Objective To investigate the articulation acoustic characteristics of children with spastic cerebral palsy and their correlation with articulation intelligibility.Methods A total of 17 children with cerebral palsy and 17 ordinary children aged 6-12 years were included in the study,and the articulation acoustics and articulation intelligi-bility performance of the two types of children were compared by using three kinds of corpus:monophthong,single word and sentence,and the correlation between them was studied.Results The articulation intelligibility of the monophthong,single word and sentence corpus of children with spastic cerebral palsy was lower than that of ordina-ry children(P＜0.01),as follows:monophthong＞single word＞sentence.In the monophthong corpus,only mandibular distance and tongue distance were significantly lower than that of ordinary children(P＜0.05),and only mandibular distance and vowel space area(VSA)were significantly correlated with articulation intelligibility(P＜0.05).In the single word corpus,mandibular distance,tongue distance and VSA were significantly lower than that of ordinary children,while vowel ellipse area(VEA)was significantly higher than that of ordinary children(P＜0.05).All other indexes except VSA and formant centralization ratio(FCR)were significantly correlated with artic-ulation intelligibility(P＜0.05).In the sentence corpus,all the other indexes except mandibular distance were sig-nificantly worse than those of ordinary children(P＜0.05),and all the acoustic indexes were significantly correlated with articulation intelligibility(P＜0.05).Conclusion Children with cerebral palsy have poor articulation acoustic cha-racteristics and articulation intelligibility,and the corpus complexity will affect the degree of correlation between the two.

Cholangiocarcinoma,as a malignant tumor with strong invasiveness and poor prognosis,has a complex metastasis mechanism,and urgently needs in-depth research.Circulating tumor cells(CTC),as the key cell type for tumor cells to shed from the primary site and enter the bloodstream,have significant research significance.In recent years,studies have found that the invasive pseudopodia of CTC play a significant role in the migration and invasion of tumor cells.Among them,in terms of signal transduction pathways,the Rho family GTPases(RhoA,Rac1,Cdc42)work in coordination to regulate the contractility of the pseudofoot,the branching polymerization and orientation of actin,and the phosphoinositide3-kinase/protein kinase B(PI3K/AKT)pathway promotes the assembly of actin and cross-communicates with the Rho family by activating AKT.At the molecular mechanism level,long non-coding RNAs regulate the expression of pseudopolypod-related genes by adsorbing miRNAs and other means.Matrix metalloproteinase(MMP)degrades the extracellular matrix(ECM)to form an invasion positive feedback.In terms of the microenvironment,cancer-associated fibroblast(CAF)and the cytokines such as transforming growth factor-β(TGF-β)secreted by macrophages,epidermal growth factor(EGF),and interleukin-6(IL-6)activate pseudopodia to form signal transduction pathways.ECM hardness and fiber arrangement affect the extension direction of pseudopodia through mechanical force conduction.This article conducted a comprehensive analysis of the biological characteristics of CTC,the formation mechanism of invasive pseudopodia in cholangiocarcinoma,the metastatic features of cholangiocarcinoma cells and their clinical significance,as well as the role of CTC in the metastatic process of cholangiocarcinoma,in order to summarize the existing research results,explore potential therapeutic targets and future research directions,and provide new ideas for the clinical treatment of cholangiocarcinoma.

In recent years,blood purification has been the first-line therapy for Guillain-Barré syndrome(GBS).Blood purification eliminates pathogenic substances such as antibodies and immune complexes through non-renal pathways to treat diseases.Plasma exchange,double filtration plasmapheresis and immunoadsorption are blood purification modalities commonly used in the treatment of immune-mediated neurological disorders such as GBS.This paper reviews the research progress in the treatment of GBS by using blood purification.

Objective To investigate the articulation acoustic characteristics of children with spastic cerebral palsy and their correlation with articulation intelligibility.Methods A total of 17 children with cerebral palsy and 17 ordinary children aged 6-12 years were included in the study,and the articulation acoustics and articulation intelligi-bility performance of the two types of children were compared by using three kinds of corpus:monophthong,single word and sentence,and the correlation between them was studied.Results The articulation intelligibility of the monophthong,single word and sentence corpus of children with spastic cerebral palsy was lower than that of ordina-ry children(P＜0.01),as follows:monophthong＞single word＞sentence.In the monophthong corpus,only mandibular distance and tongue distance were significantly lower than that of ordinary children(P＜0.05),and only mandibular distance and vowel space area(VSA)were significantly correlated with articulation intelligibility(P＜0.05).In the single word corpus,mandibular distance,tongue distance and VSA were significantly lower than that of ordinary children,while vowel ellipse area(VEA)was significantly higher than that of ordinary children(P＜0.05).All other indexes except VSA and formant centralization ratio(FCR)were significantly correlated with artic-ulation intelligibility(P＜0.05).In the sentence corpus,all the other indexes except mandibular distance were sig-nificantly worse than those of ordinary children(P＜0.05),and all the acoustic indexes were significantly correlated with articulation intelligibility(P＜0.05).Conclusion Children with cerebral palsy have poor articulation acoustic cha-racteristics and articulation intelligibility,and the corpus complexity will affect the degree of correlation between the two.

Objective To explore the clinical characteristics of Zoletil 50 poisoning.Methods The clinical data of 33 patients with Zoletil 50 poisoning admitted to our hospital recently were retrospectively analyzed.Results Thirty-two cases were male and 1 case was female in all the 33 patients.Five cases had previous exposure to psychoactive substances such as nitrous oxide,methamphetamine and ketamine,and 19 cases had a history of smoking or drinking alcohol.Limb shaking was in 33 cases(100％),blurred and yellowed vision was in 18 cases(54.55％),unresponsiveness and hypomnesia were in 17 cases(51.52％),hallucination was in 17 cases(51.52％),irritability and panic were in 16 cases(48.48％),insomnia was in 13 cases(39.39％),unfavorable speech was in 9 cases(27.27％),dizziness and lightheadedness were in 8 cases(24.24％),delusion was in 6 cases(18.18％),nausea and vomiting were in 6 cases(18.18％),frequent urination and difficulty in urination were in 5 cases(15.15％),diarrhea and bloating were in 4 cases(12.12％),itchy skin and the abnormal sensation were in 3 cases(9.09％).There was 1 case(3.03％)of epileptic seizure and 1 case(3.03％)of chills.Ataxia was in 29 cases(96.99％),cognitive dysfunction was in 17 cases(51.52％),abnormal tendon reflex was in 13 cases(39.39％),dysarthria was in 9 cases(27.27％),nystagmus was in 6 cases(18.18％),delirium was in 3 cases(9.09％),and vision loss was in 2 cases(6.06％).Auxiliary examinations suggested neutrophil abnormalities in 19 cases(57.58％),elevated transaminases in 21 cases(63.64％),elevated uric acid in 13 cases(39.39％),increased urinary crystals in 8 cases(24.24％),elevated lipids in 11 cases(33.33％),elevated homocysteine in 5 cases(15.15％),and abnormal thyroid hormone abnormalities in 11 cases(33.33％).EEG showed sinus bradycardia in 4 cases(12.12％).Among the 16 patients who underwent EEG examination,there were 2 cases of mild and moderate abnormalities.Among the 6 patients with evoked potentials,there were 5 cases of optic nerve and auditory nerve abnormalities.There were 3 cases of peripheral nerve abnormalities in 7 cases who underwent EMG.Among the 16 patients who underwent cranial MRI examination,there were 3 cases of cortical atrophy,2 cases of white matter degeneration,and 1 case of cerebellar atrophy.Spinal cord MRI showed spinal cord abnormal signal in 1 case.In the treatment,B vitamins were supplemented to control limb shaking,improve sleep,relieve anxiety,control mental symptoms,improve cognition and other symptomatic and supportive therapy.Symptoms were relieved in 29 cases;1 case was discharged automatically;1 case relapsed during treatment,and no significant improvement was observed;2 cases died.Conclusions The specific mechanism of Zoletil 50 poisoning has not been fully clarified,and the main clinical manifestations are significant limb shaking,blurred vision,slow reaction,hallucinations,insomnia,etc.,which can be fatal in severe cases.At present,symptomatic supportive treatment can only mildly relieve the symptoms.

Cholangiocarcinoma,as a malignant tumor with strong invasiveness and poor prognosis,has a complex metastasis mechanism,and urgently needs in-depth research.Circulating tumor cells(CTC),as the key cell type for tumor cells to shed from the primary site and enter the bloodstream,have significant research significance.In recent years,studies have found that the invasive pseudopodia of CTC play a significant role in the migration and invasion of tumor cells.Among them,in terms of signal transduction pathways,the Rho family GTPases(RhoA,Rac1,Cdc42)work in coordination to regulate the contractility of the pseudofoot,the branching polymerization and orientation of actin,and the phosphoinositide3-kinase/protein kinase B(PI3K/AKT)pathway promotes the assembly of actin and cross-communicates with the Rho family by activating AKT.At the molecular mechanism level,long non-coding RNAs regulate the expression of pseudopolypod-related genes by adsorbing miRNAs and other means.Matrix metalloproteinase(MMP)degrades the extracellular matrix(ECM)to form an invasion positive feedback.In terms of the microenvironment,cancer-associated fibroblast(CAF)and the cytokines such as transforming growth factor-β(TGF-β)secreted by macrophages,epidermal growth factor(EGF),and interleukin-6(IL-6)activate pseudopodia to form signal transduction pathways.ECM hardness and fiber arrangement affect the extension direction of pseudopodia through mechanical force conduction.This article conducted a comprehensive analysis of the biological characteristics of CTC,the formation mechanism of invasive pseudopodia in cholangiocarcinoma,the metastatic features of cholangiocarcinoma cells and their clinical significance,as well as the role of CTC in the metastatic process of cholangiocarcinoma,in order to summarize the existing research results,explore potential therapeutic targets and future research directions,and provide new ideas for the clinical treatment of cholangiocarcinoma.

During hospitalization in the ICU, rehabilitation exercises were recognized as a crucial method for enhancing patients′ quality of life, and the volume of exercise was shown to significantly influence the effectiveness of rehabilitation for ICU patients. This article reviews the definition of exercise volume in the context of ICU patient rehabilitation, the current status of reporting, its correlation with patient outcomes, and the available measurement tools. The aim is to provide a foundational reference for quantitative research on exercise rehabilitation in ICUs within our country.

Intrahepatic cholangiocarcinoma is a malignant tumor with an extremely poor prognosis， and its pathogenesis is complex and remains unclear. In recent years， more and more studies have focused on the role of bile-gut axis in the development and progression of intrahepatic cholangiocarcinoma. Bile-gut axis refers to the complex interaction between bile and gut microbiota， including bile salt metabolism， dynamic changes of microbiota， inflammatory response， and immune system regulation. This article elaborates on the potential mechanisms of bile-gut axis in intrahepatic cholangiocarcinoma， especially gut microbiota dysbiosis， abnormal bile salt metabolism， chronic inflammatory response， and immune system interaction， this article aims to provide new perspectives and possible therapeutic targets for future research and promote the early diagnosis and effective treatment of intrahepatic cholangiocarcinoma.

Post-stroke depression （PSD） represents a common and debilitating complication following stroke， substantially impeding neurorehabilitation outcomes and exerting a profound negative impact on patients' quality of life， while concurrently contributing to increased mortality rates. Despite a growing understanding of PSD， contemporary clinical management continues to encounter multifaceted challenges. This systematic review synthesizes extant literature to delineate pathophysiological mechanisms underlying PSD and to identify evidence-based interventions. By establishing a theoretical foundation， it aims to optimize early diagnostic protocols and personalized therapeutic regimens， thereby enhancing rehabilitation and therapeutic outcomes in stroke patients. Through rigorous evaluation of 14 original studies， this analysis comprehensively examines genetic factors， neurobiological aberrations， immunological factors， and psychosocial stressors contributing to PSD onset and progression， offering critical insights for developing comprehensive treatment strategies.［Funded by Science and Technology Plan Project of Yunnan Provincial Department of Science and Technology （number， 202101AY070001-048）］

Objective In this study,the potential profile characteristics of exercise self-efficacy of patients with inflammatory bowel disease(IBD)were explored,and the influencing factors of different types of patients were an-alyzed,so as to provide a reference for nurses to formulate standardized management measures.Methods From June 2023 to May 2024,a total of 342 hospitalized patients with IBD in tertiary A hospital in Wuxi were recruited as research subjects by a convenience sampling method.The General Information Questionnaire,Exercise Self-effica-cy Scale,Exercise Behavioral Stage Distribution Scale and the Social Support Rating Scale were used for investiga-tion.The latent profile analysis was conducted to classify exercise self-efficacy levels,while multiple Logistic regres-sion analysis was utilized to evaluate the influencing factors.Results A total of 320 valid questionnaires were col-lected,and the effective questionnaire recovery rate was 93.57％.The total score of exercise self-efficacy for IBD pa-tients was(64.61±14.83)points.The exercise self-efficacy was classified into 3 latent categories:low efficacy-somatic emotion group(n=64,20.00％),medium efficacy-work conflict group(n=158,49.38％),and high efficacy-social interfer-ence group(n=98,30.62％).Occupation,recurrence times,comorbid chronic diseases,self-assessed economic pressure,and social support level were found to be influencing factors of the latent profile classification of exercise self-effi-cacy in IBD patients(P＜0.05).Conclusion The levels of exercise self-efficacy of patients with IBD are significant-ly heterogeneous,and there are several important influencing factors.Nursing staff should formulate targeted inter-vention strategies based on the characteristics of exercise self-efficacy in such patients,so as to improve patients' exercise self-efficacy and the effectiveness of disease rehabilitation.