Objective To investigate the current research status of ferroptosis in Parkinson disease in recent years. Methods CiteSpace was used to perform bibliometric and visual analyses of the articles on the mechanism of action of ferroptosis in Parkinson disease and related prevention and treatment measures in CNKI and Web of Science （WoS）. Results A total of 92 articles from CNKI and 273 articles from WoS were included in this study. There was a tendency of increase in the number of articles published in China and globally. In CNKI， the keywords of ferroptosis， Parkinson's disease， oxidative stress， and traditional Chinese medicine were cited for many times， while in WoS， activation， cell death， alpha-synuclein， and Parkinson disease were cited for many times. There were 7 clusters of keywords in CNKI and 12 clusters in WoS. The top 5 authors （teams） in terms of the number of publications in CNKI were Yang Xinling； Zhang Lijie； Li Shaodan； Hao Mengdie； and Lu Ranran， while the top 5 authors （teams） in WoS were Ayton， Scott； Zhu， Meiling； Qu， Le； Devos， David； and Xie， Junxia. The number of team members in China was lower than that in foreign countries， mainly small team cooperation. As for the number of articles published by institutional cooperation， Qingdao University published the highest number of articles in CNKI， while the University of Melbourne published the highest number of articles in WoS. Biochemistry was the subject with the highest frequency， and there were intersections between disciplines. China was the core representative of state cooperation with the highest frequency. Conclusion The research on the association between Parkinson disease and ferroptosis mainly focuses on oxidative stress， neuroprotection， traditional Chinese medicine， and neuroinflammation， among which neuroprotection and neuroinflammation are the latest trends for development. Therefore， there may be more targeted therapies for neuroinflammation and therapies that stimulate neuroprotection in the future to alleviate pain and improve the quality of life of patients.
Parkinson Disease

Objective:To explore the application of medical dialectics combined with problem-oriented teaching based on textbooks in hematology internship teaching.Methods:A total of 100 undergraduate students who practiced in the Department of Hematology of the First Hospital of Jilin University from 2022 to 2023 were selected as the research subjects. Students were randomly assigned to a control group and an observation group, with 50 students in each group. The control group received traditional teaching, while the observation group received medical dialectics combined with textbook-based problem-oriented teaching. We assessed the theoretical and operational scores, classroom performance, comprehensive abilities, and teaching satisfaction of two groups of students using t-test and χ 2 test in SPSS 22.0. Results:The theoretical and operational scores of the observation group were (94.26±5.35) points and (92.68±4.72) points, respectively. The theoretical and operational scores of the control group were (86.16±5.42) points and (81.52±5.28) points, respectively. The differences between the two groups were statistically significant ( P<0.001). The recognition rates were significantly higher by students in the observation group than in the control group ( P<0.05) in terms of improving learning efficiency, self-learning ability, understanding and comprehensive analysis of diseases, problem-solving ability, language and organizational expression ability, integration of theory and practice, clinical thinking ability, and independent thinking ability. The satisfaction with teaching was higher in the observation group than in the control group ( P<0.05) in terms of teaching attitudes, teaching methods, teaching arrangements, practicality of teaching content, clear explanation of teaching theories, and outstanding teaching objectives. Conclusions:The medical dialectics combined with textbook-based problem-oriented teaching can improve the assessment scores of medical students, while helping to cultivate their comprehensive abilities and develop good clinical diagnosis and treatment thinking.

For two young female patients with extramedullary recurrence of reproductive system after allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia. And the characteristics of extramedullary relapse of reproductive system are summarized for exploring possible effective treatments.

Objective:To investigate the distribution of pathogenic bacteria of bloodstream infection after chemotherapy in patients with acute leukemia (AL), to analyze the risk factors for the occurrence of adverse events and to construct a nomogram model to predict the occurrence of adverse events.Methods:The clinical data of 313 AL patients with bloodstream infection who were admitted to the First Hospital of Jilin University from January 2018 to December 2020 were retrospectively analyzed, and the incidence, fatality and distribution characteristics of pathogenic bacteria after chemotherapy in AL patients were analyzed; the occurrence of adverse events (death or infectious shock) in patients with different clinicopathological characteristics were compared. Unconditional logistic binary regression model multifactor analysis was used to screen independent risk factors for the occurrence of adverse events in AL patients with bloodstream infection after chemotherapy; the nomogram model for predicting the occurrence of adverse events was developed by using R software; the Hosmer-Lemeshow test was used to verify the predictive effect of the model.Results:Of the 313 AL patients, the overall fatality rate was 4.2% (13/313), the all-cause fatality rate of bloodstream infection was 3.5% (11/313). Of the 313 cases, 254 cases (81.1%) were Gram-negative bacteria infection, mainly including 115 cases (45.3%) of Escherichia coli, 80 cases (31.5%) of Klebsiella pneumoniae, and 29 cases (11.4%) of Pseudomonas aeruginosa, and 10 cases (3.9%) died; 51 cases (16.3%) were Gram-positive cocci infection, mainly including 22 cases (43.1%) of Streptococcus spp., 20 cases (39.2%) of Staphylococcus spp., 7 cases (13.7%) of Enterococcus faecalis, and 0 case died; 8 cases (2.6%) were fungal infection, including 4 cases (1.3%) of Candida tropicalis, 2 cases (0.6%) of Candida subsmoothis, 1 case (0.3%) of Candida smooth, 1 case (0.3%) of new Cryptococcus, and 3 cases (37.5%) died. The differences in the occurrence rates of adverse events were statistically significant when comparing different treatment stage, risk stratification, timing of sensitive antibiotic use, total duration of fever, and glucocorticoid use in chemotherapy regimen, infecting bacteria carbapenem resistance, and leukemia remission (all P < 0.05). The results of logistic binary regression analysis showed that the use of glucocorticoid in chemotherapy regimen, the total duration of fever ≥7 d, the timing of sensitive antibiotic use ≥24 h, and carbapenem resistance of the infecting bacteria were independent risk factors for the occurrence of adverse events in AL patients with bloodstream infection after chemotherapy (all P < 0.05). A nomogram prediction model for the occurrence of adverse events in AL patients with bloodstream infection was established, and the nomogram model was calibrated and validated with good calibration and discrimination. Conclusions:The pathogenic bacteria of bloodstream infection after chemotherapy in AL patients is mainly Gram-negative bacteria, and the presence of glucocorticoid in chemotherapy regimen, long total duration of fever, poor timing of sensitive antibiotics, and infecting bacteria carbapenem resistance are risk factors for the occurrence of adverse events in AL patients with bloodstream infection after chemotherapy, and the nomogram prediction model based on these factors has a reliable predictive ability for the occurrence of adverse events.

Objective:To evaluate the clinical value of Xing's ureteroileal anastomosis technique in radical cystectomy.Methods:The data of 38 patients who underwent radical cystectomy with Xing's ureteroileal anastomosis technique at Cancer Hospital, Chinese Academy of Medical Sciences and Beijing Chaoyang Hospital from July 2013 to June 2021 were retrospectively reviewed. There were 30 males and 8 females. The mean age was 61.6±15.1 years old. The mean body mass index (BMI) was 25.1±2.7 kg/m 2. The American Society of Anesthesiology (ASA) graded 25 cases as grade 1, 10 cases as grade 2 and 3 cases as grade 3. There were 35 cases with stage cT 2N 0M 0 and 3 cases with cT 3N 0M 0. All patients underwent radical cystectomy and ileal conduit, and the ureteroileal anastomosis was performed using the Xing's ureteroileal anastomosis technique. Afferent loop entry was divided equally into two lumens. After 1.5 cm-long lengthwise incisions, each ureter was directly and end-to-end anastomosed to the aforementioned lumens. Postoperative information was recorded, including ureteric stricture, ureteric reflux, hydronephrosis, anastomotic leakage, renal calculus, urinary tract infection, and pyelonephritis. Results:Ureteroileal anastomosis was performed successfully in 38 cases with 76 units. The median follow-up time was 35.6 (17.0, 46.3) months. Three patients developed unilateral anastomotic stenosis after operation. Five patients had unilateral ureteral reflux. Two patients had unilateral hydronephrosis. No anastomotic leakage, urinary tract infection, or pyelonephritis occurred after the operation. Renal calculus appeared in 3 cases, all on the left unit.Conclusions:Xing's ureteroileal anastomosis technique is a simple method with few postoperative and good functional outcomes.

This article analyzes the limitations of traditional medical theory teaching, and proposes the strategies for cultivating medical students' autonomous learning ability, i.e., informatization-based flipped classroom, problem-oriented teaching, mind mapping training, semi-open book examination, exploitation of the clinical and scientific thinking, and practice activities of medical humanities. The strategies of "problem oriented teaching" and "mind mapping training" were integrated into the practice teaching of hematology. Compared with the traditional medical teaching mode, students' feedback after class showed that the teaching mode incorporating new cultivation strategies was more conducive to the improvement of students' self-learning ability ( P = 0.008), and their satisfaction with teaching mode, learning interest, and self-learning ability were all improved. Thus, the appropriate application of the above strategies can help improve students' autonomous learning ability and optimize the effect of medical theory teaching.

Inherited metabolic liver diseases can occur in multi-age groups such as children, adolescents, adults, and others. With the improvement of diagnosis and treatment levels, more and more patients with childhood-onset diseases are surviving into adulthood. Some diseases originally faced by pediatric hepatologists also appear in adult hepatology clinics. This raises new challenges for adult hepatologists, requiring them to master more professional knowledge. However, specific data on the incidence rate of most inherited metabolic liver diseases is still lacking in our country. This article reviews the research progress of hereditary metabolic liver diseases and summarizes the epidemiological characteristics of familiar hereditary metabolic liver diseases in China.

Objective To investigate the differences in UGT1A1 gene mutation sites, haplotypes, and diplotypes between patients with Gilbert syndrome (GS) and those with Crigler-Najjar syndrome type Ⅱ (CN-2). Methods A retrospective analysis was performed for the clinical data of 138 patients with GS or CN-2 who attended Beijing YouAn Hospital, Capital Medical University, from January 1, 2010 to December 31, 2019, with 109 patients in the GS group and 29 patients in the CN-2 group, and the differences in mutation sites were analyzed between the two phenotypes. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. SNPStats software was used to perform linkage disequilibrium (LD) and haplotype analyses of mutation sites. Strong LD was defined as both | D ′| and r 2 > 0.8, and moderate LD was defined as | D ′| > 0.8 and r 2 > 0.4. Results UGT1A1 gene detection was performed for all patients, and mutations mainly included -3279T > G mutation (104 patients, 75.36%) and -3152G > A mutation (82 patients, 59.42%) in the upstream promoter PBREM region, a promoter TATA box TA insertion mutation (88 patients, 63.77%), and c.211G > A mutation in Exon 1 of the coding region (66 patients, 47.83%). Compared with the CN-2 group, the GS group had a significantly higher proportion of PBREM region -3279T > G mutation (82.57% vs 48.28%, χ 2 =14.508, P < 0.001), PBREM region -3152G > A mutation (68.81% vs 24.14%, χ 2 =18.955, P < 0.001), and promoter TATA box (TA) 6 > (TA) 7 mutation (72.48% vs 31.03%, χ 2 =17.027, P < 0.001), and compared with the GS group, the CN-2 group had a significantly higher proportion of mutations at the c.211 locus (68.97% vs 42.20%, χ 2 =6.575, P =0.010) and the c.1456 locus (51.72% vs 7.34%, χ 2 =29.372, P < 0.001). LD analysis of different mutation sites of the UGT1A1 gene showed strong LD (| D ′| > 0.8, r 2 > 0.8) between (TA) 6 > (TA) 7 and -3152G > A and moderate LD (| D ′| > 0.8, r 2 > 0.4) between (TA) 6 > (TA) 7 and -3279T > G, between -3152G > A and -3279T > G, between (TA) 6 > (TA) 7 and c.211G > A, and between -3279T > G and c.211G > A. Haplotype frequency analysis showed that compared with the CN-2 group, the GS group had a significantly higher frequency of haplotype -3279G—-3152A—(TA) 7 (45.72% vs 17.24%, χ 2 =7.833, P =0.005) and significantly lower frequencies of c.1456G (4.10% vs 16.48%, χ 2 =4.873, P =0.027) and c.211A—c.1456G (1.86% vs 24.90%, χ 2 =15.210, P < 0.001). The diplotype analysis showed that diplotypes consisting of haplotype c.1456G or c.211A—c.1456G were associated with a higher level of total bilirubin (TBil). Conclusion There are differences in common mutation sites and major haplotypes of the UGT1A1 gene between patients with GS and those with CN-2, and the common diplotypes of CN-2 correspond to a higher level of TBil.

Objective:To investigate the effects of comprehensive geriatric assessment(CGA)and intervention on treatment outcomes of type 2 diabetes and concurrent emotional disorders in the elderly.Methods:108 type 2 diabetes cases with emotional disorders were enrolled from March 2020 to March 2021 in the First Affiliated Hospital of Zhengzhou University and randomly divided into the conventional treatment group and the CGA group(54 cases each). The control group was given standard drug treatment and psychological counseling, whereas the CGA group was additionally given individualized treatment based on CGA guidelines.After observation for 8 weeks, clinical effects in the two groups were examined.Changes in cognitive status, nutritional status, fall risk and results on other indicators in patients were comprehensively assessed and statistically analyzed.Results:Compared with pre-treatment data, 8 weeks of treatment for both the control group and the CGA group resulted in decreased FPG levels[control group(10.16±0.90)mmol/L, (8.70±2.98)mmol/L, t=2.58, P=0.011; CGA group: (9.94±0.82)mmol/L, (7.12±2.25)mmol/L, t=8.65, P=0.000], 2hPG levels[control group: (11.83±3.92)mmol/L, (10.53±2.70)mmol/L, t=2.01, P=0.047; CGA group: (10.64±2.99)mmol/L, (9.26±1.89)mmol/L, t=2.87, P=0.005], HbA 1C(%)[control group: (9.76±1.09)%, (8.66±2.64)%, t=2.83, P=0.006; CGA group: (9.38±2.92)%, (7.81±1.78)%, t=3.37, P=0.001], HAMD-24 scores[control group(25.69±4.70), (24.20±2.48), t=2.06, P=0.042; CGA group(24.03±4.00), (22.11±1.38), t=3.33, P=0.001], and HAMD-14 scores[control group(19.66±2.84), (18.41±2.34), t=2.50, P=0.014; CGA group(18.77±2.48), (17.39±2.36), t=2.96, P=0.004], respectively, with more marked changes in all measures in the CGA group than in the control group(all P<0.05). Conclusions:Early CGA can effectively improve blood glucose levels and relieve mood disorders in elderly type 2 diabetes with emotional disorders.

Objective:To evaluate the efficiency and safety of endoscopic anti-reflux mucosectomy (ARMS) for refractory gastroesophageal reflux disease (rGERD) in the absence of hiatus hernia (HH).Methods:Among 28 rGERD patients adimitted to Gastrointestinal Medical Center, Subei People's Hospital from Jan 2018 to Jun 2020 16 underwent endoscopic mucosal resection (EMR) and 12 did endoscopic submucosal dissection (ESD), The GERD symptoms, endoscopy, 24-h pH monitoring results, manometry, were compared before and after the procedure.Results:ARMS was successfully performed in all 28 patients. Three months after ARMS, 19 patients discontinued the use of pump inhibitors (PPIs), while 9 patients reduced their PPI dose. The GERD questionnaire scores, the median gastroesophageal flap valve grade, the median DeMeester score and acid exposure time based on 24 h esophageal pH monitoring were significantly lower than those before treatment [6.5±2.5 vs.13.4±3.1, 1(1-2) vs.3(1-3), 14.8(8.2-30) vs.34.6(16.2-60.7), 4.4%(1.3%-7.9%) vs. 8.7%(6.2%-13.9%),all P<0.01]. Esophageal sphincter pressure increased after ARMS, from (9.0±3.2) mmHg to (15.5±5.5) mmHg ( t=0.159, P<0.01). The operation time used in ESD was (66.9±4.5) minutes compared to EMR [(29.1±2.0) minutes]( t=13.911, P<0.001). The treatment cost of ESD was (19.9±1.6) thousand yuan vs. for EMR [(9.0±1.6) thousand yuan]( t=58.411, P<0.001). There were no major complications in both groups. Conclusions:ARMS is safe and effective for treatment of rGERD in the absence of HH, and EMR is less time-consuming and more acceptable technique.