Acute mitral regurgitation(MR)in the setting of myocardial infarction(MI)may be the result of papillary muscle rupture(PMR).The clinical presentation can be catastrophic,with refractory cardiogenic shock.This condition is associated with high morbidity and mortality.Transcatheter edge-to-edge repair(TEER)has become increasingly common in treating severe mitral regurgitation.This case details a successful TEER is feasible and safe in patients with acute MR following MI.TEER is an emerging treatment option in this clinical scenario that should be taken into consideration.

Objective:To systematically appraise and summarize existing evidence on enteral nutrition in patients receiving radiotherapy for head and neck cancer.Methods:Based on the 6S Pyramid of Evidence-based Resources, a systematic search was conducted to identify guidelines, expert consensuses, and evidence summaries related to enteral nutrition for radiotherapy patients with head and neck cancer published from January 2018 to September 2023. The search covered relevant websites of guidelines, websites of academic societies, and databases (in Chinese and English). Literature screening, quality assessment, and data extraction were performed independently by the researchers.Results:A total of 19 studies were included, consisting of 10 guidelines, 7 expert consensuses, and 2 evidence summaries. Four aspects and 67 items of best evidence on organizational management, nutritional screening and assessment, enteral nutritional intervention programs, and monitoring and follow-up were summarized.Conclusion:This study summarized the best evidence for enteral nutrition in patients receiving radiotherapy for head and neck cancer, which can inform the standardized nutritional management and promote the translation of evidence-based knowledge into practice.

Objective To investigate the balance control abilities and cortical activation characteristics of elderly individuals under different sensory strategies. Methods From January to May,2023,19 healthy young adults and 20 elderly individuals were recruited in Changzhou as control group and experimental group,respectively.Both groups wore functional near-infrared spectroscopy(fNIRS)caps and performed balance control tasks on a balance platform under three different sensory strategies.Test A was 40 seconds of standing on a stable surface with eyes closed,Test B was 40 seconds of standing on an unstable surface with eyes open,and Test C was 40 seconds of standing on an unstable surface with eyes closed.Before and after the tests,both groups performed 40 seconds of standing on a stable surface with eyes open.The overall stability index(OSI)and cortical activation β values of the regions of interest(ROI)were measured and compared between two groups.The ROIs included the left premotor cortex(LPMC),right premotor cortex(RPMC),left sensorimotor cortex(LSMC),right sensorimotor cortex(RSMC),left prefrontal cortex(LPFC)and right prefrontal cortex(RPFC). Results There was no significant difference in OSI and β values of each ROI in Tests A and B between two groups(P>0.05).In Test C,there was a lower OSI in the experimental group(Z=-2.056,P<0.05),and there were signifi-cant differences in the β values of RSMC(t=2.623,PFDR<0.05),LPMC(Z=-2.360,PFDR<0.05)and LPFC(t=3.202,PFDR<0.05)between two groups. Conclusion Elderly individuals experience a decline in balance control abilities,accompanied by increased activation in related brain regions,when both vision and proprioception are restricted.

The genus jujube(Ziziphus jujuba Mill.)within the Rhamnaceae family encompasses numerous varieties,such as Ziziphus jujuba Mill.var.jujuba,Ziziphus jujuba var.inermis,and var.spinosa,etc.Among these,the jujube fructus has the most abundant cultivated variants across the country,including Ziziphus jujuba cv.Hamidazao and Ziziphus jujuba cv.Huanghetanzao.Jujube plants are rich in variety and are used for both medicinal and food purposes.Polysaccharides,one of the main active ingredients of jujube,are important medicinal components that contribute to its efficacy.Jujube polysaccharides have been found to promote hematopoiesis,exhibit antioxidant and anti-tumor activities,repair liver damage,regulate the immune system,and provide anti-inflammatory effects.By comprehensively summarizing and analyzing the literature on jujube polysaccharides from different varieties and origins,this paper reviews the potential mechanisms of action of jujube polysaccharides in exerting biological activities.It also summarizes the primary structural features,such as relative molecular mass,monosaccharide composition,glycosidic linkage,and the substituent modifications of jujube polysaccharides by sulfation,phosphorylation,carboxymethylation,selenization,and acetylation.This review aims to provide a reference for the research and development of jujube in the fields of innovative polysaccharide drugs and functional foods.

Objective To investigate the prognostic value of serum adiponectin and fibroblast growth factor-23 (FGF23) levels in patients undergoing cardiac valve replacement. Methods A total of 98 patients undergoing heart valve replacement were selected as the study group. The patients in the study group were divided into good prognosis group (n=67) and poor prognosis group (n=31). A total of 90 healthy subjects were selected as control group. Spearman method was used to analyze the correlation of serum adiponectin and FGF23 levels with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and Acute Physiology and Chronic Health EvaluationⅡ (APACHE Ⅱ) scores, respectively. Multivariate Logistic regression analysis was used to analyze the prognostic factors of patients with heart valve replacement. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum adiponectin and FGF23 levels in patients with heart valve replacement. Results Serum FGF23, NT-proBNP level and APACHEⅡ score in the study group were significantly higher, and serum adiponectin level was significantly lower than that in the control group (P < 0.05). The levels of serum FGF23, NT-proBNP and APACHE Ⅱ score in the poor prognosis group were significantly higher, and the serum adiponectin level was significantly lower than that in the good prognosis group (P < 0.05). Serum FGF23 level was positively correlated with NT-proBNP level and APACHE Ⅱ score (P < 0.05). Serum adiponectin level was negatively correlated with NT-proBNP level and APACHE Ⅱ score (P < 0.05). The levels of serum adiponectin, FGF23, NT-proBNP and APACHE Ⅱ score were the influencing factors for the prognosis of patients with heart valve replacement (P < 0.05). The area under the curve (AUC) of serum adiponectin and FGF23 for predicting the prognosis of patients undergoing cardiac valve replacement was 0.862 and 0.807, respectively, and the AUC of the combined prediction was 0.911. The AUC of combined prediction of adiponectin and FGF23 was higher than that of individual prediction (P < 0.05). Conclusion The combination of serum adiponectin and FGF23 has a good effect in predicting the prognosis of patients with heart valve replacement. Serum adiponectin and FGF23 are expected to be effective indicators for evaluating the prognosis of patients undergoing heart valve replacement.

Objective To observe the effect of transthoracic echocardiography (TTE) monitoring in percutaneous closure of patent foramen ovale (PFO). Methods The data of 98 patients with PFO were retrospectively analyzed. All patients underwent interventional plugging. They were divided into X-ray group (n=50) and TTE group (n=48) according to different intraoperative guidance methods. The occlusions, complications, surgical indexes, right-to-left shunt (RLS) grading and the improvement of headache in patients with migraine were compared between the two groups. Results A total of 98 cases of PFO were successfully occluded, among which 2 cases in the TTE group received transesophageal ultrasound guidance due to poor intraoperative sound window. The operation time of the TTE group was significantly longer than that of the X-ray group (P < 0.05). After operation, RLS rating and Headache Impact Test-6 (HIT-6) score of migraine patients in the two groups were significantly lower than those before operation (P < 0.05). Conclusion Simple TTE guided percutaneous PFO occlusion has a good improvement effect on RLS and migraine in PFO patients, and can avoid radiation damage caused by X-ray to doctors and patients.

Climate change is the great health challenge for human beings in the 21^st century. Air pollution is also an important public health problem worldwide. China announced the climate commitment to achieve carbon peaking by 2030 and carbon neutrality by 2060. Achieving these goals would not only have far-reaching effects on air pollution control and climate change, but also improve the population health in China. Air pollution and climate change epidemiology are important aspects of environmental epidemiology. In this paper, we discuss the current status and future development of epidemiological research of air pollution and climate change in the context of achieving carbon peaking and carbon neutrality goals to provide ideas and suggestions for environmental and health studies in the future.
Humans ; Climate Change ; Goals ; Air Pollution/analysis* ; Environmental Health ; Public Health ; China/epidemiology* ; Carbon

Nitrogen dioxide (NO₂) is an important indoor air pollutant, with both outdoor and indoor sources contributing to indoor NO₂ exposure levels. Considering the association of high NO₂ exposure with adverse health effects, the Standards for indoor air quality (GB/T 18883-2022) have been revised to further restrict indoor NO₂ limit values. The 1-h average concentration limit value for NO₂ has been reduced from 0.24 mg/m³ to 200 μg/m³.This study analyzed the technical contents related to the determination of the limits of indoor NO₂ in Standards for Indoor Air Quality (GB/T 18883-2022), including source, exposure level, health effects, and the process and evidence basis for determining the limit value. It also proposed prospects for the direction for the implementation of the indoor NO₂ standard.
Humans ; Air Pollution, Indoor/adverse effects* ; Nitrogen Dioxide ; Air Pollutants/analysis* ; China ; Air Pollution/adverse effects*

Objective: To investigate the association between gestational diabetes mellitus (GDM) and preterm birth subtypes. Methods: Based on the cohort of pregnant women in Anqing Prefectural Hospital, the pregnant women who received prenatal screening in the first or second trimesters were recruited into baseline cohorts; and followed up for them was conducted until delivery, and the information about their pregnancy status and outcomes were obtained through electronic medical record system and questionnaire surveys. The log-binomial regression model was used to explore the association between GDM and preterm birth [iatrogenic preterm birth, spontaneous preterm birth (preterm premature rupture of membranes and preterm labor)]. For multiple confounding factors, the propensity score correction model was used to compute the adjusted association. Results: Among the 2 031 pregnant women with a singleton delivery, the incidence of GDM and preterm birth were 10.0% (204 cases) and 4.4% (90 cases) respectively. The proportions of iatrogenic preterm birth and spontaneous preterm birth in the GDM group (n=204) were 1.5% and 5.9% respectively, while the proportions in non-GDM group (n=1 827) were 0.9% and 3.2% respectively, and the difference in the proportion of spontaneous preterm birth between the two groups was significant (P=0.048). Subtypes of spontaneous preterm were further analyzed, and the results showed that the proportions of preterm premature rupture of membranes and preterm labor in the GDM group were 4.9% and 1.0% respectively, while the proportions in the non-GDM group were 2.1% and 1.1% respectively. It showed that the risk of preterm premature rupture of membranes in GDM pregnant women was 2.34 times (aRR=2.34, 95%CI: 1.16-4.69) higher than that in non-GDM pregnant women. Conclusions: Our results showed that GDM might increase the risk of preterm premature rupture of membranes. No significant increase in the proportion of preterm labor in pregnant women with GDM was found.
Infant, Newborn ; Female ; Pregnancy ; Humans ; Premature Birth ; Diabetes, Gestational ; Obstetric Labor, Premature ; Hospitals ; Iatrogenic Disease

In this paper, the clinical data of a case of accidental poisoning of dimethylformamide in a traffic accident was analyzed. The patient was trapped in the driving room, his limbs were soaked in dimethylformamide for a long time, and dimethylformamide was inhaled at the same time. After 4 days of treatment in a local hospital, he was transferred to the Department of Poisoning & Occupational Diseases, Emergency Medicine of Qilu Hospital of Shandong University for treatment. The main clinical manifestation of the patient was liver damage and intractable abdominal pain, which was cured by active treatment.
Male ; Humans ; Dimethylformamide ; Abdominal Pain ; Occupational Diseases/complications* ; Poisoning