To explore the relationship between the trajectory of blood phosphorus levels and the clinical outcome of patients with severe pneumonia.

The clinical data of 1055 patients with severe pneumonia admitted to the Department of Critical Care Medicine of the First Hospital of Lanzhou University were retrospectively analyzed. According to the changes of blood phosphorus level during hospitalization, the trajectory analysis of blood phosphorus level was carried out, and the patients were grouped according to the trajectory. The basic data between different groups of patients were analyzed, and the Kaplan-Meier survival curve was performed. Univariate and multivariate COX regression analyses were performed to explore the relationship between different blood phosphorus level trajectories and the proportion of mechanical ventilation, mechanical ventilation time, and 28-day survival.

A total of 1055 patients were divided into three trajectory groups: persistent hypophosphatemia group, normal serum phosphorus level group, and progressive hypophosphatemia group. The mortality rate was higher in the persistent hypophosphatemia group, and the proportion of tracheal intubation, mechanical ventilation time, and hospitalization time were longer. COX survival analysis showed that patients with normal serum phosphorus levels had a lower risk of death (hazard ratio=0.594, 95% confidence interval: 0.388~0.908). After adjusting for confounding factors such as SOFA score, APACHE II score, age, lactic acid, serum calcium, absolute monocyte count, absolute lymphocyte count, tracheal intubation, and ventilator use time, the results were still significant.

Persistent hypophosphatemia is associated with a poor prognosis in patients with severe pneumonia. Maintaining normal and stable serum phosphorus level is helpful to improve the short-term prognosis of such patients.

To analyze the correlation between the surface electromyography (sEMG) characteristics of the pelvic floor in patients with different types of pelvic floor dysfunction (PFD) and their clinical manifestations and prognosis, with an aim to provide a basis for precision rehabilitation.

A retrospective analysis was conducted on 447 patients with PFD who were treated at the Second Affiliated Hospital of Nanjing University of Chinese Medicine from February 2020 to January 2025. These patients were categorized into three groups based on their clinical symptoms: stress urinary incontinence (SUI) group, functional constipation (FC) group, and fecal incontinence (FI) group. sEMG data and clinical information were collected from the patients, and the correlation between electromyographic characteristics and clinical manifestations as well as prognosis was analyzed using the Kruskal-Wallis H test, DSCF method, and Wilcoxon signed-rank test.

There were 227 patients in the SUI group, 141 in the FC group, and 79 in the FI group. The clinical symptoms across all three groups were rated as moderate to severe. The total score and the scores across the five stages of sEMG differed significantly among the three groups (P<0.001). The total score, fast muscle stage score, slow muscle stage score, and endurance test score in the SUI group were significantly higher than those in the FC group and FI group (P<0.01), while the scores in the pre-rest and post-rest stages were lower. The scores in the pre-rest and post-rest stages were significantly higher in the FC group than in the SUI group (P<0.001), while the scores in the fast muscle stage, slow muscle stage, and endurance test were lower. The score in the post-rest stage was significantly higher in the FI group than in the SUI group and FC group (P<0.01), while the total score and the scores in the fast muscle stage, slow muscle stage, and endurance test stage were lower. After intervention with pelvic floor rehabilitation therapy, the clinical symptoms of the three groups were significantly improved (P<0.001), and the sEMG scores increased. The sEMG score in the post-rest stage significantly increased in the FC group (P<0.05); the sEMG scores in the total score, fast muscle stage, and slow muscle stage significantly increased in the FI group (P<0.05); and the total score and sEMG in the pre-rest stage, fast muscle stage, and slow muscle stage significantly increased in the SUI group (P<0.05).

The sEMG characteristics of patients with different types of PFD exhibit significant differences. sEMG can objectively quantify the pelvic floor dysfunction patterns in PFD patients. It is advisable to incorporate sEMG into the routine evaluation system for PFD, and develop precise stratified rehabilitation strategies based on sEMG characteristics to enhance treatment efficacy. This study suggests a correlation between sEMG features and clinical manifestations as well as short-term prognosis, though the underlying mechanisms require further validation via multimodal approaches.

To explore the impact of follow-up management based on the transtheoretical model (TTM) on health behaviors and medication adherence in patients with depression.

Using convenience sampling, 88 patients with depression hospitalized in the Department of Psychiatry and Psychosomatic Medicine of Zhongda Hospital Affiliated to Southeast University in Nanjing, Jiangsu Province from March 2022 to September 2023 were selected as participants. They were randomly divided into a control group and an intervention group using the random number table method. The control group received routine discharge follow-up management, while the intervention group underwent TTM-based follow-up management for medication adherence, starting one day before discharge and continuing for six months post-discharge. Medication adherence (assessed via the Medication Adherence Rating Scale, MARS), medication-related beliefs (evaluated using the Beliefs about Medication Questionnaire, BMQ), and insight and treatment attitudes (measured by the Insight and Treatment Attitudes Questionnaire, ITAQ) were compared between the two groups at baseline (pre-discharge), 1 month, 3 months, and 6 months post-discharge.

Repeated measures ANOVA revealed significant group-time interaction effects in medication adherence, medication beliefs, insight, and treatment attitudes (all P<0.05).

TTM-based follow-up management effectively enhances medication adherence, strengthens positive medication beliefs, improves insight and treatment attitudes, enhances disease awareness, promotes compliance with medical advice, and reduces the risk of relapse in patients with depression.

To identify the influencing factors of post-traumatic stress disorder (PTSD) in young and middle-aged stroke patients, construct a risk prediction nomogram model, and validate its predictive accuracy.

A total of 514 young and middle-aged stroke patients treated in the Department of Neurology, Huai'an Hospital Affiliated to Xuzhou Medical University from September 2023 to December 2024 were recruited as research participants using convenience sampling. Data were collected using the General Information Questionnaire, Impact of Event Scale-Revised (IES-R), Activities of Daily Living (ADL) Scale, Perceived Social Support Scale, and Connor-Davidson Resilience Scale. Univariate analysis and logistic regression analysis were conducted to identify the influencing factors of PTSD. Subsequently, a nomogram-based prediction model was developed and validated.

Education level, dysphagia, hemiplegia, and ADL score were identified as independent influencing factors for PTSD in young and middle-aged stroke patients (P<0.05). The Hosmer-Lemeshow goodness-of-fit test indicated an adequate model fit (χ²=1.468, P=0.690). The area under the receiver operating characteristic curve (AUC) for the training set was 0.838 (95% confidence interval [CI]: 0.792~0.880), with the optimal cutoff value at 0.239, achieving a sensitivity of 78.69% and specificity of 76.89%. For the test set, the AUC was 0.822 (95%CI: 0.715~0.882), with the optimal cutoff value at 0.290, resulting in a sensitivity of 77.08% and specificity of 75.52%.

The risk prediction model developed in this study is capable of effectively forecasting the incidence of PTSD, thereby assisting medical professionals in the early identification of high-risk groups among young and middle-aged stroke patients and the development of personalized intervention strategies.

To explore how dimethyl fumarate (DMF) protects against oxidative stress-induced melanocyte injury, in order to offer new ideas for vitiligo treatment.

The optimal DMF concentration for melanocytes was determined by assessing its impact on their proliferation. An oxidative stress model was created using H₂O₂. The study involved four groups: normal control, H₂O₂-treated, H₂O₂+DMF, and H₂O₂+DMF+ML385 (a Nrf2 inhibitor). Melanocyte morphology, dendrite length, and cell number were observed. The effect of DMF on melanocyte apoptosis under oxidative stress was evaluated with an apoptosis detection kit. Flow cytometry and immunofluorescence staining were used to measure intracellular ROS levels and CAT/SOD activity. Western blot analysis was performed to detect the expression of Nrf2, p-Nrf2, and HO-1. The four groups were compared for the above parameters to confirm Nrf2's role in DMF's antioxidant mechanism.

The H₂O₂-treated group had shorter dendrites, fewer dendrites, more apoptosis-positive cells, higher intracellular ROS, and lower SOD/CAT activity than the normal control group. The H₂O₂+DMF group had significantly inhibited oxidative stress-induced melanocyte apoptosis, reduced ROS, increased SOD/CAT activity, and boosted Nrf2, p-Nrf2, and HO-1 expression. In the H₂O₂+DMF+ML385 group, SOD/CAT activity decreased, and intracellular ROS rose compared to the H₂O₂+DMF group.

DMF protects against oxidative stress-induced melanocyte injury by activating the Nrf2/HO-1 pathway and enhancing antioxidant capacity, showing potential for vitiligo therapy.

Adverse environmental factors, nutritional status, and chemical exposures early in life may increase the risk of chronic diseases such as obesity, diabetes, cardiovascular disease, and musculoskeletal disorders in adulthood by affecting an individual's growth and development. Previous studies have shown that maternal smoking, antibiotic use during pregnancy, early infections, and low socioeconomic status are significantly associated with childhood obesity and increased body mass index in adulthood. In addition, breastfeeding practices and duration early in life and adverse childhood experiences are strongly associated with the development of musculoskeletal system disorders (osteoarthritis) and circulatory system disorders (atherosclerosis) in adulthood. Based on the DOHaD (Developmental Origins of Health and Disease) theory, this paper systematically comprehends the impact of early life risk factor exposure on the development of chronic diseases in adulthood, provides new ideas for the prevention and treatment of chronic diseases in adulthood, and emphasizes the importance of early life intervention.

Total joint arthroplasty (TJA) is a crucial treatment modality for various orthopedic diseases. Heterotopic ossification (HO) following TJA can lead to limited joint function, pain, and even joint stiffness, significantly compromising the surgical outcomes and increasing the risk of revision surgery. Therefore, HO is a major complication that affects the long-term efficacy of TJA. The incidence of HO after TJA is relatively high. Once it occurs, it can notably impact patients' functionality. However, there is currently no unified consensus on its prevention and treatment among clinicians. This paper systematically reviews the epidemiology, risk factors, and pathogenesis of HO after TJA, outlines the stratified diagnostic strategies involving X-ray, CT, MRI/ultrasound, and bone scan, as well as the application of the Brooker classification, compares the preventive and therapeutic options for different risk populations, and proposes a management framework of "high-risk identification + individualized combined prevention" to provide a reference for clinical practice.

Gastric cancer is one of the most common malignant tumors in the world, characterized by a high degree of malignancy and poor prognosis. In recent years, immunotargeted therapy for tumors has become a hot research topic, and more and more biological targets have been discovered. Erythropoietin-induced hepatocyte receptor A2 (EphA2) is a receptor tyrosine kinase involved in the proliferation, invasion, and metastasis of gastric cancer cells. This article reviews the role of EphA2 in the pathogenesis of gastric cancer and its therapeutic potential.

Pulmonary contusion, a common consequence of blunt chest trauma, exhibits a mortality and prognostic profile strongly linked to its severity. This article synthesizes current knowledge on the pathophysiological mechanisms of pulmonary contusion, encompassing lung tissue damage, cellular and cytokine responses, arachidonic acid metabolites, reactive oxygen species, the complement system, and the coagulation cascad. By elucidating this complex inflammatory network, we aim to bridge fundamental research with clinical practice. Furthermore, we summarize recent advances in understanding these mechanisms and discuss emerging treatment strategies that target them, with the ultimate goal of improving patient outcomes through timely intervention.

Diabetic nephropathy is becoming the main cause of chronic kidney disease. Although more and more evidence indicates that immunity and inflammation are highly involved in the pathogenesis and progression of diabetic nephropathy, the underlying mechanisms remain unclear. This review mainly summarizes the phenotypic changes of macrophages, focuses on the interaction between macrophages and intrinsic renal cells, further explores the mechanism of macrophages in the occurrence and development of diabetic nephropathy, and provides new ideas for the development of treatment methods and drugs for diabetic nephropathy.

This study analyzes the pathologic complete response (pCR) in five patients with limited-stage small-cell lung cancer (LS-SCLC) following neoadjuvant therapy, presenting their clinical characteristics, treatment regimens, and prognoses.