Trousseau′s syndrome is a thromboembolic disorder associated with malignancies, with cerebral infarction and hemorrhage representing common central nervous system complications in patients with cancer. This report details the diagnosis and treatment of a patient with gastric adenocarcinoma at our institution who concurrently developed cerebral infarction and subarachnoid hemorrhage. We performed a comprehensive literature review in the Wanfang and PubMed databases, searching for relevant studies on Trousseau′s syndrome, cerebral embolism, and subarachnoid hemorrhage. A total of 42 patients (23 male and 19 female) with complete clinical data were included, including the present case.Our analysis showed that these patients had 10 different types of tumors, with lung cancer, gastric cancer, and ovarian cancer being the most prevalent. D-dimer levels were elevated in 38 cases, and 38 patients exhibited cerebral infarction affecting three or more vascular territories. Anticoagulant therapy was administered to 40 patients, 22 experienced a recurrence of cerebral infarction within a short timeframe, and 28 died within one year. Cases of Trousseau′s syndrome associated with subarachnoid hemorrhage are rare and, to our knowledge, have not been previously reported in the literature. Patients experiencing strokes due to Trousseau′s syndrome tend to have poor prognoses. However, targeted antitumor therapy in conjunction with anticoagulation may effectively reduce the risk of stroke recurrence and enhance patient outcomes.

Objective To explore the changes of core symptoms and nursing strategies for lymphoma patients during chemotherapy using a dynamic network analysis model,and provide a reference for precise symptom intervention.Methods A longitudinal study was conducted,and lymphoma patients undergoing chemotherapy in the Department of Lymphoma at a tertiary hospital in Tianjin from September 2021 to December 2023 were conveniently sampled.The Lymphoma Patient Symptom Assessment Scale was used to track symptoms at 3 time points:7 to 14 days after the 1st treatment cycle(T1),the 3rd cycle(T2),and the 6th cycle(T3).Dynamic symptom network analysis,including network relationships,core symptoms,and bridge symptoms,was performed using R software.Results During the research process,135 participants withdrew,resulting in a final inclusion of 865 cases for analysis.Fatigue exhibited the highest incidence rate(34.80％)at T1;alopecia was the most prevalent symptom(58.03％and 53.64％,respectively)at T2 and T3.The T1→T2 dynamic network analysis showed that fever had the highest out-expected influence(EI=0.551)and bridge expected influence(EI=0.225).The T2→T3 dynamic network analysis showed that limb numbness exhibited the highest out-expected influence(EI=0.203)and bridge-expected influence(EI=0.170).Reliability tests indicated that both dynamic networks demonstrated moderate accuracy but suboptimal stability.Conclusion Fatigue was the most common symptom at T1;alopecia was the most prevalent symptom at T2 and T3.Fever was the core symptom and bridging symptom in the T1→T2 symptom network,whereas limb numbness assumed the role of the core symptom and bridging symptom in the T2→T3 symptom network.The clinical practitioners could take high-incidence symptoms and core symptoms as intervention targets to develop precise symptom management strategies for lymphoma patients undergoing chemotherapy.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To analyze changes in sleep,mood state,and brain function in healthy populations living in near-sea-level environments before and after exposure to high-altitude environment,and to explore the correlations between regional brain functional changes and variations in sleep and mood states.Methods A total of 45 healthy volunteers were enrolled.The participants came from regions of near-sea-level altitudes and were exposed to the high-altitude environment for a short period of time.The Pittsburgh Sleep Quality Index(PSQI),Zung Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9(PHQ-9),Zung Self-Rating Anxiety Scale(SAS),and Generalized Anxiety Disorder-7(GAD-7)were administered to assess sleep quality as well as depressive and anxiety symptoms at 4 time points—prior to high-altitude exposure,immediately after exposure,one month after returning to low-altitude regions,and three months after returning to low-altitude regions.Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected before and after high-altitude exposure,and regional brain functional parameters,including the amplitude of low-frequency fluctuations(ALFF)and functional connectivity strength,were analyzed.Statistical analyses were performed,including a linear mixed-effects model to evaluate longitudinal changes in scale scores,paired-sample t-tests to compare brain function differences before and after exposure,and Pearson correlation analyses to examine the relationship between brain functional changes and alterations in sleep and mood states.Results Compared with the pre-exposure findings,the participants exhibited significantly increased PSQI scores(8.89±4.41 vs.5.08±2.69,P<0.05)and PHQ-9 scores(3.60±4.19 vs.1.54±2.30,P<0.05)immediately after high-altitude exposure.One month after returning to the low-altitude environment,both sleep and depression scores decreased relative to the findings immediately after exposure(PSQI:3.88±2.13 vs.8.89±4.41,P<0.05;PHQ-9:1.50±2.25 vs.3.60±4.19,P<0.05)and showed no statistically significant difference compared with the pre-exposure findings(P>0.05).Three months after returning to near-sea-level environment,sleep,depression,and anxiety scores were all reduced compared with the findings immediately after exposure(PSQI:3.76±2.31 vs.8.89±4.41,P<0.05;PHQ-9:1.24±2.13 vs.3.60±4.19,P<0.05;SAS:23.84±5.93 vs.27.93±7.05,P<0.05),also showing no significant difference compared with the pre-exposure levels(P>0.05).Brain function analysis revealed that,relative to the pre-exposure levels,ALFF in the bilateral superior temporal gyrus,insula,and dorsolateral prefrontal cortex(DLPFC)increased after high-altitude exposure(P<0.05),and that functional connectivity strength in the DLPFC was also elevated(P<0.05).Furthermore,changes in DLPFC functional connectivity strength were positively correlated with changes in sleep and mood scores(P<0.05).Conclusion High-altitude exposure has a significant impact on the sleep,mood states,and brain function of populations from near-sea-level regions,and DLPFC,in particular,is closely associated with changes in sleep and mood states.The findings of this study provide a theoretical basis for health management and intervention strategies in high-altitude environments.

Objective To explore the changes of core symptoms and nursing strategies for lymphoma patients during chemotherapy using a dynamic network analysis model,and provide a reference for precise symptom intervention.Methods A longitudinal study was conducted,and lymphoma patients undergoing chemotherapy in the Department of Lymphoma at a tertiary hospital in Tianjin from September 2021 to December 2023 were conveniently sampled.The Lymphoma Patient Symptom Assessment Scale was used to track symptoms at 3 time points:7 to 14 days after the 1st treatment cycle(T1),the 3rd cycle(T2),and the 6th cycle(T3).Dynamic symptom network analysis,including network relationships,core symptoms,and bridge symptoms,was performed using R software.Results During the research process,135 participants withdrew,resulting in a final inclusion of 865 cases for analysis.Fatigue exhibited the highest incidence rate(34.80％)at T1;alopecia was the most prevalent symptom(58.03％and 53.64％,respectively)at T2 and T3.The T1→T2 dynamic network analysis showed that fever had the highest out-expected influence(EI=0.551)and bridge expected influence(EI=0.225).The T2→T3 dynamic network analysis showed that limb numbness exhibited the highest out-expected influence(EI=0.203)and bridge-expected influence(EI=0.170).Reliability tests indicated that both dynamic networks demonstrated moderate accuracy but suboptimal stability.Conclusion Fatigue was the most common symptom at T1;alopecia was the most prevalent symptom at T2 and T3.Fever was the core symptom and bridging symptom in the T1→T2 symptom network,whereas limb numbness assumed the role of the core symptom and bridging symptom in the T2→T3 symptom network.The clinical practitioners could take high-incidence symptoms and core symptoms as intervention targets to develop precise symptom management strategies for lymphoma patients undergoing chemotherapy.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Trousseau′s syndrome is a thromboembolic disorder associated with malignancies, with cerebral infarction and hemorrhage representing common central nervous system complications in patients with cancer. This report details the diagnosis and treatment of a patient with gastric adenocarcinoma at our institution who concurrently developed cerebral infarction and subarachnoid hemorrhage. We performed a comprehensive literature review in the Wanfang and PubMed databases, searching for relevant studies on Trousseau′s syndrome, cerebral embolism, and subarachnoid hemorrhage. A total of 42 patients (23 male and 19 female) with complete clinical data were included, including the present case.Our analysis showed that these patients had 10 different types of tumors, with lung cancer, gastric cancer, and ovarian cancer being the most prevalent. D-dimer levels were elevated in 38 cases, and 38 patients exhibited cerebral infarction affecting three or more vascular territories. Anticoagulant therapy was administered to 40 patients, 22 experienced a recurrence of cerebral infarction within a short timeframe, and 28 died within one year. Cases of Trousseau′s syndrome associated with subarachnoid hemorrhage are rare and, to our knowledge, have not been previously reported in the literature. Patients experiencing strokes due to Trousseau′s syndrome tend to have poor prognoses. However, targeted antitumor therapy in conjunction with anticoagulation may effectively reduce the risk of stroke recurrence and enhance patient outcomes.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Cell-in-cell(CIC)is a phenomenon described as the active infiltration of one or more living cells into another living cell,forming intracellular structures and producing biological effects.This phenomenon was first ob-served and detailed in the early 20th century.However,it has only become an active area of research in cell biology in the past decade.As research advanced,scientists gradually recognized that the phenomenon of CIC exists in many biological systems and diseases,and has important physiological and pathological significance in evolution,development,homeosta-sis,and diseases,especially in tumors,which has important clinical research value.Currently,five forms of CIC struc-tures have been identified:cell cannibalism,phagoptosis,enclysis,entosis,and emperipolesis.Each form represents a distinct interaction between cells,characterized by unique cell types,biological characteristics,molecular mechanisms,and implications in pathophysiology.This article aims to review the cell types involved in each CIC structure,their biologi-cal characteristics and the molecular mechanisms driving these interactions,and to explore the potential clinical signifi-cance in the diagnosis,treatment and prognosis of human diseases.