BACKGROUND: Inflammation plays a critical role in severe cerebral venous thrombosis (CVT) pathogenesis, but the benefits of anti-inflammatory therapies remain unclear. This study aimed to investigate the association between steroid therapy combined with anticoagulation and the prognosis of acute/subacute severe CVT patients. METHODS: A prospective cohort study enrolled patients with acute/subacute severe CVT at Xuanwu Hospital (July 2020-January 2024). Patients were allocated into steroid and non-steroid groups based on the treatment they received. Functional outcomes (modified Rankin scale [mRS]) were evaluated at admission, discharge, and 6 months after discharge. Serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), cerebrospinal fluid (CSF) IL-6, and intracranial pressure were measured at admission and discharge in the steroid group. Fundoscopic Frisén grades were assessed at admission and 6 months after discharge. Univariate and multivariate logistic regression were used to evaluat associations between steroid use and favorable outcomes (mRS ≤2) at the 6-month follow-up. Paired tests assessed changes in hs-CRP and other variables before and after treatment, and Spearman's correlations were used to analyze relationships between these changes and functional improvements. RESULTS: A total of 107 and 58 patients in the steroid and non-steroid groups, respectively, were included in the analysis. Compared with the non-steroid group, the steroid group had a higher likelihood of achieving an mRS score of 0-2 (93.5% vs . 82.5%, odds ratio [OR] = 2.98, P  = 0.037) at the 6-month follow-up. After adjusting for confounding factors, the result remained consistent. Pulsed steroid therapy did not increase mortality during hospitalization or follow-up, nor did it lead to severe steroid-related complications (all P  >0.05). Patients in the steroid group showed a significant reduction in serum hs-CRP, IL-6, CSF IL-6, and intracranial pressure at discharge compared to at admission, as well as a significant reduction in the fundoscopic Frisén grade at the 6-month follow-up compare to at admission (all P  <0.001). A reduction in serum inflammatory marker levels during hospitalization positively correlated with improvements in functional outcomes ( P  <0.05). CONCLUSION: Short-term steroid use may be an effective and safe adjuvant therapy for acute/subacute severe CVT when used alongside standard anticoagulant treatments, which are likely due to suppression of the inflammatory response. However, these findings require further validation in randomized controlled trials. TRAIL REGISTRATION ClinicalTrials.gov , NCT05990894.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Anticoagulants/therapeutic use* ; C-Reactive Protein/metabolism* ; Interleukin-6/metabolism* ; Intracranial Thrombosis/drug therapy* ; Prospective Studies ; Steroids/therapeutic use* ; Venous Thrombosis/drug therapy*

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with Aicardi-Goutières syndrome 3 (AGS3). METHODS: Trio whole exome sequencing was carried out for the child and his parents, and candidate variants were verified by Sanger sequencing. To further clarify their pathogenicity, the crystal structure of the variants was simulated and analyzed, and the plasmid of variants was expressed in vitro. A literature search was also carried out to summarize the phenotypic and genetic characteristics of AGS3. RESULTS: The child was found to harbor novel compound heterozygous variants of the RNASEH2C gene, namely c.434G>T (p.Arg145Leu) and c.494G>C (p.Ter165Ser), which were inherited from his mother and father, respectively. Analysis of protein crystal structure suggested that the c.434G>T (p.Arg145Leu) variant may affect the stability of local structure, and in vitro experiments showed that this variant can lead to protein degradation. The c.494G>C (p.Ter165Ser) variant has destroyed the stop codon, resulting in prolonged variant. CONCLUSION The novel compound heterozygous variants of the RNASEH2C gene probably underlay the AGS3 in this child, which has enriched the phenotypic and mutational spectrum of this disorder.
Humans ; Child ; Mutation ; Autoimmune Diseases of the Nervous System/genetics* ; Nervous System Malformations/genetics*

Objective:To explore the application effect of TBL (team-based learning) + PAL (peer assisted leaning) + Flipped Class mixed teaching mode in the course of "nursing psychology" for nursing undergraduates.Methods:A total of 146 nursing undergraduates from four classes enrolled in 2018 were subjected to cluster sampling and assigned to classes 1-2 (experimental group, n=73) and classes 3-4 (control group, n=73). The experimental group adopted the TBL + PAL + Flipped Class mixed teaching mode, while the control group adopted the traditional teaching method. After the course, the two groups were evaluated by final exam score, case analysis score, and core competence self-assessed score with a t-test in SPSS 18.0. Results:The final examination score (82.30±7.77) and case analysis score (46.13±2.91) of the experimental group were significantly higher than those in the control group (74.97±7.05 and 40.36±4.25). The experimental group showed significantly higher scores in autonomous learning ability (8.03±0.91), problem analysis ability (7.99±0.99), teamwork ability (7.67±1.09) and critical thinking ability (7.03±1.33) as compared with the control group (6.21±1.17, 5.64±1.28, 5.79±1.27, 5.15±1.16).Conclusion:TBL + PAL + Flipped Class mixed teaching mode integrates the advantages of the three teaching forms, promotes students' understanding and application of knowledge points, improves students' ability of independent learning, teamwork, and problem analysis, strengthens students' ability of transfer and application of knowledge and skills, increases the teaching effect, and expands the teaching method of nursing psychology.

Objective:To explore the effect of swallowing training combined with respiratory intervention on the swallowing function and early neurodevelopment of preterm infants.Methods:Sixty-two preterm infants in neonatal intensive care were randomly divided into a study group of 30 and a control group of 32. All received routine treatment and nursing care plus touching, but the study group was additionally provided with swallowing and respiratory training. The duration of gastric tube use was observed, and a 20-item neonatal behavioral neurological assessment (NBNA) was administered at 40 weeks of corrected gestational age.Results:The average period of gastric intubation in the study group [(56.27±22.26) days] was significantly shorter than the control group′s average [(68.97±23.96) days]. The study group′s average NBNA score was significantly higher. Moreover, the NBNA scores were significantly negatively correlated with the intubation times.Conclusions:Swallowing training combined with respiratory intervention can improve the swallowing function of preterm infants, shorten the time a gastric tube is needed, and improve their early neurodevelopment.

Objective To explore the therapeutic mechanism of kidney-reinforcing,blood-activating and phlegmresolving therapy for left ventricular fibrosis of spontaneously hypertensive rats (SHR).Methods Twenty SHR were randomly assigned to Chinese medicine group and model group.Additionally,ten Wistar-Kyoto(WKY) rats served as normal control group.After 12-week prevention,Masson staining method was used to measure the degree of fibrosis of left ventricular myocardial tissues,reverse transcription-polymerase chain reaction(RT-PCR) was used to detect Smad3 mRNA expression,and Western blotting method was used for the detection of Smad3 protein expression.Results The degree of left ventricular fibrosis myocardial tissue in Chinese medicine group was milder than that in the model group,and Samd3 protein and mRNA expression levels in Chinese medicine group were lower than those in the model group (P ＜ 0.05).Conclusion Kidney-reinforcing,blood-activating and phlegmresolving therapy can improve left ventricular fibrosis in SHR by inhibiting Smad3 expression.

The organisms in pathologic tissues of sporotrichosis were detected by ABC technique. Brown spores were found, some spores appeared to be round, or pearshaped,budding spores or asteriod hotlies were observed, and some spores were phagocytlzed by leukocytes and macrophages. The diameter of spores ranged from 2. spin to 10. 0um. The sensitivity of this method is 96. 2% and the specificity 100%. Examining one case takes about three hours. The method can be used for retrospective study, as well as rapid diagnosis of sporotrichosis.