Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

OBJECTIVE To investigate the worldwide outbreak incidents of Candida health care-associated infection so as to provide bases for clinical prevention and control of health care-associated infection.METHODS The data with the respect to outbreaks of Candida health care-associated infection from the database of global nosocomial in-fection outbreaks between its establishment and Mar.2024 were statistically analyzed.RESULTS There were 66 Candida outbreak incidents involving 22 regions,dominated by Europe and America.The worldwide outbreak inci-dents of Candida health care-associated infection generally showed a low prevalence and fluctuating upward trend.The outbreak incidents were highly prevalent in intensive care units(67.53％),with 15 department involved;neonatology department(27.27％),general surgery department(25.76％)and hematology/oncology department(16.67％)ranked the top 3.The young and middle-age adults(63.64％)and neonates(27.27％)were the major populations with predilections for the outbreak incidents,dominated by the population with bloodstream infection/sepsis(62.12％).The outbreak frequency of the non-Candida albicans was 81.82％,higher than 40.19％of the C.albicans.Healthcare workers(19.70％)and medical devices/instruments(15.15％)were the major infection sources.The major risk factors for the outbreaks included the bacterial carriers(48.48％),equipment contamina-ted with pathogens(24.24％),drugs contaminated with pathogens(21.21％).The transmission through contact(54.55％)was the major transmission route.Totally 12 items of prevention and control measures were taken for control of the outbreaks,including screening and surveillance,rigid implementation of hand hygiene,screening and surveillance of health care workers.CONCLUSIONS The outbreak incidents of Candida health care-associated infection are characterized by wide-range impact,various links involved,and great difficulties in prevention and control.It is necessary to formulate effective intervention measures based on the epidemiological characteristics of the outbreaks as early as possible so as to effectively prevent and control of the outbreaks.

Objective To explore the developmental trajectories of oral hygiene compliance and its influencing factors in children after dental caries surgery.Methods A prospective cohort study design was adopted.A total of 268 children who underwent dental caries surgery were selected as the research subjects.General and clinical data of the children were collected.The oral hygiene compli-ance changes after surgery were evaluated using the Oral Hygiene Compliance Scale.The develop-mental trajectories of oral hygiene compliance after surgery were described using the group-based traj-ectory model.Multivariate Logistic regression analysis was used to explore the influencing factors of the compliance developmental trajectories.Results The oral hygiene compliance of children after dental caries surgery could be divided into three types of developmental trajectories:the high-compliance slow-decline group[49(18.28％)],the medium-compliance slow-decline group[56(20.90％)],and the low-compliance stable-change group[163(60.82％)].Multivariate Logistic regression analysis showed that the child's gender,mother's educational level,fathers smoking history,annual per capi-ta household income,Social Support Scale score,Oral Health Self-Efficacy Scale score,and Expec-ted Social Impact Scale score were all independent influencing factors for the oral hygiene compliance to present different types of developmental trajectories(P＜0.05).Conclusion The oral hygiene compliance of children after dental caries surgery presents different types of developmental trajectories,and there are individual differences in their initial compliance levels and rates of change.Clinically,oral hygiene care intervention measures should be implemented according to the specific conditions of children to maintain their oral health.

Background Manganese is an essential trace element for the human body and maintains normal development of many organs including the brain. However, long-term exposure to a high manganese environment or excessive manganese intake will lead to manganese poisoning and result in neurological diseases, and currently no effective treatment plan is available. Objective To develop an animal model for subchronic manganese exposure and assess the impact of Dendrobium nobile Lindl. alkaloids (DNLA) on manganese associated behavioral and hippocampal effects in rats. Methods Fifty male SPF SD rats were randomly allocated into a control group (0.9% normal saline by intraperitoneal injection), two experimental groups [7.5 mg·kg⁻¹ (low) or 15 mg·kg⁻¹ (high) of MnCl₂·4H₂O by intraperitoneal injection], and two DNLA antagonistic groups [15 mg·kg⁻¹ MnCl₂·4H₂O by intraperitoneal injection then either 20 mg·kg⁻¹ (low) or 40 mg·kg⁻¹ (high) DNLA by oral administration]. All groups of rats were adminaistered 5 d per wek, once a day, for consecutive 13 weeks. Following modeling, neurobehavioral assessments were conducted using open field, Morris water maze, and Y maze. Inductively coupled plasma mass spectrometry (ICP-MS) was utilized to measure manganese levels in the blood and brain tissues of the rats, and hematoxylin-eosin (HE) staining was employed to examine neuronal morphological changes in the hippocampal tissues of the rats. Results The neurobehavioral tests revealed that the manganese-exposed rats exhibited decreased total movement distance, prolonged central zone dwelling time, and reduced motor activity in the open field test, indicating tendencies toward depression and anxiety (P<0.05). In the Y-maze test, the mean exploration distance in the novel arm, the number of entries into the novel arm, and the time spent in the novel arm of the managanses-exposed rats were all reduced, while the latency period increased, suggesting impaired spatial exploration and learning-memory functions (P<0.05). In the Morris water maze navigation test, the escape latency was significantly longer in the manganese-exposed rats compared to the control group, and the number of platform crossings decreased in the spatial probe test, indicating a significant decline in spatial learning and memory (P<0.05). The ICP-MS analysis showed elevated manganese concentrations in the blood and hippocampus of the exposed rats (P<0.05), and the histopathological observation revealed hippocampal damage. Following the DNLA intervention, the manganese-exposed rats showed increased total movement distance and reduced central zone dwelling time in the open field test (P<0.05). In the Y-maze test, the mean exploration distance in the novel arm, the number of entries into the novel arm, and the time spent in the novel arm increased, while the latency period decreased, suggesting alleviation of anxiety and improved exploratory behavior (P<0.05). In the Morris water maze test, the escape latency gradually shortened, and both the number of platform crossings and the percentage of time spent in the target quadrant increased, indicating improved spatial learning and memory (P<0.05). Additionally, the manganese levels in the blood and hippocampus decreased (P<0.05), and the hippocampal pathological changes were partially restored. Conclusion DNLA demonstrates the ability to counteract multiple neurotoxic effects following the elevation of manganese levels in the blood and hippocampal tissues of rats induced by subchronic manganese exposure. Specifically, DNLA is shown to ameliorate the behavioral alterations observed in rats after manganese exposure, and mitigate the hippocampal damage in manganese-exposed rats.

Objective:To evaluate immunotherapy combined with neoadjuvant chemotherapy before radical total gastrectomy in microsatellite stable locally advanced gastric cancer in two cases.Methods:Two male patients with clinical stage cT3N 1M0 and microsatellite-stable locally advanced gastric cancer were treated with neoadjuvant chemotherapy with PD-1 inhibitor (Nivolumab) combined with SOX (Oxaliplatin+S-1) for 4 cycles before surgery. Standard laparoscopic assisted total gastrectomy with D 2 lymphadenectomy was performed on Feb 2023 and Oct 2023 respectively after the neoadjuvant treatment. Pathological tumor regression grade(TRG) was observed to assess the degree of tumor regression, and follow-up was conducted to monitor tumor markers and abdominal enhanced CT to detect recurrence. Results:Two patients achieved pathological complete response(TRG0). They were followed up until May 2024 and no recurrence was observed.Conclusion:Preoperative combination of chemotherapy and immunotherapy may provide survival benefit for microsatellite stable locally advanced gastric cancer patients.

Cerebral small vessel disease is a group of age-related pathological syndromes with complex and diverse clinical symptoms.In the early stage,it is often asymptomatic or manifested as sleep or emotional disorders.Further disease development can lead to stroke or dementia,making it a crucial target for the early prevention and treatment of brain aging.Studies have shown that biological rhythm disorders are significantly associated with the onset,progression,and outcome of cardiovascular and cerebrovascular diseases.With the rapid development of modern society,the fast-paced lifestyle leads to the disorder of the body′s biological rhythm,thereby accelerating the aging process.However,few studies have investigated the correlation between cerebral small vessel disease and biological rhythm disorders in Western medicine.Sleep disorders and increased blood pressure variability related to cerebral small vessel disease may represent specific manifestations of biological rhythm disorders.The pathogenesis of cerebral small vessel disease is related to qi collaterals,and the biological rhythm disorder is mainly caused by the disorder of the growth and decline of yin and yang qi and the circulation of nutrient qi and defensive qi in the human body.Therefore,the disorder of qi rhythm may be involved in the early pathological mechanism of cerebral small vessel disease.By integrating Western medical research,this article explores the evolution of traditional Chinese medicine pathogenesis of cerebral small vessel disease associated with brain aging from the perspective of qi rhythm,aiming to provide novel diagnostic and treatment insights for the clinical treatment of cerebral small vessel disease.

Objective To analyze the global literatures related to Chikungunya fever(CHIKF),explore the re-search status,hotspots,and frontiers of CHIKF,and provide reference for researchers and clinical workers.Methods CHIKF-related literatures were retrieved from PubMed from 2010 to 2025.Bibliometrix and VOSviewer software were used for visualization analysis.Results From 2010 to 2025,a total of 834 CHIKF-related literatures were retrieved.The annual publication volume presented a fluctuating upward trend.The journal with the highest publication volume was PLoS Neglected Tropical Diseases(n=25,3.00％).The institution with the highest pub-lication volume was The University of Texas Medical Branch(n=36).The countries with the highest publication volume were Brazil(31.59％),India(15.52％),and the United States(10.43％).The countries with the top three citation rates were the United States(n=836),Brazil(n=671),and India(n=568).20.86％of the litera-tures had international cooperation,with the United States being the country with the most international coopera-tion.The keywords have shifted from"Chikungunya virus""infection""vector aedes"and"molecular biology mech-anism"during the period of 2010-2020 to"Chikungunya virus""vector mosq uito(Aedes aegypti)""immunity and vector control""related diseases(dengue fever)""vaccines",etc.during the period of 2021-2025.Conclusion The attention to CHIKF-related research continues to increase,and research direction is shifting from basic research to clinical applications.The development of antiviral drugs and vaccines may become a future focus.Strengthening international cooperation and optimizing resource allocation will be the key points to promoting the prevention and control of CHIKF.

Objective:To explore the real-life experiences of patients six months after laparoscopic sleeve gastrectomy (LSG), aiming to provide a reference for developing intervention plans.Methods:This was a descriptive phenomenological study. Purposeful sampling and maximum variation sampling were used to select 24 patients who underwent LSG at the Affiliated Hospital of Zunyi Medical University from February to August 2023. Semi-structured in-depth interviews were conducted, and the Colaizzi 7-step analysis method was applied to inductively extract and refine the themes.Results:A total of six main themes and ten sub-themes were identified through analysis. The main themes were: desires to improve postoperative physical symptoms (gastrointestinal symptoms, hair loss, neurological symptoms, and general symptoms) ; perception of subjective emotions (anxiety, regret, fear, and confidence) ; decreased social adaptability (decline in work ability, impaired social skills) ; general low compliance; desire for professional guidance; and postoperative benefit finding.Conclusions:Six months after LSG, patients primarily experienced physical symptom disturbances, poor psychological states, decreased social adaptability, low compliance, and a desire for professional guidance. However, they also recognized various benefits of the surgery. Healthcare providers should strengthen dynamic symptom assessments and management, guide patients psychologically, enhance social support, and actively improve follow-up and continuous care to help patients improve self-coping abilities and weight loss outcomes.

With the deepening of the aging population, China's healthcare resources and social security systems are facing increasingly significant challenges.Concurrently, the field of geriatric medicine is experiencing vigorous development, with the Chinese Medical Association playing a pivotal role in the discipline construction of geriatrics.This article will systematically outline the current development landscape, core achievements, existing challenges, and future directions of geriatric medicine in China.

Cerebral small vessel disease is a group of age-related pathological syndromes with complex and diverse clinical symptoms.In the early stage,it is often asymptomatic or manifested as sleep or emotional disorders.Further disease development can lead to stroke or dementia,making it a crucial target for the early prevention and treatment of brain aging.Studies have shown that biological rhythm disorders are significantly associated with the onset,progression,and outcome of cardiovascular and cerebrovascular diseases.With the rapid development of modern society,the fast-paced lifestyle leads to the disorder of the body′s biological rhythm,thereby accelerating the aging process.However,few studies have investigated the correlation between cerebral small vessel disease and biological rhythm disorders in Western medicine.Sleep disorders and increased blood pressure variability related to cerebral small vessel disease may represent specific manifestations of biological rhythm disorders.The pathogenesis of cerebral small vessel disease is related to qi collaterals,and the biological rhythm disorder is mainly caused by the disorder of the growth and decline of yin and yang qi and the circulation of nutrient qi and defensive qi in the human body.Therefore,the disorder of qi rhythm may be involved in the early pathological mechanism of cerebral small vessel disease.By integrating Western medical research,this article explores the evolution of traditional Chinese medicine pathogenesis of cerebral small vessel disease associated with brain aging from the perspective of qi rhythm,aiming to provide novel diagnostic and treatment insights for the clinical treatment of cerebral small vessel disease.