The contribution of the lung microbiota to pneumonia in children of varying severity remains poorly understood. This study utilized metagenomic next-generation sequencing (mNGS) technology to elucidate the characteristics of lung microbiota and their association with disease severity. This retrospective study analyzed bronchoalveolar lavage fluid (BALF) mNGS data of 92 children diagnosed with pneumonia between January 2021 and July 2022. A comparative analysis of the lung microbiota was conducted between the severe pneumonia (SP) (n = 44) and non-severe pneumonia (NSP) (n = 48) groups. Compared to conventional microbiological tests (CMT), mNGS had a higher positivity rate in etiology detection (68% vs 100%). In the NSP group, the predominant type of infection was Mycoplasma pneumoniae single infection, whereas in the SP group, the main type involved a combination of M pneumoniae and bacterial infection. The top 3 identified microbial taxa in both the groups were M pneumoniae, Rothia mucilaginosa, and Schaalia odontolyticus. Although there were no significant differences in the α and β diversity of the lung microbiota between the SP and NSP groups, the abundance of M pneumoniae was higher in the SP group (P = .053). Spearman analysis indicated a highly significant positive correlation between the abundance of Prevotella melaninogenica and M pneumoniae (P < .001). Our analysis identified an association between M pneumoniae infections and disease severity. This study provides a foundation for a better understanding of the pathogenesis of pediatric pneumonia and the relationship between microorganisms.

This study aims to evaluate the ultrasonographic features associated with testicular infarction, determine the diagnostic effectiveness of contrast-enhanced ultrasound (CEUS) in assessing the testicular vascular system, and investigate the etiological factors contributing to testicular infarction. A retrospective analysis was performed involving 12 patients with confirmed testicular infarction. Each participant underwent standard superficial ultrasound examinations, followed by CEUS. The acquired imaging data were subsequently analyzed, taking into consideration the clinical conditions preceding the imaging assessments. A total of 13 lesions were detected across the 12 patients, with 1 individual exhibiting bilateral infarcts in the left testis. Based on the CEUS imaging findings, a classification system was developed to categorize the lesions into 4 distinct types: mediastinal branch infarction, small vessel infarction, capillary infarction, and mixed testicular infarction. This classification system offers a structured approach for understanding and potentially mitigating the causes of testicular infarction. CEUS markedly improves the diagnostic accuracy for testicular infarction and serves as a crucial tool in both the diagnosis and etiological assessment of this condition.

A large number of studies have shown that high expression of vascular endothelial growth factor (VEGF) in cancer tissues is associated with poor prognosis of various cancers. However, this finding in endometrial cancer is controversial. Therefore, this meta-analysis aimed to explore the effects of VEGF on survival in patients with endometrial cancer. Four databases of PubMed, Medline, Web of Science, and China National Knowledge Infrastructure were searched to collect literature that met the inclusion criteria. The association between high VEGF expression and survival outcomes and clinicopathological features of patients with cancer was evaluated by calculating the combined hazard ratio (HR), odds ratio (OR), and 95% confidence interval (CI). The Begg test was used to assess publication bias. A total of 11 studies were included, involving 1251 patients. The results showed that compared with low VEGF expression, high VEGF expression was significantly associated with shorter overall survival (HR = 2.44, 95% CI = 1.15-5.16, I2 = 80%, P = .02) and disease-specific survival (HR = 7.87, 95% CI = 1.70-36.44, I2 = 64%, P = .008) but not with disease-free survival (HR = 1.45, 95% CI = 0.70-3.02, I2 = 68%, P = .32). In addition, VEGF expression is higher in patients with advanced stage (OR = 3.70, 95% CI = 2.22-6.19, P < .001), lower histological differentiation (OR = 2.08, 95% CI = 1.22-3.55, P = .007), and lymph node metastasis (OR = 5.42, 95% CI = 2.35-5.11, P < .001). High VEGF expression can predict poor prognosis and poor clinicopathological features in patients with endometrial cancer, and it may be a valuable new indicator to evaluate the prognosis of patients with endometrial cancer.

This study explores the application and advancements of precision nursing model (PNM) in hemodialysis for diabetic nephropathy patients. Diabetic nephropathy is a severe complication of diabetes, frequently leading to end-stage renal disease and necessitating long-term hemodialysis. The PNM aims to enhance treatment outcomes and patient quality of life through individualized care plans, multidisciplinary collaboration, and continuous quality improvement. Research indicates that this model significantly improves clinical indicators and patient satisfaction, demonstrating broad applicability. This paper provides a detailed overview of the definition, theoretical foundation, implementation strategies, and specific interventions of the PNM, and evaluates its effectiveness in hemodialysis. Additionally, it addresses the challenges faced in implementation and suggests future research directions. Emphasis is placed on the need for long-term studies, technological innovations, and cost-effectiveness analyses to further integrate precision nursing into clinical practice.

Previous studies have highlighted the correlation between inflammatory responses and vestibular neuritis (VN). The aim of Mendelian randomization was to assess the causal associations between 91 inflammatory proteins and vestibular neuritis comprehensively. By leveraging publicly accessible genetic datasets, we probed whether 91 inflammatory proteins serve as upstream determinants of vestibular neuritis. We conducted a comprehensive sensitivity analysis to assess the robustness, heterogeneity, and polygenicity of our findings. Three inflammatory proteins were found to exert a significant causal effect on the VN: eotaxin levels are associated with a reduced risk of VN (inverse variance weighting [IVW]: odds ratio [OR] = 0.7113, 95% confidence intervals [CI] = 0.5199-0.9731, P = .0331). Similarly, the measurement of monocyte chemotactic protein-2 is linked to a decreased risk of VN (IVW: OR = 0.8535, 95% CI = 0.7328-0.9942, P = .0418). Conversely, an increase in the level of the T-cell surface glycoprotein CD5 is correlated with an increased risk of VN (IVW: OR = 1.3969, 95% CI = 1.0095-1.9331, P = .0437). This study suggested that eotaxin, monocyte chemotactic protein-2, and the T-cell surface glycoprotein CD5 may play crucial roles in the pathogenesis of VN. The potential use of these inflammatory proteins for diagnosing VN or as therapeutic targets has significant clinical implications.

Over the past 2 decades, lidocaine's application in oncologic surgery has received significant attention. It has potential antitumor effects and acts as a chemosensitizer. The aim of this study is to analyze the process and frontiers of lidocaine application in oncologic surgery over the past 20 years. A bibliometric analysis was performed and CiteSpace software was used to conduct metrology, co-occurrence, and cluster analysis. Articles retrieved from the Web of Science database from January 1, 2004 to May 27, 2024. Inclusion criteria comprised peer-reviewed original articles or reviews on lidocaine and cancer, excluding conference abstracts, corrigenda, repeated publications, and unrelated articles. A total of 956 articles were included in this study. Two hundred seventeen were selected for detailed analysis. The annual publication count showed an overall increasing trend, peaking in 2022. The United States emerged as the leading country in terms of publication frequency and centrality. Major research themes included lidocaine's antiproliferative effects, enhancement of chemotherapy efficacy, and various administration methods. Based on the above results, we draw a conclusion that the relationship between lidocaine and cancer has garnered increasing attention, with research in this area rapidly developing. Lidocaine exhibits significant antitumor effects and potential as a chemosensitizer, enhancing the efficacy of traditional chemotherapy. These findings underscore the importance of further research to fully elucidate lidocaine's mechanisms and its potential clinical applications in oncology.

The Pulse Index Contour Continuous Cardiac Output (PICCO) module provides advanced and continuous monitoring of cardiac output through the use of arterial pulse contour analysis and transpulmonary thermodilution. The objective of this study was to compare the early postoperative outcomes of patients who were monitored using the conventional method and the pulse contour analysis method. A prospective observational study was conducted involving 45 patients who underwent cardiac surgery between 2020 and 2022. Patients were randomly assigned to either Group P (PICCO) or Group C (conventional). In the PICCO cohort, a femoral artery cannula was inserted for the continuous recording and management of hemodynamic data, in accordance with the decision-making algorithm of the module. In the conventional group, cannulation of the radial artery and jugular vein was performed. The postoperative hemodynamic and clinical data are subjected to analysis. The utilization of dopamine was markedly diminished in Group P at both the 0- and 6-hour postoperative intervals, whereas the administration of dobutamine was observed to be elevated (P = .008). The frequency of red packed cell transfusions was higher in Group C at postoperative hour 0. Hemodynamic data indicated a 42% increase in cardiac index and a 33% decrease in systemic vascular resistance, along with a 33% increase in global ejection fraction in patients monitored with PICCO. The mortality rates observed in the 2 groups were not statistically different. The implementation of advanced monitoring techniques, specifically the PICCO module, led to notable enhancements in hemodynamic parameters. The utilization of this technique may prove advantageous in guiding inotrope selection and transfusion decisions during the initial postoperative period. However, it is important to note that morbidity and mortality rates remain comparable.

The effectiveness of Gamma Knife radiosurgery (GKRS) in treating trigeminal neuralgia (TN) has been demonstrated by a number of previous studies. However, there is a lack of research specifically documenting the initial and long-term outcomes of paroxysmal and persistent pain respectively following GKRS for TN with concomitant continuous pain (CCP). This study retrospectively analyzed pain outcomes and complications in 46 TN patients with CCP and 112 patients without CCP who underwent GKRS as initial surgical intervention at our institution from January 2019 to January 2024. Pain outcomes were classified as excellent (BNI I), good (BNI II-IIIa), and poor (BNI IIIb-V). Demographic and clinical data, pain outcomes, and complications were compared between patients with and without CCP. Subsequently, risk factors for poor outcomes after GKRS were evaluated using univariate and multivariate Cox regression analysis. The initial rate of poor outcomes in TN patients with CCP was similar to that of patients without CCP (15.8% vs 14.4%, P = .878). Following a minimum 6-month follow-up, the rate of poor pain outcomes increased to 37.0% in patients with CCP, compared to 38.4% in those without CCP (P = .968). Notably, the rate of long-term complete pain relief in patients without CCP was significantly higher than in those with CCP (35.7% vs 15.2%, P < .001). Poor response to medication (P < .001) was identified as an independent risk factors for poor outcomes after GKRS. While most TN patients with or without CCP can achieve favorable pain outcomes after GKRS, individuals with CCP were less likely to achieve complete pain relief compared to those without CCP.

To create a nomogram for accurate prognosis of patients with clear cell renal cell carcinoma (ccRCC) based on computed tomography images. Eight hundred twenty-two ccRCC patients with contrast-enhanced computed tomography images involved in this study were collected. A rectangular region of interest surrounding the tumor was used to extract quantitative radiomics and deep-learning features, which were filtered by Cox proportional hazard regression model and least absolute shrinkage and selection operator. Then the selected features formed a fusion signature, which was assessed by Cox proportional hazard regression model method, Kaplan-Meier analysis, receiver operating characteristic curves, and concordance index (C-index) in different clinical subgroups. Finally, a nomogram constructed with this signature and clinicopathologic risk factors was assessed by C-index and survival calibration curves. The fusion signature performed better than the radiomics signature. Then we combined this signature and 2 clinicopathologic risk factors. This nomogram showed an increase of about 20% in C-index values when compared to clinical nomogram in both datasets. Its prediction probability was also in good agreement with the actual ratio. The proposed fusion nomogram provided a noninvasive and easy-to-use model for survival prognosis of ccRCC patients in future clinical use, without the requirement to perform a detailed segmentation for radiologists.

There are no reports comparing diet recovery between patients who underwent distal gastrectomy (DG) and those who underwent total gastrectomy (TG). The aim of the present study was to compare dietary habits and nutritional status after curative treatment with DG and TG in patients with gastric cancer. We retrospectively collected clinical data from 263 consecutive patients who underwent gastrectomy for gastric cancer without recurrence at a single-center between January 2016 and December 2022. Demographic data, diet questionnaires, and laboratory data were collected. Patients were divided into 2 groups: those who underwent DG and those who underwent TG. Dietary habits and nutritional status were compared between the groups from preoperation until the 36th postoperative month (POM). For the DG and TG groups, the diet volume increased similarly up to the 3rd POM. However, the diet volume of the DG group increased by approximately 10 percentage points compared to that of the TG group from the 6th POM to the 24th POM (77.7% vs 67.8%, P = .025) and 36th POM (77.8% vs 69.8%, P = .104). The volume of the DG group increased until the 24th POM, and the frequency of the DG group decreased until the 36th POM. In contrast, the diet volume of the TG group increased until the 3rd POM (P = .005) but then plateaued, and the diet frequency did not decrease until the 36th POM compared to the 1st POM (P > .05). Nutritional status did not significantly differ between the 2 groups. Patients who underwent TG had a lower diet volume and a greater diet frequency than DG patients did after 6 months. Postoperative nutrition education should be tailored differently for patients undergoing DG and TG. Specifically, TG patients should be educated to increase diet frequency rather than diet volume after surgery.