Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Objective To analyze the outcome of modified laparoscopic uterosacral fixation in the treatment of anterior and middle pelvic organ prolapse.Methods The clinical data of 30 patients with anterior and middle pelvic organ prolapse undergoing modified laparoscopic uterosacral fixation in our hospital from September 2020 to July 2023 were analyzed retrospectively.The perioperative related indicators and complications of patients during follow-up were observed.The pelvic organ prolapse quantification(POP-Q)scores,pelvic floor distress inventory-short form 20(PFDI-20)scores,pelvic floor impact questionnaire-short form 7(PFIQ-7)scores,and patient global impression of improvement(PGI-I)scores of patients before and after operation were compared.Results The operations of all patients were successfully completed without conversion to open surgery or serious complications.The average operation time was(170.8±21.5)minutes,the average intraoperative blood loss was(29.3±20.2)mL,the average postoperative exhaust time was(1.7±0.7)days,the average postoperative retaining urinal catheter time was(2.3±0.6)days,and the average postoperative hospitalization time was(4.2±0.8)days.Except for the total vaginal length,other indicators of POP-Q of patients 3 and 6 months after operation were significantly improved compared with those before operation(P<0.05).The PFDI-20 score and PFIQ-7 score of patients 6 months after operation were significantly improved compared with those before operation(P<0.05).The objective cure rate of patients was 100%;the results of PGI-I questionnaire showed that the subjective success rate of patients was 100%.Conclusion Modified laparoscopic uterosacral fixation is an effective operation for the treatment of anterior and middle pelvic organ prolapse,which has the advantages of good anatomical recovery,high satisfaction,and few postoperative complications,with a definite short-term curative effect.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

[This corrects the article DOI: 10.11909/j.issn.1671-5411.2017.08.005.].

OBJECTIVES: To explore the relationship between white matter injury (WMI) and cerebral perfusion in preterm infants using arterial spin labeling (ASL). METHODS: A total of 293 preterm infants (gestational age <34 weeks) hospitalized at the Third Affiliated Hospital of Zhengzhou University between June 2022 and June 2024 were included. After achieving clinical stability, the infants underwent brain magnetic resonance imaging (MRI) and ASL. Based on MRI findings, infants were classified into WMI (n=66) and non-WMI (n=227) groups. Cerebral perfusion parameters were compared between groups, and the association between WMI and perfusion alterations was evaluated. RESULTS: The WMI group showed a higher incidence of mild intraventricular hemorrhage (IVH) than the non-WMI group (P<0.05). Significantly lower cerebral perfusion was observed in the WMI group across bilateral frontal, temporal, parietal, and occipital lobes, as well as the basal ganglia and thalamus (P<0.05). After adjusting for gestational age, corrected gestational age at ASL scan, and mild IVH, WMI remained significantly associated with reduced regional perfusion (P<0.05). CONCLUSIONS WMI in preterm infants correlates with localized cerebral hypoperfusion. ASL-detected perfusion abnormalities may provide novel insights into WMI pathogenesis.
Humans ; White Matter/blood supply* ; Infant, Newborn ; Spin Labels ; Infant, Premature ; Female ; Male ; Cerebrovascular Circulation ; Magnetic Resonance Imaging

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

The influenza A virus (IAV), renowned for its high contagiousness and potential to catalyze global pandemics, poses significant challenges due to the emergence of drug-resistant strains. Given the critical role of RNA polymerase in IAV replication, it stands out as a promising target for anti-IAV therapies. In this study, we identified a novel C-3-substituted oleanolic acid benzyl amide derivative, A5, as a potent inhibitor of the PA_C-PB1_N polymerase subunit interaction, with an IC₅₀ value of 0.96 ± 0.21 μmol/L. A5 specifically targets the highly conserved PA_C domain and demonstrates remarkable efficacy against both laboratory-adapted and clinically isolated IAV strains, including multidrug-resistant strains, with EC₅₀ values ranging from 0.60 to 1.83 μmol/L. Notably, when combined with oseltamivir, A5 exhibits synergistic effects both in vitro and in vivo. In a murine model, dose-dependent administration of A5 leads to a significant reduction in IAV titers, resulting in a high survival rate among treated mice. Additionally, A5 treatment inhibits virus-induced Toll-like receptor 4 activation, attenuates cytokine responses, and protects against IAV-induced inflammatory responses in macrophages. In summary, A5 emerges as a novel inhibitor with high efficiency and broad-spectrum anti-influenza activity.

Objective:To analyze the detection of obesity with reduced muscle mass under different evaluation criteria and its association with metabolic abnormalities.Methods:This cross-sectional study consecutively enrolled 3 740 participants who underwent health examinations at the Health Management Center of the First Affiliated Hospital of Guangxi Medical University from January to December in 2023. Body composition parameters, including body mass index (BMI), body fat percentage (BFP), visceral fat area (VFA), waist circumference (WC), waist-to-hip ratio (WHR), and skeletal muscle mass index (SMI) were obtained via bioelectrical impedance analysis (BIA) using a standardized body composition analyzer. The waist-to-height ratio (WHtR) was calculated from these measurements. The blood lipids, blood pressure, blood glucose, and serum uric acid were also assessed. The consistency in detecting obesity with reduced muscle mass under different evaluation criteria was analyzed using the kappa test, and the association between obesity with reduced muscle mass and metabolic abnormalities was examined via the chi-square test.Results:Among the 3 740 participants included in the analysis, 2 105 were male and 1 635 were female. The detection rates of obesity with reduced muscle mass ranged from 0-3.8% in males and 0-12.7% in females. When using BMI+SMI as the evaluation criterion, only one case (0.1%) was identified with obesity and reduced muscle mass. For other criteria-BFP+SMI, VFA+SMI, WC+SMI, WHR+SMI, and WHtR+SMI-the detection rates in males was 3.8%, 2.0%, 1.0%, 3.5%, and 3.0%, respectively, while in females, it was 12.7%, 6.5%, 0.2%, 10.1%, and 3.9%, respectively. Notably, the BFP+SMI, VFA+SMI, and WHtR+SMI criteria demonstrated moderate to good inter-rater agreement ( kappa>0.4), particularly in males ( kappa>0.6) (all P<0.05). In females, the prevalence of hypertension was significantly higher in the obesity with reduced muscle mass-positive group compared to the negative group when using BFP+SMI, VFA+SMI, WHR+SMI, and WHtR+SMI criteria (20.3% vs 10.9%, 26.4% vs 11.1%, 20.0% vs 11.2%, and 25.4% vs 11.6%)(all P<0.05). When BFP+SMI and VFA+SMI were used as evaluation criteria, the detection rate of glucose metabolism disorders were higher in individuals who are positive for obesity combined with reduced muscle mass than in those who were negative (43.9% vs 36.4%, 48.6% vs 36.6%) (both P<0.05). In males, the WHtR+SMI criterion identified a significantly elevated prevalence of abnormal serum uric acid levels in the obesity with reduced muscle mass-positive group compared to the negative group (42.9% vs 30.2%) ( P<0.05). Conclusion:Compared to alternative adiposity metrics, the evaluation criteria incorporating BFP, VFA and WHtR demonstrate significantly stronger associations between obesity with reduced muscle mass and metabolic abnormalities.

INTRODUCTION: In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, children with COVID-19 in Singapore required hospital isolation. We aimed to explore the psychological experiences of children and their caregivers isolated in a tertiary university hospital due to COVID-19. METHODS: A prospective mixed-methods design was used to evaluate the psychological status of hospitalised family units with one or more children aged <18 years who had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patient medical records were reviewed for demographic and clinical information. Parents and children ≥7 years of age underwent a psychologist-administered telephone-based interview. Self-reported, age-appropriate instruments, Short Mood and Feelings Questionnaire, and Screen for Adult/Child Anxiety-Related Disorders, were used to assess anxiety and depression, respectively. Participants were also interviewed qualitatively. RESULTS: Fifteen family units were hospitalised between March 2020 and May 2020. Of these, 13 (73%) family units were recruited. The median age of the children and median hospitalisation duration were 57 months and 21 days, respectively. Median number of COVID-19 polymerase chain reaction swabs performed for each child was eight. All children had asymptomatic to mild SARS-CoV-2 disease. The criteria indicative of anxiety disorder were met by 40% of adults and 80% of children, while the criteria indicative of separation anxiety were met by 60% of parents and 100% of children. One child met the criteria indicative of depression. Uncertainty, separation, prolonged hospitalisation and frequent swabs caused significant reported anxiety. CONCLUSIONS Families, especially children, had heightened anxiety while in hospital isolation. Therefore, home-based recovery from COVID-19 and psychological support for children and their families, with focus on early recognition of anxiety disorders, are recommended. We support review of paediatric isolation policy as the pandemic evolves.
Humans ; COVID-19/epidemiology* ; Male ; Child ; Female ; Singapore/epidemiology* ; Anxiety/etiology* ; Prospective Studies ; Adolescent ; Hospitalization ; SARS-CoV-2 ; Adult ; Child, Preschool ; Pandemics ; Parents/psychology* ; Caregivers/psychology* ; Family/psychology* ; Depression ; Patient Isolation/psychology* ; Surveys and Questionnaires