Objective To analyze the caregiver presence needs and their influencing factors among hospitalized elderly non-surgical patients and provide a basis for formulating relevant policies.Methods A descriptive qualitative study method was adopted.Through purposive sampling,semi-structured interviews were conducted on elderly non-surgical patients and their families and medical staff in Peking Union Medical College Hospital from September to October 2023.MAXQDA 2020 and the 7-step phenomenological analysis method of Colaizzi were used to classify and code the interview contents and identify themes.Results The categories of caregiver presence needs of elderly non-surgical patients included basic living assistance needs,disease monitoring needs,psychological support needs,as well as the needs for family members to provide economic support and participate in treatment decision-making.The influencing factors included advanced age,frailty,the lack of self-care ability in patients with comorbidities,the susceptibility of patients to sudden situations during the disease exacerbation period,the increased risk of unexpected events in patients with psychological distress,and patients' concerns about social support and medical decision-making.Conclusion The caregiver presence needs of elderly non-surgical patients during hospitalization are high and influenced by multiple factors.
Humans ; Caregivers/psychology* ; Aged ; Hospitalization ; Social Support ; Male ; Qualitative Research ; Female

Objective To evaluate the clinical outcome of neurosurgical robot-assisted stereotactic puncture and drainage for brain abscess.Methods A retrospective analysis was conducted on the clinical data of 53 patients with brain abscess admitted to our hospital from January 2018 to December 2024.Among them,29 cases underwent craniotomy for abscess resection(craniotomy group),while 24 cases received neurosurgical robot-assisted stereotactic puncture and drainage(robot-assisted group).The operation time,intraoperative blood loss,decompressive craniectomy rate,proportion of postoperative antibiotic regimen adjustment,postoperative hospital stay,incidence of postoperative complications,mortality rate and Glasgow outcome scale(GOS)scores 6 months after surgery of patients were compared between the two groups.Results Compared with the craniotomy group,the robot-assisted group demonstrated significantly shorter operation time,less intraoperative blood loss,and lower incidence of postoperative complication,the differences were all statistically significant(P<0.05).However,there were no statistically significant differences in terms of decompressive craniectomy rate,postoperative hospital stay,mortality rate,GOS score,or proportion of the postoperative antibiotic regimen adjustment between the two groups(P>0.05).Conclusion As a precise and minimally invasive surgical method,neurosurgical robot-assisted stereotactic puncture and drainage for patients with brain abscess can effectively improve the operational efficiency,shorten the operation time,reduce intraoperative injury,and lower the risk of postoperative complications.It has high clinical application value and potential for widespread adoption.

Objective To evaluate the clinical outcome of neurosurgical robot-assisted stereotactic puncture and drainage for brain abscess.Methods A retrospective analysis was conducted on the clinical data of 53 patients with brain abscess admitted to our hospital from January 2018 to December 2024.Among them,29 cases underwent craniotomy for abscess resection(craniotomy group),while 24 cases received neurosurgical robot-assisted stereotactic puncture and drainage(robot-assisted group).The operation time,intraoperative blood loss,decompressive craniectomy rate,proportion of postoperative antibiotic regimen adjustment,postoperative hospital stay,incidence of postoperative complications,mortality rate and Glasgow outcome scale(GOS)scores 6 months after surgery of patients were compared between the two groups.Results Compared with the craniotomy group,the robot-assisted group demonstrated significantly shorter operation time,less intraoperative blood loss,and lower incidence of postoperative complication,the differences were all statistically significant(P<0.05).However,there were no statistically significant differences in terms of decompressive craniectomy rate,postoperative hospital stay,mortality rate,GOS score,or proportion of the postoperative antibiotic regimen adjustment between the two groups(P>0.05).Conclusion As a precise and minimally invasive surgical method,neurosurgical robot-assisted stereotactic puncture and drainage for patients with brain abscess can effectively improve the operational efficiency,shorten the operation time,reduce intraoperative injury,and lower the risk of postoperative complications.It has high clinical application value and potential for widespread adoption.

OBJECTIVE To explore a multimodal analgesia regimen based on spinal cord electrical stimulation for children with primary erythromelalgia and the key points of pharmaceutical care. METHODS Clinical pharmacists participated in the treatment of a child with primary erythromelalgia complicated with skin infection. After reviewing domestic and foreign literature， multimodal analgesia was formulated and pharmaceutical care was carried out to address the difficulties in treating the patient’s illness. RESULTS The treatment team applied multimodal analgesia based on spinal cord electrical stimulation for the child， including a multi-drug combination involving different analgesic pharmacological targets， multiple administration routes （oral， intravenous， epidural， percutaneous）， multiple technologies （spinal cord electrical stimulation， local nerve block， patient- controlled analgesia）， individualized schemes of adjuvant therapy， and the child was monitored for the safety of drug use. The pain was controlled during the treatment and follow-up period， the wound was healed， and no serious adverse drug reactions occurred. CONCLUSIONS Multimodal analgesia based on spinal cord electrical stimulation is a safe and effective treatment for children with primary erythromelalgia.

Through the report of 4 cases of occupational heatstroke among sanitation workers working in high-temperature weather, this study analyzes the risk of occupational heatstroke among workers in the environmental sanitation industry working in high-temperature weather, and provides scientific suggestions for standardizing occupational health management, safeguarding the health rights and interests of workers, and preventing the occurrence of occupational heatstroke in summer. Through case analysis, we aim to raise high awareness of the occupational health of sanitation workers in the whole society, in order to provide a scientific and healthy working environment for sanitation workers and promote their physical and mental health.

Through the report of 4 cases of occupational heatstroke among sanitation workers working in high-temperature weather, this study analyzes the risk of occupational heatstroke among workers in the environmental sanitation industry working in high-temperature weather, and provides scientific suggestions for standardizing occupational health management, safeguarding the health rights and interests of workers, and preventing the occurrence of occupational heatstroke in summer. Through case analysis, we aim to raise high awareness of the occupational health of sanitation workers in the whole society, in order to provide a scientific and healthy working environment for sanitation workers and promote their physical and mental health.

Objective To observe the value of CT radiomics for differentiating spinal bone islands(BI)and osteoblastic metastases(OBM).Methods Data of 109 BI lesions in 98 patients and 282 OBM lesions in 158 patients(including 103 OBM in 48 lung cancer cases,86 OBM in 52 breast cancer cases and 93 OBM in 58 prostate cancer cases)from 3 medical institutions were retrospectively analyzed.Data obtained from institution 1 were used as the internal dataset and divided into internal training set and internal validation set at a ratio of 7∶3,from institution 2 and 3 were used as external dataset.All datasets were divided into female data subset(including OBM of female lung cancer and breast cancer)and male data subset(including OBM of male lung cancer and prostate cancer).Radiomics features were extracted and screened to construct 3 different support vector machine(SVM)models,including model1 for distinguishing BI and OBM,model2 for differentiating OBM of female lung cancer and breast cancer,and model3 for differentiating OBM of male lung cancer and prostate cancer.Diagnostic efficacy of model1,CT value alone and 3 physicians(A,B,C)for distinguishing BI and OBM were assessed,as well as differentiating efficacy for different OBM of model2 and model3.Receiver operating characteristic(ROC)curves were drawn,and area under the curves(AUC)were calculated and compared.The differential diagnostic efficacy of model2 and model3 were also assessed with ROC analysis and AUC.Results AUC of model1 for distinguishing spinal OBM from BI in internal training set,internal validation set and external dataset was 0.99,0.98 and 0.86,respectively.In internal training set,model1 had higher AUC for distinguishing BI and OBM than that of physician A(AUC=0.78),B(AUC=0.87)and C(AUC=0.93)as well as that of mean CT value(AUC=0.78,all P＜0.05).AUC in internal training set,internal validation set and external dataset of model2 for identifying female lung cancer and breast cancer OBM was 0.79,0.75 and 0.73,respectively,of model3 for discriminating male lung cancer from prostate cancer OBM was 0.77,0.74 and 0.77,respectively.Conclusion CT radiomics SVM model might reliablely distinguish OBM and BI.

Objective To analyze the treatment effects of extracorporeal cardiopulmonary resuscitation(ECPR)in 3 patients with cardiac arrest due to cardiac causes in a mountain area hospital,providing a reference for clinical diagnosis and treatment.Methods The combined treatment process of 3 patients with cardiogenic cardiac arrest admitted to Wufeng Tujia Autonomous County People's Hospital from January to December 2023 was retrospectively analyzed,and the treatment experience was summarized.Results All 3 patients underwent continuous cardiopulmonary resuscitation and defibrillation while urgently initiating the ECPR combined rescue process.First,a central venous catheter(CVC)was established under ultrasound guidance to create access for extracorporeal membrane oxygenation(ECMO).Once the ECMO equipment from a higher-level hospital arrived,the circuit was replaced,significantly reducing the time required for subsequent patient treatment.Finally,two patients with acute myocardial infarction underwent emergency coronary angiography and percutaneous coronary intervention(PCI)under ECMO support,resulting in the restoration of spontaneous cardiac rhythm and gradual stabilization of vital signs.The last patient was discharged after recovery following transfer to a higher-level hospital,while another patient received rehabilitation treatment after hemodynamic stability was achieved.The third patient,who experienced cardiac arrest due to hypertrophic cardiomyopathy,regained spontaneous rhythm after ECMO,but due to poor neurological recovery after transfer to a higher-level hospital,the family chose to withdraw treatment.Conclusions ECPR is a rapid extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation method for patients who cannot regain spontaneous rhythm or experience recurrent cardiac arrest.It aims to improve patient survival rates.In grassroots medical centers lacking the necessary conditions,early assistance from regional advanced medical centers can ensure rapid transfer and surgery under ECMO support,providing a guarantee for favorable patient outcomes.

The Qa-1 in mice is homologous to human leukocyte antigen E(HLA-E), and both of them belong to the non-classical major histocompatibility complex I b(MHC-I b) molecules. Qa-1 is capable of presenting self or exogenous antigen peptides to interact with two distinct receptors, namely T cell receptor (TCR) and natural killer cell group 2 member A (or C) (NKG2A/C), thus playing an important role in immune response and regulation. Qa-1-restricted regulatory CD8⁺ T cell (CD8⁺ Treg) is one of the most studied CD8⁺ Treg subgroups, which can maintain immune homeostasis and autoimmune tolerance by exerting immunosuppressive effects. Consequently, Qa-1-restricted CD8⁺Treg cells are closely associated with the occurrence and development of various clinical diseases, such as tumors, infections, autoimmune diseases, and transplant rejections. This paper provides a comprehensive review of the phenotypic characteristics, functional effects, regulatory mechanisms of Qa-1-restricted CD8⁺ Treg cells, as well as the latest research progresses of Qa-1-restricted CD8⁺ Treg cells involved in the pathogenesis of infectious diseases.
Humans ; Animals ; T-Lymphocytes, Regulatory/immunology* ; Histocompatibility Antigens Class I/immunology* ; CD8-Positive T-Lymphocytes/immunology* ; Communicable Diseases/immunology*

Objective To analyze the treatment effects of extracorporeal cardiopulmonary resuscitation(ECPR)in 3 patients with cardiac arrest due to cardiac causes in a mountain area hospital,providing a reference for clinical diagnosis and treatment.Methods The combined treatment process of 3 patients with cardiogenic cardiac arrest admitted to Wufeng Tujia Autonomous County People's Hospital from January to December 2023 was retrospectively analyzed,and the treatment experience was summarized.Results All 3 patients underwent continuous cardiopulmonary resuscitation and defibrillation while urgently initiating the ECPR combined rescue process.First,a central venous catheter(CVC)was established under ultrasound guidance to create access for extracorporeal membrane oxygenation(ECMO).Once the ECMO equipment from a higher-level hospital arrived,the circuit was replaced,significantly reducing the time required for subsequent patient treatment.Finally,two patients with acute myocardial infarction underwent emergency coronary angiography and percutaneous coronary intervention(PCI)under ECMO support,resulting in the restoration of spontaneous cardiac rhythm and gradual stabilization of vital signs.The last patient was discharged after recovery following transfer to a higher-level hospital,while another patient received rehabilitation treatment after hemodynamic stability was achieved.The third patient,who experienced cardiac arrest due to hypertrophic cardiomyopathy,regained spontaneous rhythm after ECMO,but due to poor neurological recovery after transfer to a higher-level hospital,the family chose to withdraw treatment.Conclusions ECPR is a rapid extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation method for patients who cannot regain spontaneous rhythm or experience recurrent cardiac arrest.It aims to improve patient survival rates.In grassroots medical centers lacking the necessary conditions,early assistance from regional advanced medical centers can ensure rapid transfer and surgery under ECMO support,providing a guarantee for favorable patient outcomes.