Pruritus is one of the common comorbidities in patients with chronic kidney disease, significantly reducing life quality and increasing the risks of depression and mortality. This report presents the treatment process of a patient undergoing maintenance hemodialysis with pruritus. The patient successively received an optimized dialysis prescription, management of chronic kidney disease-related mineral and bone disorder, correction of secondary hyperparathyroidism, enhanced skin care, and administration of gabapentin. However, pruritus symptoms of this patient persisted. Subsequently, the patient was treated with nalfurafine hydrochloride, resulting in significant relief of pruritus symptoms without any adverse reaction. This case provides new insights and references for the treatment of chronic kidney disease-associated pruritus.

OBJECTIVE: To investigate the effectiveness and safety of simultaneous bilateral total knee athroplasty (SB-TKA) for the treatment of patients aged 65 years and younger with bilateral knee osteoarthritis (KOA) by comparing with patients undergoing unilateral total knee arthroplasty (U-TKA). METHODS: A clinical data of patients, who underwent primary TKA for KOA and met the selection criteria between June 2019 and July 2023, was retrospectively analyzed, including 181 patients in the U-TKA group and 52 patients in the SB-TKA group. The baseline data of age, gender, disease duration, body mass index, and preoperative hemoglobin (Hb), knee range of motion (ROM), Oxford knee score (OKS), and visual analogue scale (VAS) score for pain were compared between the two groups, with no significant difference ( P>0.05). The operation time, postoperative hospital stay, and all complications related to knee arthroplasty were recorded. Hb was measured at 2 days after operation and the difference between pre- and post-operation was calculated. The knee function and pain were evaluated by using ROM, OKS score, and VAS score and compared between the two groups. RESULTS: The operation time and postoperative hospital stay duration were significantly shorter in the U-TKA group than in the SB-TKA group ( P<0.05). The difference of Hb was significantly lower in the U-TKA group ( P<0.05). All patients were followed up 12-61 months (mean, 37.2 months). There was no significant difference in follow-up time between the two groups ( P>0.05). At last follow-up, the ROM, OKS score, and VAS score of both groups were better than the preoperative ones, and the differences were significant ( P<0.05); there were significant differences between the two groups in the ROM and OKS score ( P<0.05), while no significant difference was found in the VAS score ( P>0.05). Mild complications were observed in 31 cases (17.13%) and severe complications in 3 cases (1.66%) in the U-TKA group, while mild complications were observed in 14 cases (26.92%) in the SB-TKA group, and no severe complication occurred. There was no significant difference in the incidences of mild and severe complications between the two groups ( P>0.05). CONCLUSION In patients aged 65 years and younger with bilateral KOA, knee function and mobility can significantly improved when treated by SB-TKA. While patients had lower postoperative knee mobility and function scores compared with U-TKA, there was no significant difference in pain scores or overall incidence of complication. Strict patient selection and scientific perioperative management are important to achieve good effectiveness after operation in patients with SB-TKA.
Humans ; Arthroplasty, Replacement, Knee/adverse effects* ; Male ; Female ; Retrospective Studies ; Osteoarthritis, Knee/physiopathology* ; Range of Motion, Articular ; Treatment Outcome ; Middle Aged ; Operative Time ; Length of Stay ; Knee Joint/physiopathology* ; Pain Measurement ; Postoperative Complications/epidemiology* ; Aged

Objective To establish a high-throughput non-targeted screening and prioritization method for emerging pollutants(EPs)in sewage using direct injection high-resolution mass spectrometry(HRMS).Methods The sewage samples were filtered by membrane filter and directly subjected to the liquid chromatography-time-of-flight mass spectrometer based on a method modified from our previous study.A C18 chromatographic column was applied for a gradient elution separation,and accurate mass and mass spectral fragment information were obtained through the MS full scan mode and MS/MS DIA data collection mode.After peak detection and alignment,the features from the raw data through open source software MZmine 3,and then high-throughput screening strategies such as MassBank and PubChem databases were used for compound annotation.Finally,the candidate features were confirmed with chemical standards by compared their retention time and mass spectrum fragmentation ion peaks.Results 13 EPs were identified,including 7 industrial chemicals,4 pharmaceuticals,1 pesticide and 1 metabolite.High detection rates were observed for metformin(86.2％),2-hydroxybenzothiazole(79.3％),1,2-benzisothiazole-3-one(72.4％),and 1,2-benzisothiazole-3-one(72.4％).The quantitative concentration range of EPs was 1.37～19.05 ng/mL,with the high concentrations observed for melamine(19.05 ng/mL)and furosemide(18.49 ng/mL).Ecological risk assessment identified 1,2-benzisothiazol-3-one,4-aminoacetophenone,creatinine,2-hydroxybenzothiazole,and furosemide as key pollutants.Conclusion This direct injection coupled with HRMS workflow enables efficient non-targeted screening and prioritization of emerging EPs in sewage samples,highlighting five ecotoxicologically critical EPs.The methodology enhances environmental monitoring capabilities and provide critical technical support for interdisciplinary research such as environmental forensics and health risk assessment.

Objective To establish a high-throughput non-targeted screening and prioritization method for emerging pollutants(EPs)in sewage using direct injection high-resolution mass spectrometry(HRMS).Methods The sewage samples were filtered by membrane filter and directly subjected to the liquid chromatography-time-of-flight mass spectrometer based on a method modified from our previous study.A C18 chromatographic column was applied for a gradient elution separation,and accurate mass and mass spectral fragment information were obtained through the MS full scan mode and MS/MS DIA data collection mode.After peak detection and alignment,the features from the raw data through open source software MZmine 3,and then high-throughput screening strategies such as MassBank and PubChem databases were used for compound annotation.Finally,the candidate features were confirmed with chemical standards by compared their retention time and mass spectrum fragmentation ion peaks.Results 13 EPs were identified,including 7 industrial chemicals,4 pharmaceuticals,1 pesticide and 1 metabolite.High detection rates were observed for metformin(86.2％),2-hydroxybenzothiazole(79.3％),1,2-benzisothiazole-3-one(72.4％),and 1,2-benzisothiazole-3-one(72.4％).The quantitative concentration range of EPs was 1.37～19.05 ng/mL,with the high concentrations observed for melamine(19.05 ng/mL)and furosemide(18.49 ng/mL).Ecological risk assessment identified 1,2-benzisothiazol-3-one,4-aminoacetophenone,creatinine,2-hydroxybenzothiazole,and furosemide as key pollutants.Conclusion This direct injection coupled with HRMS workflow enables efficient non-targeted screening and prioritization of emerging EPs in sewage samples,highlighting five ecotoxicologically critical EPs.The methodology enhances environmental monitoring capabilities and provide critical technical support for interdisciplinary research such as environmental forensics and health risk assessment.

Pruritus is one of the common comorbidities in patients with chronic kidney disease, significantly reducing life quality and increasing the risks of depression and mortality. This report presents the treatment process of a patient undergoing maintenance hemodialysis with pruritus. The patient successively received an optimized dialysis prescription, management of chronic kidney disease-related mineral and bone disorder, correction of secondary hyperparathyroidism, enhanced skin care, and administration of gabapentin. However, pruritus symptoms of this patient persisted. Subsequently, the patient was treated with nalfurafine hydrochloride, resulting in significant relief of pruritus symptoms without any adverse reaction. This case provides new insights and references for the treatment of chronic kidney disease-associated pruritus.

Cerebral small vessel disease (CSVD) is an important cause of ischemic stroke and vascular dementia, which brings heavy burden to families and society. The prevention and treatment of CSVD has always been a research hotspot, but its pathogenesis is still not completely clear. This article reviews the pathogenesis of CSVD, including chronic cerebral hypoperfusion, blood-brain barrier dysfunction, vascular endothelial dysfunction, interstitial fluid reflux disorder, inflammatory response, and genetic factors, in order to provide more sufficient theoretical basis for early intervention and treatment of CSVD.

Objective: To investigate the short-term effectiveness of unicompartmental knee arthroplasty (UKA) in the treatment of knee osteoarthritis of super-age patients over 85 years old. Methods: Senile patients with unilateral compartment osteoarthritis of the knee who received UKA between November 2013 and May 2017 and met the inclusion criteria were enrolled as the research objects. Among them, 40 patients (50 knees) were more than 85 years old (super-age group) and 44 patients (50 knees) were 52-81 years old (control group). There was significant difference in age between the two groups ( t=17.33, P=0.00). There was no significant difference in body mass index, degenerative classification of medial and lateral compartments, varus deformity of knee, disease duration, complicating diseases, and preoperative hemoglobin, hematocrit (HCT), American Hospital for Special Surgery (HSS) score, range of motion (ROM) of knee, visual analogue scale (VAS) score, and femoral-tibial angle (FTA) between the two groups ( P>0.05). Hospital stay, hemoglobin, and HCT of the two groups were recorded before operation and on the first day after operation. The changes of hemoglobin and HCT after operation were calculated. During follow-up period, the ROM of the knee, HSS score, and VAS score were measured; the position of the prosthesis and FTA were observed by X-ray films. Results: There was no significant difference in hospital stay between the two groups ( t=1.05, P=0.29). Hemoglobin and HCT of the two groups on the first day after operation were significantly lower than those before operation ( P<0.05). There was no significant difference in the postoperative changes of hemoglobin and HCT between the two groups ( P>0.05). All the patients were followed up completely except 4 cases (5 knees) in the super-age group. The follow-up time ranged from 14 to 44 months of super-age group (mean, 29 months) and 21 to 33 months of control group (mean, 24 months). There were significant differences in HSS score, VAS score, ROM of the knee, and FTA between pre-operation and last follow-up in the two groups ( P<0.05). There was significant difference in HSS score between the two groups ( P<0.05), and no significant difference was found in ROM, VAS score, and FTA between the two groups ( P>0.05). X-ray film showed no adverse position of the prosthesis, infection around the prosthesis, prosthesis loosening, or pathological bright lines. Conclusion: UKA combined with reasonable perioperative management in the treatment of super-age patients over 85 years with knee osteoarthritis is safe and feasible, and can obtain satisfactory short-term effectiveness.

Objective To study the status of filial piety and anxiety among adults, explore the relationship between filial piety and anxiety, and analyze the factors that affect anxiety. Methods A total of 915 adults from Jiangsu and Anhui provinces were selected using the General Information Questionnaire, the Chinese Filial Values Index scale (FVI) and Zung Self-rating Anxiety Scale (SAS), through the online platform and on-site payment, recovery of the questionnaire to investigate. Results The overall level of filial piety was 85.23 ± 9.22 , among which the care dimension was 84.60 ± 9.75 and the respect dimension was 86.12 ± 11.76;111 adults were with anxiety (12.13％), and patients with mild and moderate anxiety respectively were 88 (9.62％) and 23 (2.51％) cases. The overall level of filial piety was negatively correlated with the level of anxiety (r=-0.403, P<0.01), and the level of filial piety is an independent factor affecting the level of anxiety in adults(B=-0.299,P<0.01). Other factors also include the quality of sleep, illness, duration, beliefs, occupational stability. Conclusion The high level of filial piety in adults is moderately correlated with anxiety and is an independent risk factor for anxiety in this population. The adult's education of filial piety should be strengthened and the positive adjustment of filial piety to anxiety should be strengthened in order to better solve the physical and mental health problems caused by the pension burden.

Objective To investigate the motivation of non-medical students choosing Medical Humanistic Care curriculum and their cognition of medical humanistic care, so as to provide reference for the popularization of medical humanistic care knowledge. Methods A total of 10 non-medical students were selected by purposive sampling method for semi-structured interviews. The research data was analyze and refine the theme by phenomenological research method. Results Motivation of taking the course and medical humanities cognition were refined, which consisted of seven aspects, including learning to care others, interest in medical science, attention on the doctor-patient relationship ,the influence of family, doctor benevolence, mutual understanding between doctors and patients, and hard working with regret. Conclusions From the perspective of non-medical majors, teachers should tap their thirst for medical humanistic care, expand their medical knowledge and enhance their humanistic care ability.

OBJECTIVETo analyze virulence genes and molecular characteristics of Vibrio parahaemolyticus isolated from sporadic cases with diarrhea in tow sentinel hospitals of Shanghai, 2010-2012.

METHODSA total of 2 729 stool samples were collected from two surveillance sentinel hospitals in Shanghai 2010-2012. Vibrio parahaemolyticus strains were isolated and identified from diarrhea out patients using TCBS agar plates and biochemical reactions. Thermostable direct hemolysingene (tdh), thermostable-related hemolysin gene (trh), hemolysin gene (tlh) were detected by multiplex PCR method. Isolates were analyzed by PFGE and MLST. The PFGE profiles were analyzed using BioNumerics software.

RESULTSA total of 30 clinical Vibrio parahaemolyticus strains isolated from 2 729 stool samples. The anually Vibrio parahaemolyticus isolation rate during 2010 to 2012 were 1.1%(11/973), 1.0%(11/1 120) and 1.3%(8/636) respectively. The PCR positive rates of virulence genes tlh, tdh and trh were 100%, 97% and 0 respectively. The Vibrio parahaemolyticus strains were divided into 13 PFGE types (P1-P13)and 3 ST types (ST-189, ST-799, ST-3). Among 13 PFGE types, P4 was the main PFGE type, accounting for 30%(9/30). P9, P10 were accounting for 12% (4/30) respectively, P1, P2, P12, P13 were accounting for 7%(2/30) respectively, the others types were 3%(1/30) respectively. MLST analysis results showed there are three ST types, ST3 was 84%(25/30), ST189 and ST799 were accounting for 13% (4/30) and 3% (1/30) respectively.

CONCLUSIONThe infection rate of Vibrio parahaemolyticus was not very high from 2010-2012 in Shanghai, all strains were positive for tlh and negative for trh. ST3 was the major type of Vibrio parahaemolyticus.

China ; Diarrhea ; Genotype ; Hemolysin Proteins ; Hospitals ; Humans ; Multilocus Sequence Typing ; Outpatients ; Polymerase Chain Reaction ; Sentinel Surveillance ; Vibrio Infections ; Vibrio parahaemolyticus ; Virulence