Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triag...Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.展开更多
BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and familie...BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and families.By integrating patient information across these three domains,it facilitates the delivery of tailored guidance,health risk assessments,and three-in-one health education.AIM To explore the effects of the HCH-CHM model on stroke risk reduction in highrisk populations.METHODS In total,110 high-risk stroke patients screened in the community from January 2019 to January 2023 were enrolled,with 52 patients in the control group receiving routine health education and 58 in the observation group receiving HCH-CHM model interventions based on routine health education.Stroke awareness scores,health behavior levels,medication adherence,blood pressure,serum biochemical markers(systolic/diastolic blood pressure,total cholesterol,and triglyceride),and psychological measures(self-rating anxiety/depression scale)were evaluated and compared between groups.RESULTS The observation group showed statistically significant improvements in stroke awareness scores and health behavior levels compared to the control group(P<0.05),with notable enhancements in lifestyle and dietary habits(P<0.05)and reductions in postintervention systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,self-rating anxiety scale,and self-rating depression scale scores(P<0.05).CONCLUSION The HCH-CHM model had a significant positive effect on high-risk stroke populations,effectively increasing disease awareness,improving health behavior and medication adherence,and appropriately ameliorating blood pressure,serum biochemical marker levels,and negative psychological symptoms.展开更多
This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretat...This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.展开更多
Objective:In recent years,the incidence and detection rate of pancreatic cystic lesions(PCLs)have increased significantly.Endoscopic ultrasound(EUS)plays an indispensable role in the diagnosis and differential diagnos...Objective:In recent years,the incidence and detection rate of pancreatic cystic lesions(PCLs)have increased significantly.Endoscopic ultrasound(EUS)plays an indispensable role in the diagnosis and differential diagnosis of PCLs.However,evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration(EUS-FNA)and fine-needle biopsy(FNB)remains limited.This study aims to compare the diagnostic yield,adequacy of tissue acquisition,and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice.Methods:A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021.The diagnostic yield,tissue acquisition adequacy,and incidence of adverse events were compared between the 2 groups.Results:A total of 90 patients with PCLs were included(52 in the FNA group and 38 in the FNB group).The diagnostic yield was similar between the FNA and FNB groups(94.2%vs 94.7%,P>0.05).The adequacy of tissue acquisition was 71.2%in the FNA group and 81.6%in the FNB group(P>0.05).No statistically significant difference was observed in the incidence of adverse events between the 2 groups(P>0.05).Conclusion:Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs,with excellent safety profiles.Both methods are safe and effective diagnostic tools for evaluating PCLs.展开更多
Calvarial lesions are usually incidental and asymptomatic,rarely detected.However,these lesions can also present with pain,a palpable mass or a bone defect.Clinical information such as the patient’s age and medical h...Calvarial lesions are usually incidental and asymptomatic,rarely detected.However,these lesions can also present with pain,a palpable mass or a bone defect.Clinical information such as the patient’s age and medical history are helpful in making the correct diagnosis.Calvarial lesions may occur due to congenital and anatomical variants,traumatic and iatrogenic,idiopathic,infectious and inflammatory,metabolic,benign and malignant neoplastic causes.Calvarial lesions may be solitary,multiple or diffuse,and may be lytic,sclerotic or mixed.Although most calvarial lesions are benign,radiologic imaging features can help to determine whether the lesion is benign or malignant.Methods that can guide treatment and are currently in use include plain radiography,ultrasonography,computed tomography,magnetic resonance imaging,angiographic studies,and nuclear scintigraphy studies such as 18F-fluorodeoxyglucose positron emission tomography and whole-body bone scintigraphy.Defects,lysis and sclerosis in the bone structure are assessed by plain radiography and computed tomography,and the soft tissue components of the lesions and their relationship to the surrounding soft tissue are assessed by magnetic resonance imaging.This article reviews the imaging findings of benign and malignant calvarial lesions and normal variants that may be confused with systemic diseases and pathologies affecting the calvarium.展开更多
Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, espe...Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.展开更多
Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive hea...Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.展开更多
BACKGROUND Precancerous lesions of gastric cancer(PLGC)represent a critical pathological stage in the development of intestinal gastric cancer.Early detection and diagnosis are key to reducing the incidence of gastric...BACKGROUND Precancerous lesions of gastric cancer(PLGC)represent a critical pathological stage in the development of intestinal gastric cancer.Early detection and diagnosis are key to reducing the incidence of gastric cancer.Substantial advancements have been made in PLGC research in recent years,making it necessary to provide updated reviews using bibliometric methods.We hypothesize that this review will identify emerging trends,key research areas,and gaps in PLGC research,providing insights that could guide future studies and enhance prevention strategies.AIM To comprehensively review the current state of research on PLGC,examining development trends and research hotspots.METHODS We conducted a bibliometric analysis of PLGC-related studies published between 2004 and 2023 using the Web of Science Core Collection database.We employed Software,including VOSviewer,CiteSpace,R software,and SCImago Graphica,to map scientific networks and visualize knowledge trends in terms of publication volume,countries/regions,institutions,journals,authors,and keywords.RESULTS A total of 4097 articles were included,and overall publication volume showed an increasing trend.Over the past two decades,China published the most articles,followed by the United States,Japan,South Korea,and Italy.Among the top 10 contributors,the United States ranked highest in institutions,authors,and citations and demonstrated the strongest international collaboration.Research keywords in this field were clustered into three main categories:Risk factors,pathogenesis,and diagnosis and treatment.Pathogenesis and molecular biomarkers remain key areas of focus.Future research should explore the mechanisms of gut microbiota,immune microenvironment,metabolic reprogramming,and epigenetics.Advanced technologies,including single-cell sequencing,spatially resolved analysis,multi-omics approaches,artificial intelligence,and machine learning,will likely accelerate in-depth investigations of PLGC.CONCLUSION PLGC research has rapidly developed in recent years,gaining considerable attention.This bibliometric analysis reveals research state and emerging trends over the past 20 years,providing insights for future studies.展开更多
Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Provinc...Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province,China.Methods:A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged18–45 years were screened between 2020 and 2021 in Jiangsu Province.Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method,and positive samples were further tested using the reverse hybridization line probe assay.Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening.To account for differences in age composition between the 2 studies,the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.Results:Overall,40 women(1.89%)were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013,and 110(1.78%)were diagnosed during 2020–2021.Among women with lesions,the standardized HPV positivity rates were 98.41%in 2012–2013 and99.24%in 2020–2021.Most cases were caused by high-risk HPV,which accounted for 87.18%of the total infections during 2012–2013and 89.91%of those in 2020–2021,with standardized positivity rates of 86.44%and 88.75%,respectively.The standardized positivity rates for single infections were 62.35%in 2012–2013 and 74.95%in 2020–2021.The top 5 high-risk HPV genotypes were HPV type 16(HPV16;29.01%),52(20.63%),18(14.28%),58(13.71%),and 33(12.12%)in 2012–2013,and HPV16(36.95%),58(22.18%),52(13.25%),31(7.63%),and 51(6.81%)in 2020–2021.The standardized positivity rate for HPV18 decreased from 14.28%in2012–2013 to 1.15%in 2020–2021.Among women with cervical or vaginal lesions,the highest proportion was observed in the 36-to 45-year group during 2012–2013,reaching 52.50%,and in the 26-to 35-year group during 2020–2021,peaking at 59.10%.Conclusions:In Jiangsu Province,no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021;however,the distribution of HPV genotypes had changed.展开更多
AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective co...AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.展开更多
Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA...Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA-EDOCH immunochemotherapy in treating aggressive B-cell lymphomas,we designed a prospective,phase 3 trial to explore the efficacy and safety of alternating R-DA-EDOCH/R-DHAP induction therapy for young patients with newly diagnosed MCL.The primary endpoint was the complete remission rate(CRR)at the end of induction(EOI).Methods:A total of 55 patients were enrolled.The CRR at the EOI was 89.1%[95%confidence interval(CI)78%±96%],and the overall response rate was 98.1%(95%CI 90%±100%).Most patients with bone marrow involvement quickly attained minimal residual disease(MRD)negative status,with a 95.7%rate at the EOI.Results:The 3-year progression-free survival(PFS)and overall survival rates were 66.3%and 83.2%,respectively.No patients discontinued treatment because of adverse events.Univariate analysis identified pathologic morphology and TP53 mutations as risk factors for PFS.However,high tumor proliferative activity and certain cytogenetic abnormalities showed no significant adverse prognostic significance.Conclusions:Intensive therapy based on a high cytarabine dose and continuously administered EDOCH achieved a high MRDnegative rate and provides an optional induction choice for young patients with MCL with high-risk factors.展开更多
Background Quantitative flow ratio(QFR) holds significant value in guiding drug-coated balloon(DCB) treatment and enhancing outcomes. However, the predictive capability of post-angioplasty QFR for long-term clinical e...Background Quantitative flow ratio(QFR) holds significant value in guiding drug-coated balloon(DCB) treatment and enhancing outcomes. However, the predictive capability of post-angioplasty QFR for long-term clinical events in patients with de novo lesions who receive DCB treatment remains uncertain. The aim of this study was to explore the potential significance of post-angioplasty QFR measurements in predicting clinical outcomes in patients underwent DCB treatment for de novo lesions.Methods Patients who underwent DCB-only intervention for de novo lesions were enrolled. QFR was conducted after DCB treatment. The patients were then categorized based on post-angioplasty QFR. The primary endpoint was major adverse cardiac events(MACE), encompassing all-cause death, cardiovascular death, nonfatal myocardial infarction, stroke, and target vessel revascularization.Results A total of 553 patients with 561 lesions were included. The median follow-up period was 505 days, during which 66(11.8%) MACEs occurred. Based on post-procedural QFR grouping, there were 259 cases in the high QFR group(QFR > 0.93) and302 cases in the low QFR group(QFR ≤ 0.93). Kaplan-Meier analysis revealed a significantly higher cumulative incidence of MACE in the low QFR group(log-rank P = 0.004). The multivariate Cox proportional hazards model demonstrated a significant inverse correlation between QFR and the occurrence of MACEs(HR = 0.522, 95%CI: 0.289-0.942, P = 0.031). Landmark analysis indicated that high QFR had a significant reducing effect on the cumulative incidence of MACEs within 1 year(log-rank P = 0.016)and 1-5 years(log-rank P = 0.026).Conclusions In patients who underwent DCB-only treatment for de novo lesions, higher post-procedural QFR values(> 0.93)were identified as an independent protective factor against adverse prognosis.展开更多
AIM:To describe the clinical manifestations,imaging features and surgical treatments in 5 cases of extraocular muscle(EOM)dysplasia presenting as orbital spaceoccupying lesions(SOL).METHODS:Records from the 5 cases wi...AIM:To describe the clinical manifestations,imaging features and surgical treatments in 5 cases of extraocular muscle(EOM)dysplasia presenting as orbital spaceoccupying lesions(SOL).METHODS:Records from the 5 cases with EOM dysplasia between 2004 and 2016 were retrospectively reviewed and clinical data were recorded including family history,age at onset,age at surgery,visual acuity,cycloplegic refraction,ocular alignment and motility,stereoacuity,exophthalmos,anterior segment and fundus,orbital computed tomography(CT)or magnetic resonance imaging(MRI)scan,surgical methods and final outcomes.RESULTS:All 5 cases(1 male,4 females)were unilateral(3 right,2 left eyes).The average age was 5.4y(range 4-6y)with no family history.Patients had unilateral strabismus(horizontal and vertical),restricted eye movement,and eyelid changes(abnormal fissures,lagophthalmos,and/or entropion)in the affected eye.None had proptosis;1 had 2-mm enophthalmos.Orbital CT/MRI showed irregular,ill-defined masses in EOM.Two anterior orbitotomies and 3 strabismus surgeries were performed,and pathology confirmed EOM dysplasia.After surgery,horizontal deviations,which ranged from exotropia(XT)10 prism diopter(PD)to esotropia(ET)10 PD(average 6 PD),decreased by an average of 18 PD,while vertical deviations,which ranged from 4 PD to 20 PD(mean 9.8 PD),decreased by an average of 23.2 PD.CONCLUSION:SOL from EOM dysplasia is non-familial and typically presenting unilaterally characterized by an irregular,diffusely infiltrating mass within the EOM.EOM involvement causes strabismus,restricted eye movement,eyelid changes,and enophthalmos likely due to cicatricial processes.展开更多
Pathological mineralizations in breast lesions are closely associated with disease progression and serves as a critical diagnostic indicator.However,systematic understanding remains lacking regarding the phase categor...Pathological mineralizations in breast lesions are closely associated with disease progression and serves as a critical diagnostic indicator.However,systematic understanding remains lacking regarding the phase categories,distribution patterns,and proportional occurrences of mineral phases across different breast lesion types.The diagnostic implications of specific phases,such as calcium oxalate,for distinguishing benign and malignant lesions remain controversial.This study employed polarizing microscopy,environmental scanning electron microscopy(SEM)with energy dispersive spectroscopy(EDS),transmission electron microscopy(TEM),Fourier transform infrared spectroscopy(FTIR),and Raman spectroscopy to analyze the phase composition of 61 mineralized samples from three lesion types:Invasive carcinoma,carcinoma in situ and benign lesions.Results demonstrate that breast lesion mineralizations predominantly comprise calcium phosphates,including hydroxyapatite(HA),amorphous calcium phosphate(ACP),and whitlockite,occasionally accompanied by calcium oxalate(monohydrate or dihydrate).Distinct distribution patterns and proportional occurrences of minerals were observed among the three types of lesion mineralizations.HA,as the predominant phase,was ubiquitously present across all three lesion categories.ACP,a mineralization precursor phase,emerged during early mineralization stages across all lesion types.Notably,whitlockite exclusively occurred in benign lesions and carcinoma in situ,with higher prevalence in benign cases,suggesting a progressive decline in Mg^(2+)concentration within the lesion microenvironment as malignancy advances.Calcium oxalate coexisted with HA in mineralized regions across all lesion types,and its presence in invasive carcinoma specimens warrants heightened clinical attention.展开更多
Diabetic foot(DF)has emerged as one of the most common chronic consequences of diabetes mellitus,characterized by prolonged disease duration,high treatment costs,a poor prognosis,and a high disability rate.Diabetic hi...Diabetic foot(DF)has emerged as one of the most common chronic consequences of diabetes mellitus,characterized by prolonged disease duration,high treatment costs,a poor prognosis,and a high disability rate.Diabetic high-risk foot is the early stage of diabetic foot,the“disease prevention”of“treating no disease”,which provides a critical window for clinical prevention and treatment.Traditional Chinese medicine(TCM)has emphasized the importance of preventive health care since ancient times.External therapies such as acupuncture,massage,acupoint injection,foot bath fumigation,and moxibustion have the advantages of simplicity,low cost,precise efficacy,and fewer side effects in preventing and treating diabetic high-risk foot.The multidisciplinary synergistic model formed by TCM complementary therapies and modern medical treatments,such as nutritional,peripheral nerve,and blood glucose regulation,provides new ideas for establishing standardized prevention and treatment protocols.In this paper,studies related to TCM-related complementary therapies for diabetic high-risk feet are systematically reviewed.Current advances in external application in TCM were described to better understand its effectiveness and safety in elderly patients.展开更多
For the treatment method of esophageal subepithelial lesions originating from the muscularis propria,conventional endoscopic resection techniques are timeconsuming and lack efficacy for small subepithelial lesions ori...For the treatment method of esophageal subepithelial lesions originating from the muscularis propria,conventional endoscopic resection techniques are timeconsuming and lack efficacy for small subepithelial lesions originating from the muscularis propria.Lu et al presented an exploration of the effectiveness and safety of ligation-assisted endoscopic submucosal resection,aiming to provide a minimally invasive method for treatment.We discussed and analyzed this study from the aspects of sample screening,clinical pathological characteristics,casecontrol analysis,and follow-up data.展开更多
WCE (Wireless Capsule Endoscopy) is a new technology that combines computer vision and medicine, allowing doctors to visualize the conditions inside the intestines, achieving good diagnostic results. However, due to t...WCE (Wireless Capsule Endoscopy) is a new technology that combines computer vision and medicine, allowing doctors to visualize the conditions inside the intestines, achieving good diagnostic results. However, due to the complex intestinal environment and limited pixel resolution of WCE videos, lesions are not easily detectable, and it takes an experienced doctor 1–2 h to analyze a complete WCE video. The use of computer-aided diagnostic methods, assisting or even replacing manual WCE diagnosis, has significant application value. In response to the issue of intestinal lesion detection in WCE videos, this paper proposes a multi-scale feature fusion network model TSD-YOLO based on the YOLO (You Only Look Once) architecture: (I) a Tiny Detection Layer to avoid the loss of shallow feature information for tiny-scale targets;(II) integrating a simple, parameter-free attention module (SimAM) at the neck to better extract local lesion features and fuse features;(III) incorporating a new loss function DIoU (Distance Intersection over Union) to better achieve boundary box regression for target detection. This model was validated using the WCE dataset from Kyushu University Hospital. For the dataset containing 18,000 images, the evaluation metrics of our model for 12 types of lesions, outperformed existing reported results from advanced models on this dataset, and the mAP (mean Average Precision) and precision evaluation metrics improved by 3.7% and 0.9% over the benchmark model.展开更多
As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenop...As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenopausal asymptomatic endometrial thickening is primarily benign, often involving endometrial polyps. However, previous clinical studies indicate a relatively high malignancy rate for postmenopausal endometrial polyps, suggesting the necessity for active intervention, particularly in cases with high-risk factors for EC. This article reviews the research progress on risk factors for endometrial lesions in postmenopausal patients with asymptomatic endometrial thickening, aiming to provide insights for clinical diagnosis and treatment.展开更多
BACKGROUND Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus(T2DM).It remains unclear whether systolic blood pressure(SBP)status of hypertension is ...BACKGROUND Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus(T2DM).It remains unclear whether systolic blood pressure(SBP)status of hypertension is related to coronary inflammation and plaques in T2DM.AIM To evaluate whether SBP variability(SBPV)and levels of hypertension are related to coronary inflammation and plaques in T2DM patients using coronary computed tomography angiography(CCTA).METHODS This retrospective study involved 881 T2DM patients with CCTA images,including 668 hypertension and 213 normotension patients.Hypertension patients were subgroup based on SBP status:(1)SBPV:Low(<8.96 mmHg)and high(≥8.96 mmHg)groups;and(2)SBP levels:Controlled(<140 mmHg)and uncontrolled(≥140 mmHg)groups.Pericoronary adipose tissue(PCAT)attenuation,high-risk plaques(HRPs)and obstructive stenosis(OS)were evaluated by CCTA.Propensity score matching was utilized to compare these CCTA findings for these groups.The impact of SBPV and SBP levels of hypertension on these CCTA findings in T2DM patients were evaluated by multivariate logistic regression and multivariable linear regression.RESULTS PCAT attenuation of the left anterior descending artery(LAD),any low attenuation plaque(LAP),any spotty calcification(SC),any positive remodeling(PR),and OS had significant differences between the hypertension group and the normotension group,as well as between the high SBPV or uncontrolled SBP group and the low SBPV or controlled SBP group(all P<0.05).Hypertension was independently positively correlated with LADPCAT attenuation(β=1.815,P=0.010),LAP(OR=1.612,P=0.019),SC(OR=1.665,P=0.013),PR(OR=1.549,P=0.033),and OS(OR=1.928,P=0.036)in all T2DM patients.Additionally,high SBPV and uncontrolled SBP were independently positively correlated with LAD-PCAT attenuation(high SBPV:β=1.673,P=0.048;uncontrolled SBP:β=2.370,P=0.004)and PR(high SBPV:OR=1.903,P=0.048;uncontrolled SBP:OR=2.230,P=0.013)in T2DM patients with hypertension.CONCLUSION Inadequately controlled hypertension,including high SBPV and/or uncontrolled SBP levels,may be related to increased coronary artery inflammation,HRPs,and OS in T2DM,leading to increased cardiovascular risk.Achieving both low SBPV and controlled SBP levels simultaneously,especially in individuals with T2DM and hypertension,warrants clinical attention.展开更多
文摘Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.
基金Supported by Guiding Project of Hebei Provincial Health Commission,No.20201190 and 20180220.
文摘BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and families.By integrating patient information across these three domains,it facilitates the delivery of tailored guidance,health risk assessments,and three-in-one health education.AIM To explore the effects of the HCH-CHM model on stroke risk reduction in highrisk populations.METHODS In total,110 high-risk stroke patients screened in the community from January 2019 to January 2023 were enrolled,with 52 patients in the control group receiving routine health education and 58 in the observation group receiving HCH-CHM model interventions based on routine health education.Stroke awareness scores,health behavior levels,medication adherence,blood pressure,serum biochemical markers(systolic/diastolic blood pressure,total cholesterol,and triglyceride),and psychological measures(self-rating anxiety/depression scale)were evaluated and compared between groups.RESULTS The observation group showed statistically significant improvements in stroke awareness scores and health behavior levels compared to the control group(P<0.05),with notable enhancements in lifestyle and dietary habits(P<0.05)and reductions in postintervention systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,self-rating anxiety scale,and self-rating depression scale scores(P<0.05).CONCLUSION The HCH-CHM model had a significant positive effect on high-risk stroke populations,effectively increasing disease awareness,improving health behavior and medication adherence,and appropriately ameliorating blood pressure,serum biochemical marker levels,and negative psychological symptoms.
文摘This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet count.Despite notable findings,significant methodological and interpretative limitations are identified.The study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold values.The nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with cirrhosis.Moreover,the study's limitations,such as selection bias and confounding factors,are not adequately addressed.Future research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.
基金supported by the Special Project for the Construction of Innovative Provinces in Hunan Province,China(2020SK2013)。
文摘Objective:In recent years,the incidence and detection rate of pancreatic cystic lesions(PCLs)have increased significantly.Endoscopic ultrasound(EUS)plays an indispensable role in the diagnosis and differential diagnosis of PCLs.However,evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration(EUS-FNA)and fine-needle biopsy(FNB)remains limited.This study aims to compare the diagnostic yield,adequacy of tissue acquisition,and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice.Methods:A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021.The diagnostic yield,tissue acquisition adequacy,and incidence of adverse events were compared between the 2 groups.Results:A total of 90 patients with PCLs were included(52 in the FNA group and 38 in the FNB group).The diagnostic yield was similar between the FNA and FNB groups(94.2%vs 94.7%,P>0.05).The adequacy of tissue acquisition was 71.2%in the FNA group and 81.6%in the FNB group(P>0.05).No statistically significant difference was observed in the incidence of adverse events between the 2 groups(P>0.05).Conclusion:Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs,with excellent safety profiles.Both methods are safe and effective diagnostic tools for evaluating PCLs.
文摘Calvarial lesions are usually incidental and asymptomatic,rarely detected.However,these lesions can also present with pain,a palpable mass or a bone defect.Clinical information such as the patient’s age and medical history are helpful in making the correct diagnosis.Calvarial lesions may occur due to congenital and anatomical variants,traumatic and iatrogenic,idiopathic,infectious and inflammatory,metabolic,benign and malignant neoplastic causes.Calvarial lesions may be solitary,multiple or diffuse,and may be lytic,sclerotic or mixed.Although most calvarial lesions are benign,radiologic imaging features can help to determine whether the lesion is benign or malignant.Methods that can guide treatment and are currently in use include plain radiography,ultrasonography,computed tomography,magnetic resonance imaging,angiographic studies,and nuclear scintigraphy studies such as 18F-fluorodeoxyglucose positron emission tomography and whole-body bone scintigraphy.Defects,lysis and sclerosis in the bone structure are assessed by plain radiography and computed tomography,and the soft tissue components of the lesions and their relationship to the surrounding soft tissue are assessed by magnetic resonance imaging.This article reviews the imaging findings of benign and malignant calvarial lesions and normal variants that may be confused with systemic diseases and pathologies affecting the calvarium.
文摘Objective: Stroke is perceived as a serious illness although it is preventable, and lifestyle alterations can be made to reduce its risk. Improvement of stroke care should be achieved through awareness of public, especially through high-risk group. Henceforth, the aim of this study was to evaluate the effect of nursing intervention on improving awareness of high-risk people about stroke prevention. Methods: A quasi-experimental design was used to carry out this study, where a purposive sample of 80 adult patients at high risk for stroke were enrolled while they were attending the out-patient clinics of Zagazig University Hospitals for follow-up treatment;they were divided into two groups: case (40 patients) and control (40 patients). An interview questionnaire was used to assess patients’ knowledge regarding warning signs, risk factors, and immediate treatment;attitude;and their practice for prevention for stroke at pretest and posttest. Results: The study revealed the poor level of knowledge, bad level of preventive behavior, and negative attitude regarding stroke prevention at pre-intervention. However, after intervention, the high-risk people had fair level of knowledge with moderate practice for stroke prevention and positive attitude, with statistically significant difference between pre-post intervention and between the case and control groups. Conclusions: The study revealed that the nursing intervention seemed to change the knowledge, practice, and attitude of subjects regarding stroke prevention. This, in turn, implies that awareness of prevention of stroke and high-risk factor control could be important to reduce the burden of stroke in Egypt. Thus, further research on a larger scale is required to improve population knowledge and behavior for stroke prevention and control.
文摘Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.
基金the National Natural Science Foundation of China,No.82374292,82205095,and 82305179the Horizontal Development Foundation of Beijing University of Chinese Medicine,No.BUCM-2021-JS-KF-065the China Postdoctoral Science Foundation Grant,No.2022M720520.
文摘BACKGROUND Precancerous lesions of gastric cancer(PLGC)represent a critical pathological stage in the development of intestinal gastric cancer.Early detection and diagnosis are key to reducing the incidence of gastric cancer.Substantial advancements have been made in PLGC research in recent years,making it necessary to provide updated reviews using bibliometric methods.We hypothesize that this review will identify emerging trends,key research areas,and gaps in PLGC research,providing insights that could guide future studies and enhance prevention strategies.AIM To comprehensively review the current state of research on PLGC,examining development trends and research hotspots.METHODS We conducted a bibliometric analysis of PLGC-related studies published between 2004 and 2023 using the Web of Science Core Collection database.We employed Software,including VOSviewer,CiteSpace,R software,and SCImago Graphica,to map scientific networks and visualize knowledge trends in terms of publication volume,countries/regions,institutions,journals,authors,and keywords.RESULTS A total of 4097 articles were included,and overall publication volume showed an increasing trend.Over the past two decades,China published the most articles,followed by the United States,Japan,South Korea,and Italy.Among the top 10 contributors,the United States ranked highest in institutions,authors,and citations and demonstrated the strongest international collaboration.Research keywords in this field were clustered into three main categories:Risk factors,pathogenesis,and diagnosis and treatment.Pathogenesis and molecular biomarkers remain key areas of focus.Future research should explore the mechanisms of gut microbiota,immune microenvironment,metabolic reprogramming,and epigenetics.Advanced technologies,including single-cell sequencing,spatially resolved analysis,multi-omics approaches,artificial intelligence,and machine learning,will likely accelerate in-depth investigations of PLGC.CONCLUSION PLGC research has rapidly developed in recent years,gaining considerable attention.This bibliometric analysis reveals research state and emerging trends over the past 20 years,providing insights for future studies.
基金supported by Xiamen University,which played a key role in the collection and analysis of the datafunded by National Natural Science Foundation of China(grants 82341031,82173584,and 82222062)+2 种基金Major Research Plan of the National Natural Science Foundation of China(grant 92269205)Science Fund for Distinguished Young Scholars of Jiangsu Province(grant BK20220064)Jiangsu Provincial Key Project of Science and Technology Plan(grants BE2021738 and BE2023601)。
文摘Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province,China.Methods:A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged18–45 years were screened between 2020 and 2021 in Jiangsu Province.Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method,and positive samples were further tested using the reverse hybridization line probe assay.Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening.To account for differences in age composition between the 2 studies,the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.Results:Overall,40 women(1.89%)were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013,and 110(1.78%)were diagnosed during 2020–2021.Among women with lesions,the standardized HPV positivity rates were 98.41%in 2012–2013 and99.24%in 2020–2021.Most cases were caused by high-risk HPV,which accounted for 87.18%of the total infections during 2012–2013and 89.91%of those in 2020–2021,with standardized positivity rates of 86.44%and 88.75%,respectively.The standardized positivity rates for single infections were 62.35%in 2012–2013 and 74.95%in 2020–2021.The top 5 high-risk HPV genotypes were HPV type 16(HPV16;29.01%),52(20.63%),18(14.28%),58(13.71%),and 33(12.12%)in 2012–2013,and HPV16(36.95%),58(22.18%),52(13.25%),31(7.63%),and 51(6.81%)in 2020–2021.The standardized positivity rate for HPV18 decreased from 14.28%in2012–2013 to 1.15%in 2020–2021.Among women with cervical or vaginal lesions,the highest proportion was observed in the 36-to 45-year group during 2012–2013,reaching 52.50%,and in the 26-to 35-year group during 2020–2021,peaking at 59.10%.Conclusions:In Jiangsu Province,no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021;however,the distribution of HPV genotypes had changed.
基金Supported by Natural Science Foundation of Hubei Province(No.2023BCB147,No.2023AFB1026).
文摘AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82200215,82170193,and 82370197)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Grant No.2022-I2M-1-002)。
文摘Objective:Our previous studies have indicated potentially higher proliferative activity of tumor cells in Chinese patients with mantle-cell lymphoma(MCL)than those in Western.Given the success and tolerability of R-DA-EDOCH immunochemotherapy in treating aggressive B-cell lymphomas,we designed a prospective,phase 3 trial to explore the efficacy and safety of alternating R-DA-EDOCH/R-DHAP induction therapy for young patients with newly diagnosed MCL.The primary endpoint was the complete remission rate(CRR)at the end of induction(EOI).Methods:A total of 55 patients were enrolled.The CRR at the EOI was 89.1%[95%confidence interval(CI)78%±96%],and the overall response rate was 98.1%(95%CI 90%±100%).Most patients with bone marrow involvement quickly attained minimal residual disease(MRD)negative status,with a 95.7%rate at the EOI.Results:The 3-year progression-free survival(PFS)and overall survival rates were 66.3%and 83.2%,respectively.No patients discontinued treatment because of adverse events.Univariate analysis identified pathologic morphology and TP53 mutations as risk factors for PFS.However,high tumor proliferative activity and certain cytogenetic abnormalities showed no significant adverse prognostic significance.Conclusions:Intensive therapy based on a high cytarabine dose and continuously administered EDOCH achieved a high MRDnegative rate and provides an optional induction choice for young patients with MCL with high-risk factors.
基金supported by grants from the National Natural Science Foundation of China (82070408)the Traditional Chinese Medicine Science and Technology Project of Zhejiang Province (2023ZL496)。
文摘Background Quantitative flow ratio(QFR) holds significant value in guiding drug-coated balloon(DCB) treatment and enhancing outcomes. However, the predictive capability of post-angioplasty QFR for long-term clinical events in patients with de novo lesions who receive DCB treatment remains uncertain. The aim of this study was to explore the potential significance of post-angioplasty QFR measurements in predicting clinical outcomes in patients underwent DCB treatment for de novo lesions.Methods Patients who underwent DCB-only intervention for de novo lesions were enrolled. QFR was conducted after DCB treatment. The patients were then categorized based on post-angioplasty QFR. The primary endpoint was major adverse cardiac events(MACE), encompassing all-cause death, cardiovascular death, nonfatal myocardial infarction, stroke, and target vessel revascularization.Results A total of 553 patients with 561 lesions were included. The median follow-up period was 505 days, during which 66(11.8%) MACEs occurred. Based on post-procedural QFR grouping, there were 259 cases in the high QFR group(QFR > 0.93) and302 cases in the low QFR group(QFR ≤ 0.93). Kaplan-Meier analysis revealed a significantly higher cumulative incidence of MACE in the low QFR group(log-rank P = 0.004). The multivariate Cox proportional hazards model demonstrated a significant inverse correlation between QFR and the occurrence of MACEs(HR = 0.522, 95%CI: 0.289-0.942, P = 0.031). Landmark analysis indicated that high QFR had a significant reducing effect on the cumulative incidence of MACEs within 1 year(log-rank P = 0.016)and 1-5 years(log-rank P = 0.026).Conclusions In patients who underwent DCB-only treatment for de novo lesions, higher post-procedural QFR values(> 0.93)were identified as an independent protective factor against adverse prognosis.
基金Supported by the National Natural Science Foundation of China(No.81670885).
文摘AIM:To describe the clinical manifestations,imaging features and surgical treatments in 5 cases of extraocular muscle(EOM)dysplasia presenting as orbital spaceoccupying lesions(SOL).METHODS:Records from the 5 cases with EOM dysplasia between 2004 and 2016 were retrospectively reviewed and clinical data were recorded including family history,age at onset,age at surgery,visual acuity,cycloplegic refraction,ocular alignment and motility,stereoacuity,exophthalmos,anterior segment and fundus,orbital computed tomography(CT)or magnetic resonance imaging(MRI)scan,surgical methods and final outcomes.RESULTS:All 5 cases(1 male,4 females)were unilateral(3 right,2 left eyes).The average age was 5.4y(range 4-6y)with no family history.Patients had unilateral strabismus(horizontal and vertical),restricted eye movement,and eyelid changes(abnormal fissures,lagophthalmos,and/or entropion)in the affected eye.None had proptosis;1 had 2-mm enophthalmos.Orbital CT/MRI showed irregular,ill-defined masses in EOM.Two anterior orbitotomies and 3 strabismus surgeries were performed,and pathology confirmed EOM dysplasia.After surgery,horizontal deviations,which ranged from exotropia(XT)10 prism diopter(PD)to esotropia(ET)10 PD(average 6 PD),decreased by an average of 18 PD,while vertical deviations,which ranged from 4 PD to 20 PD(mean 9.8 PD),decreased by an average of 23.2 PD.CONCLUSION:SOL from EOM dysplasia is non-familial and typically presenting unilaterally characterized by an irregular,diffusely infiltrating mass within the EOM.EOM involvement causes strabismus,restricted eye movement,eyelid changes,and enophthalmos likely due to cicatricial processes.
基金financially supported by the National Natural Science Foundation of China(41772033,41272048).
文摘Pathological mineralizations in breast lesions are closely associated with disease progression and serves as a critical diagnostic indicator.However,systematic understanding remains lacking regarding the phase categories,distribution patterns,and proportional occurrences of mineral phases across different breast lesion types.The diagnostic implications of specific phases,such as calcium oxalate,for distinguishing benign and malignant lesions remain controversial.This study employed polarizing microscopy,environmental scanning electron microscopy(SEM)with energy dispersive spectroscopy(EDS),transmission electron microscopy(TEM),Fourier transform infrared spectroscopy(FTIR),and Raman spectroscopy to analyze the phase composition of 61 mineralized samples from three lesion types:Invasive carcinoma,carcinoma in situ and benign lesions.Results demonstrate that breast lesion mineralizations predominantly comprise calcium phosphates,including hydroxyapatite(HA),amorphous calcium phosphate(ACP),and whitlockite,occasionally accompanied by calcium oxalate(monohydrate or dihydrate).Distinct distribution patterns and proportional occurrences of minerals were observed among the three types of lesion mineralizations.HA,as the predominant phase,was ubiquitously present across all three lesion categories.ACP,a mineralization precursor phase,emerged during early mineralization stages across all lesion types.Notably,whitlockite exclusively occurred in benign lesions and carcinoma in situ,with higher prevalence in benign cases,suggesting a progressive decline in Mg^(2+)concentration within the lesion microenvironment as malignancy advances.Calcium oxalate coexisted with HA in mineralized regions across all lesion types,and its presence in invasive carcinoma specimens warrants heightened clinical attention.
文摘Diabetic foot(DF)has emerged as one of the most common chronic consequences of diabetes mellitus,characterized by prolonged disease duration,high treatment costs,a poor prognosis,and a high disability rate.Diabetic high-risk foot is the early stage of diabetic foot,the“disease prevention”of“treating no disease”,which provides a critical window for clinical prevention and treatment.Traditional Chinese medicine(TCM)has emphasized the importance of preventive health care since ancient times.External therapies such as acupuncture,massage,acupoint injection,foot bath fumigation,and moxibustion have the advantages of simplicity,low cost,precise efficacy,and fewer side effects in preventing and treating diabetic high-risk foot.The multidisciplinary synergistic model formed by TCM complementary therapies and modern medical treatments,such as nutritional,peripheral nerve,and blood glucose regulation,provides new ideas for establishing standardized prevention and treatment protocols.In this paper,studies related to TCM-related complementary therapies for diabetic high-risk feet are systematically reviewed.Current advances in external application in TCM were described to better understand its effectiveness and safety in elderly patients.
文摘For the treatment method of esophageal subepithelial lesions originating from the muscularis propria,conventional endoscopic resection techniques are timeconsuming and lack efficacy for small subepithelial lesions originating from the muscularis propria.Lu et al presented an exploration of the effectiveness and safety of ligation-assisted endoscopic submucosal resection,aiming to provide a minimally invasive method for treatment.We discussed and analyzed this study from the aspects of sample screening,clinical pathological characteristics,casecontrol analysis,and follow-up data.
文摘WCE (Wireless Capsule Endoscopy) is a new technology that combines computer vision and medicine, allowing doctors to visualize the conditions inside the intestines, achieving good diagnostic results. However, due to the complex intestinal environment and limited pixel resolution of WCE videos, lesions are not easily detectable, and it takes an experienced doctor 1–2 h to analyze a complete WCE video. The use of computer-aided diagnostic methods, assisting or even replacing manual WCE diagnosis, has significant application value. In response to the issue of intestinal lesion detection in WCE videos, this paper proposes a multi-scale feature fusion network model TSD-YOLO based on the YOLO (You Only Look Once) architecture: (I) a Tiny Detection Layer to avoid the loss of shallow feature information for tiny-scale targets;(II) integrating a simple, parameter-free attention module (SimAM) at the neck to better extract local lesion features and fuse features;(III) incorporating a new loss function DIoU (Distance Intersection over Union) to better achieve boundary box regression for target detection. This model was validated using the WCE dataset from Kyushu University Hospital. For the dataset containing 18,000 images, the evaluation metrics of our model for 12 types of lesions, outperformed existing reported results from advanced models on this dataset, and the mAP (mean Average Precision) and precision evaluation metrics improved by 3.7% and 0.9% over the benchmark model.
文摘As of 2023, endometrial cancer (EC) ranks second among malignant tumors of the female reproductive system in China, following cervical cancer, posing a significant burden on the country’s healthcare system. Postmenopausal asymptomatic endometrial thickening is primarily benign, often involving endometrial polyps. However, previous clinical studies indicate a relatively high malignancy rate for postmenopausal endometrial polyps, suggesting the necessity for active intervention, particularly in cases with high-risk factors for EC. This article reviews the research progress on risk factors for endometrial lesions in postmenopausal patients with asymptomatic endometrial thickening, aiming to provide insights for clinical diagnosis and treatment.
基金Supported by Natural Science Foundation of Hubei Province,No.2023AFB848.
文摘BACKGROUND Inadequately controlled hypertension often leads to an increased cardiovascular death rate in type 2 diabetes mellitus(T2DM).It remains unclear whether systolic blood pressure(SBP)status of hypertension is related to coronary inflammation and plaques in T2DM.AIM To evaluate whether SBP variability(SBPV)and levels of hypertension are related to coronary inflammation and plaques in T2DM patients using coronary computed tomography angiography(CCTA).METHODS This retrospective study involved 881 T2DM patients with CCTA images,including 668 hypertension and 213 normotension patients.Hypertension patients were subgroup based on SBP status:(1)SBPV:Low(<8.96 mmHg)and high(≥8.96 mmHg)groups;and(2)SBP levels:Controlled(<140 mmHg)and uncontrolled(≥140 mmHg)groups.Pericoronary adipose tissue(PCAT)attenuation,high-risk plaques(HRPs)and obstructive stenosis(OS)were evaluated by CCTA.Propensity score matching was utilized to compare these CCTA findings for these groups.The impact of SBPV and SBP levels of hypertension on these CCTA findings in T2DM patients were evaluated by multivariate logistic regression and multivariable linear regression.RESULTS PCAT attenuation of the left anterior descending artery(LAD),any low attenuation plaque(LAP),any spotty calcification(SC),any positive remodeling(PR),and OS had significant differences between the hypertension group and the normotension group,as well as between the high SBPV or uncontrolled SBP group and the low SBPV or controlled SBP group(all P<0.05).Hypertension was independently positively correlated with LADPCAT attenuation(β=1.815,P=0.010),LAP(OR=1.612,P=0.019),SC(OR=1.665,P=0.013),PR(OR=1.549,P=0.033),and OS(OR=1.928,P=0.036)in all T2DM patients.Additionally,high SBPV and uncontrolled SBP were independently positively correlated with LAD-PCAT attenuation(high SBPV:β=1.673,P=0.048;uncontrolled SBP:β=2.370,P=0.004)and PR(high SBPV:OR=1.903,P=0.048;uncontrolled SBP:OR=2.230,P=0.013)in T2DM patients with hypertension.CONCLUSION Inadequately controlled hypertension,including high SBPV and/or uncontrolled SBP levels,may be related to increased coronary artery inflammation,HRPs,and OS in T2DM,leading to increased cardiovascular risk.Achieving both low SBPV and controlled SBP levels simultaneously,especially in individuals with T2DM and hypertension,warrants clinical attention.
