Objective:To study the epidemic characteristics and clinical symptoms of patients with Hashimoto's thyroiditis (HT) in Shandong Province, and to provide a basis for further optimizing the clinical treatment strategies for HT.Methods:Data on HT patients admitted to Shandong Provincial Center for Disease Control and Prevention from January 2018 to December 2023 were collected. A retrospective analysis was conducted to analyze their epidemiological characteristics, clinical symptoms, and auxiliary examination results.Results:A total of 192 HT patients' data were included, comprising 42 males (21.87%) and 150 females (78.13%). The average age of patients was 40.38 years old, ranging from 9 to 74 years old. Most patients resided in urban areas (129 cases, 67.19%). HT cases occurred throughout the year in every mouth, with higher incidence in June (32 cases, 16.7%) and July (20 cases, 10.4%), lower incidence in March (8 cases, 4.2%) and April (10 cases, 5.2%), and sporadic cases in other months. Based on clinical manifestations, among all HT patients, there were 66 cases (34.38%) of Hashitoxicosis type, 11 cases (5.73%) of pseudothyrotoxicosis type, 7 cases (3.65%) of exophthalmic type, 5 cases (2.60%) of subacute thyroiditis-like type, 3 cases (1.56%) of juvenile type, 35 cases (18.23%) of fibrous type, 39 cases (20.31%) of thyroid adenoma or carcinoma type, and 26 cases (13.54%) of other autoimmune diseases type. Based on disease progression, among all HT patients, there were 61 cases (31.77%) in the hyperthyroid phase, 16 cases (8.33%) in the hyperthyroid-hypothyroid coexisting phase, and 115 cases (59.90%) in the hypothyroid phase. Based on clinical symptoms, among all HT patients,there were 78 cases(40.62%) of neck mass symptoms, 101 cases (52.60%) of digestive system symptoms, and 95 cases (49.48%) of low metabolic symptoms. Laboratory tests revealed that 144 cases had elevated levels of both thyroglobulin antibody and thyroid peroxidase antibody. Color ultrasound examination showed strip-like echoes in the thyroid in 99 cases (51.56%) and grid-like echoes in 43 cases (22.40%). After treatment with antithyroid drugs or appropriate thyroid hormone supplementation, all 192 HT patients experienced symptom relief.Conclusions:HT patients in Shandong Province were predominantly female and urban residents. Common clinical symptoms included anterior neck swelling, constipation, fever, and weight gain. Early detection, diagnosis, and treatment could delay disease progression.

Objective:To study the epidemic characteristics and clinical symptoms of patients with Hashimoto's thyroiditis (HT) in Shandong Province, and to provide a basis for further optimizing the clinical treatment strategies for HT.Methods:Data on HT patients admitted to Shandong Provincial Center for Disease Control and Prevention from January 2018 to December 2023 were collected. A retrospective analysis was conducted to analyze their epidemiological characteristics, clinical symptoms, and auxiliary examination results.Results:A total of 192 HT patients' data were included, comprising 42 males (21.87%) and 150 females (78.13%). The average age of patients was 40.38 years old, ranging from 9 to 74 years old. Most patients resided in urban areas (129 cases, 67.19%). HT cases occurred throughout the year in every mouth, with higher incidence in June (32 cases, 16.7%) and July (20 cases, 10.4%), lower incidence in March (8 cases, 4.2%) and April (10 cases, 5.2%), and sporadic cases in other months. Based on clinical manifestations, among all HT patients, there were 66 cases (34.38%) of Hashitoxicosis type, 11 cases (5.73%) of pseudothyrotoxicosis type, 7 cases (3.65%) of exophthalmic type, 5 cases (2.60%) of subacute thyroiditis-like type, 3 cases (1.56%) of juvenile type, 35 cases (18.23%) of fibrous type, 39 cases (20.31%) of thyroid adenoma or carcinoma type, and 26 cases (13.54%) of other autoimmune diseases type. Based on disease progression, among all HT patients, there were 61 cases (31.77%) in the hyperthyroid phase, 16 cases (8.33%) in the hyperthyroid-hypothyroid coexisting phase, and 115 cases (59.90%) in the hypothyroid phase. Based on clinical symptoms, among all HT patients,there were 78 cases(40.62%) of neck mass symptoms, 101 cases (52.60%) of digestive system symptoms, and 95 cases (49.48%) of low metabolic symptoms. Laboratory tests revealed that 144 cases had elevated levels of both thyroglobulin antibody and thyroid peroxidase antibody. Color ultrasound examination showed strip-like echoes in the thyroid in 99 cases (51.56%) and grid-like echoes in 43 cases (22.40%). After treatment with antithyroid drugs or appropriate thyroid hormone supplementation, all 192 HT patients experienced symptom relief.Conclusions:HT patients in Shandong Province were predominantly female and urban residents. Common clinical symptoms included anterior neck swelling, constipation, fever, and weight gain. Early detection, diagnosis, and treatment could delay disease progression.

Objective To explore the clinical application value of emergency bedside echocardiography(EB-Echo)in the diagnosis and treatment of reverse-Takotsubo syndrome(r-TTS).Methods A retrospective study method was conducted,the EB-Echo imaging and clinical data of 10 patients already diagnosed with r-TTS and admitted to the department of critical care medicine of Zhengzhou People's Hospital from January 2014 to December 2021 were selected.The r-TTS group,while data from 33 concurrently admitted patients with classic Takotsubo syndrome(TTS)were selected as the classic TTS group.Comparisons were made in terms of EB-Echo detection rates,diagnosis times,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular stroke volume(LVSV)],blood volume indicators[inferior vena cava diameter(IVCD),collapse degree of inferior vena cava(cIVC)],complications[acute left ventricular outflow tract obstruction(ALVOTO),acute mitral regurgitation(AMR),and pulmonary hypertension(PH)],and prognosis between the two groups.Results The detection rate of EB-Echo in the r-TTS group was significantly higher than that in the classic TTS group[100.0%(10/10)vs.66.7%(22/33),P<0.05],and the diagnosis time was significantly shorter(minutes:26.80±3.77 vs.41.18±6.61,P<0.05).In terms of cardiac function indicators,both LVEF and LVSV were significantly lower in the r-TTS group compared to the classic TTS group[LVEF:0.36±0.05 vs.0.41±0.04,LVSV(mL):36.43±4.30 vs.40.65±5.09,both P<0.05].However,there were no significant differences in blood volume indicators(IVCD and cIVC)between the r-TTS group and the classic TTS group[IVCD(mm):15.02±1.88 vs.14.94±1.75,cIVC:(0.43±0.06)%vs.(0.44±0.07)%,both P>0.05].Concerning complications,the incidence of ALVOTO was slightly lower in the r-TTS group compared to the classic TTS group[0%(0/10)vs.21.2%(7/33),P>0.05],while the incidences of AMR and PH were similar between the two groups[AMR incidence:40.0%(4/10)vs.24.2%(8/33),PH incidence:30.0%(3/10)vs.18.2%(6/33),both P>0.05].After a follow-up ranging from 6 months to 3 years,no deaths were reported in the r-TTS group,whereas there was one fatality in the classic TTS group.Nevertheless,the mortality difference between the groups was not statistically significant.Conclusion EB-Echo demonstrates significant clinical value in the early diagnosis,guiding therapy,and enhancing prognosis of r-TTS.

Objective To search,evaluate,and summarize the best evidence of insertion and maintenance of mini-midline in adult patients,in order to provide a solid evidence-based foundation for establishing clinical standardized and safe utilization of mini-midline.Methods We systematically searched UpToDate,BMJ Best Practice,Guideline International Network,National Guideline Clearinghouse,Joanna Briggs Institute,National Institute for Health and Care Excellence,Centers for Disease Control and Prevention,Scottish Intercollegiate Guidelines Network,Canadian Medical Association:Clinical Practice Guideline,Registered Nurses'Association of Ontario,Intravenous Nurses Society,Cochrane Library,PubMed,CINAHL,Embase,Web of Science,Yimaitong,China National Knowledge Infrastructure,Wanfang Database,and China Biomedical Literature Database.It includes clinical practice guidelines,expert consensuses,evidence summaries,systematic reviews,meta-analyses,and best practice on mini-midline insertion and maintenance.The search period covered January 2013 to May 2023.2 researchers independently evaluated the literature quality and extracted the literature that met the standards.The evidence was graded using the JBI evidence pre-grading system(2014),and the extracted evidence was classified and summarized by themes.Results A total of 10 pieces of the literature were involved,including 6 guidelines,2 expert consensuses,and 2 systematic reviews.This study summarized 20 pieces of best evidence in relation to the following 4 themes:indications and contraindications for mini-midline,catheter insertion,catheter maintenance and catheter removal.Conclusion The study comprehensively and scientifically summarizes the best evidence regarding the insertion and maintenance of mini-midline.We recommend that clinical practitioners integrate this evidence into their practice,while considering individual patient preferences and medical contexts.This approach,in line with the principle of individualization,will contribute to enhancing the standardization and safety of mini-midline use in clinical settings.

Objective:To conduct a scoping review of research on the application of mobile health technology in self-management for stroke patients, identifying the main types, content elements, outcome indicators, and effectiveness of mobile health technology to provide references for related research and clinical practice.Methods:Based on the Joanna Briggs Institute's scoping review guidelines, a search was conducted in Cochrane Library, PubMed, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc for Chinese and English literature on the use of mobile health technology in self-management of stroke patients, with a search timeframe up to December 31, 2023. Literature screening and data extraction were performed, and the included studies were summarized and analyzed.Results:A total of 18 studies were included. The main forms of mobile health technology used in stroke self-management included applications, social media, wearable devices, web platforms, and health management systems. Content areas covered knowledge provision and self-management skills, exercise management, speech management, medication management, daily activity management, health data monitoring, and communication with healthcare providers. Outcome indicators included self-management capability, physiological indicators, psychological indicators, feasibility indicators, and others.Conclusions:The application of mobile health technology in stroke self-management has shown promising results, but further verification is needed. Future work should establish an integrated "online+offline" intervention model, promote multidisciplinary team collaboration, focus on elderly patients, and conduct high-quality research to explore scientific, individualized mobile health technology intervention strategies to enhance disease recovery and improve quality of life.

Objective:To conduct a scoping review of research on the application of mobile health technology in self-management for stroke patients, identifying the main types, content elements, outcome indicators, and effectiveness of mobile health technology to provide references for related research and clinical practice.Methods:Based on the Joanna Briggs Institute's scoping review guidelines, a search was conducted in Cochrane Library, PubMed, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc for Chinese and English literature on the use of mobile health technology in self-management of stroke patients, with a search timeframe up to December 31, 2023. Literature screening and data extraction were performed, and the included studies were summarized and analyzed.Results:A total of 18 studies were included. The main forms of mobile health technology used in stroke self-management included applications, social media, wearable devices, web platforms, and health management systems. Content areas covered knowledge provision and self-management skills, exercise management, speech management, medication management, daily activity management, health data monitoring, and communication with healthcare providers. Outcome indicators included self-management capability, physiological indicators, psychological indicators, feasibility indicators, and others.Conclusions:The application of mobile health technology in stroke self-management has shown promising results, but further verification is needed. Future work should establish an integrated "online+offline" intervention model, promote multidisciplinary team collaboration, focus on elderly patients, and conduct high-quality research to explore scientific, individualized mobile health technology intervention strategies to enhance disease recovery and improve quality of life.

Objective:To explore the risk factors of acute kidney injury(AKI)after liver transplantation(LT), examine its prognostic impact and construct a clinical prediction model.Methods:Clinical data are retrospectively reviewed for 220 LT recipients.They are divided into two groups of AKI(93 cases)and non-AKI(127 cases)according to the occurrence of AKI post-LT.Clinical data of two groups are compared.The variables with statistically significant inter-group differences in univariate analysis are included for multivariate analysis for obtaining the independent risk factors for AKI post-LT.Then the independent risk factors are employed for fitting a prediction model and a visual nomogram is constructed.At the same time, discrimination and calibration of the prediction model are evaluated.Extubation time, length of intensive care unit(ICU)stay, continuous renal replacement therapy(CRRT)rate, length of hospital stay, in-hospital mortality, estimated glomerular filtration rate(eGFR)at discharge, incidence of chronic renal failure(CRF)and readmission times are compared between two groups.Survival analysis is also performed between AKI and non-AKI groups and AKI 0/1 and AKI 2/3 stages.Results:The incidence of AKI post-LT is 42.3%.Age( OR=1.036, 95% CI: 1.001~1.073), preoperative serum creatinine level( OR=1.030, 95% CI: 1.011~1.049), platelet count( OR=0.992, 95% CI: 0.985~0.999), Child-Pugh class C( OR=2.678, 95% CI: 1.031~6.952), postoperative abdominal infection( OR=2.271, 95% CI: 1.120~4.603)and abdominal hemorrhage( OR=3.869, 95% CI: 1.016~14.72)are independent risk factors for AKI post-LT.The AUC/C-index of nomogram prediction model is 0.789 with a Brier score of 0.183, showing decent discrimination and calibration.According to the nomogram score, the recipients with a risk of AKI>50% are included into high-risk group while those with a risk of AKI<50% into low-risk group.Postoperative survival of low-risk group is better than that of high-risk group( P<0.001).Compared with non-AKI group, AKI group had a later extubation time( P=0.003), a longer length of ICU stay( P<0.001)and hospital stay( P=0.001), a higher rate of CRRT usage( P<0.001)and in-hospital mortality( P<0.001), a lower eGFR at discharge( P<0.001)and a higher incidence of CRF( P<0.001).Postoperative survival of non-AKI group was better than that of AKI group( P=0.048).Postoperative survival of patients with AKI 0/1 is better than that of those with AKI 2/3( P=0.002). Conclusions:Advanced age, high preoperative serum creatinine, low preoperative platelet, poor preoperative liver function, postoperative abdominal infection and abdominal hemorrhage may elevate the risks of AKI post-LT.And the nomogram prediction model based upon the above risk factors has a high value of clinical application.

Humans ; Consensus ; Pancreatic Neoplasms/therapy* ; Neuroendocrine Tumors/therapy*

Objective:To evaluate Castor single-branch covered-stent in the treatment of Stanford B aortic dissection(TBAD)with insufficient anchorage zone.Methods:Clinical data of 25 TBAD patients (proximal healthy landing zone ≤15 mm) treated with Castor branched stent-graft at Weifang People's Hospital from Apr 2019 to Sep 2021 were analyzed retrospectively.The stent model was selected according to preoperative CTA examination and intraoperative angiography,the operation result and follow up data were reviewed.Results:The operation success rate was 100%,the mean operative time was (137.8±35.8)min, and the mean blood loss was (52.8±24.5)ml. There were 2 cases of internal leakage (IA) and it was disappeared after balloon dilation, Branched stent stenosis occurred in 2 cases and relieved by balloon dilatation. The mean follow-up time was 14.6 months, and the patency rate of branch stent was 100% during the follow-up period. The true lumen diameter of thoracic aorta was significantly expanded and the false lumen diameter was significantly reduced 3 months after surgery compared with that before surgery ( P<0.05). Conclusion:Castor stenting in the treatment of TBAD with insufficient proximal anchoring area is simple and feasible, with satisfactory short term clinical effect.