This article summarizes the nursing experience of a patient with cold agglutinin syndrome who experienced 2 sudden cardiac arrests.The nursing key points included:balancing the contradiction between hypothermia rewarming and head therapeutic hypothermia,thereby optimizing the temperature management strategy;controlling the entire process to ensure the safety of blood transfusion;conducting dynamic assessment and monitoring of coagulation function,preventing both bleeding and thrombosis;timing of nutritional therapy and progressive feeding at the right time;multidisciplinary collaboration was implemented to carry out a rehabilitation activity plan during continuous renal replacement therapy;preventing ICU delirium.With comprehensive treatment and meticulous nursing care provided by the multidisciplinary team,the patient was discharged in good condition after 22 days of hospitalization,and has resumed his daily working life after 3 months of follow-up.

Selenoproteins, as the active form of selenium, play an important role in various physiological and pathological processes, such as anti-oxidation, anti-tumor, immune response, metabolic regulation, reproduction and aging. Although the expression level of selenoproteins in adipose tissue is significantly influenced by dietary selenium intake, it is closely related to the homeostasis of adipose tissue. In this review, we summarized the role of selenoproteins in the physiological function of adipose tissue and the pathogenesis of obesity in recent years, in order to provide a rationale for developing potential therapeutic agents for the treatment of obesity and related metabolic diseases.
Selenoproteins/metabolism* ; Adipose Tissue/physiology* ; Obesity/metabolism* ; Humans ; Animals ; Selenium

Objective To analysis the efficacy and safety of antiviral therapy in patients with chronic hepatitis B virus in indeterminate phase based on the new guidelines(2022 Edition of the Guidelines for the Prevention and Treatment of Chronic Hepatitis B).Methods A total of 170 patients with newly diagnosed HBV infection who visited the Third People's Hospital of Kunming from August 1,2020,to July 31,2024,were selected as study subjects.The clinical indicators of patients with normal ALT in the indeterminate phase were analyzed after 12 weeks,24 weeks,and 48 weeks of antiviral treatment,as well as those who did not receive antiviral treatment for 48 weeks.Results(1)Among the 170 patients with normal ALT during the indeterminate phase of HBV infection,the treatment group consisted of 125 patients(36 HBeAg positive and 89 HBeAg negative),while the untreated group had 45 patients.In the treatment group,the HBV-DNA load and HBsAg titer decreased significantly after 48 weeks compared to before treatment,with statistically significant differences(both P<0.05).In the untreated group,the HBV-DNA load showed an upward trend,and the HBsAg titer slightly decreased,with statistically significant differences(both P<0.05).(2)The CVR rate in the treatment group after 48 weeks was 66.67%(24/36)for HBeAg positive patients and 95.51%(85/89)for HBeAg negative patients,with a statistically significant difference(P<0.05).(3)The treatment group showed a significant decrease in GGT and AFP after 48 weeks compared to before treatment,while the untreated group saw an increase in ALT,GGT,and AFP,with statistically significant differences(all P<0.05).(4)The fibrosis indicators APRI,FIB-4,and LSM in the treatment group significantly decreased after 48 weeks compared to before treatment,with statistically significant differences(all P<0.05).(5)The safety indicators CREA,blood calcium,and blood phosphorus in the treatment group significantly decreased after 48 weeks compared to before treatment,with statistically significant differences(all P<0.05).Conclusion Expanding the antiviral treatment indications according to the new guidelines for patients with normal ALT in the indeterminate phase of HBV infection demonstrates good efficacy in controlling HBV-DNA,improving CVR rates,and enhancing fibrosis indicators,while also showing favorable renal safety.However,there may be a risk of osteoporosis due to calcium and phosphorus metabolism disorders,necessitating enhanced monitoring and prevention.

Villitis of unknown etiology (VUE) occurs in up to 15% of term placentas. Patients with VUE exhibit increased incidence of gestational diabetes mellitus, gestational hypertension, and preeclampsia, with demonstrated recurrence risk. VUE contributes to various adverse pregnancy outcomes. Its pathogenesis involves abnormal maternal immune responses against fetal allografts and may relate to unidentified microbial infections. Currently, VUE diagnosis relies exclusively on placental pathological examination. Clinical management remains primarily symptomatic, though immunomodulatory therapies show potential. This review summarizes recent advances in VUE epidemiology, pathogenesis, clinical significance, pathological features, and preventive strategies, aiming to enhance clinical understanding of this condition.

Objective:To investigate the association between prenatal environmental factors and attention defi-cit hyperactivity disorder(ADHD)and its symptom severity in children.Methods:Based on the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)diagnosis criteria,1 156 children with ADHD and 289 normal control children were included in this study.ADHD diagnoses were established using the Clinical Diag-nostic Interview Scale,core symptoms were assessed with the ADHD Rating Scale,and information on prenatal ex-posures were collected via self-developed questionnaires.Results:Maternal stress during pregnancy was associated with increased risk factor of ADHD in children(OR=1.22,P＜0.01).Among children with ADHD,preconception paternal alcohol consumption was positively associated with hyperactivity/impulsivity symptoms(β=0.08,P＜0.05),and maternal smoking during pregnancy was positively associated with total symptoms(β=0.07-0.09,P＜0.05).Conclusion:Maternal stress during pregnancy may increase the risk factor of ADHD in children.Both pre-conception paternal alcohol consumption and maternal smoking during pregnancy may be associated with increased ADHD symptom severity in children.

Objective:To evaluate the clinical efficacy of methylation sensitive-high resolution melting curve (MS-HRM) detection of IFN-induced protein 44-like (IFI44L) gene methylation in the diagnosis of systemic lupus erythematosus (SLE), as well as the relationship between IFI44L gene markers and the early onset of SLE.Methods:From February 2020 to September 2022, the MS-HRM was used to detect the methylation level of the IFI44L gene in peripheral blood mononuclear cells of 602 SLE patients and 524 other autoimmune disease patients (excluding SLE) from Beijing Peking Union Medical College Hospital, Guangdong Provincial People′s Hospital, and Shenzhen People′s Hospital, totaling 1 126 patients. Compared with the 2012 SLICC criteria, the suspected cases were followed up for 6 months until the onset and clinical diagnosis of SLE were confirmed. The measurement data of normal distribution were expressed as mean±SD, and the consistency analysis was performed using the Kappa consistency test. The clinical diagnostic efficacy indicators were calculated using the receiver operating characteristic (ROC) curve. Results:RR (95% CI) of early suspected cases was 17.06 (9.43, 30.82). The results of IFI44L gene methylation level were in good agreement with the 2012 SLICC criteria, and the sensitivity, specificity and total coincidence rate were 90.53%, 92.56% and 91.47%, respectively. The Kappa value (95% CI) was 0.829(0.796, 0.862) ( P<0.001). The diagnostic efficiency of IFI44L gene methylation level ( Kappa value 0.817) was superior to anti-nuclear antibody, anti-SM antibody and anti-dsDNA antibody ( Kappa value 0.418, 0.216 and 0.440, respectively). The Kappa values (95% CI) of methylation between MS-HRM and pyrosequencing was 0.861(0.806, 0.916), P<0.001. Conclusion:The hypomethylation of IFI44L gene methylation level detected by MS-HRM is closely related to the occurrence and development of SLE, and its diagnostic performance is better than that of three autoantibodies in SLE diagnosis, which can be used for the early diagnosis of SLE.

Objective:To investigate the characteristics and clinical effects of laparoscopic pneumovesical Cohen and laparoscopic Lich-Gregoir ureteral replantations for the treatment of primary obstructive megaloureter (POM) in children.Methods:A randomized controlled study was conducted.The clinical data of 51 children with unilateral POM admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2023 were collected.Random number table method was used in the selection of surgical methods.They were divided into the laparoscopic pneumovesical Cohen ureteral replantation group (group A, 22 cases) and the laparoscopic Lich-Gregoir ureteral replantation group (group B, 29 cases) according to the surgical method.The anterior-posterior diameter(APD), maximum ureteral diameter and differential renal function parameters on the affected side were measured by color Doppler ultrasound of the urinary system, and compared between and within the two groups before and after surgery.The operation time, blood loss and postoperative intubation time were compared between the two groups.The incidence of postoperative complications such as reflux, bladder spasm, urinary retention and urinary tract infection was recorded.The independent and paired sample t-tests were used for statistical analysis. Results:The operation time and hematuria duration of group B [(125.7±14.2) min, (1.5±0.6) d] were significantly shorter than those of group A [(142.6±14.7) min, (2.8±0.7) d] (all P<0.05). The APD, maximum ureteral diameter, and differential renal function on the affected side of group A were (21.7±7.9) mm, (11.6±3.2) mm, and (28.2±4.9)% before surgery, and (10.3±4.5) mm, (6.0±2.0) mm and (43.8±4.4)% after surgery, respectively.The APD, maximum ureteral diameter, and differential renal function on the affected side of group B were (21.1±5.6) mm, (11.3±4.6) mm, and (30.2±5.5)% before surgery, and (10.2±4.5) mm, (6.6±2.0) mm, and (42.4±5.2)% after surgery, respectively.There was no statistically significant difference in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the two groups of children (all P>0.05). However, there were statistically significant differences in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the same group of children (all P<0.01). No significant difference was found in intraoperative blood loss, postoperative intubation time, and postoperative complications between the two groups (all P>0.05). Conclusions:Both surgical methods are effective in the treatment of POM in children.Laparoscopic Lich-Gregoir ureteral replantation has advantages of less operation time compared with laparoscopic pneumovesical Cohen ureteral replantation.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.

Objective: This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals. Methods: A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test. Results: AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05). Conclusion These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.