Objective To systematically evaluate the efficacy and safety of islet transplantation (ITA) and combined islet-stem cell transplantation (ISCT) in the treatment of type 1 diabetes mellitus (T1DM). Methods CNKI, Wanfang Data, VIP, the Cochrane Library, PubMed, and Embase were searched to identify clinical studies assessing the efficacy of ITA and ISCT for T1DM, from database inception to August 2024. Two reviewers independently screened the literature and extracted data. Study quality was assessed using the MINORS scale, and meta-analysis was performed using Stata 11. Results A total of 13 studies were included, comprising 8 retrospective studies and 5 prospective studies, with 222 patients with T1DM. The meta-analysis showed that both ITA and ISCT significantly reduced glycated hemoglobin (HbA₁c), increased fasting C-peptide (C-P) levels, decreased insulin requirements, and improved insulin independence. Subgroup analysis indicated that ISCT was more effective than ITA in improving HbA₁c and C-P. In terms of safety, the main adverse events were immunosuppressant-related reactions, such as leukopenia; however, these risks were generally manageable. Conclusion Both ITA and ISCT have favorable therapeutic effects in patients with T1DM, and ISCT appears to be superior in improving transplantation outcomes and maintaining long-term function.

Objective To investigate the value of electrocardiographic parameters combined with serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and 25-hydroxyvitamin D3 (25-OH-VitD3) levels in predicting major adverse cardiovascular events (MACE) in patients with chronic heart failure (CHF). Methods This retrospective cohort study included the medical records of 272 patients with CHF admitted to the Department of Cardiology, Xinxiang First People’s Hospital, from November 2022 to November 2024. According to whether MACE occurred within 12 months of follow-up, patients were divided into a MACE group (n=76) and a non-MACE group (n=196). Baseline characteristics, electrocardiographic parameters on the day of admission (T wave peak-to-end interval [Tp-Te], corrected QT dispersion [QTcd], and QRS duration [QRSd]), and serum NT-proBNP and 25-OH-VitD3 levels were compared between the two groups. A multivariable logistic regression model was constructed to analyze the predictive value of these indicators for MACE occurrence. Results Compared with the non-MACE group, the MACE group had higher age, a higher proportion of patients with cardiac function grade Ⅲ-Ⅳ, and higher Tp-Te, QTcd, QRSd, and serum NT-proBNP levels (P<0.05), as well as lower 25-OH-VitD3 levels (P<0.05). Multivariable logistic regression analysis showed that higher Tp-Te, higher QTcd, higher QRSd, higher NT-proBNP levels, and lower 25-OH-VitD3 levels were independent risk factors for MACE within 12 months in patients with CHF (P<0.05). The combined prediction model using Tp-Te, QTcd, QRSd, serum NT-proBNP, and 25-OH-VitD3 achieved the highest predictive performance for MACE, with a sensitivity of 88.16% and a specificity of 73.98%. Conclusion Electrocardiographic parameters Tp-Te, QTcd, and QRSd, along with serum NT-proBNP and 25-OH-VitD3 levels, can serve as effective indicators for predicting MACE in patients with CHF. The logistic regression model constructed from these five indicators provides superior combined predictive performance.

Objective To investigate the clinical efficacy and application value of biliary endoscopy-assisted endoscopic retrograde appendicitis therapy (ERAT) in the minimally invasive treatment of acute and chronic appendicitis. Methods A retrospective analysis was performed on the clinical data of 27 patients with acute or chronic appendicitis who underwent biliary endoscopy-assisted ERAT in the Department of Gastroenterology, the Affiliated Fuding Hospital of Fujian University of Traditional Chinese Medicine from April 2024 to December 2025. Colonoscopic and biliary endoscopic findings, procedure-related indicators, and postoperative recovery were recorded. Patients were followed up after surgery, and the recurrence rate and treatment satisfaction rate were calculated. Results Among the 27 patients, 7 had acute appendicitis and 20 had chronic appendicitis. The biliary endoscope insertion success rate was 100%, including 18 cases of direct insertion (66.7%) and 9 cases of guidewire-assisted insertion (33.3%). The procedure time was 19 (14, 28) min, and no complications such as bleeding or perforation occurred during the operation. Colonoscopy showed hyperemia and edema of the appendiceal orifice in 16 cases (59.3%), purulent discharge in 5 cases (18.5%), submucosal protrusion-like changes at the appendiceal orifice in 4 cases (14.8%), and fecalith impaction in 1 case (3.7%). Under biliary endoscopy, hyperemia and edema of the appendiceal mucosa were observed in 23 cases (85.2%), fecaliths/fecal debris in 16 cases (59.3%), and pus/flocculent material in 11 cases (40.7%). At 6 h after surgery, all patients had a visual analogue scale score <3, with a 100% symptom and sign relief rate. The mean hospital stay was (5.11±1.83) d. After a median follow-up of 12 months, the recurrence rate was 0 and the treatment satisfaction rate was 100%. In the 4 patients with appendiceal stents placed, all stents spontaneously detached 1 month after surgery. Pathology of 1 patient who underwent mucosal biopsy suggested hyperplastic polyp. In addition, 3 patients with negative preoperative abdominal CT findings were definitively diagnosed and successfully treated with this technique. Conclusion Biliary endoscopy-assisted ERAT is safe and effective for nonperforated, nongangrenous acute and chronic appendicitis. It offers a high insertion success rate, rapid postoperative recovery, and a low recurrence rate, while also providing diagnostic value for differential diagnosis. It may serve as a reference for clinical decision-making in appendicitis treatment.

Objective To analyze the clinical factors associated with anxiety symptoms in patients with ulcerative colitis (UC), and to provide evidence for early identification and intervention. Methods This retrospective study included 104 patients with UC admitted to the First Affiliated Hospital of Henan University from November 2022 to November 2025. Based on the Hamilton Anxiety Scale (HAMA), patients were divided into an anxiety group (HAMA total score ≥14, n=42) and a non-anxiety group (HAMA total score <14, n=62). Clinical information were collected for both groups, including the Pittsburgh sleep quality index (PSQI) score and serum brain-derived neurotrophic factor (BDNF) level. Multivariate logistic stepwise regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify factors associated with anxiety symptoms in patients with UC. Results There were statistically significant differences between the two groups in sex, disease activity, lesion extent, PSQI score, and serum BDNF level (P<0.05). Multivariate logistic regression analysis showed that female sex, severe disease activity, lesion extent of E3 type, and higher PSQI score were independent risk factors for anxiety symptoms in patients with UC, whereas higher serum BDNF level was an independent protective factor (P<0.05). ROC curve analysis showed that both PSQI score and serum BDNF level could be used to assess anxiety symptoms in patients with UC, with area under the curve values of 0.780 and 0.929, respectively (both P<0.05). Conclusion Sex, disease activity, lesion extent, PSQI score, and serum BDNF level are associated with anxiety symptoms in patients with UC. Clinically, greater attention should be given to female patients, those with severe disease activity, extensive lesions (E3 type), PSQI score ≥8.996, and serum BDNF level ≤14.792 μg/L, and psychological intervention should be initiated when necessary.

Objective To analyze the epidemiological characteristics of multiple pathogens causing acute respiratory infections under sentinel surveillance in China from 2024 to 2026, and to provide evidence for clinical diagnosis, treatment, and scientific prevention and control of respiratory infections. Methods Epidemiological data on pathogens from national sentinel surveillance of acute respiratory infections, as released by the Chinese Center for Disease Control and Prevention, were collected from week 46 of 2024 to week 17 of 2026. Data on multiple respiratory pathogens, including 10 viruses-severe acute respiratory syndrome coronavirus 2, influenza virus, respiratory syncytial virus, adenovirus, human metapneumovirus, parainfluenza virus, common coronavirus, bocavirus, rhinovirus, and enterovirus-as well as Mycoplasma pneumoniae, were statistically analyzed according to weekly positivity rates, geographic region, and age. Results Among outpatient and emergency department patients with influenza-like illness, influenza virus had the highest nucleic acid positivity rate among respiratory pathogens, with a winter-spring predominance and a maximum detection rate of 54.2%. This was followed by severe acute respiratory syndrome coronavirus 2 and rhinovirus. Among hospitalized patients with severe acute respiratory infection, respiratory syncytial virus showed the highest nucleic acid positivity rate, followed by influenza virus and rhinovirus. The epidemiological characteristics of pathogens varied across regions and age groups, and co-circulation of multiple pathogens was observed. Conclusion The epidemiological characteristics of different respiratory pathogens show marked seasonal, geographic, and age-related differences. Differential clinical diagnosis, treatment, and prevention and control strategies should be developed according to regional, age-specific, and seasonal variations.

Objective To investigate the clinical efficacy of fiberoptic bronchoscopy lavage combined with methylprednisolone sodium succinate in the treatment of severe pneumonia in children. Methods A retrospective analysis was conducted on 80 children diagnosed with pneumonia and treated at Puyang People’s Hospital between August 2023 and October 2025. According to the treatment regimen, the patients were divided into a control group (n=40) and an observation group (n=40). Both groups received conventional anti-infective therapy. The control group was treated with methylprednisolone sodium succinate, while the observation group received fiberoptic bronchoscopy lavage combined with methylprednisolone sodium succinate on this basis. Indicators were observed before and after treatment in both groups. Results After treatment, the resolution times of pulmonary rales, cough, and fever were shorter in the observation group than in the control group (P<0.05). In both groups, the levels of interleukin-6 (IL-6), interleukin-17 (IL-17), high-sensitivity C-reactive protein (hs-CRP), and procalcitonin (PCT) decreased after treatment, with lower levels in the observation group than in the control group (P<0.05). The levels of immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) increased in both groups, with higher levels in the observation group than in the control group (P<0.05). The incidence of adverse reactions and recurrence rate were lower in the observation group than in the control group (P<0.05). The overall clinical response rate was higher in the observation group than in the control group (P<0.05). Conclusion Fiberoptic bronchoscopy lavage combined with methylprednisolone sodium succinate is more effective than methylprednisolone sodium succinate alone in the treatment of severe pneumonia in children and has favorable clinical value.

Objective To analyze the clinical characteristics, causes of misdiagnosis, and seizure mechanisms of dural arteriovenous fistula (DAVF) presenting primarily as epilepsy, and to improve clinical awareness and diagnostic accuracy. Methods The clinical data of 4 patients with DAVF presenting mainly with epileptic seizures were retrospectively reviewed, and relevant literature was summarized. Results All 4 patients were male, with a mean age at onset of 53.5 years, and the core clinical manifestation in all cases was generalized epileptic seizures. Three cases were initially misdiagnosed as cerebral infarction and Parkinson syndrome. The reasons for misdiagnosis included atypical initial symptoms, failure to promptly complete cerebrovascular evaluation, and insufficient recognition of seizures caused by venous sinus lesions. All cases were ultimately confirmed by digital subtraction angiography (DSA) as sigmoid sinus DAVF, and 3 cases had concomitant ipsilateral sigmoid sinus stenosis/occlusion. In terms of treatment, 3 patients underwent transarterial Onyx embolization plus sigmoid sinus balloon angioplasty and stent implantation, while 1 patient underwent transarterial Onyx embolization alone. Follow-up after surgery showed seizure control and favorable prognosis in 2 cases. One patient developed secondary hydrocephalus after surgery and later suffered cerebral hemorrhage after surgical treatment, resulting in dementia. One patient had a disease course of up to 10 years, progressed to refractory status epilepticus, and died after discontinuing treatment. Conclusion DAVF presenting with epilepsy is highly prone to misdiagnosis. Impaired venous sinus drainage, cortical venous hypertension, and blood-brain barrier disruption are key mechanisms triggering seizures. Ipsilateral sigmoid sinus stenosis further exacerbates hemodynamic disturbance and promotes seizure progression. DAVF is a rare but curable cause of late-onset epilepsy in adults. For patients with recurrent seizures of unknown cause, electroencephalography and DSA should be performed promptly, and early interventional treatment may improve long-term prognosis.

Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with levodopa and benserazide hydrochloride tablets in the treatment of Parkinson’s disease (PD), and to evaluate its effects on serum epidermal growth factor (EGF) and neuron-specific enolase (NSE) levels, as well as gait-related indicators. Methods A total of 246 patients with PD treated at Nanyang Central Hospital from January 2022 to January 2025 were enrolled and randomly assigned using a random number table. The control group (n=123) received levodopa and benserazide hydrochloride tablets, while the experimental group (n=123) received rTMS in combination with levodopa and benserazide hydrochloride tablets. The two groups were compared in terms of the Unified Parkinson’s Disease Rating Scale (UPDRS), serum indicators before and after treatment (EGF and NSE), gait-related indicators (Simple Test for Evaluating Hand Function [STEF], Modified Barthel Index [MBI], and Modified Ashworth Scale [MAS]), quality of life (Generic Quality of Life Inventory-74 [GQOLI-74]), and adverse reactions. Results After treatment, the UPDRS score in the experimental group was significantly lower than that in the control group (P<0.05). The experimental group had higher STEF and MBI scores and higher EGF levels, but lower NSE levels and MAS scores than the control group (P<0.05). The GQOLI-74 score in the experimental group was higher than that in the control group (P<0.05). A total of 16 patients (13.01%) in the experimental group and 14 patients (11.38%) in the control group experienced adverse reactions, with no statistically significant difference between the two groups (P>0.05). Conclusion The combination of rTMS and levodopa and benserazide hydrochloride tablets is effective in improving motor dysfunction and activities of daily living in patients with PD. Its mechanism may be related to upregulation of serum EGF and downregulation of NSE, thereby promoting neural repair. This regimen significantly improves quality of life without increasing the incidence of adverse reactions.

Objective To analyze the risk factors for adverse pregnancy outcomes in patients with hypertensive disorders of pregnancy (HDP), construct and validate a random forest prediction model by integrating routine clinical indicators, and evaluate the predictive value of multiple combined indicators. Methods A total of 152 patients with HDP who received diagnosis and treatment at the First People’s Hospital of Zhumadian from August 2022 to August 2025 were included. According to pregnancy outcomes, they were divided into an adverse outcome group (n=48) and a good outcome group (n=104). The incidence of adverse pregnancy outcomes and general clinical data were analyzed. Multivariate logistic regression was used to identify independent risk factors, and a random forest prediction model was constructed. The total sample was randomly split in a 7∶3 ratio into a training set (n=106) and a validation set (n=46). The training set was used to build the model, and the validation set was used to evaluate model performance. Results Among the 152 patients with HDP, 48 had adverse pregnancy outcomes, with an overall incidence of 31.58%. Compared with the good outcome group, the adverse outcome group had an earlier gestational age at onset and higher proportions of irregular antenatal care, systolic blood pressure (SBP), umbilical artery systolic/diastolic ratio (S/D), pentraxin-3 (PTX-3) level, and serum soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PLGF) ratio (P<0.05). Multivariate logistic regression confirmed that irregular antenatal care, SBP, umbilical artery S/D, elevated PTX-3 level, and increased sFlt-1/PLGF ratio were independent risk factors for adverse pregnancy outcomes in patients with HDP, whereas later gestational age at onset was a protective factor (P<0.05). Using these 6 independent risk factors from the multivariate logistic regression analysis as predictors, a random forest model was constructed. The results showed that the area under the curve(AUC) for predicting adverse pregnancy outcomes in patients with HDP was 0.874(95%CI: 0.829-0.918), with a sensitivity of 78.20%(95%CI: 0.726-0.851) and a specificity of 79.20%(95%CI: 0.754-0.896). In addition, based on the Gini coefficient importance scoring method, the contribution ranking from highest to lowest was sFlt-1/PLGF (51.676), gestational age at onset (42.945), umbilical artery S/D (40.135), SBP (34.866), PTX-3 (25.239), and irregular antenatal care (22.689). Conclusion Gestational age at onset, irregular antenatal care, SBP, umbilical artery S/D, PTX-3 level, and sFlt-1/PLGF are all influencing factors for adverse pregnancy outcomes in patients with HDP. The random forest prediction model established based on these variables demonstrated good discrimination and calibration, providing a potential tool for early identification of high-risk patients in clinical practice.

Objective To investigate the clinical characteristics, diagnosis, and management of aortic dissection (AD) in patients undergoing hemodialysis through a case report and literature review. Methods We retrospectively analyzed one case of Stanford type B AD in a patient undergoing maintenance hemodialysis (MHD) and reviewed the relevant literature. Results The patient was a young man who had been receiving MHD for more than 5 years and was admitted because of chest pain during dialysis for 1 h. He had longstanding severe secondary hyperparathyroidism and disorders of calcium-phosphorus metabolism. After 1 h of hemodialysis, the patient developed sudden severe chest pain. At the time of symptom onset, blood pressure was measured at 196/103 mmHg. After hemodialysis was terminated, whole-aorta computed tomography angiography showed Stanford type B (Debakey type III) AD. The patient subsequently underwent endovascular aortic repair in the cardiovascular department, recovered smoothly after surgery, and had a favorable prognosis while continuing MHD. Conclusion Appropriate control of intradialytic hypertension and active management of parathyroid hormone levels and hyperphosphatemia are key to preventing AD in patients undergoing hemodialysis.

Objective To investigate the clinical characteristics, treatment strategy, and warning implications of severe pregabalin poisoning. Methods A retrospective analysis was performed on the clinical data of a 19-year-old male patient who developed severe intoxication after intentional ingestion of a large dose of pregabalin (2400 mg, 42.9 mg/kg). The clinical manifestations, laboratory findings, diagnostic process, treatment, and outcome were summarized. Results After medication ingestion, the patient developed progressive disturbance of consciousness and was in deep coma on admission (Glasgow Coma Scale [GCS] score of 6). Laboratory tests revealed hyperuricemia (746 μmol/L), progressive thrombocytopenia (nadir 64×10⁹/L), and a marked increase in D-dimer (peak 14.56 mg/L). Imaging examinations showed no obvious abnormalities. After gastric lavage, hemoperfusion combined with continuous renal replacement therapy, and comprehensive supportive treatment, the patient regained consciousness within 3 d. Platelet count and coagulation function gradually returned to normal. He was discharged smoothly on hospital day 4 and had no sequelae during 3-month follow-up. Conclusion Severe pregabalin poisoning can cause serious disturbance of consciousness and coagulation abnormalities. Early combined hemoperfusion and continuous renal replacement therapy is an effective strategy for critically poisoned patients. Clinicians should pay close attention to the risk of pregabalin abuse in adolescents and strengthen medication assessment and monitoring.

Objective To explore the phenotypic characteristics of the “sleep-mood-somatic symptoms” comorbidity pattern in patients with sleep disorders complicated by anxiety and depression, and to evaluate the clinical effect of a precision intervention strategy developed according to phenotypic classification. Methods A total of 102 patients with sleep disorders complicated by anxiety and depression admitted between June 2024 and December 2025 were enrolled. The Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), self-rating depression scale (SDS), and somatic symptom scale (SSS) were used for comprehensive assessment. Dimension-specific scores from each scale were collected, and K-means cluster analysis was applied to classify comorbidity phenotypes. Targeted precision intervention plans were formulated according to the core symptom characteristics of each phenotype. The intervention period was 8 weeks. Improvements in sleep quality, emotional status, and somatic symptoms were compared before and after intervention across the groups. Results Cluster analysis identified 3 comorbidity phenotypes among the 102 patients: phenotype 1 (sleep-dominant type), 42 cases, characterized by severe sleep disturbance, moderate anxiety and depression, and mild somatic symptoms; phenotype 2 (mood-dominant type), 36 cases, characterized by moderate sleep disturbance, severe anxiety and depression, and moderate somatic symptoms; and phenotype 3 (somatic-mood-sleep severe type), 26 cases, characterized by severe sleep disturbance, severe anxiety and depression, and severe somatic symptoms. Significant differences were observed among the phenotype groups in disease duration and the incidence of underlying diseases (P<0.05), whereas no significant differences were found in sex or age distribution (P>0.05). After precision intervention, PSQI, SAS, SDS, and SSS scores in all three groups were significantly lower than those before intervention (P<0.05). In terms of overall response rate, the rates were 92.86% in phenotype 1, 94.29% in phenotype 2, and 78.26% in phenotype 3; the differences in overall response rate among the three groups were statistically significant (P<0.05). Conclusion Patients with sleep disorders complicated by anxiety and depression exhibit distinct “sleep-mood-somatic symptoms” comorbidity phenotypes.