Parkinson′s disease (PD) is a neurodegenerative disorder prevalent among the elderly, characterized by the degeneration of dopaminergic neurons in the substantia nigra. The motor symptoms of PD include resting tremor, bradykinesia, rigidity, and postural gait disturbances. Additionally, non-motor symptoms such as depression, pain, cognitive impairment, sleep disorders, and autonomic dysfunction are gaining increasing attention. Among these, bladder and urethral dysfunction is one of the most common manifestations of autonomic dysfunction and significantly impacts patients′ quality of life in the later stages of the disease. This article provides a review of recent research on the epidemiology, pathogenesis, and treatment of bladder and urethral dysfunction in PD, aiming to enhance the understanding and management of urinary symptoms associated with PD.

Objective:To determine the diagnosis of microtia-associated syndrome through genetic testing.Methods:Peripheral venous blood samples were collected from members of a two-generation family with a syndrome associated with ear malformations (3 patients and 1 normal control). Pathogenic mutations were identified using whole exome sequencing analysis, Sanger sequencing validation, and bioinformatics analysis. Based on the genetic diagnosis and a review of the literatures, the patients′ clinical phenotypes were thoroughly evaluated to confirm the clinical diagnosis.Results:All three patients carried a novel heterozygous insertion mutation (c.1171_1172insGGCC: p.Pro391fs) in the paired box 1 ( PAX1) gene. This mutation showed genotype-phenotype co-segregation within the family and was predicted to be pathogenic. Consequently, the family was diagnosed with autosomal dominant otofaciocervical syndrome 2. The clinical phenotypes of the patients included not only ear malformations and conductive hearing loss but also branchial cleft fistula, preauricular fistula, bilateral facial asymmetry, spinal deformities, and short stature, which were major symptoms of otofaciocervical syndrome 2. Imaging also revealed previously unreported phenotypes, including parotid gland malformation and facial nerve dysplasia. Conclusion:The heterozygous insertion in PAX1 (c.1171_1172insGGCC: p.Pro391fs) found in this family causes otomandibular-cervical syndrome type 2 in an autosomal dominant manner, leading to congenital anomalies affecting external and middle ear, craniofacial region, and spine.

Through collecting the existing clinical evidences on acupuncture and moxibustion for urticaria, the distribution of evidence in this field was mapped. A systematic search of Chinese and English literature was conducted in CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library for treatment of urticaria with acupuncture and moxibustion, published up to December 31, 2023 since inception of each database. The research status in this field was summarized using an evidence mapping approach, and methodological quality was assessed. A total of 323 randomized controlled trials (RCTs) and 22 systematic reviews were included. The number of studies on acupuncture and moxibustion for urticaria has been increasing, with a significant rise in recent years. In most RCTs, the study scale was small, and the subjects focused on chronic spontaneous urticaria in adolescents and middle-aged adults, aged 14 to 60 years. Regarding the intervention measures, the single therapy of acupuncture and moxibustion was predominant such as acupoint injection, acupoint embedding thread, and filiform needling. In acupuncture with filiform needles, the commonly used acupoints were Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), Zusanli (ST36) and Hegu (LI4). The main outcome measures referred to effectiveness rate, score of disease severity, recurrence rate, laboratory indexes, and score of quality of life; and the short-term effect was evaluated specifically. The overall methodological quality of the included studies was relatively low. It is suggested that the future research should focus on large-scale, multi-center, high-quality clinical trials, optimize the protocols for acupuncture and moxibustion intervention, standardize the outcomes, and draw the attention to the evaluation of long-term efficacy, so as to provide clinical evidences of high certainty for urticaria treated with acupuncture and moxibustion.
Humans ; Moxibustion ; Acupuncture Therapy ; Urticaria/therapy* ; Acupuncture Points ; Randomized Controlled Trials as Topic ; Adolescent ; Adult ; Young Adult

OBJECTIVE: To reveal the gap between the evidence of systematic reviews (SRs) and clinical concerns by systematically summarizing the evidence on acupuncture and moxibustion for frozen shoulder and investigating the concerns and needs of clinicians in treatment with acupuncture and moxibustion for this disease. METHODS: The articles of SR and Meta-analysis on acupuncture and moxibustion for frozen shoulder were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library, starting from the inception of each database up to December 31st, 2022. Two researchers screened the articles and extracted data independently. Using AMSTAR-2, the methodological quality of the included studies was evaluated. Based on systematic reviews and expert discussion, a questionnaire on clinical concerns of acupuncture and moxibustion for frozen shoulder was developed and distributed to clinicians. The discrepancies between the evidence and clinical concerns were compared from 5 dimensions, including population, interventions, control measures, outcome indicators and review time points. RESULTS: The evidence gaps existed between SRs and clinical concerns. In the existing studies, the needs of personalized treatment were not fully considered in terms of different syndromes/patterns of frozen shoulder and stages of illness, the outcome indicators were not employed properly, the time for outcome measurement was vague, the control groups were set up outside of standardization, and the methodological quality was lower. CONCLUSION It is suggested that future studies should improve the quality of methodology, lay more consideration to different patient groups, optimize outcome indicators and standardize the setting of control groups, so as to better meet the needs of patients and achieve the best match between evidence and clinicians' needs.
Humans ; Acupuncture Therapy ; Bursitis/therapy* ; Evidence Gaps ; Moxibustion ; Systematic Reviews as Topic ; Meta-Analysis as Topic

Objective:To investigate the current talent cultivation among young pediatricians, and to provide insights for fostering a virtuous cycle in their education, scientific research, and career growth.Methods:This study enrolled 152 young pediatricians (under 45 years of age) who had completed or were participating in standardized residency training at the Children's Hospital of Soochow University since September 2014. The pediatricians were surveyed on clinical training, scientific research process, career development planning, policies, and incentive mechanisms using a self-administered questionnaire. SPSS 23.0 was used for statistical analysis. Enumeration data, expressed as the number of cases and composition ratios, were analyzed using chi-square tests, while ordinal data were analyzed using rank sum tests. The SPSS macroprogram PROCESS v3.3 was used for mediating effect analysis.Results:The results of the questionnaire survey of 152 respondents were as follows: 65.79% (100/152) were aged 25-34 years; 57.24% (87/152) held a master's degree; 13.82% (21/152), 16.45% (25/152), and 69.74% (106/152) held deputy senior professional titles and above, intermediate professional titles, and junior professional titles and below, respectively. More than half of the respondents desired expanded training in professional skill updates, scientific research capacity enhancement, and simulation teaching. The current training system was deemed simplistic in content and method, requiring optimization. The frequency of clinical teaching activities ( P<0.001), training methods ( P<0.001), and departmental mentorship atmosphere ( P<0.001) were correlated with the degree of satisfaction with clinical training. Among the respondents, 81.58% (124/152) reported insufficient time, energy, and motivation for scientific research. The frequency of training ( P<0.001), participation frequency ( P<0.001), diversity of training methods ( P=0.024), departmental mentorship atmosphere ( P<0.001), opportunities for collaboration ( P<0.001), and training in methodology and innovative thinking ( P=0.042) were correlated with the degree of satisfaction with the scientific research capability enhancement training. Notably, there was a marginally significant difference in degree of satisfaction with scientific research training among young physicians with different titles ( P=0.053). Only 38.16% (58/152) of the respondents had established mid-to-long-term career plans, indicating a lack of career planning awareness. Age ( P=0.001), educational background ( P=0.009), professional titles ( P=0.001), and completion status of standardized residency training ( P=0.011) were correlated with degree of satisfaction with career development planning. The departmental mentorship atmosphere ( P=0.013) and flexible work arrangements ( P=0.039) were correlated with degree of satisfaction with policies and incentive mechanisms, with a marginal significance for performance-based reward system ( P=0.057). The frequency of clinical training ( P=0.030) and scientific research training ( P=0.010) had a significant indirect mediating effect on the degree of satisfaction with clinical training through the departmental mentorship atmosphere. Conclusions:Optimizing the development pathway for young physicians requires improvements in clinical training system, scientific research management, career planning guidance, and overall supportive environment.

With the improvement of people's living standards and the development of medical and health technologies, the trend of population aging in China has become increasingly severe. The long-term care insurance system is an important strategic measure to address population aging and the long-term care of disabled elderly people. By introducing the current implementation situation of the long-term care insurance system in some provinces and cities, this paper explores and excavates the experience of how to develop and deepen the long-term care insurance, aiming to provide a reference for improving and developing China's long-term care insurance system for the elderly.

Objective:This study aims to explore the current situation of scientific and technological achi evements transformation in district and county-level medical institutions, by analyzing 102 successfully transformed patents from a distric level III comprehensive hospital.Methods:Based on the hospital′s scientific and technological transformation registration data, this study comprehensively utilized patent databases and enterprise inquiry platforms, employing EXCEL and SPSS AU software for analysis.Results:Utility model patents predominate, primarily transformed through patent (application) right transfers, the average contract amount was 42 690 yuan and a relatively long transformation cycle. Female inventors and those under 50 years old account for a high proportion, with nurses being the most common first inventors of patents. Collaborating enterprises were mainly local hospitals, startups, as well as science and technology promotion and application service enterprises.Conclusions:District and county-level medical institutions face many challenges in transforming technological achievements. However, by deeply exploring clinical needs, developing differentiated training and support strategies, and focusing on key partner enterprises, it is possible to promote high-quality and sustainable technological achievement transformation.

Objective:This study aims to explore the current situation of scientific and technological achi evements transformation in district and county-level medical institutions, by analyzing 102 successfully transformed patents from a distric level III comprehensive hospital.Methods:Based on the hospital′s scientific and technological transformation registration data, this study comprehensively utilized patent databases and enterprise inquiry platforms, employing EXCEL and SPSS AU software for analysis.Results:Utility model patents predominate, primarily transformed through patent (application) right transfers, the average contract amount was 42 690 yuan and a relatively long transformation cycle. Female inventors and those under 50 years old account for a high proportion, with nurses being the most common first inventors of patents. Collaborating enterprises were mainly local hospitals, startups, as well as science and technology promotion and application service enterprises.Conclusions:District and county-level medical institutions face many challenges in transforming technological achievements. However, by deeply exploring clinical needs, developing differentiated training and support strategies, and focusing on key partner enterprises, it is possible to promote high-quality and sustainable technological achievement transformation.

Objective:To investigate the current talent cultivation among young pediatricians, and to provide insights for fostering a virtuous cycle in their education, scientific research, and career growth.Methods:This study enrolled 152 young pediatricians (under 45 years of age) who had completed or were participating in standardized residency training at the Children's Hospital of Soochow University since September 2014. The pediatricians were surveyed on clinical training, scientific research process, career development planning, policies, and incentive mechanisms using a self-administered questionnaire. SPSS 23.0 was used for statistical analysis. Enumeration data, expressed as the number of cases and composition ratios, were analyzed using chi-square tests, while ordinal data were analyzed using rank sum tests. The SPSS macroprogram PROCESS v3.3 was used for mediating effect analysis.Results:The results of the questionnaire survey of 152 respondents were as follows: 65.79% (100/152) were aged 25-34 years; 57.24% (87/152) held a master's degree; 13.82% (21/152), 16.45% (25/152), and 69.74% (106/152) held deputy senior professional titles and above, intermediate professional titles, and junior professional titles and below, respectively. More than half of the respondents desired expanded training in professional skill updates, scientific research capacity enhancement, and simulation teaching. The current training system was deemed simplistic in content and method, requiring optimization. The frequency of clinical teaching activities ( P<0.001), training methods ( P<0.001), and departmental mentorship atmosphere ( P<0.001) were correlated with the degree of satisfaction with clinical training. Among the respondents, 81.58% (124/152) reported insufficient time, energy, and motivation for scientific research. The frequency of training ( P<0.001), participation frequency ( P<0.001), diversity of training methods ( P=0.024), departmental mentorship atmosphere ( P<0.001), opportunities for collaboration ( P<0.001), and training in methodology and innovative thinking ( P=0.042) were correlated with the degree of satisfaction with the scientific research capability enhancement training. Notably, there was a marginally significant difference in degree of satisfaction with scientific research training among young physicians with different titles ( P=0.053). Only 38.16% (58/152) of the respondents had established mid-to-long-term career plans, indicating a lack of career planning awareness. Age ( P=0.001), educational background ( P=0.009), professional titles ( P=0.001), and completion status of standardized residency training ( P=0.011) were correlated with degree of satisfaction with career development planning. The departmental mentorship atmosphere ( P=0.013) and flexible work arrangements ( P=0.039) were correlated with degree of satisfaction with policies and incentive mechanisms, with a marginal significance for performance-based reward system ( P=0.057). The frequency of clinical training ( P=0.030) and scientific research training ( P=0.010) had a significant indirect mediating effect on the degree of satisfaction with clinical training through the departmental mentorship atmosphere. Conclusions:Optimizing the development pathway for young physicians requires improvements in clinical training system, scientific research management, career planning guidance, and overall supportive environment.