Objective To investigate the effect of lateral wedge insoles (LWI) with different heights on lower limb biomechanical characteristics during single-leg landing in patients with chronic ankle in? stability (CAI). Methods Thirty CAI undergraduates (15 males and 15 females) were recruited. All participants were required to perform a single-leg landing task from a height of 30 cm. They first un? derwent the test with flat insoles (FI),followed by tests with 3 mm and 6 mm LWI in a randomized order. A Qualisys 3D motion capture system and Kistler force platform were used to synchronously col? lect data. Kinematic and kinetic data of the lower limb tri-joints (hip,knee and ankle) were ana? lyzed from the moment of ground contact to the body stabilization phase. Results(1) Kinematically,compared with the FI group,the 3 mm and 6 mm LWI groups showed greater hip and knee flexion angles (P<0.001),smaller hip adduction (P<0.05,P<0.01),ankle plantarflexion (P<0.05,P<0.001),and knee valgus angles (P<0.05,P<0.001) at the moment of ground contact. The 6 mm LWI group had larger hip/knee flexion angles (P<0.001) and smaller ankle plantarflexion angles (P<0.001) at contact than the 3 mm LWI group. Additionally,compared with the FI group,the 6 mm LWI group showed significantly smaller ankle eversion angles (P<0.05). The 6 mm LWI group showed larger peak knee flexion angle (P<0.05) and peak ankle eversion angle (P<0.01) than the FI group,while the 3 mm LWI group also had a greater peak ankle eversion angle (P<0.05) than the FI group. Meanwhile,the 3 mm and 6 mm LWI groups had a larger knee flexion-extension range of motion (ROM)(P<0.05,P<0.01) but smaller ankle flexion-extension ROM (P<0.001) than the FI group. The 6 mm LWI group showed a significantly greater hip adduction-abduction ROM (P<0.001,P<0.05) than the other groups,with a smaller ankle plantar flexion-extension ROM (P<0.05) than the 3 mm LWI group. (2) The peak vertical ground reaction force (peak vGRF) of the LWI groups was signifi? cantly lower than the FI group (P<0.01),with that of the 6 mm LWI group significantly lower than the 3 mm LWI group (P<0.001). Moreover,there were significantly greater peak hip flexion moment (P<0.01) and smaller peak ankle plantarflexion moment of the LWI groups than the FI group (P<0.001),with a smaller peak ankle plantarflexion moment of the 6 mm LWI group than the 3 mm LWI group (P<0.05). (3) Significantly greater subjective comfort was observed in the 6 mm LWI group than the FI group (P<0.01). Conclusion LWI can improve landing patterns in CAI patients,re? duce their ground reaction forces,and lower the risk of ankle sprain. The 6 mm LWI outperforms the 3 mm LWI in improving flexion angles of the lower limb tri-joints at ground contact,ankle flexion-ex? tension ROM,peak vGRF,and peak ankle plantarflexion moment during single-leg landing tasks. Therefore,LWI can be used as a wearable protective device during rehabilitation to prevent recurrent ankle sprains among such patients.

To summarise the nursing experience of caring for a patient with focal segmental glomerulosclerosis for kidney re-transplantation.Nursing key points:early recognition of recurrence of the original disease and rapid activation of emergency response;stabilization of cyclosporine concentration by precision management;optimizing in vitro anticoagulation regimens and vigilance for bleeding and clotting;regulate adrenocorticotropic hormone use and being alert for adverse effects;implementing the whole process of infection prevention and control to prevent infection;implementing the whole process of psychological counseling to alleviate negative emotions.After active treatment and careful care,the patient's transplanted kidney function recovered and was successfully discharged.After a follow-up for 2 months,the patient recovered well.

Objective:To conduct a scoping review of current research on the application of mobile health (mHealth) in patients with left ventricular assist device (LVAD) implantation, aiming to inform clinical practice in mHealth management for this population.Methods:A systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Data from database inception to November 30, 2024. Relevant studies on mHealth applications in LVAD patients were screened and analyzed.Results:A total of 18 studies were included. The primary carriers of mHealth interventions were mobile phones, mobile applications, smart wearable devices, and invasive or implantable devices. The main components of mHealth management included monitoring of LVAD pump parameters, disease surveillance, health education, and self-management. Evaluation indicators mainly involved clinical outcomes, usability and safety assessments, and quality of life metrics.Conclusions:Mobile applications and smart wearable devices are the primary tools for mHealth management in LVAD patients. Platforms with comprehensive content and multifunctional features attract more patient engagement. Future efforts should focus on developing universally applicable, systematic mHealth platforms through multidisciplinary collaboration to enhance the quality and effectiveness of mHealth interventions in LVAD care.

Gastric cancer is one of the most common malignant tumors of the digestive tract globally, causing a heavy burden on society due to its high incidence and mortality rates. Patients with gastric cancer and peritoneal metastasis suffer poor prognosis, and peritoneal metastasis is a major factor in the recurrence and metastasis of gastric cancer. Currently, the diagnosis of peritoneal metastasis mainly relies on contrast-enhanced CT, PET-CT, and other imaging techniques, but these technologies have a limited capability to detect small lesion of peritoneal metastases. Laparoscopic exploration is still considered as the most reliable method to diagnose peritoneal metastasis of gastric cancer. It allows direct visualization of the abdominal cavity and peritoneal regions, facilitating the detection of metastases. Furthermore, it enables the collection of histological or cytological specimens for definitive pathological diagnosis. However, the area formed by the parietal peritoneum and visceral peritoneum is large and has many folds in space. To explore the tumor and peritoneum as comprehensively as possible, our team has proposed the "Four-Step Procedure" of laparoscopic exploration for gastric cancer to standardize the operation process of laparoscopic exploration, which is characterized by its safety, comprehensiveness, precision and ease of implementation. This article primarily discusses the limitation of routine clinical techniques in diagnosing peritoneal metastasis in gastric cancer and introduce the significant value of the "Four-Step Procedure" in diagnosing peritoneal metastasis in gastric cancer.

Immune-mediated myocarditis is a rare but life-threatening complication of immune checkpoint inhibitor therapy. We report a case of a patient with high-grade urothelial carcinoma and lymph node metastasis. After exhibiting cisplatin intolerance postoperatively, the patient received dual immunotherapy. On day 19 of treatment, following physical exertion, the patient developed progressive chest tightness and dyspnea, accompanied by markedly elevated cardiac biomarkers (troponin Ⅰ: 550.7 pg/mL; creatine kinase: 9 669 U/L). Multidisciplinary evaluation confirmed the diagnosis of grade 4 immune-mediated myocarditis. Immediate discontinuation of immunotherapy was followed by intensive care unit admission for hormonal shock therapy and additional symptomatic management. After two months of targeted management, both clinical symptoms and laboratory parameters normalized. The patient remained stable with no cardiac sequelae during three-month post-discharge follow-up.

Gastric cancer is one of the most common malignant tumors of the digestive tract globally, causing a heavy burden on society due to its high incidence and mortality rates. Patients with gastric cancer and peritoneal metastasis suffer poor prognosis, and peritoneal metastasis is a major factor in the recurrence and metastasis of gastric cancer. Currently, the diagnosis of peritoneal metastasis mainly relies on contrast-enhanced CT, PET-CT, and other imaging techniques, but these technologies have a limited capability to detect small lesion of peritoneal metastases. Laparoscopic exploration is still considered as the most reliable method to diagnose peritoneal metastasis of gastric cancer. It allows direct visualization of the abdominal cavity and peritoneal regions, facilitating the detection of metastases. Furthermore, it enables the collection of histological or cytological specimens for definitive pathological diagnosis. However, the area formed by the parietal peritoneum and visceral peritoneum is large and has many folds in space. To explore the tumor and peritoneum as comprehensively as possible, our team has proposed the "Four-Step Procedure" of laparoscopic exploration for gastric cancer to standardize the operation process of laparoscopic exploration, which is characterized by its safety, comprehensiveness, precision and ease of implementation. This article primarily discusses the limitation of routine clinical techniques in diagnosing peritoneal metastasis in gastric cancer and introduce the significant value of the "Four-Step Procedure" in diagnosing peritoneal metastasis in gastric cancer.

As a hot spot in clinical research today, immune checkpoint inhibitor has been recommended by guidelines in the first- and second-line treatments of advanced cervical cancer as immune monotherapy or combination therapy. It has also achieved good efficacy in clinical practice. In locally advanced cervical cancer, immune checkpoint inhibitors have been included in the guidelines for adjuvant therapy, and good tumor regression effects have been achieved in clinical practice. Based on the results of existing trials, immune checkpoint inhibitors have also shown good clinical potential as neoadjuvant therapy. Furthermore, the issue of immunotherapy rechallenge has increasingly captured clinicians’ attention, offering a potential new therapeutic strategy for cervical cancer patients with prior immunotherapy exposure. In this article, the clinical application and research progress of immune checkpoint inhibitors in the treatment of cervical cancer in recent years are summarized to provide valuable ideas and directions for clinical treatment.

To summarise the nursing experience of caring for a patient with focal segmental glomerulosclerosis for kidney re-transplantation.Nursing key points:early recognition of recurrence of the original disease and rapid activation of emergency response;stabilization of cyclosporine concentration by precision management;optimizing in vitro anticoagulation regimens and vigilance for bleeding and clotting;regulate adrenocorticotropic hormone use and being alert for adverse effects;implementing the whole process of infection prevention and control to prevent infection;implementing the whole process of psychological counseling to alleviate negative emotions.After active treatment and careful care,the patient's transplanted kidney function recovered and was successfully discharged.After a follow-up for 2 months,the patient recovered well.

OBJECTIVE: To explore the mechanism by which ω-3 polyunsaturated fatty acids (hereinafter referred to as "ω-3") exert antioxidant stress protection and promote osteogenic differentiation in MC3T3-E1 cells, and to reveal the relationship between ω-3 and the key antioxidant stress pathway involving nuclear factor E2-related factor 2 (Nrf2) and NAD (P) H quinone oxidoreductase 1 (NQO1) in MC3T3-E1 cells. METHODS: The optimal concentration of H ₂O ₂ (used to establish the oxidative stress model of MC3T3-E1 cells in vitro) and the optimal intervention concentrations of ω-3 were screened by cell counting kit 8. MC3T3-E1 cells were divided into blank control group, oxidative stress group (H ₂O ₂), low-dose ω-3 group (H ₂O ₂+low-dose ω-3), and high-dose ω-3 group (H ₂O ₂+high-dose ω-3). After osteoblastic differentiation for 7 or 14 days, the intracellular reactive oxygen species (ROS) level was measured by fluorescence staining and flow cytometry, and the mitochondrial morphological changes were observed by biological transmission electron microscope; the expression levels of Nrf2, NQO1, heme oxygenase 1 (HO-1), Mitofusin 1 (Mfn1), and Mfn2 were detected by Western blot to evaluate the cells' antioxidant stress capacity; the expression levels of Runt-related transcription factor 2 (RUNX2) and osteocalcin (OCN) were detected by immunofluorescence staining and Western blot; osteogenic potential of MC3T3-E1 cells was evaluated by alkaline phosphatase (ALP) staining and alizarin red staining. RESULTS: Compared with the oxidative stress group, the content of ROS in the low and high dose ω-3 groups significantly decreased, and the protein expressions of Nrf2, NQO1, and HO-1 significantly increased ( P<0.05). At the same time, the mitochondrial morphology of MC3T3-E1 cells improved, and the expressions of mitochondrial morphology-related proteins Mfn1 and Mfn2 significantly increased ( P<0.05). ALP staining and alizarin red staining showed that the low-dose and high-dose ω-3 groups showed stronger osteogenic ability, and the expressions of osteogenesis-related proteins RUNX2 and OCN significantly increased ( P<0.05). And the above results showed a dose-dependence in the two ω-3 treatment groups ( P<0.05). CONCLUSION ω-3 can enhance the antioxidant capacity of MC3T3-E1 cells under oxidative stress conditions and upregulate their osteogenic activity, possibly through the Nrf2/NQO1 signaling pathway.
Oxidative Stress/drug effects* ; NF-E2-Related Factor 2/metabolism* ; NAD(P)H Dehydrogenase (Quinone)/metabolism* ; Animals ; Mice ; Osteogenesis/drug effects* ; Cell Differentiation/drug effects* ; Fatty Acids, Omega-3/pharmacology* ; Signal Transduction/drug effects* ; Osteoblasts/drug effects* ; Reactive Oxygen Species/metabolism* ; Cell Line ; Hydrogen Peroxide/pharmacology* ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Antioxidants/pharmacology* ; Heme Oxygenase-1/metabolism*

Objective:To analyze the changes and structural variations in hospitalization costs for patients with lung malignancies after the implementation of diagnosis-intervention packet (DIP) payment system, and to evaluate its effectiveness.Methods:Data from the first page of medical records and hospitalization cost data from the hospital information system of a tertiary general hospital in Henan Province were extracted for patients diagnosed with lung malignancies from 2020 to 2023. The data were divided into pre-implementation group (2020—2021) and post-implementation group (2022—2023) based on the implementation time of DIP. Chi-square test, t test, and Wilcoxon rank-sum test were used to analyze the differences in basic characteristics and hospitalization costs of patients with lung malignancies before and after the implementation of DIP. Grey relational analysis was employed to examine the internal associations between total hospitalization costs and various cost components. Structural variation analysis was used to assess the changes in the structure of hospitalization costs after the implementation of DIP. Results:A total of 14 587 hospitalized patients with lung malignancies were included, with 6 807 cases in the pre-implementation group and 7 780 cases in the post-implementation group. The average length of hospital stay decreased from (13.17±6.74) days before implementation to (12.02±6.49) days after implementation ( P<0.05). The proportion of level-four surgeries increased from 46.4% to 57.0% ( P<0.05). The average hospitalization cost per patient with lung malignancies decreased from 56 952 yuan before DIP implementation to 55 560 yuan after implementation ( P<0.05). For patients with lung malignancies diagnosed as C34.1, C34.2, C34.3, and C34.8, the top four cost components most strongly associated with total hospitalization costs were treatment costs, material costs, comprehensive medical service costs, and diagnostic costs, with correlation coefficients all>0.80. For patients with C34.9, the top four cost components most strongly associated with total hospitalization costs were treatment costs, comprehensive medical service costs, diagnostic costs, and Western medicine costs, with correlation coefficients>0.95. For patients diagnosed as C34.1, C34.2, C34.3, and C34.9, diagnostic costs, Western medicine costs, and material costs contributed significantly to the structural variation of hospitalization costs, with contribution rate of structure variation all exceeding 75%, among which Western medicine costs and material costs showed negative variation. For patients diagnosed as C34.8, treatment costs, Western medicine costs, and material costs contributed significantly to the structural variation of hospitalization costs, with contribution rate of structure variation all exceeding 80%, among which Western medicine costs showed negative variation. Conclusions:The implementation of DIP reduced the hospitalization costs for patients with lung malignancies, optimized the structure of hospitalization costs, improved the efficiency of medical services, and promoted the rational allocation of medical resources.