Objective To investigate the association between cerebrospinal fluid(CSF)oligoclonal band(OCB)positivity and clinical manifestations in patients with neuromyelitis optica spectrum disorder(NMOSD).Methods A retrospective analysis of clinical data from patients with NMOSD treated at our hospital from May 2019 to January 2024 was conducted.Based on OCB test results,patients were categorized into OCB-positive and OCB-negative groups.We compared baseline characteristics between the two groups and analyzed the relationship between clinical features and OCB positivity.Results This study included a total of 62 patients,comprising 17 in the OCB+group and 45 in the OCB-group.Compared with the OCB-group,patients in the OCB+group exhibited more pronounced central nervous system inflammatory features.Specifically,OCB+group had significantly higher proportions of patients with cerebrospinal fluid white blood cell counts>8×10?/L(64.7%vs.26.7%,P=0.003)and elevated immunoglobulin indices(0.72 vs.0.61,P=0.037).Additionally,the OCB+group exhibited more complex and diverse clinical presentations.Specifically,this group showed a higher incidence of mild consciousness impairment during the acute phase(P=0.005)and a greater tendency to present with multiple core symptoms(≥3 core symptoms)occurring concurrently(52.9%vs.20.0%,P=0.025)and misdiagnosis(29.4%vs.8.9%,P=0.101).This was particularly notable when comparing to acute myelitis involving the cervical spinal cord(82.4%vs.53.3%,P=0.036)and acute diencephalic syndrome[41.2%vs.6.7%,P=0.004,including hyponatremia(35.3%vs.8.9%,P=0.033)].Multivariate logistic regression analysis demonstrated that OCB positivity(OR=3.895,95%CI:1.065-14.249)was significantly associated with the presence of multiple core symptoms.Conclusion In acute-phase NMOSD patients,OCB+is associated with significantly higher rates of co-occurrence of multiple core symptoms(≥3 core symptoms)and misdiagnosis.Notably,acute myelitis involving the cervical spinal cord and acute diencephalic clinical syndrome are particularly prevalent in this OCB+subgroup.The clinical manifestations are complex and diverse,suggesting the need for enhanced clinical identification and timely intervention.

Objective To investigate the association between cerebrospinal fluid(CSF)oligoclonal band(OCB)positivity and clinical manifestations in patients with neuromyelitis optica spectrum disorder(NMOSD).Methods A retrospective analysis of clinical data from patients with NMOSD treated at our hospital from May 2019 to January 2024 was conducted.Based on OCB test results,patients were categorized into OCB-positive and OCB-negative groups.We compared baseline characteristics between the two groups and analyzed the relationship between clinical features and OCB positivity.Results This study included a total of 62 patients,comprising 17 in the OCB+group and 45 in the OCB-group.Compared with the OCB-group,patients in the OCB+group exhibited more pronounced central nervous system inflammatory features.Specifically,OCB+group had significantly higher proportions of patients with cerebrospinal fluid white blood cell counts>8×10?/L(64.7%vs.26.7%,P=0.003)and elevated immunoglobulin indices(0.72 vs.0.61,P=0.037).Additionally,the OCB+group exhibited more complex and diverse clinical presentations.Specifically,this group showed a higher incidence of mild consciousness impairment during the acute phase(P=0.005)and a greater tendency to present with multiple core symptoms(≥3 core symptoms)occurring concurrently(52.9%vs.20.0%,P=0.025)and misdiagnosis(29.4%vs.8.9%,P=0.101).This was particularly notable when comparing to acute myelitis involving the cervical spinal cord(82.4%vs.53.3%,P=0.036)and acute diencephalic syndrome[41.2%vs.6.7%,P=0.004,including hyponatremia(35.3%vs.8.9%,P=0.033)].Multivariate logistic regression analysis demonstrated that OCB positivity(OR=3.895,95%CI:1.065-14.249)was significantly associated with the presence of multiple core symptoms.Conclusion In acute-phase NMOSD patients,OCB+is associated with significantly higher rates of co-occurrence of multiple core symptoms(≥3 core symptoms)and misdiagnosis.Notably,acute myelitis involving the cervical spinal cord and acute diencephalic clinical syndrome are particularly prevalent in this OCB+subgroup.The clinical manifestations are complex and diverse,suggesting the need for enhanced clinical identification and timely intervention.

Objective:To investigate the characteristics of serum immunoglobulin G (IgG) N-glycans in male patients with different subtypes and severity grades of androgenetic alopecia (AGA) .Methods:A cross-sectional study was conducted on male patients diagnosed with male-pattern hair loss (MPHL) or female-pattern hair loss (FPHL) who attended the Department of Dermatology, Huashan Hospital, Fudan University between June and December 2022. Clinical data were collected, and serum IgG N-glycans were quantitatively analyzed using ultra-performance liquid chromatography (UPLC) . The content of serum IgG N-glycan structures was compared between patients with different AGA subtypes and among patients with different severity grades of MPHL or FPHL, while derived traits were compared between patients with different AGA subtypes. Point-biserial correlation analysis was conducted to assess associations between serum IgG N-glycans and hair loss severity.Results:A total of 85 male patients with AGA were included, comprising 44 MPHL patients and 41 FPHL patients. No significant differences were observed between the two subgroups in terms of age, age at onset, or serum levels of testosterone, sex hormone-binding globulin, uric acid, and 25-hydroxyvitamin D (all P > 0.05) . UPLC showed 23 serum IgG glycans and 5 derived glycan traits (afucosylation, fucosylation, bisecting GlcNAc, terminal galactosylation, and terminal sialylation) . Compared with the MPHL patients, the FPHL patients exhibited significantly increased levels of N-glycans GP5, GP11, GP17, and GP20 (all P < 0.05) , significantly elevated levels of afucosylated IgG N-glycans ( P = 0.047) , but significantly reduced core fucosylated IgG N-glycans ( P = 0.047) . No significant differences in serum IgG N-glycan composition were observed among patients with varying severity grades of MPHL (all P > 0.05) . In the FPHL patients, the levels of N-glycans GP10 ( r = 0.32, P = 0.039) and GP22 ( r = -0.32, P = 0.045) were significantly positively and negatively correlated with hair loss severity respectively; receiver operating characteristic curve analysis showed that both GP10 and GP22 had moderate diagnostic value for predicting hair loss severity, with the area under the curve values being 0.69 (95% CI: 0.52 - 0.86) and 0.71 (95% CI: 0.55 - 0.86) , respectively. Conclusion:Serum IgG N-glycan profiles differed among male patients with different AGA subtypes, and N-glycans GP10 and GP22 may serve as potential biomarkers for early assessment of hair loss severity in male FPHL patients.

Objective:To investigate the characteristics of serum immunoglobulin G (IgG) N-glycans in male patients with different subtypes and severity grades of androgenetic alopecia (AGA) .Methods:A cross-sectional study was conducted on male patients diagnosed with male-pattern hair loss (MPHL) or female-pattern hair loss (FPHL) who attended the Department of Dermatology, Huashan Hospital, Fudan University between June and December 2022. Clinical data were collected, and serum IgG N-glycans were quantitatively analyzed using ultra-performance liquid chromatography (UPLC) . The content of serum IgG N-glycan structures was compared between patients with different AGA subtypes and among patients with different severity grades of MPHL or FPHL, while derived traits were compared between patients with different AGA subtypes. Point-biserial correlation analysis was conducted to assess associations between serum IgG N-glycans and hair loss severity.Results:A total of 85 male patients with AGA were included, comprising 44 MPHL patients and 41 FPHL patients. No significant differences were observed between the two subgroups in terms of age, age at onset, or serum levels of testosterone, sex hormone-binding globulin, uric acid, and 25-hydroxyvitamin D (all P > 0.05) . UPLC showed 23 serum IgG glycans and 5 derived glycan traits (afucosylation, fucosylation, bisecting GlcNAc, terminal galactosylation, and terminal sialylation) . Compared with the MPHL patients, the FPHL patients exhibited significantly increased levels of N-glycans GP5, GP11, GP17, and GP20 (all P < 0.05) , significantly elevated levels of afucosylated IgG N-glycans ( P = 0.047) , but significantly reduced core fucosylated IgG N-glycans ( P = 0.047) . No significant differences in serum IgG N-glycan composition were observed among patients with varying severity grades of MPHL (all P > 0.05) . In the FPHL patients, the levels of N-glycans GP10 ( r = 0.32, P = 0.039) and GP22 ( r = -0.32, P = 0.045) were significantly positively and negatively correlated with hair loss severity respectively; receiver operating characteristic curve analysis showed that both GP10 and GP22 had moderate diagnostic value for predicting hair loss severity, with the area under the curve values being 0.69 (95% CI: 0.52 - 0.86) and 0.71 (95% CI: 0.55 - 0.86) , respectively. Conclusion:Serum IgG N-glycan profiles differed among male patients with different AGA subtypes, and N-glycans GP10 and GP22 may serve as potential biomarkers for early assessment of hair loss severity in male FPHL patients.

The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

Medical students differ greatly in their thinking and cognition of the value and pursuit of life existence. The mainstream values are positive and pragmatic, but they are also characterized by decentralization, diversification, individualization and variability. Value education needs to be object-centered, take care of students’ individual lives, understand and answer their real questions to be more accurate and effective. In the intelligent technology society, the education of life value of medical students in the ideological and political courses should rely on the intelligent technology platform to achieve the precise coupling of object and value goal through the form of question exchange. It is necessary to transcend the limitations of medical science perspective, realize accurate life value education, face the nihilistic challenge of life value, understand the systematic and dialectical significance of life events, and return to the original intention and mission of medical science to take care of life itself.

ObjectiveTo investigate the clinical significance of highly sensitive nucleic acid detection in precise antiviral therapy for patients with liver cirrhosis and its association with aminotransferase level. MethodsA total of 377 patients with hepatitis B cirrhosis who were hospitalized or attended the outpatient service from May 2013 to April 2019 were enrolled and tested by both domestic HBV DNA detection and highly sensitive Cobas HBV DNA detection. All patients underwent biochemical examination, four blood coagulation tests, routine blood test, and upper abdominal computed tomography or ultrasound. Sensitivity of different HBV DNA detection reagents was compared in liver cirrhosis patients with a low viral load, and the correlation between alanine aminotransferase (ALT) level and viral load was analyzed. The paired t-test was used for comparison of continuous data before and after treatment. The receiver operating characteristic (ROC) curve was used to screen out the optimal predictive values of ALT at different cut-off values of HBV DNA. ResultsAmong the 377 patients with hepatitis B cirrhosis, 215 tested positive and 162 tested negative by domestic HBV DNA, and among these 162 patients, 104 (64.2%) tested positive by Cobas HBV DNA detection, with a mean level of 267.5±42.3 IU/ml. After 24 weeks of antiviral therapy, the 104 patients with hepatitis B cirrhosis had significant improvements in viral replication level, ALT, and Child-Pugh score for liver function; HBV DNA decreased from 267.5±32.2 IU/ml before treatment to 59.6±7.7 IU/ml after treatment (t=3.486, P=0.002), ALT decreased from 871±10.8 U/L before treatment to 36.5±7.6 U/L after treatment (t=3.235, P=0.020), and the Child-Pugh score decreased from 6.5±0.7 before treatment to 5.7±0.5 after treatment (t=2.928, P=0.041). The ROC curve analysis of ALT in predicting HBV DNA decision point showed that an ALT level of 29 IU/L was the most sensitive cut-off value for predicting HBV DNA ＜20 IU/ml, with an area under the ROC curve of 0.904, a sensitivity of 1.0, and a specificity of 0.237. ConclusionPrecise detection helps to guarantee the precise clinical treatment of patients with hepatitis B cirrhosis and improve their treatment outcome and prognosis. An ALT level of 29 IU/L is a sensitive indicator for predicting patients with negative Cobas HBV DNA, so as to achieve individualized precise screening and treatment.

Objective: To evaluate the clinical efficacy of modified lateral window for maxillary sinus floor augmentation (MSFA). Methods: Fifty-five patients who visited the Stomatology Hospital Affiliated to Zhejiang University School of Medicine between June 2012 and October 2014 were enrolled in the study. Patients underwent MSFA with Bio-Oss grafts based on modified access window. During the operation the vertical height of the bony window was reduced from 6-8 mm of conventional oval window to 4-5 mm of slot-shaped window. The sinus membrane was detached completely via the lateral access and large particle Bio-Oss graft was placed in the sub-mucosal space. The implant survival, graft height, graft volume and resorption rates were measured. Intra-op and post-op complications were recorded. Results: There were 86 implants inserted. The 2-4 year cumulative survival rates were 97.67% by implant-based analysis and 96.36% by patient-based analysis. The residual bone height was (4.7±2.6) mm and bone width was (8.4±2.7) mm. The bone height of implantation site immediately after operation was (16.1±2.5) mm and it was (16.2±2.2) mm at restoration. The bone heights at 1 and 2 years after operation were (14.9±2.5) mm and (13.6±2.6) mm, respectively. The graft height was (10.6±2.8) mm and the graft volume was (1569±745) mm³ immediately after operation. The resorption rate of graft height 6 months after operation was 3.79% and that of graft volume was 7.87%. The 1-year accumulative resorption rate of graft height was 6.63% and that of graft volume was 10.89%. The 2-year accumulative resorption rate of graft height was 7.58% and that of graft volume was 15.26%. Small membrane perforation during MSFA was observed in 5 cases and all were successfully repaired by a collagen Bio-Gide membrane. Conclusion: The modified lateral technique obtains high implant survival rate, excellent graft stability and low complication rate at 2-4 year clinical follow-up, indicating that it is a safe, predictable and minimally invasive surgical method for severe atrophic maxillary posterior dentition.
Dental Implantation, Endosseous ; Follow-Up Studies ; Humans ; Maxillary Sinus ; surgery ; Sinus Floor Augmentation ; methods ; Treatment Outcome

Objective:To study the effect and safety of transradial percutaneous coronary intervention (PCI).Meth-ods:Clinical data of 306 patients,who received PCI in our hospital from Mar 2012 to Jan 2014,were retrospectively analyzed,including radial group (n=153),and femoral group (n=153).Therapeutic effect,time and postoperative complications etc.were compared between two groups.Results:A total of 151 cases completed PCI successfully in radial group,the success rate was 98.7%;a total of 150 cases completed PCI successfully in femoral group,the suc-cess rate was 98.0%,there was no significant difference in success rate of operation between two groups,P >0.05. Compared with femoral group,there were significant reductions in hospitalization time [(8.0±3.5)d vs.(3.5± 1.7)d],treatment cost [(3.74±2.06) × 104 yuan vs.(2.61 ± 1.4) × 104 yuan],P <0.01 both,in incidence rates of postoperative coronary occlusion (3.92% vs.0%),arrhythmia (11.76% vs.1.31%),vascular spasm (6.54% vs.1.96%)and hematoma (7.19% vs.0.65%)etc.in radial group,P < 0.05 or < 0.01. Conclusion:Transradial PCI possesses better effect than that of transfemoral ,and it can reduce hospitalization time,cost and postoperative complications,which is worth extending.