Search

To assess the feasibility, safety and effectiveness of microwave ablation (MWA) for soft tissue venous malformations (VMs).We retrospectively analyzed 20 patients with symptomatic VMs of the lower extremities and trunk. MWA was performed in all patients. Contrast-enhanced ultrasonography (CEUS) was performed immediately and one month after ablation. The data on complete ablation rate, improvement of symptoms, and patient satisfaction were collected. Follow-up began one- month after ablation for two to 19 months.MWA was performed on 20 patients. The overall complete ablation rate was 75% (n=15/20). The complete ablation rates in patients with lesions5 cm and5 cm were 100% (11/11) and 44% (4/9), respectively. The complete ablation rates in patients with localized and extensive lesions were 93% (13/14) and 33% (2/6), respectively. Five patients had incomplete ablation; one had a5 cm lesion with ectopic drainage vessels; one had multiple lesions adherent to blood vessels and nerves; three had large and extensive lesions. Thirteen patients showed significant improvements in clinical symptoms; six showed slight improvement; one showed no change in symptoms. No complications or recurrences were observed. All patients were satisfied with the therapeutic effect (n = 20; 100%); 12 patients were significantly satisfied, and eight were slightly satisfied.MWA with ultrasound guidance is a safe, effective, and minimally invasive therapy for symptomatic soft-tissue VMs and may be a promising approach in the future.

Circulating concentration of insulin-like growth factor (IGF)-1 in patients with polycystic ovary syndrome (PCOS) is still unclear. Therefore, we aimed to investigate the association of IGF-1 with PCOS through this meta-analysis.Literature search was conducted through PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (up to July 2022). A manual search was performed on the references of related original research. Then, we applied the random-effects model to evaluate the overall effect size by calculating the standard mean difference and its 95% CI. Subgroup analyses were used to explore the sources of heterogeneity. In addition, a sensitivity analysis was performed and publication bias was assessed.Twenty studies were included in this meta-analysis involving 657 individuals: 362 patients with PCOS and 295 normal controls. The results of meta-analysis showed that serum IGF-1 levels were significantly higher in patients with PCOS than in controls (standard mean difference, 0.89; 95% CI, 0.34-1.45; P = .002). The final pooled data were determined by the random-effects model because a significant high heterogeneity (IThese data suggest that elevated serum IGF-1 levels may not be a major cause of PCOS pathogenesis. Body mass index may be a major determinant of serum IGF-1.

Tao Sun,1,* Xian-Hong Huang,1,* Shu-E Zhang,2,* Hong-Yan Yin,3 Qing-Lin Li,2 Lei Gao,2 Ye Li,2 Li Li,4 Bing Cao,5 Jin-Hong Yang,6 Bei Liu7 1Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China; 2Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China; 3Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, 163319, People’s Republic of China; 4Department of Administration, School of Law, Zhejiang University City College, Hangzhou, 310015, People’s Republic of China; 5Department of Oncology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China; 6Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People’s Republic of China; 7Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bei Liu, Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China, Email 18827380717@163.comAim: To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic.Methods: A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses.Results: Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction.Conclusion: Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses’ fatigue and negative attitudes during times of public health emergencies.Keywords: ICU nurses, fatigue, burnout, job satisfaction, turnover intention, COVID-19 pandemic

In this paper, the second-order fuzzy homogeneous differential equation is transformed into a more special simplest form under the condition that the solution of the boundary value problem of the equation exists and is unique. Then the eigenvalues of the boundary value problem of the second-order simplest fuzzy homogeneous differential equation are studied and the theorems that make the eigenvalues exist are proposed and then illustrated with examples. Finally, it is proved that when the second-order fuzzy coefficient p ˜ ( t ) in the second-order fuzzy homogeneous differential equation is a fuzzy number, the solution set of its corresponding second-order granular homogeneous differential equation becomes larger, that is, the solution set of fuzzy differential equations with real numbers is a subset of the solution set with fuzzy coefficients as fuzzy numbers.

Introduction: Various types of cerebral small vessel diseases (cSVD) markers commonly coexist. The neurological function outcome is affected by their combined effect. To investigate the effect of cSVD on intra-arterial thrombectomy (IAT), our study aimed at developing and testing a model with fusing a combination of multiple cSVD markers as total cSVD burden to predict the outcome of acute ischemic stroke (AIS) patients after IAT treatment. Methods: From October 2018 to March 2021, continuous AIS patients with IAT treatment were enrolled. We calculated the cSVD markers identified by magnetic resonance imaging. The outcomes of all patients were assessed according to the modified Rankin Scale (mRS) score at 90 days after stroke. The relationship between total cSVD burden and outcomes was analyzed by logistics regression analysis. Results: A total of 271 AIS patients were included in this study. The proportions of score 0∼4 in the total cSVD burden group (i.e., score 0, 1, 2, 3, and 4 groups) were 9.6%, 19.9%, 23.6%, 32.8%, and 14.0%, respectively. The higher the cSVD score, the more patients with a poor outcome. Heavier total cSVD burden (1.6 [1.01∼2.27]), diabetes mellitus (1.27 [0.28∼2.23]), and higher national institute of health stroke scale (NIHSS) on admission (0.15 [0.07∼0.23]) were associated with poor outcome. In the two Least Absolute Shrinkage and Selection Operator regression models, model 1 using age, duration from onset to reperfusion, Alberta stroke program early CT score (ASPECTS), NIHSS on admission, modified thrombolysis in cerebral infarction (mTICI) and total cSVD burden as variables perform well on predicting short-term outcome in area under curve (AUC) of 0.90. Model 2, including all of the variables above except cSVD, showed less predictive capability than model 1 (AUC 0.90 vs. 0.82, p = 0.045). Conclusions: The total cSVD burden score was independently associated with the clinical outcomes of AIS patients after IAT treatment and it may be a reliable predictor for poor outcomes of AIS patients after IAT treatment.

We analyzed the clinical characteristics and outcomes of patients with Streptococcus suis meningitis in Liuzhou, China, to improve diagnostic accuracy and lower the chances of misdiagnosis. The major clinical manifestations, auxiliary examination results, treatment strategies, treatment efficacy, and follow-up results of 17 consecutively admitted patients with S. suis meningitis were evaluated. The most common clinical manifestations were fever (15/17), sensorineural hearing loss (13/17), headache (11/17), and altered mental status (8/17). In addition, 64.71% of the patients had residual symptoms of sensorineural hearing loss at discharge, and moderate disabilities occurred in 68.75% of the patients in the form of sensorineural deafness (11/17) and hemiparesis (1/17). The cerebrospinal fluid (CSF) of nine patients was used for metagenomic analysis with next-generation sequencing. The metagenomic analysis of CSF of four patients was positive, whereas blood and CSF cultures were negative. The average modified Rankin Scale (mRS) and Activities of Daily Living (ADL) scores improved significantly at the 6-month follow-up compared with those at admission (P < 0.05). There was no correlation between altered mRS and ADL scores and the CSF findings (P > 0.05). Early administration of antibiotics can prevent sensorineural hearing loss. Early CSF metagenomic analysis may be superior to blood and CSF culture.

The prognosis of patients with locally advanced esophageal squamous cell carcinoma with different recurrence backgrounds is highly heterogeneous. This study aims to explore the effects of recurrence patterns on prognosis.The phase III, multicenter, prospective NEOCRTEC5010 trial enrolled 451 patients with stage IIB-III esophageal squamous cell carcinoma randomly assigned to neoadjuvant chemoradiotherapy combined with surgery (NCRT group) or surgery alone (S group) and followed them long-term. We investigated the effects of recurrence patterns on survival in patients undergoing radical esophagectomy.In total, 353 patients were included in the study. The 5-year overall survival of patients with different recurrence patterns was significantly different: recurrence versus recurrence-free (17.8% vs 89.2%; P .001), early recurrence versus late recurrence (4.6% vs 51.2%; P .001), and distant metastasis versus locoregional recurrence (17.0% vs 20.0%; P = .666). Patients with early recurrence had significantly shorter survival after recurrence than those with late recurrence (hazard ratio, 1.541; 95% confidence interval, 1.047-2.268, P = .028). There was no significant difference in postrecurrence survival between patients with distant metastasis and locoregional recurrence (hazard ratio, 1.181; 95% confidence interval, 0.804-1.734; P = .396). Multivariate logistic analysis showed that pN1 stage, lymph node dissection20, and lack of response to NCRT were independent risk factors for postoperative early recurrence. Multivariate Cox regression suggested that NCRT, age ≥60 years, early recurrence, and the pN1 stage were independent risk factors for shortened survival after recurrence.Prerecurrence primary tumor stage is inaccurate in predicting postrecurrence survival. In contrast, recurrence patterns can guide follow-up while also predicting postrecurrence survival. NCRT prolongs disease-free survival but is associated with a worse prognosis in patients with recurrence, especially early recurrence.

In eukaryotes, the ubiquitin-proteasome system (UPS) and the autophagy-lysosome pathway (ALP) are essential for maintaining cellular proteostasis and associated with cancer progression. Our previous studies have demonstrated that phosphatase and tensin homolog (PTEN), one of the most frequently mutated genes in human cancers, limits proteasome abundance and determines chemosensitivity to proteasome inhibitors in cholangiocarcinoma (CCA). However, whether PTEN regulates the lysosome pathway remains unclear.We tested the effects of PTEN on lysosome biogenesis and exosome secretion using loss- and gain-of-function strategies in CCA cell lines. Using in vitro dephosphorylation assays, we explored the regulatory mechanism between PTEN and the key regulator of lysosome biogenesis, transcription factor EB (TFEB). Using the migration assays, invasion assays, and trans-splenic liver metastasis mouse models, we evaluated the function of PTEN deficiency, TFEB-mediated lysosome biogenesis, and exosome secretion on tumor metastasis. Moreover, we investigated the clinical significance of PTEN expression and exosome secretion by retrospective analysis.PTEN facilitated lysosome biogenesis and acidification through its protein phosphatase activity to dephosphorylate TFEB at Ser211. Notably, PTEN deficiency increased exosome secretion by reducing lysosome-mediated degradation of multi-vesicular bodies (MVBs), which further facilitated the proliferation and invasion of CCA. TFEB agonist curcumin analog C1 restrained the metastatic phenotype caused by PTEN deficiency in mouse models, and we highlighted the correlation between PTEN deficiency and exosome secretion in clinical cohorts.In CCA, PTEN deficiency impairs lysosome biogenesis to facilitate exosome secretion and cancer metastasis in a TFEB phosphorylation-dependent manner.

Background: Pregnancy body mass index (BMI) influences fetal weight, yet no studies focused on the comparison of formulas’ predictive accuracy after considering it. Objective: This study aimed to find out the most accurate formula for predicting birth weight, especially in different BMI pregnant women. Methods: It is a prospective observational study. Using a convenient sampling, the participants who met the criteria for inclusion were recruited in a tertiary hospital from January to March 2019. BMI was calculated according to the pregnant woman’s weight and height at the first obstetric visit. The estimated birth weights were predicted by five formulas based on participants’ uterine height and abdominal circumference of the last obstetric examination. The actual birth weight was scaled in the delivery room. The root mean square error (RMSE), empirical cumulative distribution map (ECDP) and Bland–Altman plot were used to determine the accuracy of the formulas in predicting birth weight. Results: A total of 1197 pregnant women were recruited. The RMSE, median value and difference of Zhuo’s formula in predicting the actual birth weight were the smallest (348.7), the closest to 0 (20.0) g, and the smallest (-0.141 ± 11.511) g, respectively. In subgroup analysis, the RMSE of Zhuo’s formula was the smallest in the low and normal BMI groups, and the difference of Zhuo’s formula by Bland- Altman plot was the smallest (only 0.729±10.440) g in the overweight and obese group. Conclusion: Zhuo’s formula for predicting birth weight has the highest accuracy in different BMI groups. Thus, it is worth recommending for clinical use.