Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

Objective:To investigate the influencing factors of the outcome in patients with asymptomatic intracranial hemorrhage (aICH) after endovascular therapy (EVT) for large vessel occlusive stroke in anterior circulation.Methods:Patients with large vessel occlusive stroke in anterior circulation underwent EVT at Dongguan People's Hospital from January 2019 to January 2023 were included retrospectively. According to the CT re-examination results within 72 hours after EVT and the changes in the National Institutes of Health Stroke Scale (NIHSS) score, the patients were divided into non-ICH group and aICH group. At 90 days after onset, the modified Rankin Scale was used to evaluate functional outcome, >2 points were defined as a poor outcome. Multivariate logistic regression analysis was used to determine the independent correlated factors for outcome. Results:A total of 173 patients who did not experience intracranial hemorrhage (ICH) or experienced aICH after EVT were enrolled, including 121 males (69.9%), median aged 64.0 years. Sixty-four patients (37.0%) developed aICH after EVT, of which 44 (68.8%) were hemorrhagic infarction (HI) and 20 (31.2%) were parenchymal hematoma (PH). The incidence of poor outcome in the ICH group was significantly higher than that in the non-ICH group (42.2% vs. 26.6%; χ2=4.472, P=0.034). In aICH patients with poor collateral circulation, the proportion of patients with poor outcome was significantly higher than in all non-ICH patients (68.7% vs. 26.6%; χ2=11.388, P<0.001), while there was no significant difference in the proportion of patients with poor outcome in the good collateral circulation group compared to all non-ICH patients (23.5% vs. 26.6%; χ2=0.072, P=0.788). In aICH patients, the proportion of PH (68.7% vs. 11.8%; χ2=14.561, P<0.001) and poor outcome (68.7% vs. 23.5%; χ2=7.209, P=0.027) in patients with poor collateral circulation were significantly higher than that of good collateral circulation. Multivariate logistic regression analysis showed that poor collateral circulation (odds ratio [ OR] 3.84; 95% confidence interval [ CI] 1.07-12.76; P=0.039), older age ( OR 1.07, 95% CI 1.02-1.11; P=0.004), unsuccessful recanalization ( OR 6.36, 95% CI 1.74-23.23; P=0.005) , and PH ( OR 6.14, 95% CI 1.83-20.58; P=0.003) were the independent risk factors for poor outcome in patients with aICH. Conclusions:Among patients who developed aICH after EVT, the proportion of patients with poor outcome in the good collateral circulation group is comparable to that in the non-ICH group, but the risks of PH and poor outcome are significantly increased in the poor collateral circulation group. Poor collateral circulation is an independent risk factor for poor outcome in patients with aICH after EVT for large vessel occlusive stroke in anterior circulation.

Objective:To observe the effect of the combination therapy of Qingtong formula and Dapagliflozin on the renal function of diabetic mice.Methods:A total of 24 10-week-old diabetic model（db/db）mice were selected and divided into four groups with six db/db mice in each group by random number table method：db/db mice（control group），db/db mice + Dapaglifozin（western medicine group），db/db mice + Dapagliflozin + Qingtong formula［traditional Chinese medicine（TCM）combined with western medicine group］，and db/db mice + Qingtong formula（TCM group）. The changes of urine creatinine and urinary albumin / creatinine（ACR）before and after treatment were compared，and the levels of serum creatinine and urea nitrogen after treatment were also compared.Results:After treatment，the serum creatinine level in the TCM combined with western medicine group showed a downward trend compared with that of the control group and significantly decreased compared with the western medicine group and the TCM group，and the difference was statistically significant（ P < 0.01）. There was no significant difference in urea nitrogen level among all groups（ P > 0.05）. After treatment，urinary creatinine level in the TCM combined with western medicine group was significantly higher than those in other three groups，with statistical significance differences（ P < 0.05 or P < 0.01）. There was no significant difference in urinary ACR level among groups before and after treatment（ P > 0.05）. Conclusion:The combination therapy of Qingtong formula and Dapaglifozin can significantly increase urine creatinine excretion of db/db mice，lower the level of serum creatinine，thus improving renal function.

Objective:To observe the effect of the combination therapy of Qingtong formula and Dapagliflozin on the renal function of diabetic mice.Methods:A total of 24 10-week-old diabetic model（db/db）mice were selected and divided into four groups with six db/db mice in each group by random number table method：db/db mice（control group），db/db mice + Dapaglifozin（western medicine group），db/db mice + Dapagliflozin + Qingtong formula［traditional Chinese medicine（TCM）combined with western medicine group］，and db/db mice + Qingtong formula（TCM group）. The changes of urine creatinine and urinary albumin / creatinine（ACR）before and after treatment were compared，and the levels of serum creatinine and urea nitrogen after treatment were also compared.Results:After treatment，the serum creatinine level in the TCM combined with western medicine group showed a downward trend compared with that of the control group and significantly decreased compared with the western medicine group and the TCM group，and the difference was statistically significant（ P < 0.01）. There was no significant difference in urea nitrogen level among all groups（ P > 0.05）. After treatment，urinary creatinine level in the TCM combined with western medicine group was significantly higher than those in other three groups，with statistical significance differences（ P < 0.05 or P < 0.01）. There was no significant difference in urinary ACR level among groups before and after treatment（ P > 0.05）. Conclusion:The combination therapy of Qingtong formula and Dapaglifozin can significantly increase urine creatinine excretion of db/db mice，lower the level of serum creatinine，thus improving renal function.

Objective To explore the effect of nursing intervention based on the transtheoretical model and stages of change on breastfeeding knowledge, self-efficacy, and duration of breastfeeding in newly born pregnant women, aimed to provide reference for breastfeeding behavior health education model for pregnant women. Methods The 130 primiparas who came to the hospital graded a class- three of Shanxi Province for perinatal examination were selected as the research subjects from May to June in 2017 , they were divided into test group and control group by random digits table method. In the control group, the normal breastfeeding health guidance was carried out in the three stages of prenatal, hospitalized and after discharge. The test group divided the primipara from the beginning of pregnancy to 6th months postpartum period into 5 stages according to transtheoretical model and stages of change. The new strategy of breastfeeding should be formulated and implemented according to different stages and behavior changing processes. Results The total score of breastfeeding knowledge of primipara were (8.76±1.14), (8.92±1.21), (9.90±1.27), (9.94±1.29) points in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, and they were (9.11 ± 1.42), (12.02 ± 1.64), (13.04 ± 1.67), (15.00±1.83) points respectively in test group, the differences were statistically significant(Ftime= 51.823, Fgroup=10.406, Finteractive=56.641, all P < 0.05). The total scores of breastfeeding self-efficacy of primipara were (84.62 ± 1.14), (88.96 ± 1.41), (86.65 ± 1.47), (84.31 ± 1.57) points respectively in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, while in test group they were (84.98 ± 1.20), (104.02 ± 1.42), (111.00 ± 1.45), (120.04 ± 1.40) points, the differences were statistically significan (Ftime=12.592, Fgroup=229.674, Finteractive=79.955, all P<0.05). The pure breastfeeding rates of primipara were 60.0％(33/55) , 41.8％(23/55), 21.8％(12/55) in control group on the 3rd day, the 42nd day and the 6th month after delivery, they were 84.7％(50/59), 76.3％(45/59) , 49.2％(29/59) in the test group. The differences was statistically significant (χ2=8.804, 14.038, 9.235, all P <0.01). Conclusion Breastfeeding intervention based on the theory of behavioral staged transition can help primipara to improve breastfeeding knowledge and self-efficacy, and improve breastfeeding status.

Objective: To compare the short-term outcomes of a collagen matrix (CM) and free gingival graft (FGG) in augmenting keratinized mucosa around dental implants. Methods: Nineteen partially edentulous patients who had undergone implant surgery or implant review from June 2017 to June 2018 at Department of Periodontology, Peking University School and Hospital of Stomatology with lack of keratinized mucosa at buccal aspect of implants (<2 mm) were recruited in this study. According to the width of keratinized mucosa (KW) pre-operation, 9 patients including 5 males and 4 females were assigned into control group (KW<0.5 mm) which performed free gingival graft (17 implants) and 10 patients including 3 males and 7 females were assigned into experimental group (KW≥0.5 mm) which used collagen matrix as the grafts (15 implants). The KW at buccal aspect of each implant were measured pre-operation and 2 weeks, 1 month, 2 months, 3 months after surgery respectively. Each of the patients was required to fill out a questionnaire using a visual analogue scale to assess the postoperative morbidity. Results: The KWs around implants were increased significantly during the 3 months follow-up period in both groups (P<0.01). At 3 months after surgery, KW gain in control group was (3.44±1.64) mm, in experimental group was (2.30±0.82) mm, the difference between two groups was statistically significant (P<0.05). Meantime, the total shrinkage of KW in control group [(34±25)%] and experimental group [(51±11)%] also showed a statistically significant difference (P<0.01). However, by using collagen matrix as the grafts, augmented tissues had a much more comparable appearance with adjacent tissues than that in control group. And the patients of experimental group experienced much less postoperative bleeding than those of control group. Conclusions Both collagen matrix and free gingival graft can significantly increase the KW around implants within the 3 months post-surgery follow-up period. There were more KW gain and less shrinkage in group FGG than that in group CM. However, surgery time were reduced and the postoperative bleeding were less in group CM than in group FGG as no harvesting procedure was needed.

Objective To observe the clinical effects of Qintong prescription combined with pancreatic kininogenase enteric-coated tablets on proteinuria of diabetic nephropathy.Methods Randomized parallel control study was carried out in the 2 groups,which were the western medicine group (or the pancreatic kininogenase enteric-coated tablet group) and the combined treatment group (or the combined Qintong prescription and pancreatic kininogenase enteric-coated tablet group).Changes in the levels of fasting blood glucose (FBG),HbA1C,urinary trace albumin/creatinine were observed and compared before and after treatment.Results After treatment,fasting glucose,glycosylated hemoglobin and the urine trace albumin/creatinine levels in the 2 groups were significantly decreased,as compared with those before treatment (P ＜0.01).After treatment,the levels of urine trace albumin/creatinine in the combined treatment group were significantly decreased,as compared with the western medicine group (P ＜ 0.01).Conclusions Qintong prescription combined with pancreatic kininogenase enteric-coated tablets could significantly reduce the level of proteinuria in the patients with diabetic nephropathy,which showed to have better therapeutic effect than that of the single western medicine therapy.

Objective To observe the clinical effects of Qintong prescription combined with pancreatic kininogenase enteric-coated tablets on proteinuria of diabetic nephropathy.Methods Randomized parallel control study was carried out in the 2 groups,which were the western medicine group (or the pancreatic kininogenase enteric-coated tablet group) and the combined treatment group (or the combined Qintong prescription and pancreatic kininogenase enteric-coated tablet group).Changes in the levels of fasting blood glucose (FBG),HbA1C,urinary trace albumin/creatinine were observed and compared before and after treatment.Results After treatment,fasting glucose,glycosylated hemoglobin and the urine trace albumin/creatinine levels in the 2 groups were significantly decreased,as compared with those before treatment (P ＜0.01).After treatment,the levels of urine trace albumin/creatinine in the combined treatment group were significantly decreased,as compared with the western medicine group (P ＜ 0.01).Conclusions Qintong prescription combined with pancreatic kininogenase enteric-coated tablets could significantly reduce the level of proteinuria in the patients with diabetic nephropathy,which showed to have better therapeutic effect than that of the single western medicine therapy.

Objective To investigate the expression levels of bone morphogenetic protein (BMP-4) in the people with simple obesity in coastal areas and its relationship with the BMP-4 expression,body mass index (BMI),waist hip ratio (WHR),fasting blood glucose (FBG),fasting insulin (FINS) and HOMA-IR.Plasma BMP-4 levels of 40 cases with simple obesity and the controls were respectively detected by ELISA.And then,the association of BMP-4 levels with BMI,WHR,HOMA-IR,blood lipids,HbA1c,FBG,FINS and HOMAIR were analyzed by Logistic regression.Methods The BMP-4 levels in the patients with simple obesity (10.98 ±6.76) were significantly higher than those of the control group (5.12 ±3.01),with statistical significance (P ＜ 0.01).Logistic regression analysis indicated that the BMP-4 levels were positively correlated with the levels of triglyceride(TG),BMI,FINS and HOMA-IR,with the r value being respectively 0.421,0.425,0.473 and 0.396 (P ＜ 0.01).Multiple regression analysis was made with BMP-4 as the function,sex,age,WHR,BMI,TG,total cholesterol (TC),low density lipid (LDL),high density lipid (HDL),HbA1c,FBG,FINS and BMP-4 as the independent variables.Results indicated that the FINS level was a related factor affecting the BMP-4 level.Binomial Logistic regression analysis indicated that the BMP-4 level was still significantly correlated with simple obesity,following tight control of such factors as sex,age,WHR,TG,TC,LDL,HDL,HbA1c,FBG and FINS.Conclusions The changes in the BMP-4 levels were associated with metabolism disorder of the patients with simple obesity,which might be involved in the pathogenesis of simple obesity.