Post-stroke depression （PSD） represents a common and debilitating complication following stroke， substantially impeding neurorehabilitation outcomes and exerting a profound negative impact on patients' quality of life， while concurrently contributing to increased mortality rates. Despite a growing understanding of PSD， contemporary clinical management continues to encounter multifaceted challenges. This systematic review synthesizes extant literature to delineate pathophysiological mechanisms underlying PSD and to identify evidence-based interventions. By establishing a theoretical foundation， it aims to optimize early diagnostic protocols and personalized therapeutic regimens， thereby enhancing rehabilitation and therapeutic outcomes in stroke patients. Through rigorous evaluation of 14 original studies， this analysis comprehensively examines genetic factors， neurobiological aberrations， immunological factors， and psychosocial stressors contributing to PSD onset and progression， offering critical insights for developing comprehensive treatment strategies.［Funded by Science and Technology Plan Project of Yunnan Provincial Department of Science and Technology （number， 202101AY070001-048）］

This study was performed to evaluate the oncological and reproductive outcomes of childbearing-age women treated with fertility-sparing surgery (FSS) for non-epithelial ovarian tumors in China. One hundred and forty eight non-epithelial ovarian tumor women treated with FSS between January 1, 2000 and August 31, 2015 from two medical centers in China were identified. Progression-free survival (PFS) was 88.5%, whereas overall survival (OS) was 93.9%. Univariate analysis suggested that delivery after treatment is related to PFS (P = 0.023), whereas histology significantly influenced OS. Cox regression analysis suggested that only histology was associated with PFS and OS (P < 0.05). Among the 129 women who completed adjuvant chemotherapy (ACT), none developed amenorrhea. Among the 44 women who desired pregnancy, 35 (79.5%) successfully had 51 gestations including 35 live births without birth defects. Non-epithelial ovarian tumors can achieve fulfilling prognosis after FSS and chemotherapy. Histology might be the only independent prognostic factor for PFS and OS. FSS followed by ACT appeared to have little or no effect on fertility. Meanwhile, postoperative pregnancy did not increase the PFS or OS. Use of gonadotropin-releasing hormone agonist was not beneficial for fertility.
Adolescent ; Adult ; Chemotherapy, Adjuvant ; adverse effects ; Child ; China ; Female ; Humans ; Infertility, Female ; etiology ; prevention & control ; Neoplasm Staging ; Organ Sparing Treatments ; Ovarian Neoplasms ; drug therapy ; surgery ; Pregnancy ; Pregnancy Rate ; Prognosis ; Retrospective Studies ; Survival Analysis ; Young Adult

Objective To analyze serum levels of C1q in children with nephrotic syndrome (NS),and investigate the clinical significance and the relationship among the altered serum C1q levels and other lipid/lipoprotein and renal function parametersin children with NS inacute and remission phases.Methods Serum levels of C1q were measured in 78 NS children with acute phase,in 64NS children with remission and in 77 healthy control children.The other lipid/lipoprotein and renal function parameters were also analyzed in these children,including TP,ALB,TC,TG,LDL-C,HDL-C,Urea,Cr and Uric.Results Compared with the healthy control children [173.00(161.00～185.00)mg/L],children with NS inacute [203.50(183.75 ～ 223.75) mg/L] and remission phases [185.00 (161.00 ～ 202.00) mg/L] all had a significantly increasedserum levels of C1q.Compared with NS children in remission,those in acute phase showed a significantly increased C1q (P＜0.001).In all the NS children,the serum levels of C1q were positively correlated with the levels of TC (r=0.483,P＜0.001),TG (r=0.423,P＜0.001) and LDL-C (r=0.450,P＜0.001),while negatively correlated with the levels of TP (r=-0.276,P=0.001 ＜0.01) and ALB (r=-0.410,P＜0.001).Multiple linear regression analyses showed that serum levels of C1q were independently associated with serum TG levels (β=9.235,P＜0.001;adjusted R2 =0.215) after adjustment of other related factors.Conclusion Serum levels of C1q were significantly increased in NS children in association with their conditions and the levels of lipid/lipoprotein parameters,and may be function as anovel parameter for assessing the development of NS.

Objective The systemic inflammatory response syndrome ( SIRS) can be caused by infection and non-infection factors, which have similar clinical features but differ in treatment and prognosis .Rapid synthesis of procalcitonin ( PCT) during infec-tion can be used as a biomarker for the early diagnosis of sepsis .The present study aims to assess the value of the serum PCT level in the etiological diagnosis and prognosis of SIRS in the surgical ICU . Methods We retrospectively analyzed the data on 166 cases of SIRS from the surgical ICU in Jinling Hospital between June 2014 and June 2015 .The data obtained were associated with the patients'demograph-ics, primary diseases, laboratory results, and clinical outcomes.We analyzed the serum PCT values , blood culture results , and clinical outcomes. Results Totally, 131 of the patients were diagnosed with sepsis, with a median value of serum PCT of 2.43 (0.81-10.51) ng/mL, of whom 109 were PCT-positive (≥0.47 ng/mL), with a positive rate of 83.2%.Among the 35 non-infection SIRS patients, the mean level of serum PCT was 0.23 (0.1 -0.39) ng/mL, with a positive rate of 17.14%(6/35).There were statistically significant differences between the two groups in both the ser-um PCT level and positive rate (P<0.05).The PCT-positive rate was significantly higher in the bacteria-infected than in the fungi-in-fected group (86.5%[83/96] vs 74.3%[26/35], P<0.05), with a median value of 4.28 (1.05-14.59) ng/mL and 0.89 (0.37-1.59) ng/mL, respectively, so was it in the survivors than in the non-survivors (94.4%[34/36] vs 78.9%[75/95], P<0.05), with a median value of 12.89 (4.76-47.73) ng/mL and 1.41 (0.54-4.00) ng/mL, respectively. Conclusion The se-rum PCT level might be used to distinguish between sepsis and non-infection SIRS, significantly higher in bacteria-infected and survival groups than in fungi-infected and non-survival groups .Serum PCT determination contributes to the etiological diagnosis and prognosis of SIRS.

OBJECTIVE: To assess the efficacy and safety of glucocorticoid in initial treatment of sudden hearing loss with intratympanic (IT) and systemic ways. METHOD: We searched the database of PubMed, Cochrane, Embase,CBM, CNKI, VIP, Wanfang systematically. Literatures were screened according to the preestablished inclusion and exclusion standards,and all the RCT literatures associated with intratympanic and systemic glucocorticoid in the initial treatment of sudden hearing loss before may 2015 were collected. All the data, which meet the inclusion standards, were analyzed by using Meta-analysis software. RESULT: Among all the qualified literatures, 11 randomized controlled trials were included. A total of 1298 cases were involved, including 521 cases with intratympanic administration, 410 with IV-therapy, and 201 with oral therapy. Meta analysis results showed that there was significant difference of the total effective rate and improvement rate between the intratympanic and systemic administration. Intratympanic injection (P > 0.05) was more effective than systemic administration. There was no significant difference between intratympanic group and oral group (RR = 1.15, 95% CI: 0.92-1.42, P > 0.05). A significant difference of the effective rate occurred between intratympanic group and IV therapy group (RR = 1.17, 95% CI: 1.02-1.34, P < 0.05). The major complications of intratympanic were pain, dizziness/vertigo, which occurred more frequently than systemic therapy group; The major complications of systemic therapy group were hyperglycaemia, loss of appetite and insomnia. CONCLUSION This study shows that the intratympanic (IT) glucocorticoid for sudden deafness is more effective than the systemic administration. But it was not the first choice in clinical treatment. Further studies are warranted.
Administration, Oral ; Glucocorticoids ; administration & dosage ; therapeutic use ; Hearing Loss, Sudden ; drug therapy ; Humans ; Hyperglycemia ; Injection, Intratympanic ; Randomized Controlled Trials as Topic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome