Background: and Purpose Essential tremor with a midline distribution (Mid-ET) may represent a distinct subtype of essential tremor (ET) that primarily affects midline structures, often indicating advanced disease stage and increased severity. Recent studies have highlighted the complexity of Mid-ET, but research on neurological soft signs (NSS) in Mid-ET remains insufficient. Methods: The patients with ET included in this cross-sectional study were divided into two subgroups based on whether or not the ET had a midline distribution: Mid-ET and No-MidET. Comparative analyses were performed to assess clinical features and NSS prevalence in these subgroups. Results: Among 1,160 patients, 567 (48.9%) were Mid-ET and 593 (51.1%) were No-Mid-ET.The prevalence rates of head, face (including the jaw), and voice tremors were 31.9%, 23.0%, and 25.8%, respectively. In Mid-ET, tremor often affects multiple midline structures simultaneously. In the entire cohort, 24.7%, 16.6%, and 7.6% of patients exhibited tremors in one, two, and three midline structures, respectively. The prevalence of common NSS, including mild cognitive impairment, impaired tandem gait, and questionable dystonic posturing, was significantly higher in the Mid-ET than the No-Mid-ET subgroup (all p<0.001). Furthermore, we found that female sex (p<0.001), olfactory dysfunction (p=0.003), and questionable dystonic posturing (p=0.004) were associated with Mid-ET. Conclusions Mid-ET and No-Mid-ET presented significant clinical differences. The presence of questionable dystonic posturing may contribute to the distinct characteristics of Mid-ET, suggesting the presence of pathophysiological differences between the subgroups. Further investigations are warranted to determine the potential pathophysiological link between NSS and Mid-ET.

Background: and Purpose Essential tremor with a midline distribution (Mid-ET) may represent a distinct subtype of essential tremor (ET) that primarily affects midline structures, often indicating advanced disease stage and increased severity. Recent studies have highlighted the complexity of Mid-ET, but research on neurological soft signs (NSS) in Mid-ET remains insufficient. Methods: The patients with ET included in this cross-sectional study were divided into two subgroups based on whether or not the ET had a midline distribution: Mid-ET and No-MidET. Comparative analyses were performed to assess clinical features and NSS prevalence in these subgroups. Results: Among 1,160 patients, 567 (48.9%) were Mid-ET and 593 (51.1%) were No-Mid-ET.The prevalence rates of head, face (including the jaw), and voice tremors were 31.9%, 23.0%, and 25.8%, respectively. In Mid-ET, tremor often affects multiple midline structures simultaneously. In the entire cohort, 24.7%, 16.6%, and 7.6% of patients exhibited tremors in one, two, and three midline structures, respectively. The prevalence of common NSS, including mild cognitive impairment, impaired tandem gait, and questionable dystonic posturing, was significantly higher in the Mid-ET than the No-Mid-ET subgroup (all p<0.001). Furthermore, we found that female sex (p<0.001), olfactory dysfunction (p=0.003), and questionable dystonic posturing (p=0.004) were associated with Mid-ET. Conclusions Mid-ET and No-Mid-ET presented significant clinical differences. The presence of questionable dystonic posturing may contribute to the distinct characteristics of Mid-ET, suggesting the presence of pathophysiological differences between the subgroups. Further investigations are warranted to determine the potential pathophysiological link between NSS and Mid-ET.

Background: and Purpose Essential tremor with a midline distribution (Mid-ET) may represent a distinct subtype of essential tremor (ET) that primarily affects midline structures, often indicating advanced disease stage and increased severity. Recent studies have highlighted the complexity of Mid-ET, but research on neurological soft signs (NSS) in Mid-ET remains insufficient. Methods: The patients with ET included in this cross-sectional study were divided into two subgroups based on whether or not the ET had a midline distribution: Mid-ET and No-MidET. Comparative analyses were performed to assess clinical features and NSS prevalence in these subgroups. Results: Among 1,160 patients, 567 (48.9%) were Mid-ET and 593 (51.1%) were No-Mid-ET.The prevalence rates of head, face (including the jaw), and voice tremors were 31.9%, 23.0%, and 25.8%, respectively. In Mid-ET, tremor often affects multiple midline structures simultaneously. In the entire cohort, 24.7%, 16.6%, and 7.6% of patients exhibited tremors in one, two, and three midline structures, respectively. The prevalence of common NSS, including mild cognitive impairment, impaired tandem gait, and questionable dystonic posturing, was significantly higher in the Mid-ET than the No-Mid-ET subgroup (all p<0.001). Furthermore, we found that female sex (p<0.001), olfactory dysfunction (p=0.003), and questionable dystonic posturing (p=0.004) were associated with Mid-ET. Conclusions Mid-ET and No-Mid-ET presented significant clinical differences. The presence of questionable dystonic posturing may contribute to the distinct characteristics of Mid-ET, suggesting the presence of pathophysiological differences between the subgroups. Further investigations are warranted to determine the potential pathophysiological link between NSS and Mid-ET.

Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.

Objective To investigate the predictive value of four thrombotic markers[thrombin-antithrombin complex(TAT),tissue-type plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC),plasmin-α2-plasmin inhibitor complex(PIC)and thrombomodulin(TM)]for short-term prognosis of patients with acute leukemia complicated by disseminated intravascular coagu-lation(DIC).Methods A prospective cohort study was conducted.Fifty-two patients with acute leukemia complicated by DIC were selected as study group,and 50 patients with simple acute leuke-mia were selected as control group.The general data and levels of the four thrombotic markers(PIC,TAT,TM,t-PAIC)were compared between the two groups.The Kaplan-Meier(KM)survival curve was plotted to analyze the 28-day prognosis of the patients in the study group.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of the four thrombotic markers for poor short-term prognosis in patients with acute leukemia complicated by DIC.Results The plas-ma levels of TAT,PIC,t-PAIC and TM in the study group were higher than those in the control group,and the differences were statistically significant(P＜0.05).Among the patients in the study group,there were 17 deaths(poor prognosis)and 35 survival cases(good prognosis)at 28 days.The plas-ma levels of TAT,PIC,t-PAIC and TM in patients with poor prognosis were higher than those in pa-tients with good prognosis at admission,and the differences were statistically significant(P＜0.05).The ROC curve showed that the area under the curve(AUC)for TAT,PIC,t-PAIC,and TM in predicting poor short-term prognosis in patients with acute leukemia complicated by DIC alone were 0.775,0.769,0.767,and 0.770,respectively.The AUC for the combined prediction of the four thrombotic markers was 0.939,which was higher than that for each individual marker(Z=1.986,2.014,2.026,2.003;P=0.021,0.010,0.008,0.014).Conclusion The four thrombotic markers(TAT,PIC,t-PAIC,TM)have a high predictive value for the short-term prog-nosis of patients with acute leukemia complicated by DIC.Combined detection can provide a refer-ence basis for clinical prognosis prediction in these patients.

Objective:To study the correlation between spontaneous cerebrospinal fluid rhinorrhea and increased intracranial pressure.Methods:Clinical data of patients with spontaneous cerebrospinal fluid rhinorrhea treated in the Department of Otorhinolaryngology of the Provincial Hospital of Shandong First Medical University from January 2019 to December 2023 and their epidemiology, clinical symptoms and signs, preoperative cerebrospinal fluid pressure, imaging data, leakage site, repair method and the presence or absebce of increased intracranial pressure were analysed. SPSS 23.0 software was used for statistical analysis.Results:Of the 57 patients with cerebrospinal fluid nasolacrimal leakage, 84.2%(48/57) were females and 15.8%(9/57) were males; 80.7%(46/57) were between 40 and 60 years old; and overweight and obese patients accounted for 75.4%(43/57). Of 57 patients, 35 patients received cranial MRI+magnetic resonance venography, and among them, 12(34.3%) patients were clinically with headache symptoms; the incidences of empty pterygoid and venous sinus stenosis were 40.0%(14/35) and 51.4%(18/35), respectively; and 33 patients underwent preoperative lumbar puncture examination, of whom 25(75.8%) patients had the increased cerebrospinal fluid pressure and 1 patient had idiopathic intracranial hypertension. All 57 patients underwent dural repair of the skull base, the postoperative follow-up period ranged from 3 to 60 months, and the success rate of surgery was 94.7%. The success rate was 100% in female patients and 33.3%(3/9) in male patients, including one with surgical failure receiving reoperation and two with postoperative recurrence in other areas of the skull base, with significant difference in the success rate of surgery between males and females (χ 2=16.890, P<0.001). Conclusions:Most patients with spontaneous cerebrospinal fluid rhinorrhea have the increased cerebrospinal fluid pressures, but very few fulfil the diagnosis of idiopathic intracranial hypertension. The success rate of surgical repair alone is high, but some recurrences still exist, especially in male patients.

Cuproptosis is a new type of cell death that depends on intracellular copper accumulation to trigger the aggregation of mitochondrial lipoacylated protein and the degradation of iron-sulfur cluster protein,with a different mechanism of action from autophagy,ferroptosis,pyroptosis,and necroptosis.Cuproptosis is closely association with the development of liver cancer and resistance to antitumor drugs,as well as the progression of various liver diseases such as hereditary liver diseases,nonalcoholic fatty liver disease,viral hepatitis,and liver cirrhosis.This article summarizes the mechanism of cuproptosis and its role in liver diseases,in order to provide a reference for further research and treatment of liver diseases.

OBJECTIVES: The conventional Fr26 resectoscope is difficult to use in patients with benign prostatic hyperplasia (BPH) complicated by urethral stricture. This study aims to evaluate the safety and efficacy of transurethral plasmakinetic resection of the prostate (PKRP) using a small-caliber (Fr18.5) plasmakinetic resectoscope combined with urethral dilation in patients with BPH and mild urethral stricture. METHODS: A retrospective analysis was conducted on 37 patients with BPH and mild urethral stricture treated at the Department of Urology, Hunan Provincial People's Hospital from January 2023 to December 2023. All patients underwent PKRP with a small-caliber plasmakinetic resectoscope, followed by routine placement of a Fr20 three-way Foley catheter for continuous bladder irrigation. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q_max), post-voiding residual urine volume (PVR), and Quality of Life (QOL) scores were compared before and after surgery. Perioperative indicators (intraoperative bleeding, operative time, postoperative catheterization time, and postoperative hospital stay) and complications were recorded. RESULTS: The median age was 69 years, and the median duration of voiding difficulty was 36 months. Median total prostate specific antigen (T-PSA) was 2.095 ng/mL, free prostate specific antigen (F-PSA) 0.561 ng/mL, and F/T ratio 0.3. Median prostate diameter was 48 mm and volume 41 mL. All 37 surgeries were completed successfully: 11 had external meatal stricture, 19 had mild anterior urethral stricture, and 7 had mild posterior urethral stricture (1 patient with a 1 cm pseudo-blind tract near the membranous urethral). Operative time was (2.4±0.7) hours, blood loss was (40±29) mL, median catheterization duration was 7 days, and median hospital stay was 7 days. No cases of postoperative urinary incontinence, recurrent hematuria, or sepsis occurred, and patients were satisfied with the surgical outcome. At 3 to 6 months follow-up, IPSS, Q_max, PVR, and QOL scores significantly improved compared to preoperative levels (all P<0.01), with no cases of urethral stricture progression or new-onset stricture. CONCLUSIONS PKRP using a small-caliber plasmakinetic resectoscope is safe and effective for treating BPH with mild urethral stricture. It offers advantages such as minimal trauma, rapid postoperative recovery, and a lower risk recovery, and a lower risk of aggravating urethral injury.
Humans ; Male ; Prostatic Hyperplasia/complications* ; Urethral Stricture/complications* ; Retrospective Studies ; Aged ; Transurethral Resection of Prostate/instrumentation* ; Middle Aged ; Treatment Outcome ; Quality of Life ; Aged, 80 and over

Resection is crucial for treating non-small cell lung cancer. Routine follow-up after surgery is an effective method for early detection and treatment of tumor recurrence and metastasis or the second primary tumor, which can improve the quality of life of patients and their prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of non-small cell lung cancer patients in China, and further improve the standardization of lung cancer diagnosis and treatment.