Thyroid-associated ophthalmopathy(TAO)is a progressive eye disease characterized by immune-mediated inflammation of the extraocular muscles and orbital connective tissue.TAO tends to have complex and diverse symptoms and signs,with the features of diversity and concealment,which seriously affect the quality of life of patients.The pathogenesis of TAO is closely associated with thyroid autoimmunity.This article reviews the pathogenesis,clinical features,and treatment of TAO.

Objective To make a comprehensive review about transitional care practice for patients receiving percutaneous transhepatic biliary drainage(PTBD)and to analyze the current transitional care contents and evaluation indexes so as to provide guidance for improving the quality of transitional care services for discharged patients carrying a PTBD tube.Methods A scoping review study design was used to conduct a computerized retrieval of academic papers concerning the transitional care practice for discharged patients carrying a PTBD tube from the databases of PubMed,WOS Core Collection,CINAHL,Embase,Cochrane Library,CNKI,VIP,Wanfang med online,and Sinomed.The retrieval time period was from the establishment of the database to August 20,2024.Two investigators independently screened the literature to determine the studies to be included and the relevant information to be extracted.Results A total of 18 papers were enrolled in this study.The transitional care ways included telephone follow-up,home visit,online platform follow-up,and outpatient clinic follow-up.The intervention contents extended from in-hospital to out-of-hospital for up to 6 months.The evaluation indexes focused on the patient's knowledge about PTBD tube,the incidence of tube-related complications,the satisfaction with care,self-care ability,etc.Conclusion At present,the transitional care for discharged patients carrying a PTBD tube has a variety of content elements,which can improve the self-care ability and quality of life of the discharged patients carrying a PTBD tube to a certain extent,although more individualized transitional care modes need to be further explored.The evaluation indexes are mainly the outcome assessment of PTBD tube care.It is necessary to strengthen the quality supervision of organizational structure and nursing process.

Clinical practice guideline adaptation (hereinafter referred to as "guideline adaptation") is the consolidation and revision of existing high-quality guidelines so that the recommendations are better suited to the specific needs of different regions, thereby guiding optimal clinical practice. Currently, the guideline adaptations is increasing in number internationally, but their reporting quality still needs to be improved. In 2022, the RIGHT-Ad@pt guideline adaptation reporting checklist was released. It provides a detailed description of the guideline adaptation process and reporting content, which will significantly enhance the rigor, transparency, and standardization of guideline adaptations. This paper interprets and analyzes the 34 items on the checklist, with the aim of providing reference for guideline adapters to standardize the reporting process.

Liver transplantation, the only effective treatment for end stage liver disease, is characterized by complicated surgery, long surgery time, and high trauma. Patients may experience a variety of difficulties following surgery, including infection, abdominal bleeding and rejection, all of which directly affect the quality of rehabilitation. Enhanced Recovery After Surgery (ERAS), a novel perioperative management strategy, can effectively promote postoperative recovery of patients and has been extensively implemented in various fields of surgery. However, there are no scientific and universal ERAS protocols in the fields of liver transplantation in China. The first Consensus Recommendations of Enhanced Recovery for Liver Transplantation was issued by the International Liver Transplantation Society in December 2022, offering recommendations about ERAS strategies for liver transplantation recipients who receive deceased and living organ donations, and for living donors of liver transplantation. This paper provides a detailed interpretation of the key points to offer a practical reference for domestic liver transplantation perioperative ERAS management.

One of the critical pathogenic factors contributing to non-healing chronic wounds is the formation of bacterial biofilms. In light of this, exploring effective strategies for the prevention and control of biofilms to improve the prognosis of patients with chronic wounds has become a research focus in the field of wound care and treatment. This review aimed to provide an in-depth exploration of the concept of bacterial biofilms, their complex formation mechanisms, and how they promote persistent infection states within the context of chronic wounds, offering valuable references for the detection and treatment of these biofilms in chronic wounds.

A large proportion of patients with non-small cell lung cancer (NSCLC) are diagnosed with metastatic and incurable advanced lung cancer at the time of discovery, so these patients are given no surgical opportunity and have a low 5-year survival rate. In the era of immunotherapy, many kinds of immune checkpoint inhibitors (ICIs) have been approved as the first/second-line treatment for patients with advanced NSCLC with negative driving genes and have been combined with radiotherapy as an important treatment strategy for patients with advanced NSCLC. The innovative strategy of combining radiotherapy and immunotherapy has shown feasibility as supported by practical evidence in clinical research. A preclinical experiment of observing the immune mechanism at the molecular and cellular levels preliminarily revealed the interaction among tumor, radiation, and immune system. This paper briefly reviews the progress of combined radiotherapy and immunotherapy in the treatment of advanced NSCLC with negative drvier genes.

Objective:To investigate the clinical features, treatment, and prognosis of transient hyperammonemia of the newborn (THAN).Methods:Data of two infants with severe THAN admitted to the Department of Neonatology of Shanghai Children's Hospital in September 2021 and August 2022 were retrospectively investigated. Clinical data of confirmed THAN cases (blood ammonia>400 μmol/L) were collected from relevant literature retrieved from the Wanfang Database, China National Knowledge Infrastructure, Chinese Medical Journal Database, and PubMed up to July 2022. A descriptive method was used for statistical analysis.Results:A total of 24 cases were involved (two in the present study, and 22 in 12 retrieved articles), including 19 (79.2%) premature newborns and five term infants. The average birth weight was (2 237±608) g and the average onset time was 27 h (4-55 h) after birth. The early clinical symptoms included respiratory distress and hyporesponsiveness (drowsiness, lethargy, coma or hypotonia) in 18 cases (75.0%), metabolic acidosis in 11 cases (45.8%), hypocalcemia in seven cases (29.2%), pupil fixation/dilation in six cases (25.0%), convulsion in five cases (20.8%), apnea in three cases (12.5%) and sinus bradycardia in one case (4.2%). The serum ammonia levels were 1 422.8 μmol/L (547.2-4 494.1 μmol/L). Treatments included peritoneal dialysis plus exchange transfusion in eight cases (33.3%), exchange transfusion in seven cases (29.2%), continuous renal replacement therapy (CRRT) in four cases (16.7%), arginine in two cases (8.3%), peritoneal dialysis in two cases (8.3%), and CRRT+peritoneal dialysis in one case (4.2%). During follow-ups of four months (one month to six years), 13 cases (54.2%) showed no abnormalities in development; two (8.3%) had a neurodevelopmental delay, and six (25.0%) died. The follow-up of the other three cases (12.5%) were not reported in the literature.Conclusions:The early clinical manifestation of severe THAN is atypical. A good prognosis can be expected through early exclusion of possible hyperammonemia-related genetic metabolic diseases and lowering the serum ammonia level. Long-term follow-up is needed for neurological evaluation.

OBJECTIVE：To study the inhibi tory effects of genistein on the growth of human nasopharyngeal carcinoma. CNE 1 cells and predict its potential target. METHODS ：CCK-8 method was used to test the effects of 0（blank control ），12.5，25，50， 100，150 µmol/L genistein on the proliferation of CNE 1 cells after treated for 24，48，72 h. Flow cytometry was carried out to detect the effects of 0（blank control ），15，30，60 µmol/L genistein on the cell cycle and ap optosis of CNE 1 cells after treated for 24 h. Scratch test was used to investigate the effects of 0（blank control ）， 10， 20， 30 µmol/L genistein on themigration ability of CNE 1 cells after treated for 24 h. High （No.18210156） throughput sequencing was conducted to discover the differential genes in CNE 1 cells after treated with 0（blankcontrol），30 µmol/L genistein for 24 h. RT-qPCR assay was adopted to verify the mRNA expression of related differential genes in above trials. RESULTS ： Compared with blank control，12.5，25，50，100，150 µmol/L genistein sho wed significant inhibitory effect on the proliferation of CNE 1 cells（P＜ 0.01），in a concentration- time-effect manner ；15，30 µmol/L genistein could arrest CNE 1 cell cycle at G 0/G1 stage（P＜0.05 or P＜ 0.01）；30，60 µmol/L could arrest CNE 1 cell cycle at G 2/M stage and promoted cell apoptosis （P＜0.05 or P＜0.01）. 10，20，30 µmol/L genistein could significantly inhibit the migration ability of CNE 1 cells（padj＜0.01）. High throughput sequencing revealed a total of 2 271 differentialgenes（P＜0.05），1 154 of which were up-regulated while 1 117 of which were down-regulated ；8 potential target genes ，including p53，p21，STC2，FGF2，CDK6，CYCLIN D ，PI3K，AKT，were screened by cell experiment. After validated by RT-qPCR assay ，mRNA expression of p53，p21，STC2，FGF2，CDK6，CYCLIN D and AKT were significantly down-regulated（P＜0.05），which consistent with the sequencing results. CONCLUSIONS ：Genistein can effectively inhibit the growth of human nasopharyngeal carcinoma CNE 1 cells，the mechanism of which may associated with inhibiting the expression of mutant gene p53，restoring the function of wild-type P 53 protein and inhibiting the activity of PI 3K/Akt pathway.

Objective:To investigate the clinical and molecular genetic features of neonatal congenital Netherton syndrome (NS) caused by mutations in serine protease inhibitor of Kazal type 5 ( SPINK5) gene. Methods:This study retrospectively analyzed the clinical data of an NS neonate admitted to Shanghai Children's Hospital in November 2018. SPINK5 gene was analyzed using high-throughput sequencing and Sanger sequencing. Relevant articles were retrieved from various databases including China National Knowledge Infrastructure, Wanfang and PubMed, and the reported cases who were diagnosed as NS within two months after birth with SPINK5 gene sequencing results were reviewed. Clinical features, gene mutations, treatment and follow-up results of NS were summarized using descriptive statistical analysis. Results:The patient presented with diffuse erythema and desquamation, sparse hair and repeated infections shortly after birth. Laboratory tests revealed elevated IgE (111 IU/ml) and "invagination-like" change in the hair under optical microscope. SPINK5 gene analysis found that there were compound heterozygous mutations of c.2468dup (p.Lys824Glufs*4) and c.377_378del (p.Tys126*) in the child. The pedigree analysis found that the two mutations were respectively inherited from the father and the mother, which supported the diagnosis of NS caused by SPINK5 gene mutation. Though skin rash improved after comprehensive treatments including anti-infection therapy, gamma globulin injection and skincare, the patient suffered from recurrent infection and was discharged from the hospital after giving up treatment and died of infection at two months old. Eleven NS cases were retrieved from literature and altogether 12 cases were analyzed here. The most common clinical manifestations in the 12 patients were early skin diffuse erythema and desquamation (12/12), infection (8/12), dry hair (7/12), hypernatremia dehydration (7/12), high IgE (5/12), growth retardation (4/12), respiratory failure (3/12), atopic constitution (2/12), diarrhea (2/12), dysphagia (1/12), hypothermia (1/12), wheezing (1/12), hypertension (1/12), liver failure (1/12) and metabolic alkalosis (1/12). Conclusions:NS is caused by SPINK5 gene mutation with atypical manifestations in neonates. Neonates with diffuse erythema and desquamation of the skin, repeated infections, dry hair and especially with high blood IgE should be considered the possibility of NS. Genetic testing is conducive to early diagnosis, guiding treatment decisions and providing a basis for genetic counseling.