01). Illness acceptance played a partial mediating role between self-compassion and rehabilitation motivation, and the mediating effect accounted for 31.38% of the total effect (0.150/0.478) . Conclusions:The levels of self-compassion, illness acceptance, and rehabilitation motivation in stroke patients with partial disability need to be further improved. Illness acceptance exerts a partial mediating effect between self-compassion and rehabilitation motivation. Clinically, the rehabilitation motivation of patients can be enhanced by improving their levels of self-compassion and illness acceptance.