Alzheimer’s disease (AD) is a prevalent neurodegenerative condition characterized by progressive cognitive decline and memory loss. As the incidence of AD continues to rise annually, researchers have shown keen interest in the active components found in natural plants and their neuroprotective effects against AD. Quercetin, a flavonol widely present in fruits and vegetables, has multiple biological effects including anticancer, anti-inflammatory, and antioxidant. Oxidative stress plays a central role in the pathogenesis of AD, and the antioxidant properties of quercetin are essential for its neuroprotective function. Quercetin can modulate multiple signaling pathways related to AD, such as Nrf2-ARE, JNK, p38 MAPK, PON2, PI3K/Akt, and PKC, all of which are closely related to oxidative stress. Furthermore, quercetin is capable of inhibiting the aggregation of β‑amyloid protein (Aβ) and the phosphorylation of tau protein, as well as the activity of β‑secretase 1 and acetylcholinesterase, thus slowing down the progression of the disease.The review also provides insights into the pharmacokinetic properties of quercetin, including its absorption, metabolism, and excretion, as well as its bioavailability challenges and clinical applications. To improve the bioavailability and enhance the targeting of quercetin, the potential of quercetin nanomedicine delivery systems in the treatment of AD is also discussed. In summary, the multifaceted mechanisms of quercetin against AD provide a new perspective for drug development. However, translating these findings into clinical practice requires overcoming current limitations and ongoing research. In this way, its therapeutic potential in the treatment of AD can be fully utilized.

In July 2024,the Diagnosis Related Groups(DRG)2.0 is released based on the Notice from the National Healthcare Security Administration on Issuing the DRG 2.0 and Deepening the Relevant Work.Compared with DRG 1.1,version 2.0 was established based on a wider range of suggestions regarding the Adjacent Diagnosis Related Groups(ADRG),Major Comorbidity or Complication(MCC),and Comorbidity or Complication(CC)from various institutions.A list of disease diagnoses and surgical operations that are not used as grouping rules was compiled,and grouping efficacy was further improved by upgrading the algorithms for MCC and CC with the help of AI.Meanwhile,it is necessary to pay more attention to the number of cases of ADRG,the better methods to list the MCC/CC,the suggestions of various doctors and continuously standardize the data and update the grouping scheme of DRG.

In July 2024,the Diagnosis Related Groups(DRG)2.0 is released based on the Notice from the National Healthcare Security Administration on Issuing the DRG 2.0 and Deepening the Relevant Work.Compared with DRG 1.1,version 2.0 was established based on a wider range of suggestions regarding the Adjacent Diagnosis Related Groups(ADRG),Major Comorbidity or Complication(MCC),and Comorbidity or Complication(CC)from various institutions.A list of disease diagnoses and surgical operations that are not used as grouping rules was compiled,and grouping efficacy was further improved by upgrading the algorithms for MCC and CC with the help of AI.Meanwhile,it is necessary to pay more attention to the number of cases of ADRG,the better methods to list the MCC/CC,the suggestions of various doctors and continuously standardize the data and update the grouping scheme of DRG.

Objective:To systematically evaluate the qualitative studies on the experience of role transition among caregivers of patients with young-onset dementia.Methods:A computer-based search was conducted in the Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc for qualitative studies on the experience of role transition among caregivers of patients with young-onset dementia. The retrieval time limit was from the establishment of the database to May 2024. The quality of the literature was evaluated by using the quality evaluation criteria of the Evidence-Based Health Care Center of the Joanna Briggs Institute, and the Meta-synthesis of the results was carried out by using the pooling integration method.Results:A total of 14 articles were included, 46 results were extracted, and nine categories were formed by induction. Three integration results were comprehensively obtained, namely, individuals and families were troubled by multiple problems, there was a strong demand for role support during the transition period, and positive coping led to role growth.Conclusions:Caregivers of patients with young-onset dementia have multiple problems and diverse care needs during the role transition period, and positive coping in this process can lead to role growth.

Objective To evaluate the feasibility and technical advantages of modified laparoscopic ileal-neobladder fistula repair.Methods A retrospective analysis was conducted on the clinical data of 4 patients who underwent radical cystectomy+orthotopic neobladder surgery and subsequently developed ileal-neobladder fistula and received modified repair surgery in our hospital during Jan.2019 and Dec.2023.Under laparoscopy,the ileum at both ends of the fistula was transected,and an end-to-end ileal anastomosis bypass was established.Results All 4 patients successfully completed the operation.Their age was 66,50,76 and 59 years,respectively.Ileal-neoblbladder fistula occurred 4,1,2 and 16 months after radical resection.The operation time was 129,98,105 and 90 minutes.The intraoperative blood loss was 50,60,70 and 50 mL.The postoperative exhaust time was 3,4,3 and 5 days.The postoperative hospital stay was 8,7,7 and 9 days,and the postoperative drainage tube indwelling time was 5,4,5 and 7 days.No obvious complications occurred after operation.During follow-up of 1 to 6 years,none recurrence or long-term stenosis of the intestinal anastomosis occurred.The symptoms of urinary tract infection improved significantly,and the bladder function remained stable.Conclusion The modified laparoscopic repair of ileal-neobladder fistula achieves minimally invasive repair by avoiding extensive adhesion separation.It has the advantages of safe operation,rapid recovery,and few complications,and is a safe option for the treatment of ileal-neobladder fistula.

Objective To preliminarily investigate the safety and efficacy of percutaneous microwave ab-lation(MWA)in patients with advanced breast cancer involving the skin or nipple-areola complex(NAC).Methods This study included breast cancer patients with skin or NAC involvement treated at the Fifth Medical Center of the Chinese PLA General Hospital from January 2011 to August 2024.Patients underwent percutaneous MWA with water isolation technique to protect surrounding tissues.Clinical data were retrospectively collected,and the technical success rate,complications,prognosis,patient satisfaction with breast aesthetics,and quality of life improvement were analyzed.Results A total of 19 patients(24 lesions)meeting the inclusion and ex-clusion criteria were analyzed.The cases included 4 with T4N0M0,2 with T4N1M0,3 with T4N2M0,1 with T4N3M0,1 with T4N2M1,and 8 with T4N3M1.The average diameter of the 24 lesions was(4.9±3.4)cm,with an average of(1.6±0.6)ablation sessions per lesion.The median ablation time was 36.9(26.1,61.7)minutes,and the median ablation energy was 84.2(45.6,149.2)kJ.The technical success rate was 100%.Postoperatively,7 patients(7/19,36.8%)experienced skin burns around the lesion or nipple shedding,all of which healed naturally.The median overall survival was 35.0(17.0,45.5)months,and the median recur-rence-free survival was 17.0(11.0,38.5)months.Patient satisfaction with post-treatment breast aesthetics was 89.5%,and all patients reported significant improvement in their quality of life.Conclusions Percutane-ous microwave ablation for breast cancer involving the skin or NAC was preliminary demonstrates to be safe and effective,suggesting its potential as a viable treatment option for patients with inoperable breast cancer.

Objective:To summarize the clinical characteristics, treatment, and prognosis of children with anti-GT1a antibody-positive Guillain-Barré syndrome (GBS).Methods:A case series study was conducted, including 25 children diagnosed with serum anti-GT1a antibody-positive GBS at Guangzhou Women and Children′s Medical Center from March 2019 to December 2024. Clinical data, treatment protocols, and follow-up outcomes were analyzed. Mann Whitney U test was used to compare the changes in Hughes functional grading scale (HFGS). Results:A total of 25 children included 12 boys and 13 girls, and the age at first onset was (71±8) months. There were 16 children (64%) had preceding infections, and of which 13 children had predominantly respiratory tract infections. At disease peak, neurological manifestations included limb weakness (21 cases (84%)), bulbar palsy (13 cases (52%)), drowsiness (7 cases (28%)), limb pain (9 cases (36%)), ataxia (6 cases (24%)), respiratory muscle paralysis (5 cases (20%)), ophthalmoplegia (5 cases (20%)), and unilateral facial nerve palsy (4 cases (16%)). Cerebrospinal fluid analysis in 23 children revealed albuminocytological dissociation in 18 children. All 25 children underwent whole-spine magnetic resonance imaging (MRI), demonstrated spinal nerve root enhancement in 18 children, with leptomeningeal enhancement combined with spinal nerve root enhancement in 1 child. Electromyography in 16 children showed 15 children abnormality, of which demyelinating lesions in 8 children, mixed demyelinating-axonal changes in 4 children, and pure axonal involvement in 3 children. Intravenous immunoglobulin (IVIG) was administered to 21 cases (84%), of which 3 children required mechanical ventilation and blood purification (plasma exchange in 2 children and immunoadsorption in 1 child) due to disease progression. Four children (16%) received intravenous methylprednisolone (IVMP) instead of IVIG, with 1 child requiring ventilatory support due to respiratory muscle paralysis, and the tracheal tube was removed after continued sequential IVMP treatment. The hospitalization duration of 25 children was (23±3) d. At discharge, HFGS was 1.6 (0.6, 2.7) score. At a follow-up of 12 (4, 18) months, HFGS was 0.1 (0.0, 0.5) score, and higher than that at discharge ( Z=4.38, P<0.05). Two children relapsed but achieved remission after IVIG retreatment with no recurrence during 1-year follow-up. Conclusions:Anti-GT1a antibody-positive GBS in children predominantly presents with limb weakness and bulbar palsy, occasionally complicated by respiratory failure in the acute phase. Demyelinating neuropathy and spinal nerve root enhancement on MRI are characteristic. IVIG therapy yields favorable outcomes, with low residual disability. Relapses are rare but manageable with re-treatment.

Chronic diseases in the elderly are characterised by high incidence rates and prolonged duration.Regular participation in multi-component exercise programs promotes both the physical and mental health of the elderly with chronic diseases and reduces the risk of morbidity,making it the key to prevent chronic diseases in the elderly.This review introduces the concepts of multi-component exercise,elucidates the mechanism in improvement of physical and cognitive functions and evaluates the applications as well as the advantages and disadvantages in the management of chronic diseases in the elderly.This review intends to provide references for clinicians who undertake management role of the chronic diseases in elderly populations.

Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

Based on the ultra performance liquid chromatography-quadrupole Exactive Orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap-MS) technology, combined with related literature, databases, and reference material information, this study qualitatively analyzed the components of Dayuanyin in the tissue of rats after gavage and employed molecular docking technology to predict the rationality of the mechanism behind the antipyretic effect of the in vivo components in Dayuanyin. A total of 21, 26, 20, 21, 14, and 31 prototype components and 3, 16, 3, 7, 5, and 24 metabolites were identified from the heart, liver, spleen, lung, kidney, and hypothalamus of the rats, respectively, and the binding ability of key components and targets was further verified by molecular docking. The results showed that all components had good binding ability with targets. The established UPLC-Q-Exactive Orbitrap-MS could effectively and quickly identify the Dayuanyin components distributed in tissue and preliminarily identify their metabolites. Many components were identified in the hypothalamus, which suggested that the components delivered to the brain should be focused on in the study on Dayuanyin in the treatment of febrile diseases. The molecular docking technology was used to predict the rationality of the mechanism behind its antipyretic effect, which lays the foundation for the clarification of the material basis and action mechanism of Dayuanyin, the development of new preparations, and the prediction of quality markers.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Rats ; Molecular Docking Simulation ; Male ; Antipyretics/metabolism* ; Rats, Sprague-Dawley ; Tissue Distribution ; Mass Spectrometry ; Chromatography, High Pressure Liquid ; Hypothalamus/metabolism*