Objective To evaluate the clinical application of CT-guided coaxial needle biopsy in pancreatic puncture-cutting biopsy via adipose tissue space.Methods The clinical data of 30 patients,who received CT-guided pancreatic coaxial needle biopsy via adipose tissue space at the Pingdu Hospital Area of Affiliated Hospital of Qingdao University of China from June 2021 to April 2024,were retrospectively analyzed.The patients included 20 males and 10 females with a mean age of(65.1±8.7)years.The lesions were located in the pancreatic head(n=7),pancreatic neck(n=4),pancreatic body(n=7),pancreatic tail(n=10)and uncinate process(n=2).Under CT guidance,a 17 G co-axial guiding needle was inserted to establish a puncture pass through adipose tissue space,then an 18 G biopsy needle was used to make tissue sampling.A total of 32 procedures of pancreatic puncture-cutting biopsy were performed,two of these patients received two times of biopsy.After sampling,a self-made blocking agent(a mixed liquid of gelatin sponge particles and snake venom hemagglutinin),was used to occlude the puncture channel so as to prevent complications such as bleeding,pancreatic leakage,needle tract implantation metastasis,etc.Results A total of 32 procedures of pancreatic puncture-cutting biopsy with coaxial guiding needle via adipose tissue space were performed,including two patients who received two times of biopsy.The success rate of puncturing was 100％(32/32),the success rate of sampling was 93.8％(30/32),and the accuracy of sampling was 93.8％(30/32).No serious puncture-related complications occurred in all patients.Conclusion CT-guided pancreatic coaxial needle biopsy via adipose tissue space is clinically safe,accurate in sampling and minimally-invasive.This interventional diagnostic technique is worth applying in clinical practice.

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Premature ovarian insufficiency(POI)is a disease that seriously affects the health and life of women,which is also one of the main causes of female infertility.The incidence of POI is increasing in recent years.The diagnostic criteria of POI are not uniform,and different diagnostic criteria have inconsistent thresholds for various indicators.Strict diagnostic criteria are more conducive to early detection and treatment of POI.At present,complementary and alternative therapies such as traditional Chinese medicine,acupuncture and moxibustion are widely used in the treatment of POI.This article reviewed the recent studies on the complementary and alternative therapy of traditional Chinese medicine in the treatment of POI,and finds that the dialectical treatment of traditional Chinese medicine is based on the perspective of traditional Chinese medicine theory and puts forward corresponding treatment plans for different dialectical types.For example,treatment from the kidney,tonifying kidney filling essence,regulating chongren;Treatment from the liver,soothing the liver,regulating qi,nourishing blood and softening the liver;Treatment from the heart and spleen,nourishing Yangming,tonifying the spleen and nourishing the heart.In terms of acupuncture treatment,regulating menstruation and promoting pregnancy and regulating the conception vessel and toning the governor vessel and toning the kidney are often used to treat POI.In addition,moxibustion regulates body function by stimulating the bladder meridian and conception vessel and governor vessel acupoints.Other methods,such as ear acupoint bean-pressing,acupoint thread-embedding and acupoint injection,have also shown potential in the treatment of POI.This article summarizes the role and characteristics of traditional Chinese medicine in the treatment of POI,in order to provide ideas and basis for clinical treatment of POI.

Premature ovarian insufficiency(POI)is a disease that seriously affects the health and life of women,which is also one of the main causes of female infertility.The incidence of POI is increasing in recent years.The diagnostic criteria of POI are not uniform,and different diagnostic criteria have inconsistent thresholds for various indicators.Strict diagnostic criteria are more conducive to early detection and treatment of POI.At present,complementary and alternative therapies such as traditional Chinese medicine,acupuncture and moxibustion are widely used in the treatment of POI.This article reviewed the recent studies on the complementary and alternative therapy of traditional Chinese medicine in the treatment of POI,and finds that the dialectical treatment of traditional Chinese medicine is based on the perspective of traditional Chinese medicine theory and puts forward corresponding treatment plans for different dialectical types.For example,treatment from the kidney,tonifying kidney filling essence,regulating chongren;Treatment from the liver,soothing the liver,regulating qi,nourishing blood and softening the liver;Treatment from the heart and spleen,nourishing Yangming,tonifying the spleen and nourishing the heart.In terms of acupuncture treatment,regulating menstruation and promoting pregnancy and regulating the conception vessel and toning the governor vessel and toning the kidney are often used to treat POI.In addition,moxibustion regulates body function by stimulating the bladder meridian and conception vessel and governor vessel acupoints.Other methods,such as ear acupoint bean-pressing,acupoint thread-embedding and acupoint injection,have also shown potential in the treatment of POI.This article summarizes the role and characteristics of traditional Chinese medicine in the treatment of POI,in order to provide ideas and basis for clinical treatment of POI.

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Objective:To construct a clinical skills practice training model for pelvic floor rehabilitation specialist nurses based on the Taylor model, providing reference for cultivating the practical abilities of pelvic floor rehabilitation nurses.Methods:Based on the Taylor model, a preliminary draft of the clinical skills practice training model for pelvic floor rehabilitation specialist nurses was formulated through literature review, semi-structured interviews, and group discussions. From July to August 2023, 17 experts in nursing education, medical care, and pelvic floor rehabilitation nursing were invited to conduct two rounds of Delphi expert consultations to determine the various indicators of the training model. Analytic hierarchy process was used to determine the weights of indicators at all levels.Results:In the two rounds of consultation, the effective response rates of the questionnaires were all 100.00% (17/17), and the expert authority coefficients were 0.876. Kendall harmony coefficients of various indicators were 0.106 to 0.235 and 0.204 to 0.235 ( P<0.05). A clinical skills practice training model for pelvic floor rehabilitation specialist nurses was ultimately developed, which included three primary indicators, 12 secondary indicators, and 32 tertiary indicators. Analytic hierarchy process showed that the consistency ratios of each matrix for the tertiary indicators were all less than 0.100, passing the consistency test. Conclusions:The clinical skills practice training model for pelvic floor rehabilitation specialist nurses constructed highlights nursing characteristics, has high reliability and practicality, and can provide reference for practical training of pelvic floor rehabilitation skills.

Objective:To discuss the postoperative survival of the gastric cancer patients with different expression levels of myeloid ecotropic viral integration site 1(MEIS1),and to analyze the predictive value of MEIS1 expression in the prognosis evaluation of gastric cancer.Methods:In a gastric cancer survival cohort,215 patients who underwent radical gastrectomy were selected.Immunohistochemical staining was used to detect the expression levels of MEIS1 in both gastric cancer and adjacent normal tissues.The relationship between expression level of MEIS1 and the clinicopathological characteristics of the patients were analyzed by x2 test or Fisher's exact probability method;survival curves were plotted by Kaplan-Meier method;the differences in survival of the patients between MEIS1 high expression group and MEIS1 low expression group were compared by Log-rank test;multivariate Cox proportional hazards regression model was used to calculate the hazard ratios(HR)and 95％confidence intervals(CI)to assess the relationship between MEIS1 expression level and the survival of the gastric cancer patients.Results:The immunohistochemical staining result showed that the expression level of MEIS1 in gastric cancer tissue was decreased.The univariate analysis results showed that the patients with high MEIS1 expression had a longer overall survival than those with low expression(P=0.049),and had a better prognosis.The multivariate Cox proprotional hazards regression analysis results showed that the low MEIS1 expression and high TNM stage were the independent risk factors for poor prognosis of the patients with gastric cancer(HR=1.577,95％CI:1.011-2.460,P=0.045;HR=2.709,95％CI:1.708-4.297,P＜0.001).Conclusion:The gastric cancer patients with low expression of ME1S1 have a shorter postoperative overall survival;MEIS1 is a promising biomarker for prognosis assessment of the patients after radical gastrectomy.

To explore the clinical and genetic features of Aicardi-Goutières syndrome (AGS) caused by IFIH1 gene mutation.

Pelvic inflammatory disease （PID） is an infection of women's reproductive organs， which lasts a long time and features frequent recurrence. It is mainly caused by apoptosis， low immunity， abnormal metabolism and blood rheology indexes， and bacterial imbalance. The pathological manifestations are tissue adhesion， fibrosis， and chronic inflammation， and inflammatory response occurs in the whole process of this disease. Therefore， interfering with the inflammatory response tends to be a solution. A few therapies are available in western medicine and antibiotics are commonly used. However， antibiotic resistance is still a bottleneck in the treatment and thus the symptoms of patients fail to be obviously relieved， with pelvic tissue adhesions remained. In the treatment of inflammation， traditional Chinese medicine has remarkable effect and internal-use and external-use medicines are both used， such as oral Chinese medicinal decoction， Chinese medicine enema， Chinese medicine iontophoresis， and acupuncture. They exert therapeutic effect by regulating the conduction of related signaling pathways and influencing the expression of inflammatory cytokines. At the moment， most articles focus on the efficacy of traditional Chinese medicine in the treatment of PID， and there is a lack of summary on traditional Chinese medicine regulation of relevant signaling pathways and the pathogenesis of PID. Therefore， by summarizing relevant research， this review proposed five signaling pathways related to the occurrence of this disease， namely， transforming growth factor-β/Smads protein （TGF-β/Smads） signaling pathway， Janus kinase/signal transducer and transcription activator （JAK/STAT） signaling pathway， nuclear factor-κB （NF-κB） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， and Hippo signaling pathway， and described the pathogenesis of this disease. Thereby， this study is expected to provide effective targets and ideas for the treatment of this disease.

Objective:To explore the effect of epalrestat combined with calcium dobesilate on cardiovascular and cerebrovascular diseases and oxidative stress in diabetes patients with peripheral neuropathy.Methods:In a retrospective analysis, 92 patients with diabetic peripheral neuropathy were admitted to the Department of Endocrinology and Metabolism Hospital of Bozhou People’s Hospital from Jun. 2018 to Jun. 2021, which were divided into observation group and control group according to the different treatment methods, with 46 cases in each group. The control group were treated with epalrestat. On this basis, the observation group were given calcium dobesilate combined treatment. The two groups were compared in terms of the Michigan diabetes neuropathy score (MDNS) Michigan neuropathy screening instrument (MNSI) score, oxidative stress reaction [serum superoxide dismutase (SOD), reduced glutathione (GSH) ], clinical efficacy, complications and adverse reactions Using t-test and chi square test.Result:After treatment, the MDNS and MNSI scores of both groups decreased, and the observation group [ (23.49±3.73), (8.49±1.97) ] were lower than the control group [ (28.49±3.85), (11.53±2.28) ] ( t=8.337, 6.843, P<0.05) ; After treatment, the levels of SOD and GSH in both groups increased compared to those before treatment, and the observation group [ (38.96±4.89), (89.79±6.92) ] were higher than the control group those [ (36.42±4.61), (86.74±6.20) ] ( t=2.563, 2.226, P=0.012, 0.028) ; The clinical efficacy of the observation group was higher than that of the control group ( Z=1.592, P=0.042) ; The incidence of complications in the observation group after 1 year was significantly lower than that in the control group ( χ2=4.389, P=0.036) ; The incidence of adverse reactions in the observation group was slightly lower than that in the control group ( χ2=0.155, P=0.694) . Conclusion:Epalrestat combined with calcium dobesilate is effective in the treatment of diabetes peripheral neuropathy, can effectively reduce complications, and has high treatment safety, which is worthy of clinical application.