As the third-level diagnosis of migraine， recurrent gastrointestinal disturbance is a group of disorders with recurrent episodic attacks of abdominal pain and/or discomfort and nausea and/or vomiting that may be associated with migraine， and it is a clinical syndrome with the core symptom of abdominal pain， with the presence of clinical and neurobiological associations. This article reviews the similarities of the two diseases from the aspects of epidemiological characteristics， gender distribution tendency， clinical course， auxiliary examination， and treatment response， as well as three potential mechanisms in pathophysiology. This strong association between functional recurrent abdominal pain and migraine suggests that although there is no definitive evidence， adult functional recurrent abdominal pain， or at least its specific subsets， may belong to the spectrum of migraine. In other words， functional recurrent abdominal pain itself without headache may be a “migraine phenomenon”. In the future， it is necessary to conduct more rigorously designed observational studies on the association between the two diseases to clarify such possibility， in order to provide strong supporting evidence for the diagnosis and treatment of patients with functional recurrent abdominal pain and migraine and relieve pain as soon as possible.

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Objective To investigate the relationship between serum orexin-A(OXA)and aspartate amin-otransferase(AST)levels and the disease severity and prognosis in patients with acute ischemic stroke(AIS).Methods A total of 167 AIS patients(AIS group)treated at Hebei Provincial People's Hospital from January 2021 to January 2024 and 84 healthy individuals undergoing physical examinations(control group)were selected as the research objects.AIS patients were categorized by severity into mild AIS group[National Institutes of Health Stroke Scale(NIHSS)score＜5,42 cases],moderate AIS group(NIHSS score 5—＜16,56 cases),moderate-to-severe AIS group(NIHSS score 16—＜21,36 cases),and severe AIS group(NIHSS score ≥21,33 cases).Based on 3-month prognosis(modified Rankin scale),patients were divided into poor prognosis group(＞2 grade,54 cases)and good prognosis group(≤2 grade,113 cases).Spearman correlation analysis was used to assess the relationship between NIHSS scores and serum OXA and AST levels in AIS pa-tients.Multivariate unconditional Logistic regression was used to determine the relationship between serum OXA and AST levels and the prognosis of AIS patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum OXA and AST levels for prognosis.Results Compared with the control group,serum OXA level in the AIS group was lower,while AST level was higher(P＜0.05).Ser-um OXA level progressively decreased,and AST level progressively increased across the mild,moderate,mod-erately severe,and severe AIS groups(P＜0.05).NIHSS score was negatively correlated with serum OXA level and positively correlated with AST level in AIS patients(P＜0.05).High OXA level was an independent protective factor for poor prognosis in AIS patients,while high AST level was an independent risk factor(P＜0.05).The area under the curve(AUC)of the combined assessment of serum OXA and AST levels in predic-ting poor prognosis in AIS patients was 0.873,which was greater than the AUC of OXA(0.793)and AST(0.770)alone(P＜0.05).Conclusion In AIS patients,lower serum OXA level and higher AST level are as-sociated with disease severity and poor prognosis.The combined evaluation of serum OXA and AST levels has higher predictive value for AIS prognosis.

Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic stroke. Stenting is a treatment option for symptomatic ICAS, but it also has problems such as procedure-related complications and in-stent restenosis. This article reviews the application of stenting, particularly different stent systems, in patients with symptomatic ICAS.

Objective To investigate the correlations of serum levels of platelet activation com-plex-1(PAC-1)and soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)with neu-rological deficit and clinical prognosis in patients with acute cerebral infarction(ACI).Methods A total of 170 ACI patients(ACI group)and 85 healthy volunteers(control group)were enrolled in this study.Based on severity of neurological deficit assessed by the National Institutes of Health Stroke Scale(NIHSS)score,ACI patients were divided into of mild neurological deficit group(43 cases),moderate neurological deficit group(57 cases),moderate-to-severe neurological deficit group(37 cases),and severe neurological deficit group(33 cases).Additionally,based on the 6-month fol-low-up prognosis,ACI patients were divided into 51 cases of poor prognosis group and 119 cases of good prognosis group.Enzyme-linked immunosorbent assay was used to measure serum levels of PAC-1 and sTWEAK.Spearman correlation analysis was performed to evaluate their correlations with NIHSS scores in ACI patients.Multivariate unconditional Logistic regression analysis was conducted to determine their relationships with clinical prognosis.Receiver operating characteristic curves were used to explore their evaluation efficacy for poor clinical prognosis.Results Serum levels of PAC-1 and sTWEAK were significantly higher in the ACI group than in the control group(P＜0.05).Ser-um levels of PAC-1 and sTWEAK increased sequentially in the mild,moderate,moderate-to-severe,and severe neurological deficit groups(P＜0.05).Spearman correlation analysis showed that serum levels of PAC-1 and sTWEAK were positively correlated with NIHSS scores in ACI patients(rs=0.715 and 0.706,respectively;P＜0.001).Multivariate unconditional Logistic regression analysis revealed that older age,higher NIHSS score,larger infarct volume,higher PAC-1 level,and higher sTWEAK level were independent risk factors for poor prognosis in ACI patients(P＜0.05).The ar-ea under the curve for the combined assessment of serum PAC-1 and sTWEAK levels for poor clini-cal prognosis in ACI patients was 0.895,which was greater than the areas under the curve for the individual assessments(0.792 and 0.786,respectively;P＜0.05).Conclusion Elevated serum levels of PAC-1 and sTWEAK are closely related to increased neurological deficit and poor clinical prognosis in ACI patients.The combined detection of these two markers has high evaluation efficacy for clinical prognosis in ACI patients.

Purpose To predict preoperative BRAF mutation and perform prognostic stratification in colorectal cancer patients using CT radiomics nomogram.Materials and Methods A retrospective analysis was conducted on 333 pathologically confirmed colorectal cancer in the First People's Hosptial of Yancheng from January 2017 to June 2020,comprising a training set(234 cases)and a validation set(99 cases).The region of interest for the entire tumor was segmented,and radiomics features were extracted.The maximum-relevance minimum-redundancy algorithm and the least absolute shrinkage and selection operator algorithm were used to screen for radiomics features closely associated with BRAF mutation.A nomogram was constructed by combining these radiomics features with clinically significant parameters.The diagnostic performance was quantified using the area under the receiver operating characteristic curve.Kaplan-Meier analysis was utilized to depict survival curves for the high-risk and low-risk groups.Results Seven radiomics features were retained to construct the radiomics model.The radiomics nomogram,integrating these radiomics features with three clinically significant parameters(age,tumor location,carcinoembryonic antigen),achieved area under the curve values of 0.850 in the training set and 0.829 in the validation set.Furthermore,there was a significant disparity in overall survival between the high-risk group(BRAF mutation)and low-risk group(wild-type BRAF)predicted by the nomogram(P<0.001),with the high-risk group exhibiting a markedly shorter overall survival compared to the low-risk group.Conclusion CT radiomics nomogram demonstrates the capability to accurately predict preoperative BRAF mutation in colorectal cancer patients and effectively stratify their prognosis.

Objective:To establish the haemodynamic response during the verbal fluency task(VFT)in patients with MCI and to find a screening tool that could be used as a predictor of dementia. Method:Functional near-infrared spectroscopy(fNIRS)can detect changes in blood oxygen in the brain,thus revealing the patient's functional brain activity status,and is used to study the level of brain function in MCI.We evaluated the hemodynamic response in the prefrontal and temporal regions of MCI patients and healthy controls in our study. Result:The results found a significantly reduced haemodynamic response in the prefrontal brain regions in the MCI group. Conclusion:The results suggested that a reduced haemodynamic response in the prefrontal brain regions could be used as a diagnostic biomarker for dementia.

This article provides an overview of metaverse medicine and summarizes the challenges faced by cancer patients, the applications and effects of metaverse medicine in this population, and the limitations and difficulties in clinical practice. These challenges include legal and ethical restrictions, as well as the need for further validation of clinical acceptability and feasibility. Researchers are encouraged to conduct extensive studies to refine the legal and regulatory frameworks, enhance the safety and adoption of metaverse medicine, and facilitate its localized development in cancer care.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To systematically evaluate qualitative studies on the perceptions and feelings of nursing staffs implementing neonatal palliative care, aiming to provide insights for advancing clinical practice in China.Methods:The databases including China National Knowledge Infrastructure, Wanfang, VIP, Chinese Biomedical Literature Database, PubMed, CINAHL, Embase, Cochrane Library, Web of Science, and PsycINFO were included to retrieve the literature on the perceptions and feelings of nursing staffs from inception until March 28, 2024. The literature quality was assessed utilizing the Joanna Briggs Institute Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research (2016), and the findings were synthesized through Meta-integration techniques.Results:A total of 12 studies were included, yielding 46 themes were extracted; 8 categories were summarized and 3 synthesis results were obtained: nursing staffs experience both negative and positive aspects, the real-life challenges faced by nursing staffs in implementing neonatal palliative care, and the practical experiences and needs of nursing staffs regarding neonatal palliative care.Conclusions:It is crucial to continually address nursing staffs′ negative emotions and tackle challenges related to staffing, training, communication, and ethical dilemmas to ensure appropriate end-of-life symptom management in neonatal palliative care.