Objective To evaluate clinical effect of remote ischemic conditioning(RIC)in patients with spontaneous intracerebral hemorrhage(sICH).Methods Sixty-four patients with sICH who were diagnosed and admitted to the Department of Neurosurgery,the Sixth Medical Center of PLA General Hospital from January 2023 to May 2024 were selected as research subjects.Following the principle of matching baseline characteristics between groups,a computerized random grouping program was used to divide them into an observation group of 32 cases and a control group of 32 cases.Patients in the control group received standard basic medication according to the'Chinese Clinical Management Guidelines for Cerebrovascular Diseases',while the observation group received RIC treatment in addition to the control group's treatment,with a course of 14 d.The changes in National Institutes of Health Stroke Scale(NIHSS)scores and Barthel index(BI,daily living ability score table)on the day of admission and after 14 d of treatment,the changes in hematoma volume on computed tomography(CT)imaging,and the incidence of adverse events were compared between the two groups.Results At admission,the difference is not statistically significant in NIHSS scores,BI,and CT imaging hematoma volume between the two groups(P>0.05).After 14 d of treatment,the NIHSS scores of both groups were reduced compared to before treatment,and the scores of the observation group were lower than those of the control group(P<0.05);the BI of both groups was increased compared to before,and the scores of the observation group were higher than those of the control group(P<0.05);there were no significant differences in CT imaging hematoma volume and the incidence of adverse events between the two groups(P>0.05).Conclusion Continuous RIC treatment for 14 d is safe and well-tolerated in patients with spontaneous intracerebral hemorrhage and can effectively improve the neurological function of patients.

Objective To evaluate clinical effect of remote ischemic conditioning(RIC)in patients with spontaneous intracerebral hemorrhage(sICH).Methods Sixty-four patients with sICH who were diagnosed and admitted to the Department of Neurosurgery,the Sixth Medical Center of PLA General Hospital from January 2023 to May 2024 were selected as research subjects.Following the principle of matching baseline characteristics between groups,a computerized random grouping program was used to divide them into an observation group of 32 cases and a control group of 32 cases.Patients in the control group received standard basic medication according to the'Chinese Clinical Management Guidelines for Cerebrovascular Diseases',while the observation group received RIC treatment in addition to the control group's treatment,with a course of 14 d.The changes in National Institutes of Health Stroke Scale(NIHSS)scores and Barthel index(BI,daily living ability score table)on the day of admission and after 14 d of treatment,the changes in hematoma volume on computed tomography(CT)imaging,and the incidence of adverse events were compared between the two groups.Results At admission,the difference is not statistically significant in NIHSS scores,BI,and CT imaging hematoma volume between the two groups(P>0.05).After 14 d of treatment,the NIHSS scores of both groups were reduced compared to before treatment,and the scores of the observation group were lower than those of the control group(P<0.05);the BI of both groups was increased compared to before,and the scores of the observation group were higher than those of the control group(P<0.05);there were no significant differences in CT imaging hematoma volume and the incidence of adverse events between the two groups(P>0.05).Conclusion Continuous RIC treatment for 14 d is safe and well-tolerated in patients with spontaneous intracerebral hemorrhage and can effectively improve the neurological function of patients.

Objective To analyze the epidemiological characteristics and drug resistance of pathogenic bacteria in 276 hospitalized children with lower respiratory tract infection to facilitate prevention and treatment. Methods Among of 276 hospitalized children with lower respiratory tract infection from January 2019 to December 2021 were analyzed. Data on the distribution of pathogenic bacteria were collected and analyzed. At the same time, the information on drug resistance was collected, and the potential relationship between pathogen distribution and drug resistance was briefly analyzed and discussed. Results A total of 532 strains of pathogenic bacteria were detected in the blood samples from 276 patients in this study. There were 207 strains of Gram-positive bacteria, including 104 strains of Staphylococcus aureus, 96 strains of Staphylococcus epidermidis and 7 strains of others. Gram negative bacteria (325 strains) were 172 strains of Klebsiella and 153 strains of Escherichia coli. The distribution of pathogenic bacteria in different gender and age groups (under 5 years old, 5-10 years old, and over 10 -14 years old) was calculated separately. The results showed that the distribution of pathogenic bacteria in female children under 5 years old (n=49 cases) was different from the total population: the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis was the highest (P<0.05). The distribution characteristics of children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics were the same in children of different sex and age. Conclusion The pathogenic bacteria in children with lower respiratory tract infection in pediatric ward are mainly Gram-negative bacteria, and the main pathogenic bacteria have a high resistance rate to common drugs. The distribution of pathogenic bacteria in female children under 5 years old is unique: the infection of Gram-positive bacteria is higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis is the highest, which deserves attention. The clinical drug sensitivity test can be used as an important reference for the treatment of drugs to guide the rational selection of antibiotics.

Objective:To explore the development trends, frontiers, and hotspots of research on early rehabilitation for patients with severe neurological diseases at home and abroad in the past 10 years, with a view to providing reference for the development of early rehabilitation for patients with severe neurological diseases in China.Methods:The article on early rehabilitation for patients with severe neurological diseases was systematically searched in the Web of Science and China National Knowledge Infrastructure (CNKI) . The search period was from January 1, 2012 to June 1, 2022. CiteSpace software was used to construct a visual graph of early rehabilitation for patients with severe neurological diseases in authoritative databases in both Chinese and English, for agency cooperation, author cooperation, keyword co-occurrence, and keyword clustering analysis.Results:A total of 349 articles were included, including 237 Chinese articles and 112 English articles. According to the search results of CNKI, there were 161 institutions publishing article related to early rehabilitation for patients with severe neurological diseases in China, among which the Nursing Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medicine School had the highest number of publications (4 articles) . The search results of the Web of Science showed that there were 160 institutions publishing article in this field, among which the Florey Institute of Neuroscience and Mental Health in Australia in Australia had the highest number of publications (16 articles) . Foreign researchers mainly focused on the safety assessment and timing of early rehabilitation for patients with severe neurological diseases, while domestic research mainly focused on the evaluation of the effectiveness of different rehabilitation methods on early rehabilitation for patients with severe neurological diseases.Conclusions:The research on early rehabilitation of patients with severe neurological diseases in foreign countries is more in-depth and comprehensive than in China, and there are more multi-center clinical studies, providing a high-level evidence for clinical decision-making. On the basis of existing research results, domestic scholars should focus on strengthening interdisciplinary and inter institutional cooperation, improving the quality and effectiveness of rehabilitation, and fully leveraging the leading role of nurses while collaborating across multiple disciplines.

Lung cancer is the malignant tumor with the highest incidence and mortality in China, and is prone to brain metastasis in the process of disease development, which seriously affects the quality of life and survival of patients. The treatment methods for brain metastasis of lung cancer include surgery, chemotherapy, whole brain radiotherapy, stereotactic radiosurgery, molecular targeted therapy, immunotherapy, anti-angiogenesis therapy, etc. It's one of the research hotspots to choose reasonable and effective treatment schemes for different patients. This paper reviews the research progress in the treatment of brain metastasis from lung cancer, to provide reference for selecting more reasonable clinical treatment for the patients.

Background: Excessive delivery of free fatty acids (FFAs) to the liver promotes steatosis and insulin resistance (IR), with IR defined as reduced glucose uptake, glycogen synthesis and anti-lipolysis stimulated by normal insulin levels. Whether the associations between FFAs and diabetes development differ between patients with and without nonalcoholic fatty liver disease (NAFLD) remains unclear. Methods: Consecutive subjects (2,220 NAFLD subjects and 1,790 non-NAFLD subjects according to ultrasound imaging) were enrolled from the First Affiliated Hospital of Sun Yat-sen University between 2009 and 2019. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Results: There was an approximate J-shaped relationship between FFA levels and HOMA-IR in the NAFLD group. Higher FFA concentration quartiles were associated with higher risks of IR (odds ratio [OR], 9.24; 95% confidence interval [CI], 6.43 to 13.36), prediabetes (OR, 10.48; 95% CI, 5.66 to 19.39), and type 2 diabetes mellitus (T2DM; OR, 19.43; 95% CI, 12.75 to 29.81) in the NAFLD group but not in the non-NAFLD group. The cut-off points for the FFA levels increased in a stepwise manner in discriminating IR, prediabetes and T2DM (573, 697, and 715 μmol/L) in the NAFLD group but not in non-NAFLD individuals. Conclusion A distinct dose-dependent relationship of FFA levels was found with IR, prediabetes and T2DM in NAFLD patients. Screening serum FFA levels in NAFLD patients would be valuable in preventing diabetes development.

Background: Excessive delivery of free fatty acids (FFAs) to the liver promotes steatosis and insulin resistance (IR), with IR defined as reduced glucose uptake, glycogen synthesis and anti-lipolysis stimulated by normal insulin levels. Whether the associations between FFAs and diabetes development differ between patients with and without nonalcoholic fatty liver disease (NAFLD) remains unclear. Methods: Consecutive subjects (2,220 NAFLD subjects and 1,790 non-NAFLD subjects according to ultrasound imaging) were enrolled from the First Affiliated Hospital of Sun Yat-sen University between 2009 and 2019. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Results: There was an approximate J-shaped relationship between FFA levels and HOMA-IR in the NAFLD group. Higher FFA concentration quartiles were associated with higher risks of IR (odds ratio [OR], 9.24; 95% confidence interval [CI], 6.43 to 13.36), prediabetes (OR, 10.48; 95% CI, 5.66 to 19.39), and type 2 diabetes mellitus (T2DM; OR, 19.43; 95% CI, 12.75 to 29.81) in the NAFLD group but not in the non-NAFLD group. The cut-off points for the FFA levels increased in a stepwise manner in discriminating IR, prediabetes and T2DM (573, 697, and 715 μmol/L) in the NAFLD group but not in non-NAFLD individuals. Conclusion A distinct dose-dependent relationship of FFA levels was found with IR, prediabetes and T2DM in NAFLD patients. Screening serum FFA levels in NAFLD patients would be valuable in preventing diabetes development.

Poor dietary habit is an important cause of the global prevalence of metabolic associated fatty liver disease (MAFLD), and the adjustment of dietary pattern is the cornerstone of MAFLD management. In recent years, a large number of new dietary intervention methods have been proposed and applied in the treatment of MAFLD, including calorie restrict diet, low-carbohydrate diet, low-glycemic index diet, low free sugar diet, intermittent fasting pattern, high protein diet, and Mediterranean diet, and these new methods have different effects in clinical practice. This article introduces the treatment concepts and practical methods of these new dietary treatment strategies and the evidence of their benefits in the treatment of MAFLD in China and globally, so as to provide a new perspective for clinicians to guide patients to achieve individualized nutritional therapy.

Hepatorenal syndrome (HRS) is one of the common serious complications in patients with end-stage liver disease and has poor prognosis and high mortality, and in-depth studies on its pathogenesis will help to achieve precise prevention and treatment. Although the exact pathogenesis of HRS has not yet been fully elucidated, achievements have been made in the pathogenesis of HRS. The classic mechanism of the hypothesis of visceral vasodilation continues to be enriched and perfected, and new understandings have been gained for the role of systemic inflammation and intestinal bacterial translocation in pathogenesis. In addition, a new concept of cardiorenal syndrome is put forward for the involvement of cardiac dysfunction in HRS, and renal pathology has been questioned and challenged. This article reviews the research advances in the pathogenesis of HRS in recent years and related implications for clinical work.

Abnormal uric acid metabolism is closely associated with the development and progression of nonalcoholic fatty liver disease (NAFLD). This article describes the relationship between uric acid and the prevalence and severity of NAFLD, and point out that uric acid metabolic disorders directly affect the development and progression of NAFLD through complicated pathways such as insulin resistance, oxidative stress, direct influence on the expression of lipid synthetase, and inflammatory response. Control of uric acid is expected to become one of the multimodality therapies for NAFLD.