Introduction: Early identification of patients at risk for severe multisystem inflammatory syndrome in children (MIS-C) is essential for favourable clinical outcomes. This study aims to identify the clinical characteristics, factors and outcomes associated with severe MIS-C. Materials and methods: In this retrospective cohort study involving 14 major hospitals in Malaysia, children <15 years who met the United States Centres for Disease Control and Prevention case definition for MIS-C were included. Severe MIS-C was defined as children who required inotropic support, ventilatory support (invasive or non-invasive ventilation), or left ventricular ejection fraction of <55%. The factors investigated for severe MIS-C were demographic characteristics, the presence of comorbidities, clinical characteristics, and laboratory measures. Multivariable logistic regression was used to compute the adjusted odds ratio (aORs) of factors associated with severe MIS-C. Results: Among the 155 patients, 91 (58.7%) presented with severe MIS-C. Severe MIS-C was more likely in patients aged ≥5 years old (aOR 2.13, 95% confidence interval [CI] 1.08-4.21), with dehydration (aOR 3.80, 95% CI 1.53-9.45), lethargy (aOR 2.02, 95% CI 0.97-4.18), tachycardia (aOR 8.33, 95% CI 3.27-21.22), albumin <30g/L (aOR 3.36, 95% CI 1.58-7.13), creatine kinase >200U/L (aOR 3.68, 95% CI 1.57-8.64), D-dimer >3.0µg/mL (aOR 2.11, 95% CI 1.08-4.13), ferritin >500ng/mL (aOR 3.77, 95% CI 1.88-7.55), prothrombin time >12.7 seconds (aOR 3.22, 95% CI 1.61-6.43), and urea >6mmol/L (aOR 5.09, 95% CI 2.04-12.71). Conclusion: Identification of these associated factors of severity in MIS-C could aid in early recognition and prompt escalation of care, leading to better outcomes.

AIM:To compare the effect of AT TORBI 709M and Tecnis ZMT intraocular lenses on astigmatism correction in patients with corneal astigmatism at 3 mo after operation based on the standard astigmatism vector analysis.METHODS: This was a retrospective case-control study. The clinical data of 69 patients(69 eyes)with corneal astigmatism who underwent phacoemulsification and implantation of toric intraocular lens(IOL)from June 2021 to December 2021 in Day Surgery Center of Xi'an No.1 Hospital was analyzed. The patients were divided into two groups. In group one, 38 cases(38 eyes)were implanted with AT TORBI 709M, and 31 patients(31 eyes)with Tecnis ZMT in group two. The axial length, preoperative astigmatism and axis, and the degree of intraocular lens were recorded. The uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), diopter, residual astigmatism and axis were recorded preoperatively and at 1 wk, 1 and 3 mo postoperatively. The postoperative surgical indicators, including spherical equivalent(SE), target induced astigmatism vector(TIA), surgically induced astigmatism vector(SIA), magnitude of error(ME), absolute value of angle of error(|AE|), absolute value of difference vector(|DV|), correction index(CI), and index of success(IOS)were evaluated by the standard astigmatism vector analysis.RESULTS:Postoperative UCDVA and BCDVA were significantly improved(all P<0.001), and there were statistically significant differences compared to preoperative UCDVA and BCDVA(all P<0.001). While, there was no significant difference in UCDVA and BCDVA between the two groups(P=0.275, 0.124). The standard astigmatism vector analysis showed that a good astigmatism correction was achieved in both AT TORBI 709M group and Tecnis ZMT group, and both |DV| and IOS were close to 0(P=0.329, 0.288). The CI of the AT TORBI 709M group was closer to 1, indicating a better astigmatism correction, while the CI of the Tecnis ZMT group was higher than 1, suggesting an overcorrection of astigmatism. However, the difference between the two groups was not statistically significant(P=0.193). The mean residual astigmatism at 3 mo postoperatively was -0.11±0.91 D in the AT TORBI 709M group and -0.46±0.76 D in the Tecnis ZMT group, respectively, showing no statistically significance difference(t=1.732, P=0.088).CONCLUSION:Both the flat loop AT TORBI 709M and the double C-loop Tecnis ZMT intraocular lenses can effectively improve postoperative visual acuity in patients with regular corneal astigmatism, showing good rotational stability and comparable correction abilities for both astigmatism with the rule and against-the-rule astigmatism.

Methamphetamine(METH)is highly addictive and neurotoxic,which causes cognitive and memory dysfunction in abusers.The harm of METH lies not only in its own toxicity,but also in the high physical and mental dependence of drug addicts,often causing mental disorders and violent behavior,bringing great safety risks to society.Non-coding RNA(ncRNA)does not encode proteins and is an important factor in regulating gene expression at the post-transcriptional level.Studies have shown that ncRNA plays an important regulatory role in methamphetamine-induced addiction and neurotoxicity,but the specific mechanism is unclear.This article reviews the current research progress of ncRNA in regulating METH-induced addiction and neurotoxicity to provide a reference for ncRNA as a forensic identification index and potential therapeutic target for METH abusers.

Objective:To explore the current situation and influencing factors of quality of life of septic patients in intensive care unit (ICU) after discharge, and to provide theoretical basis for clinical early psychological intervention and continuity of care.Methods:A prospective observational study was conducted. The septic patients who were hospitalized in the department of critical care medicine of the Affiliated Hospital of Jining Medical University and discharged with improvement from January 1 to December 31, 2022 were selected as the research objects. The demographic information, basic diseases, infection site, vital signs at ICU admission, severity scores of the condition within 24 hours after ICU admission, various biochemical indexes, treatment process, and prognostic indexes of all the patients were recorded. All patients were assessed by questionnaire at 3 months of discharge using the 36-item short-form health survey scale (SF-36 scale), the activities of daily living scale (ADL scale), and the Montreal cognitive assessment scale (MoCA scale). Multiple linear regression was used to analyze the factors influencing the quality of life of septic patients after discharge from the hospital.Results:A total of 200 septic patients were discharged with improvement and followed up at 3 months of discharge, of which 150 completed the questionnaire. Of the 150 patients, 57 had sepsis and 93 had septic shock. The total SF-36 scale score of septic patients at 3 months of discharge was 81.4±23.0, and the scores of dimensions were, in descending order, role-emotional (83.4±23.0), mental health (82.9±23.6), bodily pain (82.8±23.3), vitality (81.6±23.2), physical function (81.4±23.5), general health (81.1±23.3), role-physical (79.5±27.0), and social function (78.8±25.2). There was no statistically significant difference in the total SF-36 scale score between the patients with sepsis and septic shock (82.6±22.0 vs. 80.7±23.6, P > 0.05). Incorporating the statistically significant indicators from linear univariate analysis into multiple linear regression analysis, and the results showed that the factors influencing the quality of life of septic patients at 3 months after discharge included ADL scale score at 3 months after discharge [ β= 0.741, 95% confidence interval (95% CI) was 0.606 to 0.791, P < 0.001], length of ICU stay ( β= -0.209, 95% CI was -0.733 to -0.208, P = 0.001), duration of mechanical ventilation ( β= 0.147, 95% CI was 0.122 to 0.978, P = 0.012), total dosage of norepinephrine ( β= -0.111, 95% CI was -0.044 to -0.002, P = 0.028), mean arterial pressure (MAP) at ICU admission ( β= -0.102, 95% CI was -0.203 to -0.007, P = 0.036) and body weight ( β= 0.097, 95% CI was 0.005 to 0.345, P = 0.044). Conclusions:The quality of life of patients with sepsis at 3 months after discharge is at a moderately high level. The influencing factors of the quality of life of patients with sepsis at 3 months after discharge include the ADL scale score at 3 months after discharge, the length of ICU stay, the duration of mechanical ventilation, the total dosage of norepinephrine, MAP at ICU admission and body weight, and healthcare professionals should enhance the treatment and care of the patients during their hospitalization based on the above influencing factors, and pay attention to early psychological intervention and continued care for such patients.

The close relationship between gastric cancer (GC) and type 2 diabetes mellitus (T2DM) has garnered significant attention. On one hand, T2DM may play a role in the development and progression of GC, correlating with poor patient outcomes. On the other hand, after radical surgery for GC, T2DM can be effectively managed, potentially improving tumor prognosis. In recent years, bariatric and metabolic surgery (BMS) has revolutionized T2DM treatment for obese and overweight patients. Comparative analyses reveal similarities between surgical approaches for gastric cancer and BMS, leading to the emergence of the onco-metabolic surgery (OMS) concept, which suggests that radical tumor resection and T2DM remission in GC patients can be potentially achieved through a single procedure. However, there are notable differences between OMS and BMS, including target populations, surgical details, and perioperative management. Therefore, optimizing the application of the OMS concept in GC patients holds significant clinical importance. This article provides a review to facilitate the better implementation of this concept in practice.

Objective:To investigate the effect of enteral nutrition support on quality of life and therapeutic effect in patients with metastatic colorectal cancer.Methods:A total of 100 patients with metastatic colorectal cancer admitted to Anqing Petrochemical Hospital from Jan. 2020 to Dec. 2023 were selected and divided into parenteral nutrition group and enteral+parenteral nutrition group with 50 cases each using random number table method. The parenteral nutrition group received parenteral nutrition, and the parenteral + parenteral nutrition group was supplemented with enteral nutrition. The therapeutic effect, nutritional indexes, intestinal flora, survival time and quality of life before and after treatment were compared between the two groups.Results:The effective rate of enteral + off-site nutrition group was 76.00%, that of parenteral nutrition group was 54.00%, and that of enteral + off-site nutrition group was higher than that of parenteral nutrition group ( P<0.05). There were no significant differences in nutritional indexes, flora imbalance grade or QLQ-C30 score between the two groups before intervention ( P>0.05). After the intervention, the albumin and total protein in the enteral + parenteral nutrition group were (38.76±6.02) g/L, (64.09±6.71) g/L, the number of normal microbiota disorder cases was 46, the survival time was (17.055±4.33) months, the physical function score was (74.59±7.55) points, and the emotional function score was (78.94±7.96) points, cognitive function score (88.95±9.03) points, role function score (85.49±8.61) points, social function score (81.45±8.27) points. In the parenteral nutrition group, the albumin was (34.51±5.47) g/L, the total protein was (58.91±6.55) g/L, the number of normal microbiota disorder cases was 33, the survival time was (12.48±3.59) months, the physical function score was (67.21±6.81) points, and the emotional function score was (73.55±7.78) points, cognitive function score was (83.47±8.55) points, role function score was (80.14±8.26) points, social function score was (76.93±7.827) points, and enteral + off-site nutrition group was higher than parenteral nutrition group ( P<0.05). In the enteral + off-site nutrition group, the transferrin was (1.45±0.57) g/L, and there were 2 cases of class II flora dysregulation and 2 cases of class III flora dysregulation; in the off-site nutrition group, the transferrin was (1.71±0.61) g/L, and the number of class II flora dysregulation was 8 cases and the number of class III flora dysregulation was 9 cases. Enteral + off-site nutrition group was lower than parenteral nutrition group ( P<0.05) . Conclusion:Enteral + parenteral nutrition support Enteral nutrition support can help improve the treatment effect of metastatic colorectal cancer, improve the nutritional status and survival time of patients, and improve the quality of life of patients.

Objective:To observe the clinical efficacy of filiform needle combined with fire needles for cervical radiculopathy(CR)due to wind-cold obstructing the meridians. Methods:A total of 60 patients with CR due to wind-cold obstructing the meridians were randomized into an observation group and a control group,with 30 cases in each group.The control group was treated with filiform needle treatment,and the observation group was treated with additional fire needle point-pricking treatment.The visual analog scale(VAS)and 20-point scale of CR developed by Yasuhisa TANAKA(YT-20)were scored before treatment and after 1,2,3,and 4 weeks of treatments.The tenderness threshold was measured.The local skin temperature was measured by an infrared thermal imager.A safety evaluation was performed after treatment. Results:After treatment,the VAS score in the observation group at each time point was lower than that in the control group(P<0.05).The YT-20 score,tenderness threshold,and local skin temperature in the observation group were all higher than those in the control group(P<0.05).The VAS score in the observation group at each time point after treatment was lower than that before treatment(P<0.05),and the YT-20 score,tenderness threshold,and local skin temperature at each time point were higher than those before treatment(P<0.05).After 3 and 4 weeks of treatments,the VAS score in the control group was lower than that before treatment(P<0.05),and the YT-20 score,tenderness threshold,and local skin temperature were higher than those before treatment(P<0.05).The group factor effects of VAS and YT-20 scores,tenderness threshold,and local skin temperature between the two groups were statistically significant(P<0.05).There was no significant difference in the time effect and the interaction effect between time and group(P>0.05). Conclusion:Filiform needle combined with fire needle or applied alone both can relieve neck pain in patients with CR due to wind-cold obstructing the meridians,and improve the temperature of the neck.The combination of filiform needle and fire needle works more quickly and has better efficacy.

Objective:To summarize the best evidence related to intermittent catheterization in adult patients with neurogenic bladder, and provide reference for clinical practice and patient self-management.Methods:According to the "6S" pyramid model, the system searched UpToDate, Guidelines International Network, European Association of Urology, UK National Institute for Health and Clinical Excellence, Scottish Interhospital Guidelines Network, Cochrane Library, PubMed, Web of Science, EmBase, EBSCO, OVID, Scopus, SinoMed, CNKI, Wanfang, VIP, Yimaitong, literature on intermittent catheterization of neurogenic bladder in adults, including clinical decision, best practice, guidelines, expert consensus, etc. The retrieval period was from the database establishment to August 2023. The search time was established until August 2023. The literature was screened by two research members, and four research members evaluated the quality of the literature and extracted the evidence.Results:A total of 14 articles were included, including 1 clinical decision, 1 evidence summary, 4 systematic reviews, 5 guidelines, 2 expert consensus, and 1 best practice. Finally, 31 pieces of best evidence were summarized, involving 5 aspects such as intermittent catheterization (IC) indication, IC timing, IC implementation process, IC health education, extended care.Conclusions:The evidence summary strictly follows the evidence-based process and the content of the evidence is comprehensive. The incidence of neurogenic bladder complications can be reduced by comprehensive management of intermittent catheterization, ultimately improving the quality of care. The localization characteristics should be combined in the application of evidence to improve the quality of life of patients.

Objective Explore a non-contact physiological and psychological detection model based on facial video in simulations of weightlessness effects,research new methods for non-contact heart rate and negative mood state detection in long-term simulations of weightlessness effect analysis.Methods Construct a non-contact physiological and psychological data collection system for fusion analysis of visible light and thermal infrared videos.Collect physiological and psychological data of volunteers in the"Earth Star-Ⅱ"90-day head-down bed rest experiment.A non-contact heart rate detection model based on GCN facial multi-region feature fusion and a non-contact negative mood state detection model considering data reliability were constructed,and the effectiveness of the models were validated with finger clip heart rate and POMS-SF scale as labels.Results The experimental results show that the average difference in the Bland-Altman plot of the non-contact heart rate detection model is-1.26 bpm,and 96.3%of value error detection data falls within the 95%confidence interval,indicating a high consistency between the model detected heart rate and the finger clip heart rate.The non-contact negative mood state detection model achieves an accuracy of>0.85 for detecting tension,depression,anger,and fatigue.Features such as heart rate,AU06,eye gaze,and head pose were observed to be important to mood state detection.Conclusion Non-contact physiological and psychological detection methods not only can be utilized for long-term physiological analysis in simulations of weightlessness effects,but also provide a novel technical approach for on-orbit astronauts health assurance during long-term space flight in the future.

Objective:To explore the potential categories and associated factors of mild cognitive impairment (MCI) in community-dwelling older adults.Methods:A total of 393 community-dwelling older adults with MCI in Huzhou City were selected through multistage random sampling from January to July 2022.The survey was conducted by the general information questionnaire, Montreal cognitive assessment (MoCA), Pittsburgh sleep quality index (PSQI) and 15-item geriatric depression scale(GDS-15). Latent profile analysis (LAP) was applied to explore latent categories based on the characteristics of cognitive impairment, and Logistic regression analysis was performed to examine the factors associated with these MCI categories. The statistical software was SPSS 26.0.Results:The community-dwelling older adults with MCI was categorized into four subgroups: generalized mildly impaired subgroup, mixed impaired with visuospatial executive dysfunction subgroup, narrative memory dysfunction impaired subgroup, and high-risk severely impaired subgroup, with corresponding MoCA scores of (23.10±0.96), (21.87±0.92), (20.43±0.93), (19.00±0.00), PSQI scores of (6.00 (4.00)), (7.00 (6.00)), (7.00 (6.00)), (10.00 (3.00)), and GDS-15 scores of (4.00 (4.00)), (4.00(5.00)), (6.00(5.00)), (8.00 (3.00)), respectively. Logistic regression analysis revealed that compared to generalized mildly impaired subgroup, gender, age, exercise habits, sleep quality, depressive symptoms, chronic disease count, and medication count significantly affected other three subgroups, with female, older age, and never/irregular exercise as common risk factors. Poor sleep quality and depressive symptoms could positively predict mixed impaired with visuospatial executive dysfunction subgroup and narrative memory dysfunction impaired subgroup( B=0.82, OR=2.27, 95% CI=1.26-4.08; B=1.12, OR=3.06, 95% CI=1.36-6.91).Additionally, poor sleep quality, depressive symptoms, chronic disease and medication count could significantly predict high-risk severely impaired subgroup ( B=4.13, OR=62.32, 95% CI= 1.71->999.99; B=3.31, OR=27.49, 95% CI=1.37-549.99; B=1.20, OR=3.32, 95% CI= 1.06-10.41 and B=0.80, OR=2.22, 95% CI=1.04-4.71). Conclusion:Four latent MCI categories are identified among community-dwelling older adults, and each category was characterized by unique cognitive impairment features and factors. Healthcare professionals are advised to customize assessments and management strategies according to these specific characteristics to effectively slow cognitive decline.