Objective: To investigate the possible association between cross-domain associative memory (AM) impairment and hippocampal subfield volumes in patients with schizophrenia (SCZ). Methods: We enrolled 28 SCZ patients from Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, and 28 healthy controls (HCs) between 2019 and 2021. Based on an innovative AM paradigm and automated segmentation, 3D-T1 weighted data of the objects were processed with PhiPipe and FreeSurfer. Differences in subfield volums between the two groups were analyzed using ANCOVA, while their relationship with AM scores was assessed using Pearson correlation. Results: SCZ patients exhibited significantly poorer AM performance across three conditions compared with HCs. Marginally significant reductions were observed in the total volume of bilateral hippocampus, encompassing both the hippocampal head and body. Significant volume reductions were identified in the bilateral presubiculum and parasubiculum. The volumes of bilateral presubiculum head (r=0.273, P=0.042), parasubiculum (r=0.397, P=0.002), and CA1 head (r=0.382, P=0.004) exhibited positive correlations with cross-domain AM performance. Conclusion: The bilateral presubiculum and parasubiculum, as hippocampal subregions significantly associated with cross-modal AM deficits in SCZ, may play a crucial role in the pathology of AM.
Objective: To describe and analyze the current status, changing trend and influencing factors of the disease burden of cervical, endometrial and ovarian cancer in China from 1990 to 2021. Methods: Data on incidence, mortality, disability-adjusted life year (DALY), and other indicators for cervical, endometrial and ovarian cancer were collected from the 2021 Global Burden of Disease database. Joinpoint regression models were used to analyze time trends, and age-period-cohort (APC) models assessed their impact on incidence and mortality. Spearman correlation analysis was performed to evaluate the relationship between the sociodemographic index (SDI) and the cancer indicators. Finally, the attributable risk factors for the disease burden were analyzed. Results: From 1990 to 2021, age-standardized incidence rates of cervical and endometrial cancers in China significantly increased, while ovarian cancer showed no significant change. Age-standardized mortality, DALY, and years of life lost due to premature death (YLL) decreased significantly. The disease burden was heavier in middle-aged and older groups. APC model indicated an increase in cervical cancer incidence and a decrease in mortality over time. Furthermore, the incidence risks of cervical and endometrial cancers were elevated in successive birth cohorts, whereas a lower risk was observed for ovarian cancer. Correlation analysis showed significant associations between cancer incidence and mortality with SDI. Obesity has significantly contributed to the disease burden of common gynecologic cancers in China. Conclusion: Mortality rates of cervical, endometrial and ovarian cancer have declined, while the incidence of cervical and endometrial cancers has significantly increased. The trends in incidence and mortality are influenced by age, period and cohort effects. Future efforts should focus on controlling risk factors like obesity to reduce the disease burden.
Objective: To investigate the effect of Nde1 gene knockout on early neural development of zebrafish by visualizing the development of neural networks in zebrafish. Methods: Transgenic zebrafish Tg (Nde1-/-; HuC: RFP+/-) was constructed by crossing Nde1-/- with Tg (HuC: RFP+/-). The HuC promoter was employed to drive the expression of red fluorescent protein in neurons, which allowing the visualization of zebrafish neural networks and tracking of neural development. Furthermore, by using Image J and Prism to compare the average fluorescence intensity of neurons and the expression level of fluorescent reporter proteins between Nde1 deficiency zebrafish and wild type zebrafish, the effect of Nde1 gene knockout on zebrafish neural development was analyzed. Results: From 48 hours post-fertilization (hpf) to 7 days dpf, the average fluorescence intensity of red fluorescence expressed by trigeminal sensory neurons and spinal cord neurons in Nde1 deficiency zebrafish was lower than that in wild type zebrafish. RT-qPCR results also showed that the mRNA expression level of red fluorescent reporter protein in Nde1 deficiency zebrafish was significantly lower than that in the wild type zebrafish. Conclusion: Nde1 gene deletion may lead to abnormal development of trigeminal sensory neurons and spinal cordneurons by affecting neural progenitor cell differentiation and increasing apoptosis.
Objective: To investigate the characteristics of changes in pain-anxiety-depression-fatigue symptom clusters and their possible associated factors in adolescents with acute lymphoblastic leukemia (ALL) during early chemotherapy. Methods: A prospective longitudinal study was conducted from Nov 2019 to Oct 2021, enrolling newly diagnosed adolescent ALL patients from 5 tertiary or pediatric specialty hospitals in Shanghai, Zhejiang Province, Sichuan Province, Anhui Province and Guangdong Province. Patient-reported pain, anxiety, depression, and fatigue were collected at five time points within the first nine weeks of chemotherapy using the PROMIS Pediatric-25 instrument. Latent profile analysis (LPA) and latent transition analysis (LTA) were applied to explore the latent classes of symptom clusters, their transition probabilities over time, and possible risk or protective factors associated with class membership. Results: A total of 134 ALL cases were enrolled, and symptom clusters at all the 5 time points (T1-T5) were consistently classified into three groups of mild, moderate and severe symptoms. The severe symptoms group accounted for the largest proportion at each time point (54.5%, 59.7%, 66.4%, 49.3%, and 47.0%, respectively), while the mild and moderate symptoms groups showed an initial decline followed by an increase. Among participants, 40.2% maintained the same symptom status, and 77.4% experienced at least one episode of severe symptom status during the trajectory. Religious affiliation (T5) and family monthly income > 5 000 Yuan (T2, T4 and T5) served as protective factors against severe symptoms. Higher baseline fatigue (T1) was associated with membership in the severe symptoms group at subsequent time points. Conclusion: Pain-anxiety-depression-fatigue symptoms in adolescents with ALL during early chemotherapy can be categorized into mild, moderate and severe symptoms with dynamic transitions over time. Higher baseline fatigue was associated with increased risk of severe symptoms, whereas higher family income and religious affiliation appeared protective effects.
Objective: To rescue a strain of Chikungunya virus (CHIKV) using reverse genetics system. Methods: Molecular cloning experiments, including PCR, agarose gel electrophoresis and homologous recombination were employed to generate an infectious cDNA clone (pFK-CHIKV-LN) derived from the isolated Caribbean Chikungunya strain (Caribbean strain, isolate M100, Genbank LN898083.1). The mRNA obtained from vitro transcription were transfected into BHK-21 to rescue the CHIKV. The viral titer was determined by 50% tissue culture infection dose (TCID50), with calculations performed using the Reed-Muench method. Western blot (WB) and real time quantitative polymerase chain reaction (RT-qPCR) were employed to assess the levels of viral protein and mRNA at various time points during infection. Results: The full-length cDNA clone of CHIKV was successfully constructed, enabling the rescue of CHIKV progeny. RT-qPCR and WB confirmed the significant increasing expression levels of NS1 mRNA and proteins (NS3, E1) of BHK-21 during the infection process. Conclusion: The full-length infectious clone of CHIKV has been constructed successfully, which provides a good tool for subsequent studies on the gene structure, protein function and pathogenic mechanism of CHIKV.
Objective: To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness (ILI) and severe acute respiratory infection (SARI) cases in Huzhou, Zhejiang Province before and after the COVID-19 pandemic, so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases. Methods: ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020 (pre-COVID-19 pandemic period) and Dec 2022 to Apr 2024 (post-COVID-19 mitigation phase) were selected as the participants. Seven common viral respiratory pathogens were tested, including influenza A virus (H1N1 and H3N2 subtypes), influenza B virus (Victoria lineage, FluB), respiratory syncytial virus (RSV), rhinovirus (HRV), adenovirus (ADV), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time. Results: A total of 7 948 ILI samples and 2 294 SARI samples were included. The overall positive rate of ILI samples increased from 33.6% to 47.1%, primarily due to the increase in influenza and COVID-19 infections; the overall positive rate of SARI samples decreased from 31.4% to 24.8%, mainly due to the reduction in HRV and ADV infections. During the post-COVID-19 mitigation phase, SARS-CoV-2 (22.1%), H3N2 (12.7%), and FluB(6.0%) were the primary pathogens in ILI samples, while RSV (7.1%), H3N2 (5.3%), and HRV (4.5%) dominated in SARI samples. During the post-COVID-19 mitigation phase, the influenza virus circulation period was shortened. Before the COVID-19 pandemic, RSV was mainly detected in autumn and winter, while during the post-COVID-19 mitigation phase, out-of-season RSV epidemics were observed in spring and summer. Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase, predominantly consisting of co-infections of COVID-19 and influenza A virus, while co-infection rate in SARI cases showed a decline. Conclusion: We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period, including increased positive rates of influenza and COVID-19, and disruptions to the seasonal patterns of influenza and RSV. The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.
Objective: To explore the differences in coronary-based and lesion-based fat attenuation index (FAI) in patients with coronary artery disease (CAD) across different risk stratifications, and to compare the diagnostic efficiency of coronary-based and lesion-based FAI in stable CAD patients with myocardial ischemia. Methods: The patients with CAD, who underwent preoperative coronary CT angiography (CCTA) and invasive coronary angiography (ICA) with coronary fractional flow reserve (FFR) measurement between Apr 2019 and Oct 2022 in Zhongshan Hospital, Fudan University, were retrospectively collected. There were 57 cases of acute coronary syndrome (ACS) patients and 206 cases of stable CAD patients included following inclusion criteria. The coronary-based and lesion-based FAI were measured, and the differences in these indices were recorded and analyzed among ACS patients, ischemic and non-ischemic groups of stable CAD patients (FFR=0.8 as the threshold). ROC curves were utilized to assess the diagnostic efficiency of coronary-based and lesion-based FAI for myocardial ischemia in stable CAD patients. Results: The coronary-based FAI and lesion-based FAI in ACS patients were significantly higher than those in stable CAD patients [coronary-based FAI: (-72.40±6.83) HU vs. (-76.82±9.01) HU, P < 0.001; lesion-based FAI: (-65.65±4.79) HU vs. (-77.48±8.64) HU, P < 0.001]. Among stable CAD patients, the lesion-based FAI in the ischemic group was significantly higher than that in the non-ischemic group [(-69.28±5.65) HU vs. (-80.10±7.75) HU, P < 0.001]. The diagnostic efficiency of lesion-based FAI for predicting myocardial ischemia in stable CAD patients was superior to coronary-based FAI (AUC: 0.892 vs. 0.525, Z=9.803, P < 0.001). Conclusion: Coronary-based and lesion-based FAI tended to be higher in ACS patients than in stable CAD patients, suggesting a potential for stratifying CAD patients with different risks. Lesion-based FAI showed some promise in evaluating myocardial ischemia among stable CAD patients.
Objective: To summarize and analyze the clinicopathological characteristics, imaging manifestations, treatment and prognosis of anaplastic lymphoma kinase (ALK)-positive histiocytosis (APH) involving the central nervous system (CNS), so as to enhance understanding of this rare disease. Methods: A retrospective analysis was conducted on 5 cases of CNS-involved APH diagnosed in Huashan Hospital, Fudan University between 2019 and 2023. Clinical, imaging and pathological data were collected, and supplemented by immunohistochemical staining (IHC), fluorescence in situ hybridization (FISH) and high-throughput sequencing for auxiliary diagnosis and molecular characterization. The findings were summarized and integrated with previous literature for a comprehensive analysis. Results: All five patients were male, with a mean age of 27.6 years, in which 2 cases exhibited multi-system involvement, while 3 cases exhibited single system involvement. Imaging revealed multiple intracranial lesions in multi-system cases and solitary lesions in single system cases, with well-defined boundaries and homogeneous enhancement. Histologically, tumor cells were intermingled with lymphocytes, displaying an alternating "light and dark" pattern in 1 case. Granuloma-like structures were observed in 4 cases, along with frequent nuclear grooves, indentations and convolutions. Tumor cells usually infiltrated surrounding tissues. IHC demonstrated that tumors expressed histiocytic markers (CD68/CD163) and ALK predominantly expressed in the cytoplasm. FISH confirmed ALK gene rearrangements in all patients, while high-throughput sequencing identified KIF5B-ALK fusions in 2 cases. All single system CNS cases achieved complete remission after surgical resection with or without adjuvant chemotherapy/ALK inhibitors. Among multi-system cases, one achieved partial remission, and one experienced relapse and progression. Conclusion: CNS APH is prone to preoperative misdiagnosis. Its histopathological features, ALK immunohistochemical expression, and ALK gene fusions are critical for diagnosis. Patients with single system involvement demonstrate overall superior outcomes compared to multi-system cases. Total resection is effective for localized disease, while multi-system cases require systemic therapy. Multidisciplinary collaboration is crucial for precise diagnosis and treatment.
Objective: To investigate the practical effects of pediatric rapid sequence intubation (RSI) nursing coordination training based on the LSPPDM (learn, see, practice, prove, do, maintain) framework in order to provide evidence for optimizing pediatric RSI nursing training programs. Methods: Nurses from the intensive care unit (ICU) of Children's Hospital, Fudan University during Feb 2023 and Jan 2024 were divided into the experimental group (n=35) and the control group (n=35) by block randomization. The experimental group received LSPPDM framework-based training, while the control group underwent conventional training with theoretical lectures and procedural demonstrations. Outcomes included training satisfaction, theoretical knowledge and procedural skill assessment scores, team collaboration compliance and RSI procedure time were compared between the two groups. Results: The experimental group demonstrated significantly higher training satisfaction (123.80±2.04 vs. 117.26±9.82, P < 0.05), superior post-training theoretical knowledge and procedural skills (P < 0.05), enhanced team collaboration compliance (P < 0.05), and shorter RSI completion time (P < 0.05) compared with the control group. Conclusion: Pediatric RSI nursing coordination training based on the LSPPDM framework can effectively increase training satisfaction, promote theoretical and procedural skills and reduce completion time in nurses.
Objective: To analyze the characteristics of capsule endoscopy (CE) in small intestinal diseases and the effect of prokinetic agents on CE, and to explore the diagnostic value of CE in small intestinal diseases. Methods: Clinical data were collected from 332 patients who underwent CE in Jinshan Hospital, Fudan University between May 2020 and Mar 2024, and the etiology and endoscopic characteristics of small intestinal diseases were analyzed. Patients were categorized based on the administration of metoclopramide into the non-use group (Group A) and use group (Group B). Group A was further subdivided based on whether the CE reached the cecum, forming the non-reach group (Group c) and the reach cecum group (Group d). Then we compared the capsule gastric transit time, small intestine transit time, completion rate of the entire small intestine examination, and lesion detection rate across these groups. Additionally, the detection rates of CE were compared with those of colonoscopy, small bowel enteroscopy-CT (SBE-CT), and double-balloon enteroscopy (DBE). Results: The most prevalent small intestinal lesions identified were erosions and ulcers, with Crohn's disease (CD) being the primary cause of ulcers, endoscopic ulcers exhibited atypical and diverse presentations, including aphthous and irregular ulcers. In comparison to Group A, Group B demonstrated a shorter small bowel transit time (P < 0.05) and a higher lesion detection rate (P < 0.05), while no significant difference was observed in the completion rate of the entire small bowel examination. Gastric emptying time and small intestinal transit time were prolonged in Group c compared with Group d (P < 0.05). There was no significant difference in the diagnostic rate of terminal ileum lesions between CE and colonoscopy, while the diagnostic rate of CE was higher in patients with terminal ileum lesions under colonoscopy (P < 0.05). The diagnostic rate of CE was higher than that of SBE-CT(P < 0.05), and the detection rate of CE and DBE was comparable. Conclusion: The morphology of small intestinal ulcers varies, and the endoscopic findings are not specific. Metoclopramide administered in real time after capsule ingestion can shorten the intestinal transit time and improve the diagnostic rate of CE. Positive lesions found during colonoscopy should be further evaluated with CE examination, the diagnostic accuracy of CE is higher than that of SBE-CT, CE and DBE have the same diagnostic value for small intestinal diseases.
Objective: To summarize the perioperative nursing experience for patients undergoing high-risk complex percutaneous coronary intervention (PCI) with the support of the percutaneous transvalvular left-ventricular assist system (SynFlow 3.0), and to explore the role of nursing interventions in improving procedural success and promoting patient recovery. Methods: A retrospective analysis was conducted on the clinical data of 26 patients who underwent SynFlow 3.0-assisted high-risk complex PCI in Zhongshan Hospital, Fudan University between Aug 2022 and Jul 2024. Stage-specific comprehensive nursing interventions were implemented throughout the perioperative period: Preoperatively, personalized nutritional support and cardiac function optimization were provided for patients with nutritional risk (NRS≥3), hypoalbuminemia (Alb < 30 g/L), or an early warning score≥4. Intraoperatively, the SynFlow 3.0 operational procedures were standardized, with reinforcement of aseptic techniques and hemodynamic monitoring. Postoperatively, patients were transferred to the ICU for continuous monitoring of circulatory parameters (blood pressure, central venous pressure, urine output, etc.) and hemolysis-related indicators, alongside active prevention of vascular complications, vagal reflex, and thrombotic events. Results: The procedural success rate was 100% in all 26 patients, with no severe complications occurring. Nursing interventions effectively maintained an intraoperative mean arterial pressure≥60 mmHg. Postoperative circulatory parameters remained stable (systolic blood pressure 90-130 mmHg, urine output > 50 mL/h), and no thrombotic or hemolytic events were reported. The left ventricular ejection fraction significantly increased from 32.44%±4.46% preoperatively to 38.55%±5.42% at 30 days postoperatively, and the difference was statistically significant (t=16.065, P < 0.001). Conclusion: The implementation of a full-process comprehensive nursing strategy for patients undergoing SynFlow 3.0-assisted high-risk complex PCI effectively stabilizes perioperative hemodynamics, reduces the risk of complications, ensures procedural safety, and promotes cardiac function recovery.
Objective: To compare the capture performance differences between TruSeq® Exome and NimbleGen SeqCap EZ Human Exome kits in children with cerebral palsy (CP), and to provide a technical selection basis for clinical genetic research and diagnosis. Methods: Peripheral blood samples from 48 sporadic CP patients were included. Exome libraries were constructed using TruSeq (DNA probes) and NimbleGen (RNA probes), followed by sequencing on the Illumina HiSeq 2000 platform. Bioinformatics analysis was applied to evaluate mapping rate, target region coverage, variant concordance, and clinical relevance based on a CP-related gene set (2 293 genes). The statistical analysis was performed using a paired t-test with a significance threshold of α=0.05. Results: The results showed no significant differences between NimbleGen and TruSeq exome capture kits in basic data quality (alignment rate, insert size) and GC content. However, they exhibited complementary characteristics in key performance metrics: NimbleGen demonstrated superior performance in specific depth coverage (1×coverage rate, P=1.84×10-5; 20×coverage rate, P=1.49×10-20). TruSeq, on the other hand, showed higher sensitivity in Indel detection (TruSeq vs. NimbleGen: 11 371±1 689 vs. 11 274±1 670, P=3.24×10-7) and rare variant capture (TruSeq vs. NimbleGen: 3 164±766 vs. 3 072±774, P=1.20×10-4), successfully identifying all 11 pathogenic variants (including 2 missed by NimbleGen). Conclusion: TruSeq, with its superior variant detection rate, is more suitable for clinical diagnostic applications, while NimbleGen's coverage stability may be advantageous for research-oriented projects.
Objective: To observe the effect of RAW264.7 cells on calcium sparks in a insulin resistance model of C2C12 cells induced by sodium palmitate. Methods: C2C12 cells and RAW264.7 cells were co-cultured to simulate the in vivo state of skeletal muscle. C2C12 cells were cultured in high-glucose medium containing 2% horse serum to induce differentiation into mature myotubes, and then divided into 5 groups: control (RAW264.7 cells), co-culture of C2C12 with RAW264.7, C2C12 alone, co-culture of C2C12 with RAW264.7 plus sodium palmitate (PA), and C2C12 alone with PA. PA of 5 mmol/L was used to induce insulin resistance in C2C12 cells for 24 hours. Revived and expanded RAW264.7 cells were evenly added to C2C12 cells and co-cultured for two days. Subsequently, cells were maintained in modified suspension culture, and both cell types were loaded with the calcium ion fluorescent probe Fluo-4 AM. Finally, Paraxanthine was used to induce intracellular calcium sparks, which was captured and recorded under a laser confocal microscope. Results: No significant calcium signal change was observed in the control group. Co-cultured C2C12 cells exhibited rapid and pronounced calcium signal changes, whereas calcium signals in C2C12 cells cultured alone increased slowly throughout the observation period without a sharp decline. The peak calcium signal was reached significantly faster in co-cultured C2C12 cells than that in C2C12 cells cultured alone (P < 0.001). With PA induction, calcium signal changes in C2C12 cells were not markedly altered, while distinct calcium fluctuations were still observed in co-cultured C2C12 cells, and the peak calcium signal was reached significantly faster in co-cultured C2C12 cells than that in C2C12 cells cultured alone (P < 0.001). Conclusion: RAW264.7 cells enhance the dynamic responsiveness of calcium signaling in both normal and PA-stimulated C2C12 cells.
The lung is a vital organ that is in direct contact with the external environment. It is extremely susceptible to a variety of exogenous factors, which can trigger a series of inflammatory responses and lead to varying degrees of tissue damage. With the development of genetic engineering technology, silencing specific target genes through RNA interference has become a new strategy for the treatment of lung injury. Small interfering RNA (siRNA) is a crucial role in RNA interference that can bind to the target gene through base complementary pairing to inhibit its expression, thereby producing a corresponding regulatory effect. Due to its specific targeting and low biological toxicity, siRNA is gradually becoming an ideal tool for the treatment of lung injury and other lung diseases. This article reviews the mechanism of action of siRNA and its application progress and research status in the treatment of lung injury.
The mode of cell death as well as the role of necroptosis in inflammatory diseases has gained importance in recent years. Chronic airway inflammatory diseases are common respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, which are often accompanied by persistent airway inflammation, and the pathogenesis of these diseases is complex and involves cell death pathways. The involvement of necroptosis in their pathogenesis is getting more and more attention. This review introduces reviewed the important pathways and factors of necroptosis, as well as its advances in mechanism of chronic airway inflammatory diseases, aiming to provide new ideas and targets for the research and treatment of chronic airway inflammatory diseases.
Calpain-mediated fibrosis, a physiological tissue repair process that almost occurs in most of tissues and organs, is closely related to multiple cellular pathways and is widely involved in the progression of diseases. It is believed that the pro- and anti-fibrotic systems are dynamic regulated in vivo, so pathological organ fibrosis still may be controlled and even reversed. This review summarizes the latest researches on the role of Calpain family in different organ fibrosis and the intervention of Calpain inhibitor in fibrosis progression, aiming to providing a reference for the research of Calpain family in fibrotic diseases context.
To explore an effective health management model for obese students, a comprehensive intervention was carried out for obese students with cardiovascular and metabolic risks, and the effectiveness of this intervention model was evaluated. From Jan to Apr 2024 (excluding the winter vacation), 300 students were selected from 6 primary schools in Qibao Community, Minhang District, Shanghai, to participate in the study (28 students dropped out during the study period). The study subjects were divided into two intervention groups (pilot intervention group: equipped with a health vice principal; general intervention group: not equipped with a health vice principal) and a control group. The intervention group received comprehensive intervention measures such as science popularization, diet, exercise and psychology, while the control group received daily health management. The post-intervention results showed that the intervention group had significant improvements in healthy diet, scientific exercise and positive psychology, with significant differences compared to the control group (P < 0.05). At the same time, the intervention group had a reduced detection rate of obesity (BMI≥P95), and a decreased detection rate of abnormal metabolic indicators such as blood pressure, fasting blood glucose and triglyceride, especially significant differences in fasting blood glucose and triglyceride compared with the control group (P < 0.001). In addition, the pilot intervention group under the operation of health vice principal showed better effects in changing healthy behaviors and improving some metabolic indicators compared with the general intervention group. The implementation of this project provided a scientific basis for the promotion of a comprehensive intervention model for student health under the oprtation of health vice principle.
A 21-year-old unmarried female visited Obstetrics and Gynecology Hospital, Fudan University with the chief complaint, memory decline for more than 20 days and discovery of a pelvic mass for more than 10 days. Through systematic examination, she was diagnosed with teratoma-associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. The patient underwent bilateral ovarian teratoma enucleation, and postoperative pathology revealed immature teratoma grade Ⅰ in the left ovary and mature teratoma in the right ovary. Perioperative combined immunotherapy significantly improved her neuropsychiatric symptoms. The diagnosis and treatment of ovarian teratoma-associated anti-NMDAR encephalitis require multidisciplinary collaboration, with accurate diagnosis, timely surgical resection within 1 month, and early initiation of immunotherapy being critical factors for improving prognosis. Clinicians should remain vigilant to avoid missed or misdiagnosed cases, as this condition can lead to severe outcomes.
Cowden syndrome is a rare autosomal dominant disorder caused by a variant of the PTEN gene, with clinical manifestations mainly of fetal overgrowth and organ tumors. The pregnant woman in this case was 32 years old with gravida 1 and para 0. Prenatal ultrasound in Obstetrics and Gynecology Hospital, Fudan University demonstrated fetal biological parameters abnormally increased (especially in biparietal diameter and circumference of the head) and hepatic tumor. Genetic testing suggested a PTEN gene variant [NM_000314.4:c.193T > G(p.Tyr65Asp)]. After termination of pregnancy, autopsy pathology diagnosed fetal organs overgrowth and hepatic hemangioma. This article focuses on the prenatal ultrasound phenotype and genetic features of Cowden syndrome to increase clinicians' awareness of this rare disease.
Observational studies are important approaches for obtaining real-world evidence. However, due to the lack of randomized allocation, differences in baseline characteristics between groups often introduce confounding bias, which may distort the results. Traditional stratified analyses and multivariable regression models have limited ability to control confounding when multiple covariates are involved. Propensity score matching estimates the probability of receiving an intervention based on observed covariates, then matches individuals with similar propensity scores between treatment and control groups, thereby balancing covariate distributions and reducing confounding. In recent years, propensity score matching has been widely applied in various fields, including chronic disease management and drug effectiveness evaluation, public health policy and health service assessment, vaccine effectiveness studies focusing on population disparities, and evaluations of telemedicine interventions. This review summarizes common matching methods and application scenarios of propensity score matching in observational studies.
