China has now entered into the aging acceleration period, and the demand for medical care, elderly care, and health services is also greatly increased. In view of the nature of the "combination of medical treatment and care" and the modern medical model of "the combination of biological treatment and psychological treatment" in our hospital, our department has carried out clinical practice on hospice care. Supportive treatment of physical diseases in the elderly is our primary care service, while psychological support for family members is also an important part of our work. The medical staff in our department summarize and develop psychological support services for the dying elderly family members in the long-term clinical work, gradually developing a mature model and drawing the following conclusion: psychological support of hospice patients and their families is very necessary, feasible, and important and can be very effective to improve our service levels and clinician-patient communication. At the same time, hospice care services need the participation of doctors of many disciplines such as medicine, sociology, law, ethics, psychology, and pedagogy to promote the development of hospice care.

Chloasma is a disorder of symmetrical distribution of excessive facial melanosis, which usually occurs in middle-aged female and can affect their quality of life. The pathogenesis of chloasma is affected by many factors, including ultraviolet radiation, endocrine disorders, hormone levels change and genetic factors, etc. The pathogenesis remains unclear due to its complexity. There are various treatment methods for chloasma, especially laser treatment, whose accuracy and selectivity are reported to be excellent. Here the authors review relevant research of laser treatment in chloasma.

To assess the clinical curative effect of bundling bone fragments with double figure-of-eight suture in bony mallet finger.

A retrospective analysis was performed on 24 patients (24 fingers) with chronic bony mallet finger who underwent surgery at the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from June 2021 to May 2023. During the procedure, bundling bone fragment with double figure-of-eight suture was performed on the base of the distal phalanx. After removal of the Kirschner wire at postoperative 6 weeks, the flexion and extension of the affected finger were gradually strengthened, the range of motion (ROM) and the total active range of motion (TAM) of the finger were recorded. Finger function was evaluated according to the TAM system of the American Association of Hand Surgeons.

A total of 24 patients were enrolled, including 14 males and 10 females, and the age ranged from 16 to 54 years old. According to the Wehbe and Schneider classification, there were 5 cases of type Ia, 5 cases of type Ib, 8 cases of type IIa, 4 cases of type IIb, 1 cases of type Ⅲa, and 1 cases of type Ⅲb. The range of time from injury to operation was 21 days to 64 days. All incisions healed well, with no broken nail and no shedding nail. Mallet finger deformities were all corrected postoperatively, and all fractures healed well. All the 24 cases were followed, and the follow-up period was 6.0 to 9.3 months. At the last follow-up, the mean active ROM of the distal interphalangeal joint of the injured finger was 28.5°~39.2° [31.5° (31.1°, 33.7°)], and the mean active ROM of the distal interphalangeal joint of the healthy finger was 30.6°~40.2° [31.8° (32.°1, 35.2°)]. There was no significant difference in ROM between the injured finger and the healthy finger (Z=-3.92, P=0.724). The TAM of the injured finger was 229.4°~238.5° [232.2° (230.8°, 234.5°)], and that of the healthy finger was 230.2°~241.3° [234.1° (233.5°, 235.7°)]. There was no significant difference in TAM between the injured finger and the healthy finger (Z=-1.84, P=0.314). According to the evaluation criteria of the TAM system, 21 cases had excellent outcomes, and 3 had good outcomes, and the rate of excellent and good outcomes was 100%.

Satisfactory therapeutic outcomes for bony mallet finger deformity can be achieved by bundling bone fragment with double figure-of-eight suture, and it is an effective and practical method.

Tumorigenesis and tumor progression are inseparable from the tumor ecosystem consisting of the tumor itself and its microenvironment. The clinical translation from bench to bedside can help breast oncologists develop more comprehensive and effective treatment strategies for breast cancer. The rise of immunotherapy is changing the pattern of systemic treatment of breast cancer. Combination of immunotherapy with traditional treatment can further improve the prognosis of breast cancer patients. In the future, discovering new targets and more accurate predictive biomarkers for anti-tumor immunotherapy are of importance to improve the clinical effect of immunotherapy for breast cancer patients.

Schizoaffective disorder is a kind of psychogenic co-occurrence of both psychotic and affective symptoms. Although the latest DSM-5 diagnostic criteria have been published, there are still many problems related to the clinical application of the DSM-5 diagnostic criteria. This paper reviews the evolution of the diagnosis of schizoaffective disorder as well as its latest diagnostic criteria, etiology, treatment, and prognosis evaluation.

With the deepening of study on the immune mechanism of sepsis, it is now generally believed that host immune responses to sepsis involve multiple sequential or concurrent processes, including both excessive inflammation and immunosuppression. The main mechanism is immune dysfunction, including abnormalities in innate and adaptive immune responses. Based on the recent study of immune mechanism in sepsis, we explore the changes of the body′s immune response in sepsis from the perspective of innate immunity and adaptive immunity.

Interleukin (IL)-33, belonging to the IL-1 cytokine family, induces a Th2 immune response through the ST2 membrane receptor and plays an important role in the regulation of the immune system. IL-33 is mainly secreted by epithelial cells and can also be produced by other cells such as bone marrow cells, dendritic cells, macrophages, and mast cells. The IL-33 receptor ST2 is widely expressed in a variety of cells. Th2 cells, mast cells, basophils, and eosinophils areall involved in the development of bronchial asthma (BA). IL-33 is thought to be the initiating factor of the Th2 type of immune response, and the development of allergic diseases such as asthma is induced by activating the innate immunity and adaptive immunity. Further understanding of the biological characteristics of IL-33 can help to elucidate its role in the treatment of asthma.

Bronchial asthma (asthma) is a chronic inflammatory airway disease involving a variety of inflammatory cells and inflammatory mediators. The imbalance of Thl/Th2 immune responses leads to airway hyperresponsiveness and eosinophilic airway inflammation. However, Th17 cells play a role in the pathophysiology of asthma through the recruitment and activation of neutrophils. Neutrophil infiltration is related to the occurrence of moderate-to-severe asthma. Therefore, Th17 cells may be a potential therapeutic target for asthma, especially moderate-to-severe asthma. Further studies to dissect the molecular mechanism of Th17 cell differentiation will contribute to developing a novel strategy for treatment of neutrophilic asthma.

Deep-learning computer-assisted decision-making (DL-CAD) medical device software has high technical content, high clinical value and high social attention. Center for Medical Device Evaluation (CMDE) has introduced several policies to encourage technological innovation and promote industry development. As an innovative clinical application technology, neither manufacturer nor reviewer has enough experience with registration and evaluation of DL-CAD devices. In consequence, many misunderstanding exist in its clinical evaluation requirement. This article aims to provide reference for investigators, manufacturers and reviewers, as well as summarize elements of clinical trial design, and bias control methods, by investigating and surveying global supervision requirements & experience, academic research achievements.

Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder, with clinical manifestations of irregular menses, hyperandrogenaemia or excess levels of androgen, insulin resistance, anovulatory infertility, etc. At present, the exact etiology and pathogenesis of PCOS is still unclear. Studies have found that vitamin D deficiency is common in PCOS, and appropriate vitamin D supplementation may help improve clinically relevant symptoms and fertility status in patients with PCOS. This article reviews the current literature on the influence of vitamin D on PCOS patients.

Syringomyelia occurs in about 70% of cases with Chiari malformation and 10% of cases with basilar invagination. There are many surgical treatments for Chiari malformation with syringomyelia, such as posterior fossa decompression and cavitary shunt. Different methods of posterior fossa decompression have been performed in Chiari malformation with syringomyelia, with varying failed rates reported. At present, there are many reoperation procedures for failed cases, such as second foramen magnum decompression, syringo-subarachnoid shunt, syringo-abdominal shunt, syringo-thoracic shunt, fourth ventricle-cervical subarachnoid shunt, and surgical treatments for special complications. Each procedure should be selected based on the patient's condition to relieve the symptoms.

Graves disease (GD), also known as toxic diffuse goiter, is the most common cause of hyperthyroidism. Recent studies have shown that the interaction between genetic susceptibility and environmental predisposing factors is possibly the key cause of GD, and epigenetics is a bridge between the environment and genetics. Evidence indicates that epigenetic changes including DNA methylation, histone covalent modification, and gene silencing mediated by non-coding RNA molecules play an important role in the pathogenesis of GD. This article mainly describes the epigenetics involved in the pathogenesis of GD and its potential clinical applications.

To identify the risk factors for osteoporosis (OP) associated with type 2 diabetes mellitus (T2DM), and to assess the clinical application values of quantitative CT in the early diagnosis of this condition.

We selected 220 T2DM patients at Northern Jiangsu People′s Hospital as study subjects. Dual-energy X-ray absorptiometry (DXA) and quantitative CT were used to detect the bone mineral density (BMD) and volume bone mineral density of the lumbar spine, respectively. The patients were divided into either an OP group or a non-OP group according to the BMD of the lumbar spine detected by DXA. Gender, age, duration of disease, BMI, FPG, 2hPG, FCP, 2hCP, HbA1c, CHO, TG, HDL-C, LDL-C, alkaline phosphatase, phosphorus, calcium, parathormone (PTH), CTx, N-MID, TP1NP, vitamin D, and creatinine were compared between the two groups, and correlation and regression analyses were also performed.

The prevalence of OP in women was higher than that in men (46.4% vs 29.3%, χ²=8.319, P=0.012). The average age, duration of disease, HbA1c, PTH, and CTx of the OP group were significantly higher than those of the non-OP group (P<0.05). BMI, N-MID, TP1NP, and vitamin D in the OP group were significantly lower than those in the non-OP group (P<0.05). CTx was negatively associated with 2hPG (r=-0.165, P<0.05). TP1NP was negatively associated with FPG (r=-0.224, P<0.05) and 2hPG (r=-0.191, P<0.05). N-MID was negatively associated with FPG (r=-0.280, P<0.05), 2hPG (r=-0.183, P<0.05), TG (r=-0.293, P<0.05), and HbA1c (r=-0.238, P<0.05). Vitamin D was inversely associated with duration of T2DM (r=-0.224, P<0.05) and positively associated with BMI (r=0.167, P<0.05). BMD of the lumbar spine in T2DM patients was negatively correlated with age (r=-0.371, P<0.05), HbA1c (r=-0.173, P<0.05), and duration of T2DM (r=-0.230, P<0.05), and positively correlated with BMI (r=0.231, P<0.05). There was a linear regression relationship between BMD of the lumbar spine and age, duration, BMI, HbA1c, PTH, and CTx in T2DM patients. Compared with DXA, quantitative CT had a sensitivity of 100% and specificity of 80.3% in the early diagnosis of type 2 diabetic osteoporosis.

Poor glucose control is associated with decreased bone formation in T2DM patients. Female gender, advanced age, long duration of T2DM, and poor blood glucose control are the main risk factors for OP, while BMI in a certain range is a protective factor for OP. The influence of age, HbA1c, duration of T2DM, PTH, CTx, and BMI on BMD of the lumbar vertebrae gradually increases. Compared with DXA, quantitative CT has greater value in the early diagnosis of type 2 diabetic osteoporosis.

Multiparametric magnetic resonance imaging (MRI) plays an important role in the diagnosis and treatment of breast cancer. With the development of breast MRI, more quantitative indicators from functional sequences have emerged to facilitate breast cancer screening, diagnosis, and evaluation of treatment and prognosis. This paper will review the requirements and protocol of multiparametric breast MRI, indications for clinical examination, and new promising innovations in breast MRI.