Myasthenia gravis is an autoimmune disorder characterized by impaired neuromuscular transmission. Thymectomy is one of the therapeutic options for acetylcholine receptor antibody-positive myasthenia gravis patients. The quality of perioperative care is directly associated with surgical safety and patient outcomes. However, there is currently a lack of specialized nursing consensus or guidelines specifically addressing the care of these patients domestically or internationally. To promote the standardization and normalization of perioperative nursing care for myasthenia gravis patients undergoing thymectomy and to ensure treatment efficacy, a panel of 57 experts from relevant fields was convened. Based on evidence-based medicine and clinical practice experience, discussions were held on various aspects including condition assessment, nutritional support, medication management, and airway care, resulting in a consensus with 18 final recommendations by using the Delphi method through two rounds of expert consultation. This consensus aims to provide a scientific reference for the perioperative nursing care of myasthenia gravis patients undergoing thymectomy.

With the progression of liver cirrhosis， patients often develop sarcopenia and lipid metabolism disorders， and the complex interaction between p sarcopenia and lipid metabolism disorders not only promotes the progression of liver cirrhosis， but also affects the prognosis and quality of life of patients. As an effective intervention for alleviating complications associated with liver cirrhosis， transjugular intrahepatic portosystemic shunt （TIPS） can improve sarcopenia to a certain degree by improving hepatic hemodynamics and reducing portal venous pressure. In addition， there might be varying degrees of changes in blood lipid levels after TIPS， which may be closely associated with the recovery of liver metabolic function and the alterations in hemodynamics. This article introduces the association between liver cirrhosis， sarcopenia， and lipid metabolism disorders， elaborates on the effect of TIPS on sarcopenia and abnormal lipid metabolism， and discusses related mechanism and clinical significance， in order to provide a theoretical basis for clinical treatment.

Objective To explore the effect of enhanced recovery after surgery(ERAS)nursing combined with isokinetic muscle strength visual feedback training on postoperative patients with knee joint injury.Methods A total of 100 patients with knee joint injury who were treated in 909th Hospital(Southeast Hospital Affiliated of Xiamen University)from May 2022 to May 2023 were selected as the subjects.According to a random number table method,the patients were divided into control group(n=50)and observation group(n=50).The control group received ERAS nursing,and observation group received isokinetic muscle strength visual feedback training on the basis of control group.The pain,knee function recovery,quality of life and complications of two groups were compared.Results At 1 day,1 month,3 months and 6 months after operation,the pain visual analogue scale scores of observation group were lower than those of control group(P＜0.05).At 6 months after operation,the scores of knee joint function scale and World Health Organization quality of life scale in two groups were higher than before operation,and observation group were higher(P＜0.05).The total incidence of complications in observation group was lower than chat in control group(P＜0.05).Conclusion ERAS nursing combined with isokinetic muscle strength visual feedback training can significantly reduce postoperative pain in patients with knee joint injury,effectively promote the recovery of knee joint function.

The grade of histological severity is a determining factor to evaluate the prognosis and survival rate in primary biliary cholangitis (PBC). However, liver biopsy is limited by sampling error, invasiveness, high cost, and poor compliance. Therefore, in order to overcome the limitations of liver biopsy, some non-invasive evaluation methods have been studied and applied to evaluate the progression of liver fibrosis in PBC. The prognostic score can be calculated using routine laboratory test results obtained at the time of diagnosis, which are characterized by their simplicity, affordability, ease of acquisition, and superior reproducibility. Recent studies have reported that the prognostic score can be employed as a non-invasive liver fibrosis model to diagnose the liver fibrosis stage in PBC and predict the transplant-free survival rate, in addition to being used to evaluate the patient prognosis and transplant-free survival (TFS). This paper reviews, summarizes, and explores the research progress of different prognostic scores as non-invasive liver fibrosis models via their diagnostic performance and predictive accuracy for PBC.

Under the multi-campus development model of public hospitals,cultural integration and innovation face nu-merous challenges due to spatial constraints,personnel structure differences,and functional positioning across campuses.System-atic cultural development is required to bridge these gaps and enhance the sense of belonging among both patients and staff in new campuses.This case study focuses on the Huangpu Campus of Sun Yat-sen University Cancer Center,launched in 2021,explo-ring a dual-dimensional approach to multi-campus cultural integration through"healing spaces."The practical strategies include:①Direct Space Construction:Establishing patient-centered healing environments through service hubs to optimize clinical experi-ences and humanistic care;(②Inidirect Environment Development:Leveraging staff service centers to foster the integration of the hospital's"collaborative,fulfilling,and striving culture,"thereby strengthening employee engagement.Post-implementation,significant improvements were observed in both patient and staff satisfaction metrics.The initiative has yielded a replicable cultur-al management framework for multi-campus public hospitals,offering valuable insights for cultural innovation in similar healthcare settings.

Objective:To evaluate the clinical significance of morular metaplasia (MM) in fertility-preserving treatment for young patients with endometrial hyperplasia and grade 1 endometrial endometrioid carcinoma.Methods:Clinical data was retrospectively collected from patients diagnosed with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma under 40 years old who underwent progestin-based fertility-sparing treatmentat in Tianjin Medical University General Hospital between January 2018 and November 2022.Patients were divided into the MM group (37 cases) and the non-MM group (63 cases) based on pathological findings. Clinical characteristics, hysteroscopic features, treatment efficacy and fertility outcomes were compared between the two groups. The MM group was further stratified into three subgroups based on the timing of MM occurrence:(1) MM-Bef group ( n=10): MM was present in the initial endometrial curettage or hysteroscopic biopsy pathology before fertility-sparing treatment and disappeared after treatment; (2) MM-Sus group ( n=14): MM persisted consistently before and after therapy;(3) MM-Aft group ( n=13): MM was absent before therapy but appeared after treatment. The risk factors which had impact on the treatment outcomes of the patients were analyzed using univariate and multivariate Cox regression analysis. Results:The rate of polycystic ovary syndrome were higher in the MM group than the non-MM group [51% (19/37) vs 27% (17/63), P=0.014]. The complete response (CR) rate was significantly lower in the MM group than in the non-MM group [73% (27/37) vs 95% (60/63), P=0.006], and the median time to CR was significantly longer in the MM group (6.0 vs 5.0 months, P=0.005).Multivariate analysis identified that MM-Sus ( HR=0.355, 95% CI:0.174-0.723; P=0.004) and MM-Aft ( HR=0.314, 95% CI:0.145-0.681; P=0.003) were independent risk factors for delayed CR in fertility-sparing treatment. The patients in the MM group and non-MM group underwent hysteroscopic biopsy for 76 and 131 times. "Gravel-like change" was a more frequent hysteroscopic manifestation in the MM group than that in the non-MM group [18% (14/76) vs 2% (2/131), P<0.001]. Conclusions:Patients in the MM group have poorer treatment outcomes than patients in the non-MM group. MM-Sus and MM-Aft are risk factors for fertility-preserving treatment in young patients with endometrial hyperplasia or grade 1 endometrial endometrioid carcinoma. "Gravel-like change" is the characteristic hysteroscopic manifestations of MM.

Objective:To analyze the changes of peripheral blood CD 4+ T lymphocyte subsets caused by nanosecond pulse ablation in C57BL/6J liver cancer mice and its effect on the immunity of liver cancer mice. Methods:According to the randomallocation, 32 female C57BL/6J mice weighing 18-20 g and aged 8-10 weeks were divided into the blank control group (Group A), the liver cancer control group (Group B), the radical liver lobectomy group (Group C), and the nanosecond pulse ablation treatment group (Group D), with 8 mice in each group. The in situ liver cancer models for mice in groups B, C, and D were established using Hepa 1-6 hepatoma cell line. On the 7th day after modeling, group C underwent liver lobectomy, and group D underwent nanosecond pulse ablation. After 7 days of treatment, the subtypes Th1, Th2, Th17 and Treg cell levels of CD 4+ T cells in the peripheral blood of the four groups of mice were detected by flow cytometry. Results:Flow cytometry was used to detect and analyze the proportions of CD 4+ T cell subsets Th1, Th2, Th17 and Treg in the peripheral blood of four groups of mice. Comparisons of each index among the groups showed statistically significant differences (all P<0.001). The proportion of Th1 cells detected by flow cytometry was (8.4±1.1) % in group A, (8.5±1.5)% in group D, (3.5±0.5)% in group B, and (2.4±0.5)% in group C. Both group A and Group D were higher than group B and group C, and the differences were statistically significant (all P<0.001). The proportion of Th2 cells detected by flow cytometry was (5.1±0.8)% in group A, (5.1±1.3)% in Group B, (5.4±0.9)% in group C, and (3.6±0.9)% in group D. The proportion of Th2 cells in groups A, B, and C was higher than that in group D, and the differences were statistically significant (all P<0.05). The proportion of Th17 cells detected by flow cytometry was (1.5±0.6)% in group A, (8.6±1.3)% in group B, (8.2±1.5)% in group C, and (1.7±0.3)% in group D. The proportion of Th17 cells in both group B and group C was higher than that in group A and group D, and the differences were statistically significant (all P<0.001). The proportion of Treg cells detected by flow cytometry was (7.0±0.9)% in group B, (6.8±0.9)% in group C, (3.8±0.8)% in group D, and (0.9±0.2)% in group A. The proportion of Treg in group B and group C was higher than that in group A and group D, and the difference was statistically significant (all P<0.001). Conclusion:Nanosecond pulse ablation for liver cancer in mice can regulate CD 4+ T cell subsets in peripheral blood, enhance the immune response of Th1 cells, inhibit the expression of Th2, Th17 and Treg cells, and improve the immunosuppressive state caused by liver cancer.

Tumor diseases have emerged as a major threat to human health.In this case,cancer hospitals must optimize patient experience while developing their facilities and medical resources.This paper takes the Huangpu Campus of Sun Yat-Sen University Cancer Center as an example to explore the strategies and practical effects of optimizing patient experience on the cam-pus from the perspective of peak experience.This hospital has successfully created high-quality peak experiences across multiple dimensions such as visual perception,trust,emotion,operations,efficiency,and lifestyle.The results indicated that Huangpu Hospital significantly improved patient satisfaction,medical resource expansion,operational efficiency,and social recognition.These achievements have validated the effectiveness of peak experience theory in the field of medical services,providing valuable insights for other hospitals.

BACKGROUND: Neglected tropical diseases (NTDs) and malaria pose a major health challenge, especially in low- and middle-income countries. METHODS: Initially, we performed a descriptive analysis of the Global Burden of Disease (GBD) 2021 database, categorizing data by subtypes. Next, linear regression models were employed to analyze temporal trends. We then utilized four predictive models to forecast the future burden. Additionally, we explored the relationship between estimated annual percentage change (EAPCs) and age-standardized rates (ASRs), as well as Human Development Index (HDI) scores for 2021. Furthermore, decomposition analysis was applied to assess the influence of aging, population dynamics, and epidemiological changes. Lastly, frontier analysis was conducted to examine the connection between disease burden and sociodemographic development. RESULTS: In 2021, NTDs and malaria contributed significantly to the global disease burden, with considerable disparities across genders, age groups, Socio-demographic Index (SDI) regions, GBD regions, and individual countries. From 1990 to 2021, both the number of cases and the associated ASRs have shown a recent downward trend. The EAPCs are positively correlated with ASRs and HDI scores. Projections indicate a continued decline in disease burden through 2046. Additionally, our decomposition analysis highlighted the positive impact of aging and epidemiological shifts on the reduction of the disease burden. Finally, frontier analysis revealed that countries and regions with higher SDI scores have greater potential for further reducing their health burden. CONCLUSION While the global burden of NTDs and malaria has improved overall, significant disparities remain across regions and countries. Our findings highlight the importance of implementing targeted intervention strategies and maintaining sustained investments to tackle the ongoing challenges.
Malaria/epidemiology* ; Humans ; Neglected Diseases/epidemiology* ; Global Burden of Disease/trends* ; Global Health/statistics & numerical data* ; Male ; Female ; Tropical Medicine ; Adult ; Cost of Illness ; Child, Preschool ; Middle Aged ; Adolescent ; Young Adult ; Infant

The most common medications for the treatment of zoonotic toxoplasmosis are pyrimethamine and sulfadiazine, which may cause serious undesirable side effects. Thus, there is an urgent need to develop novel therapeutics. Baicalein (BAI, C₁₅H₁₀O₅) has been shown to perform well against protozoan parasites including Leishmania and Cryptosporidium. In this study, the inhibition efficacy of BAI on Toxoplasma gondii was evaluated using plaque, invasion, and intracellular proliferation assays. BAI effectively inhibited T. gondii (half-maximum inhibitory concentration (IC₅₀)=6.457×10^-5 mol/L), with a reduced invasion rate (33.56%) and intracellular proliferation, and exhibited low cytotoxicity (half-maximum toxicity concentration (TC₅₀)=5.929×10^-4 mol/L). Further investigation using a mouse model shed light on the inhibitory efficacy of BAI against T. gondii, as well as the potential mechanisms underlying its anti-parasitic effects. The survival time of T. gondii-infected ICR mice treated with BAI was remarkably extended, and their parasite burdens in the liver and spleen were greatly reduced compared with those of the negative control group. Histopathological examination of live sections revealed effective therapeutic outcomes in the treatment groups, with no notable pathological alterations observed. Furthermore, alterations in cytokine levels indicated that BAI not only effectively suppressed the growth of T. gondii but also prevented excessive inflammation in mice. Collectively, these findings underscore the significant inhibitory efficacy of BAI against T. gondii, positioning it as a promising alternative therapeutic agent for toxoplasmosis.
Animals ; Toxoplasma/drug effects* ; Flavanones/therapeutic use* ; Mice ; Antiparasitic Agents/therapeutic use* ; Mice, Inbred ICR ; Toxoplasmosis/drug therapy* ; Female