Objective To enhance the patient's medical experience by facilitating real-time reading monitoring of their offline outpatient medical progress,providing a centralized display of the status of various medical processes,and proactively de-livering the essential message notifications to patients at designated intervals.Methods The system was developed by adopting a message reminder functionality and integrating with the display of critical diagnostic and treatment processes(including registra-tion,payment,examination,testing,medication collection,and evaluation)so as to ensure that patients receive timely informa-tion that guides their subsequent actions.Results Following the developement and implementation of the system,empirical evi-dence demonstrated that patients were able to clearly comprehend their diagnostic and treatment progress.The system reduced waiting time and confusion.In addition,it enhanced the coherence and convenience of medical services.Conclusion The out-patient medical guidance system,grounded on the Internet hospital model,has effectively minimized patient confusion and stre-amlined operational procedures through an active service approach.Future enhancements are anticipated to further elevate the in-telligence of medical services by broadening business coverage and integrating advanced technologies such as big data and artificial intelligence and other technologies in the future.

Peripherally induced movement disorders are a rare in clinical practice.This study presents a case of scar-related chorea in a patient who developed abnormal movements under a surgical scar within one year following spinal surgery.The symptoms worsened with emotional excitement and partially improved when lying flat or sleeping,with no significant impact from voluntary movements or distraction.Examination revealed involuntary movements of the muscles beneath the scar.Brain magnetic resonance imaging demonstrated no remarkable structural abnormalities.The patient exhibited limited response to oral pharmacotherapy but achieved marked symptomatic improvement following botulinum toxin type A injection.Therapeutic effects persisted for approximately three months without adverse events.The underlying pathophysiology may involve abnormal activation of mechanically sensitive ion channel Piezo1 within the scar region.Botulinum toxin type A primarily alleviates symptoms by inhibiting muscle contraction and may also act indirectly by reducing mechanical stress-induced activation of Piezo1 channels.

Peripherally induced movement disorders are a rare in clinical practice.This study presents a case of scar-related chorea in a patient who developed abnormal movements under a surgical scar within one year following spinal surgery.The symptoms worsened with emotional excitement and partially improved when lying flat or sleeping,with no significant impact from voluntary movements or distraction.Examination revealed involuntary movements of the muscles beneath the scar.Brain magnetic resonance imaging demonstrated no remarkable structural abnormalities.The patient exhibited limited response to oral pharmacotherapy but achieved marked symptomatic improvement following botulinum toxin type A injection.Therapeutic effects persisted for approximately three months without adverse events.The underlying pathophysiology may involve abnormal activation of mechanically sensitive ion channel Piezo1 within the scar region.Botulinum toxin type A primarily alleviates symptoms by inhibiting muscle contraction and may also act indirectly by reducing mechanical stress-induced activation of Piezo1 channels.

Objective To enhance the patient's medical experience by facilitating real-time reading monitoring of their offline outpatient medical progress,providing a centralized display of the status of various medical processes,and proactively de-livering the essential message notifications to patients at designated intervals.Methods The system was developed by adopting a message reminder functionality and integrating with the display of critical diagnostic and treatment processes(including registra-tion,payment,examination,testing,medication collection,and evaluation)so as to ensure that patients receive timely informa-tion that guides their subsequent actions.Results Following the developement and implementation of the system,empirical evi-dence demonstrated that patients were able to clearly comprehend their diagnostic and treatment progress.The system reduced waiting time and confusion.In addition,it enhanced the coherence and convenience of medical services.Conclusion The out-patient medical guidance system,grounded on the Internet hospital model,has effectively minimized patient confusion and stre-amlined operational procedures through an active service approach.Future enhancements are anticipated to further elevate the in-telligence of medical services by broadening business coverage and integrating advanced technologies such as big data and artificial intelligence and other technologies in the future.

Background and objective Low-dose spiral computed tomography(LDCT)has been recommended for lung cancer screening in high-risk populations.However,evidence from Chinese populations was limited due to the dif-ferent criteria for high-risk populations and the short-term follow-up period.This study aimed to evaluate the effectiveness in Chinese adults based on the Lung Cancer Screening Program in Minhang District of Shanghai initiated in 2013.Methods A total of 26,124 subjects aged 40 years or above were enrolled in the Lung Cancer Screening Program during the period of 2013 and 2017.Results of LDCT examination,and screen-detected cancer cases in all participants were obtained from the Report-ing System of the Lung Cancer Screening Program.The newly-diagnosed cases and their vital status up to December 31,2020 were identified through a record linkage with the Shanghai Cancer Registry and the Shanghai Vital Statistics.Standardized incidence ratio(SIR)and 95％CI were calculated using the local population at ages of 40 or above as the reference.Proportions of early-stage cancer(stage 0-Ⅰ),pathological types,and 5-year observed survival rates of lung cancer cases were estimated and compared between the cases derived from the screened and non-screened populations.Cox regression models were applied to evaluate the hazard ratio(HR)and 95％CI of LDCT screening with all-cause death of the lung cancer cases.Results The crude and age-standardized incidence of lung cancer in screened population were 373.3(95％CI:343.1-406.1)and 70.3 per 100,000 person-years,respectively,with an SIR of 1.8(95％CI:1.6-1.9),which was observed to decrease with following-up time.The early-stage cancer accounted for 49.4％of all lung cancer cases derived from the screened population,significantly higher than 38.4％in cases from the non-screened population during the same period(P＜0.05).The proportion of lung adenocarcinoma(40.7％vs 35.9％)and 5-year survival rate(53.7％vs 41.5％)were also significantly higher in the cases from the screened popu-lation(all P＜0.05).LDCT screening was associated with 30％(HR=0.7,95％CI:0.6-0.8)reduced all-cause deaths of the cases.Conclusion The participants of the screening program are at high-risk of lung cancer.LDCT favors the early-detection of lung cancer and improves 5-year survival of the screened cases,indicating a great potential of LDCT in reducing the disease burden of lung cancer in Chinese populations.

Humans ; Stroke/therapy* ; Thrombectomy ; Treatment Outcome ; Brain Ischemia/therapy* ; Retrospective Studies

Objective:To study the phenotypes and genotypes of neonatal nonketotic hyperglycinemia (NKH).Methods:A neonate with severe NKH admitted to our hospital was retrospectively analyzed. Using keywords 'glycine cleavage enzyme', 'glycine decarboxylase', 'nonketotic hyperglycinemia' and 'glycine encephalopathy' (both in Chinese and English), multiple medical databases were searched until December 31, 2022. The clinical phenotypes and genotypes of neonatal NKH were summarized.Results:For our case, the neonate was lethargy and had no appetite on the second day of life, followed by recurrent seizures and irregular breathing, requiring mechanical ventilation. She died at 3 weeks of age. Two compound heterozygous variants were found in GLDC gene from whole exome sequencing , one was c.848C>G(p.A283G) of maternal origin and one was c.1607G>A(p.R536Q) of paternal origin. The former was a novel mutation. A total of 54 cases (including this case) were collected. The main clinical manifestations included poor feeding, decreased muscle tone, hiccups, progressive lethargy, irregular breathing, apnea and neonatal seizures. 42 cases (77.8%) had GLDC gene mutations, 9 cases (16.7%) had AMT gene mutations, 2 cases (3.7%) had LIAS gene mutations and 1 case (1.9%) had GCSH gene mutations. Conclusions:Neurological manifestations are most common in neonatal NKH with wide clinical variations. GLDC gene mutations are the predominant pathogenic mutations.

Objective:To prepare a phase-change lipid nanoparticle modified by tumor homing membrane-penetrating peptide (tLyP-1) and carrying paclitaxel (PTX) engineered by metal polyphenol network (TA-Fe 3+ ), and evaluate the therapeutic effects of tumor targeting, ultrasound/photoacoustic imaging and photothermal combined chemotherapy in vitro. Methods:Phase-change lipid nanoparticles (t-P@TFP) with TA-Fe 3+ engineered PTX mediated by tLyP-1 were prepared by solvent replacement method, thin film hydration method and double emulsification method. Its detection and characterization, in vitro targeting ability, photothermal conversion ability, in vitro photoacoustic and ultrasonic imaging ability, CCK-8 method, cell live and death double staining method and flow cytometry method were used to detect the safety of nanoparticles and the killing effects of different nanoparticles on 4T1 cells. Results:t-P@TFP nanoparticles were successfully prepared. Transmission electron microscopy showed that the nanoparticles were spherical with uniform shape and size, with a particle size of (209.8±1.56)nm and a potential of (-25.9±1.36)mV. Laser confocal scanning microscopy showed that t-P@TFP nanoparticles could gather around 4T1 cells in a targeted manner. It had an efficient photothermal conversion effect, and nanoparticles could quickly become microbubbles after being irradiated by near-infrared laser, which enhanced the in vitro ultrasonic imaging effect; The photoacoustic signal of nanoparticles increased with the increase of concentration. CCK-8 method, double staining of living and dead cells and flow cytometry showed that t-P@TFP combined photothermal chemotherapy had the best anti-tumor effect. Conclusions:t-P@TFP nanoparticles are successfully prepared. The nanoparticles have good targeting ability for photoacoustic and ultrasonic imaging and have good photothermal effect, killing breast cancer cells, which is expected to realize the integration of diagnosis and treatment.

Objective:To explore the methods of fertility preservation in prepubertal patients with thalassemia major (TM), and to provide further data support for the fertility preservation in prepubertal patients with hematologic diseases.Methods:A case of a prepubertal patient with TM who required urgent hematopoietic stem cell transplantation (HSCT) receiving ovarian tissue cryopreservation (OTC) and in vitro maturation (IVM) to preserve fertility was reported, and the timing, the indications and strategies of fertility preservation in prepubertal girls with thalassemia were discussed in combination with related literature. Results:After ovarian tissue extraction, a total of 24 cumulus-oocyte complexes (COCs) and 11 ovarian cortex pieces were obtained through puncture and aspiration. After IVM for 48 h, a total of 9 M Ⅱ oocytes were frozen by vitrification. Conclusion:For the prepubertal girls facing HSCT urgently, cryopreserving ovarian tissue in combination with retrieving immature oocytes followed by IVM can preserve the fertility of patients to the greatest extent in a short period of time, as well as improve the therapeutic effect of fertility preservation in patients.

Objective:To explore the methods of fertility preservation in prepubertal patients with thalassemia major (TM), and to provide further data support for the fertility preservation in prepubertal patients with hematologic diseases.Methods:A case of a prepubertal patient with TM who required urgent hematopoietic stem cell transplantation (HSCT) receiving ovarian tissue cryopreservation (OTC) and in vitro maturation (IVM) to preserve fertility was reported, and the timing, the indications and strategies of fertility preservation in prepubertal girls with thalassemia were discussed in combination with related literature. Results:After ovarian tissue extraction, a total of 24 cumulus-oocyte complexes (COCs) and 11 ovarian cortex pieces were obtained through puncture and aspiration. After IVM for 48 h, a total of 9 M Ⅱ oocytes were frozen by vitrification. Conclusion:For the prepubertal girls facing HSCT urgently, cryopreserving ovarian tissue in combination with retrieving immature oocytes followed by IVM can preserve the fertility of patients to the greatest extent in a short period of time, as well as improve the therapeutic effect of fertility preservation in patients.