Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

OBJECTIVE: To explore the role of the natural compound hesperidin in glycolysis, the key ratelimiting enzyme, in colorectal cancer (CRC) cell lines. METHODS: In vitro, HCT116 and SW620 were treated with different doses of hesperidin (0-500 µmol/L), cell counting kit-8 and colone formation assays were utilized to detected inhibition effect of hesperidin on CRC cell lines. Transwell and wound healing assays were performed to detect the ability of hesperidin (0, 25, 50 and 75 µmol/L) to migrate CRC cells. To confirm the apoptotic-inducing effect of hesperidin, apoptosis and cycle assays were employed. Western blot, glucose uptake, and lactate production determination measurements were applied to determine inhibitory effects of hesperidin (0, 25 and 50 µmol/L) on glycolysis. In vivo, according to the random number table method, nude mice with successful tumor loading were randomly divided into vehicle, low-dose hesperidin (20 mg/kg) and high-dose hesperidin (60 mg/kg) groups, with 6 mice in each group. The body weights and tumor volumes of mice were recorded during 4-week treatment. The expression of key glycolysis rate-limiting enzymes was determined using Western blot, and glucose uptake and lactate production were assessed. Finally, protein interactions were probed with DirectDIA Quantitative Proteomics, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. RESULTS: Hesperidin could inhibit CRC cell line growth (P<0.05 or P<0.01). Moreover, hesperidin presented an inhibitory effect on the migrating abilities of CRC cells. Hesperidin also promoted apoptosis and cell cycle alterations (P<0.05). The immunoblotting results manifested that hesperidin decreased the levels of hexokinase 2, glucose transporter protein 1 (GLUT1), GLUT3, L-lactate dehydrogenase A, 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 2 (PFKFB2), PFKFB3, and pyruvate kinase isozymes M2 (P<0.01). It remarkably suppressed tumor xenograft growth in nude mice. GO and KEGG analyses showed that hesperidin treatment altered metabolic function. CONCLUSION Hesperidin inhibits glycolysis and is a potential therapeutic choice for CRC treatment.
Hesperidin/therapeutic use* ; Colorectal Neoplasms/metabolism* ; Glycolysis/drug effects* ; Animals ; Humans ; Apoptosis/drug effects* ; Mice, Nude ; Cell Movement/drug effects* ; Cell Line, Tumor ; Cell Proliferation/drug effects* ; Glucose/metabolism* ; Cell Cycle/drug effects* ; Mice, Inbred BALB C ; Mice ; HCT116 Cells ; Lactic Acid

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Objective:To investigate the optimal timing for stage II vitreous surgery for open ocular trauma and its effects on complications, intraocular pressure, and visual acuity.Methods:A total of 98 patients with open ocular trauma were selected as subjects from the Third Department of Ophthalmology at Baoji People's Hospital who received treatment between May 2021 and March 2024. This study used a retrospective design. Based on the different intervals between stage I emergency debridement and suturing and stage II vitreous surgery, the patients were divided into two groups: the control group (with an interval of > 14 days) and the observation group (with an interval of ≤ 14 days), with 49 cases in each group. The postoperative complications, intraocular pressure recovery, and visual acuity improvement were compared between the two groups.Results:At 1 month after surgery, the total cure rate in the observation group was significantly higher than that in the control group [95.92% (47/49) vs. 81.63% (40/49), χ2 = 5.02, P = 0.025]. In the observation group, the visual acuity levels were as follows: level I [2.05% (1/49)], level II [4.08% (2/49)], level III [6.12% (3/49)], level IV [77.55% (38/49)], and level V [10.20% (5/49)]. These results were significantly better than those in the control group, which had the following levels: 18.37% (9/49), 20.41% (10/49), 24.49% (12/49), 34.69% (17/49), and 2.05% (1/49) for levels I-V respectively ( Z = 5.12, P < 0.001). At 1 week after surgery, there were no statistically significant differences in the rates of normal intraocular pressure, high intraocular pressure, or low intraocular pressure between the observation and control groups (all P > 0.05). At 1 week after surgery, the levels of interleukin-4 (IL-4), IL-6, IL-12, IL-17, and interferon-γ in the observation group were (14.85 ± 2.82) ng/L, (7.52 ± 0.54) ng/L, (10.05 ± 2.63) ng/L, (9.17 ± 1.83) ng/L, and (8.95 ± 2.30) ng/L, respectively. These levels in the observation group were significantly lower than those in the control group [(16.48 ± 2.46) ng/L, (7.83 ± 0.64) ng/L, (11.30 ± 2.60) ng/L, (10.22 ± 1.46) ng/L, (10.03 ± 2.24) ng/L, t = -2.79, -2.37, -2.16, -2.87, -2.15, all P < 0.05]. The incidences of silicone oil-dependent eyes, secondary glaucoma, re-vitreal hemorrhage, and ocular atrophy in the observation group were not statistically different from those in the control group (all P > 0.05). The incidence of traumatic proliferative vitreo-retinopathy in the observation group was significantly lower than that in the control group [0 vs. 10.20% (5/49), χ2 = 5.27, P = 0.022]. Conclusions:In patients with open ocular trauma, performing stage II vitreous surgery within 2 weeks after stage I emergency debridement and suturing yields better therapeutic outcomes. This approach can significantly increase the retinal reattachment rate, improve postoperative visual acuity, and effectively prevent and reduce the incidence of traumatic proliferative vitreoretinopathy.

The patent data in the key technology field of capsule endoscopy industry was retrieved in IncoPat Global Patent Database from January 1,2003 to December 31,2022,and the development trend of key technologies and patent competition in the global capsule endoscopy industry were analyzed in terms of the applicant,concentration of China's patent applications and regional layout.It's pointed out Japan's Olympus company gained advantages in the key technology field,the enterprise played a main role in the innovation of the key technology field,the main exporters and target markets included the United States,South Korea,Japan and China and China became more and more important for the innovation of the key technology field.References were provided for the technology development of capsule endoscopy industry in China.[Chinese Medical Equipment Journal,2025,46(5):60-65]

The patent data in the key technology field of capsule endoscopy industry was retrieved in IncoPat Global Patent Database from January 1,2003 to December 31,2022,and the development trend of key technologies and patent competition in the global capsule endoscopy industry were analyzed in terms of the applicant,concentration of China's patent applications and regional layout.It's pointed out Japan's Olympus company gained advantages in the key technology field,the enterprise played a main role in the innovation of the key technology field,the main exporters and target markets included the United States,South Korea,Japan and China and China became more and more important for the innovation of the key technology field.References were provided for the technology development of capsule endoscopy industry in China.[Chinese Medical Equipment Journal,2025,46(5):60-65]

Objective:To investigate the optimal timing for stage II vitreous surgery for open ocular trauma and its effects on complications, intraocular pressure, and visual acuity.Methods:A total of 98 patients with open ocular trauma were selected as subjects from the Third Department of Ophthalmology at Baoji People's Hospital who received treatment between May 2021 and March 2024. This study used a retrospective design. Based on the different intervals between stage I emergency debridement and suturing and stage II vitreous surgery, the patients were divided into two groups: the control group (with an interval of > 14 days) and the observation group (with an interval of ≤ 14 days), with 49 cases in each group. The postoperative complications, intraocular pressure recovery, and visual acuity improvement were compared between the two groups.Results:At 1 month after surgery, the total cure rate in the observation group was significantly higher than that in the control group [95.92% (47/49) vs. 81.63% (40/49), χ2 = 5.02, P = 0.025]. In the observation group, the visual acuity levels were as follows: level I [2.05% (1/49)], level II [4.08% (2/49)], level III [6.12% (3/49)], level IV [77.55% (38/49)], and level V [10.20% (5/49)]. These results were significantly better than those in the control group, which had the following levels: 18.37% (9/49), 20.41% (10/49), 24.49% (12/49), 34.69% (17/49), and 2.05% (1/49) for levels I-V respectively ( Z = 5.12, P < 0.001). At 1 week after surgery, there were no statistically significant differences in the rates of normal intraocular pressure, high intraocular pressure, or low intraocular pressure between the observation and control groups (all P > 0.05). At 1 week after surgery, the levels of interleukin-4 (IL-4), IL-6, IL-12, IL-17, and interferon-γ in the observation group were (14.85 ± 2.82) ng/L, (7.52 ± 0.54) ng/L, (10.05 ± 2.63) ng/L, (9.17 ± 1.83) ng/L, and (8.95 ± 2.30) ng/L, respectively. These levels in the observation group were significantly lower than those in the control group [(16.48 ± 2.46) ng/L, (7.83 ± 0.64) ng/L, (11.30 ± 2.60) ng/L, (10.22 ± 1.46) ng/L, (10.03 ± 2.24) ng/L, t = -2.79, -2.37, -2.16, -2.87, -2.15, all P < 0.05]. The incidences of silicone oil-dependent eyes, secondary glaucoma, re-vitreal hemorrhage, and ocular atrophy in the observation group were not statistically different from those in the control group (all P > 0.05). The incidence of traumatic proliferative vitreo-retinopathy in the observation group was significantly lower than that in the control group [0 vs. 10.20% (5/49), χ2 = 5.27, P = 0.022]. Conclusions:In patients with open ocular trauma, performing stage II vitreous surgery within 2 weeks after stage I emergency debridement and suturing yields better therapeutic outcomes. This approach can significantly increase the retinal reattachment rate, improve postoperative visual acuity, and effectively prevent and reduce the incidence of traumatic proliferative vitreoretinopathy.

Objective:To describe the epidemiological distribution of hemorrhoids in a physical exami-nation population in China,which could provide evidence for precision prevention and early intervention of hemorrhoids.Methods:Chinese subjects over 18 years of age who underwent a physical examination in a nationwide chain of physical examination centers in 2018 were studied in a cross-sectional design,which collected information by a questionnaire and physical examination results from each subject.The epidemiological distribution of hemorrhoids was described using Logistic models.The gender-,age-,and region-detection rates of hemorrhoids were standardized to the Sixth National Population Census of the People's Republic of China(2010).Results:A total of 2 940 295 adult subjects were included in the study,of whom the average age was(41.7±14.0)years,and 52.6％were females.The standardized detection rate of hemorrhoids was higher for females(43.7％)than that for males(17.7％;P＜0.001)in this study.In the females,the age distribution of hemorrhoids was inverted U-shaped,with the highest standardized detection rate of hemorrhoids in the age group of 30-39 years(63.5％).In the males,the standardized detection rate of hemorrhoids increased along with age,with the highest percentage of 17.2％in the age group of 50-59 years,and the standardized detection rate of hemorrhoids in the age group of 60 and above decreased slightly(P＜0.001 for trend test).The participants with hypertension had a higher standardized detection rate of hemorrhoids than those with normal blood pressure in both males and females(P＜0.001).The standardized detection rate of hemorrhoids showed a positive corre-lation with body mass index(P＜0.001 for trend test in males).Conclusion:The detection rate of hemorrhoids varied to gender,age,obesity,and hypertension status,which could help to identify the risk factors and the high-risk sub-groups,and hence to strengthen health education and early detection accordingly,which could eventually reduce the incidence of hemorrhoids and improve the quality of life and health in the Chinese population.This study was conducted in a physical examination population,and the conclusions of this study should be extrapolated with caution.

We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.
Humans ; Consensus ; Critical Care/methods* ; Intensive Care Units ; Pain/drug therapy* ; Analgesics/therapeutic use* ; Delirium/therapy* ; Critical Illness