Objective:To explore the current research status, hotspots, and trends of self-advocacy among patients with chronic diseases, and to provide a reference for conducting research on self-advocacy in chronic diseases.Methods:A computer-based search was conducted in the China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, and the Web of Science Core Collection for literature related to self-advocacy among patients with chronic diseases, with the time frame from database inception to October 1, 2024. The CiteSpace 6.3.R1 software was used to perform visual analysis on publication volume, countries, institutions, authors, keywords, and citation status.Results:A total of 721 articles were included in the study. The country with the largest number of publications related to self-advocacy among patients with chronic diseases was the United States. Authors and journals were mainly from the fields of psychology and sociology. Research hotspots mainly included women, cancer, breast cancer, quality of life (health-related quality of life), cancer screening, and individual experiences. Future research trends are expected to focus on influencing factors and theoretical research, impacts on medical decision-making, psychological and social support, as well as the development of scales and assessment tools of self-advocacy.Conclusions:Research on self-advocacy in China started relatively late. It is suggested that in the future, domestic scholars conduct multi-center and large-sample studies on self-advocacy among populations in different regions and with various types of chronic diseases.

Objective To study the effect of diltiazem on coronary microcirculation and vascular endothelial function in patients with acute coronary syndrome(ACS)before surgery.Methods A total of 96 ACS patients admitted to Fengfeng General Hospital of North China Medical and Health Group between October 2023 and October 2024 were selected as subjects.The patients were divided into experimental group(n=48)and control group(n=48)by using a random number table method.The experimental group received slow intravenous infusion of diltiazem dilution before surgery and continued intravenous diltiazem during the procedure,while the control group received normal saline both preoperatively and intraoperatively.During the operation,coronary microcirculation parameters[coronary angiography,myocardial perfusion grading(TIMI),microcirculatory resistance index,intraoperative slow blood flow,and no-reflux status]were monitored.Vascular endothelial indexes(endothelin-1,vascular endothelial growth factor)were detected before and one week after surgery.Cardiovascular adverse events were also observed within six months postoperative.Results Postoperative TIMI myocardial perfusion grading in experimental group was superior to than that in control group,and the incidence of slow blood flow and no reflux during surgery in experimental group were lower than those in control group.The levels of endothelin-1 and vascular endothelial growth factor in experimental group were lower than those in control group,and the incidence of cardiovascular adverse events in experimental group were lower than those in control group,with statistically significant differences(P＜0.05).Conclusion The use of diltiazem before percutaneous coronary intervention in patients with ACS can effectively increase coronary blood flow,improve coronary microcirculation,and protect vascular endothelial function.

This report presents the management of a critically ill 36-year-old woman diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph +ALL) at 28 weeks of gestation. The patient rapidly deteriorated, developing disseminated intravascular coagulation (DIC) , diffuse alveolar hemorrhage (DAH) , septic shock, and multi-organ dysfunction, necessitating admission to the hematological intensive care unit. Given her critical condition and advanced pregnancy, a chemotherapy-free induction regimen comprising imatinib and dexamethasone was initiated, alongside comprehensive supportive measures, including mechanical ventilation, continuous renal replacement therapy (CRRT) , broad-spectrum antibiotics, and high-dose corticosteroids. During treatment, intrauterine fetal demise occurred, and a stillborn was delivered following obstetric intervention. With aggressive treatment, the patient's respiratory failure, DIC, and DAH gradually resolved, and she achieved complete remission. She subsequently received consolidation chemotherapy, CAR-T cell therapy, and allogeneic hematopoietic stem cell transplantation, achieving sustained complete molecular remission on long-term follow-up. This case demonstrates that for critically ill pregnant patients with Ph + ALL, a chemotherapy-free regimen of targeted therapy and corticosteroids, when combined with intensive supportive care, is a safe and effective approach that may offer a therapeutic option for similar cases.

This report presents the management of a critically ill 36-year-old woman diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph +ALL) at 28 weeks of gestation. The patient rapidly deteriorated, developing disseminated intravascular coagulation (DIC) , diffuse alveolar hemorrhage (DAH) , septic shock, and multi-organ dysfunction, necessitating admission to the hematological intensive care unit. Given her critical condition and advanced pregnancy, a chemotherapy-free induction regimen comprising imatinib and dexamethasone was initiated, alongside comprehensive supportive measures, including mechanical ventilation, continuous renal replacement therapy (CRRT) , broad-spectrum antibiotics, and high-dose corticosteroids. During treatment, intrauterine fetal demise occurred, and a stillborn was delivered following obstetric intervention. With aggressive treatment, the patient's respiratory failure, DIC, and DAH gradually resolved, and she achieved complete remission. She subsequently received consolidation chemotherapy, CAR-T cell therapy, and allogeneic hematopoietic stem cell transplantation, achieving sustained complete molecular remission on long-term follow-up. This case demonstrates that for critically ill pregnant patients with Ph + ALL, a chemotherapy-free regimen of targeted therapy and corticosteroids, when combined with intensive supportive care, is a safe and effective approach that may offer a therapeutic option for similar cases.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective To study the effect of diltiazem on coronary microcirculation and vascular endothelial function in patients with acute coronary syndrome(ACS)before surgery.Methods A total of 96 ACS patients admitted to Fengfeng General Hospital of North China Medical and Health Group between October 2023 and October 2024 were selected as subjects.The patients were divided into experimental group(n=48)and control group(n=48)by using a random number table method.The experimental group received slow intravenous infusion of diltiazem dilution before surgery and continued intravenous diltiazem during the procedure,while the control group received normal saline both preoperatively and intraoperatively.During the operation,coronary microcirculation parameters[coronary angiography,myocardial perfusion grading(TIMI),microcirculatory resistance index,intraoperative slow blood flow,and no-reflux status]were monitored.Vascular endothelial indexes(endothelin-1,vascular endothelial growth factor)were detected before and one week after surgery.Cardiovascular adverse events were also observed within six months postoperative.Results Postoperative TIMI myocardial perfusion grading in experimental group was superior to than that in control group,and the incidence of slow blood flow and no reflux during surgery in experimental group were lower than those in control group.The levels of endothelin-1 and vascular endothelial growth factor in experimental group were lower than those in control group,and the incidence of cardiovascular adverse events in experimental group were lower than those in control group,with statistically significant differences(P＜0.05).Conclusion The use of diltiazem before percutaneous coronary intervention in patients with ACS can effectively increase coronary blood flow,improve coronary microcirculation,and protect vascular endothelial function.

Objective:To explore the clinical and imaging features of the concomitant gastric-type endocervical adenocarcinoma(G-EAC)in female patients with Peutz-Jeghers syndrome(PJS),so as to improve the early diagnostic level for PJS.Methods:A retrospective analysis was performed on the clinical and imaging data of 12 patients who were confirmed as PJS with G-EAC at Air Force Medical Center,PLA from June 2021 to December 2024.The 12 patients all received computed tomography(CT)examination before surgery,and 6 cases among of them received magnetic resonance imaging(MRI)examination at the same time.The features of clinical performance,and imaging features of CT and MR in all patients were analyzed.Results:In 12 G-EAC patients,7 cases(58.3%)did not occurred any abnormally relative symptoms of gynaecology and obstetrics,while 5 cases(41.7%)occurred increase of vaginal drainage and/or vaginal bleeding.The results of imaging examination indicated that 12 cases occurred concomitant cyst,including 5 cases(41.7%)with large cysts,6 cases(50.0%)that micro cysts coexisted with large cysts,1 case(8.3%)that solid mass combined with small amount of micro cysts,and 4 cases(33.3%)that combined with small amount of uterine cavity effusion.MR performance was the most of occurrences were quasi-circular object with long T1/T2 signals,and the sequences of diffusion weighted imaging(DWI)appeared there was no diffusion or mild restriction,and apparent diffusion coefficient(ADC)appeared slightly high signal.The tumors that mainly were solid components appeared longer T2 signals,which diffusion was limited,and which ADC values appeared low signals.CT images of them presented enlarged cervixes,and mixed-density cystic and solid nodules and mass shadows at local tissues,and cellular change at local lesions.There was not significant strengthen at the cystic fields of the lesion with enhanced scan,and the solid fields appeared uneven enhancement.The accuracy rates both of preoperative CT and MR diagnosis were 50.0%.Conclusion:The clinical appearance,and imaging futures of CT and MR examinations of PJS female patients with G-EAC are respectively:partial patients occur vaginal drainage and/or vaginal bleeding,the most of tumors often occurs at the entire cervix(includes upper segment),often combines with cystic changes,and often appears infiltrating growth.The clinical PJS appearance,CT and MR examinations contribute to early diagnosis for G-EAC.

Objective:To explore the current research status, hotspots, and trends of self-advocacy among patients with chronic diseases, and to provide a reference for conducting research on self-advocacy in chronic diseases.Methods:A computer-based search was conducted in the China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, and the Web of Science Core Collection for literature related to self-advocacy among patients with chronic diseases, with the time frame from database inception to October 1, 2024. The CiteSpace 6.3.R1 software was used to perform visual analysis on publication volume, countries, institutions, authors, keywords, and citation status.Results:A total of 721 articles were included in the study. The country with the largest number of publications related to self-advocacy among patients with chronic diseases was the United States. Authors and journals were mainly from the fields of psychology and sociology. Research hotspots mainly included women, cancer, breast cancer, quality of life (health-related quality of life), cancer screening, and individual experiences. Future research trends are expected to focus on influencing factors and theoretical research, impacts on medical decision-making, psychological and social support, as well as the development of scales and assessment tools of self-advocacy.Conclusions:Research on self-advocacy in China started relatively late. It is suggested that in the future, domestic scholars conduct multi-center and large-sample studies on self-advocacy among populations in different regions and with various types of chronic diseases.

Objective:To explore the clinical and imaging features of the concomitant gastric-type endocervical adenocarcinoma(G-EAC)in female patients with Peutz-Jeghers syndrome(PJS),so as to improve the early diagnostic level for PJS.Methods:A retrospective analysis was performed on the clinical and imaging data of 12 patients who were confirmed as PJS with G-EAC at Air Force Medical Center,PLA from June 2021 to December 2024.The 12 patients all received computed tomography(CT)examination before surgery,and 6 cases among of them received magnetic resonance imaging(MRI)examination at the same time.The features of clinical performance,and imaging features of CT and MR in all patients were analyzed.Results:In 12 G-EAC patients,7 cases(58.3%)did not occurred any abnormally relative symptoms of gynaecology and obstetrics,while 5 cases(41.7%)occurred increase of vaginal drainage and/or vaginal bleeding.The results of imaging examination indicated that 12 cases occurred concomitant cyst,including 5 cases(41.7%)with large cysts,6 cases(50.0%)that micro cysts coexisted with large cysts,1 case(8.3%)that solid mass combined with small amount of micro cysts,and 4 cases(33.3%)that combined with small amount of uterine cavity effusion.MR performance was the most of occurrences were quasi-circular object with long T1/T2 signals,and the sequences of diffusion weighted imaging(DWI)appeared there was no diffusion or mild restriction,and apparent diffusion coefficient(ADC)appeared slightly high signal.The tumors that mainly were solid components appeared longer T2 signals,which diffusion was limited,and which ADC values appeared low signals.CT images of them presented enlarged cervixes,and mixed-density cystic and solid nodules and mass shadows at local tissues,and cellular change at local lesions.There was not significant strengthen at the cystic fields of the lesion with enhanced scan,and the solid fields appeared uneven enhancement.The accuracy rates both of preoperative CT and MR diagnosis were 50.0%.Conclusion:The clinical appearance,and imaging futures of CT and MR examinations of PJS female patients with G-EAC are respectively:partial patients occur vaginal drainage and/or vaginal bleeding,the most of tumors often occurs at the entire cervix(includes upper segment),often combines with cystic changes,and often appears infiltrating growth.The clinical PJS appearance,CT and MR examinations contribute to early diagnosis for G-EAC.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.