Myosteatosis is one of the common complications in patients with end-stage liver disease, which is significantly associated with poor outcomes after liver transplantation. Currently, diagnostic criteria of myosteatosis have not been established, and CT is the most commonly used for diagnosis. The pathogenesis of myosteatosis is multifactorial, and the pathophysiological mechanisms linking it to end-stage liver disease are not fully understood. An increasing number of scholars have recognized that the severity of myosteatosis is closely related to its clinical consequences, but there are no effective treatment options available. This article reviews the pathophysiological mechanisms and diagnostic methods of myosteatosis, and its impact on the prognosis of liver transplant recipients, and discusses current treatment strategies to provide references for the perioperative management of liver transplant recipients.

COMPERA 2.0 risk stratification has been demonstrated to be useful in patients with precapillary pulmonary hypertension (PH). However, its suitability for patients at risk for post-capillary PH or PH associated with left heart disease (PH-LHD) is unclear. To investigate the use of COMPERA 2.0 in patients with severe aortic stenosis (SAS) undergoing transcatheter aortic valve replacement (TAVR), who are at risk for post-capillary PH, a total of 327 eligible SAS patients undergoing TAVR at our institution between September 2015 and November 2020 were included in the study. Patients were classified into four strata before and after TAVR using the COMPERA 2.0 risk score. The primary endpoint was all-cause mortality. Survival analysis was performed using Kaplan-Meier curves, log-rank test, and Cox proportional hazards regression model. The study cohort had a median (interquartile range) age of 76 (70‒80) years and a pulmonary arterial systolic pressure of 33 (27‒43) mmHg (1 mmHg=0.133 kPa) before TAVR. The overall mortality was 11.9% during 26 (15‒47) months of follow-up. Before TAVR, cumulative mortality was higher with an increase in the risk stratum level (log-rank, both P<0.001); each increase in the risk stratum level resulted in an increased risk of death (hazard ratio (HR) 2.53, 95% confidential interval (CI) 1.54‒4.18, P<0.001), which was independent of age, sex, estimated glomerular filtration rate (eGFR), hemoglobin, albumin, and valve type (HR 1.76, 95% CI 1.01‒3.07, P=0.047). Similar results were observed at 30 d after TAVR. COMPERA 2.0 can serve as a useful tool for risk stratification in patients with SAS undergoing TAVR, indicating its potential application in the management of PH-LHD. Further validation is needed in patients with confirmed post-capillary PH by right heart catheterization.
Humans ; Aortic Valve Stenosis/complications* ; Aged ; Hypertension, Pulmonary/mortality* ; Male ; Female ; Transcatheter Aortic Valve Replacement ; Aged, 80 and over ; Risk Assessment/methods* ; Proportional Hazards Models ; Kaplan-Meier Estimate ; Retrospective Studies

Background::Uterine fibroids (UFs), the most common tumors in women worldwide, may reduce quality of life and daily activities and even lead to adverse fertility and general health events in patients, causing significant societal health and financial burdens. The objective of this study was to evaluate the global burden through epidemiological trends and examine the potential risk factors for UFs at the national level.Methods::Data on the incidence, prevalence, disability-adjusted life years (DALYs), age-standardized incidence rates (ASIRs), age-standardized prevalence rates (ASPRs), and age-standardized DALY rates for UFs were collected, and the associations with the Human Development Index (HDI) and fertility were evaluated. The age trends in the average annual percent change (AAPC) of the incidence and prevalence rates of UFs were evaluated by joinpoint regression analysis. The associations between lifestyle, metabolic, and socioeconomic factors and the ASIRs of UFs were examined using multivariable linear regression analysis.Results::The worldwide incidence and prevalence of UFs have been increasing in the past decade, with AAPCs of 0.27% in the incidence rate and 0.078% in the prevalence rate. During 2010-2019, significant increasing trends in UF ASIR were observed in 52 of 88 countries. The age-specific incidence and prevalence of UFs in most age groups showed increasing trends except for 45-54-year-old women which showed no significant trend. Ecological analysis demonstrated no relationship between the incidence of UFs and the HDI but an inverse association with fertility. The incidence of UFs was positively correlated with alcohol intake, hypertension, overweight, and obesity and negatively correlated with smoking.Conclusion::With the increasing incidence and prevalence worldwide, effective targeted prevention and control of relevant risk factors at the national level should be encouraged to reduce the disease burden of UFs.

Objective:To investigate the application of Wuxing music combined with traditional Chinese medicine bath and golden paste encapsulation in patients with psoriasis vulgaris(blood-heat syndrome).Methods:In this prospective study,80 patients with psoriasis vulgaris(blood heat syndrome)admitted to our hospital from Nov 2020 to Nov 2022 were included and randomly divided into the control group and the observation group,with 40 cases in each group.The control group received routine nursing intervention,and the observation group received Wuxing music combined with traditional Chinese medicine bath and golden paste encapsulation nursing on the basis of control group,4 weeks as a course of treatment.After 2 courses of nursing,nursing effect,the scores of SCL-90 and DQOLS,the levels of serum inflammatory factors[interleukin-13(IL-13),transforming growth factor-β(TGF-β),and tumor necrosis factor-α(TNF-α)],and nursing satisfaction were compared between the two groups.Results:The area and severity of skin lesions in the two groups were lower than before nursing,and the changes in the observation group were more significant(P＜0.05).The scores of SCL-90 and DQOLS in the two groups were lower than those before nursing,and the changes in the observation group were more significant(P＜0.05).The levels of IL-13,TGF-β and TNF-α in the two groups were lower than those before nursing,and the levels of these indicators in the observation group were significantly lower than those in the control group(P＜0.05).The satisfaction rate of the observation group was higher than that of the control group(P＜0.05).Conclusions:Wuxing music combined with traditional Chinese medicine bath and golden paste encapsulation has a significant nursing effect on patients with psoriasis vulgaris(blood heat syndrome).It can decrease serum inflammatory factors,alleviate the degree of skin lesions,and iprove quality of life and nursing satisfaction.

Objective:To explore the awareness and experiences of elder abuse among staff in nursing homes.Methods:Qualitative studies on elder abuse by nursing home staff were systematically searched in databases, including China Biology Medicine disc, Wanfang data, Web of Science, and PubMed, up to August 15, 2023. A meta-synthesis approach was employed to categorize and integrate the findings.Results:Fourteen articles were included, yielding 93 themes. After repeated reading, analysis, and comparison, similar results were categorized into 12 new categories, synthesized into three integrated outcomes: causes of elder abuse, forms of elder abuse, and strategies for prevention and intervention of elder abuse.Conclusions:Staff should pay attention to the issue of elder abuse in nursing homes, establish closer connections between institutions, the aged, and their families, and promote healthy aging within these facilities.

Objective To investigate the changes in interleukin-34 (IL-34)levels in serum and bronchoalveolar lavage fluid (BALF) of patients with severe pneumonia and their prognostic value. Methods A total of 66 patients with severe pneumonia (severe pneumonia group), 35 patients with non-severe pneumonia (non-severe pneumonia group), and 27 healthy adults (control group) were enrolled. The severe pneumonia group was further divided into survival group of 38 patients and non-survival group of 28 patients based on 28-day survival. Clinical data of all subjects were analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the predictive power of serum IL-34 and relative IL-34 gene expression in BALF for 28-day mortality in patients with severe pneumonia, as well as the predictive power of serum IL-34 for severe pneumonia. Kaplan-Meier survival curves were plotted, and the Log-rank test was used to compare cumulative survival rates. Cox regression analysis was conducted to explore risk factors for 28-day mortality in patients with severe pneumonia. Pearson correlation analysis was used to assess the correlation between serum IL-34 levels and relative IL-34 gene expression in BALF of patients with severe pneumonia. Results Serum IL-34 levels were higher in the severe pneumonia group than those in the non-severe pneumonia group, and were higher in the non-severe pneumonia group than in the control group (P < 0.05). Serum IL-34 levels and relative IL-34 gene expression in BALF were higher in the non-survival group than in the survival group (P < 0.05). ROC curve analysis showed that the areas under the curve for predicting 28-day mortality in patients with severe pneumonia were 0.908 for serum IL-34 levels and 0.878 for relative IL-34 gene expression in BALF. The optimal cutoff value for serum IL-34 levels in predicting severe pneumonia was 129.9 pg/mL. Multivariate Cox regression analysis showed that increased serum IL-34 levels and increased relative IL-34 gene expression in BALF were independent risk factors for 28-day mortality in patients with severe pneumonia (P < 0.05). The Kaplan-Meier survival analysis results indicate that, with a cutoff value of 129.9 pg/mL, patients with severe pneumonia who had high serum levels of IL-34 exhibited a lower cumulative survival rate compared to those with low IL-34 level(Log-rank P < 0.001). Conclusion Serum IL-34 levels are significantly increased in patients with severe pneumonia, and relative IL-34 gene expression in BALF is positively correlated with serum IL-34 levels. Both can be used as indicators for predicting the prognosis of 28-day mortality in patients with severe pneumonia.

Objective:To understand the incubation periods of infections of Omicron variants BA.2 and BF.7 in two COVID-19 epidemics and related factors in Beijing and provide basic parameters for the establishment of 2019-nCoV dynamic transmission model.Methods:The COVID-19 cases with specific exposure time and onset time in the Omicron variant BA.2 infection epidemic in April 2022 and in the Omicron variant BF.7 infection epidemic in October 2022 in Beijing were included in the analysis. The rank-sum test was conducted to estimate the differences in the incubation period between two types of infections. The incubation period distribution of the Omicron variant infection was fitted by using Weibull, Gamma and lognormal distributions. Multivariate analysis of variance was conducted to assess the effects of age, sex, variant type and vaccination status on the incubation periods.Results:A total of 64 cases of variant BA.2 infection and 58 cases of variant BF.7 infection were included. The M( Q1,Q3) of the incubation period was 3.00 (3.00, 4.00) days for BA.2 infection and 3.00 (2.00, 3.25) days for BF.7 infection. The lognormal distribution was the best fit. Multivariate analysis of variance showed that there were some differences in the incubation periods between two types of infections of Omicron variants, and the incubation period of variant BF.7 infection was shorter than that of variant BA.2 infection. Conclusion:Omicron variant BF.7 infection had shorter incubation period compared with Omicron variant BA.2 infection.

Objective To analyze the effect of different doses of esketamine and different time in-tervals on reducing propofol injection pain(PIP)before intravenous propofol using factorial design.Methods A total of 360 elective general anesthesia surgical patients,167 males and 193 females,aged 18-64 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ were selected.Randomized numerical table method was used to divide the patients into three groups:esketamine 0.05 mg/kg(group A),esketamine 0.075 mg/kg(group B),and esketamine 0.1 mg/kg(group C),120 cases in each group.Each group was further randomly divided into 3 subgroups with 40 cases in each.Groups A1,A2,and A3 received intrave-nous propofol after induction of anesthesia with intravenous esketamine 0.05 mg/kg at intervals of 30 sec-onds,45 seconds,and 1 minute respectively.Groups B1,B2,and B3 received intravenous propofol after induction of anesthesia with intravenous esketamine 0.075 mg/kg at intervals of 30 seconds,45 seconds,and 1 minute respectively.Groups C1,C2,and C3 received intravenous propofol after induction of anesthe-sia with intravenous esketamine 0.1 mg/kg at intervals of 30 seconds,45 seconds,and 1 minute respective-ly.The McCririck scale was used to evaluate the occurrence of PIP.The induced dose of propofol,postoper-ative nausea and vomiting,respiratory amnesia,irritability,confusion,depressed and other adverse reactions were recorded.Results Comparison of the use of different doses of esketamine or different time intervals on the reduction of PIP showed a statistically significant difference respectively(P＜0.05).There was an interaction between different doses of esketamine and different intervals(P＜0.05).There were no significant differences in propofol induction dose and adverse reactions such as,postoperative nausea and vomiting,respiratory amnesia,irritability,confusion,depressed in nine groups of patients.Conclusion Compared with esketamine 0.05 and 0.1 mg/kg and intervals of 30 seconds and 1 minute,the use of esket-amine 0.075 mg/kg and intervals of 45 seconds followed by intravenous propofol is effective in suppressing PIP without the occurrence of significant adverse effects.

Objective:To review the scope of research on the application of managing cancer and living meaningfully (CALM) in cancer patient populations, and provide reference for follow-up research and clinical promotion and application.Methods:Using the research method of scope review, two evidence-based trained researchers independently conducted a blind literature search. A total of 12 databases were searched, including CNKI, Wanfang, VIP, China Biomedical Literature Database, Cochrane Library, PubMed, Web of Science, CTNAHL, Embase, Scopus, Medline and EBSCO. The search time limit was from database establishment to September 26, 2022. Collected relevant literature on the application of CALM therapy to cancer patients, extracted data included in the literature, summarize and report research results.Results:A total of 2 089 articles were retrieved, and 13 were eventually included through the inclusion criteria, including 8 randomized controlled studies, 2 quasi experimental studies and 3 qualitative studies. The results showed that CALM therapy included 4 themes, 3 to 8 separate psychotherapy sessions, each lasting for 3 to 6 months for 30 to 60 minutes. It was a short and flexible evidence-based personalized psychotherapy method that was easily accepted by patients, could alleviate the negative emotions of patients with advanced cancer, and promote their mental health. There was no literature reports on the occurrence of adverse events related to CALM therapy.Conclusions:CALM therapy has a positive impact on cancer patients, with safety and feasibility. In the future, it is necessary to construct a specific, standard, and localized CALM therapy program, conduct large sample, high-quality research to verify the application effect of CALM therapy in cancer patients, and provide evidence-based basis for formulating the best CALM therapy program for cancer patients.

Objective:To systematically evaluate the lived experience and inner needs of patients with young-onset dementia and to provide a basis for developing targeted interventions in clinical practice.Methods:Qualitative studies on the lived experience and inner needs of patients with young-onset dementia were retrieved from PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, China National Knowledge Internet, VIP, Wanfang Database, and China Biology Medicine disc from the start to September 2022.Two investigators trained in evidence-based knowledge screened the literature inclusion and exclusion criteria independently and rigorously, and used an aggregative synthesis to integrate and categorize the results.Results:A total of 11 articles were included, 33 results were extracted. These results were clustered into 8 categories, and 3 integrated results were synthesized: patients faced difficulties and challenges in daily life, social activities and work,experienced severe psychological burden and stigma; there were differences in coping styles among patients with different emotional experiences, manifesting as avoidance, confrontation, and adoption of positive coping styles; patients had unmet needs in multiple dimensions such as poor communication between doctors and patients, lack of peer support, lack of age-appropriate services, and desired to obtain support from multiple sources.Conclusions:The community, hospital, and society should be fully connected to provide support for patients with young-onset dementia to reduce stigma, improve the diagnostic process, and encourage positive coping. More research is needed in the future to help healthcare professionals understand the experience and needs of patients with young-onset dementia, with the aim of improving the quality of life of patients.