Objective To explore the risk factors of progression to dementia within 2 years in patients with recent subcortical small infarction (RSSI) complicated with cognitive dysfunction. Methods A total of 340 patients with RSSI complicated with cognitive dysfunction who were treated in the hospital and completed 2-year follow-up were selected from February 2021 to February 2025. According to whether the patients progressed to dementia, they were classified into dementia group (n=105) and non-dementia group (n=235). The clinical data were compared between both groups, and the independent risk factors were screened by Logistic regression analysis. Results Multivariate logistic regression analysis suggested that history of hypertension (OR=1.919), history of diabetes mellitus (OR=1.597), multiple infarctions (OR=1.455), severe white matter lesions (OR=1.595), no cognitive function training (OR=1.923), increased infarct size (OR=1.069), reduced MMSE score (OR=0.945) and increased levels of NfL (OR=1.049) and IL-6 (OR=1.038) were independent risk factors for the progression to dementia (all P<0.05). Conclusion The progression to dementia in patients with recent subcortical small infarction and cognitive dysfunction is affected by multiple factors. In clinical practice, the integration of vascular risk factors, imaging features, cognitive assessment and serum biomarkers (NfL, IL-6) helps to construct an early risk prediction model and implement targeted interventions for high-risk groups.

Objective:To summarize and analyze the risk factors associated with bronchial mucus plugs (BMPs) in children with Mycoplasma pneumoniae pneumonia (MPP),providing a clinical basis for the indication of bronchoscopy in children with MPP.Methods:A total of 72 children with MPP admitted to the Department of Pediatrics at the Fourth Affiliated Hospital of Nanjing Medical University from December 2022 to December 2024,who underwent bronchoscopy,were selected for this study.According to the presence or absence of BMPs under tracheoscopy,the patients were divided into the mucus plug group and the non-mucus plug group,and their clinical data were analyzed and compared.Results:Among the 72 children with MPP,30 cases (41.7%) were in the mucus plug group,while 42 cases (58.3%) were in the non-mucus plug group.Univariate Logistic regression analysis showed that thermal peak ( OR 2.086,95% CI 1.029-4.299, P=0.041),thermal duration ( OR 1.453,95% CI 1.197-1.763, P < 0.001),thermal duration ≥10 days ( OR 26.154,95% CI 5.316-128.661, P<0.001),combined with pleural effusion ( OR 4.727,95% CI 1.136-19.677, P=0.033),atelectasis ( OR 5.636,95% CI 2.024-15.699, P<0.001),lymphocyte proportion( OR 0.936,95% CI 0.888-0.978, P=0.014),neutrophil proportion( OR 1.048,95% CI 1.005-1.093, P=0.028),lactatedehydrogenase ( OR 1.005,95% CI 1.001-1.009, P = 0.028),D-dimer ( OR 2.203,95% CI 1.133-4.280, P = 0.020),fibrin degradation products ( OR 1.563,95% CI 1.095-2.231, P=0.014),and no heat regression within 72 hours of hormone use ( OR 0.239,95% CI 0.085-0.667, P=0.006) were significant influencing factors for the formation of BMPs in children with MPP.Multivariate Logistic regression analysis showed that thermal duration ≥10 days and atelectasis were independent risk factors for BMPs formation ( P<0.05). Conclusion:For MPP children with thermal duration≥10 days,especially with atelectasis,BMPs may have been formed,and it is recommended to perform bronchoscopy as soon as possible.

Objective To explore the effects of Emotional Freedom Techniques combined with PERMA model intervention on fear of disease progression and quality of life in postoperative liver cancer patients.Methods A total of 58 liver cancer patients admitted from September 2023 to February 2024 were randomly divided into the experimental group(n=29)and the control group(n=29)using a random number table method.The experimental group received Emotional Freedom Techniques combined with PERMA-based positive psychological intervention,while the control group received the holistic nursing and routine psychological guidance.Both groups underwent the continuous intervention for 8 weeks.Outcomes were assessed using the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Distress Thermometer(DT),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Cancer Fatigue Scale(CFS),Athens Insomnia Scale(AIS)and Index of Well-Being(IWB).Results After the intervention,the experimental group showed the significantly lower scores than those in the control group in FoP-Q-SF(24.97±2.34/34.10±8.46),DT(2.24±0.95/2.93±1.33),SAS(49.55±1.35/58.55±4.60),SDS(51.86±1.58/61.79±4.00),CFS(4.03±0.94/5.10±1.18),and AIS(2.45±1.12/4.07±0.96)(all P<0.05),while the IWB score(10.56±1.74/7.39±2.05)was significantly higher than that in the control group(P<0.05).Conclusion The combination of Emotional Freedom Techniques and PERMA model intervention can effectively alleviate the disease-related fears,improve the negative emotions,reduce the physical symptoms and enhance the subjective well-being in postoperative liver cancer patients,and it has a significant clinical application value.

To summarize the nursing experience of a patient with Danon disease after heart transplantation.Nursing key points:closely monitor heart function,prevent right heart failure;phased analgesic and sedative measures were implemented to reduce the occurrence of related complications.Skeletal muscle function was evaluated and rehabilitation training was strengthened to promote the prognosis of patients.The patient was transferred to the general ward 5 days after operation,and was discharged 22 days after operation.

Objective To explore the impact of different delay time of umbilical cord ligation on the outcome of preterm infants.Methods A total of 266 preterm infants born in the obstetric department of this hospital from January 2021 to December 2022 were selected as the research subjects and divided into the in-stant group(umbilical cord ligation immediately after birth,n=53),30 s group(delayed umbilical cord liga-tion for 30 s,n=50),60 s group(delayed umbilical cord ligation for 60 s,n=55),90 s group(delayed umbili-cal cord ligation for 90 s,n=55)and 120 s group(delayed umbilical cord ligation for 120 s,n=52)according to the random number table method.The Hb and HCT levels and the incidence rates of anemia,blood transfu-sion,hyperbilirubinemia,intracranial hemorrhage,necrotizing enterocolitis(NEC)and bronchopulmonary dys-plasia(BPD)after birth were compared among 5 groups.Results The Hb and HCT levels at 24 h after birth in the 60,90,120 s groups were higher than those in the instant group and 30 s group,moreover the 120 s group was higher than the 60 s group and 90 s group,and the differences were statistically significant(P＜0.05).The anemia incidence rate and blood transfusion rate in the 60,90,120 s groups were lower than those in the instant group and 30 s group,and the differences were statistically significant(P＜0.05).The hyperbil-irubinemia incidence rate in the 120 s group was higher than that in the other 4 groups,and the difference was statistically significant(P＜0.05).The intracranial hemorrhage incidence rate in the 60,90,120 s groups were lower than those in the instant group and 30 s group,and the differences were statistically significant(P＜0.05).The NEC incidence rate in the 60 s and 90 s group was lower than that in the instant group and 30 s group,but the 120 s group was higher than that in the other 4 groups,and the differences were statistically significant(P＜0.05).The BPD incidence rate had no statistical difference among 5 groups(P＞0.05).Con-clusion Delayed umbilical cord ligation for 60 s or 90 s could improve the outcomes of preterm infants.

Background Asthma poses a serious threat to children's growth, development, and mental health, thus there has been an increasing focus on the control of asthma morbidity in children and the assessment of its risk factors. A growing body of research has found that exposure to ambient air pollutants an significatly increase the risk of childhood asthma. Objective To understand the changes of ambient air pollutant concentrations in Nanjing and asthma outpatient visits to Nanjing Children's Hospital, and to quantitatively analyze the effects of exposure to different ambient air pollutants on children's asthma outpatient visits. Methods Daily data of ambient air pollutants fine particulate matter (PM_2.5), inhalable particle (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), ozone (O₃), meteorological factors (air temperature & relative humidity), and outpatient visits due to asthma in the hospital from January 1, 2019 to December 31, 2023 were collected, and a generalized additive model based on quasi poisson distributions was used to quantitatively analyze the short-term effects of ambient air pollutant exposure on outpatient visits due to asthma in the hospital. Results The annual average concentrations of PM_2.5, PM₁₀, SO₂, and NO₂ in Nanjing from 2019 to 2023 did not exceed the national limits. For single-day lagged effects, the single-pollutant model showed that the effects of PM_2.5, PM₁₀, NO₂, and CO on children's asthma outpatient visits were greatest for every 10 units increase at lag0, with excess risk (ER) of 1.39% (95%CI: 0.65%, 2.14%), 1.46% (95%CI: 0.97%, 1.95%), 5.46% (95%CI: 4.36%, 6.57%), and 0.18% (95%CI: 0.11%, 0.26%), respectively, and SO₂ reached the maximum effect at lag1, with an ER of 23.15% (95%CI: 13.57%, 33.53%) for each 10 units increase in concentration. Different pollutants reached their maximum cumulative lag effects at different time. The PM₁₀, PM_2.5, SO₂, NO₂, and CO showed the largest cumulative lag effects at lag01, lag01, lag02, lag02, and lag03, respectively, with ERs of 1.35% (95%CI: 0.77%, 1.92%), 0.96% (95%CI: 0.10%, 1.83%), 28.50% (95%CI: 15.49%, 42.98%), 6.92% (95%CI: 5.53%, 8.33%), and 0.31% (95%CI: 0.20%, 0.42%), respectively. The influences of PM_2.5 and PM₁₀ on outpatient visits due to asthma in the hospital became more pronounced with advancing age, while the associations with NO₂, SO₂, and CO were weakened as children grew older. Conclusion Ambient air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO) can increase childhood asthma visits, and different pollutants have varied effects on the number of asthmatic children's visits at different ages.

To summarize the nursing experience of a patient with severe pulmonary hypertension complicated with giant heart after lung transplantation.Key nursing points:to set up volume management measures in stages to avoid hemodynamic disorders;to monitor cardiac function closely and be alert to the occurrence of low cardiac output syndrome;to closely observe heart rate and heart rhythm to correct arrhythmia as soon as possible;the sequential ventilation strategy was adopted to promote the recovery of lung function.Progressive implementation of individual rehabilitation was conducted,and the patient activity tolerance was improved.After careful treatment and nursing,the patient was successfully transferred to the general ward 29 days after surgery,recovered from the hospital 41 days after surgery,followed up for 6 months,and recovered well.

This report described the multidisciplinary management of a preterm infant with congenital tracheal agenesis (TA). The infant, delivered via cesarean section at 32 +5 weeks' gestation, had Apgar scores of 6 and 8 at 1 and 5 minutes, respectively. Although skin color improved after 30 seconds of bag-mask ventilation, the infant exhibited no cry, weak spontaneous breathing, and failed multiple intubation attempts. The patient was transferred to Anhui Children's Hospital of Fudan University under continuous bag-mask positive-pressure ventilation at 3 hours after birth (September 10, 2024). Combined imaging and fiberoptic bronchoscopy confirmed TA (Floyd type Ⅱ/Faro type C) with multiple anomalies, including duodenal atresia, aortic coarctation, and butterfly vertebrae. Whole-genome sequencing revealed a suspected mosaic SCN2A c.5317G>A variant (wild-type parents) and an ERCC5 c.2974C>T heterozygous variant inherited from the mother (homozygous). Following esophageal intubation, invasive mechanical ventilation, and continuous gastrointestinal decompression, respiratory distress significantly improved with a stabilized condition. The infant died 30 hours after birth following treatment withdrawal.

Objective:To investigate the expression and biological function of AHNAK nucleoprotein 2(AHNAK2)in thyroid cancer.Methods:The expression of AHNAK2 in thyroid cancer tissues was analyzed using The Cancer Genome Atlas(TCGA),Gene Expression Omnibus(GEO),and Human Protein Atlas(HPA)databases.The correlation between AHNAK2 expression and patients'prognosis,clinicopathological characteristics,immune cell infiltration,and subcellular localization was evaluated.AHNAK2 mRNA expression in thyroid cancer cells was detected by RT-qPCR.A stable AHNAK2 knockdown TPC-1 cell line was established via lentiviral transfection,and the transfection efficiency was validated using RT-qPCR and Western blot.TPC-1 cells were divided into the sh-NC and sh-AHNAK2 groups.The impact of AHNAK2 knockdown on TPC-1 cell proliferation,migration,and invasion was assessed using colony formation assay,CCK-8 assay,wound healing assay,and Transwell assay.Results:AHNAK2 was up-regulated in thyroid cancer tissues and was associated with poor prognosis.It was primarily localized in the cytoplasm and cytoplasmic membrane.GO analysis revealed that AHNAK2 was mainly enriched in biological processes such as organelle disassembly,cellular components such as the spindle,and molecular functions such as microtubule binding.KEGG pathway analysis indicated that AHNAK2 was primarily enriched in the cell cycle pathway.Immune infiltration analysis suggested that AHNAK2 expression was positively correlated with macrophage infiltration and negatively correlated with plasmacytoid dendritic cell infiltration in thyroid cancer.AHNAK2 was overexpressed in multiple thyroid cancer cell lines.In vitro experiments demonstrated that AHNAK2 knockdown inhibited the proliferation,migration,and invasion of TPC-1 cells.Conclusion:AHNAK2 may serve as an important prognostic biomarker and immunotherapy target for thyroid cancer,as it can promote the proliferation,migration and invasion of thyroid cancer cells.

Urinary incontinence is the most common complication after radical prostatectomy.Traditional Chinese medicine treatments for this disease,such as acupuncture,are diverse and have definite therapeutic effects.The disease is located in the bladder,and its etiology and pathogenesis are mostly related to the dysfunction of the kidney,spleen,triple energizer and other viscera.In view of the insufficiency of kidney essence,decline of the gate of vitality fire(mingmen fire),Qi deficiency leading to impaired bladder containment,compounded by obstruction of meridians from pathogenic factors including blood stasis,damp-heat,and phlegm turbidity.The"Shuanggu Yitong"acupuncture achieves"Dual fortification"through tonifying the kidney and primordial qi consolidation,combined with spleen strengthening and qi supplementation.Additionally,"purging"targets the elimination of blood stasis,phlegm turbidity,damp-heat and other solid evils.This integrated approach combines acupuncture and moxibustion modalities with reinforcing-reducing needle manipulation techniques,simultaneously addressing both the symptoms and root causes of the problem.By coordinating pathogen elimination with constitutional regulation,this method demonstrates favorable therapeutic outcomes in clinical practice and is worthy of further clinical promotion.