To investigate the awareness of cognitive impairment disorders among residents of the Xizang Autonomous Region and its influencing factors, thereby providing a basis for targeted prevention and treatment efforts.

Purpose: The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs). Materials and Methods: Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients. Results: A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804. Conclusion USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.

Purpose: The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs). Materials and Methods: Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients. Results: A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804. Conclusion USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.

Purpose: The genomic characteristics of uterine sarcomas have not been fully elucidated. This study aimed to explore the genomic landscape of the uterine sarcomas (USs). Materials and Methods: Comprehensive genomic analysis through RNA-sequencing was conducted. Gene fusion, differentially expressed genes (DEGs), signaling pathway enrichment, immune cell infiltration, and prognosis were analyzed. A deep learning model was constructed to predict the survival of US patients. Results: A total of 71 US samples were examined, including 47 endometrial stromal sarcomas (ESS), 18 uterine leiomyosarcomas (uLMS), three adenosarcomas, two carcinosarcomas, and one uterine tumor resembling an ovarian sex-cord tumor. ESS (including high-grade ESS [HGESS] and low-grade ESS [LGESS]) and uLMS showed distinct gene fusion signatures; a novel gene fusion site, MRPS18A–PDC-AS1 could be a potential diagnostic marker for the pathology differential diagnosis of uLMS and ESS; 797 and 477 uterine sarcoma DEGs (uDEGs) were identified in the ESS vs. uLMS and HGESS vs. LGESS groups, respectively. The uDEGs were enriched in multiple pathways. Fifteen genes including LAMB4 were confirmed with prognostic value in USs; immune infiltration analysis revealed the prognositic value of myeloid dendritic cells, plasmacytoid dendritic cells, natural killer cells, macrophage M1, monocytes and hematopoietic stem cells in USs; the deep learning model named Max-Mean Non-Local multi-instance learning (MMN-MIL) showed satisfactory performance in predicting the survival of US patients, with the area under the receiver operating curve curve reached 0.909 and accuracy achieved 0.804. Conclusion USs harbored distinct gene fusion characteristics and gene expression features between HGESS, LGESS, and uLMS. The MMN-MIL model could effectively predict the survival of US patients.

BACKGROUND: High temperatures are known to be associated with an increased risk of self-harm, but the influence of demographic changes and country-level indicators on the burden of heat-related self-harm remains unclear. This study examined the key factors driving changes in self-harm mortality linked to high temperatures and explored their impact at the country level. METHODS: This is an ecological study that analyzes data from the 2021 Global Burden of Disease (GBD) study, the World Bank, and the Climate Research Unit (CRU) were analyzed. Decomposition analyses were used to identify key factors driving changes in high temperature-related self-harm mortality between 1990 and 2021. A panel data model assessed the impact of national indicators on heat-related self-harm mortality. RESULTS: In 2021, 14,885 deaths globally were attributed to heat-related self-harm, a 41.94% increase from 1990, with low-middle SDI regions accounting for 47.84% of these deaths. While the global death rate from heat-related self-harm declined slightly over this period, South Asia and low-middle SDI regions contributed most to the decline. However, population aging exacerbated mortality rates. Demographic and meteorological factors were also linked to heat-related self-harm. CONCLUSION The global decline in heat-related self-harm mortality is largely driven by reductions in females, low-middle SDI regions, and South Asia. However, population aging and growth in these regions have added to the mortality burden, slowing the overall decline. Factors such as population density are also associated with heat-related self-harm. Targeted measures are needed to mitigate heat-induced self-harm more effectively in future.
Humans ; Self-Injurious Behavior/etiology* ; Hot Temperature/adverse effects* ; Global Health/statistics & numerical data* ; Female ; Male ; Adult ; Middle Aged ; Aged ; Young Adult ; Adolescent

Objective To explore the efficacy of bilateral facial muscle training combined with visual electromyography biofeedback on facial nerve function recovery in patients with idiopathic facial nerve palsy. Methods Patients with idiopathic facial nerve palsy admitted to Shanghai Fifth People’s Hospital, Fudan University from July 2022 to July 2024 were selected and randomly divided into a control group and an intervention group. The control group received conventional physical factor therapy, while the intervention group received bilateral facial muscle training combined with visual electromyography biofeedback therapy based on the control group’s regimen. After 20 treatment sessions, the total effective rate, the House-Brackmann (H-B) facial nerve grading system, the Sunnybrook Facial Grading System (SFGS) score, and the average value ratio of maximal amplitudes of bilateral frontalis and zygomaticus muscles were compared between the two groups. Results A total of 90 patients were included, 45 in each group. After 20 treatment sessions, the total effective rate was significantly higher in the intervention group than in the control group (84.4% vs 75.6%, P＝0.003). Compared with the control group, the intervention group demonstrated a significantly lower H-B grade (P＝0.003) and a higher SFGS score (P＝0.001). The average value ratios of maximal amplitudes of the affected versus healthy side frontalis (P＝0.013) and zygomatic (P＝0.022) muscles were higher in the intervention group than in the control group. Conclusions Bilateral facial muscle training combined with visual electromyography biofeedback is an effective approach for treating idiopathic facial nerve palsy, effectively promoting the recovery of facial nerve function, and improving facial symmetry and facial muscle function.

Objective: To explore the clinical efficacy of Xiaoshuan enteric-coated capsule (XSECC) in treating cerebral infarction and its potential mechanism of action. Methods: Patients with acute ischemic stroke (AIS) of the qi deficiency and blood stasis type were randomly assigned to the control and observation groups. They were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living (ADL), Hachinskilnchemic Scale (HIS), Barthel Index (BI), clinical efficacy scores, and TCM syndrome scores on days 0, 14, 30, and 90. Furthermore, VEGF and BDNF levels were measured on days 30 and 90. Finally, we analyzed the changes in each scale score and vascular neurological factor in both groups. Results: After 14 days of treatment, the difference values in NIHSS, ADL, and BI were higher, and TCM syndrome and clinical efficacy scores were increased in the observation group compared with those of the control group (all P < .05). After 30 days, the NIHSS, ADL, HIS, and TCM syndrome scores were decreased compared with those of the control group, while BI and clinical efficacy scores were increased (all P < .05). After 90 days, the difference value in ADL was higher, and TCM syndrome score was increased in the observation group compared with that of the control group (P = .047, P = .005, respectively). The levels of VEGF and BDNF were higher in the observation group than in the control group on days 14, 30, and 90 (all P < .05). VEGF and BDNF levels on day 0 were associated with prognosis of patients with AIS; therefore, they have a predictive value for the prognosis of acute cerebral infarction. Conclusions XSECC therapy can improve clinical outcomes in patients with acute and recurrent cerebral infarctions. Its mechanism of action may be associated with the secretion of VEGF and BDNF.

Objective To explore the therapeutic effect of dual microcatheter technology on patients with intracranial wide necked aneurysms and its impact on their neurological function.Method This article adopts a prospective randomized controlled study,collect clinical data of 55 patients with intracranial wide neck aneurysms from the First People's Hospital of Suzhou City from March 2017 to March 2022.According to different treatment methods,divided treatment group 28 cases and control group 27 cases.The control group patients received stent assisted therapy,while the treatment group patients received dual microcatheter intervention therapy.Compare efficacy and complications two groups;changes in NIHSS score and ADL score before and 6 months after surgery;Postoperative prognosis at 6 months.Result The total effective rate of the treatment group was 100.00％,while the total effective rate of the control group was 96.30％;two groups of patients with intracranial wide necked aneurysms treatment efficacy no significant difference(P＞0.05).The treatment group complications in patients with intracranial wide necked aneurysms(7.14％)less control group(33.33％)(P＜0.05).The two groups NIHSS score of patients with intracranial wide necked aneurysms lower before surgery at 6 months after surgery,while the ADL score higher before surgery(P＜0.05);the treatment group NIHSS score of patients with intracranial wide necked aneurysms(8.76±0.87)score lower control group(9.82±0.96)score after 6 months of treatment,while the ADL score(57.82±5.43)score higher control group(64.52±5.16)score(P＜0.05).There was no significant difference in mRS Scores between the two groups(P＞0.05).Conclusion The dual microcatheter technology has a good therapeutic effect on IWNA patients,can reduce the occurrence of complications,improve patient neurological function.

An online sample decomposition and detection method for high-throughput determination of Se content in organic samples was established based on oxygen combustion combined with hydride generation atomic fluorescence spectrometry.The sole product of Se in oxygen combustion,SeO2,was quantitatively captured on the walls of the combustion flask in an open system.It was then eluted online and reacted in situ with 10％(V/V)HC1 carrier solution and 2％(m/V)NaBH4 reductant solution within the combustion flask.After optimization,for a maximum sample processing amount of 0.2 g,the sample analysis throughput was 20 sample/h.The detection limit(LOD,3SD)for Se reached 0.012 mg/kg,and the relative standard deviations for parallel determinations(RSDs,n=6)was 1.7％.The analytical results of certified reference materials,scallop(GBW10024)and chicken(GBW10018),were consistent with the certified values,and the analytical results of real samples were in good agreement with those obtained by traditional wet digestion.

Objective To investigate the safety and efficacy of bybrid surgery in the treatment of cerebral arteriovenous malformation(CAVM)and possible factors for postoperative symptom progression.Methods A total of 61 patients with CAVM admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University from January 1,2016 to December 31,2021 who underwent bybrid surgery were retrospectively included.Demographic information(sex,age),incidence(first diagnosis of CAVM by imaging and/or first appearance of CAVM-related symptoms such as hemorrhage and epilepsy),time from onset to hybrid surgery,modified Rankin scale(mRS)score at admission,history of previous CAVM treatment(surgical removal of previous CAVM and intravascular treatment),CAVM imaging data(lesion location,size,drainage),Spetzler-Martin grade,lesion density(loose,dense),CAVM combined with aneurysm or aneurysmal structure,surgical method(microsurgery+intraoperative DSA,microsurgery+intraoperative DSA+endovascular embolism),treatment-related complications(intracranial hemorrhage and/or ischemic events and/or edema in surgery-related areas,puncture site hematoma and/or fistula and/or pseudoaneurysm,gastrointestinal and/or gingival bleeding and/or epistaxis,contrast hypersensitivity,all-cause death),clinical and radiological follow-up data were recorded.The safety(treatment-related complications,symptom progression[positive difference between the mRS score at 6 months postoperatively and the baseline mRS score])and effectiveness(occlusion,complete absence of the malformation on DSA at 6 months postoperatively;good prognosis,mRS score≤2 at 6months postoperatively)of hybrid surgery treatment were evaluated.Based on the clinical follow-up results at 6 months after surgery,patients who underwent hybrid surgery for CAVM were divided into the progressive group and the non-progressive group,and their baseline and clinical characteristics were compared.Results(1)Among the 61 patients who underwent hybrid surgery for CAVM,37(60.7％)were male,with a median age of 25(13,42)years;11(18.0％)were asymptomatic,and 39(63.9％)had hemorrhage as their initial symptom,while 11(18.0％)had seizures as their initial symptom.At admission,54(88.5％)patients had an mRS score of ≤2,including 38(62.3％)patients who had undergone previous endovascular embolization and had residual or recurrent CAVM;the Spetzler-Martin grade of the CAVM lesion was Ⅰ,Ⅱ,Ⅲ,or Ⅳ in 13(21.3％),22(36.1％),21(34.4％),and 5(8.2％)patients,respectively;24 patients underwent DSA verification during surgery using a hybrid surgical platform,and 37 patients underwent DSA verification and assisted endovascular embolization using a hybrid surgical platform.(2)Clinical follow-up completion rate was 77.0％(47/61);the follow-up time ranged from 6 to 24 months and the median follow-up time was 12(6,24)months.The good prognosis rate was 91.5％(43/47),there was no death.The incidence of treatment-related complications was 10.6％(5/47).The completion rate of imaging follow-up was 72.1％(44/61)and the median follow-up time was 15(10,22)months.There were 40(90.9％)of CAVM occlusion,2(4.5％)of residual CAVM and 2(4.5％)of recurrent CAVM.(3)Among the 47 patients who completed clinical follow-up,15 patients developed symptoms and 32 patients did not develop symptoms.There were no significant differences in sex,age,onset symptoms,mRS score at admission,lesion location,lesion density and aneurysm or aneurysmal structure between the two groups(all P＞0.05).In the progressive group,the proportion of lesions with the largest diameter＜3 cm,3-6 cm and＞6 cm were 3/15,10/15 and 2/15,respectively,and the largest diameter was mainly 3-6 cm.In the non-progressive group,the proportion of the largest diameter＜3 cm and 3-6 cm were 18/32 and 14/32,respectively,and the largest diameter＜3 cm was the main proportion(x2=8.321).Deep venous drainage(x2=11.937)and residual and/or recurrence(x2=8.507)were present in the progressive group,and the differences between the groups were statistically significant(all P＜0.05).Conclusions Hybrid surgery has certain safety and effectiveness in the treatment of CAVM.Patients with CAVM who experienced progression after undergoing composite surgery have characteristics such as larger maximum diameter,the presence of deep venous drainage and residual and/or recurrence,and the factors affecting progression need to be further explored in the future.