Kataveni et al’s meta-analysis offers an important contemporary synthesis of randomized evidence comparing fractional flow reserve-guided percutaneous coronary intervention and coronary artery bypass grafting(CABG)in...Kataveni et al’s meta-analysis offers an important contemporary synthesis of randomized evidence comparing fractional flow reserve-guided percutaneous coronary intervention and coronary artery bypass grafting(CABG)in multivessel coronary artery disease(CAD).The pooled analysis found no significant difference in all-cause mortality or stroke,yet CABG was superior in reducing myocardial infarction,major adverse cardiac events,and repeat revascularization.These results confirm CABG’s durability even in the era of physiological lesion assessment and second-generation drug-eluting stents.From a traditional Chinese medicine(TCM)perspective,multivessel CAD corresponds to syndromes such as“heart vessel obstruction”and“Qi and blood stagnation”,in which local blockage is compounded by systemic imbalance.While revascularization addresses the structural impediment to blood flow,TCM approaches,including herbal medicine,acupuncture,and lifestyle therapy,aim to improve microcirculation,reduce inflammation,and support recovery,potentially mitigating recurrent ischemic events.This commentary argues that future research should integrate optimal revascularization strategies with rigorously evaluated TCM interventions to address both the anatomical and systemic dimensions of CAD and improve long-term patient outcomes.展开更多
The recent study by Chen et al highlights the paradoxical role of the histone deacetylase inhibitor(HDACi)Trichostatin A(TSA)in esophageal squamous cell carcinoma(ESCC),revealing its promotion of epithelial-mesenchyma...The recent study by Chen et al highlights the paradoxical role of the histone deacetylase inhibitor(HDACi)Trichostatin A(TSA)in esophageal squamous cell carcinoma(ESCC),revealing its promotion of epithelial-mesenchymal transition(EMT)and tumor migration via the BRD4/c-Myc/endoplasmic reticulum(ER)-stress pathway.While HDACis are traditionally considered anti-tumor agents,these findings underscore the need for alternative therapeutic strategies.In this commentary,we discuss the potential of traditional medicine-derived com-pounds,such as berberine,curcumin,and resveratrol,in modulating epigenetic regulators and mitigating TSA-induced oncogenic pathways.Additionally,we emphasize the prognostic significance of histone acetylation markers,particularly acetylated histone H3,which could serve as predictive biomarkers for ESCC progression and HDACi therapy responsiveness.Further,we explore the role of ER stress in tumor aggressiveness and suggest that compounds like quercetin and baicalein,known for their ER stress-alleviating properties,warrant further inves-tigation.Integrating traditional medicine-based interventions with biomarker-driven targeted therapy may enhance ESCC treatment efficacy while minimizing HDACi-associated risks.We advocate for future research focusing on the inter-play between epigenetic modulation,natural compounds,and biomarker identification to refine personalized therapeutic strategies for ESCC.展开更多
Small-bowel capsule endoscopy(SBCE)is the first-line diagnostic tool for obscure gastrointestinal bleeding but is limited by labor-intensive review,reader dependency,and interobserver variability.In this issue,Kwon et...Small-bowel capsule endoscopy(SBCE)is the first-line diagnostic tool for obscure gastrointestinal bleeding but is limited by labor-intensive review,reader dependency,and interobserver variability.In this issue,Kwon et al present a convolutional neural network-based system capable of both gastrointestinal segment localization and multi-lesion detection,erosions/ulcers,angiodysplasia,and bleeding,using full-length SBCE videos.The model achieved>97%localization accuracy and approximately 99%lesion detection accuracy in internal testing,and in external validation reduced reading time from nearly one hour to nine minutes without compromising detection performance.Methodological strengths include a two-step detection-classification pipeline,temporal smoothing,and ensemble learning,closely simulating human reading workflow.Compared with previous artificial intelligence(AI)-SBCE studies,this integrated“localization+detection”approach represents a step toward clinically deployable AI assistance.However,generalizability remains limited by single-platform training,a focus on three lesion types,and modest external validation size.Wider lesion coverage,multiplatform validation,and real-time integration will be essential for broader adoption.This study underscores the potential of AI to improve efficiency and consistency in SBCE interpretation and marks meaningful progress toward its routine clinical use.展开更多
文摘Kataveni et al’s meta-analysis offers an important contemporary synthesis of randomized evidence comparing fractional flow reserve-guided percutaneous coronary intervention and coronary artery bypass grafting(CABG)in multivessel coronary artery disease(CAD).The pooled analysis found no significant difference in all-cause mortality or stroke,yet CABG was superior in reducing myocardial infarction,major adverse cardiac events,and repeat revascularization.These results confirm CABG’s durability even in the era of physiological lesion assessment and second-generation drug-eluting stents.From a traditional Chinese medicine(TCM)perspective,multivessel CAD corresponds to syndromes such as“heart vessel obstruction”and“Qi and blood stagnation”,in which local blockage is compounded by systemic imbalance.While revascularization addresses the structural impediment to blood flow,TCM approaches,including herbal medicine,acupuncture,and lifestyle therapy,aim to improve microcirculation,reduce inflammation,and support recovery,potentially mitigating recurrent ischemic events.This commentary argues that future research should integrate optimal revascularization strategies with rigorously evaluated TCM interventions to address both the anatomical and systemic dimensions of CAD and improve long-term patient outcomes.
文摘The recent study by Chen et al highlights the paradoxical role of the histone deacetylase inhibitor(HDACi)Trichostatin A(TSA)in esophageal squamous cell carcinoma(ESCC),revealing its promotion of epithelial-mesenchymal transition(EMT)and tumor migration via the BRD4/c-Myc/endoplasmic reticulum(ER)-stress pathway.While HDACis are traditionally considered anti-tumor agents,these findings underscore the need for alternative therapeutic strategies.In this commentary,we discuss the potential of traditional medicine-derived com-pounds,such as berberine,curcumin,and resveratrol,in modulating epigenetic regulators and mitigating TSA-induced oncogenic pathways.Additionally,we emphasize the prognostic significance of histone acetylation markers,particularly acetylated histone H3,which could serve as predictive biomarkers for ESCC progression and HDACi therapy responsiveness.Further,we explore the role of ER stress in tumor aggressiveness and suggest that compounds like quercetin and baicalein,known for their ER stress-alleviating properties,warrant further inves-tigation.Integrating traditional medicine-based interventions with biomarker-driven targeted therapy may enhance ESCC treatment efficacy while minimizing HDACi-associated risks.We advocate for future research focusing on the inter-play between epigenetic modulation,natural compounds,and biomarker identification to refine personalized therapeutic strategies for ESCC.
文摘Small-bowel capsule endoscopy(SBCE)is the first-line diagnostic tool for obscure gastrointestinal bleeding but is limited by labor-intensive review,reader dependency,and interobserver variability.In this issue,Kwon et al present a convolutional neural network-based system capable of both gastrointestinal segment localization and multi-lesion detection,erosions/ulcers,angiodysplasia,and bleeding,using full-length SBCE videos.The model achieved>97%localization accuracy and approximately 99%lesion detection accuracy in internal testing,and in external validation reduced reading time from nearly one hour to nine minutes without compromising detection performance.Methodological strengths include a two-step detection-classification pipeline,temporal smoothing,and ensemble learning,closely simulating human reading workflow.Compared with previous artificial intelligence(AI)-SBCE studies,this integrated“localization+detection”approach represents a step toward clinically deployable AI assistance.However,generalizability remains limited by single-platform training,a focus on three lesion types,and modest external validation size.Wider lesion coverage,multiplatform validation,and real-time integration will be essential for broader adoption.This study underscores the potential of AI to improve efficiency and consistency in SBCE interpretation and marks meaningful progress toward its routine clinical use.
