Medicine
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Observational Study
Acute upper gastrointestinal bleeding: Analysis of 462 hospitalized Chinese patients in Shanghai.
While acute upper gastrointestinal bleeding (AUGIB) remains clinically critical, the etiology of bleeding and risk factors for mortality remain uncertain. This study aimed to evaluate the underlying causes of AUGIB and identify risk factors associated with fatality. A retrospective survey was conducted in a major clinical hospital in Shanghai, where inpatients diagnosed with AUGIB were meticulously collected and analyzed. ⋯ Peptic ulcers remained the primary cause of AUGIB. Old age, low hemoglobin levels, and comorbidities were the main risk factors contributing to mortality; nearly half of the patients died from malignant tumors. Hemorrhagic shock was independently associated with a high risk of in-hospital mortality in patients with cirrhotic hemorrhage.
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This study evaluates the efficacy of GPT-4, a Large Language Model, in simplifying medical literature for enhancing patient comprehension in glaucoma care. GPT-4 was used to transform published abstracts from 3 glaucoma journals (n = 62) and patient education materials (Patient Educational Model [PEMs], n = 9) to a 5th-grade reading level. GPT-4 was also prompted to generate de novo educational outputs at 6 different education levels (5th Grade, 8th Grade, High School, Associate's, Bachelor's and Doctorate). ⋯ LSA revealed high semantic consistency, with an average cosine similarity of 0.861 across all abstracts and 0.937 for PEMs, signifying topical themes were quantitatively shown to be consistent. This study shows that GPT-4 effectively simplifies medical information about glaucoma, making it more accessible while maintaining textual content. The improved readability scores for both transformed materials and GPT-4 generated content demonstrate its usefulness in patient education across different educational levels.
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This retrospective study aims to assess the adjunctive efficacy of warm needle moxibustion and gua sha care in the treatment of eszopiclone tablets on sleep quality and psychological stress in insomnia patients. Data of 138 insomnia patients from Gansu Baoshihua hospital between January and December 2022 were collected. Patients were bifurcated into 2 groups: those solely treated with eszopiclone (n = 71) and those administered a combined regimen of eszopiclone, warm needle moxibustion, and gua sha (n = 67). ⋯ The PSS-10 scores remained unchanged in both groups post-intervention. The intervention group reported a significant decrease in the prevalence of nausea and dizziness posttreatment (P < .05), with a notably lower post-intervention nausea prevalence compared to the control group (P < .05). Incorporating warm needle moxibustion and gua sha nursing care into the eszopiclone treatment regimen potentially amplify sleep quality while reducing side effects in patients with insomnia.
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Comparative Study
Comparative genomic analysis unveiling the mutational landscape associated with premalignant lesions and early-stage gastric cardia cancer.
This study enrolled 10 patients diagnosed with premalignant lesions and early-stage gastric cardia adenocarcinoma (GCA), confirmed through endoscopic examination. These patients were subjected to next-generation sequencing (NGS) using a customized 1123-gene panel to identify genetic alterations and signaling pathways. The results were compared to stage IIB to IV GCA samples from the cancer genome atlas (TCGA) and a cohort of Hong Kong patients. ⋯ Furthermore, 80% patients had corresponding potential therapeutic inhibitors based on molecular mutation results in our cohort. Certain mutational characteristics involved in the occurrence and progression of GCA are already present in premalignant lesions and early-stage GCA, which can be assessed and prevented through early molecular testing. Additionally, EPHA2 mutations are more common in premalignant lesions and early-stage GCA, which provided potential biomarkers for the diagnosis and detection of premalignant lesions and early-stage GCA.
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Comparative Study
Comparative study on blood pressure and metabolic improvements in hypertensive patients using copper bianstone scraping.
To evaluate the effectiveness and feasibility of the copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy program by comparing and analyzing the improvement of blood pressure, blood lipids and blood glucose in hypertensive patients who received copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy intervention. We selected 160 cases of hypertensive patients from July 2022 to March 2024 for the study. They were divided into 80 cases in the comparison group and 80 cases in the observation group according to whether or not they underwent copper bianstone scraping combined with Chinese modified dietary therapy for termination of hypertension. ⋯ The difference in comparison was statistically significant (P-value < 0.05). After the intervention, the improvement of homocysteine, vitamin D, serum calcium, albumin, hemoglobin and transferrin in the observation group was greater than that in the comparison group, and the difference was statistically significant (P-value < 0.05). Copper bianstone scraping combined with Chinese modified termination of hypertension dietary therapy in hypertensive patients has a better effect, can effectively improve the patient's blood glucose and lipid levels, improve the nutritional status of the patient, can be promoted in the rehabilitation management of hypertension.