Objective:To systematically evaluate the prevalence of dysphagia after treatment in patients with head and neck cancer.Methods:The Wanfang, CNKI, Web of Science, Embase, and PubMed databases were searched from their inception to May 2025. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. The pooled prevalence and 95% confidence interval (CI) were used as effect measures, with heterogeneity assessed using the I2 statistics. Sensitivity analysis was conducted by a leave-one-out approach, and publication bias was evaluated using Egger's test and funnel plots. Results:A total of 18 studies were included, comprising 2,518 patients with head and neck cancer, of whom 1,303 were diagnosed with dysphagia. The meta-analysis showed that the overall prevalence of dysphagia after treatment was 51.2% (95% CI: 42.2%-60.2%). Subgroup analysis indicated higher prevalence among males (49.8%, 95% CI: 35.6%-64.0%), Asian populations (57.7%, 95% CI: 36.8%-77.2%), tumors of the hypopharynx and larynx (45.7%, 95% CI: 39.3%-52.2%), stage Ⅲ-Ⅳ disease (46.3%, 95% CI: 34.9%-58.0%), patients receiving concurrent chemoradiotherapy (51.0%, 95% CI: 41.5%-60.4%), smokers (53.0%, 95% CI: 35.1%-70.6%), studies published in 2020 or earlier (51.9%, 95% CI: 38.3%-65.4%), high-quality studies (66.5%, 95% CI: 45.1%-84.9%), and patients with a post-treatment interval ≤6 months (60.7%, 95% CI: 41.8%-78.1%) (all P<0.001). Conclusions:The prevalence of dysphagia after treatment in patients with head and neck cancer is high, with significant variations related to gender, tumor site, disease stage, geographic region, treatment modality, smoking status, publication year, study quality, and post-treatment interval. Early screening and timely intervention are recommended to improve the quality of life of patients with head and neck cancer.

Objective:To explore the risk factors for severe acute kidney injury (AKI) in children with sepsis in the pediatric intensive care unit (PICU) and construct a prediction model to assist early clinical identification.Methods:A retrospective analysis was performed on clinical data of 987 children with sepsis admitted to the PICU of Hunan Children′s Hospital from July 1, 2018 to January 31, 2021. Children who developed severe AKI during hospitalization were included in the AKI stage 2-3 group ( n=228), and the remaining were included in the No-AKI/AKI stage 1 group ( n=759). General information and biochemical indicators were compared between the two groups. Logistic regression analysis was used to identify risk factors for severe AKI in children with sepsis, and a prediction model and nomogram were established. Results:The mortality rate in the AKI stage 2-3 group was 2.49 times that of the No-AKI/AKI stage 1 group [31.1%(71/228) vs 12.5%(95/759), P<0.05]. Compared with the No-AKI/AKI stage 1 group, the AKI stage 2-3 group had lower levels of platelet count (PLT), total protein (TP), albumin (ALB), antithrombin Ⅲ (AT3), and fibrinogen (FIB), but higher levels of lactate dehydrogenase (LDH), serum creatinine (SCr), blood urea nitrogen (BUN), magnesium ion (Mg 2+ ), activated partial thromboplastin time (APTT), fibrinogen degradation products (FDP), and D-dimer (D-D) (all P<0.05), with no significant difference in total bile acid (TBAC) ( P>0.05). Multivariate logistic regression analysis showed that decreased AT3 ( OR=0.989, 95% CI: 0.980-0.997, P=0.007), increased LDH ( OR=1.001, 95% CI: 1.000-1.001, P<0.001), increased SCr ( OR=1.051, 95% CI: 1.037-1.066, P<0.001), and increased BUN ( OR=1.099, 95% CI: 1.028-1.174, P=0.005) were risk factors for severe AKI in children with sepsis. The prediction model was Logist Pr=-3.184-0.012 X1+ 0.001 X2+ 0.050 X3+ 0.094 X4 ( X1=AT3, X2=LDH, X3=SCr, X4=BUN), with the optimal cut-off value of 0.374 (Youden index=0.560). A nomogram was constructed by binary assignment of predictive variables, with an area under the curve of 0.826 (95% CI: 0.790-0.861, P<0.001). Conclusions:The mortality rate of septic children with severe AKI in PICU is significantly increased. Decreased AT3, and increased LDH, SCr, and BUN are risk factors for severe AKI in children with sepsis. Clinicians should be alert to severe AKI when the predicted probability of the early warning model exceeds 0.374.

Objective:To systematically evaluate the prevalence of dysphagia after treatment in patients with head and neck cancer.Methods:The Wanfang, CNKI, Web of Science, Embase, and PubMed databases were searched from their inception to May 2025. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. The pooled prevalence and 95% confidence interval (CI) were used as effect measures, with heterogeneity assessed using the I2 statistics. Sensitivity analysis was conducted by a leave-one-out approach, and publication bias was evaluated using Egger's test and funnel plots. Results:A total of 18 studies were included, comprising 2,518 patients with head and neck cancer, of whom 1,303 were diagnosed with dysphagia. The meta-analysis showed that the overall prevalence of dysphagia after treatment was 51.2% (95% CI: 42.2%-60.2%). Subgroup analysis indicated higher prevalence among males (49.8%, 95% CI: 35.6%-64.0%), Asian populations (57.7%, 95% CI: 36.8%-77.2%), tumors of the hypopharynx and larynx (45.7%, 95% CI: 39.3%-52.2%), stage Ⅲ-Ⅳ disease (46.3%, 95% CI: 34.9%-58.0%), patients receiving concurrent chemoradiotherapy (51.0%, 95% CI: 41.5%-60.4%), smokers (53.0%, 95% CI: 35.1%-70.6%), studies published in 2020 or earlier (51.9%, 95% CI: 38.3%-65.4%), high-quality studies (66.5%, 95% CI: 45.1%-84.9%), and patients with a post-treatment interval ≤6 months (60.7%, 95% CI: 41.8%-78.1%) (all P<0.001). Conclusions:The prevalence of dysphagia after treatment in patients with head and neck cancer is high, with significant variations related to gender, tumor site, disease stage, geographic region, treatment modality, smoking status, publication year, study quality, and post-treatment interval. Early screening and timely intervention are recommended to improve the quality of life of patients with head and neck cancer.

Objective:To explore the risk factors for severe acute kidney injury (AKI) in children with sepsis in the pediatric intensive care unit (PICU) and construct a prediction model to assist early clinical identification.Methods:A retrospective analysis was performed on clinical data of 987 children with sepsis admitted to the PICU of Hunan Children′s Hospital from July 1, 2018 to January 31, 2021. Children who developed severe AKI during hospitalization were included in the AKI stage 2-3 group ( n=228), and the remaining were included in the No-AKI/AKI stage 1 group ( n=759). General information and biochemical indicators were compared between the two groups. Logistic regression analysis was used to identify risk factors for severe AKI in children with sepsis, and a prediction model and nomogram were established. Results:The mortality rate in the AKI stage 2-3 group was 2.49 times that of the No-AKI/AKI stage 1 group [31.1%(71/228) vs 12.5%(95/759), P<0.05]. Compared with the No-AKI/AKI stage 1 group, the AKI stage 2-3 group had lower levels of platelet count (PLT), total protein (TP), albumin (ALB), antithrombin Ⅲ (AT3), and fibrinogen (FIB), but higher levels of lactate dehydrogenase (LDH), serum creatinine (SCr), blood urea nitrogen (BUN), magnesium ion (Mg 2+ ), activated partial thromboplastin time (APTT), fibrinogen degradation products (FDP), and D-dimer (D-D) (all P<0.05), with no significant difference in total bile acid (TBAC) ( P>0.05). Multivariate logistic regression analysis showed that decreased AT3 ( OR=0.989, 95% CI: 0.980-0.997, P=0.007), increased LDH ( OR=1.001, 95% CI: 1.000-1.001, P<0.001), increased SCr ( OR=1.051, 95% CI: 1.037-1.066, P<0.001), and increased BUN ( OR=1.099, 95% CI: 1.028-1.174, P=0.005) were risk factors for severe AKI in children with sepsis. The prediction model was Logist Pr=-3.184-0.012 X1+ 0.001 X2+ 0.050 X3+ 0.094 X4 ( X1=AT3, X2=LDH, X3=SCr, X4=BUN), with the optimal cut-off value of 0.374 (Youden index=0.560). A nomogram was constructed by binary assignment of predictive variables, with an area under the curve of 0.826 (95% CI: 0.790-0.861, P<0.001). Conclusions:The mortality rate of septic children with severe AKI in PICU is significantly increased. Decreased AT3, and increased LDH, SCr, and BUN are risk factors for severe AKI in children with sepsis. Clinicians should be alert to severe AKI when the predicted probability of the early warning model exceeds 0.374.

METHODS: Rat BMSCs were isolated, cultured and identified. The time-dependent expressions of TSP-2 and Sox9 in BMSCs under a dynamic mechanical pressure of 0–120 kPa at 0.1 Hz for 1 h were tested by qPCR and Western blotting. The role of TSP-2 in chondrogenic differentiation of BMSCs under mechanical pressure was validated by using small interfering RNA. The impact of TSP-2 and mechanical pressure on chondrogenesis were detected and the downstream signaling molecules were explored using Western blotting. RESULTS: Mechanical pressure stimulation of 0–120 kPa for 1 h significantly upregulated the expression of TSP-2 in BMSCs. The expression of the chondrogenesis markers Sox9, Aggrecan, and Col-II were all upregulated under dynamic mechanical pressure or TSP-2 stimulation. Additional exogenous TSP-2 may potentiate the chondrogenic effect of mechanical stimulation. After knock down TSP-2, the upregulation of Sox9, Aggrecan and Col-II under mechanical pressure was inhibited. The NF-jB signaling pathway responded to both dynamic pressure and TSP-2 stimulation, and the cartilage-promoting effect was blocked by an NF-jB signaling inhibitor. CONCLUSION TSP-2 plays an essential role in the chondrogenic differentiation of BMSCs under mechanical pressure. NF-jB signaling is involved in the mechano-chemical coupling of TSP-2 and mechanical pressure for the chondrogenic differentiation of BMSCs.

Objective:To analyze the risk factors for the most common adverse events, i.e. abdominal pain and distension in sedation-free colonoscopy.Methods:This was a multicenter clinical study, in which clinical data of patients including outpatients and inpatients who underwent selective sedation-free colonoscopy at six gastrointestinal endoscopy centers from July 2017 to December 2019 were collected, including patients' general information, complicating diseases, examination time, examination results, and occurrence of adverse events of abdominal pain and distension. Univariate and multivariate logistic regression was performed to analyze the risk factors for adverse events of abdominal pain and distension during sedation-free colonoscopy.Results:A total of 2 394 patients underwent sedation-free colonoscopy, among whom 690 (28.8%) suffered from abdominal pain, and 1 151 (48.1%) experienced abdominal distension. The results of multivariate logistic analysis showed that overweight ( OR=1.33, 95% CI:1.09-1.62, P=0.005), obesity ( OR=1.55, 95% CI:1.14-2.11, P=0.005) and combination of hypertension ( OR=1.58, 95% CI:1.23-2.02, P<0.001) were independent risk factors for abdominal pain during sedation-free colonoscopy, and overweight ( OR=1.40, 95% CI:1.17-1.68, P<0.001) and combination of hypertension ( OR=1.39,95% CI:1.10-1.76, P=0.006) were independent risk factors for abdominal distension during sedation-free colonoscopy. Conclusion:Obesity, overweight and combination of hypertension are independent risk factors for abdominal pain, and overweight and combination of hypertension are independent risk factors for abdominal distension during sedation-free colonoscopy.

The diagnosis and treatment of spontaneous rupture and massive hemorrhage of tuberous sclerosis-related renal hamartoma in a woman in the third trimester are reported. The patient was admitted at 39 weeks of gestation, with threatened labor and a history of bilateral renal hamartoma, which had been hidden. Placental abruption was considered due to persistent lumbago, abdominal pain, abdominal muscle tension, uterine tension and fetal heart rate dropping to 90 bpm, and an emergency cesarean section was performed at 39 +1 weeks. About 200 ml of bloody ascites was found in the peritoneal cavity. A live boy was delivered and no blood clot was seen in the maternal face of the placenta. After the uterine incision was closed, a huge bluish purple mass was detected on the right-side retroperitoneum and the renal angiography showed rupture and hemorrhage of a right renal hamartoma. A selective right renal artery embolization was performed. The patient recovered after the operation and was discharged seven days later required by the family. The patient was in good condition except for hematuria during a 30-day postpartum follow-up, and oral everolimus treatment and regular follow-up were continued. The newborn with a birth weight of 2 355 g was transferred to the neonatology department after birth due to severe asphyxia, and postnatal echocardiography suspected heart rhabdomyoma. The baby had one seizure but was otherwise well, and was discharged after eight days. The seizure did not recur to the neonate after discharge. Clinicians should pay attention to pregnant women with renal hamartoma. If abnormal abdominal distension, hematuria or lumbago occur during pregnancy, rupture of renal hamartoma and possible massive hemorrhage should be considered.

Objective To analyze the effects of Xueshuantong and alprostadil combined with hyperbaric oxygen ( HBO ) on clinical efficacy, hemodynamics and serum inflammatory indexes in elderly patients with lower extremity arteriosclerosis occlusion. Methods One hundred and eighteen patients with lower extremity arteriosclerosis occlusion admitted into the surgical department of the hospital from May 2017 to January 2019 were randomly divided into the combined medication group (n=59) and the control group (n=59). The control group was just treated with alprostadil injection, while the combined medication group was treated with Xueshuantong and alprostadil combined with HBO treatment. Clinical efficacy after treatment, changes in atherosclerosis indexes, hemodynamic indexes ( whole blood viscosity, plasma viscosity and fibrinogen), the levels of serum inflammatory indexes, such as hs-CRP, interleukin-6, interleukin 8 and tumor necrosis factor-α( TNF-α) before and after treatment were compared between the patients of the 2 groups. Results The total effective rate of the combined medication group was 93. 22％, which was significantly higher than 79. 66％ of the control group(P<0. 05). The blood flow of dorsal pedal artery, ankle-brachial indexes and toe-brachial indexes in the patients of the 2 groups after treatment were all significantly higher than those before treatment (P<0. 05), and the combined medication group was obviously superior to the control group, with statistical significance (P <0. 05). The whole blood viscosity, plasma viscosity and fibrinogen (FIB) levels in the patients of the 2 groups after treatment all significantly decreased as compared with those before treatment (P<0. 05), and the indexes of the combined medication group were significantly lower than those of the control group, also with statistical significance(P<0. 05). The levels of TNF-a, hs-CRP, IL-6 and IL-8 in the patients of the 2 groups after treatment were significantly lower than those before treatment (P<0. 05), and the combined medication group was also obviously superior to the control group, with statistical significance (P<0. 05). Conclusion Xueshuantong and alprostadil combined with HBO in the treatment of elderly patients with peripheral arterial disease ( PAD) could achieve significant clinical effects, and in the meantime could evidently delay the occurrence of lower extremity arteriosclerosis, improve hemodynamics, relieve inflammation reactions. For this reason, it is worth further clinical extension.

Objective To analyze the effects of Xueshuantong and alprostadil combined with hyperbaric oxygen ( HBO ) on clinical efficacy, hemodynamics and serum inflammatory indexes in elderly patients with lower extremity arteriosclerosis occlusion. Methods One hundred and eighteen patients with lower extremity arteriosclerosis occlusion admitted into the surgical department of the hospital from May 2017 to January 2019 were randomly divided into the combined medication group (n=59) and the control group (n=59). The control group was just treated with alprostadil injection, while the combined medication group was treated with Xueshuantong and alprostadil combined with HBO treatment. Clinical efficacy after treatment, changes in atherosclerosis indexes, hemodynamic indexes ( whole blood viscosity, plasma viscosity and fibrinogen), the levels of serum inflammatory indexes, such as hs-CRP, interleukin-6, interleukin 8 and tumor necrosis factor-α( TNF-α) before and after treatment were compared between the patients of the 2 groups. Results The total effective rate of the combined medication group was 93. 22％, which was significantly higher than 79. 66％ of the control group(P<0. 05). The blood flow of dorsal pedal artery, ankle-brachial indexes and toe-brachial indexes in the patients of the 2 groups after treatment were all significantly higher than those before treatment (P<0. 05), and the combined medication group was obviously superior to the control group, with statistical significance (P <0. 05). The whole blood viscosity, plasma viscosity and fibrinogen (FIB) levels in the patients of the 2 groups after treatment all significantly decreased as compared with those before treatment (P<0. 05), and the indexes of the combined medication group were significantly lower than those of the control group, also with statistical significance(P<0. 05). The levels of TNF-a, hs-CRP, IL-6 and IL-8 in the patients of the 2 groups after treatment were significantly lower than those before treatment (P<0. 05), and the combined medication group was also obviously superior to the control group, with statistical significance (P<0. 05). Conclusion Xueshuantong and alprostadil combined with HBO in the treatment of elderly patients with peripheral arterial disease ( PAD) could achieve significant clinical effects, and in the meantime could evidently delay the occurrence of lower extremity arteriosclerosis, improve hemodynamics, relieve inflammation reactions. For this reason, it is worth further clinical extension.

Objective To study the clinical effect of Danhong injection combined with acupuncture in the treatment of vascular Parkinson syndrome (VP). Methods A total of 98 patients with VP who were treated in the hospital from January 2015 to January 2017 were enrolled in this study. According to the digital random table method, the patients were divided into two groups, the observation group and the control group with each 49 cases. Both groups were given basic treatment, and based on that, the observation group was treated with Danhong injection and acupuncture treatment. Both groups were compared before and after 8 weeks of treatment with the outcome indices of exercise and motor function score, blood rheology index and cerebral hemodynamic indexes, as well as adverse reactions. Results The total effective rate of the observation group was 87.76% (43/49), while the control group was 71.43% (35/49), and the difference was statistically significant(χ 2=4.021,P<0.05).After treatment,the motor function score(27.4 ± 10.5 vs.32.8 ± 8.2,t=2.865), the scores of non-motor function(4.1 ± 2.2 vs.9.8 ± 4.0,t=8.785)of the observation group were lower than those of the control group(P<0.05).After treatment,the plasma viscosity(1.49 ± 0.21 mPa?s vs.1.64 ± 0.28 mPa?s,t=3.000),fibrinogen(3.18 ±0.77 g/L,vs.3.86 ±0.70 g/L,t=4.574),and the RI index(0.49 ±0.12 vs. 0.62 ± 0.16, t=4.550) of the observation group was significantly lower than those of the control group (P<0.05). The Vs(81.97 ± 12.65 cm/s vs.74.39 ± 9.48 cm/s,t=3.357) and Vm(61.54 ± 7.10 cm/s vs.55.87 ± 6.24 cm/s,t=4.199) of observation group was significantly higher than those of the control group(P<0.05). The total incidence of adverse reactions in the observation group was 14.29%, which was no significant difference compared with that of the control group of 16.33%(χ 2=0.079,P>0.05).Conclusions The Danhong injection combined with acupuncture showed better effect on VP patients, and it could improve the clinical symptoms and blood circulation.